Location, distribution, and quantification of myenteric plexus neurons of the jejunum of quails fed with different levels of commercial Macleaya cordata extract / Localização, distribuição e quantificação dos neurônios do plexo mioentérico do jejuno de codornas de postura alimentadas com diferentes inclusões do extrato comercial de Macleaya cordata

ABSTRACT: Coturniculture has been promising, progressing from a subsistence to a technical activity due to its quick production, low breeding investment, and rapid economic return. After the restriction of antimicrobials as growth promoters, some studies aimed to evaluate alternative products that would make the farming of healthy birds viable without impacting their performance, with commercial Macleaya cordata extract being one of these substitutes. The functions of the gastrointestinal tract are coordinated mainly by the enteric nervous system, and the myenteric plexus is responsible for the reflex control of contractile activities of the external muscles. Thus, this study located and demonstrated the distribution of the myenteric plexus, quantifing the total population of myenteric neurons (Giemsa+) and the subpopulation of myenteric nitrergic neurons (NADPH-d+), and evaluated the effects of commercial Macleaya cordata extract on these populations of quail jejunum neurons. A total of 240 one-day-old female laying quails were distributed into four treatments, with four repetitions of 15 birds each. The test groups (T1, T2, and T3) were treated with commercial Macleaya cordata extract throughout the experimental period using the following doses: T1 - test group, basal diet added with 150 ppm of the extract in the feed; T2- test group, basal diet added with100 ppm of the extract in the feed; T3 - test group, basal diet added with 50 ppm of the extract in the feed; and T4 - control group, basal diet with no added extract. The study included histological analysis, Giemsa+, and NADPH-d+ myenteric neuron staining. The results showed that the myenteric plexus is located between longitudinal layer fibers and in the transition region between the longitudinal and circular layers of the muscular tunic, with the myenteric population organized into ganglia and isolated in the region of neuronal fiber bundles. The commercial Macleaya cordata extract showed no quantitative changes in the myenteric Giemsa+ population and myenteric NADPH-d+ subpopulation, however, the groups that consumed the extract showed greater NADPH-d+ neuron activity compared to the control group, implying that the food remained longer in the intestinal lumen, therefore, enabling greater nutrient use and resulting in increased productive performance.

RESUMO: A coturnicultura tem apresentado características promissoras, deixando de ser uma atividade de subsistência e ocupando patamares tecnificados devido a sua precocidade produtiva, baixo investimento de criação e rápido retorno econômico. A partir da restrição da utilização de antimicrobianos como promotores de crescimento, estudos foram direcionados com o objetivo de se avaliar produtos alternativos que viabilizassem a criação de aves saudáveis, sem comprometer seu desempenho, sendo o extrato comercial da Macleaya cordata um destes substitutos. As funções do trato gastrintestinal são coordenadas principalmente pelo sistema nervoso entérico, sendo o plexo mioentérico responsável pelo controle reflexo das atividades contráteis da musculatura externa. Desta forma, o presente trabalho teve como objetivo localizar e demonstrar a distribuição do plexo mioentérico, quantificar a população total de neurônios mioentéricos (Giemsa+), e a subpopulação de neurônios mioentéricos nitrérgicos (NADPH-d+), além de avaliar os efeitos do extrato comercial da Macleaya cordata sobre estas populações de neurônios do jejuno de codornas. Foram alojadas 240 codornas de postura, fêmeas, com um dia de idade, distribuídas aleatoriamente em quatro tratamentos, com quatro repetições de 15 aves cada. Os grupos testes (T1, T2 e T3) foram tratados com extrato comercial de Macleaya cordata durante todo o período experimental conforme as doses indicadas, sendo: T1 - grupo teste, com dieta basal adicionada de 150 ppm do extrato na ração; T2 - grupo teste, com dieta basal adicionada de 100 ppm do extrato na ração; T3 - grupo teste, com dieta basal adicionada de 50 ppm do extrato na ração, e T4 - grupo controle, com dieta basal isenta do extrato. Foram realizadas análise histológica e a marcação dos neurônios mioentéricos Giemsa+ e NADPH-d+. Os resultados demonstraram que o plexo mioentérico está localizado entre as fibras do estrato longitudinal, e na região de transição entre os estratos longitudinal e circular da túnica muscular, estando a população mioentérica organizada em gânglios, e também isoladamente na região dos feixes das fibras neuronais. O extrato comercial da Macleaya cordata não alterou quantitativamente os neurônios da população mioentérica Giemsa+ e da subpopulação mioentérica NADPH-d+, mas os grupos que consumiram o extrato apresentaram maior atividade dos neurônios NADPH-d+ em relação ao grupo controle, permitindo inferir que o alimento permaneceu maior tempo no lúmen intestinal e, portanto, possibilitou um maior aproveitamento dos nutrientes, podendo refletir em melhor desempenho produtivo.

