Impacto presupuestario de XEN®63 en el tratamiento del glaucoma primario de ángulo abierto en España / Budget impact analysis of the XEN®63 for the treatment of primary open angle glaucoma in Spain

Antecedentes y objetivo Evaluar el impacto económico en España derivado de la introducción del implante XEN®63 como alternativa quirúrgica en el manejo del glaucoma primario de ángulo abierto (GPAA) con o sin cataratas en pacientes refractarios. Materiales y métodos Se diseñó un análisis de impacto presupuestario para estimar los costes del tratamiento quirúrgico del GPAA desde la perspectiva del Sistema Nacional de Salud (SNS) español, en un horizonte temporal de1 año. Los comparadores considerados (trabeculectomía, esclerectomía profunda no perforante, válvula de Ahmed, iStent inject®, Preserflo® microshunt y XEN®45) se corresponden a los empleados en la práctica clínica pública española. Para el cálculo de la población diana, cuotas de mercado y uso de recursos en términos de visitas de seguimiento, procedimientos adicionales y complicaciones poscirugía, se emplearon datos de la literatura y se validaron con un panel de cuatro expertos. Los costes unitarios (€de2021) se obtuvieron de la base de datos ESALUD Resultados la inclusión de XEN®63 podría generar un ahorro de 2.569.737€ tras un año desde su introducción, derivado del ahorro en el coste del implante y del procedimiento (−423.120; −0,7%), de las visitas de seguimiento (−777.407€; −4,5%), de los procedimientos adicionales (−1.048.145€, −20,6%) y de las complicaciones poscirugía (−321.065€, −14,2%). Conclusiones La incorporación de XEN®63 en el arsenal quirúrgico para el tratamiento del GPAA refractario con y sin cataratas podría generar ahorros para el SNS (AU)

Background and objective To evaluate the economic impact in Spain derived from the introduction of the XEN®63 implant as a surgical alternative in the management of primary open angle glaucoma (POAG) with or without cataract in refractory patients. Materials and methods A budget impact analysis was designed to estimate the costs of surgical treatment of POAG from the perspective of the Spanish National Health System (NHS), over a time horizon of 1year. The comparators considered (trabeculectomy, deep non-perforating sclerectomy, Ahmed valve, iStent inject®, Preserflo® microshunt and XEN®45) correspond to those used in Spanish public clinical practice. For the calculation of the target population, market shares and resource use in terms of follow-up visits, additional procedures and post-surgery complications, data from the literature were used and validated with a panel of 4 experts. Unit costs (€2021) were obtained from the ESALUD database. Result The inclusion of XEN®63 could generate savings of €2,569,737 after one year since its introduction, derived from savings in the cost of the implant and procedure (−€423,120; −0.7%), follow-up visits (−€777,407; −4.5%), additional procedures (−1,048,145; −20.6%) and post-surgery complications (−€321,065; −14.2%). Conclusion The incorporation of XEN®63 in the surgical arsenal for the treatment of refractory POAG with and without cataracts could generate savings for the NHS (AU)

Budget impact analysis of the XEN®63 for the treatment of primary openangle glaucoma in Spain.

BACKGROUND AND OBJECTIVE: To evaluate the economic impact in Spain derived from the introduction of the XEN®63 implant as a surgical alternative in the management of primary open angle glaucoma (POAG) with or without cataract in refractory patients. MATERIALS AND METHODS: A budget impact analysis was designed to estimate the costs of surgical treatment of POAG from the perspective of the Spanish National Health System (NHS), over a time horizon of 1 year. The comparators considered (trabeculectomy, deep non-penetrating sclerectomy, Ahmed valve, iStent inject, Preserflo® microshunt and XEN®45) correspond to those used in Spanish public clinical practice. For the calculation of the target population, market shares and resource use in terms of follow-up visits, additional procedures and post-surgery complications, data from the literature were used and validated with a panel of 4 experts. Unit costs (€ 2021) were obtained from the ESALUD database. RESULTS: The inclusion of XEN®63 could generate savings of €2,569,737 after one year since its introduction, derived from savings in the cost of the implant and procedure (-€423,120; -0.7%), follow-up visits (-€777,407; -4.5%), additional procedures (-€1,048,145; -20.6%) and post-surgery complications (-€321,065; -14.2%). CONCLUSIONS: The incorporation of XEN63®in the surgical arsenal for the treatment of refractory POAG with and without cataracts could generate savings for the NHS.

