Bronchoalveolar lavage (BAL) in tapirs (Tapirus terrestris) withMycobacterium tuberculosis

This paper describes the in vivo Bronchoalveolar lavage (BAL)technique by endoscopy in tapirs (Tapirus terrestris) with clinicalsigns of tuberculosis. The technique was performed in two tapirs, male and female,from Curitiba Zoo, Paraná, Brazil. A flexible endoscope and a polyethylene catheterwere used after the chemical restraint of the animals. For BAL technique, 60mL ofsaline 0.9% were infused with a polyethylene catheter, introduced by the endoscope'working channel, and 15mL of BAL were recovered, analyzed and submitted tocytocentrifugation. Slides were stained by Papanicolaou, periodic acid-Schiff (PAS)and Ziehl-Neelsen methods contained high quantity of inflammatory cells on lightmicroscopy (macrophages 27.5%, lymphocytes 0.5%, neutrophis 67% and eosinophis 5%).BAL samples were submitted to culture, bacilloscopy and PCR and were negative forboth animals. Based on this study, it was concluded that the bronchoalveolar lavagetechnique in tapirs is feasible, simple, noninvasive, practical and fast, providingan important clinical information in vivo regarding the functionalstatus of the lower respiratory tract.

Informática na Educação de jovens e adultos: Análise de um Programa de Intervenção a favor da inclusão social e digital

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Imaginando o outro e a nação nas relações internacionais: Commentary Magazine, The New Republic e o intervencionismo dos Estados Unidos na Nicarágua e El Salvador (1977 - 1992)

Pós-graduação em Relações Internacionais (UNESP - UNICAMP - PUC-SP) - FFC

Validation of cone-beam computed tomography and magnetic resonance imaging of the porcine spine: a comparative study with multidetector computed tomography and anatomical specimens

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

Internal carotid artery pseudoaneurysm after tonsillectomy treated by endovascular approach. A case report

Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.

Induction of short gut syndrome and transplantation in a porcine model

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

Behavioral measures to reduce non-adherence in renal transplant recipients: a prospective randomized controlled trial

Solid-organ transplant recipients present a high rate of non-adherence to drug treatment. Few interventional studies have included approaches aimed at increasing adherence. The objective of this study was to evaluate the impact of an educational and behavioral strategy on treatment adherence of kidney transplant recipients. In a randomized prospective study, incident renal transplant patients (n = 111) were divided into two groups: control group (received usual transplant patient education) and treatment group (usual transplant patient education plus ten additional weekly 30-min education/counseling sessions about immunosuppressive drugs and behavioral changes). Treatment adherence was assessed using ITAS adherence questionnaire after 3 months. Renal function at 3, 6, and 12 months, and the incidence of transplant rejection were evaluated. The non-adherence rates were 46.4 and 14.5 % in the control and treatment groups (p = 0.001), respectively. The relative risk for non-adherence was 2.59 times (CI 1.38-4.88) higher in the control group. Multivariate analysis demonstrated a 5.84 times (CI 1.8-18.8, p = 0.003) higher risk of non-adherence in the control group. There were no differences in renal function and rejection rates between groups. A behavioral and educational strategy addressing the patient's perceptions and knowledge about the anti-rejection drugs significantly improved the short-term adherence to immunosuppressive therapy.

Long-term evaluation of oral gavage with periodontopathogens or ligature induction of experimental periodontal disease in mice

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

Escrita e Liberdade: as relações de causa e consequência na expressão discente

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise comparativa de exposição do operador à radiação entre as técnicas radial, femoral e radial com dispositivo protetor em procedimentos de cardiologia intervencionista

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Treinamento de habilidades sociais educativas parentais: comparação de procedimentos a partir do tempo de intervenção

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

Portal único (SILSTM) para ovário-histerectomia vídeo-assistida em cadelas

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

Análise da organização das ações municipais de saúde bucal na atenção básica

Pós-graduação em Odontologia Preventiva e Social - FOA

Diagnosis and management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

Severe distal cytomegalovirus esophagitis with aerodigestive symptoms in an immunocompetent infant

We report a case of an immunocompetent infant, with no evidence of neurological disorders, which developed clinical manifestation of recurrent crisis of choking, dysphagia, laryngeal stridor and sub costal retractions since the first day of life. Direct laryngoscopy was unremarkable. Upper gastrointestinal series showed a dilated tortuous esophagus with severe peristalsis impairment and reflux episodes till the proximal third of the esophagus. An upper gastrointestinal endoscopy showed a moderately dilated esophagus with erosive lesions in the distal esophagus. Esophageal biopsy specimens revealed CMV inclusion bodies associated to moderate inflammation and immunohistochemistry was positive for CMV early antigen. Prolonged 24 h esophageal pH metry was within normal limits. Antiviral therapy with intravenous ganciclovir was introduced and was associated with rapid improvement of the symptoms. Child gradually increased oral intake and weight gain, and there were no side effects related to therapy. Thus, the respiratory symptoms could have been a supra esophageal manifestation of a non-acid reflux disease related to the CMV esophagitis.