Fatores associados ao óbito e à reposição volêmica em pacientes com trauma por lesões penetrantes / Factors associated with death or volume replacement in patients with trauma due to penetrating injuries

Objective: to evaluate the prognostic factors of volume replacement in patients with trauma due to penetrating injuries. Methods: retrospective cohort study whose data were obtained by analyzing medical records of 544 patients who were admitted to the emergency unit, victims of penetrating trauma. Results: among the victims, 282 (51.9%) suffered stab wound, 262 (48.2%) injury by firearms, 486 (89.3%) were male, 382 (70.2%) were aged between 14 and 30 years. Most who received volume greater than 2000ml, systolic blood pressure ≤90mmHg and mean arterial pressure ≤65mmHg presented more mortality, with p <0.05, p <0.002 and p <0.003, respectively. Conclusion: the limited volume replacement can help in the good prognosis of victims of penetrating trauma.

Avaliar os fatores prognósticos da reposição volêmica em pacientes com trauma por lesões penetrantes. Métodos: estudo de coorte retrospectiva cujos dados foram obtidos através da análise de prontuários de 544 pacientes que deram entrada no serviço de emergência, vítimas de traumatismo penetrante. Resultados: dentre as vítimas, 282 (51,9%) sofreram ferimento por arma branca, 262 (48,2%) ferimento por arma de fogo, 486 (89,3%) eram do sexo masculino, com idade entre 14 e 30 anos 382 (70,2%). A maioria que recebeu fluído maior que 2000ml, pressão arterial sistólica ≤90mmHg e pressão arterial média ≤65mmHg, apresentou mais mortalidade, com valor de p<0,05, p<0,002 e p<0,003, respectivamente. Conclusão: a reposição volêmica limitada pode auxiliar no bom prognóstico do paciente vítima de trauma penetrante.

Análise comparativa entre as metodologias de PCR metilação-específica (MSP), southern blot (SB) e FISH utilizadas no diagnóstico genético molecular de pacientes com suspeita clínica das síndromes de Prader-Willi ou Angelman / Comparative analysis of methylation-specific PCR (MSP), southern blot (SB) and FISH in molecular genetic diagnosis of patients with clinical picture suggestive of Prader-Willi or Angelman syndromes

Introdução: Prader-Willi (SPW) e Angelman (SA) são síndromes clinicamente distintas, causadas pela perda de expressão de genes na região cromossômica 15q11.2-q13, de origem paterna ou materna, respectivamente. Ambas compartilham os mesmos métodos diagnósticos. Nossos objetivos foram: a) analisar por PCR metilação-específica (MSP) pacientes com suspeita clínica de SPW/SA; b) comparar resultados de diferentes metodologias de diagnóstico molecular; c) aplicar a técnica MSP na rotina assistencial de pacientes encaminhados ao Serviço de Genética Médica/Hospital de Clínicas de Porto Alegre (SGM/HCPA). Métodos: Foram analisados 123 pacientes com suspeita clínica de SPW (n = 71) ou SA (n = 52) por MSP. Desses, 79 possuíam análise prévia por hibridação in situ fluorescente (FISH) e/ou Southern blot (SB). Resultados: Foram detectados 21 casos positivos – 15 de SPW (12,19%) e 6 de SA (4,88%). Nove pacientes tiveram etiologia molecular determinada, sendo sete com diagnóstico de SPW (quatro dissomias uniparentais – UPD15 materna – e três deleções na região 15q11-13) e dois com diagnóstico de SA (um com UPD15 paterna e um com deleção na região 15q11-13). Foram observados resultados equivalentes entre MSP e SB e resultados discrepantes entre MSP e FISH (n = 4). Foram padronizados dois protocolos de MSP para confirmação dos resultados e controle interno de qualidade. Conclusão: O perfil de detecção de cada técnica varia de acordo com o mecanismo etiológico presente. A análise por MSP detecta alterações no padrão de metilação geradas por deleção, UPD e defeitos de imprinting, sem identificar o mecanismo etiológico responsável...

