Caprine lentivirus in sheep milk and semen / Lentivírus caprino em leite e sêmen de ovinos

With the objective of detecting the presence of caprine lentivirus (CLV) in ewe milk and in ram semen, ten matrixes and four reproducers experimentally infected with CLV were used. Samples of ewe milk were collected during the four months of lactation, five collections per animal, totaling 50 samples. Regarding the rams, eight semen collections were made per animal, during one year of experimentation, totaling 32 samples. The milk and semen samples were submitted to DNA extraction and the nested polymerase chain reaction test (nPCR) to detect CLV proviral DNA. Eight (16%) of the milk samples were positive in nPCR originating from two ewes. Only one (3.12%) semen sample was positive. The amplification products were sequenced, and were confirmed to be a CLV genomic sequence. Thus, the presence of CLV proviral DNA in sheep milk and semen was demonstrated, confirming the feasibility of infection between species, and alerting to the risk of spreading infections.(AU)

Com o objetivo de detectar a presença do lentivírus caprino (LVC) no leite de ovelhas e no sêmen de carneiros, utilizaram-se 10 matrizes e quatro reprodutores infectados experimentalmente com o LVC. Foram coletadas amostras de leite das ovelhas durante os quatro meses de lactação, ocorrendo cinco coletas por animal, totalizando 50 amostras. Quanto aos carneiros, realizaram-se oito coletas de sêmen por animal, durante um ano de experimentação, totalizando 32 amostras. As amostras de leite e de sêmen foram submetidas à extração de DNA e à prova de reação em cadeia da polimerase do tipo nested (nPCR) visando à detecção de DNA proviral do LVC. Oito (16%) amostras de leite foram positivas na nPCR oriundas de duas ovelhas. Apenas uma (3,12%) amostra de sêmen apresentou positividade. Produtos da amplificação foram sequenciados, confirmando-se tratar de sequência genômica do LVC. Dessa forma, demonstrou-se a presença do DNA proviral do LVC em leite e sêmen de ovinos, confirmando a viabilidade da infecção entre espécies e, assim, alertando sobre o risco de que a infecção seja disseminada.(AU)

Identificação de Mycobacterium bovis em carcaças de bovinos abatidos no estado da Bahia, Brasil, por métodos bacteriológico e molecular / Identification of Mycobacterium bovis in carcasses of cattle slaughtered in Bahia state, Brazil by bacteriological and molecular methods

O objetivo do presente trabalho foi utilizar métodos bacteriológicos e moleculares para a identificação do Mycobacterium bovis em lesões observadas em carcaças de bovinos durante a inspeção post mortem de rotina em matadouros-frigoríficos com serviço de inspeção oficial. Foram acompanhados o abate e a inspeção de 825.394 bovinos, sadios, ao exame ante mortem pelo serviço de inspeção oficial em 10 matadouros-frigoríficos do estado da Bahia, entre abril de 2009 e abril de 2012. Cento e oitenta bovinos apresentaram lesões sugestivas de tuberculose e outras linfadenites, as quais foram avaliadas quanto à presença de Mycobacterium bovis por exame bacteriológico e pela PCR multiplex. A maioria das lesões estava localizada em linfonodos do trato respiratório e 71% eram provenientes de bovinos machos com até 32 meses de idade. No isolamento bacteriano, 13,9% (25/180) das amostras apresentavam colônias pequenas, de superfície granular e de coloração creme-amareladas, em meio de cultura Stonebrink-Leslie, e o crescimento médio foi de 34 dias. Todos os esfregaços dos isolados evidenciaram BAAR, e, pela PCR multiplex, 56% (14/25) dos isolados foram identificados como M. bovis. A associação entre exame post mortem, bacteriológico e PCR multiplex permitiu a identificação do agente de forma rápida e em regiões com status sanitário de baixa prevalência, demonstrando ser importante para a detecção dos focos de tuberculose bovina e o auxílio nos programas de controle e erradicação da tuberculose...

