Ruptura diafragmática traumática em felinos

Resumo. A ruptura diafragmática traumática é uma afecção de urgência frequente em pequenos animais, o presente trabalho reuniu estudos que apontam os gatos machos, jovens e não castrados como os mais suscetíveis, principalmente os que possuem acesso à rua. Traumas diretos ou indiretos causam a ruptura do diafragma, fazendo com que os órgãos abdominais migrem para a cavidade torácica, danos graves à cavidade e aos órgãos torácicos podem ocorrer como consequência do trauma. Os sinais clínicos podem incluir dispneia, cianose e abafamento dos sons cardiopulmonares à ausculta; entretanto, podem ser inespecíficos dependendo do acometimento e tempo da ruptura. O tratamento é cirúrgico, sendo indicado uma técnica de herniorrafia diafragmática, que consiste na síntese do diafragma no local onde foi rompido para recompor a estrutura anatômica do mesmo, restituindo sua função na respiração e reestabelecendo a pressão negativa do tórax

Impaired nutritional status in outpatients in remission or with active Crohn's disease : classified by objective endoscopic and imaging assessments

Crohn's disease is a chronic inflammatory disease consisting of alternated periods of relapse and remission. The disease is associated with altered body composition and micronutrient deficiencies. This study aimed to evaluate the nutritional status of Crohn's disease outpatients in remission and activity of the disease. Patients were classified according to Crohn's Disease Endoscopic Index of Severity or Magnetic Resonance Imaging scan. Anthropometric and biochemical analysis was performed for nutritional status evaluation. A total of 60 patients were evaluated of which 31 were in endoscopic remission (mean Crohn's Disease Endoscopic Index of Severity: 1.76) and 29 in activity (mean Crohn's Disease Endoscopic Index of Severity: 7.88). Regarding markers of fat and lean mass, lower values were observed in the activity group when compared to the remission group (p < 0.05). There was a positive correlation regarding the duration of the disease and the anthropometric parameters in patients with active disease. Interestingly, the prevalence of overweight/obese patients was 55% in remission group and 28% in activity group according to the Body Mass Index classification. In addition, lower levels of iron, folic acid and albumin were also observed in Crohn's disease activity group. We observed important differences in nutritional markers between patients in remission and activity phases, with higher prevalence of overweight/obese in patients with remission of the disease336065COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESnão te

Infliximab monitoring in Crohn’s disease: a neural network approach for evaluating disease activity and immunogenicity

Background: The treatment for Crohn’s disease (CD) has increasingly required the use of biological agents. Safe and affordable tests have led to the active implementation of therapeutic drug monitoring (TDM) in clinical practice, which, although not yet widely available across all health services, has been proven effective. Objective: To analyze serum infliximab (IFX) and antidrug antibody (ADA) levels in CD patients, compare two tests, as well as construct a prediction of neural network using a combination of clinical, epidemiological, and laboratory variables. Design: Cross-sectional observational study. Method: A cross-sectional observational study was conducted on 75 CD patients in the maintenance phase of IFX treatment. The participants were allocated into two groups: CD in activity (CDA) and in remission (CDR). Disease activity was defined by endoscopic or radiological criteria. Serum IFX levels were measured by enzyme-linked immunosorbent assay (ELISA) and rapid lateral flow assay; ADA levels were measured by ELISA. A nonparametric test was used for statistical analysis; p value of ⩽0.05 was considered significant. Differences between ELISA and rapid lateral flow results within the measurement range were assessed by the Wilcoxon test, Passing–Bablok regression, and Bland–Altman method. Prediction models were created using four neural network sets. Neural networks and performance receiver operating characteristic curves were created using the Keras package in Python software. Results: Most participants exhibited supratherapeutic IFX levels (>7 mg/mL). Both tests showed no difference in IFX levels between the CDA and CDR groups ( p  > 0.05). The use of immunosuppressive therapy did not affect IFX levels ( p  > 0.05). Only 14.66% of patients had ADA levels >5 AU/mL, and all ADA-positive participants exhibited subtherapeutic IFX levels in both tests. The median results of both tests showed significant differences and moderate agreement ( r  = −0.6758, p  80%