Introduction: Prader-Willi (PWS) and Angelman (AS) are clinically different syndromes caused by loss of expression of genes located on the chromosome 15q11.2-q13, of paternal or maternal origin, respectively. Both syndromes have the same diagnostic methods. The aims of the present study were: a) to perform a molecular analysis of 123 patients with clinical findings suggestive of PWS or AS using methylation-specific PCR (MSP); b) to compare the results obtained using different molecular diagnostic methodologies; c) to standardize MSP to be used in the routine care of patients at Medical Genetics Service/Hospital de Clínicas de Porto Alegre (SGM/HCPA). Methods: 123 patients with clinical findings suggestive of PWS (n = 71) or AS (n = 52) were analyzed by MSP. 79 had undergone previous laboratory analysis by fluorescence in situ hybridization (FISH) and/or Southern blot (SB). Results: MSP detected 21 positive cases – 15 PWS (12,19%) and 6 AS (4,88%). Molecular etiology was determined in 9 patients only – 7 were diagnosed with PWS (4 had uniparental disomy – maternal UPD15 – and 3 had deletions at 15q11-13) and 2 were diagnosed with AS (1 of paternal UPD15 and 1 deletion at 15q11-13). Comparing both methodologies, it was possible to observe concordant results between MSP and SB and discordant results between MSP and FISH (n = 4). We standardized two MSP methods in order to confirm the results and for internal quality control. Conclusion: The resulting profile of each technique varies according to the existing etiological mechanism. The methylation analysis by MSP technique detects changes on methylation pattern caused by deletion, UPD and imprinting defects, but it does not identify the responsible etiologic mechanism...

Sympathetic glial cells and macrophages develop different responses to Trypanosoma cruzi infection or lipopolysaccharide stimulation.

Nitric oxide (NO) participates in neuronal lesions in the digestive form of Chagas disease and the proximity of parasitised glial cells and neurons in damaged myenteric ganglia is a frequent finding. Glial cells have crucial roles in many neuropathological situations and are potential sources of NO. Here, we investigate peripheral glial cell response to Trypanosoma cruzi infection to clarify the role of these cells in the neuronal lesion pathogenesis of Chagas disease. We used primary glial cell cultures from superior cervical ganglion to investigate cell activation and NO production after T. cruzi infection or lipopolysaccharide (LPS) exposure in comparison to peritoneal macrophages. T. cruzi infection was greater in glial cells, despite similar levels of NO production in both cell types. Glial cells responded similarly to T. cruzi and LPS, but were less responsive to LPS than macrophages were. Our observations contribute to the understanding of Chagas disease pathogenesis, as based on the high susceptibility of autonomic glial cells to T. cruzi infection with subsequent NO production. Moreover, our findings will facilitate future research into the immune responses and activation mechanisms of peripheral glial cells, which are important for understanding the paradoxical responses of this cell type in neuronal lesions and neuroprotection.

Sympathetic glial cells and macrophages develop different responses to Trypanosoma cruzi infection or lipopolysaccharide stimulation

Nitric oxide (NO) participates in neuronal lesions in the digestive form of Chagas disease and the proximity of parasitised glial cells and neurons in damaged myenteric ganglia is a frequent finding. Glial cells have crucial roles in many neuropathological situations and are potential sources of NO. Here, we investigate peripheral glial cell response to Trypanosoma cruzi infection to clarify the role of these cells in the neuronal lesion pathogenesis of Chagas disease. We used primary glial cell cultures from superior cervical ganglion to investigate cell activation and NO production after T. cruzi infection or lipopolysaccharide (LPS) exposure in comparison to peritoneal macrophages. T. cruzi infection was greater in glial cells, despite similar levels of NO production in both cell types. Glial cells responded similarly to T. cruzi and LPS, but were less responsive to LPS than macrophages were. Our observations contribute to the understanding of Chagas disease pathogenesis, as based on the high susceptibility of autonomic glial cells to T. cruzi infection with subsequent NO production. Moreover, our findings will facilitate future research into the immune responses and activation mechanisms of peripheral glial cells, which are important for understanding the paradoxical responses of this cell type in neuronal lesions and neuroprotection.

Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients.

BACKGROUND: Leprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST). Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods. METHODOLOGY/PRINCIPAL FINDINGS: This work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain). The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6) and 80.8% (SD = 24.9), respectively. CONCLUSIONS/SIGNIFICANCE: We observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its diagnostic applicability, particularly in selected cases with only discrete sensory impairment, patients unable to perform the sensory test and especially those with nonspecific histopathological finds.

Flavonoids in the therapy and prophylaxis of flu: a patent review.

