Steps towards eliminating Hansen's disease stigma.

Persons affected by Hansen's disease (PAHD) can develop long-term physical disabilities and psychological problems if the disease is not managed promptly and correctly. The complex and multi-faceted nature of stigma related to Hansen's Disease, and the discrimination arising from it, demands multiple parallel steps to improve the health, well-being and lived experience of People Affected by Hansen's Disease, including: 1) adoption and pursuance of a human rights based approach; 2) revocation of discriminatory laws; 3) education and training for healthcare workers; 4) new techniques and therapies to diagnose and treat HD without side-effects and to reduce risk of disabilities; 5) elimination of stigmatising terminology.

Cellular and humoral immunity of broilers subjected to posthatch fasting and a prestarter diet containing conjugated linoleic acid.

This study aimed to evaluate the immunity of chickens up to 35 d subjected to posthatch fasting and supplementation with conjugated linoleic acid (CLA). A total of 320 chicks were housed in a completely randomized design with a 2 × 2 factorial arrangement (0 or 12 h of fasting × 0.000 or 0.025% CLA in a prestarter diet), totaling 4 treatments (No-F-12 h; F-12 h; No-CLA; CLA) with 8 replicates of 10 birds each. The relative weights (% body weight) of the spleen and bursa were determined 12 h posthatch (Post-12 h) and then weekly. Immunoglobulin Y (IgY) titers against Newcastle disease virus (NDV) were measured by ELISA in the yolk sac contents Post-12 h and in the serum weekly. Hypersensitivity to phytohemagglutinin (PHA) inoculation was evaluated by toe-web swelling response on d 13 and 34, 4 times a day (after 3 h, 6 h, 12 h, and 24 h inoculation, respectively, PHA-3 h, PHA-6 h, PHA-12 h, and PHA-24 h). The data were subjected to analysis of variance (P < 0.05). F-12h reduced the Post-12 h relative weight of the spleen, and CLA reduced the relative weight of the bursa at this stage and at 28 d. At 13 d, F-12 h reduced PHA-3 h, whereas PHA-12 h was increased by CLA. At 34 d, CLA reduced PHA-3 h. A greater reaction was observed in the No-F-12 h-CLA chicks, for the PHA-24 h. In the Post-12 h evaluation, F-12h reduced, whereas CLA increased NDV-specific IgY titers in the yolk sac. No-F-12 h-No-CLA chicks had the lowest serum titers. At 21 d, F-12 h-CLA chicks exhibited the highest serum titers. Titers were higher in the F-12 h-No-CLA chicks, when compared to other treatments. At 28 d, fasting reduced the titers. In conclusion, F-12 h and CLA accelerated the transfer of immunoglobulins from the yolk sac to the serum. F-12 h impairs cellular immunity, whereas CLA favors it.

Coronary artery bypass surgery in patients with COVID-19: What have we learned ?

COVID-19 caused by the novel coronavirus SARS-CoV-2 led to the pandemic, causing unprecedented health and social crisis worldwide. Acute coronary syndromes patients, especially when coronary artery bypass graft (CABG) surgery is needed, may present with higher severity risk if affected by COVID-19. Extracorporeal circulation leads to activation of endothelium and microcirculatory network, which activates the coagulation, platelet aggregation and inflammation 1. COVID-19 may also course with severe inflammation, massive secretion of inflammatory cytokines, plaque rupture and a procoagulant state 2. Therefore, it is advisable to postpone surgeries interventions when possible. However, our institution is a public tertiary referral hospital for high-risk cardiovascular patients even in SARS-CoV-2 pandemic. We describe a series of thirteen high risk coronary artery disease patients submitted to CABG and who had COVID-19 infection during the same hospitalization, six patients had COVID-19 before surgery, three patients were operated with active infection and four patients were infected after surgery…

Pesquisa de Mycoplasma em aves da família Psittacidae mantidas em diferentes cativeiros no Brasil Central / Research of Mycoplasma in the family Psittacidae kept in different captivities in Central Brazil

