Cisto coloide no terceiro ventrículo e morte súbita em jovem

Morte súbita de jovem, sexo masculino, 23 anos, assintomático, suscitou verificação de óbito. Antes queixou-se de cefaleia excruciante, em sala de aula, caindo sobre o computador. Encéfalo apresentou edema e congestão vascular. Sem herniações. Cortes coronais evidenciaram dilatação dos ventrículos laterais e nódulo aderido ao teto do terceiro ventrículo. À microscopia o diagnóstico foi cisto coloide do terceiro ventrículo. A ameaça de morte súbita em portadores de cisto coloide é sério problema diagnóstico na emergência médica. A relevância deste caso está em lembrar aos médicos que esta entidade deve permanecer como diagnóstico diferencial nas cefaleias em crianças, adolescentes e adultos jovens.

Miocardite chagásica em caninos no Estado do Rio Grande do Sul

Neste trabalho, são relatados dois casos de morte súbita por doença de Chagas aguda em caninos da zona rural de Porto Alegre, Rio Grande do Sul, Brasil. Os cães, um macho Pit Bull com nove meses (canino 1) e uma fêmea Labrador Retriever com dois anos (canino 2), morreram em janeiro de 2005 e maio de 2008, respectivamente. As necropsias revelaram aumento cardíaco em ambos os casos. O coração do canino 2 apresentou formato globoso com múltiplas áreas pálidas na musculatura cardíaca, mais evidentes no ventrículo direito e câmaras cardíacas dilatadas, principalmente as da direita. Ao exame histológico, ambos os casos apresentaram alterações semelhantes caracterizadas por infiltrado inflamatório difuso não-purulento acentuado, predominantemente linfocitário intersticial. Nas fibras miocárdicas, havia grande número de pseudocistos, repletos de formas amastigotas do Trypanosoma cruzi. Ao teste sorológico TESA-blot, amostra do canino 2 foi positiva para anticorpos IgM e IgG anti-T.cruzi, achado característico da fase aguda da miocardite chagásica. Os resultados indicam que a doença de Chagas deve ser investigada em casos de morte súbita em cães na região Sul do Brasil e que a espécie pode servir como reservatório e sentinela da doença em humanos.

Treatment of pulmonary thromboembolism in patients with systemic blood pressure stability and right ventricular dysfunction

Pulmonary thromboembolism (PTE) ranges from incidental, clinically unimportant thromboembolism to massive embolism with sudden death. Its treatment is well established in two groups of patients: heparin for those with normal systemic blood pressure without right ventricular dysfunction (RVD) and thrombolysis for those with RVD and circulatory shock. In an intermediate group of patients with systemic blood pressure stability combined with RVD, which is usually associated with worse outcome, the treatment is controversial. There are authors who strongly suggest thrombolysis while others contraindicate this procedure and recommend anticoagulation with heparin. This is a narrative review that includes clinical trials comparing thrombolysis and heparin for the treatment of PTE patients with systemic blood pressure stability and RVD published since 1973. The results show that there are only four trials on this subject with less than 500 patients. Many PTE patients with systemic blood pressure stability and RVD might benefit from thrombolysis but, on the other hand, the risk for hemorrhagic events may be increased. Large randomized clinical trials are required to clarify this. © 2008 Bentham Science Publishers Ltd.

A comparison between diuretics and angiotensin-receptor blocker agents in patients with stage I hypertension (PREVER-treatment trial): Study protocol for a randomized double-blind controlled trial

Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted.Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution.Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil. Clinical trials registration number: ClinicalTrials.gov: NCT00971165. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Prevention of hypertension in patients with pre-hypertension: Protocol for the PREVER-prevention trial

Background: Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.Methods: This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.Discussion: The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.Trial Registration: Clinical Trials NCT00970931. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Effect of Storage Time and Temperature of Equine Epididymis on the Viability, Motion Parameters, and Freezability of Epididymal Sperm

