Defeitos congênitos em bovinos da Região Central do Rio Grande do Sul / Congenital defects in cattle from central Rio Grande do Sul, Brazil

Foram revisados casos de defeitos congênitos (DCs) diagnosticados em bovinos no Laboratório de Patologia da Universidade Federal de Santa Maria em 1964-2010. Durante o período estudado, foram examinados materiais provenientes da necropsia de 7.132 bovinos e foram encontrados 31 bezerros (0,4 por cento) com DCs, os quais foram classificados em 34 tipos e alocados nos sistemas orgânicos primariamente afetados. Os DCs ocorriam isoladamente (19 [61,3 por cento]) ou afetavam múltiplos sítios anatômicos (15 [28,7 por cento]) com frequência semelhante em ambos os sexos. Como vários terneiros mostraram múltiplos DCs, um total de 53 DCs foi computado. Dos 53 DCs diagnosticados, 15 (28,3 por cento) afetavam o sistema nervoso central (craniósquise [4], abiotrofia cerebelar [2], degeneração esponjosa [2], hidrocefalia [2], meningocele [2], espinha bífida [1], hipoplasia cerebelar [1] e hipomielinogênese [1]); nove (17,0 por cento) afetavam o sistema urogenital (agenesia testicular [1], agenesia vaginal [1], hipoplasia peniana [1], formação de cloaca [1], freemartinismo [1], hamartoma vascular de ovário [1], hipoplasia renal [1], cistos renais [1] e úraco persistente [1]); oito DCs (15,1 por cento) eram primários do sistema musculoesquelético (artrogripose [4], escoliose [1], plagiocefalia, [1] schistosomus reflexus [1] e diprosopia [1]); e outros oito (15,1 por cento) foram alocados no sistema digestivo (palatosquise [3], atresia anal [1], atresia anorretal [1], atresia - anocolônica [1], fístula reto-vaginal [1] e fístula reto-uretral [1]); em cinco ocasiões (9,4 por cento) o DC afetava o sistema cardiovascular (persistência do ducto arterioso [2], persistência do forame oval [2] e defeito do septo ventricular [1]); quatro (7,5 por cento) afetavam o sistema linfático e consistiam de hipoplasia ou aplasia de vasos linfáticos e linfonodos associadas a linfedema. Dois casos (3,4 por cento), de hipotricose foram observados afetando o integumento; um caso (1,9 por cento) de estenose traqueal foi encontrado no sistema respiratório e um caso (1,9 por cento) de bócio envolvia o sistema endócrino. Os resultados indicam que a maioria dos DCs em bovinos na Região Central do Rio Grande do sul é esporádica. No entanto, seu estudo continuado é importante para o estabelecimento de sua etiologia e controle.

Cases of congenital defects (CDs) in cattle diagnosed at the Laboratory of Veterinary Pathology of the Federal University of Santa Maria from 1964 to 2010 were reviewed. During the studied period tissues collected from the necropsy of 7,132 cattle were examined and 31 calves (0.4 percent) with CDs were found. These CDs were classified into 34 different types and ascribed to the body system primarily affected. CDs were solitary (19 [61.3 percent]) or multiple (12 [38.7 percent]) and found with similar frequency in calves of both sexes. As several calves displayed multiple defects, a total of 53 CDs were computed. Out of the 53types of CDs diagnosed 15 (28.3 percent) affected the central nervous system (cranioschisis [4], cerebellar abiotrophy [2], spongy degeneration [2], hydrocephalus [2], meningocele [2], spina bifida [1], cerebellar hypoplasia [1], and hypomyelinogenesis [1]); nine (17.0 percent) affected the urogenital system (testicular agenesis [1], vaginal agenesia [1], penile hypoplasia [1], cloacal formation [1], freemartinism [1], ovarian vascular hamartoma [1], renal hypoplasia [1], renal cysts [1], and persistent urachus [1]); eight CDs (15,1 percent) were primary to the musculoskeletal system (arthrogryposis [4], scoliosis [1], plagiocephaly [1] schistosomus reflexus [1], and diprosopus [1]) and another eight (15,1 percent) were in the digestive system (palatoschisis [3], anal atresia [1], anorectal atresia [1], ano-colonic atresia [1], recto-vaginal fistula [1], and recto-urethral fistula [1]); in five instances (9.4 percent) the CD affected the cardiovascular system (persistent ductus arteriosus [2], persistence of foramen ovale [2], and ventricular septal defect [1]); four (7.5 percent) affected the lymphatic system and consisted of inherited hypoplasia or aplasia of lymphatic vessels and lymph nodes associated with lymphedema. Two cases (3.0 percent), of hypotrichosis were observed affecting the integument; one case (1.9 percent) of tracheal stenosis was found in the respiratory system and one case of goiter (1.9 percent) involved the endocrine system. The results of this survey inidicate that the majority o CDs in cattle in the central Rio Grande do Sul are sporadic; nevertheless their continued study is important for determining the etiology and control.

