Dermatite alérgica à picada de Culicoides em muar: relato de caso / Allergic dermatitis due to bite of Culicoides in muar: case report

A dermatite alérgica à picada de ectoparasitos é uma enfermidade alergoparasitária bastante comum entre animais domésticos, sendo relatada principalmente em pequenos ruminantes e em animais de companhia. Contudo, a doença é pouco diagnosticada na clínica de equídeos devido a similaridades nosológicas com outras dermatopatias. Objetivou-se, com este relato de caso, descrever a síndrome clínica, o plano diagnóstico e a conduta terapêutica de um muar acometido por essa enfermidade. Atendeu-se, no Hospital Veterinário da Universidade Federal Rural do Pernambuco, uma mula de oito anos de idade, que apresentava lesões cutâneas pápulo-crostosas e pruriginosas com evolução clínica de dois anos. Em três situações anteriores, a doença havia sido tratada como dermatite fúngica por outros médicos veterinários. Para o diagnóstico, foram solicitados exame citopatológico e parasitológico de pele, cultivo bacteriológico e fúngico, análise histopatológica e hemograma. Os exames demonstraram uma dermatite superficial perivascular eosinofílica crônica, sendo indicada a terapia tópica com dimetilsufóxido, sulfadiazina, ureia e vitamina A. O protocolo terapêutico mostrou-se satisfatório, permitindo completa remissão do quadro clínico. Este trabalho relatou achados clínicos e patológicos da dermatite alérgica à picada de Culicoides spp. em muar, além de alertar sobre a importância de exames complementares para a realização do diagnóstico diferencial e para o direcionamento terapêutico adequado.(AU)

Allergic dermatitis to ectoparasite bites is a common parasitic disease among domestic animals, being reported mainly in small ruminants and companion animals. However, the disease is poorly diagnosed in equine clinics due to nosological similarities with other skin diseases. The aim of this case report was to describe the clinical syndrome, the diagnostic plan and the therapeutic management of a mule affected by this disease. An 8-year-old mule was observed at Universidade Federal Rural de Pernambuco, presenting papular-crusted and pruritic cutaneous lesions with clinical evolution of two years. In three previous situations, the disease had been treated as fungal dermatitis by other veterinarians. For the diagnosis, cytopathological and parasitological examination of the skin, bacteriological and fungal culture, histopathological analysis and blood count were performed. The exams showed a chronic eosinophilic perivascular superficial dermatitis. A topical therapy with dimethyl sulfoxide, sulfadiazine, urea, and vitamin A was indicated. The therapeutic protocol was satisfactory, allowing complete remission of the clinical condition. This work reported clinical and pathological findings of allergic dermatitis to the bites of Culicoides spp. in muar, in addition to alerting about the importance of complementary examinations for the accomplishment of the differential diagnosis and adequate therapeutic orientation.(AU)

Efficacy of lead foil for reducing doses in the head and neck: a simulation study using digital intraoral systems.

OBJECTIVES: To assess the efficacy of lead foils in reducing the radiation dose received by different anatomical sites of the head and neck during periapical intraoral examinations performed with digital systems. METHODS: Images were acquired through four different manners: phosphor plate (PSP; VistaScan(®) system; Dürr Dental GmbH, Bissingen, Germany) alone, PSP plus lead foil, complementary metal oxide semiconductor (CMOS; DIGORA(®) Toto, Soredex(®), Tuusula, Finland) alone and CMOS plus lead foil. Radiation dose was measured after a full-mouth periapical series (14 radiographs) using the long-cone paralleling technique. Lithium fluoride (LiF 100) thermoluminescent dosemeters were placed in an anthropomorphic phantom at points corresponding to the tongue, thyroid, crystalline lenses, parotid glands and maxillary sinuses. RESULTS: Dosemeter readings demonstrated the efficacy of the addition of lead foil in the intraoral digital X-ray systems provided in reducing organ doses in the selected structures, approximately 32% in the PSP system and 59% in the CMOS system. CONCLUSIONS: The use of lead foils associated with digital X-ray sensors is an effective alternative for the protection of different anatomical sites of the head and neck during full-mouth periapical series acquisition.

Artefact expression associated with several cone-beam computed tomographic machines when imaging root filled teeth.