The recovery of sperm from the epididymal cauda may be the last chance to obtain genetic material when sudden death or serious injuries occur in valuable stallions. However, the lack of technical knowledge regarding the storage and transportation of the epididymis often prevents the preservation of the sperm. Therefore, the aim of this study was to compare sperm parameters of sperm obtained immediately after orchiectomy with sperm recovered from epididymal cauda at different times after storage at 5°C and at room temperature (RT). For that, 48 stallions of different breeds were used. In group 1 (control group), eight stallions were used, and the harvest of the epididymal sperm was performed immediately after orchiectomy. In group 2, 40 stallions were used, which were divided into five groups according to the storage time of the epididymis after orchiectomy (6, 12, 18, 24, or 30 hours), making a total of eight stallions per group. One epididymis of each stallion was stored at 5°C, and the contralateral epididymis was stored at RT, both for the same period. The sperm parameters of total motility, progressive motility, progressive linear velocity, curvilinear velocity, percentage of rapid sperm, and plasma membrane integrity were evaluated in all the groups after sperm recovery, resuspension in a sperm freezing diluent, and thawing. In conclusion, the storage of the testis-epididymis complex at 5°C provided better preservation of epididymal sperm than the storage at RT, and regardless of the temperature, the progressive motility is the sperm parameter that is most sensitive to storage time. © 2013 Elsevier Inc.

Cooling of ejaculated and epididymal stallion sperm

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

Variabilidade da frequência cardíaca como ferramenta de análise da função autonômica de tabagistas: revisão de literatura e estudo do plot de Poincaré

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação clínica da cardiomiopatia chagásica crônica em cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Criopreservação e fertilidade de espermatozóides recuperados da cauda do epidídimo de garanhões

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

Separação de virus de importância fitopatológica em citros: CTV e CSDaV através de citometria de fluxo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da variabilidade da frequência cardíaca em cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aspectos epidemiológicos e clínico-patológicos comparados da intoxicação por Arrabidaea bilabiata (Bignoniaceae) em búfalos e bovinos

Através de estudo experimental, verificou-se que, embora o quadro clínico-patológico seja essencialmente o mesmo, o búfalo é pelo menos duas vezes mais resistente que o bovino à ação tóxica de Arrabidaea bilabiata (Sprague) Sandw. Os experimentos demonstraram também, que as folhas novas desta planta são duas vezes (em outubro, fim da época de seca) ou uma vez e meio (em maio, fim da época de chuva) mais tóxicas do que as folhas maduras, e que a planta é mais tóxica em outubro. Esses dados indicam que a menor incidência de intoxicação por plantas do grupo das que causam morte súbita, em búfalos na Amazônia, deva-se, em parte, à maior resistência dessa espécie animal. Também parece importante a coincidência do habitat preferencial dos búfalos (várzea) com o habitat de A. bilabiata, planta menos tóxica que Palicourea marcgravii St.Hil., encontrada em terra firme que é o habitat preferido pelos bovinos.

Origens sociais e trajetórias profissionais das primeiras mulheres policiais pertencentes ao círculo de oficiais da Polícia Militar do Pará

