Systemic and Gastrohepatic Mucormycosis in Dogs.

We describe two cases of mucormycosis with systemic and gastrohepatic involvement in two male poodles. Respiratory, neurological and gastrointestinal signs progressed to death within 3 and 19 days of the onset of clinical signs, respectively. In case 1, there was systemic disease affecting the lungs, heart and brain. The lesions were characterized by yellow or red, raised, irregular areas that extended into deeper tissue from the surface. In case 2, there was gastric rupture; the margins of the rupture and the gastric mucosa were covered by a thick, white, friable material. In the liver, there were multiple yellow-white cavitated nodules. Histologically, pyogranulomas occurred in the affected organs and were associated with vasculitis, thrombosis and fungal hyphae. The diagnosis of mucormycosis was based on the characteristic microscopical lesions together with the morphology and staining features of the fungus. The hyphae were strongly labelled by monoclonal antibody specific for Rhizopus arrhizus on immunohistochemistry. Underlying immunosuppression was suspected in both cases.

Effect of an educational booklet for prevention and treatment of foot musculoskeletal dysfunctions in people with diabetic neuropathy: the FOotCAre (FOCA) trial II, a study protocol of a randomized controlled trial.

BACKGROUND: This study is a part of a series of two clinical trials. We consider diabetic polyneuropathy (DPN), a common chronic and progressive complication of diabetes mellitus that has several impacts on individuals' foot health and quality of life. Based on the current trends of self-monitoring and self-care, providing a tool with foot-related exercises and educational care may help patients to avoid or reduce the musculoskeletal complications resulting from DPN, improving autonomous performance in daily living tasks. The aim of this trial is to evaluate the effects of an educational booklet for foot care and foot muscle strengthening on DPN symptoms and severity, clinical outcomes, and gait biomechanics in patients with DPN. METHODS/DESIGN: The FOotCAre (FOCA) trial II study has been designed as a single-blind, two-parallel-arm randomized controlled trial. It will include 48 patients with DPN who will be randomly allocated to a control (recommended foot care by international consensus with no foot exercises) group or an intervention (foot-related exercises using an educational booklet three times/week at home for 8 weeks) group. Participants from both groups will be assessed at baseline, after 8 weeks, and at 16 weeks for follow-up. The primary outcomes are the DPN symptoms and severity, and the secondary outcomes are foot-ankle kinematics, gait kinetics, plantar pressure distribution during gait, tactile and vibratory sensitivities, foot strength, functional balance, and foot health and functionality. DISCUSSION: The booklet is a management tool that allows users to be autonomous in their treatment by choosing how and where to perform the exercises. This allows the patients to perform the exercises regularly as a continuous habit for foot care and health, which is an important element in the management of the diabetic foot. As the booklet focuses on specific foot-ankle exercises, we expect that it will improve the clinical aspects of DPN and produce beneficial biomechanical changes during gait, becoming a powerful self-management tool that can be easily implemented to improve the performance of daily living tasks. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04008745. Registered on 2 July 2019.

Study protocol for a randomized controlled trial on the effect of the Diabetic Foot Guidance System (SOPeD) for the prevention and treatment of foot musculoskeletal dysfunctions in people with diabetic neuropathy: the FOotCAre (FOCA) trial I.

BACKGROUND: This study is part of a series of two clinical trials. Taking into account the various musculoskeletal alterations of the foot and ankle in people with diabetic peripheral neuropathy (DPN) and the need for self-care to avoid more serious dysfunctions and complications, a self-manageable exercise protocol that focuses on strengthening the foot muscles is presented as a potentially effective preventive method for foot and gait complications. The aim of this trial is to investigate the effect of a customized rehabilitation technology, the Diabetic Foot Guidance System (SOPeD), on DPN status, functional outcomes and gait biomechanics in people with DPN. METHODS/DESIGN: Footcare (FOCA) trial I is a randomized, controlled and parallel two-arm trial with blind assessment. A total of 62 patients with DPN will be allocated into either a control group (recommended foot care by international consensus with no foot exercises) or an intervention group (who will perform exercises through SOPeD at home three times a week for 12 weeks). The exercise program will be customized throughout its course by a perceived effort scale reported by the participant after completion of each exercise. The participants will be assessed at three different times (baseline, completion at 12 weeks, and follow-up at 24 weeks) for all outcomes. The primary outcomes will be DPN symptoms and severity classification. The secondary outcomes will be foot-ankle kinematics and kinetic and plantar pressure distribution during gait, tactile and vibration sensitivities, foot health and functionality, foot strength, and functional balance. DISCUSSION: As there is no evidence about the efficacy of rehabilitation technology in reducing DPN symptoms and severity or improving biomechanical, clinical, and functional outcomes for people with DPN, this research can contribute substantially to clarifying the therapeutic merits of software interventions. We hope that the use of our application for people with DPN complications will reduce or attenuate the deficits caused by DPN. This rehabilitation technology is freely available, and we intend to introduce it into the public health system in Brazil after demonstrating its effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04011267. Registered on 8 July 2019.

