APLICAÇÕES DOS ANTIMICROBIANOS NA MEDICINA VETERINÁRIA: HISTÓRICO, EVOLUÇÃO, USO INDISCRIMINADO E RESISTÊNCIA

Antimicrobianos são fármacos utilizados no combate a agentes infecciosos, que atuam inibindo a ação de microrganismos no hospedeiro. Na Medicina Veterinária, o uso de antimicrobianos pode ser bem versátil, uma vez que assim como na clínica médica de humanos, pode ser utilizado clinicamente em animais acometidos por doenças infecciosas, ou como promotores de crescimento em animais de produção. A grande problemática da utilização das mais variadas classes de antibióticos, se dá devido à capacidade que células procarióticas possuem de desenvolver mecanismos de resistência a esses antimicrobianos. Portanto, o objetivo desta revisão é fazer uma análise das aplicações de antimicrobianos, assim como seus mecanismos de ação e impacto na saúde pública

Billroth I Technique Application After Resection of Gastric Leiomyoma in a Dog

Background: Gastric neoplasia is rare, corresponding to less than 1% of cases, with a lower prevalence of those involving smooth muscle tissues. In these cases, clinical signs worsen in the occurrence of pyloric obstruction, leading to clinical manifestations such as chronic emesis. The exeresis of the neoplasm is promoted as a therapeutic measure to reestablish gastrointestinal flow. There partial gastrectomy followed by gastroduodenal anastomosis, using the Billroth I technique, is among the available surgical techniques. The therapeutic success of the Billroth I technique after pylorectomy was reported in a dog with gastric leiomyoma.Case: Canine, poodle, 9 years old, 9.5 kg, with a history of chronic vomiting starting three months ago, progressive weight loss, and melena, previously treated by another Veterinarian as idiopathic gastroenteritis. The physical evaluation of the animal showed a state of normal consciousness, body score 4/9, pale ocular and oral mucous membranes, respiratory rate 20 mpm, heart rate 166 bpm, a rectal temperature of 37.9 °C, and dehydration degree of 8.0%. Blood count showed normocytic normochromic anemia and leukocytosis with shift to the right. Radiographic and endoscopic examinations were not noteworthy. Endoscopic biopsy after a histopathological evaluation showed no cellular or tissue atypia. On the other hand, abdominal ultrasound assessment revealed thickening with loss of echotexture and definition of the muscular layer of the gastric wall, pyloric and duodenum region compatible with benign antral muscle hypertrophy and/or pyloric neoplasia. The animal worsened five days after the initial treatment, with progressive episodes of emesis and melena, opting for an exploratory laparotomy. A mass of firm consistency measuring approximately 2.5 × 6.0 cm in diameter was found in the pyloric region, opting for a pylorectomy. The excised fragment was sent for histopathological examination. Then, gastroduodenal anastomosis was performed using the Billroth I technique. After the surgery, a pasty diet was introduced orally, without using gastroenteric tubes. Dry food was offered ten days after the surgical procedure. The animal returned for clinical reevaluation on the fifteenth day and was clinically well. Histopathological examination revealed a diagnosis of gastric leiomyoma.Discussion: The casuistry of gastric neoplasia in dogs has a low incidence, with an occurrence of less than 1%, with adenocarcinoma being the most common type. However, there are less frequent reports of other gastric neoplasia, such as smooth muscle tumors. Abdominal ultrasonography is indicated for the diagnosis of gastrointestinal changes, proof of which ultrasonography was of paramount importance in this case. The surgical procedure of pylorectomy guaranteed a margin of one centimeter, meeting the principles of oncological surgery. Absorbable monofilament suture materials are the choice for the synthesis stage in hollow organs, being used in this case. The most-reported expected complications of gastrointestinal surgeries aiming at removing neoplasms are vomiting, anorexia, melena, hematochezia, hematemesis, necrosis with anastomotic ulceration, and, consequently, septic peritonitis, which were not reported in this case. The life expectancy of patients with gastric neoplasia is quite variable, with longer survival in cases of benign neoplasia. Therefore, the type of neoplasia in this case, together with the appropriate choice of therapy and the appropriate performance of the technique, was important for the good result achieved

Perfil de ação da Maytenus aquifolium sobre radicais livres e espécies reativas do oxigênio