O presente estudo teve como objetivo investigar a presença de Mycoplasma gallisepticum e M. synoviae em diferentes espécies de psitacídeos cativos no Brasil Central. Um total de 300 amostras foram coletadas e corresponderam a 41 espécies de psitacídeos da fauna brasileira, provenientes do CETAS, criadouro comercial e criadouro conservacionista. Quatorze espécies apresentaram amostras positivas para M. gallisepticum destacando a maracanã-verdadeira (Primolius maracana) (01/02, 50%), a arara-canindé (Ara ararauna) (15/48, 33,3%) e a jandaia-verdadeira (Aratinga jandaia) (03/10, 30%). Amostras do CETAS obtiveram total de 21,62% (16/74) de amostras positivas, do criadouro comercial 15,7% (19/121) e do criadouro conservacionista 6,66% (7/105). Apenas três espécies foram positivas para M. synoviae sendo essas, a maracanã-pequena (Primolius maracana) (1/10 - 10%), arara-macao (Ara macao) (1/12, 8,3%) e arara-canindé (Ara ararauna) (2/48, 4,1%). O CETAS obteve 2,7% (2/74) de amostras positivas totais, enquanto o criadouro conservacionista obteve total de 1,9% (2/105) de amostras. Não ocorreram amostras positivas para M. synoviae no criadouro comercial. Os resultados mostraram um considerável número de amostras positivas para M. gallisepticum em espécies da família Psittacidae, indicando que estes animais podem ser uma fonte de infecção silenciosa para outras aves, uma vez que não apresentaram sintomatologia clínica.(AU)

The study aimed to investigate the presence of Mycoplasma gallisepticum and M. synoviae in different species of captive parrots, in Central Brazil. A total of 300 samples were collected from 41 brazilian species of Psittacidae at three captivities: Centro de Triagem de Animais Silvestres (CETAS), a conservation and a commercial captivity. Fourteen species presented positive samples for M. galisepticum, the most affected were blue-winged macaw (Primolius maracana) (01/02, 50%), blue-and-yellow macaw (Ara ararauna) (15/48, 33.3%), and jandaia parakeet (Aratinga jandaia) (03/10, 30%). CETAS facility showed 21.62% (16/74) of positive samples, while the commercial captivity showed 15.7% (19/121), and the conservation captivity 6.66% (7/105). Only three species presented positive samples for M. synoviae: blue-winged macaw (Primolius maracana) (1/10, 10%), scarlet macaw (Ara macao) (1/12, 8.3%) e blue-and-yellow macaw (Ara ararauna) (2/48, 4.1%). CETAS facility showed 2.7% (2/74) of positive samples, while the conservation captivity presented 1.9% (2/105), and no positive samples were found in the commercial captivity. Results showed a considerable number of positive samples for M. galisepticum in species of Psittacidae family, indicating that these animals can be a silent source of infection for other birds, since they did not present clinical symptoms.(AU)

Phenotypic and molecular detection of Salmonella sp. on growing, rearing and production phases in a commercial group of laying hens / Detecção fenotípica e molecular de Salmonella sp. nas fases de cria, recria e produção em lote de poedeiras comerciais

This present study was developed with the objective of detect Salmonella sp. by conventional bacteriology and qPCR techniques in samples of flooring material from transport crates (meconium); raising environment (swab of cages and drinking fountains); cloacal swab; food and insects from growing, rearing and production phases in a commercial group of laying hens. A total of 864 samples were collected, among whom 248 originated from growing, 392 from rearing and 224 from production phase. Among the 864 samples, 2,8% where positives in bacteriologic technique and 15.3% in qPCR. Contamination was higher in growing and rearing phases and declined in production phase. Twenty four isolations of Salmonella where typified as Salmonella Agona (41.7%), Salmonella Livingstone (33.3%), Salmonella Cerro (16.7%), Salmonella Senftenberg (4.2%) and Salmonella Schwarzengrund (4.2%). During growing phase Salmonella Livingstone was identified. These findings suggest vertical contamination in the group. During rearing and production phases, isolated materials belong to serovars Agona, Cerro, Senftenberg and Schwarzengrund, pointing to horizontal contamination. It is possible to conclude that both vertical and horizontal contaminations are important during the cycle of commercial egg production and contamination in rearing phase is higher than in growing and production phases.(AU)

O presente estudo foi desenvolvido com objetivo de detectar Salmonella sp. pelas técnicas de bacteriologia convencional e PCR em tempo real em amostras de forros de caixas de transporte (mecônio), de ambientes de criação (suabes de gaiola e de bebedouro), suabes de cloaca, ração e insetos oriundos das fases de cria, recria e produção de um lote de poedeiras comerciais. Foram coletadas 864 amostras das quais 248 foram originadas da cria, 392 da recria e 224 da produção. Das 864 amostras 2,8% foram positivas na técnica bacteriológica e 15,3% no PCR em tempo real. A contaminação aumentou da fase de cria para a recria e declinou na fase de produção. Vinte e quatro isolados de Salmonella foram tipificados como Salmonella Agona (41,7%), Salmonella Livingstone (33,3%), Salmonella Cerro (16,7%), Salmonella Senftenberg (4,2%) e Salmonella Schwarzengrund (4,2%). Na fase de cria identificou-se Salmonella Livingstone. Esses achados sugerem a contaminação vertical do lote. Nas fases de recria e produção os isolados pertenceram aos sorovares Agona, Cerro, Senftenberg e Schwarzengrund apontando para a contaminação horizontal. Pode-se concluir com este estudo que tanto a contaminação vertical como a horizontal são importantes no ciclo de produção de ovos comerciais e que a contaminação na fase de recria é maior que na fase de cria e de produção.(AU)