The aim of the present study was to perform bacteriological and molecular methods for identification of Mycobacterium bovis in lesions derived from bovine carcasses detected during routine post-mortem examination in officially inspected slaughterhouses. We checked the slaughter and inspection of 825,394 bovines, health upon ante-mortem examination, by the official service in 10 slaughterhouses of Bahia state from April, 2009 to April 2012. Lesions suggestive of tuberculosis were collected from 180 bovines and further evaluated by bacteriology and multiplex PCR. The majority of lesions were located in the respiratory tract lymph nodes and 71% were from male bovines up to 32 months old. 13.9% of samples presented small, granular and creamy-yellowish colonies after being cultured in Stonebrink-Leslie with an average growth time of 34 days. All smears from the isolated samples were Acid Fast Bacilli (AFB) and among them 56% were identified by mPCR as M. bovis. Thus, the association between post-mortem examination, culture and multiplex PCR allowed the bacillus identification in a reduced time and in regions of low prevalence, pointing out its importance for bovine tuberculosis detection and as a supportive tool for the tuberculosis control and eradication program...

Frequência de anticorpos contra o vírus da língua azul em ovinos do estado do Ceará, Brasil / Antibodies against the bluetongue virus in sheep flocks of Ceará state, Brazil

O objetivo deste trabalho foi avaliar a ocorrência de ovinos soropositivos para o vírus da línguaazul (VLA) no Estado do Ceará, Brasil, e analisar as proteínas imunogênicas das cepas virais circulantes nesses rebanhos. O teste de imunodifusão em gel de agarose (IDGA) foi utilizado para pesquisar 271 amostras de soro oriundas de 16 rebanhos. Os resultados demonstraram que 27,3% (74/271) das amostras analisadas apresentaram anticorpos contra o agente e 68,8% (11/16) das propriedades tiveram animais positivos. O immunoblotting (IB) foi utilizado para analisar as proteínas imunogênicas do VLA a partir dos soros de animais positivos no IDGA. Os soros demonstraram forte reação contra a proteína viral VP2. Para o VLA, das sete proteínas estruturais, a VP2 é a principal a estimular a resposta imune protetora. Concluiu-se que a soropositividade para a língua azul (LA) nos rebanhos ovinos estudados no Ceará é alta, apesar dos animais não apresentarem sinais clínicos, indicativo de que o vírus ocorra de forma endêmica. Além disso, a resistência à doença apresentada pelos animais pode estar relacionada com a forte reação imunológica desses à proteína VP2. Sendo assim, outros estudos são necessários para melhor esclarecer a situação epidemiológica da LA no país, através da identificação dos vetores e sorotipos virais circulantes nas diferentes regiões.

Antibodies against the bluetongue virus in sheep flocks of Ceará state, Brazil. The objective of this work was to verify the occurrence of sheep serologically positive for bluetongue virus (BTV) in the state of Ceará, Brazil, and analyze immunogenic proteins of circulating viral strains in these flocks. The agar gel immunodifusion test (AGID) was used to examine 271 serum samples from 16 herds. The results demonstrated that 27.3% (74/271) ofthe analyzed samples presented antibodies for the agent, and that 68.8% (11/16) of the propertiespresented positive animals. Immunoblotting (IB) was used to analyze the immunogenicproteins of BTV derived from AGID positive sera. Sera showed strong reaction against viral protein VP2. Of the seven BTV structural proteins, VP2 is the major protein to elicit protective immuneresponses. It was concluded that bluetongue (BT) seropositivity in sheep flocks studied in Ceará is high, despite that the animal's do not show clinical signs, indicating that it occurs in an endemic form. The animals’ resistance to the disease may be related to the strong immune response to the protein VP2. Therefore, further studies are needed to better clarify the epidemiological situation of BT in Brazilian sheep flocks, through the identification of viral vectors and serotypes circulating in different regions.

Anticorpos contra o vírus da língua azul em rebanhos ovinos da microrregião de Juazeiro, Bahia / Antibodies against the bluetongue virus in sheep flocks of Bahia state, Brazil

O objetivo desta pesquisa foi verificar a frequência de ovinos soropositivos para o vírus da língua azul na microrregião de Juazeiro, Bahia. O teste de imunodifusão em gel de ágar (IDGA) foi utilizado para pesquisar 469 amostras de soro oriundas de 58 rebanhos. Durante as colheitas, um questionário foi aplicado a cada criador a fim de se obter dados sobre o sistema de criação e correlacioná-los com a sorologia. Os resultados demonstraram que 0,43% (2/469) das amostras analisadas apresentaram anticorpos contra o agente. Esta região é caracterizada pelo clima semiárido e pela predominância do tipo de exploração extensiva, com presença de animais nativos, mestiços e sem raça definida para produção de carne e pele, com baixa produtividade e tecnificação.

