Common and uncommon CT findings in CVID-related GL-ILD: correlations with clinical parameters, therapeutic decisions and potential implications in the differential diagnosis

Purpose: To investigate computed tomography (CT) findings of Granulomatous Lymphocytic Interstitial Lung Disease (GL-ILD) in Common Variable Immunodeficiency (CVID), also in comparison with non-GL-ILD abnormalities, correlating GL-ILD features with functional/immunological parameters and looking for GL-ILD therapy predictive elements. Methods: CT features of 38 GL-ILD and 38 matched non-GL-ILD subjects were retrospectively described. Correlations of GL-ILD features with functional/immunological features were assessed. A logistic regression was performed to find a predictive model of GL-ILD therapeutic decisions. Results: Most common GL-ILD CT findings were bronchiectasis, non-perilymphatic nodules, consolidations, Ground Glass Opacities (GGO), bands and enlarged lymphnodes. GL-ILD was usually predominant in lower fields. Multiple small nodules (≤10 mm), consolidations, reticulations and fibrotic ILD are more indicative of GL-ILD. Bronchiectasis, GGO, Reticulations and fibrotic ILD correlated with decreased lung performance. Bronchiectasis, GGO and fibrotic ILD were associated with low IgA levels, whereas high CD4+ T cells percentage was related to GGO. Twenty out of 38 patients underwent GL-ILD therapy. A model combining Marginal Zone (MZ) B cells percentage, IgA levels, lower field consolidations and lymphnodes enlargement showed a good discriminatory capacity with regards to GL-ILD treatment. Conclusions: GL-ILD is a lower field predominant disease, commonly characterized by bronchiectasis, non-perilymphatic small nodules, consolidations, GGO and bands. Multiple small nodules, consolidations, reticulations and fibrotic ILD may suggest the presence of GL-ILD in CVID. MZ B cells percentage, IgA levels at diagnosis, lower field consolidations and mediastinal lymphnodes enlargement may predict the need of a specific GL-ILD therapy

Extension of the core map of common bean with EST-SSR, RGA, AFLP, and putative functional markers

Microsatellites and gene-derived markers are still underrepresented in the core molecular linkage map of common bean compared to other types of markers. In order to increase the density of the core map, a set of new markers were developed and mapped onto the RIL population derived from the ‘BAT93’ × ‘Jalo EEP558’ cross. The EST-SSR markers were first characterized using a set of 24 bean inbred lines. On average, the polymorphism information content was 0.40 and the mean number of alleles per locus was 2.7. In addition, AFLP and RGA markers based on the NBS-profiling method were developed and a subset of the mapped RGA was sequenced. With the integration of 282 new markers into the common bean core map, we were able to place markers with putative known function in some existing gaps including regions with QTL for resistance to anthracnose and rust. The distribution of the markers over 11 linkage groups is discussed and a newer version of the common bean core linkage map is proposed

Epidemiological aspects of dog bites considering biter dogs and victims

The aim of this study was to characterize dog bites using data on biter dogs and victims. An exploratory cross-sectional study was performed using 203 records of individuals who had attended in public health services in 2009 in the municipality of Araçatuba, São Paulo, Brazil, after they had been bitten by a dog. Over 70% (92/129) of the biter dogs were male and most of them (71%) received as a gift. Dog owners reported companionship as the main reason for acquiring the dog. The victims who were children were predominantly male, while the victims who were elderly were predominantly female. Most children were bitten on the head/neck, while adults were bitten on the hands/feet and lower limbs (p<0.0001). The owner of the dog was known in 83.2% of cases. However, rabies observation of the biter dog following the attack was only reported in 59.4% of cases. Situations involving aggression were related to dogs having escaped from their home (18.7%) or roaming free on the streets (17.0%). The analysis of biting dog characteristics using information obtained from dog bite victims and biting dog owners can help direct the medical treatment for dog bite victims. Moreover, concepts of responsible dog ownership can reduce the occurrence of bites.El presente estudio tuvo como objetivo caracterizar los ataques de perros incluyendo datos sobre el animal y su víctima. Se realizó un estudio exploratorio de corte transversal a partir de las fichas médicas de 203 habitantes que procuraron los servicios de la red pública de salud de Araçatuba, São Paulo, Brasil, después de sufrir mordeduras de perros durante 2009. Más del 70% de los perros (92/129) eran del sexo masculino y la mayoría (71%) fue recibido como regalo. El principal motivo para la adquisición de los animales fue como animal de compañia. Dentro del perfil de personas agredidas, hubo predominio de niños del sexo masculino y de mujeres de edad avanzada. La mayoría de los niños fue mordido en la cabeza / cuello y los adultos en las manos, los pies y en las extremidades inferiores (p <0,0001). El propietario del animal era conocido en el 83,2% de los casos, con la observación de que el perro se indica sólo en el 59,4% de los casos. Los principales escenarios de agresión entubieron relacionados con el perro escapando de casa (18,7%) o permaneciendo suelto en la calle (17,0%). El análisis de las características de los perros agresores, de las víctimas y de los dueños puede auxiliar en el tratamiento médico en estos casos. Además, existe la necesidad de mayor cuidado en la criación de los perros, dado que el concepto de propiedad responsable puede reducir la prevalencia de mordeduras.O presente estudo buscou caracterizar as agressões por cães, envolvendo dados sobre o animal e sua vítima. Foi realizado um estudo exploratório transversal envolvendo 203 fichas de habitantes que procuraram a rede pública de saúde de Araçatuba, São Paulo, Brasil, em 2009, após sofrerem mordedura canina. Mais de 70% dos cães (92/129) eram machos, sendo a maioria (71%) recebida como presente. A busca por companhia foi o principal motivo de aquisição. Houve predomínio do sexo masculino em crianças e do sexo feminino em idosos. A maioria das crianças foi mordida na cabeça/pescoço, e dos adultos, nas mãos/pés e membros inferiores (p<0,0001). O proprietário do animal era conhecido em 83,2% dos casos, sendo indicada apenas observação do cão em 59,4% dos casos. As principais situações que envolveram as agressões foram o cão ter escapado (18,7%) ou permanecer solto na rua (17,0%). A análise de características de cães agressores com informações obtidas junto às suas vítimas e proprietários pode auxiliar a conduta médica nesses casos. Além disso, há necessidade de maior responsabilidade na criação de cães, pois conceitos de posse responsável podem reduzir a ocorrência de mordeduras

