Teste de caminhada para caracterização de intolerância ao esforço de indivíduos com insuficiência cardíaca com fração de ejeção preservada: um estudo observacional / Walk test for characterization of exercise intolerance in individuals with heart failure with preserved ejection fraction: an observational study

INTRODUÇÃO: A Insuficiência Cardíaca com Fração de Ejeção Preservada (ICFEP) é uma condição clínica caracterizada por intolerância ao esforço e, nesse contexto, ferramentas que possam mensurar objetivamente este sintoma podem ser de grande valor na prática clínica. A abordagem diagnóstica atual da ICFEP requer aplicação de escores. O escore europeu HFA-PEFF, considera domínios morfológico, funcional e de peptídeos natriuréticos. Cada domínio tem um critério maior, que vale 2 pontos, e um critério menor, que vale 1 ponto. Se o total do escore for ≥ 5 pontos, o paciente tem diagnóstico de ICFEP. O teste de caminhada de seis minutos (TC6min) é uma ferramenta capaz de avaliar objetivamente a capacidade funcional traduzindo a habilidade dos pacientes em realizar tarefas cotidianas. OBJETIVOS: Avaliar a capacidade funcional de uma população de indivíduos em investigação para ICFEP. MÉTODOS: Trata-se de um estudo observacional transversal realizado em uma população de indivíduos com suspeita de ICFEP de um centro terciário de cardiologia. Foram incluídos sujeitos que realizaram o TC6min e categorizados de acordo com a probabilidade de ICFEP pelo escore HFA-PEFF. A normalidade dos dados foi avaliada pelo teste Shapiro-Wilk e a comparação entre os grupos foi realizada por meio do teste de Kruskal-Wallis. O nível de confiança adotado foi de 95%. Realizou-se ainda modelos de regressão linear univariado e multivariado. RESULTADOS: A amostra foi 105 indivíduos com idade de 59,5 ± 12,0 anos, 64% sexo feminino, IMC=31(5,8) Kg/m². A probabilidade de ICFEP foi baixa em 32 indivíduos, intermediária em 46; e alta em 27. A distância percorrida no TC6min foi de 416(±90) m. Para indivíduos com baixa probabilidade a distância percorrida foi de 472(±72) m, probabilidade intermediária de 406(±73) m e com alta probabilidade 356(±96) m. A diferença na distância percorrida entres os grupos com alta e baixa probabilidade de ICFEP foi estatisticamente significativa (P<0,05). Em um modelo de regressão multivariada, o efeito se manteve quando ajustado para idade, sexo e IMC. CONCLUSÃO: O presente estudo sugere que indivíduos com alta probabilidade de ICFEP classificados pelo escore HFA-PEF percorreram distâncias menores no TC6min quando comparados a indivíduos sem ICFEP (baixa probabilidade). Estes achados demonstram o valor clínico do TC6min na avaliação de indivíduos com suspeita de ICFEP. Palavras chaves: Insuficiência Cardíaca com Fração de Ejeção Preservada, Teste de Caminhada de Seis Minutos, Capacidade Funcional.

Antifungal and antiocratoxigenic potential of Alpinia speciosa and Cymbopogon flexuosus essential oils encapsulated in poly(lactic acid) nanofibres against Aspergillus fungi.

Essential oils encapsulated in a polymeric matrix can be used as an alternative method to control fungi and mycotoxins. The essential oils were extracted by hydrodistillation and characterized by gas chromatography. The nanofibres were produced from poly (acid lactic) (PLA) containing essential oils by the Solution Blow Spinning method. The antifungal and antimicotoxygenic properties were evaluated against Aspergillus ochraceus and Aspergillus westerdijkiae by the fumigation method. Terpinen-4-ol (20·23%), sabinene (20·18%), 1·8-cineole (16·69%) and γ-terpinene (11·03%) were the principal compounds present in the essential oil from Alpinia speciosa, whereas citral (97·67%) was dominant from Cymbopogon flexuosus. Microscopy images showed that the addition of essential oils caused an increase in the diameter of the nanofibres. The infrared spectroscopy results indicated the presence of essential oils in the PLA nanofibres. Differential scanning calorimetry curves also indicated the existence of interactions between the essential oils and polymeric macromolecules through their plasticizing action. The hydrophobic character of nanofibres was revealed by the contact angle technique. An antifungal effect was observed, the mycelial growths (3·25-100%) and the synthesis of ochratoxin A (25·94-100%) were inhibited by the presence of the nanofibres. The results suggest that bioactive nanofibres hold promise for application to control toxigenic fungi.