The objective of this work was to verify the frequency of sheep with positive serology for Bluetongue virus in the micro-region of Juazeiro, Bahia State, Brazil. The agar gel immunodifusion test (AGID) was used to examine 469 serum samples of 58 herds. During collection, an epidemiological questionnaire was applied to each farmer. The results demonstrated that 0.43% (2/469) of the analyzed samples presented antibodies for the agent. This region is characterized by a semi-arid climate, and the predominant livestock management system is the extensive one, with a presence of native and crossbred animals, aiming at the production of meat and fleece, with low productivity and technification.

Small rodents fleas from the bubonic plague focus located in the Serra dos Orgãos Mountain Range, State of Rio de Janeiro, Brazil.

Eleven species of fleas were collected from 601 small rodents, from November 1995 to October 1997, in areas of natural focus of bubonic plague, including the municipalities of Nova Friburgo, Sumidouro and Teresópolis, State of Rio de Janeiro, Brazil. Among 924 fleas collected, Polygenis (Polygenis) rimatus (Rhopalopsyllidae) was the predominant species regarding the frequency, representing 41.3% (N:382), followed by P. (Neopolygenis) pradoi, representing 20% (N:185) and Craneopsylla minerva minerva (Stephanocircidae), representing 18.9% (N:175). The host Akodon cursor harbored 47.9% of these fleas. Other six host species were infested by 52.1% of the remaining fleas. Fleas were found on hosts and in places within the focus not previously reported by the literature.

[Intestinal entomothoramycosis: report of a case]. / Entomoftoromicose intestinal: relato de caso.

A case of intestinal entomophthoramycosis caused by Entomophthorales in a man with 19 years-old, farmer and without associated disease. The patient was submitted to a intestinal resection and diagnosis was carried through after analysis of the surgical specimen. After a review of the literature, the clinical evolution, clinico-pathologic features, difficulties in diagnosis and treatment are discussed.

[Acute cerebrovascular disorder and arterial hypertension. Prospective study with 248 patients]. / O acidente vascular cerebral agudo e a hipertensão arterial. Estudo prospectivo com 248 doentes.

OBJECTIVE: To evaluate the hypertension associated to different types and sub-types of cerebrovascular disease (stroke), with particular reference to the frequency of hypertension, the values of blood pressure, the risk factors and the involvement of other target organs. DEFINITION: Prospective study in 248 patients with acute stroke admitted to a Clinical Medicine Unit in three independent time periods. SETTING: Internal Medicine Clinic of University Hospital in Lisbon. METHODS: Medical, neurological and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a computer tomography scan of the brain, and an echocardiogram. The values of blood pressure were measured in the admission at the urgent service and 24 h after in the the ward. We identified three sub-types of stroke: intracerebral hemorrhage (IH), ischaemic stroke (IS) and lacunes (L). For each sub-type and for those with hypertension or not, we evaluated: age, sex, duration of stay in hospital and mortality. We also compared for each sub-type the values of blood pressure, the risk factor and the repercussion on other target organs. PATIENTS: Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years, and ages among 40 and 92 years. Thirty-seven patients (15%) died. MAIN RESULTS: In the entire population (n = 248) hypertension were more prevalent in IH 83% and L 82% than in IS 59% (p < 0.0005). Hypertension was present in 172 patients (69%) and 81 (47%) were IS, 58 (34%) L and 33 (19%) IH. Sixty six percent of the 172 patients with hypertension had at least another risk factor and the most aged ones (> 65 years old) were more frequent in IS 75% than in HI 45% or L 58% (p < 0.001). For all subtypes blood pressure measurements were higher in admission than in ward and they were also higher in IH than in IS (p < 0.05). Hypertensive cardiopathy was more prevalent in IH 76% and L 61% than in IS 49% (p < 0.05). Renal failure was more frequent in IS 37% than in IH 28% and L 17% (p < 0.05). CONCLUSIONS: Hypertension is very frequent, and like advanced age is a major risk factor of stroke. Hypertension is frequently associated with one or more risk factors. Hypertensive cardiopathy is more related with IH and L and the renal involvement with IS.

