Caso para Diagnóstico

Descreve-se caso clínico de paciente do sexo masculino, jovem, imunocompetente, portador de melanoníquia fúngica no terceiro pododáctilo causado por Scytalidium dimidiatum. Discutem-se a semiotécnica diagnóstica, seus diferenciais e a terapêutica adequada. Os autores destacam que a etiologia fúngica deva ser considerada no diagnóstico das melanoníquias.

Discrepancies between clinical diagnoses and autopsy findings

Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.

Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

Background: Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances.Methods/Design: An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow.Discussion: Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.

Estrutura de uma comunidade arbórea de floresta estacional semidecídua não pertubada no noroeste paulista em relação à outra comunidade com indicadores de perturbação

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Freqüência do parvovírus suíno em fetos mumificados, abortados e natimortos detectado através da reação em cadeia pela polimerase (PCR)

Porcine parvovirus (PPV) is associated with reproductive failure and it has been found worldwide, including Brazil. Many diagnostic procedures are used for its detection, for example, immunofluorescence, HA, HI and PCR and this is an important technique because it is very specific and sensitive. In this work, the presence of PPV in fetuses from swine farms with reproductive problems was detected by PCR. All of 170 samples from aborted fetuses, mummies or stillborns were sampled by PCR with primers designed to VP2 region of PPV and c-myc (endogenous control). Only 142 samples (83,53%) were positive for c-myc and among them six samples (4,22%) were positive for PPV which were tested in HA. In this test, erythrocytes suspension 1% was used and three samples (50%) agglutinated but they presented low titer (4). For this work, porcine parvovirus was detected in the samples analyzed by PCR and HA. It is important to emphasize the use of endogenous control when material with elevated degree of autolysis is examined

Monitoramento da Qualidade do leite: Procedimentos Diagnósticos

Means for milk, not otherwise specified, the product from complete and uninterrupted milking , in a hygienic, healthy cows, well fed and rested. The milk of other animals must be called according to origin of species. One of the main characteristics that defined the milk is the set of their sensory characteristics, and the main flavor. The control of milk quality in Brazil has been an important factor for the consolidation of the entire production chain, passing necessarily by the dairy industry. The production of milk with good quality guarantees, of course, food safety for consumers. The measures to obtain milk begin on the property, in carrying out correct procedures for milking, storage and transportation of the product also in the dairy. Later, in the laboratory evaluation of physicochemical properties, research fraud, and microbiological examinations. Finally, measures of health education are need for producers to become aware of the economic benefits by obtaining a better quality milk. The objective of this review is to emphasize the importance of using diagnostic procedures methods for the control of mastitis and consequently obtain better Milk quality

Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp pneumoniae during a translocation program of free-ranging animals in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mineral element and heavy metal poisoning in animals

Mineral elements are essential to animal health, survival and production because they are part of physiological, structural, catalytic and regulatory organism functions. Therefore, they should be present in diet. However, these minerals when ingested in excessive doses due to errors in balancing mineral supplements and/or complete ration, intake of plants with high mineral concentration, resulting from addition of fertilizers, herbicides, insecticides and fungicides in pasture or tillage where plants and/or grains will be used to feed animals, decomposition of urban and industrial wastes, leaks and accidental spills of pollutants may result in accumulation of toxic mineral elements in the environment poisoning the animals and may lead them to death. However, toxic doses, physiological changes during poisoning, symptoms and mineral concentration in tissues of poisoned animals to confirm diagnosis are not completely known. Thus, this study reviews mineral element doses that some authors considered toxic for animals intake, as its concentration in tissues of poisoned animals and its physiological effects, symptoms, diagnostic procedures and treatment for poisoning by cadmium, lead, copper, chromium, iodine, manganese, molybdenum, selenium and zinc.

Assessment of the ergonomic design of diagnostic ultrasound transducers through wrist movements and subjective evaluation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

TF-Test Modified: new diagnostic dool for human enteroparasitosis

Intestinal parasitosis is highly prevalent worldwide, being among the main causes of illness and death in humans. Currently, laboratory diagnosis of the intestinal parasites is accomplished through manual technical procedures, mostly developed decades ago, which justifies the development of more sensitive and practical techniques. Therefore, the main objective of this study was to develop, evaluate, and validate a new parasitological technique referred to as TF-Test Modified, in comparison to three conventional parasitological techniques: TF-Test Conventional; Rugai, Mattos & Brisola; and Helm Test/Kato-Katz. For this realization, we collected stool samples from 457 volunteers located in endemic areas of Campinas, São Paulo, Brazil, and statistically compared the techniques. Intestinal protozoa and helminths were detected qualitatively in 42.23% (193/457) of the volunteers by TF-Test Modified technique, against 36.76% (168/457) by TF-Test Conventional, 5.03% (23/457) by Helm Test/Kato-Katz, and 4.16% (19/457) by Rugai, Mattos & Brisola. Furthermore, the new technique presented almost perfect kappa agreement in all evaluated parameters with 95% (P < 0.05) of estimation. The current study showed that the TF-Test Modified technique can be comprehensively used in the diagnosis of intestinal protozoa and helminths, and its greater diagnostic sensitivity should help improving the quality of laboratory diagnosis, population surveys, and control of intestinal parasites.

TF-Test modified: new diagnostic tool for human enteroparasitosis

Intestinal parasitosis is highly prevalent worldwide, being among the main causes of illness and death in humans. Currently, laboratory diagnosis of the intestinal parasites is accomplished through manual technical procedures, mostly developed decades ago, which justifies the development of more sensitive and practical techniques. Therefore, the main objective of this study was to develop, evaluate, and validate a new parasitological technique referred to as TF-Test Modified, in comparison to three conventional parasitological techniques: TF-Test Conventional; Rugai, Mattos & Brisola; and Helm Test/Kato-Katz. For this realization, we collected stool samples from 457 volunteers located in endemic areas of Campinas, São Paulo, Brazil, and statistically compared the techniques. Intestinal protozoa and helminths were detected qualitatively in 42.23% (193/457) of the volunteers by TF-Test Modified technique, against 36.76% (168/457) by TF-Test Conventional, 5.03% (23/457) by Helm Test/Kato-Katz, and 4.16% (19/457) by Rugai, Mattos & Brisola. Furthermore, the new technique presented “almost perfect kappa” agreement in all evaluated parameters with 95% (P < 0.05) of estimation. The current study showed that the TF-Test Modified technique can be comprehensively used in the diagnosis of intestinal protozoa and helminths, and its greater diagnostic sensitivity should help improving the quality of laboratory diagnosis, population surveys, and control of intestinal parasites.