INTRODUCTION: Influenza viruses are common agents of flu outbreaks, epidemics, and pandemics that have occurred through the centuries. Prevention and control of flu are of great clinical importance, since they cause serious damage to health, with a consequent impact on quality of life and economy of a country. Resistance against the current drugs justifies the development of new anti-influenza molecules. Flavonoids exhibit significant activity against flu through their anti-inflammatory and antiviral properties. The profile of these molecules makes them particularly promising as therapeutic agents against flu. AREAS COVERED: This review focus on the activity of flavonoids on different influenza virus targets as well as their use in patented pharmaceutical formulations. Twenty-one patents of these compounds for prophylaxis and treatment of influenza infection are discussed. EXPERT OPINION: The H1N1 influenza pandemic in 2009 resulted in a significant increase in the number of patents claiming pharmaceutical formulations for prophylaxis and treatment of flu. The research advances on flavonoids showing anti-influenza activity and the efforts made by researchers and industries consolidate the interest on new alternatives for the therapy of an infectious disease that represents a serious public health problem throughout the world.

Prevalence of upper aerodigestive symptoms in patients who underwent thyroidectomy with and without the use of intraoperative laryngeal nerve monitoring.

BACKGROUND: Upper aerodigestive symptoms (UADS) have been reported by patients who have had thyroidectomies. This study evaluated the long-term prevalence of UADS after thyroidectomy in patients who did and who did not have intraoperative neuromonitoring (IONM). METHODS: This was a cross-sectional study of patients with normal vocal fold mobility who had a thyroidectomy. It included patients who did and did not have this surgery with IONM. All patients answered a questionnaire regarding UADS occurring one or more years after thyroidectomy. The questionnaire dealt with UADS relating to voice and swallowing symptoms and sought to quantify their severity. The 208 patients who underwent thyroidectomy without IONM were designated the control group (CG). The 100 patients who underwent thyroidectomy with IONM were designated the neuromonitored group (NMG). RESULTS: The proportion of patients in the CG who reported UADS was 45%; 25.9% of these patients reported voice symptoms, and 33.6% reported swallowing symptoms. The proportion of patients in the NMG who reported UADS was 39%; 27% of these patients reported voice symptoms, and 22% reported swallowing symptoms. Thus, patients in the CG had more swallowing symptoms and a greater severity of UADS-related symptoms than patients in the NMG. CONCLUSIONS: In this study, IONM had a favorable effect in terms of decreasing the prevalence and severity of UADS occurring one year or more after thyroidectomy.

Conhecimentos dos familiares no cuidar da criança adolescente com doença crónica / Knowledge of family members in the care of the adolescent child with chronic disease

Este trabalho, intitulado Conhecimentos dos Familiares no Cuidar da Criança/Adolescente com Doença Crónica, objectivou: conhecer o perfil sociodemográfico dos familiares que prestam cuidados a crianças/adolescentes com doença crónica e da própria criança/adolescente; averiguar os seus conhecimentos acerca da doença; saber quais os ensinos que foram efectuados para cuidar da criança/adolescente; averiguar as dificuldades que estas famílias sentem no cuidar da criança/adolescente e o apoio que lhes é dado. Para se poderem alcançar os objectivos supracitados, optei por um estudo de natureza qualitativa, recorrendo à entrevista, cujos resultados foram sujeitos à análise de conteúdo. A amostra é constituída por 10 participantes: seis cuidadoras de crianças/adolescentes utentes da APCV; duas cuidadoras de crianças/adolescentes internados no Serviço de Pediatria do Hospital São Teotónio EPE - Viseu; duas cuidadoras de crianças/adolescentes a realizar Cinesiterapia Respiratória no Serviço de Medicina Física de Reabilitação, da mesma instituição. Concluiu-se que as dificuldades que as cuidadoras sentem em relação aos cuidados a ter com a sua criança/adolescente com doença crónica resultam, essencialmente, do facto destas não terem sido bem informadas aquando do início do diagnóstico da doença e/ou porque os profissionais de saúde utilizavam um vocabulário muito técnico, não possibilitando uma compreensão clara das informações. A maioria das cuidadoras não sente dificuldades em cuidar do seu doente (vestir, higiene, posicionamentos, alimentação por gastrostomia, aspiração de secreções), o que se deve às explicações que lhes foram dadas. Constatámos também que quase todas as entrevistadas sentem falta de apoios sociais, emocional e familiar.