AIM: To evaluate the characteristic artefact patterns associated with teeth root filled with Gutta-percha when scanned with four cone-beam CT devices. METHODOLOGY: Whilst using soft tissue simulation, ten root filled human premolars were placed in empty sockets in a dry human skull. Subsequently, the skull was scanned using 3D Accuitomo 170(®) , WhiteFox(®) , Cranex 3D(®) and Scanora 3D(®) following clinical protocols with the highest resolution and artefact reduction. After proper image registration in OnDemand3D(®) software (Cybermed, Seoul, Korea), each image slice was evaluated by three trained and calibrated dentomaxillofacial radiologists, which scored absence (0) and presence (1) of cupping artefact, hypodense halos and streak artefacts. Kappa test was performed for intra- and interobserver agreement. RESULTS: A moderate to perfect agreement for each observer (intra-observer κ = 0.5-1.0) was found. Agreement between the different observers was moderate to almost perfect for the different artefact patterns (interobserver κ = 0.55-0.9). Cupping artefact was the most prevalent (70%), followed by a hypodense halo (35%) and streak artefacts (16%). The Chi-squared test revealed significantly more streaks in axial slices (P < 0.0001), with some CBCT systems yielding significantly inferior results to others (P < 0.05). The dedicated EndoMode and artefact reduction did not improve the result significantly. CONCLUSIONS: The variation of artefact expression was significantly different amongst CBCT machines for root filled teeth. Continuous efforts are needed to improve CBCT reconstruction algorithms, with a specific focus on reducing artefacts induced by dense dental materials, whilst striving for enhanced image quality at low-radiation doses.

Terapia floral em gatos domésticos (Felis catus, Linnaeus, 1758) portadores do complexo da doença respiratória felina: estudo clínico e hematológico / Flower therapy in domestic cats (Felis catus, Linnaeus, 1758) with feline respiratory disease complex: clinical and hematological study

A terapia floral é considerada, atualmente, prática médica alternativa utilizada em diversas situações clínicas, constituindo possibilidade a mais de prevenção e cura de muitas doenças de natureza física e emocional. Este estudo objetivou pesquisar o efeito das essências do Sistema Brasileiro de Florais Compostos de Joel Aleixo num mesmo grupo de gatos domésticos com sinais clínicos sugestivos de Doença Respiratória Felina (DRF), tratados em diferentes momentos (M0, M1, M2, M3). Foram utilizados 20 gatos domésticos, de ambos os sexos, sem raça definida, com idade média de 5,63 ± 3,02 anos criados em gatil na UFRPE. Os animais foram submetidos ao tratamento com os florais por via oral em duas etapas. Na primeira etapa com os florais Desintus Total e Helminthus Total por 14 dias, e na segunda etapa com os florais Antibius e Regius por 28 dias. Os resultados observados, quanto aos aspectos clínicos, foram redução de secreção nasal, secreção ocular e estertores pulmonares; desaparecimento de sinais clínicos como fezes alteradas, úlceras na cavidade oral, pêlos eriçados e permanência da hipertrofia dos linfonodos. Quanto aos aspectos hematológicos houve interferência nas variáveis relacionadas ao hemograma (hemoglobina, VCM, CHCM, leucócitos, linfócitos e monócitos). Conclui-se que a terapia floral mostrou-se eficaz em gatos domésticos com sinais sugestivos de DRF criados nas mesmas condições de manejo.

Flower therapy is currently considered an alternative medical practice used in several clinical situations, providing another way to prevent and cure many diseases of physical and emotional nature. This study aimed to investigate the effect of essences of the Brazilian Compound Flower System of Joel Aleixo in one same group of domestic cats showing suggestive clinical signs of Feline Respiratory Disease (FRD), treated in different moments (M0, M1, M2, M3). Twenty domestic cats, males and females, of mixed breed, with average age 5.63 ± 3.02, raised in the UFRPE's cattery, were used. The animals were orally treated with flower essences in two steps. Firstly with Total Desintus and Total Helminthus flower for 14 days and in the second step with Antibius and Regius for 28 days. The obtained results related to clinical aspects were a decrease in nasal and ocular discharge, and lung stertors; disappearance of clinical signal such as altered stool, ulcers in the oral cavity, bristling and hypertrophy of lymph nodes. Regarding hematological aspects, there was interference in the variables related to the blood (hemoglobin, MCV, MCHC, leucocytes, lymphocytes and monocytes). It can be concluded that flower therapy was effective in cats with signs suggestive of FRD raised under the same management conditions.

Orthotopic liver transplantation for hepatocellular carcinoma: one center's experience in the Northeast of Brazil.