Clinical and neurophysiological findings in patients with hereditary neuropathy with liability to pressure palsy and chromosome 17p11.2 deletion.

INTRODUCTION: Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disorder, typically presenting with recurrent episodes of mononeuropathy in nerves susceptible to compression, with similar neurophysiological characteristics. However, other clinical and neurophysiological presentations have been reported. METHODS: We retrospectively analysed the clinical and neurophysiological characteristics of 20 patients with genetically confirmed HNPP. Sixteen patients were studied in our department between 1996 and 2016. RESULTS: In addition to the typical characteristics of HNPP, we found atypical forms including recurrent positional sensory symptoms in 3 patients, chronic sensorimotor polyneuropathy in one, and non-progressive mononeuropathy in one. Onset was early in 2 patients: one at the age of 7 years, with common peroneal nerve injury, and another at birth, with brachial plexus involvement. By frequency, the main pathological findings in the nerve conduction study were: decreased sensory nerve conduction velocity in the sural (84%) and the median and superficial peroneal nerves (94%); decreased motor nerve conduction velocity in the ulnar nerve through the elbow (97%), and increased motor distal latency of the median and deep peroneal nerves (74%). CONCLUSION: Our results confirm the clinical variability of HNPP, with the most frequent nerve conduction study findings being the generalised decrease in sensory nerve conduction velocity, in addition to motor involvement, mainly in locations susceptible to nerve compression. The nerve conduction study can detect typical, atypical, and asymptomatic cases of HNPP.

Monitoring bovine tick fever on a dairy farm: An economic proposal for rational use of medications.

In this study, we evaluated the monitoring of tick fever (TF) in a Brazilian dairy farm in the Minas Gerais state, Brazil, from July 10 to August 4, 2018. We aimed to identify diagnostic and treatment flaws in the protocol adopted by the farm, and to establish a novel and accurate TF monitoring protocol based on precision dairy farming and rational use of antimicrobials and antiparasitic drugs, while evaluating the economic benefits of the proposed strategy. We monitored TF in 395 heifer calves aged between 3 and 14 mo. According to the farm's standard protocol, all calves with an increase of 0.5°C in rectal temperature compared with the previous week's measurement were treated for Anaplasma spp. and Babesia spp. Blood smears were collected from the tail tip of the treated calves. During the last week of the study, we prepared blood smears of all calves regardless of treatment indication. Economic analysis was performed. The results indicated that at least 56.86% (261/459) of the calves did not require treatment for TF, whereas only 23.09% (106/459) had treatment indications. Negative blood smears (45.97%; 211/459) indicated the possibility of calves being affected by another disease or a condition that was not being adequately treated or those not necessarily sick. These results demonstrate the excessive use of medications, representing a direct economic loss, in addition to potentially favoring the occurrence of resistance to antimicrobials. In contrast, 9.42% (26/276) of calves had no treatment indication based on rectal temperature but had treatment indications based on blood smears. Only 5.73% (42/735) of blood smears had co-infection with hemopathogens, and none had triple co-infection. Therefore, we proposed the monitoring of TF using rectal temperature and microscopic analysis. If implemented, this strategy would result in a direct annual savings of approximately $22,638.96 (77.99%) related to medication for the treatment of TF. Therefore, implementing the proposed protocol would be cheaper than treatment based only on rectal temperatures. The currently implemented TF protocols overestimate the occurrence of TF, resulting in overtreatment. Thus, implementing a TF monitoring protocol based on a microscopy tool is justified, with benefits including rational use of medication, potential to generate savings, and reduced morbidity and mortality rates, in addition to enabling other diagnoses.

Effect of dairy by-products as milk replacers on quality attributes of ice cream.