Epidemiological aspects of dog bites considering biter dogs and victims

The aim of this study was to characterize dog bites using data on biter dogs and victims. An exploratory cross-sectional study was performed using 203 records of individuals who had attended in public health services in 2009 in the municipality of Araçatuba, São Paulo, Brazil, after they had been bitten by a dog. Over 70% (92/129) of the biter dogs were male and most of them (71%) received as a gift. Dog owners reported companionship as the main reason for acquiring the dog. The victims who were children were predominantly male, while the victims who were elderly were predominantly female. Most children were bitten on the head/neck, while adults were bitten on the hands/feet and lower limbs (p<0.0001). The owner of the dog was known in 83.2% of cases. However, rabies observation of the biter dog following the attack was only reported in 59.4% of cases. Situations involving aggression were related to dogs having escaped from their home (18.7%) or roaming free on the streets (17.0%). The analysis of biting dog characteristics using information obtained from dog bite victims and biting dog owners can help direct the medical treatment for dog bite victims. Moreover, concepts of responsible dog ownership can reduce the occurrence of bites.El presente estudio tuvo como objetivo caracterizar los ataques de perros incluyendo datos sobre el animal y su víctima. Se realizó un estudio exploratorio de corte transversal a partir de las fichas médicas de 203 habitantes que procuraron los servicios de la red pública de salud de Araçatuba, São Paulo, Brasil, después de sufrir mordeduras de perros durante 2009. Más del 70% de los perros (92/129) eran del sexo masculino y la mayoría (71%) fue recibido como regalo. El principal motivo para la adquisición de los animales fue como animal de compañia. Dentro del perfil de personas agredidas, hubo predominio de niños del sexo masculino y de mujeres de edad avanzada. La mayoría de los niños fue mordido en la cabeza / cuello y los adultos en las manos, los pies y en las extremidades inferiores (p <0,0001). El propietario del animal era conocido en el 83,2% de los casos, con la observación de que el perro se indica sólo en el 59,4% de los casos. Los principales escenarios de agresión entubieron relacionados con el perro escapando de casa (18,7%) o permaneciendo suelto en la calle (17,0%). El análisis de las características de los perros agresores, de las víctimas y de los dueños puede auxiliar en el tratamiento médico en estos casos. Además, existe la necesidad de mayor cuidado en la criación de los perros, dado que el concepto de propiedad responsable puede reducir la prevalencia de mordeduras.O presente estudo buscou caracterizar as agressões por cães, envolvendo dados sobre o animal e sua vítima. Foi realizado um estudo exploratório transversal envolvendo 203 fichas de habitantes que procuraram a rede pública de saúde de Araçatuba, São Paulo, Brasil, em 2009, após sofrerem mordedura canina. Mais de 70% dos cães (92/129) eram machos, sendo a maioria (71%) recebida como presente. A busca por companhia foi o principal motivo de aquisição. Houve predomínio do sexo masculino em crianças e do sexo feminino em idosos. A maioria das crianças foi mordida na cabeça/pescoço, e dos adultos, nas mãos/pés e membros inferiores (p<0,0001). O proprietário do animal era conhecido em 83,2% dos casos, sendo indicada apenas observação do cão em 59,4% dos casos. As principais situações que envolveram as agressões foram o cão ter escapado (18,7%) ou permanecer solto na rua (17,0%). A análise de características de cães agressores com informações obtidas junto às suas vítimas e proprietários pode auxiliar a conduta médica nesses casos. Além disso, há necessidade de maior responsabilidade na criação de cães, pois conceitos de posse responsável podem reduzir a ocorrência de mordeduras

