Quarenta anos de leishmaniose visceral no Estado do Piauí: revisão

A leishmaniose visceral (LV) é conhecida no Piauí desde 1934. Ao longo dos anos a doença, que era tipicamente rural, passou a ocorrer também em zonas urbanas, concentrando-se, principalmente em Teresina. Durante o processo de urbanização, Teresina experimentou a primeira epidemia urbana da leishmaniose visceral no Brasil, com mais de 1.000 casos notificados entre o período de 1981 a 1986. O crescimento populacional juntamente com o processo migratório promoveu ocupação de terras na periferia de Teresina que contribuíram para a proliferação dos vetores e aumento da incidência da doença humana e canina no Estado. Atualmente a incidência da doença humana e canina em Teresina é bastante elevada e fora de controle. Algumas medidas, como a eliminação de cães sorologicamente positivos no município, parecem não contribuir de modo relevante para a diminuição do número de casos novos de LV. Apesar dos estudos relacionados aos aspectos epidemiológicos da doença, ainda pouco se conhece sobre o real papel de cães no ciclo da LV. Objetivou-se com esta revisão divulgar a situação da LV em Teresina-PI, nos últimos 40 anos, enfocando os principais aspectos que contribuem para a alta incidência e persistência da infecção.Visceral leishmaniasis (VL) has been known to occur in the state of Piauí since 1934. The typically rural disease began to appear in urban areas over time, being concentrated mainly in Teresina, the capital of Piauí. Teresina was also affected by the first urban epidemic of VL in Brazil. Over 1,000 cases of the disease were reported during urbanization (1981-1986). Human population growth and migration led to land occupation on the outskirts of Teresina. These factors have contributed to vector proliferation, increasing the incidence of VL. At present, the incidence of human and canine disease is quite high and uncontrolled in Piauí. It seems that some measures, such as the elimination of seropositive dogs, failed to significantly reduce the number of new VL cases in Teresina. Despite previously conducted studies, little is known about VL epidemiology in urban areas. The aim of this review is to reveal the situation of VL in Teresina during the last 40 years, focusing on the major factors that may contribute to the high incidence and persistence of VL infection

Ocorrência de anticorpos contra Leptospira spp em cães de Teresina, Piauí, Brasil

A leptospirose é uma doença sistêmica causada por bactéria Leptospira spp. que afeta seres humanos, animais domésticos e selvagens. O presente trabalho investigou a presença de anticorpos anti-Leptospira spp. na população canina da cidade de Teresina-Piauí, e os respectivos sorovares predominantes. Amostras de sangue de 425 cães foram coletadas no Centro de Controle de Zoonoses de Teresina, no período de julho de 2010 a janeiro de 2012, e submetidas à prova de Soroaglutinação Microscópica (SAM). Este estudo encontrou uma taxa de infecção média com 17,41% (IC 95%; 13,8 – 21,0) e 11 sorovares reagentes, sendo os prevalentes Canicola (18,9%), Autumnalis (16,2%), Icterohaemorrhagiae (12,1%) e Butembo (12,1%). As questões levantadas neste estudo indicam a ocorrência de infecção por Leptospira spp em cães da cidade de Teresina-Piauí, Brasil.Leptospirosis is a systemic disease caused by the species of bacteria Leptospira spp., which affects human beings, domestic and wild animals. The present study searched the presence of antibodies against Leptospira spp. in the canine population of the city Teresina, Piauí, and the most common serovars. Blood samples from 425 stray dogs were collected in the local zoonosis center in Teresina from July 2010 to January 2012 and submitted to the Microscopic Seroagglutination Test (MAT). This study found an average infection rate of 17.41% (IC 95%; 13,8 – 21,0) by 11 different serovars; the four most frequent were Canicola (18.9%), Autumnalis (16.2%), Icterohaemorrhagiae (12.1%), and Butembo (12.1%). The questions raised in this study indicated the occurrence of Leptospira spp infection in dogs of Terezina- Piaui, Brazil

One or two ligatures inducing periodontitis are sufficient to cause fatty liver

Periodontitis is a chronic disease that due to an intense inflammatory response triggers systemic changes such as hepatic alterations. This study aimed to compare hepatic damage in rats that received experimental periodontitis at one or two periodontal sites with ligatures. Eighteen rats were separated into three groups: control, without ligature; periodontitis 1, with one ligature; and periodontitis 2, with two ligatures. The following parameters were assessed: gingival bleeding index, probing pocket depth, tooth mobility, alveolar bone loss, malondialdehyde (MDA) and myeloperoxidase (MPO) activity in periodontal tissue; histopathological evaluation of hepatic tissue (steatosis score); glutathione levels (GSH), MDA, MPO, cholesterol and triglycerides in the liver; and serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Periodontal evaluation data showed that the periodontitis model worked well. The groups with periodontitis did not differ significantly in relation to MPO activity and MDA levels in the gingival samples, but they were significantly different when compared with the control group. Steatosis was observed in the histological analysis of the groups with periodontitis, but between the periodontitis groups, two ligatures did not cause increase in steatosis score. The levels of GSH, MDA, total cholesterol and triglycerides in the hepatic tissue were not altered between groups with periodontitis, but they showed significant differences in comparison with the control group. The activity of MPO in hepatic tissue and serum levels of AST and ALT did not present significant difference among the three groups. In conclusion, our results demonstrated that one or two ligatures inducing periodontitis were both sufficient to cause fatty liver. Steatosis caused by two ligatures did not present larger extension and severity than steatosis caused by one ligature