The aim of this study was to evaluate the effect of ricotta whey (RW), cheese whey (CW), and butter whey (BUW) as replacers of whole milk (WM) at different ratios (0:100, 25:75, 50:50, 75:25, and 100:0) in the physicochemical and sensory qualities of ice cream. All formulations, including a commercial sample used as reference, were analyzed for nutritional composition, energy value, pH, titratable acidity (TA), melting behavior, desorption index, instrumental color properties, instrumental hardness, and consumer sensory testing. Overall, the addition of RW, CW, and BUW increased the moisture content, TA, melting rate, and redness (a*) and yellowness (b*) values but decreased the pH, lightness (L*) value, energy value, levels of ash, protein, lipid, and carbohydrate. As exception, CW did not influence the TA, and BUW resulted in lower lipid reduction and in lower hardness changes, and it did not affect the content of ash, protein, and a* and b* values of ice creams. Any ice cream formulation had dietary fibers and a desorption index. Ricotta whey and CW at all ratios and BUW at 25% did not affect overall liking compared with the commercial sample, whereas purchase intention was only decreased by the addition of BUW from 50 to 100%. Ricotta whey at 75 and 100% decreased melting velocity and creaminess, and BUW at 50, 75, and 100% increased hardness, TA, and cream flavor but decreased creaminess, which contributed negatively to overall liking. Therefore, the evaluated dairy by-products, especially RW and CW, have great potential for replacing milk in ice creams.

An outbreak of compressive myelopathy due to pyogranulomatous reaction to the oily adjuvant of the foot-and-mouth disease vaccine - case report / Surto de mielopatia compressiva associada à reação piogranulomatosa ao adjuvante oleoso da vacina contra Febre Aftosa em Minas Gerais - relato de caso

Cases of compressive myelopathy syndrome associated with post vaccinal pyogranulomas were diagnosed post mortem in three cows from a farm in Minas Gerais state, Brazil. These cows presented ataxia and bilateral paresis of the pelvic limbs, which evolved to paralysis, and sternal recumbence. On necropsy, locally extensive areas of the longissimus dorsi muscle were replaced by pyogranulomas supported by moderate amounts of fibrous connective tissue. On the cut surface, some nodules contained yellowish and viscous fluid (purulent exudate) or whitish fluid (interpreted as the oily adjuvant of a vaccine). In the spinal canal of the subjacent vertebrae, compressing the spinal cord, were pyogranulomas identical to those described in the skeletal muscle. Histologically, the pyogranulomas were composed of a central clear vacuole (consistent with the space left by the oil adjuvant droplets), surrounded by neutrophils and, more externally, by large numbers of epithelioid macrophages and fewer multinucleated giant cells. In the white matter of the spinal cord were numerous well-defined, clear vacuoles (Wallerian degeneration). The association of the clinical history and pathological findings allowed the diagnosis of compressive myelopathy associated with pyogranulomatous reaction to the oily adjuvant of the foot-and-mouth disease vaccine, in this case, due to its inadequate application.(AU)

São descritos casos de síndrome de compressão medular, associada a granulomas pós-vacinais, em bovinos Nelore, provenientes de uma propriedade em Minas Gerais. Esses bovinos apresentavam ataxia e paresia bilateral dos membros pélvicos, que evoluiu para paralisia e decúbito esternal. Na necropsia, áreas focalmente extensas da musculatura na região torácica dorsal (músculo longissimus dorsi) eram substituídas por numerosos piogranulomas, separados por tecido brancacento e firme (tecido conjuntivo fibroso). Ao corte, alguns nódulos continham material amarelado e viscoso (exsudato purulento) ou material esbranquiçado e fluido (sugestivo de adjuvante de vacina). No canal medular das vértebras subjacentes, havia granulomas idênticos aos observados no tecido muscular. Histologicamente, os piogranulomas continham, no centro, vacúolo, bem delimitado e arredondado (consistente com o espaço deixado pela gotícula de lipídio do adjuvante), circundado por variável quantidade de neutrófilos degenerados e íntegros e, mais externamente, por numerosos macrófagos epitelioides e algumas células gigantes multinucleadas. Nas áreas da medula espinhal, circundadas pelos granulomas, numerosos vacúolos, bem definidos, eram observados na substância branca (degeneração walleriana). A associação do histórico clínico e de achados patológicos permitiu o diagnóstico de mielopatia compressiva associada à reação granulomatosa ao adjuvante oleoso da vacina contra febre aftosa, no caso, induzida pela aplicação inadequada da vacina.(AU)

Clinical and neurophysiological findings in patients with hereditary neuropathy with liability to pressure palsy and chromosome 17p11.2 deletion. / Hallazgos clínico-neurofisiológicos en neuropatías hereditarias sensibles a la presión con deleción del cromosoma 17p11.2.