Aspectos clínicos e terapêuticos de infecção por Mycobacterium bovis em gato doméstico - relato de caso / Clinical and therapeutic aspects of infection by Mycobacterium bovis in domestic cat - case report

Este artigo tem como objetivo relatar um caso de infecção por Mycobacterium bovis em um gato doméstico, com seis meses de idade, enfatizando seus aspectos clínicos e terapêuticos. O felino apresentava como histórico a ingestão de leite de vaca não fervido e posteriormente desenvolveu sinais de anorexia, tosse não produtiva e linfadenomegalia. Para elucidação do diagnóstico, foram realizados exames complementares de imagem, hematológicos, citológicos e reação em cadeia da polimerase (PCR). Diante da confirmação de infecção por Mycobacterium, o tratamento foi instituído por meio da associação de três antimicrobianos (enrofloxacino 5mg/kg, claritromicina 10mg/kg e rifampicina 15mg/kg), por via oral, a cada 12 horas, aos quais o animal respondeu positivamente, apresentando significativa diminuição dos sinais clínicos; entretanto, após 60 dias de tratamento, foi a óbito devido a um atropelamento. Conclui-se que a realização do tratamento em gatos com tuberculose pode ocasionar melhora dos sinais clínicos e que, embora de ocorrência rara no Brasil, essa enfermidade deve ser incluída como diagnóstico diferencial das enfermidades infecciosas nessa espécie.(AU)

This article aims to report a case of Mycobacterium bovis infection in a six-month-old domestic cat, emphasizing its clinical and therapeutic aspects. The feline presented as history the intake of unboiled cow's milk and later developed signs of anorexia, non-productive cough and lymphadenomegaly. Additional imaging, hematological, cytological and polymerase chain reaction (PCR) tests were performed to elucidate the diagnosis. In the presence of Mycobacterium infection, treatment was instituted by the combination of three antimicrobials (Enrofloxacin 5mg/kg, Clarithromycin 10mg/kg, and Rifampicin 15mg/kg) orally every 12 hours, to which the animal responded positively, presenting significant decrease of the clinical signs, however after 60 days of treatment the cat died accidentally, hit by a car on the street. It is concluded that the treatment in cats affected by tuberculosis can cause improvement of clinical signs and that although rare in Brazil, this disease should be included as a differential diagnosis of infectious diseases in this species.(AU)

Síndrome de Eisenmenger em um gato / Eisenmenger syndrome in cat

A 6-month-old female, 1.0kg, uncastrated female Persian cat was brought to the Veterinary Hospital at State University of Ceara, with a history of dyspnea, prostration, hyporexia and progressive weight loss for a month. On physical examination, systolic cardiac murmur, cyanosis and dyspnea were detected. Unfortunately, the cat died during oxygen therapy. Necropsy examination revealed an increase in cardiac silhouette and ventricular septal defect of 2cm in diameter. Macroscopically the lungs were collapsed, with absent and diffusely reddish blackish crepitus, and the liver with blackish red coalescent multifocal areas, interspersed with lighter areas and lobular pattern with irregular brownish multifocal areas intercepted by brownish areas. Thus, the necropsy results together with the history and physical examination of the animal confirmed the diagnosis of Eisenmenger Syndrome, becoming the report of the first case, in a cat, in Brazil.(AU)

Fluorescent membrane markers elucidate the association of Borrelia burgdorferi with tick cell lines.