[Harlequin fetus]. / Feto arlequim.

The authors show a typical case of harlequin fetus. After a description of the gross features found in a male newborn, several aspects concerning genetics, physiopathology, diagnosis, treatment and prognosis are discussed.

[Acute cerebrovascular accident and heart disease. Prospective study of 248 patients]. / O acidente vascular cerebral agudo e a doença cardíaca. Estudo prospectivo com 248 doentes.

OBJECTIVE: To evaluate the heart disease associated to different type and sub-types of cerebrovascular disease with particular reference to potential cardiac sources of embolus (CPE). DESIGN: Prospective study in 248 consecutive patients with acute stroke, admitted to a Clinical Medicine Unit in three independent time periods. SETTING: Internal Medicine Clinic of University Hospital in Lisbon. METHODS: Neurologic and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a Computer Tomography Scan of the brain (TAC) and a Echocardiogram (ECO). We identified two types and two sub-types: intracerebral haemorrhage (HI) or ischemic stroke (AI) and among AI, cortical (C) or subcortical (SC) ischemic stroke. For each type and sub-type we evaluated past history, heart disease, hypertension (HTA), electrocardiogram, echocardiogram (ECO) and CPE. PATIENTS: Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years and ages between 40 and 92 years. Thirty seven (15%) died. MAIN RESULTS: Eighty four percent were AI and among them 45% were C. Previous strokes were more prevalent in AI 29% (p < 0.01). There was heart disease in 81% and hypertensive cardiopathy was more frequent in HI 63% (p < 0.002). HTA and atrial fibrillation (FA) were more frequent in HI 83% (p < 0.05) and in AI 25% (p < 0.004) respectively. ECO showed a dilatation of left atrium more frequent in AI 28% (p < 0.05) and left ventricular concentric hypertrophy index (IHCE) in HI 50% (p < 0.05). CPE, including FA, was identified in 34% of patients, was more prevalent in AI 38% (p < 0.001) and among it FA was significantly more frequent in C 32% (p < 0.02). CONCLUSIONS: Heart disease is very frequent in stroke. The diagnosis of this condition is very important for stroke prophylaxis and prognosis. HTA and hypertensive cardiopathy have a great prevalence and were more related to HI. CPE and FA were very frequent and their diagnosis are important for prevention of AI and specially for embolic stroke. ECO is useful to identify CPE in elderly patient in particular to characterize heart disease.

[Blood glucose and insulin in arterial hypertension. The elderly hypertensive patient]. / Glicemia e insulinemia na hipertensão arterial. Em destaque o hipertenso idoso.

The clinical importance of relationship between insulin resistance, hyperinsulinemia and high blood pressure is not yet fully understood. The aim of this study was to evaluate the influence of age in the relation between hyperglycemia, hyperinsulinemia and hypertension (HT). Two groups of patients with moderate to severe essential hypertension, aged < 65 (n = 40) and > or = 65 (n = 55) were compared with two other groups of normotensive subjects (NT) matched for sex (n = 14) and age (n = 18). The radioimmunoassay method and glucose oxidase methods were used to evaluate plasma insulin and plasma glucose concentrations. The global analysis shows: The plasma glucose level was significantly lower (p < 0.02) in NT group (n = 32; glycemia: 67.52 +/- 44 mg/dl) than in the HT group (n = 95; glycemia: 86.25 +/- 34.7 mg/dl. Further more the plasma insulin level in NT (3.37 +/- 3.18 microU/ml) was also lower than in HT (4.29 +/- 3.08 microU/ml) although without statistical significance. The patients (HT) aged < 65 years old had higher glycemia (85.76 +/- 26.8 mg/dl) and insulinemia (4.92 +/- 3.56) than NT of same age (glycemia: 59.0 +/- 11.8 mg/dl, insulinemia: 2.86 +/- 1.86), respectively p < 0.001 and p < 0.05. In HT aged > or = 65 the glycemia (82.38 +/- (9.67 mg/dl) was higher than in the NT matched group (65.5 +/- 20.36 mg/dl), p < 0.01, but plasma insulin was not different in the two groups (3.88 +/- 2.63 and 3.80 +/- 2.27 microU/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

[Automatic measurement of arterial pressure]. / Medição automática da pressão arterial.