INTRODUCTION: Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disorder, typically presenting with recurrent episodes of mononeuropathy in nerves susceptible to compression, with similar neurophysiological characteristics. However, other clinical and neurophysiological presentations have been reported. METHODS: We retrospectively analysed the clinical and neurophysiological characteristics of 20 patients with genetically confirmed HNPP. Sixteen patients were studied in our department between 1996 and 2016. RESULTS: In addition to the typical characteristics of HNPP, we found atypical forms including recurrent positional sensory symptoms in 3 patients, chronic sensorimotor polyneuropathy in one, and non-progressive mononeuropathy in one. Onset was early in 2 patients: one at the age of 7 years, with common peroneal nerve injury, and another at birth, with brachial plexus involvement. By frequency, the main pathological findings in the nerve conduction study were: decreased sensory nerve conduction velocity in the sural (84%) and the median and superficial peroneal nerves (94%); decreased motor nerve conduction velocity in the ulnar nerve through the elbow (97%), and increased motor distal latency of the median and deep peroneal nerves (74%). CONCLUSION: Our results confirm the clinical variability of HNPP, with the most frequent nerve conduction study findings being the generalised decrease in sensory nerve conduction velocity, in addition to motor involvement, mainly in locations susceptible to nerve compression. The nerve conduction study can detect typical, atypical, and asymptomatic cases of HNPP.

Mineral profile of crossbred F 1 Holstein x Gyr dairy cows during the transition period in summer and winter / Perfil mineral de vacas F1 Holandês x Gir durante o período de transição no verão e inverno

The transition period is often a great challenge for dairy cows and mineral imbalances are frequent. With the aim to better understand the mineral profile of F1 Holstein x Gyr dairy cows and their performances under the different conditions of summer and winter, we collected blood samples to measure calcium, magnesium and phosphorus. Samplings were performed during summer and winter, on 15 and 13 pluriparous F1 Holstein x Gyr dairy cows, respectively. Blood sampling started 4 weeks prior to the expected calving date until 30 days postpartum. The mean concentrations of all three minerals had a different pattern during the transition period in each season, representing the interaction time x season. Calcium concentration was lower in winter and more animals suffered from subclinical hypocalcemia (100%) then in summer (38.46%). Magnesium concentration was also lower in winter and 46.67% of animals had hypomagnesemia, contributing for the higher hypocalcemia frequency observed in the same season. A high proportion of animals had hyperphosphatemia what can represent an environmental problem and more attention should be given to it. The high frequency of animals with subclinical hypocalcemia is alarming once that can lead to greater consequences.(AU)

O período de transição é uma fase de grandes desafios para vacas leiteiras, e desequilíbrios minerais são frequentes. O objetivo ao desenvolver este trabalho foi de entender melhor o perfil mineral de vacas leiteiras F1 Holandês x Gir e suas performances sob as diferentes condições de verão e inverno. Para isso, foram mensurados cálcio, magnésio e fósforo sanguíneo. As coletas de sangue foram realizadas durante os períodos de verão e inverno, e utilizaram-se, respectivamente, 15 e 13 vacas leiteiras pluríparas, todas F1 Holandês x Gir. As coletas de sangue começaram quatro semanas antes da data prevista do parto até 30 dias pós-parto. As concentrações médias e o padrão de variação dos três minerais foram distintos em cada estação do ano, representando a interação tempo de coleta x estação do ano. A concentração de cálcio foi menor no inverno, período em que todos os animais apresentaram hipocalcemia subclínica, enquanto no verão 38,46% apresentaram essa condição. A concentração de magnésio foi maior no verão e nenhum animal teve hipomagnesemia, enquanto no inverno 46,67% dos animais apresentaram hipomagnesemia subclínica, contribuindo para a maior frequência de hipocalcemia observada no inverno. Uma alta proporção de animais teve hiperfosfatemia, o que pode representar um problema ambiental. A alta frequência de animais com hipocalcemia subclínica é alarmante principalmente devido às consequências geradas por essa condição.(AU)

Digestibility of diets with flour fish silage for the growing of arawana (Osteoglossum bicirrhossum) / Digestibilidad de dietas con harina de hidrolizado de pescado, para el levante de arawana (Osteoglossum bicirrhossum)