In vivo hydrogen peroxide diffusivity in brain tissue supports volume signaling activity.

Hydrogen peroxide is a major redox signaling molecule underlying a novel paradigm of cell function and communication. A role for H2O2 as an intercellular signaling molecule and neuromodulator in the brain has become increasingly apparent, with evidence showing this biological oxidant to regulate neuronal polarity, connectivity, synaptic transmission and tuning of neuronal networks. This notion is supported by its ability to diffuse in the extracellular space, from source of production to target. It is, thus, crucial to understand extracellular H2O2 concentration dynamics in the living brain and the factors which shape its diffusion pattern and half-life. To address this issue, we have used a novel microsensor to measure H2O2 concentration dynamics in the brain extracellular matrix both in an ex vivo model using rodent brain slices and in vivo. We found that exogenously applied H2O2 is removed from the extracellular space with an average half-life of t1/2 = 2.2 s in vivo. We determined the in vivo effective diffusion coefficient of H2O2 to be D* = 2.5 × 10-5 cm2 s-1. This allows it to diffuse over 100 µm in the extracellular space within its half-life. Considering this, we can tentatively place H2O2 within the class of volume neurotransmitters, connecting all cell types within the complex network of brain tissue, regardless of whether they are physically connected. These quantitative details of H2O2 diffusion and half-life in the brain allow us to interpret the physiology of the redox signal and lay the pavement to then address dysregulation in redox homeostasis associated with disease processes.

Reproducibility, validity, and reliability of the incremental step test for subjects with moderate to severe asthma.

OBJECTIVE: We investigated the measurement properties of the incremental step test in subjects with moderate to severe asthma. METHODS: Subjects with moderate to severe persistent asthma were recruited from a tertiary university hospital specializing in treating severe asthma. All subjects performed one cardiopulmonary exercise test (CPET) and two incremental step tests (IST) in random sequences. Pulmonary gas exchange was measured during all exercise tests. The measurement properties investigated were reliability by intraclass correlation coefficient (ICC), measurement error by the standard error of measurement and minimum detectable difference, construct validity by Pearson's correlation, and interpretability by the ceiling and floor effects. RESULTS: Fifty subjects (38 females, mean [SD], age 43.7 [11.6] yr, % FEV1 70 [14.3], BMI 28.5 [5.3] kg/m2) completed the study. The peak oxygen uptake (peak VO2) for the CPET was 27.6 [±6.8] ml/kg/min, for the first IST was 22.3 [±5.3] ml/kg/min and for the second IST was 23.3 [±5.3] ml/kg/min. The IST presented excellent reliability (ICC=0.93, CI95% 0.88-0.96), very good measurement error (2.5%), and construct validity for peak VO2 measurement compared to the CPET (r = 0.85; p < 0.001) to assess exercise capacity in subjects with moderate to severe asthma, with appropriate ceiling (10%) and floor (0%) effects. CONCLUSION: The IST presented excellent reliability and very good measurement error and validity to assess exercise capacity in subjects with moderate to severe asthma, without ceiling or floor effects.

Motor reserve: How to build neuronal resilience against ageing and neurodegeneration?

With the percentage of the population above age 65 expected to double by 2030, the healthcare costs across neurodegenerative diseases will in all likelihood significantly increase. As such, disease-modifying, preventive strategies are urgently needed. However, despite major technological advances and massive concerted efforts, we still fall short of disease prevention, delayed progression or reversal when it comes to neurodegenerative diseases. An increasing wealth of information has come to formally demonstrate that exercise serves as one of the best strategies for coping with neurodegeneration. Herein, we review the available evidence on how and to which extent physical activity can expand one's motor reserve in the settings of neuropathology and ageing. Individuals who attain higher levels of functionality via lifelong experience develop a higher motor reserve throughout life and clinically relevant symptoms only later in life. The higher the motor reserve, the higher the degree of resilience and the better individuals can cope with a given level of neuropathology. Physical exercise is an efficacious and efficient way of strengthening one's motor reserve, allowing for an increased ability to cope with neuropathology throughout life and resulting in delayed disease onset and progression. Motor learning, and not necessarily motor performance, seems to be the key when aiming at maximizing the benefits of physical exercise in the context of motor reserve. As a result, a variety of challenging activities are to be recommended and maintained throughout life.

Unravelling the fungal darkness in a tropical cave: richness and the description of one new genus and six new species.