Reactive oxygen species (ROS) and free radical species have been implicated in initiating, accompanying or causing many diseases in living organisms; there is thus, a continual need for antioxidants molecules to inactivate ROS/free radicals. Many studies of plants crude extracts have demonstrated free-radical scavenging and antioxidant action. Maytenus species have long been used, in several countries, as traditional medicines against gastric ulcers, dyspepsia and others gastric problems and for their anti-inflammatory properties. In this study, Maytenus aquifolium (Celastraceae) root bark ethanol extract was assessed for its ability to scavenge free radicals and reactive oxygen species. The results were expressed as percentage inhibition of the active species. The extract was efficient against studied reactive species: DPPH radical (obtained inhibition = 35.5 ± 1.3 %), ABTS+ (IC50 = 0.0036 ± 0.0003 mg/mL), HOCl (IC50 = 0.002 ± 0.0001 mg/mL ), O2- (obtained inhibition = 36.0 ± 2.1 %), and NO (obtained inhibition = 18.3 ± 0.4 %).Espécies Reativas do Oxigênio (ERO) e radicais livres têm tido implicações na iniciação e evolução de muitas doenças ou nas causas das mesmas em organismos vivos; há portanto, necessidade contínua por moléculas antioxidantes para inativar ERO/radicais livres. Estudos sobre extratos brutos de plantas têm demonstrado suas ações antioxidante e seqüestradora de radicais livres. Espécies do gênero Maytenus são utilizadas, em vários países, como medicamentos tradicionais no combate a úlceras gástricas, dispepsia e outras desordens gástricas, bem como por suas propriedades antiinflamatórias. Neste estudo, o extrato bruto etanólico da raiz da Maytenus aquifolium (Celastraceae) foi avaliado quanto à sua habilidade em seqüestrar radicais livres e outras espécies reativas do oxigênio. Os resultados são expressos como porcentagem de inibição das espécies ativas. O extrato foi eficiente contra as espécies estudadas: radical DPPH (inibição alcançada = 35,5 ± 1,3 %), ABTS+ (IC50 = 0,0036 ± 0,0003 mg/mL), HOCl (IC50 = 0,002 ± 0,0001 mg/mL ), O2- (inibição alcançada = 36,0 ± 2,1 %), and NO· (inibição alcançada = 18,3 ± 0,4 %)

Estudo de seguimento por dois anos de idosos residentes em São Paulo, Brasil: metodologia e resultados preliminares

INTRODUCTION: Previous cross-sectional studies have shown a high prevalence of chronic disease and disability among the elderly. Given Brazil s rapid aging process and the obvious consequences of the growing number of old people with chronic diseases and associated disabilities for the provision of health services, a need was felt for a study that would overcome the limitations of cross-sectional data and shed some light on the main factors determining whether a person will live longer and free of disabling diseases, the so-called successful aging. The methodology of the first follow-up study of elderly residents in Brazil is presented. METHOD: The profile of the initial cohort is compared with previous cross-sectional data and an in-depth analysis of nonresponse is carried out in order to assess the validity of future longitudinal analysis. The EPIDOSO ( Epidemiologia do Idoso ) Study conducted a two-year follow-up of 1,667 elderly people (65+), living in S. Paulo. The study consisted of two waves, each consisting of household, clinical, and biochemical surveys. RESULTS AND CONCLUSIONS: In general, the initial cohort showed a similar profile to previous cross-sectional samples in S. Paulo. There was a majority of women, mostly widows, living in multigenerational households, and a high prevalence of chronic illnesses, psychiatric disturbances, and physical disabilities. Despite all the difficulties inherent in follow-up studies, there was a fairly low rate of nonresponse to the household survey after two years, which did not actually affect the representation of the cohort at the final household assessment, making unbiased longitudinal analysis possible. Concerning the clinical and blood sampling surveys, the respondents tended to be younger and less disabled than the nonrespondents, limiting the use of the clinical and laboratory data to longitudinal analysis aimed at a healthier cohort. It is worth mentioning that gender, education, family support, and socioeconomic status were not important determinants of nonresponse, as is often the case.INTRODUÇÃO: Estudos transversais recentes mostraram alta prevalência de doenças crônicas e incapacidades físicas entre idosos. Considerando o rápido processo de envelhecimento do Brasil e as conseqüências que esse aumento de idosos com doenças crônicas e incapacidades associadas acarretará para o sistema de saúde, fazia-se necessário estudo que pudesse superar as limitações dos dados transversais, permitindo determinar quais os fatores determinantes de uma vida longa e livre de doenças incapacitantes, o chamado envelhecimento bem sucedido. É apresentada a metodologia do primeiro estudo epidemiológico longitudinal com idosos residentes na comunidade, no Brasil. MÉTODO: O perfil do cohorte inicial é comparado com dados de estudos anteriores a com o perfil dos não respondentes para avaliar a validade de análises longitudinais futuras.O projeto EPIDOSO (Epidemiologia do Idoso) seguiu por dois anos 1.667 idosos (65+), residentes em São Paulo. Consistiu de duas ondas, cada qual com três inquéritos: domiciliar, clínico e laboratorial. RESULTADOS E CONCLUSÕES: O perfil da população não diferiu de estudos anteriores, mostrando maioria de mulheres, viúvas, vivendo em domicílios multigeracionais, com uma alta prevalência de doenças crônicas, distúrbios psiquiátricos e incapacidades físicas. A despeito de todas as dificuldades inerentes a um estudo longitudinal, o grupo de não-respondentes ao segundo inquérito domiciliar não diferiu significativamente dos respondentes, assegurando análises longitudinais livres desse tipo de viés. Em relação aos inquéritos clínico e laboratorial, os não-respondentes mostraram-se mais velhos e mais incapacitados que os respondentes, limitando o uso dos dados clínicos e laboratoriais a análises pertinentes a uma cohorte mais jovem e saudável. Sexo, educação, apoio familiar e nível socioeconômico não influenciaram de forma significativa a taxa de não - resposta, ao contrário do que se costuma verificar.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Estudos da comissão especial de direito médico da OAB Tocantins: reflexões e perspectivas

- Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.- Localização na estante: 347.56:614.25(81) E82c- Felippe Abu-Jamra Corrêa é o coordenador da obra

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

A memória como cinza em W. G. Sebald: um itinerário

This paper seeks to investigate the nuances of the memory as ashes in the work of the writer W.G. Sebald. Centered on the effects of destruction, Sebald's writing continuously supports the idea of retention. Having The Rings of Saturn as central framework, due to its strong tone of compendium and the amplitude of the examined theme, the following itinerary registers the flux of the rescue of the ashes – understood as residue, reminiscence – through three essential points of convergence: Space, Image and Literature. The abovementioned categories will consider recurring aspects of the author's work, seen through the lenses of the proposed framework. Among them, the following shall be highlighted: the theme of pilgrimage – fundamental strategy of Sebald's narratives, in which the notion of the mobilization of space is intrinsically connected to the mobilization of memory; the strong interest towards the work of art and photography – especially, the understanding of the work of art as a residue; and the constant literary incidences – of the references evoked by the writer to register the memory of the dead, who are, essentially, also writers. Lastly, this paper endeavors to criticize Sebald's work under the perspective of the crossing between the dimensions of memory and oblivion, and, consequently, of the rescue made through his works. When examining Sebald's writing, it is possible to affirm that the author has the formalization of an absence as a principle. This procedure, which will be examined through this work, aims to contribute to the understanding of the work of art through the appreciation of what is forgotten – and must be rescued. It is within this context that the writer's obsessive preoccupation with the past is configured. In correlation, the followed itinerary seeks to replicate this movement of rescue and to unveil the author's intents

Uso da transformada de Hough na vetorização de moldes e outras aplicações

The growing use of the digital images increases the necessity of new approaches on applications on how information from acquired captured images can be obtained. The principal objective of this line of works is aid modeling model on apparel industry. The main point is to identify on a pattern of garment the lines and curves that forms its border and than to reconstruct it from a minimum set of information. The aim is improve the current procedure that involves extensive manual work on digitalization of the 2D patterns. In this work a methodology that applies the Hough Transform for equations of first and second degrees is proposed, implemented and tested. This system can be used in several other applications to identify forms. In some uses as in the hardness measure and the quality control it presents an alternative way. The presented tests and examples illustrate the effectiveness of the developed system and methodology.Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorA popularização das imagens digitais ampliou as opções de processamento das mesmas e com isso a possibilidade de extração de diversas informações. Esta dissertação tem por objetivo dar subsídios à indústria de vestuário, na pesquisa de um sistema automático de identificação e vetorização de moldes a partir de uma imagem digital. A idéia principal é identificar formas compostas por segmentos de retas e curvas e posteriormente reconstruílas a partir de um conjunto mínimo de informação. Com o objetivo de efetuar a vetorização automática ou reduzir o procedimento atual que envolve trabalho manual extenso através da utilização de uma mesa digitalizadora. Para isso foi desenvolvido um sistema baseado em uma metodologia que aplica a transformada de Hough de equações matemáticas de primeiro e segundo grau a fim de identificarmos formas genéricas que possam estar presentes na imagem. Ao longo do desenvolvimento desta dissertação outras funcionalidades do sistema desenvolvido foram descobertas além da vetorização, entre elas, surge como mais uma alternativa de medição na aplicação de teste de dureza e também como método de controle de qualidade na área de medicamentos. Os testes e exemplos apresentados confirmam a eficácia tanto do sistema quanto da metodologia desenvolvida