Objective. The purpose of this research was to evaluate the digestibility of different nutritional and energy components of artificial diets containing flour fishsilage used in growing of arawana fingerlings (O. bicirrhossum). Materials and methods. 240 fingerlings distributed in 12 tanks with 20 fish per experimental unit were handled, in a completely randomized design made up of 4 treatments with three replicates, each with inclusions of 0 (0ESH), 10 (10ESH), 20(20ESH) and 30% flour fish silage (30ESH) of treatments T0, T1, T2 and T3 respectively; fromflour fish silagein order to formulate isoenergetic and isonitrogenous diets in the different treatments to avoid sources of miscalculation of the experimental variables. Results. High digestibility coefficients were observed in treatments T1 (10ESH) and T3 (30ESH). The protein, lipid and energy utilization ratios were greater than 60%, which shows the importance of including flour fish silage as a source of protein to improve the various growth parameters. Significant differences between treatments were found in the increase of length (p≤0.05), showing that the T1 was the best treatment with an average of 1.21±0.29 cm. Conclusions. According to the coefficients of digestibility, length increase and benefit - cost ratio, the best treatment was T1 (10ESH) used to feed arawana (O. bicirrhossum), during the growing period, demonstrating the economic and ecological advantages for utilization of this source of protein in aquaculture.

Objetivo. Analizar la digestibilidad de los diferentes componentes nutricionales y energéticos en dietas balanceadas con niveles de harina de hidrolizado de vísceras de cachama en el alevinaje de arawana (O. bicirrhossum). Materiales y métodos. Se evaluaron 240 alevinos, distribuidos en 12 acuarios a razón de 1 animal/5 L. Se utilizó un diseño completamente al azar, conformado por cuatro tratamientos con tres réplicas cada uno, con inclusiones de 0 (0ESH), 10 (10ESH), 20 (20ESH) y 30% de extracto seco de hidrolizado de vísceras de cachama (30ESH) para los tratamientos T0, T1, T2 y T3 respectivamente; para evitar fuentes de error en el cálculo de las variables experimentales, se formularon dietas isoenergéticas e isonitrogenadas. Resultados. Se detectaron diferencias estadísticas significativas en el incremento de longitud (p≤0.05), indicando que el T1 (10ESH) es el mejor tratamiento con un promedio de talla de 1.21 ±0.29 cm, además, se obtuvieron coeficientes de digestibilidad superiores al 60% en los tratamientos T1 (10ESH) y T3 (30ESH) en lo referente a proteína, lípidos y Coeficientes de Utilización Energética (CUE); demostrando la importancia de incluir el extracto seco de hidrolizado de vísceras de cachama, en las dietas de los peces para mejorar las distintas variables zootécnicas, teniendo en cuenta la importancia acuariofílica de la especie. Conclusiones. De acuerdo con los coeficientes de digestibilidad, incrementos de longitud y la relación beneficio - costo el mejor tratamiento fue el T1 (10 ESH) en dietas de levante para O. bicirrhossum; demostrando las ventajas económicas y ecológicas de la incorporación de esta materia prima en la alimentación acuícola.

Energetic status of crossbreed dairy cows during transition period in two different seasons / Perfil energético de vacas leiteiras mestiças no período de transição em duas estações do ano

We used 31 crossbreed dairy cows to compare the energetic profile in summer and winter. Blood samples were taken weekly prepartum, at calving and on days 2, 5, 10, 15, 21 and 30 postpartum. All metabolic indicators analyzed were influenced by the physiological status. The glucose concentrations were higher during winter while the triglyceride concentrations and lactate dehydrogenase (LDH) were higher in the summer. The season influenced the concentrations of cholesterol, AST and GGT, showing a different pattern between summer and winter. Non-esterified fatty acids (NEFA) and beta-hidroxibutirate (BHB) were not influenced by the season. Cows that calved during winter had a greater body condition score (BCS) and lost more BCS until calving. During summer, 32.26% of the animals and 29.03% during winter had NEFA concentrations above the optimum level and 22.58% of the animals in summer and 19.35% in the winter had subclinical ketosis at some point during the transition period, making then more susceptible to diseases.