Indicadores de adoecimento antes e após o ingresso da criança na creche / Indicators of illness before and after the child´s entry into a day nursery

Apesar da existência de diversos trabalhos apresentando resultados controversos ou métodos inconsistentes, a literatura continua afirmando relações de causa e efeito entre creche e adoecimento da criança. Assim, investigou-se a ocorrência de doenças em 109 prontuários médicos de crianças de classe média em função de seu ingresso na creche, através da verificação de mudança(s) no número de consultas e no número de doenças nos primeiros doze meses de freqüência à creche, quando comparados com os dois meses anteriores ao ingresso. A análise estatística foi realizada através do teste de Wilcoxon, considerando significativos os valores p d 0,05. A análise revelou que, na amostra estudada, não houve aumento de consultas nos doze meses após a entrada na creche, porém houve aumento significativo das queixas no 1°, 2° e 3° bimestres. Pode-se supor que a família e, principalmente, a mãe, quando diante do profissional, com suas concepções baseadas nos numerosos estudos científicos da relação creche/doença, apresenta mais queixas com relação à saúde da criança. Tais queixas, transformadas em diagnóstico de doença levariam à confirmação da predição médica. Contudo, para que se possa avaliar o real efeito dessa profecia auto-realizadora são necessários estudos complementares para testar essa hipótese.(AU)

In the scientific literature, even the studies that show not only variants but sometimes inconclusive results, do not always manage to free themselves from the relation of cause and effect between nursery education and illness. This study investigated the occurrence of illness in the medical records of 109 middle-class children and the relation of the results to their entry into day nurseries, through the identification of variation(s) in the number of appointments and in the number of illnesses in the first twelve months of attendance at nursery school, when compared with the two months preceding entry. The statistical analysis of these variations was made through the Wilcoxon's test, considering significant the values p d 0,05. The analysis revealed that, in the samples studied, there was no increase or variation in the variable appointments in the twelve months after entry into nursery education, although there was a significant increase in the complaints in the 1st, 2nd, and 3rd bimesters. It's possible that the family, especially the mother, when faced with a professional influenced by numerous scientific studies showing the relation between nursery education/ illness, presents more health complaints with relation to the child, even though the child does not in fact become ill more frequently, and hence, does not require more frequent medical attention. These complaints, which are transformed into the diagnosis of illnesses, lead to the confirmation of the medical prediction. However, in order to be able to evaluate the real effect of this self-fulfilling prophecy, complementary studies are needed so that this hypothesis can be better evaluated.(AU)

Altered GH elimination kinetics in type 1 diabetes mellitus can explain the elevation in circulating levels: bicompartmental approach.

Type 1 diabetes mellitus (DM 1) is associated with elevated circulating GH concentrations. Because these high GH levels could be explained either by an augmented pituitary secretion and/or delayed elimination clearance or distribution, we sought to evaluate GH pharmacokinetics to propose a model that better explains the elimination kinetics in patients with DM 1 and assess possible differences with normal volunteers that could justify elevation in GH circulating levels in these patients. A multicompartmental analysis was applied to serum GH concentrations measured at different times for 150 min in six patients with DM 1 and six age-, sex-, and body mass index-matched normal subjects after the administration of an iv bolus of recombinant human GH (200 microg), previous suppression of endogenous GH release with octreotide. The best fitting to the GH disappearance profiles was obtained with the biexponential equation in both groups. From it, we propose a bicompartmental model to explain GH kinetics in normal and diabetic patients. The mean transit time in both compartments and the mean residence time in patients with DM 1 were more than twice the values from control group. So in DM 1 elevated circulating GH concentrations are, at least partially, caused by a delayed GH plasmatic clearance. The DM 1 patients included in this study had a normal renal function; thus, our results agree with the hypothesis that DM 1 constitutes a GH-insensitivity state because a reduced GH clearance by its receptor-mediated mechanism might explain the delayed GH elimination kinetics shown in patients with DM 1. However, the possibility of additional factors contributing to the slowed GH removal from circulation is not completely excluded.