Cardiovascular disease in familial hypercholesterolaemia: influence of low-density lipoprotein receptor mutation type and classic risk factors.

AIM: To determine the effect of the type of mutation in low-density lipoprotein receptor gene and the risk factors associated with the development of premature cardiovascular disease (PCVD) in a large cohort of heterozygous familial hypercholesterolemia (hFH) subjects with genetic diagnosis in Spain. METHODS AND RESULTS: A cross-sectional study was conducted on 811 non-related FH patients (mean age 47.1+/-14 years, 383 males and 428 females) with a molecular defect in the low-density lipoprotein receptor (LDLR) gene from the Spanish National FH Register. Prevalence of PCVD was 21.9% (30.2% in males and 14.5% in women, P<0.001). Mean age of onset of cardiovascular event was 42.1 years in males and 50.8 years in females. Of those patients with PCVD, 59.5% of males and 27% of females suffered a second cardiovascular (CV) event. In multivariate analysis male gender, age, tobacco consumption (ever), and total cholesterol/HDL-cholesterol (TC/HDL-C) ratio were significantly associated with PCVD. Two hundred and twenty different mutations were found with a large heterogeneity. Patients carrying null-mutations had significantly higher frequency of PCVD and recurrence of CV events. No relationship with Lp(a) levels and genotype of Apo E were found. CONCLUSIONS: This study confirms the importance of identifying some classic risk factors such as smoking and TC/HDL-C ratio, and also the type of mutation in LDLR gene in order to implement early detection and intensive treatment for the prevention of cardiovascular disease in FH patients.

Fibrilación auricular aberrada que simula una taquicardia ventricular como primera manifestación de un síndrome de Wolf Parkinson White / Aberrated atrial fibrillation mimicking ventricular tachycardia as first manifestation of a Wolf-PArkinson-White syndrome

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Rotura traumática parcial de tráquea / Partial traumatic rupture of the trachea

No disponible

Factores predictivos de osteopenia en mujeres diagnosticadas de anorexia nerviosa: la importancia de la masa grasa corporal / Predictive factors for osteopenia in women with anorexia nervosa: importance of total body fat