Farmacopuntura com acepromazina para tranquilização de suínos

In order to tranquilize swine with acepromazine subdose in yin tang acupoint (located in the medium point of a line joined lateral cantus of the eyes in frontal region) was made this study. It was delineated in four steps in different days with five pigs. In first step (S1) acepromazine was administrated at 0.03mg/kg by intramuscular route. In second step (S2), the same drug was administrated at 0.003mg/kg at same route. In the third step (S3), acepromazine was administrated in yin tang acupoint at same dose utilized in S2. In the last step (S4) acupuncture needle was introduced in yin tang acupoint. Twenty minutes after S1, all animals presented spontaneous decubitus, palpebral ptosis, and sleepiness. In S2, only one animal had spontaneous decubitus and three showed palpebral ptosis, and sleepiness. In S3 all animals had palpebral ptosis, and sleepiness, and four spontaneous decubitus. In S4 occurred spontaneous decubitus, and sleepiness in all animals, two had palpebral ptosis. In conclusion, acepromazine at sub-dose in yin tang acupoint tranquilizes pigs. The acupuncture needle introduction in yin tang acupoint tranquilizes pigs too, but with technical difficulties because the needle must remain in acupoint for the necessary time.  Foi realizado um estudo para tranqüilizar suínos com subdose de acepromazina no acuponto yin tang, localizado no ponto médio frontal de uma linha traçada entre os cantos laterais dos olhos. O estudo foi delineado em quatro etapas, realizadas em dias diferentes, utilizando-se cinco suínos. Na primeira etapa (E1) administrou-se acepromazina por via intramuscular (IM), na dose de 0,03mg/kg. Na segunda etapa (E2) administrou-se acepromazina na dose de 0,003mg/kg, IM. Na terceira etapa (E3) foi administrada acepromazina no acuponto yin tang, na mesma dose empregada em E2. Na última etapa (E4) foi introduzida agulha de acupuntura no acuponto yin tang. Vinte minutos após E1, todos os animais apresentaram decúbito espontâneo, ptose palpebral e sonolência. Em E2, apenas um animal teve decúbito espontâneo, três apresentaram sonolência e ptose palpebral. Na E3, quatro animais tiveram decúbito espontâneo e todos apresentaram sonolência e ptose palpebral. Em E4 ocorreu decúbito espontâneo e sonolência em todos os animais; dois tiveram ptose palpebral. Concluiu-se que a administração de acepromazina em subdose no acuponto yin tang tranqüiliza suínos. A introdução da agulha no acuponto yin tang também tranquilizou os suínos, mas com dificuldades técnicas, pois a agulha deve permanecer no acuponto durante o tempo requerido para traquilização

Development and validation of the MMCD score to predict kidney replacement therapy in COVID-19 patients

Abstract Background Acute kidney injury (AKI) is frequently associated with COVID-19, and the need for kidney replacement therapy (KRT) is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting the need for KRT in hospitalised COVID-19 patients, and to assess the incidence of AKI and KRT requirement. Methods This study is part of a multicentre cohort, the Brazilian COVID-19 Registry. A total of 5212 adult COVID-19 patients were included between March/2020 and September/2020. Variable selection was performed using generalised additive models (GAM), and least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC-ROC). Results The median age of the model-derivation cohort was 59 (IQR 47–70) years, 54.5% were men, 34.3% required ICU admission, 20.9% evolved with AKI, 9.3% required KRT, and 15.1% died during hospitalisation. The temporal validation cohort had similar age, sex, ICU admission, AKI, required KRT distribution and in-hospital mortality. The geographic validation cohort had similar age and sex; however, this cohort had higher rates of ICU admission, AKI, need for KRT and in-hospital mortality. Four predictors of the need for KRT were identified using GAM: need for mechanical ventilation, male sex, higher creatinine at hospital presentation and diabetes. The MMCD score had excellent discrimination in derivation (AUROC 0.929, 95% CI 0.918–0.939) and validation (temporal AUROC 0.927, 95% CI 0.911–0.941; geographic AUROC 0.819, 95% CI 0.792–0.845) cohorts and good overall performance (Brier score: 0.057, 0.056 and 0.122, respectively). The score is implemented in a freely available online risk calculator ( https://www.mmcdscore.com/ ). Conclusions The use of the MMCD score to predict the need for KRT may assist healthcare workers in identifying hospitalised COVID-19 patients who may require more intensive monitoring, and can be useful for resource allocation