Detection and Extraction of Vascular Networks using Hough Transform

Doenças vasculares são um problema mundial, que representa 28% das mortes no mundo e 66% do total de doenças que acometem os brasileiros. Dessa forma, há um grande interesse em pesquisar formas de prevenção e tratamento dessas doenças. Algumas medidas são relevantes no auxílio de diagnóstico, tal como: tamanho médio dos ramos, diâmetro médio das seções transversais dos vasos e padrões de divisão de ramos. Calcular essas medidas de forma manual é uma tarefa demorada e trabalhosa. Assim, esta Tese tem como objetivo, propor um método computacional de rastreamento e extração de atributos em redes vasculares a partir de imagens 3D de angiografia por ressonância magnética e por tomografia computadorizada. Trata-se de uma abordagem de rastreamento e identificação de bifurcações que difere das técnicas anteriores, utilizando a Transformada de Hough para identificar o diâmetro do vaso em cortes transversais num dado ponto ao longo de um vaso sanguíneo. Mais detalhadamente, essa abordagem utiliza um campo vetorial advindo do cálculo de uma matriz formada por derivadas parciais de segunda ordem, obtida da intensidade luminosa da imagem, para identificar a direção de um ramo de vaso. Além disso, durante o processo de rastreamento de um ramo de vaso, são calculados vários descritores de forma com o objetivo de classificar regiões como pertencentes a uma bifurcação ou não. Em adição a estes descritores, desenvolvemos uma nova medida chamada de variância do raio que permite distinguir, bifurcações, não-bifurcações e segmentos de vaso com stents (aparelho metálico usado para aumentar o diâmetro dos vasos). Para a classificação de bifurcações, criamos a medida de bifurcação, que trata-se de uma combinação linear de todos os descritores de forma apresentados neste trabalho. Testes foram realizados para atestar a eficácia da abordagem proposta, utilizando tanto imagens sintéticas quantoimagens reais. Os resultados mostraram que o método é capaz de rastrear 91% de uma rede vascular sintética variando o ponto de inicialização e 76% variando o nível de ruído. Também foi observado por meio de testes que o método proposto consegue rastrear vasos e identificar bifurcações em imagens reais sem avaliação numérica. Essa abordagem permite a extração da relação hierárquica entre os ramos em uma rede vascular e a extração do padrão de divisão dos vasos, o que contribui sobremaneira para o estudo do comportamento do fenômeno da angiogênese e no auxílio no diagnóstico de anomalias vasculares.Vascular diseases are a main health problem, representing 28% of deaths worldwide and 66% of all diseases affecting the Brazilian population. Thus, it is important that researches in prevention and treatment of this type of disease increase. Moreover, there are several demands, such as computational tools capable of analyzing and extracting attributes from non-invasive images. The scope of this work is the analysis and extraction of data from magnetic resonance angiography and computed tomography angiography images by highlighting blood vessels. In this context, this thesis aims the development of a novel computational tracking and feature extraction method for vascular networks from 3D images. Our approach presents the following steps: First, identify the vessel cross-sections along it using the Hough transform. Then, compute a matrix composed of second order partial derivatives of image intensity to identify the direction of the vessel. Perform a feature analysis of the vessel contour to classify the bifurcation point, and finally, identify the direction of the new branch in a bifurcation point. The main contribution of this Thesis is the two new measures developed, called radius ratio and bifurcation measure, the radius ratio is capable to distinguish between a region with bifurcation, stents or without both of them. The bifurcation measure is a linear combination that allows to classify a region as bifurcation or not. Tests were performed in order to verify the proposed approach effectiveness, using both synthetic images and real images. The results showed the method is capable to track 91% of synthetic vascular networks varying the seed point and 76% varying the level of noise. Also, we performed tests in real images and by visual evaluation, we could observed that the proposed method was able to track vessels and identify bifurcations from different parts of the body. This approach allows to calculate, in the future, the density of bifurcations in a vascular network, the distance between them, the stenosis and aneurysms grading and characterize specific vessels. In addition, the vascular networks extraction allows the study of the angiogenesis phenomena and vascular anomalies