About the icteric index and the fasting bilirubinaemia in equines

Os AA., procurando estabelecer o índice ictérico normal para os eqüinos, apresentam os resultados de dosagens, pelo método de Lamounier, em 20 cavalos puro sangue, de corrida, com regime alimentar bem equilibrado, em semi-estabulação, sem trabalho forçado e considerados clinicamente normais, mediante assistência veterinária periódica; encontram como limites de normalidade (critério M ± 2) para o índice ictérico, nesses animais, valores de 0,5 a 8 unidades: êsses limites podem ser admitidos como normais até que a análise estatística de observações mais numerosas os delimitem definitivamente. Procedendo à determinação do índice ictérico em um segundo lote de26 animais P. S., em regime de trabalho de corrida, surpreenderam-se com a verificação de valores mais elevados, sendo a diferença entre as médias nos dois grupos não atribuível a flutuações de amostras simples. Relacionando o fato com a chamada hiperbilirrubinemia do jejum, dado o regime alimentar ao qual estão submetidos os cavalos da segunda série, estudam êste fenômeno em um lote de quatro animais, com dosagem do índice ictérico de 2 em 2 horas, durante 34 horas ininterruptas, verificando o aumento do índice ictérico em função do tempo, a partir de 6 horas de jejum; apresentam, em gráfico, as equações de regressão para cada um dos animais e para a média do lote. Sugerem a possibilidade de que o elevado índice ictérico dos animais do segundo lote, dado o regime alimentar carente, possa corresponder a uma hiperbilirrubinemia de jejum qualitativo, não podendo apontar no momento o componente ou os componentes do regime normal cuja falta nesses animais seja responsável pelo fenômeno estudado.The A. A. is trying to establish the normal icteric index for equines; they show the results of the tests, by Lamounier’s method; in 20 thoroughbred race horses, which aren’t running, with a well balanced diet and considered clinically normal by periodic veterinary assistence, they found the limits of normality (using M ± 2) for icteric index, in these animals, amount from 0.5 to 8 Units; these limits may be admitable as normal until a statistic analise of a greater number of observations well give us definit values. Proceding the determination of icteric index from 26 thoroughbred race horses (which were working on races), the A.A. were surprised in verifying the greater values, the difference between the average of the two being groups excluding fluctuation samples. These animals got a very small ration of green food value. In relation to this fact with the so called bilirubinaemia of the fasting they studied this phenomeno in a group of 4 animals, with determination of icteric index every 2 hours, during 4 ininterrupted hours, they found an increase in icteric index in relation with the fasting time, they show in a grafic the regretion equation for each animals and for the average of the groups. They suggested the possibility of the high level of icteric index in thoroughbred race horses probably corresponds to a qualifying fasting hiperbilirubinaemia. They can’t, show at the moment the missing of component or components of the normal diet which is responsible for this phenomeno in that race horses

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research