Hygienic and sanitary characteristics in milk-producing farms of settlement in northwestern São Paulo State

ABSTRACT. Oliveira T.C.B., Curci V.C.L.M, Alves A.J.S., Morelli F.C.G., Buso D.S. & Queiroz L.H. [Hygienic and sanitary characteristics in milk-producing farms of settlement in northwestern São Paulo State.] Características higiênicas e sanitárias em propriedades produtoras de leite de assentamento da Região Noroeste do Estado de São Paulo. Revista Brasileira de Medicina Veterinária, 37(4):321- 326, 2015. Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária de Araçatuba, Universidade Estadual Paulista, Rua Clóvis Pestana, 793, Araçatuba, SP 16050-680, Brasil. E-mail: [email protected] In order to check the hygienic and sanitary conditions of milk-producing farms from a settlement located at the northwestern region of São Paulo State, 62 of the resident families (246 people) were interviewed by using a questionnaire which addressed since issues concerning to general infrastructure until animal health management. The results showed that: in all the farms water comes from wells and the sewage is disposed in septic tanks; the burning of domestic waste is a common practice in 90.3% of the farms; the average dairy herd cattle is 30.6 and the purchase of new animals is done from other farms within the same settlement; in all properties veterinary care is provided by ITESP’s (Land Institute of São Paulo State) technicians and mastitis was the main disease of the herds occurring in 59,7% of the farms. Milk is collected in buckets or drums that are daily cleaned and stored in communal tanks distributed by the settlement. Alizarol is the only test performed every day. 100% of the farmers vaccinate their animals against foot and mouse disease and brucellosis, according to Official vaccination program. 62.9% of the interviewed owners do not eliminate correctly the carcasses. This study shows that properties needs infrastructure improvements, training of settlers to implementing measures of general and health management as well as special attention to the quality of the final generated products

Evaluation of knowledge and experience of dentists of São Paulo State, Brazil about cardiopulmonary resuscitation

Este trabalho descreve o conhecimento e experiência dos cirurgiões dentistas em reanimação cárdio-respiratória (RCR). Foram entrevistados 182 cirurgiões dentistas do Estado de São Paulo, Brasil: 59% julgava-se capaz de definir RCR, embora somente 46% tivesse um conceito correto; 54% acreditava ser capaz de realizar RCR, no entanto nenhum deles referiu ter recebido treinamento prático em RCR; 3% dos entrevistados mencionou a ocorrência de parada cárdio-respiratória no consultório odontológico. Concluiu-se que os cirurgiões dentistas brasileiros deveriam ser melhor treinados em emergências médicas que podem ocorrer nos consultórios odontológicos.This work describes the knowledge and experience of dentists about cardiopulmonary resuscitation (CPR). A total of 182 dentists from São Paulo State, Brazil were interviewed: 59% judged themselves able to define CPR, although only 46% had a correct concept; 54% believed himself to be able to perform CPR, however, none of them referred to have received practical training in CPR; 3% of the interviewed professionals mentioned the occurrence of cadiopulmonary arrest in their dental office. It was concluded that dental surgeons in Brazil should be better trained for medical emergencies that can occur in the dental office.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

The Importance of Endoscopy with Biopsy: Real-World Evidence of Gastrointestinal Involvement in Primary Immunodeficiency in Two Main Northern Italian Centres

Introduction: Inborn errors of immunity (IEI) represent a heterogeneous group of diseases in which the true prevalence of GI involvement is not well-known. This study evaluates the prevalence of lower GI manifestations in patients with common variable immunodeficiency (CVID), analysing the histologic findings in colonic samples and assessing any correlations with biochemical abnormalities. Materials and Methods: A retrospective study was performed by collecting the data of IEI adult patients followed up at two main Northern Italian centres. Demographic and clinical data, and blood tests were collected. A colonoscopy with multiple biopsies in standard sites, in addition to a biopsy for any macroscopic lesion, was performed. The gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) and the short Inflammatory Bowel Disease Questionnaire (sIBDQ) were used to assess GI symptoms. Results: 141 patients were included: 121 (86.5%) with CVID, 17 (12.1%) with IgG subclass deficiency, and 2 (1.4%) with X-linked agammaglobulinemia. Of the patients, 72 (51%) complained of GI symptoms. No differences were seen between patients receiving or not IgRT. GI infections were found in 9 patients (6.4%). No significant correlations were found between gut infections and symptoms or leukocyte infiltrates. Colonoscopy alterations were present in 79 patients (56%), and the most common were colon polyps (42%). Microscopical abnormalities were seen in 60 histologic samples (42.5%) and the most frequent was nodular lymphoid hyperplasia (40%). A leukocyte infiltrate was present in 67 samples (47.5%), and the most common was a lymphocyte infiltrate (33%). No correlation was found between GI symptoms and macroscopic alterations, whereas a positive correlation between symptoms and microscopic alterations was detected. Conclusions: GI symptoms and microscopic alterations in colon samples are closely related; hence, it is important to carry out serial colonic biopsies in every CVID patient, even in the absence of macroscopic lesions