Introducción La elevada prevalencia de baja densidad mineral ósea en mujeres con anorexia nerviosa es de origen multifactorial. Nuestro estudio analiza los factores implicados en esta pérdida del contenido óseo y se evalúa especialmente la influencia del estado nutricional. Pacientes y métodos Estudio transversal en 33 pacientes diagnosticadas de anorexia nerviosa (DSM IV), con recogida prospectiva de datos basales (antes del inicio del tratamiento y en amenorrea). Resultados La prevalencia de osteopenia (­1 desviación estándar >= Z-score > 2,5 desviaciones estándar) fue del 54% y la de osteoporosis (Z-score ¾ 2,5 desviaciones estándar) del 15% en la columna lumbar. La media de la densidad mineral ósea en la columna lumbar fue de 0,839 g/cm2 (intervalo de confianza [IC] del 95%, 0,798-0,880) y en el fémur, de 0,778 (IC del 95%, 0,737-0,819). La media de las Z-scores de la densidad mineral ósea fue de ­1,56 (IC del 95%, ­1,98 a ­1,14) en las vértebras lumbares y de ­1,57 (IC del 95%, ­1,97 a ­1,17) en el fémur. La evaluación nutricional demuestra una malnutrición grave, con un índice de masa corporal bajo (media = 16,5 kg/m2; IC del 95%, 15,9-17,1) y unos índices antropométricos con percentiles por debajo del 10%. La encuesta dietética revela un déficit de ingesta calórica (1.429 kcal/día, IC del 95%, 1.173-1.685), de calcio (783 mg/día; IC del 95%, 615-951) y una distribución alterada de la proporción de principios inmediatos (hidratos de carbono, 42%; grasas, 32%, y proteínas, 19,6%). En el estudio de regresión multilineal destaca la medida del pliegue subescapular como variable con mayor potencia predictiva de la reducción de la densidad mineral ósea (r2 = 0,79; p < 0,01), reflejo del bajo porcentaje en el contenido de masa grasa corporal. Otras variables predictivas han sido la albúmina plasmática (p < 0,01), el tiempo de evolución (p < 0,05) y la edad (p < 0,05). Conclusión La reducción del componente graso corporal es un factor determinante de la pérdida de densidad ósea que presentan las pacientes anoréxicas. Mejorar el déficit nutricional, con especial atención al componente graso, es probablemente un objetivo prioritario en la prevención y el tratamiento de la osteopenia de estas pacientes, junto con la reversión farmacológica del hipoestrogenismo (AU)

Introduction The high prevalence of low bone mineral density (BMD) in women with anorexia nervosa (AN) is due to multiple factors. This study analyses the factors involved in the loss of bone content, especially the influence of nutritional status. Patients and methods A cross-sectional study was performed in 33 women diagnosed with AN (DSM IV) with prospective collection of baseline data (before onset of amenorrhea and treatment initiation). Results The prevalence of osteopenia (-1SD >= Z-score > ­2.5SD) was 54% and that of osteoporosis (Z-score ¾ ­2.5SD) was 15% in lumbar spine. The mean BMD was 0.839 g/cm2 (95% CI 0.798-0.880) in lumbar spine and 0.778 g/cm2 (95% CI 0.737-0.819) in femoral neck. The mean Z-score of BMD was ­1.56 (95% CI 95% -1.98/-1.14) in lumbar spine and ­1.57 (95% CI -1.97/-1.17) in femoral neck. Nutritional evaluation demonstrated severe malnutrition with a low body mass index (mean: 16.5 Kg/m2 95% CI: 15.9-17.1) and anthropometric indices showed percentiles below 10%. Dietary records revealed insufficient intake of calories (1429 Kcal/day, 95% CI: 1173, 1685) and calcium (783 mg/day 95% CI: 615, 951) and an altered distribution of the proportion of immediate principles (carbohydrates 42%, fats 32% and proteins 19.6%). In multivariate regression analyses, the variable with greatest predictive power in reducing BMD was a low percentage in total body fat as measured by subscapular skinfold (r2 = 0.79 p < 0.01). Other predictive variables were serum albumin (p < 0.01), disease duration (p < 0.05), and age (p < 0.05). Conclusion Reduction of body fat is a determining factor for loss of bone density in anorexic patients. Improvement of nutritional deficiency, with special attention to the fat component, is probably a high-priority objective in the prevention and treatment of osteopenia in these patients, along with pharmacological treatment of low estrogen levels (AU)

Protocolo unificado de utilización de la hormona del crecimiento en pacientes adultos deficitarios / Unified protocol for the use of growth hormone (GH) in GH deficient adults

En este artículo se especifica el protocolo unificado de utilización de hormona de crecimiento en pacientes adultos deficitarios: indicaciones para el inicio de tratamiento, diagnóstico bioquímico de la deficiencia de GH, contraindicaciones al tratamiento, dosis recomendadas y seguimiento (AU)

Latent infection by bovine herpesvirus type-5 in experimentally infected rabbits: virus reactivation, shedding and recrudescence of neurological disease.