Caves are special environments that harbour an incredible diversity of life, including fungal species. Brazilian caves have been demonstrated to be biodiversity hotspots for known and unknown fungal species. We investigated the richness of culturable fungi in a tropical cave in Brazil by isolating these microorganisms from the sediment and air. The fungal abundance of colony-forming units (CFUs) was 3 178 in sediment and 526 in air. We used morphological features and phylogenetic analyses of actin (actA), calmodulin (cmdA), internal transcribed spacer regions and intervening 5.8S rRNA (ITS), large subunit (LSU) rDNA, RNA polymerase II second largest subunit (rpb2), translation elongation factor 1-alpha (tef1), and ß-tubulin (tub2) genes to identify these isolates. Forty-one species belonging to 17 genera of Ascomycota and two of Basidiomycota were identified, and the genus Aspergillus was most commonly observed in the cave (13 taxa). Twenty-four species were found in sediment (16 exclusives) and 25 species were found in air (17 exclusives). In this study, we introduced a new genus (Pseudolecanicillium gen. nov.) in the family Cordycipitaceae and six new species (14 % of the total taxa identified) of fungal isolates obtained from sediment and air: Aspergillus lebretii sp. nov., Malbranchea cavernosa sp. nov., Pseudohumicola cecavii sp. nov., Pseudolecanicillium caatingaense sp. nov., Talaromyces cavernicola sp. nov., and Tritirachium brasiliense sp. nov. In addition, we built a checklist of the fungal taxa reported from Brazilian caves. Our results highlight the contribution of Brazilian caves to the estimation of national and global fungal diversity. Citation: Alves VCS, Lira RA, Lima JMS, Barbosa RN, Bento DM, Barbier E, Bernard E, Souza-Motta CM, Bezerra JDP (2022). Unravelling the fungal darkness in a tropical cave: richness and the description of one new genus and six new species. Fungal Systematics and Evolution 10: 139-167. doi: 10.3114/fuse.2022.10.06.

Dimethylacetamide in Rooster Semen Cryopreservation.

BACKGROUND: Sperm cryopreservation of cockerels is a major challenge, and so far there is no adequate information to enable commercial use of frozen semen. OBJECTIVE: To test the toxicity of dimethylacetamide (DMA). MATERIALS AND METHODS: DMA was added at 3%, 6%, 9% and 12% to the freezing diluent, and maintained for equilibration with the semen sample for 1 min, 3 min, 5 min, 7 min and 9 min prior to freezing. Thawed semen was evaluated for kinetic characteristics by computer-assisted semen analysis (CASA) and for structural and functional properties by flow cytometry (plasma membrane rupture, mitochondrial functionality and plasma membrane functionality). RESULTS AND CONCLUSION: The addition of 6% DMA for 3-min equilibration resulted in the highest total and progressive motility, 42.0% and 36.9%, respectively. The point of intersection between a good protection and low plasma membrane rupture was obtained with the addition of 6% of DMA for 3-min equilibration with the rooster semen.

Pharmacological approaches to induce follicular growth and ovulation for fixed-time artificial insemination treatment regimens in ewes.

In Experiment I, during the non-breeding season, after intravaginal devices containing progesterone (P4) were withdrawn (n = 28), estrous rates were greater with treatment with 400 IU eCG (P < 0.05) than with FSH (10 and 15 mg) and no treatment. During the breeding season (n = 147), estrous and pregnancy rates after fixed-time artificial inseminations (FTAI) were similar among groups: 300 IU eCG; 10 mg FSH; and control (P > 0.05). In Experiment II (non-breeding season), ewes of one group were treated with 300 IU eCG (n = 8) and of two groups were treated with 10 mg FSH. In one FSH group, 250 µg estradiol benzoate (EB) were administered after 24 h (n = 9); in the other, 4 µg GnRH were administered after 36 h (n = 10). Serum P4 concentrations were greater in eCG-treated ewes (P < 0.05). Estrous rates were similar for the eCG- and FSH plus EB-treated ewes (P > 0.05). In Experiment III (breeding season), the treatments were: 300 IU eCG; 250 µg estradiol cypionate; 250 µg EB; or control (n = 22). Follicular growth was greater for eCG-treated ewes within 0-24 h and for control ewes within 48-72 h (P = 0.001). Although estrous and ovulation rates did not differ (P > 0.05), all eCG-treated ewes had ovulations. During the non-breeding season, FSH treatment promoted follicular growth but did not induce ovulations. For FTAI regimens, eCG was more effective than FSH plus GnRH and estradiol esters in inducing estrus and ovulation.

