Performance assessment of 11 commercial serological tests for SARS-CoV-2 on hospitalised COVID-19 patients.

BACKGROUND: Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction). METHODS: Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals. RESULTS: The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation. CONCLUSIONS: This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.

B-mode and Doppler ultrasonography of adrenal glands of healthy dogs / Ultrassonografia modo B e Doppler das glândulas adrenais de cães saudáveis

The aim of this study was to determine the vascular indices of adrenal blood flow in healthy dogs (systolic velocity - SV; diastolic velocity - DV; resistance index - RI). Eighteen dogs (thirty six adrenal) were studied. Physical examination, biochemical profile and dexamethasone suppression test were performed to determine general health status. Echotexture, size, contours and margins, and overall shape of the adrenal gland (right and left) were assessed via ultrasound. By spectral Doppler of the phrenic-abdominal artery, the SV, DV, and RI were acquired. Animals did not show alterations in clinical and laboratory examination and suppression of cortisol. Normal homogeneous and echotexture, regular contours and margins and normal shape and size were verified via B mode. Spectral Doppler of the phrenic-abdominal artery showed monophasic-patterned waves and low vascular resistance and systolic peak evident with means values: left adrenal - SV = 31.34cm/s, DV = 9.54cm/s and RI = 0.69; and right adrenal - SV = 27.83cm/s, DV = 7.71cm/s and RI = 0.68. Doppler evaluation of adrenal was easily implemented and may provide base line data in the study, allowing for the use of this technique as a diagnostic tool for diseases of the dog's adrenal.(AU)

Objetivou-se determinar os índices vasculares do fluxo sanguíneo das glândulas adrenais de cães saudáveis (velocidade sistólica - VS; velocidade diastólica - VD; o índice de resistência - IR). Foram utilizados neste estudo 18 cães (36 adrenais). Foram realizados exame físico, perfil bioquímico e teste de supressão com dexametasona para determinar o estado geral de saúde (higidez). Ecotextura, ecogenicidade, tamanho, contornos e margens e o formato das glândulas adrenais (direito e esquerdo) foram avaliados por meio da ultrassonografia convencional. Ao Doppler espectral da artéria frênico-abdominal, foram adquiridos a VS, a VD e o IR. Os animais não apresentaram alterações aos exames clínico, laboratorial e de supressão do cortisol. Ao exame ultrassonográfico, foram verificados ecotextura homogênea, ecogenicidade, formato e tamanhos normais, além de os contornos e as margens serem regulares. Ao Doppler espectral da artéria frênico-abdominal, verificaram-se ondas com padrão monofásico, com resistência vascular baixa e pico sistólico evidente, sendo os valores médios: adrenal esquerda - VS = 31,34cm/s, VD = 9,54cm/s e IR = 0,69; e adrenal direita - VS = 27,83cm/s, VD = 7,71cm/s e IR = 0,68. A avaliação Doppler das adrenais foi facilmente implementada e pode fornecer dados de referência, permitindo a utilização dessa técnica como uma ferramenta de diagnóstico para doenças das adrenais em cães.(AU)

Severe malaria--clinical case.

We report a clinical case of severe malaria, where the rate of initial parasitaemia by Plasmodium falciparum was 43 %. Multiple organ dysfunction, including ARDS, forced admission in a close surveillance unit, with survival of the same. A brief review of the subject is made, focusing on severity and general conduct, alerting and awareness for this entity, whose expression, among us, could take on increasing importance.

Efeito dos exercícios de alongamento na melhora da dor, flexibilidade e qualidade de vida em pacientes com fibromialgia / The effects of stretch exercises on pain, flexibility and quality of life in patients with fibromyalgia

Fibromialgia (FM) é uma síndrome reumática caracterizada por dor musculoesquelética cr6onica e difusa assim como baixo limiar de dor em pontos anatômicos específicos chamados tender points