Foram utilizadas 31 vacas leiteiras mestiças para comparar o perfil energético em duas estações, verão e inverno. Amostras de sangue foram colhidas semanalmente durante o pré-parto, no dia do parto e nos dias dois, cinco, 10, 15, 21 e 30 do pós-parto. Todos os metabólitos analisados foram influenciados pelo estádio fisiológico. As concentrações de glicose foram maiores no inverno, enquanto as concentrações de triglicérides e lactato desidrogenase (LDH) foram maiores no verão. As concentrações de colesterol, AST e GGT mostraram um padrão de comportamento diferente entre o verão e o inverno. Ácidos graxos não esterificados (NEFA) e beta-hidroxibutirato (BHB) não foram influenciados pela estação do ano. As vacas que pariram durante o inverno tinham um escore de condição corporal (ECC) maior e perderam mais ECC até o parto. No verão, 32,26% e, no inverno, 29,03% dos animais apresentaram concentrações de NEFA acima do recomendado no pré-parto; 22,58% dos animais no verão e 19,35% no inverno tiveram cetose subclínica em algum momento do período de transição, tornando-os mais suscetíveis a outras doenças.

Collaborative Brazilian Pediatric Renal Transplant Registry (CoBrazPed-RTx): A Report From 2004 to 2013.

BACKGROUND: The Collaborative Brazilian Pediatric Renal Transplant Registry started in 2004 as a multicenter initiative aiming to analyze, report, and share the results of pediatric kidney transplantation in Brazil. Data from all pediatric kidney transplants performed between January 2004 and December 2013 were recorded electronically and periodically updated. All patients under 18 years old from the participating centers were enrolled. Demographic data, etiology of chronic kidney disease, and patient and graft survival were analyzed. From a total of 2443 pediatric kidney transplants performed in Brazil during the study period, we report data from 1751 pediatric renal transplants performed in 13 centers enrolled in the collaborative study. Median age at transplantation was 12.4 years, and most of recipients were male (56%). The most common underlying renal etiologies were obstructive uropathy (31%) and glomerulopathy (26%). METHODS: According to donor source, 1155 (66%) of transplants were performed with deceased donors (DD). Initial immunosuppression consisted mainly of tacrolimus, mycophenolate, steroids, and induction therapy with anti-IL-2R antibodies. RESULTS: One-year graft survival (death-censored) was 93% and 90% (log rank test, P < .01), respectively, for living donor (LD) and DD. Graft losses (15%) were most frequently caused by vascular thrombosis, chronic allograft nephropathy, death with functioning kidney, acute rejection, and recurrent renal disease. Recipients of DD had 2.02 (95% confidence interval: 1.14-3.59) times the hazard of graft loss compared with those of LD (P = .015). Patient survival rates at 1 and 5 years were 98% and 97% for LD and 97% and 93% for DD, respectively. The mortality rate was 3.8%, mainly as the result of infection and cardiovascular disease. CONCLUSIONS: The results of this collaborative pediatric transplant study are comparable to international registries. Our effort has been able to maintain an exchange of information, both among the participating centers and with other international registries.

Autopercepción del estado nutricional según índice de masa corporal en el personal de salud / Self-perception of nutritional status according to body mass index in health workers

Introducción: Se han reportado altas cifras de sobrepeso y obesidad en el equipo de salud, lo cual influiría en la atención médica de pacientes obesos. Objetivo: comparar el estado nutricional (EN) auto percibido con el real, según índice de masa corporal (IMC) en el personal de salud; y determinar algunos factores de riesgo cardiovascular (FRCV). Pacientes y Método: Se incluyeron 67 miembros del equipo de salud desde el 1° de Marzo al 15 de Mayo de 2013, que aceptaron ser encuestados. Se determinó mediante encuesta su auto percepción del EN, y se calculó el IMC. Se determinó la correlación entre la auto percepción del EN con el calculado, utilizando Chi cuadrado para independencia mediante el software SPSS versión 15. Resultados: edad promedio: 33,4 años (18 a 66, mediana 29 años). El 86,6 porciento fueron mujeres. La prevalencia desobrepeso fue de 46 porciento y de obesidad de 17 porciento. Un 74,6 porciento de la muestra tuvo una adecuada correlación entre su EN autopercibido y el calculado por IMC, lo que fue estadísticamente significativo (÷2 =63,27 con p<0,001). Del 25,4 porciento restante, la mayoria subestimo su EN. El 14,9 porciento (n=10) de la muestra tenia diagnóistico de hipertensión arterial, un 13,4 porciento (n=9) diabetes mellitus, un 11,9 porciento (n=8) dislipidemia, y 1,5 porciento (n=1) enfermedad coronaria. Un 28,3 porciento (n=19) fumaba activamente y un 20,8 porciento (n=14) habia suspendido el tabaquismo. Un 43,3 porciento (n=29) realizaba ejercicio al menos una vez a la semana. Conclusiones: Pese al bajo número muestral, hubo una adecuada correlación entre el EN auto percibido por el personal de salud y el calculado por IMC, y quienes fallaron en percibir adecuadamente su EN, lo subestimaron. La baja prevalencia de FRCV puede estar relacionada con el tamaño muestral, la edad y el sesgo de participación voluntaria en el estudio.