The bioactivity of neuronal-derived nitric oxide in aging and neurodegeneration: Switching signaling to degeneration.

The small and diffusible free radical nitric oxide (•NO) has fascinated biological and medical scientists since it was promoted from atmospheric air pollutant to biological ubiquitous signaling molecule. Its unique physical chemical properties expand beyond its radical nature to include fast diffusion in aqueous and lipid environments and selective reactivity in a biological setting determined by bioavailability and reaction rate constants with biomolecules. In the brain, •NO is recognized as a key player in numerous physiological processes ranging from neurotransmission/neuromodulation to neurovascular coupling and immune response. Furthermore, changes in its bioactivity are central to the molecular pathways associated with brain aging and neurodegeneration. The understanding of •NO bioactivity in the brain, however, requires the knowledge of its concentration dynamics with high spatial and temporal resolution upon stimulation of its synthesis. Here we revise our current understanding of the role of neuronal-derived •NO in brain physiology, aging and degeneration, focused on changes in the extracellular concentration dynamics of this free radical and the regulation of bioenergetic metabolism and neurovascular coupling.

Automatização em nutrição parentérica: controlo de qualidade antes e após a sua implementação / Automation in parenteral nutrition: quality control of the process before and after it`s implementation

A nutrição parentérica (NP) desempenha um papel vital em doentes críticos, sendo muitas vezes necessária a sua preparação personalizada, ajustada às necessidades de doentes com carências específicas. A manipulação de NP poderá ser realizada de forma manual ou automatizada, requerendo sempre condições asséticas e pessoal treinado. A implementação de um sistema automatizado requer uma análise cuidada da sua necessidade/justificação, de forma a que, baseado em fundamentação adequada, se estruture um plano exequível. A monitorização do desempenho do sistema automatizado é um processo fundamental de validação farmacêutica. Nos Serviços Farmacêuticos (SF) do Centro Hospitalar e Universitário de São João (CHUSJ), elaborou-se um estudo de controlo de qualidade gravimétrico antes e após implementação do sistema automatizado, no sentido de monitorizar a precisão dos resultados obtidos para este ensaio de verificação. Como resultados estatísticos, o método de enchimento automatizado relacionou-se com a menor média para o desvio ao peso teórico, assim como menor desvio padrão, corroborando uma menor percentagem de erro e também uma menor dispersão dos resultados. Da análise dos resultados obtidos concluiu-se que a implementação da automatização se traduziu em melhorias a nível de precisão de resultados para o controlo gravimétrico das bolsas nutritivas, aumentando a segurança das misturas produzidas e, consequentemente, a qualidade dos cuidados prestados ao doente. É de elevada importância que se implementem procedimentos de validação do desempenho do sistema automatizado, como foi o caso, sendo que deverão ser complementados com outro tipo de avaliações, preferencialmente realizadas por entidades externas à instituição em causa. (AU)

Parenteral nutrition (PN) plays a vital role in critically ill patients and custom preparation is often necessary, adjusted to the needs of patients with specific needs. Compounding PN handling can be performed manually or automated, always requiring aseptic conditions and trained personnel. The implementation of an automated system requires a careful analysis of its need/ justification, so that, based on adequate rationale, a feasible execution plan may be structured. Monitoring the performance of the automated system is a key process which requires of pharmaceutical validation. In the Pharmaceutical Service of the Centro Hospitalar e Universitário de São João (CHUSJ), a study of gravimetric quality control was carried out before and after the implementation of the automated system, in order to monitor the accuracy of the results obtained for this verification test. As statistical results, the automated filling method was related to the lower average for the deviation to the theoretical weight, as well as lower standard deviation, corroborating a lower percentage of error but also a smaller dispersion of the results with this method. From the analysis of the results obtained, it was concluded that the implementation of automation resulted in improvements in the accuracy of results for the gravimetric control of nutritional bags, increasing the safety of the mixtures produced and, consequently, the quality of care provided to the patient. It is of highly importance that procedures for validating the performance of the automated system are implemented, as was the case, and these should be complemented by other types of evaluations, preferably performed by external entities to the institution in question. (AU)

Evaluation of the malaria elimination policy in Brazil: a systematic review and epidemiological analysis study.