Whenever we have a new technique for the measurement of Blood Pressure (BP), variations to standard devices should be expected. Recent guidelines for measurement and validation of automatic devices by Scientific Societies should be followed if doctors want to improve the accuracy of readings, avoiding mistakes in the diagnosis and monitoring of hypertension. To characterize the variability and reproducibility of the DINAMAP (Dynamic Automatic Mean Arterial Pressure), a random comparison with two observers (A; B) between this device and the sphygmomanometer was performed in a group of 80 patients with different pathologies. To evaluate the variability and reproducibility in the same person we analysed as well the mean variation in a setting of successive readings in 3 persons. The global correlation was good for both systolic (r = 0.9) and diastolic pressures. The behaviour of the DINAMAP for different pressure levels was obtained by the regression analyses of the pressures differences between both devices. The best correlation is found around the 140 mmHg measurements, pressures above or under this level are respectively underestimated and undervalued. We discuss the needs of a standard statistical methodology with physiological meaning for the analysis which enables to understand the multiple variations that doctors can find when performing the comparison tests.

[Delayed-action calcium antagonists and therapy of arterial hypertension]. / Antagonistas do cálcio de acção prolongada e terapêutica da hipertensão arterial.

Drug treatment of high blood pressure had important improvements is the last few decades, that allowed an efficiente control of hypertension, avoiding or stabilysing cardiovascular consequences. Non pharmacological management is always important; however most hypertensive patients need also drug treatment that is unavoiable in severe and in most cases of moderate hypertension. Borderline hypertension involves difficult decisions. Quantitative diagnosis of high blood pressure has been based on casual measurement. Non invasive ambulatory blood pressure measurement gives access to much more valures over the whole day and night periods, and has been an important tool for clinical research. However it implicates a correct assessment of the device's accuracy and calibration, and also a correct statistical treatment of the huge range of values obtained. Blood pressure control over the 24 hours is probably obtained with some long acting drugs. So, calcium antagonista are reviewed, exemplofying with slow release diltiazem. It has been prescribed twicely a day, and more recently once a day, what is considered by some authors quite adequate on the point of view of pharmacocinetics and pharmacodynamics. So the benefits depending on patient's compliance and the possible obliteration of hypertensive spikes may be important. There is perhaps, in the overall, reduction of health care costs, in what concerns hypertension.

[Hypertensive cardiopathy. Functional evaluation during isometric effort after regression of left ventricular hypertrophy]. / Cardiopatia hipertensiva. Avaliação funcional durante esforço isométrico após regressão da hipertrofia ventricular esquerda.

OBJECTIVE: Echocardiographic evaluation of the response to isometric exercise of hypertensive patients with and without left ventricular hypertrophy. PARTICIPANTS: 28 patients with severe arterial hypertension on long-term follow-up with or without regression of left ventricular hypertrophy on medical therapy; a control group of 10 healthy volunteers. METHODS: Two groups were considered: Group A persistent left ventricular hypertrophy and group B normalization of the left ventricular wall thickness and mass index. The arterial blood pressure and heart rate were evaluated and an echocardiographic record was obtained both at rest and after isometric exercise (maximal effort for 1 to 1.5 minutes). The following echocardiographic data were obtained: left ventricular diameters and thickness of septum and posterior wall during systole and diastole. Volumes, shortening and ejection fractions, cardiac output and index, mass index, end-systolic stress, contractility index and periferal resistance were calculated as usual. RESULTS: During isometric exercise there was a rise in systolic, diastolic and mean arterial pressures and heart rate. Systolic function was normal in all groups at rest. The shortening fraction was not altered in normotensive individuals with isometric exercise. Hypertensive patients showed a significant reduction within normal limits, however. End-systolic stress increased significantly in all groups although the rise was greater in hypertensive patients. The cardiac index rose significantly only in normotensives and hypertensive patients without left ventricular hypertrophy (group B). On the contrary the periferal resistance rose significantly only in hypertensive patients with left ventricular hypertrophy (group A). The contractility index (end-systolic stress/end-systolic volume index) increased significantly only in normotensive and hypertensive patients without left ventricular hypertrophy. CONCLUSIONS: There are functional alterations in hypertensive heart disease which although not evident at rest, can be revealed by isometric exercise. The regression of left ventricular hypertrophy back to normal, sets a trend for normalization of function and cardiac inotropic reserve, suggesting the importance of a complete regression of ventricular hypertrophy.