Essa dissertação é um estudo da origem social e da trajetória profissional das oficiais femininos e seu pioneirismo. Foram entrevistadas nove mulheres oficiais em busca de informações qualitativas, suas histórias de vida e suas percepções sobre o pioneirismo feminino da instituição, para investigar as condições objetivas e subjetivas de sua trajetória na instituição policial. Optou-se pela abordagem qualitativa de modo a identificar padrões socioculturais e um saber adquirido pela vivência, além das estratégias de sobrevivência, afirmação e autoproteção na carreira policial. As dificuldades foram muitas, pois não conseguimos sensibilizar os sujeitos para a importância de se resgatar a história das mulheres, que não se envolveram com o tema. Outra dificuldade, o brusco falecimento da líder do grupo, o que provocou um arrefecimento do ânimo dos sujeitos, causando sérias dificuldades no convencimento das demais quanto à sua participação. Ao ouvir seus relatos percebe-se a herança identificadora da instituição pelas agentes, que mesmo após um tempo de reserva preservam o habitus adquirido ao vestir a farda, uma herança de um sistema simbólico institucional, fazendo com que falem em nome da instituição. Percebeu-se que as policiais sofreram violência, seja quando são estigmatizadas como minoria, quando seu trabalho é relegado à esfera administrativa, um não reconhecimento de suas habilidades, quer pelo preconceito e discriminação que sofrem tanto em relação às cotas de inserção e quanto à distribuição de cargos, quer pelo emprego nas funções menos relevantes, mas principalmente por não darem-se conta desses fatos. Ser policial feminino é fazer parte de um grupo estigmatizado e visto de forma negativa, cujas diferenças não são aceitas nem reconhecidas, cuja verdade é desqualificada por um grupo dominante. Esta subalternidade dá origem a um fenômeno chamado “teto de vidro”, caracterizado por uma “barreira invisível”, institucionalizada pelo universo masculino, impedindo a ascensão profissional do segmento feminino na hierarquia da organização paraense.

Leucoencefalomalácia em equídeos da região Leste de Mato Grosso

Background: Fumonisins produced by Fusarium verticillioides are among the most important medical mycotoxins known. The intake of concentrate based on corn and corn by-products contaminated with fumonisins can cause severe poisoning in horses. The injuries are observed mainly in the white matter of the brain, and the disease is known as Equine Leukoencephalomalacia (ELEM). This study aims to describe and discuss the epidemiological, clinical and diagnostic aspects of an outbreak of ELEM occurred in three farms in the municipalities of Canarana and Agua Boa, in the eastern region of Mato Grosso, Brazil.Materials, Methods & Results: The outbreak occurred between May and August 2010. The disease affected six horses and four mules of different ages and sex. Clinical examination was only possible in animals with chronic evolution of the disease. All the affected animals showed neurological clinical signs such as ataxia and recumbency, which progressed to death or sudden death. Histopathological analysis showed foci of necrosis that predominantly affected the white matter, and the presence of gitter cells. Degenerative lesions were observed in the liver of the animals. Mortality rate ranged from 12.5 to 71%, and lethality reached 100%. The cases were preceded by sudden drops in the weather temperature. Fumonisins levels of 6.6 ppm were detected in the feed of the animals.Discussion: The presumptive diagnosis of leukoencephalomalacia was consistent and based on clinical and epidemiological studies. However, the definitive diagnosis was based upon the histological features of the brain including the presence of extensive areas of malacia. Moreover, the animals were being fed with corn or corn by-products contaminated with fumonisins levels considered to be toxic to equids. The mortality and lethality rates are in agreement with outbreaks described in previous studies. The animals showed neurological signs as the predominant clinical manifestation, with gait ataxia followed by recumbency, prostration and death between 24 h and 29 days. Similarly to other reports, the disease was more frequent in adult animals, which succumbed in 24-48 h. Conversely, the evolution of the disease in young animals was of 10 to 29 days. Sudden death was more prevalent in the mules. Previous studies have shown a predominance of cerebral and brainstem lesions in horses, whereas in mules the clinical signs are related to brainstem lesions. Corn and corn by-products are commonly used as energy supplementation to horses in the southern of Mato Grosso state, but outbreaks of the disease are uncommon. This may be influenced by the prevalence of hot climate conditions, which does not favor the production of toxin by the fungus. The atypical low weather temperatures (9-11 degrees C) observed prior to the outbreak could have contributed to the mycotoxin production by F. verticillioides, which requires temperatures between 8-12 degrees C to produce toxins. However, the disease in the region may be underestimated, considering that the practice of necropsies is not common among field technicians, mainly in the occurrence of sporadic deaths among horses intended for work. Preventive measures include avoiding the use of corn and corn by-products for horses after periods of sudden drops in temperature in the region. Furthermore, clinical and epidemiological surveys and post-mortem and histopathological analyses are undoubtedly important for appropriate differential diagnosis, especially in equids with neurological signs.