This study, titled Knowledge of the families in taking care of their relatives child/adolescent with chronic illness, has the following objectives: characterize the demographic and social profile of the families that taking care of their relatives children/adolescent with chronic illness and the profile of the child/adolescent himself; analyze their knowledge about the illness; identify which educations had been performed regarding the taking care of the child/adolescent; analyze the difficulties that these families experienced in taking care of their children/adolescent and the support that was given to them. To accomplish these objectives, it was chosen a qualitative study using the interview method to collecting data. The results were submitted to a content analysis. The sample was constituted by ten participants: six caregivers of children/adolescent that frequent the APCV; two caregivers of children/adolescent admitted in the department of Pediatrician of the Hospital São Teotónio EPE - Viseu; two caregivers of children/adolescent performing chest cinesiotherapy in the department of Physical Medicine and Rehabilitation of the same institution. We concluded that the difficulties felt by the caregivers resided, essentially, in the fact that these caregivers were not well informed by the health professionals, at the time of the illness diagnosis. They used a very technical vocabulary, making difficult a clear understanding of the information transmitted. The majority of the caregivers did not feel difficulties in taking care of their patients (dressing, performing personal hygiene, positioning, feeding by the gastrostomy tube and aspiration of secretions). This could be explained by the good information transmitted to the caregivers. We found that almost all the interviewed caregivers felt lack of social emotional and familiar support.

Digestibilidade de nutrientes e balanço de Ca e P em suínos recebendo dietas com ácido butírico, fitase e diferentes níveis de cálcio / Nutrient digestibility and Ca and P balance in pigs receiving butyric acid, phytase and different calcium levels

Estudou-se o uso do ácido butírico (AB) e da fitase em dietas de suínos na fase de crescimento, variando no nível de cálcio. O experimento foi subdivido no tempo em dois períodos de 17 dias, sendo três de adaptação e 14 de mensurações. Em cada período, foram utilizados 16 suínos machos castrados, com peso de 24,6±0,7kg no primeiro e 43,2±1,77kg no segundo período. As dietas diferiam no nível de cálcio (0,5 ou 0,72 por cento), de AB (0 ou 0,3 por cento de butirato de sódio 84 por cento) e de fitase (0 ou 500 FTU kg-1, fitase de origem bacteriana derivada de Escherichia coli). O delineamento foi em blocos casualizados (períodos), em decomposição fatorial 2x2x2, com quatro repetições. Foram avaliadas a digestibilidade aparente dos nutrientes e da energia bruta e o balanço de Ca e P. O AB melhorou a digestibilidade da proteína bruta, mas, de forma individual ou em combinação com a fitase, não aumentou a retenção de minerais. A fitase aumentou a retenção de P, reduzindo sua excreção fecal e urinária. O menor nível de Ca na dieta proporcionou maior retenção de Ca e menor retenção de P, em decorrência do aumento da excreção de P na urina (P<0,0001). Apesar de ter melhorado a digestibilidade protéica, o AB não aumentou a retenção de minerais, nem teve efeito aditivo ao uso de fitase, enquanto que a fitase apresentou efeito positivo para retenção de P.

It was studied the use of butyric acid (BA) and phytase in growing pigs diets, varying calcium level. The experiment was divided into two periods of time, of 17 days, with 3 days of adaptation and 14 of measurements. In each period, it was used 16 barrows weighing 24.6±0.7kg in the first and 43.2±1.77kg in the second. Diets were different in calcium level (0.5 or 0.72 percent), AB (0 or 0.3 percent sodium butyrate 84 percent) and phytase (0 or 500FTU kg-1 phytase of bacterial origin derived from Escherichia coli). The experimental design was in randomized blocks (periods), decomposed in 2x2x2 factorial, with four replications. It was evaluated the apparent digestibility of nutrients, gross energy and balance of Ca and P. AB improved crude protein digestibility, but individually or in combination with phytase did not increase minerals retention. Phytase increased P retention by reducing urinary and fecal excretion. The lowest diet calcium level provided higher Ca retention and lower P retention as a result of increased P excretion in urine (P<0.0001). Despite improving protein digestibility, AB did not increase mineral retention and didn't have an additive effect with the use of phytase, while phytase had positive effect on retention of P.

Doença meningocógica: investigação de surto comunitário no distrito administrativo do Grajaú, município de São Paulo, julho de 2006 / meningococcical disease: communitarian outbreak investigation in Grajaú, in the city of São Paulo, july, 2006

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Laqueadura tubária: controvérsias éticas, morais, físicas e psicológicas / Horn ligature: ethics controversy, morals, physics and psychological

O presente estudo foi desenvolvido com clientes do Programa de Assistência Integral à Saúde da Mulher, em um bairro da periferia de uma capital do Nordeste. Os dados encontrados permitiram às autoras identificar os métodos anti-concepcionais utilizados pelas clientes, seus conhecimentos, principalmente a respeito de métodos irreversíveis, com ênfase nos aspectos éticos, morais fisiológicos e psicológicos, relacionados à laqueadura tubária. Foram consideradas as variáveis: principal método anti-concepcional utilizado, idade, número de filhos, motivos da seleçäo do método e consequências a ele atribuídas.