Atividade de lipase em quimo de três espécies tropicais de peixes Teleostei de água doce

O objetivo do presente trabalho foi avaliar a atividade de lipase no quimo dos intestinos médio e posterior de três espécies de peixes Teleostei, com hábitos alimentares diferentes, piracanjuba (Brycon orbignyanus), piau (Leporinus friderici), onívoros, e surubim (Pseudoplatystoma curuscans), preferencialmente carnívoro, visando fornecer referência à nutrição para o ajuste de diferentes sistemas de alimentação artificial. Foram determinadas as atividades de lipase, utilizando-se kit BIOCLIN. Os resultados demonstraram atividade específica média de lipase de 99,86%, sendo menor para a piracanjuba (1,89 UI/mg) em relação ao piau (1347,82 UI/mg), ambos de hábito alimentar onívoro. A diferença de atividade específica de lipase entre piracanjuba e surubim (793,76 UI/mg) também apresentou média de 99,76%. O surubim apresentou atividade específica de lipase 41,11% menor que o piau. Estes dados sugerem que o piau apresenta atividade específica de lipase mais próxima à de um peixe carnívoro que onívoro. Estudos adicionais com testes de alimentação são necessários para a avaliação do comportamento destas espécies a novos sistemas de alimentação.The objective of this work was to evaluate the lipase activity in the chime present in the intestines or in the rectum of three tropical freshwater Teleostei species with different feeding habits: piracanjuba, Brycon orbignyanus (Valenciennes, 1849), piau, Leporinus friderici, omnivorous, and surubim (Pseudoplatystoma coruscans), preferably carnivorous, aiming to provide nutritional data for the adjustment of different artificial feeding systems. The lipase activity was thus determined by the use of BIOCLIN kit. The results showed average specific lipase activity of 99.86%, being lower for piracanjuba (1.89 UI/mg) as compared to piau (1347.82 UI/mg), both omnivorous, while the activity of the same enzyme for piracanjuba was 99.76% lower when compared to surubim (793.76 UI/mg). Surubim showed specific activity of 41.11% lower than of piau. This data suggests that piau presented specific lipase activity closely to carnivorous fish than the omnivorous one. Additional studies with feeding test are necessary to evaluate the behavior of these species under a new feeding systems

Camurati-Engelmann disease: case report

Objetivos: Fornecer informações sobre a doença de Camurati-Engelmann, também conhecida como Displasia Diafisária Progressiva, possibilitando o seu diagnóstico pelo profissional de saúde. Método: Relato de caso associado a revisão da literatura científica sobre o tema. Discussão: Doença rara, de herança autossômica dominante, caracterizada por hiperostose progressiva com envolvimento das diáfises dos ossos. Os sintomas mais comuns são dores em extremidades, alteração da deambulação, fatigalibidade e fraqueza muscular. Seu diagnóstico é clínico-radiológico. O tratamento consiste basicamente na administração de glicocorticóides e anti-inflamatórios não esteroidais para melhorar os sintomas clínicos como dor e fadiga.Goals: To provide information about Camurati-Engelmann disease, also known as progressive diaphyseal dysplasia, allowing its diagnosis by a healthcare professional. Methods: A case report associated with literature review. Discussion: It is a rare, autosomal dominant type, disease characterized by progressive hyperostosis involving the diaphysis of bones. The most commom clinical symptoms are pain in extremities, waddling gait, fatigability and muscle weakness. Its diagnosis may be determined by clinical and radiological data. Treatment involves basically glucocorticosteroids and non-steroid anti-inflammatory administration to promote improvement in clinical symptoms such as pain and fatigue

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030