Introduction: High numbers of overweight and obesity have been reported among health workers, which would influence the medical care of obese patients. Objective: To compare self-perceived nutritional state (NS) with that according to Boby Mass Index (BMI) in health personnel and determine some cardiovascular risk factors (CVRF). Patients and methods: 67 members of the health staff where included between March 1st to May 15th of 2013. Self – perceived NS was measured by means of a survey whereas real NS was measured according to BMI. Correlation between self – perceived NS and that according to BMI was calculated with chi – square distribution for independence using SPSS software version 15. Results: Average age: 33.4 years (18 to 66, median 29 years). Overweight and obesity prevalence were 46 percent and 17 percent, respectively. 74.6 percent of the sample had an adequate correlation between self – perceived NS and that according to BMI, which was statistically significant (÷2= 63.27 with p< 0.001). Of the 25.4 percent remaining, most underestimated their NS. 14.9 percent (n=10) of the sample had previous diagnosis of high blood pressure, 13.4 percent (N=9) diabetes mellitus, 11.9 percent (n=8) dyslipidemia, and 1,5 percent (n=1) coronary heart disease. 28.3 percent (n=19) smokes tobacco actively and 20.8 percent (N=14) had suspended tobacco related habits. 43.3 percent (n=29) performed physical activity at least once a week. Conclusions: In spite of the low sample size, there was an adequate correlation between self – perceived NS and that according to BMI among the health workers. Those who failed to correctly self – perceive their NS, underestimated it. The low prevalence of CVRF may be related to the sample size, age and voluntary participation bias.

Avaliação microbiológica do sorvete de creme elaborado com soro de leite fluído pasteurizado

No Brasil, foi relatada a ocorrência de um surto de gastrenterite no Amapá, por Salmonella Paratyphi C, veiculado por sorvete . Existem para os gelados comestíveis padrões microbiológicos estabelecidos pela Comissão Nacional de Normas e Padrões para Alimentos do Ministério da Saúde, que tolera nesses produtos, no máximo 100 bactérias do grupo coliformes totais / g e 200.000 UFC / g de bactérias mesófilas.

Fratura de fíbula e lesões de ligamento colateral e menisco lateral em muar: relato de caso / Fibula fracture and injuries to the collateral ligament and lateral meniscus in mules: case report

Relata-se a ocorrência de fratura de fíbula e lesões de ligamento colateral e menisco lateral em um muar, fêmea, de dois anos de idade, provavelmente produzida por um coice na região da articulação femorotibiopatelar do membro pélvico esquerdo. O animal apresentava claudicação de grau 5 desse membro e obteve melhora após bloqueio dos nervos fibular, tibial e safena e da articulação afetada. O exame radiográfico da região acometida revelou fratura do terço proximal da fíbula e, ao exame ultrassonográfico, observaram-se pontos anecoicos no ligamento colateral lateral e menisco.

This is a report of the occurrence of fibula fracture and injuries of the collateral ligament and lateral meniscus in a two year old mule, probably due to a kick in the joint area of the femurtibiopatellar left pelvic limb. The animal presented degree 5 lameness which improved after a nerve block of the affected joint. Radiographic examination of the affected area revealed a fracture on the proximal third of the fibula, and the ultrasound examination showed anechoic points observed in the lateral collateral ligament and meniscus.