After a centenary fight against malaria, Brazil has seen an opportunity for change with the proposal of the malaria elimination policy set by the Brazilian government, in line with malaria elimination policies in other Latin American countries. Brazilian malaria experts regard eliminating malaria by 2030 to be within reach. Herein we evaluated the likelihood that malaria elimination can be accomplished in Brazil through systematic review of the literature on malaria elimination in Brazil and epidemiological analysis. Fifty-two articles referring to malaria eradication/elimination in Brazil were analyzed to identify challenges and technological breakthroughs for controlling malaria. Monthly deaths (1979-2016) and monthly severe malaria cases (1998-2018) were analyzed according to age groups, geographic region and parasite species. As a result, we observed that the declining malaria burden was mostly attributable to a decline in Plasmodium falciparum-malaria. At the same time, the proportional increase of Plasmodium vivax-malaria in comparison with P. falciparum-malaria was notable. This niche replacement mechanism was discussed in the reviewed literature. In addition, the challenges to P. vivax-malaria elimination outnumbered the available technological breakthroughs. Although accumulated and basic information exists on mosquito vector biology, the lack of specific knowledge about mosquito vector taxonomy and ecology may hamper current attempts at stopping malaria in the country. An impressive reduction in malaria hospitalizations and mortality was seen in Brazil in the past 3 decades. Eliminating malaria deaths in children less than 5 years and P. falciparum severe cases may be achievable goals under the current malaria policy until 2030. However, eliminating P. vivax malaria transmission and morbidity seems unattainable with the available tools. Therefore, complete malaria elimination in Brazil in the near future is unlikely.

Congenital Zika syndrome is associated with maternal protein malnutrition.

Zika virus (ZIKV) infection during pregnancy is associated with a spectrum of developmental impairments known as congenital Zika syndrome (CZS). The prevalence of this syndrome varies across ZIKV endemic regions, suggesting that its occurrence could depend on cofactors. Here, we evaluate the relevance of protein malnutrition for the emergence of CZS. Epidemiological data from the ZIKV outbreak in the Americas suggest a relationship between undernutrition and cases of microcephaly. To experimentally examine this relationship, we use immunocompetent pregnant mice, which were subjected to protein malnutrition and infected with a Brazilian ZIKV strain. We found that the combination of protein restriction and ZIKV infection leads to severe alterations of placental structure and embryonic body growth, with offspring displaying a reduction in neurogenesis and postnatal brain size. RNA-seq analysis reveals gene expression deregulation required for brain development in infected low-protein progeny. These results suggest that maternal protein malnutrition increases susceptibility to CZS.

Efeito da somatotropina bovina recombinante (rbST) na produção in vivo e na maturação in vitro de oócitos bovinos da raça Sindi / Effect of recombinant bovine somatotropin (rbST) on the in vivo production and in vitro maturation of bovine oocytes of the Sindi breed

A fim de avaliar o efeito de diferentes doses da rbST sobre a dinâmica folicular, a produção e a maturação in vitro de oócitos, 20 vacas Sindi, divididas em três grupos, receberam um dispositivo de progesterona intravaginal, estradiol e PGF2α, além de 2mL de solução salina (grupo controle), 250 (grupo rbST 250) ou 500mg de rbST (grupo rbST 500). Cinco dias depois, realizou-se a ovum pick up, e os complexos cumulus-oócitos (CCOs) recuperados foram selecionados, classificados e maturados in vitro. Os dados de contagem foram comparados pelo procedimento glht (General Linear Hypothesis Test), e os dados em porcentagem foram submetidos ao qui-quadrado, no programa estatístico R, onde as diferenças foram consideradas significativas quando P<0,05. Não houve diferença (P>0,05) entre os grupos quanto à quantidade de folículos e à taxa de maturação. Os grupos rbST 250 e rbST 500 foram significativamente superiores (P<0,05) ao grupo controle em relação ao número de folículos grandes (0,42±0,20 vs. 0). O grupo rbST 500 apresentou maior (P<0,05) porcentagem de oócitos viáveis (91,52%) do que os grupos controle (67,85%) e rbST 250 (53,33%). A rbST aumenta o número de folículos grandes, e 500mg de rbST aumentam a porcentagem de oócitos viáveis em vacas Sindi.(AU)