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third leading cause of cancer-related death. In this study, we sought to assess the outcome of patients with HCC who underwent orthotopic liver transplantation (OLT) in a center in the northeast of Brazil. Between May 2002 and July 2008, 294 OLTs were performed at our center. In 45 patients, HCC was confirmed by histological examination of the explant. Patients were predominantly men of ages ranging from 14-67 years. Hepatitis C virus was involved in 55.4% of the cases. Alpha fetoprotein (AFP) levels were normal in 65.2% of the patients and surpassed 100 ng/mL in only 10.4%. The median waiting time on the list was 10 months. Seventeen patients (37.7%) presented a solitary nodule, 19 (42.2%) had 2 or 3 nodules, and 9 patients (20%) had more than 3 nodules. The maximal diameter of the largest tumor was <3 cm in 26 patients (57.7%) and exceeded 5 cm in 6 patients (13.3%). Ten tumors were well differentiated, 32 were moderately differentiated, and 3 were poorly differentiated. Eleven tumors showed microvascular invasion. There have been 4 tumor recurrences. There was an association between microvascular invasion and tumor recurrence with a statistically significant relative risk. In conclusion, OLT is an excellent option for patients with HCC. The recurrence rate was low (<10%). However, we believe that more prospective studies are needed about OLT beyond the Milan criteria because our study suggested that microvascular invasion may be more important than tumor size or number.

Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase of isolates from the Amazon Region of Brazil

Since the late 1970s pyrimethamine-sulfadoxine (PS; FansidarTM Hoffman-LaRoche, Basel) has been used as first line therapy for uncomplicated malaria in the Amazon basin. Unfortunately, resistance has developed over the last ten years in many regions of the Amazon and PS is no longer recommended for use in Brazil. In vitro resistance to pyrimethamine and cycloguanil (the active metabolite of proguanil) is caused by specific point mutations in Plasmodium falciparum dihydrofolate reductase (DHFR), and in vitro resistance to sulfadoxine has been associated with mutations in dihydropteroate synthase (DHPS). In association with a proguanil-sulfamethoxazole clinical trial in Brazil, we performed a nested mutation-specific polymerase chain reaction to measure the prevalence of DHFR mutations at codons 50, 51, 59, 108 and 164 and DHPS mutations at codons 436, 437, 540, 581 and 613 at three sites in the Brazilian Amazon. Samples from two isolated towns showed a high degree of homogeneity, with the DHFR Arg-50/Ile-51/Asn-108 and DHPS Gly-437/Glu-540/Gly-581 mutant genotype accounting for all infections in Peixoto de Azevedo (n = 15) and 60 percent of infections in Apiacás (n = 10), State of Mato Grosso. The remaining infections in Apiacás differed from this predominant genotype only by the addition of the Bolivia repeat at codon 30 and the Leu-164 mutation in DHFR. By contrast, 17 samples from Porto Velho, capital city of the State of Rondônia, with much in- and out-migration, showed a wide variety of DHFR and DHPS genotypes.

Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase of isolates from the Amazon region of Brazil.

Since the late 1970s pyrimethamine-sulfadoxine (PS; FansidarTM Hoffman-LaRoche, Basel) has been used as first line therapy for uncomplicated malaria in the Amazon basin. Unfortunately, resistance has developed over the last ten years in many regions of the Amazon and PS is no longer recommended for use in Brazil. In vitro resistance to pyrimethamine and cycloguanil (the active metabolite of proguanil) is caused by specific point mutations in Plasmodium falciparum dihydrofolate reductase (DHFR), and in vitro resistance to sulfadoxine has been associated with mutations in dihydropteroate synthase (DHPS). In association with a proguanil-sulfamethoxazole clinical trial in Brazil, we performed a nested mutation-specific polymerase chain reaction to measure the prevalence of DHFR mutations at codons 50, 51, 59, 108 and 164 and DHPS mutations at codons 436, 437, 540, 581 and 613 at three sites in the Brazilian Amazon. Samples from two isolated towns showed a high degree of homogeneity, with the DHFR Arg-50/Ile-51/Asn-108 and DHPS Gly-437/Glu-540/Gly-581 mutant genotype accounting for all infections in Peixoto de Azevedo (n = 15) and 60% of infections in Apiacás (n = 10), State of Mato Grosso. The remaining infections in Apiacás differed from this predominant genotype only by the addition of the Bolivia repeat at codon 30 and the Leu-164 mutation in DHFR. By contrast, 17 samples from Porto Velho, capital city of the State of Rondônia, with much in- and out-migration, showed a wide variety of DHFR and DHPS genotypes.