[Arterial hypertension and the right heart. A hemodynamic and echocardiographic study]. / Hipertensão arterial e coração direito. Estudo hemodinâmico e ecocardiográfico.

OBJECTIVE: To evaluate the effects of arterial hypertension on the pulmonary circulation and the right heart. SETTING: Coronary Care Unit (UTIC Arsénio Cordeiro) Hemodynamics Laboratory and Medicine I Echocardiography Laboratory-Santa Maria Hospital. PARTICIPANTS: 38 hypertensive patients separated in two groups: 24 with thickened septum and left ventricular posterior wall (10 with hemodynamic evaluation)--Group A--and 14 without thickening--Group B; a control group of 12 healthy volunteers--Group C. RESULTS: The hypertensive patients with hemodynamic evaluation had normal pulmonary capillary wedge pressure the average pulmonary resistance (135.29 +/- 63.47 dyn.cm.5), pulmonary systolic (31.30 +/- 10.01 mmHg) and mean pressures (18.23 +/- 8.21 mmHg) were raised, but the diastolic pulmonary pressure was normal. The right ventricle systolic pressure was raised (32.10 +/- 9.12 mmHg) and there was no modification of the right atrial or ventricular telediastolic pressures. On echocardiography there was a diastolic thickening of the right ventricular free wall in both group A (7.08 +/- 1.41 mm) and B (4.07 +/- 1.00 mm) as compared to group C (3.08 +/- 0.51 mm); there were similar findings regarding systolic thickness with statistical significance in group A (p less than 0.001). The right ventricular ejection fraction was normal in both groups. There was a positive correlation between the diastolic thickness of left ventricular posterior wall and right ventricular free wall in hypertensive patients and normotensive volunteers (r = 0.7754; p less than 0.001). CONCLUSIONS: The findings suggest an anatomic an functional relationship between both ventricles regarding the cardiac repercussions of arterial hypertension.

[Arterial pressure and race. A study in pauper children attending schools in an urban strip in Lisbon]. / Pressão arterial e raça. Um estudo em crianças pobres de escolas duma franja urbana de Lisboa.

OBJECTIVE: To determine whether race is a factor of blood pressure levels in school-age children of similar social status, and to investigate other potential determinants of the levels of blood pressure. DESIGN: Inquiry in schools of the suburbs of Lisbon. SETTING: Three schools, four medical observers (general practitioners with school-health functions). SUBJECTS: Three hundred ninety seven children, aged 6-14 years, both sexes, 296 being white and 101 non-white. INTERVENTIONS: Inquiry to the following individual characteristics--sex, age, race, birthplace, type of housing, house availability of water, electricity and waste water, type of transportation to school, number of cohabitans, family income, school marks. Individual determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), weight and height. MEASUREMENTS AND MAIN RESULTS: Blood pressure values were cross-analyzed with all the determined variables, and the virtual correlations were checked. Main results as follows: Race does not influence either SBP or DBP. In this age group, sex does not influence blood pressure values. The used markers of socioeconomical status have equally no influence on blood pressure. Age has only a significant repercussion on SBP. No significant correlation was found between height and blood pressure. Body weight, however, influence either SBP or DBP. SBP was found to be lower in the second of two successive measurements, and the difference increases with age. CONCLUSIONS: In this school-aged biracial population, body weight seems to be the major factor of blood pressure levels, in the sense-bigger weight, higher SBP and DBP.

[Ambulatory monitoring of blood pressure. Validation of a method]. / Medicação ambulatória da pressão arterial. validação do método.

Before the routine use of our ambulatory blood pressure (ABP) device, we did the correlation analysis of 153 pairs of blood pressure measurements within the ABP and gold-standard sphygmomanometer. We got a good correlation but a systematic statistical error about less 7 mmHg on systolic measurement and 11 mmHg on diastolic measurement by the ABP device. The different qualities found among the devices that we have in the market, lead to the proposal of protocols of validation in the premarketing and periodic quality assessment by the clinics.