Latent infection with bovine herpesvirus type-5 (BHV-5) was established in rabbits inoculated with two South American isolates (EVI-88 and 613) by intranasal or conjunctival routes. Nine rabbits (613, 8/27; EVI-88, 1/34) developed neurological disease and died during acute infection and other three (613, n=2; EVI-88, n=1) developed a delayed neurological disease, at days 34, 41 and 56 post-inoculation (p.i.). Between days 56 and 62 p.i., the remaining rabbits were submitted to five daily administrations of dexamethasone (Dx) to reactivate the infection. Twenty-five out of 44 rabbits (56.8%) shed virus in nasal or ocular secretions after Dx treatment. Virus shedding was first detected at day two post-Dx and lasted from one to 11 days. The highest frequencies of virus reactivation were observed in rabbits inoculated conjunctivally (10/15 versus 15/29); and among rabbits infected with isolate 613 (12/16 versus 13/28). Virus reactivation upon Dx treatment was accompanied by neurological disease in nine rabbits (20.4%), resulting in six deaths (13.6%). Virus in moderate titers and mild to moderate non-suppurative inflammatory changes in the brain characterized the neurological infection. Three other rabbits showed severe neurological signs followed by death after 31 to 54 days of Dx treatment. Virus, viral nucleic acids and inflammatory changes were detected in their brains. The late-onset neurological disease, after acute infection or Dx treatment, was probably a consequence of spontaneous virus reactivation. These results demonstrate that BHV-5 does establish a latent infection in rabbits and that clinical recrudescence may occur upon reactivation.

Experimental infection of pregnant ewes with bovine viral diarrhea virus type-2 (BVDV-2): effects on the pregnancy and fetus.

The reproduction effects of bovine viral diarrhea virus type-2 (BVDV-2) infection were investigated in ewes inoculated with a non-cytopathic BVDV-2 isolate at three stages of gestation. Virus inoculation was followed by a transient viremia, accompanied by a transient and mild hyperthermia and nasal discharge in a few animals. Some ewes were sacrificed at different time-points after virus inoculation to study the kinetics of fetal infection. Infectivity and viral antigens were detected in placentomes from day 7 to 36 post-inoculation (pi) and in fetal fluids and tissues between days 10 and 28 pi. Cardiac petechial hemorrhages and hemoperitoneum accompanied by a severe fibrinous ulcerative placentitis were observed in fetuses examined at days 21, 28 and 36 pi. Inoculation of ewes at days 55-60 of gestation resulted in a prolonged virus replication in placentomes and fetal tissues; ewes that were allowed to proceed with pregnancy had 77% of abortions or fetal and perinatal deaths. Seven stillbirths, unviable and viable lambs born to these ewes were virus-positive at birth. Infectious virus was repeatedly isolated from leukocytes of two lambs up to 2 and 6 months of age, indicating they were persistently infected. Ewes inoculated at days 65-70 of gestation had 66.6% of fetal and perinatal losses. Three viable lambs born to these ewes were healthy, BVDV antibody-positive and virus-negative. A transient viral replication in placentomes and in a few fetal tissues, followed by the rise of fetal neutralizing antibodies and virus clearance was the result of inoculating ewes at days 120-125 of gestation. Lambs born to these ewes were healthy, antibody-positive and virus-negative. These results demonstrate that the biology of BVDV-2 infection in pregnant sheep is essentially similar to that of BVDV-1 in pregnant cattle and sheep. These features make this species an attractive animal model for studying the pathogenesis of congenital BVDV-2 infection.

Taquicardia supraventricular secundaria a síndrome de preexcitación de tipo Mahaim / Supraventricular tachycardia secondary to Mahaim-type preexcitation syndrome