Efeitos do polietilenoglicol 3350 e de soluções acidificantes e alcalinizantes sobre o perfil bioquímico de éguas hígidas / Effects of polyethylene glycol 3350 and alkalizing and acidifying solutions on the biochemical profile of healthy mares

Avaliou-se o perfil bioquímico de cinco éguas hígidas tratadas com polietilenoglicol 3350 (PEG); ou com polietilenoglicol 3350+Ringer lactato (PEG+RL); ou com solução isotônica poliônica enteral (SIPE); ou com solução isotônica poliônica enteral associada ao Ringer lactato intravenoso (SIPE+RL); ou com solução de cloreto de sódio a 0,9% (NaCl 0,9%). Os parâmetros avaliados foram: sódio, cloreto, potássio, cálcio ionizado, fósforo, magnésio total, proteínas totais, albumina, creatinina, ureia e osmolaridade calculada no soro de sangue venoso. O tratamento PEG não alterou os parâmetros bioquímicos. O PEG+RL diminuiu o fósforo. O SIPE diminuiu o fósforo e aumentou o cloreto. O SIPE+RL aumentou o sódio, e o NaCl 0,9% ocasionou o aumento do cloreto e a redução da osmolaridade sérica. Concluiu-se que o tratamento PEG associado ao Ringer lactato pode provocar o aparecimento de hipofosfatemia, o SIPE ocasiona hipercloremia, o NaCl 0,9% diminui a osmolaridade sérica e o SIPE+RL provoca hipernatremia.

The biochemical profile of five healthy mares treated with polyethylene glycol 3350 (PEG); or polyethylene glycol 3350+Ringer lactate intravenous (PEG+RL); or enteral polionic isotonic solution (EPIS); or enteral polionic isotonic solution associated with Ringer lactate intravenous (EPIS+RL); or chloride sodium solution 0.9% (NaCl 0.9%) was evaluated. The parameters evaluated were: sodium, chloride, potassium, ionized calcium, phosphorus, total magnesium, total protein, albumin, creatinine, urea, and calculated serum osmolality of venous blood. PEG treatment did not alter biochemical parameters. PEG+RL decreased phosphorus. SIPE decreased phosphorus and increased chloride. The EPIS+RL caused an increase of sodium and NaCl 0.9% caused an increase of chloride and a reduction of serum osmolarity. It is concluded that PEG treatment associated with Ringer lactate solution can cause the appearance of hypophosphatemia, EPIS causes hyperchloremia, NaCl 0.9% decreases the serum osmolality and EPIS+RL causes hypernatremia.

[Pseudo-conduction block in nonsystemic vasculitic neuropathy]. / Pseudobloqueo de conducción en vasculitis aislada del sistema nervioso periférico.

SUMMARY: Introduction. Nonsystemic vasculitic neuropathy (NSVN) is an inflammatory disorder of the vasa nervorum which usually is expressed as a mononeuritis multiplex. We present a patient with NSVN with histological confirmination focused on the neurophysiological findings at the early stages. CASE REPORT: A 36 years-old woman presented with paresthesia and weakness in her right hand followed by left footdrop. The first neurophysiologic examination showed low amplitude of the right median nerve (RMN) CMAP with proximal stimulation. A second examination showed signs of axonal damage in several nerves, including the RMN. CONCLUSIONS: The acute ischemic damage of a nerve can give a pattern of conduction block in the electroneurographic study as in the RMN of the presented case. This phenomenon is referred as "pseudo-conduction block", since it is transient and evolves towards a definite pattern of axonal neuropathy. When a vasculitic neuropathy is suspected, repeated neurophysiologic studies are necessary in order to ensure a proper (appropriate) characterization of the lesional patterns.

Relationship between optimism, disease variables, and health perception and quality of life in individuals with epilepsy.

Epilepsy is a relatively frequent chronic condition with an important impact on the health perception and quality of life (QOL) of patients. The aim of the present study was to identify variables related to health status perception and QOL in persons with epilepsy. Participants were 200 persons with epilepsy, 53.5% of whom were males. The mean age was 39.6; 95% had seizures, and 99% were taking antiepileptic medication. The self-report questionnaire administered assessed four types of variables: demographic, disease, epilepsy-specific optimistic attitude, and outcome variables. Results demonstrated that an optimistic orientation is related to better perception of physical and mental health status and better perception of QOL. The variables that best predict positive outcomes are optimistic orientation, perception of cognitive functioning, and perception of seizure control. These results question the importance attributed to seizure characteristics for everyday functioning and everyday life of individuals with epilepsy, and stress the importance of facilitating an epilepsy-specific optimistic orientation.