This study aimed to describe the association of Borrelia burgdorferi s.s. with ixodid tick cell lines by flow cytometry and fluorescence and confocal microscopy. Spirochetes were stained with a fluorescent membrane marker (PKH67 or PKH26), inoculated into 8 different tick cell lines and incubated at 30°C for 24 h. PKH efficiently stained B. burgdorferi without affecting bacterial viability or motility. Among the tick cell lines tested, the Rhipicephalus appendiculatus cell line RA243 achieved the highest percentage of association/internalization, with both high (90%) and low (10%) concentrations of BSK-H medium in tick cell culture medium. Treatment with cytochalasin D dramatically reduced the average percentage of cells with internalized spirochetes, which passed through a dramatic morphological change during their internalization by the host cell as observed in time-lapse photography. Almost all of the fluorescent bacteria were seen to be inside the tick cells. PKH labeling of borreliae proved to be a reliable and valuable tool to analyze the association of spirochetes with host cells by flow cytometry, confocal and fluorescence microscopy.

Fluorescent membrane markers elucidate the association of Borrelia burgdorferi with tick cell lines

This study aimed to describe the association of Borrelia burgdorferi s.s. with ixodid tick cell lines by flow cytometry and fluorescence and confocal microscopy. Spirochetes were stained with a fluorescent membrane marker (PKH67 or PKH26), inoculated into 8 different tick cell lines and incubated at 30°C for 24 h. PKH efficiently stained B. burgdorferi without affecting bacterial viability or motility. Among the tick cell lines tested, the Rhipicephalus appendiculatus cell line RA243 achieved the highest percentage of association/internalization, with both high (90%) and low (10%) concentrations of BSK-H medium in tick cell culture medium. Treatment with cytochalasin D dramatically reduced the average percentage of cells with internalized spirochetes, which passed through a dramatic morphological change during their internalization by the host cell as observed in time-lapse photography. Almost all of the fluorescent bacteria were seen to be inside the tick cells. PKH labeling of borreliae proved to be a reliable and valuable tool to analyze the association of spirochetes with host cells by flow cytometry, confocal and fluorescence microscopy.

Genetic diversity and population structure of different varieties of Morada Nova hair sheep from Brazil.

The aim of this study was to analyze genetic diversity and population structure among varieties of White (N = 40), Red (N = 32), and Black (N = 31) Morada Nova hair sheep from flocks in the northeastern Brazilian semiarid region. Fifteen nuclear microsatellite markers and two regions of mitochondrial DNA were used. The intra-population analysis demonstrated that the White variety had higher diversity, while the Red variety had the lowest values. The Bayesian analysis to assess the genetic population structure allowed differentiation between White, Red, and Black varieties, and revealed a tendency towards sub-structuring in the White variety flocks from the States of Ceará and Paraíba. The results of analyses of molecular variance showed that the greatest genetic structure was found when comparing flocks rather than varieties (8.59 vs 6.64% of the total variation, P < 0.001). Based on genetic distance, Dtl, both the dendrogram analysis and the principal coordinate analysis showed the formation of two main groups: one composed of White and another of Black and Red individuals. Five and two haplotypes were found for the D-loop region and the ND5 gene, respectively. A haplotype unique to the Red variety was found in the D-loop region and a variety haplotype unique to the Black variety was found in the ND5 gene; however, these frequencies were low and therefore require further validation. These results support the existence of substantial differences between the Red and White varieties and should be used as separate genetic resources and to improve conservation programs.

Biohydrogen production through dark fermentation by a microbial consortium using whey permeate as substrate.

Nowadays, hydrogen produced globally has been synthesized from fossil fuel with limited source. Therefore, research has been developed in order to explore biological H2 production by dark fermentation. The purpose of this work was to evaluate the effect of initial pH and ferrous sulfate and ammonium sulfate concentrations on the production of biohydrogen by dark fermentation. The process was carried out in batch mode under anaerobic conditions, in the absence of light, and at standard room temperature and pressure. A microbial consortium provided by the effluent treatment plant of a local dairy company was inoculated into a synthetic medium supplemented with cheese whey permeate (20 g/L of lactose) as a carbon source. The influence of three variables was analyzed by a central composite design 2((3)), and the optimum results of hydrogen yield (4.13 mol H2/mol lactose) and productivity (86.31 mmol H2/L/day) were achieved at initial pH 7.0 and FeSO4 and (NH4)2SO4 concentrations of 0.6 and 1.5 g/L, respectively. Under these conditions, the kinetic parameters of fermentation were investigated by analyzing the profile of H2 yield and productivity, metabolite concentrations, pH, and concentration of dissolved iron. In the kinetic analysis, the modified Gompertz equation described adequately the fermentative hydrogen production from cheese whey permeate (R (2) = 0.98). The profile of ethanol and volatile organic acids showed that lactic acid and butyric acid were the main metabolites produced, and the sum of both by-products corresponded to about 58 % of the total metabolites.