In order to evaluate the effect of different doses of rbST on the follicular dynamics, production, and in vitro maturation of oocytes, 20 Sindhi cows were divided into three groups, receiving an intravaginal progesterone device, estradiol and PGF2α, and 2mL of solution saline (Control Group), 250 (rbST 250 Group) or 500mg rbST (rbST 500 Group). Five days later, the ovum pick up was performed, and the cumulus-oocyte (CCO) complexes recovered were selected, classified, and matured in vitro. The counting data were compared by the glht (General Linear Hypothesis Test) procedure, and the percentage data were submitted to Qui- square, in the statistical program R, where differences were considered significant when P< 0.05. There was no difference (P> 0.05) between the groups regarding follicle quantity and maturation rate. The rbST 250 and rbST 500 groups were significantly higher (P< 0.05) than the Control group in relation to the number of large follicles (0.42±0.20 versus 0). The rbST 500 group presented higher (P< 0.05) percentage of viable oocytes (91.52%) than the Control (67.85%) and rbST 250 (53.33%) groups. rbST increases the number of large follicles and 500mg rbST increases the percentage of viable oocytes in Sindhi cows.(AU)

Evaluation of the malaria elimination policy in Brazil: a systematic review and epidemiological analysis study

@#After a centenary fight against malaria, Brazil has seen an opportunity for change with the proposal of the malaria elimination policy set by the Brazilian government, in line with malaria elimination policies in other Latin American countries. Brazilian malaria experts regard eliminating malaria by 2030 to be within reach. Herein we evaluated the likelihood that malaria elimination can be accomplished in Brazil through systematic review of the literature on malaria elimination in Brazil and epidemiological analysis. Fifty-two articles referring to malaria eradication/elimination in Brazil were analyzed to identify challenges and technological breakthroughs for controlling malaria. Monthly deaths (1979–2016) and monthly severe malaria cases (1998–2018) were analyzed according to age groups, geographic region and parasite species. As a result, we observed that the declining malaria burden was mostly attributable to a decline in Plasmodium falciparum-malaria. At the same time, the proportional increase of Plasmodium vivax-malaria in comparison with P. falciparum-malaria was notable. This niche replacement mechanism was discussed in the reviewed literature. In addition, the challenges to P. vivax-malaria elimination outnumbered the available technological breakthroughs. Although accumulated and basic information exists on mosquito vector biology, the lack of specific knowledge about mosquito vector taxonomy and ecology may hamper current attempts at stopping malaria in the country. An impressive reduction in malaria hospitalizations and mortality was seen in Brazil in the past 3 decades. Eliminating malaria deaths in children less than 5 years and P. falciparum severe cases may be achievable goals under the current malaria policy until 2030. However, eliminating P. vivax malaria transmission and morbidity seems unattainable with the available tools. Therefore, complete malaria elimination in Brazil in the near future is unlikely.

Cervical vertebral osteomyelitis secondary to Streptococcus equi infection in an adult horse - case report / Osteomielite vertebral cervical secundária à infecção por Streptococcus equi em um cavalo adulto - relato de caso

A 15-year-old, mixed breed, male horse was attended with a history of multiple abscesses in the cervical region with a three-year evolution. Upon admission, three fistulous tracts with drainage of purulent secretions in the cervical region, low body score, restriction of cervical movements, and painful sensitivity to palpation were observed. The horse was diagnosed with osteomyelitis secondary to Streptococcus equi infection. The initial treatment was antibiotic therapy and local curative. Owing to the lack of response, surgical debridement was performed. An initial favorable response was observed; however, after 4 months, drainage recurred, and the animal was euthanized. A post-mortem computed tomography scan was performed to obtain details of the injury. Cervical osteomyelitis is rare, and its occurrence through hematogenous spread in adult horses and the tomographic findings had not been reported previously. The long period of evolution, difficulty in performing an aggressive debridement, and the presence of multi-drug resistant bacteria contributed to the negative outcome.(AU)

Um equino macho, sem raça definida, de 15 anos de idade, foi atendido com histórico de múltiplos abscessos cervicais com evolução de três anos. Na admissão, foram observados: três trajetos fistulosos com drenagem de material purulento na região cervical; baixo escore corporal; restrição de movimentos cervicais; e sensibilidade dolorosa à palpação da região. Foi diagnosticada osteomielite vertebral cervical secundária à infecção por Streptococcus equi. O tratamento inicial consistiu na administração de antibióticos e curativo local. Na ausência de resposta à terapia, realizou-se o debridamento cirúrgico. Inicialmente, obteve-se uma resposta favorável, entretanto, após quatro meses, houve recidiva da lesão e o animal foi submetido à eutanásia. Realizou-se tomografia computadorizada no post mortem para detalhamento da lesão. A osteomielite vertebral cervical é rara, e sua ocorrência por meio de disseminação hematógena em animais adultos não foi previamente reportada. O longo período de evolução, aliado à dificuldade de realização de um debridamento agressivo, e a característica multirresistente do agente etiológico contribuíram para o desfecho negativo do caso.(AU)