Presentamos el caso de un individuo joven que acude al Servicio de Urgencias, por segunda vez, presentando un cuadro oligosintomático caracterizado por la presencia de palpitaciones y cuyo electrocardiograma basal muestra una taquicardia de origen sinusal con depresiones significativas del segmento ST en derivaciones precordiales que podrían hacer pensar en la existencia de una coronariopatía. Una vez realizado el estudio se demuestra la existencia de un síndrome de preexcitación cuya vía se define como del tipo Mahaim, cuya tasa de presentación es relativamente escasa y cuyos criterios electrocardiográficos vienen definidos por la existencia de un intervalo PR correspondiente a la conexión auriculoventricular que no se aparta de la normalidad eléctrica (>12 milisegundos) y un ventriculograma en el que llama la atención la prolongación en el tiempo del complejo de despolarización (QRS superior a 12 milisegundos) y la existencia de anomalías significativas en la repolarización ventricular (depresión de segmento ST).Destacamos la aparición de cuadros de taquicardia supraventricular, de origen sinusal, secundarias a la existencia de este síndrome de preexcitación de tipo Mahaim como forma de presentación de cuadros de taquiarritmia en corazones estructuralmente sanos y que a pesar de las anomalías en la repolarización están exentos de presentación de cardiopatía coronaria. Las implicaciones pronósticas y terapéuticas derivadas de la aceptación de este modelo se traducen no ya sólo en la posibilidad de ingreso urgente sino en la indicación de tratamiento antiarrítmico o antianginoso (AU)

Experimental infection of sheep with bovine herpesvirus type-5 (BHV-5): acute and latent infection.

We demonstrated that sheep are susceptible to acute and latent infection by bovine herpesvirus type-5 (BHV-5). Lambs inoculated intranasally with two South American BHV-5 isolates replicated the virus with titers up to 10(7.1) TCID50/ml for up to 15 days and showed mild signs of rhinitis. Four lambs in contact with the inoculated animals acquired the infection and excreted virus for up to seven days. One lamb developed progressive signs of neurological disease and was euthanized in extremis. Clinical signs consisted of tremors of the face, bruxism, ptyalism, incoordination, lateral flexion of the neck and head, circling, walking backwards, recumbency and paddling. The virus was detected in the anterior and posterior cerebrum, dorso- and ventro-lateral cortex, cerebellum, pons, midbrain and olfactory bulb. Viral nucleic acids were demonstrated in neurons and astrocytes of the anterior and ventro-lateral cortex by in situ hybridization. Histological changes consisting of non-suppurative meningitis, perivascular mononuclear cuffing, focal gliosis, neuronal necrosis and intranuclear inclusions were observed in the anterior cerebrum, ventro-lateral cortex and midbrain. Dexamethasone treatment at Day 50 pi resulted in reactivation of the latent infection and virus shedding in 13/16 (81%) of the lambs. Together with previous reports of BHV-5 antibodies in sheep, these findings show that sheep are fully susceptible to BHV-5 suggesting that infection by BHV-5 in sheep may occur naturally.

Prolactin and interleukin-6 in neuropsychiatric lupus erythematosus.

We investigated the levels of prolactin (PRL) and interleukin-6 (IL-6) in the cerebrospinal fluid (CSF) and serum of systemic lupus erythematosus patients with central nervous system involvement (CNS-SLE), and examined whether PRL and IL-6 have a relationship. Serum and CSF PRL and IL-6 were measured in the following groups of patients and controls: group I: seven patients with CNS-SLE; group II: three SLE patients without CNS involvement (non CNS-SLE); group III: 10 patients with neurocysticercosis; and group IV: six healthy women. The patients were clinically assessed. CSF PRL and IL-6 were elevated in group I (CNS-SLE) in comparison with all other groups (p<0.001). In addition, four of seven patients had higher levels of IL-6 and PRL in CSF than in serum. A positive correlation between PRL and IL-6 in CSF of SLE was observed (r=0.88, p<0.001). The mean serum PRL concentrations were not significantly different in all groups, but high levels of IL-6 were found in the serum of group I in comparison with groups II and IV (p<0.001). The serum levels of group III were not different from those of group I. These results demonstrate the presence of intrathecal synthesis and elevations of CSF PRL and IL-6 in active CNS-SLE involvement and indicate that measurements of CSF PRL and IL-6 may be useful in the evaluation of neuropsychiatric lupus erythematosus.

[Biatrial recurrence of a left atrial myxoma]. / Recidiva biauricular de un mixoma auricular izquierdo.

A biatrial myxoma was diagnosed by 2D echocardiography in a man who was minimally symptomatic. Five years previously another similar tumour, located in the left atrium, attached to the interatrial septum, was excised. Similar histological features were present in both cases. The rarity of biatrial recurrence of this sort of myxoma is emphasized.