Low frequency of ankyrin mutations in hereditary spherocytosis: identification of three novel mutations.

Hereditary spherocytosis (HS) is a common hemolytic anemia caused by defects in the erythrocyte membrane proteins. The screening of mutations in the ankyrin-1 (ANK1) gene of 28 Brazilian HS patients showed two new missense mutations (His276Arg and Ile1054Thr) and one novel promoter mutation (-153 G-->A). The His276Arg mutation affected the invariable TPLH sequence on repeat 9. The -153 mutation was linked in cis to the known -108 T-->C mutation. In contrast to other populations, we were able to detect mutations in the ankyrin-1 gene in only 10% of our patients. It is also interesting to point out that, from 15 informative subjects for the 3' Acn repeats, only one presented a loss of heterozigosity at the cDNA level. Taken together, these results suggest that mutations in the ankyrin-1 gene might not be as common in Brazil as described for other populations.

Avaliaçäo plaquetária de doadores de sangue / Assessment of the platelet function of blood donnors

A utilizaçäo de hemoderivados constitui-se atualmente numa modalidade terapêutica de fundamental importância no exercício da medicina. Dentre os diversos hemocomponentes que podem ser utilizados, o concentrado de plaquetas (CP) é de grande utilizaçäo em situaçöes de distúrbios hemorrágicos. O estudo teve por objetivo avaliar perfil laboratorial de doadores de plaquetas na sua fase de triagem e o monitoramento dos CP utilizados para fins terapêuticos. Foram avaliados 120 indivíduos adultos selecionados na triagem. As bolsas de CP obtidas foram divididas em grupos de 30 bolsas, respectivamente 0h, 24hs, 48h e 72h após sua preparaçäo. Na triagem a média de plaquetas foi de 1,76x10 a quinta potência/mm cúbicos. Os testes de agregaçäo com colágeno, ADP e adrenalina demonstraram respectivamente 20, 43 e 40 porcento de doadores hipoagregantes. Nas bolsas de CP foi encontrado um volume médio de 50,9ml com concentraçäo plaquetária inicial de 1,74x10 a sexta potência/mm cúbicos, reduzindo 48 porcento em 24hs. A agregaçäo plaquetária reduziu significativamente por colágeno após 48hs e para ADP e adrenalina em 24hs. O pH inicial das bolsas foi de 7,39 alterando-se significativamente em 24hs porém, mantendo-se dentro dos limites normais. Os resultados obtidos nos permitem inferir que o processo de separaçäo e armazenamento promovem um grau de ativaçäo plaquetária significativos. O estudo também demonstra a necessidade de uma reavaliaçäo para os indicadores laboratoriais necessários a doaçäo de plaquetas objetivando adequar a qualidade deste hemoderivado em benefício da populaçäo

Quantity and quality of information desired by Portuguese cancer patients.

Disclosure of the diagnosis of cancer to the patients affected has always been a controversial issue in the doctor-patient relationship. Undoubtedly this is so not only because of differences between countries and cultures, but also because there have been changes of opinion over the years. The aim of this study was to evaluate the quality and quantity of information desired by Portuguese cancer patients, and how and from whom they want to hear this information. Our sample comprised a total of 193 cancer patients, 87 men and 106 women. We found that 68.9% knew what their diagnosis was. In our sample, 74% wanted "as much information as possible, good or bad"; 85% said they wanted to know if their disease was cancer; 95% wanted to know the best or worst likely outcome of their disease; and 96.4% wanted to know the chances of getting cured. Most patients said they would prefer to be informed by physicians (92.7%) and have access to a telephone help-line, books and television. In conclusion, most patients wanted to know as much as possible about their illness and treatment, and the majority preferred to be involved in treatment decisions.