Assessment Of The Epilepsy Treatment Gap In Two Cities Of South-east Of Brazil.

To assess the epilepsy treatment gap in Campinas and São Josédo Rio Preto, two cities in the State of São Paulo, Brazil. The treatment gap was estimated using the formula n1-n2/n1x100, where n1 was calculated using 1.86% prevalence and represented the number of individuals with epilepsy, while n2 represented the number of people who could be treated with an adult standard dose for a year utilizing the antiepileptic drugs supplied by the public health system. Our estimates revealed that in 2001, approximately 50% of the population with epilepsy was treated with the recommended antiepileptic medication. These results suggest that a relevant percentage of patients with epilepsy are not untreated. Further epidemiological studies are needed to investigate the reasons for this treatment gap so that interventions can reduce this gap and improve the quality of life of patients with epilepsy.62761-

A lacuna de tratamento em epilepsia em duas cidades do sudeste do Brasil

OBJECTIVE: To assess the epilepsy treatment gap in Campinas and São José do Rio Preto, two cities in the State of São Paulo, Brazil. METHOD: The treatment gap was estimated using the formula n1-n2/n1x100, where n1 was calculated using 1.86% prevalence and represented the number of individuals with epilepsy, while n2 represented the number of people who could be treated with an adult standard dose for a year utilizing the antiepileptic drugs supplied by the public health system. RESULTS: Our estimates revealed that in 2001, approximately 50% of the population with epilepsy was treated with the recommended antiepileptic medication. CONCLUSION: These results suggest that a relevant percentage of patients with epilepsy are not untreated. Further epidemiological studies are needed to investigate the reasons for this treatment gap so that interventions can reduce this gap and improve the quality of life of patients with epilepsy.OBJETIVO: Estimar a lacuna de tratamento em epilepsia nas cidades de Campinas e São José do Rio Preto, interior do Estado de São Paulo. MÉTODO: Estimamos a lacuna de tratamento através da fórmula n1-n2/n1x100, onde se utiliza o número de pessoas com epilepsia, calculado pela prevalência (n1), e a quantidade de pessoas que podem ser tratadas com a dose padrão para adultos das DAEs, distribuídas no período de um ano na localidade (n2). Usamos a prevalência estimada de 1,86% e consumo de medicação antiepiléptica fornecida pela rede básica de saúde nestas duas cidades. RESULTADOS: Nossas estimativas mostram que somente em torno de metade da população com epilepsia foi tratada em 2001 usando doses preconizadas de medicação antiepiléptica. CONCLUSÃO: A nossa estimativa aponta que uma parcela importante dos pacientes com epilepsia não está sendo tratada no nosso meio. Estudos epidemiológicos futuros devem explorar os motivos desta lacuna de tratamento para que intervenções sejam realizadas para melhorar a qualidade de vida dos pacientes com epilepsia.76176

GLOBULAR AND CORDIFORM COFFEE SOMATIC EMBRYOS INDUCED BY BAP E SUCROSE

The conventional breeding programs for coffee plants require a long period for obtaining new cultivars. Techniques of tissue culture are used to minimize such problem. The effect of BAP and sucrose in somatic embryogenesis of coffee plants was evaluated. Calli of Coffea arabica L. Acaiá Cerrado were inoculated in test tubes containing 15 ml of a R regeneration semi-solid culture medium. The treatments consisted of different BAP concentrations (0, 2, 4, 6 and 8 mg.L-1) and sucrose (0, 15, 30 and 60 g.L-1), and the culture medium was supplemented with 7 g.L-1 agar. The pH was adjusted to 5.8 before being sterilized at 121 ºC and 1.5 atm for 20 minutes. The calli were inoculated in test tubes in laminar flow chamber and the cultures were kept in a growth room at 27 ± 1 ºC, 16-hour photoperiod and 32 mM.m-2.s-1 light intensity. The highest number of globular and cordiform embryos were obtained by using 8 mg.L-1 of BAP combined to 60 mg.L-1 sucrose which provided a total of 247 and 182 embryos per explant, respectively.Os programas convencionais de melhoramento de cafeeiro requerem um período longo para obtenção de novas cultivares. Uma alternativa para minimizar tal problema é a utilização das técnicas de cultura de tecidos. Objetivou-se estudar o efeito de BAP e sacarose na embriogênese somática de cafeeiro. Calos de Coffea arabica L. cv. Acaiá Cerrado foram inoculados em tubos de ensaio, contendo 15 ml do meio de cultura semi-sólido R de regeneração. Os tratamentos consistiram de combinação de diferentes concentrações de BAP (0, 2, 4, 6 e 8 mg.L-1) e sacarose (0, 15, 30 e 60 g.L-1), acrescido de 7 g.L-1 de ágar e pH ajustado para 5,8, antes da autoclavagem a 121 ºC e 1,5 atm por 20 minutos. A inoculação foi realizada em câmara de fluxo laminar e os calos foram mantidos em sala de crescimento com temperatura de 27±1ºC, fotoperíodo de 16 horas e 32mM.m-2.s-1 de intensidade luminosa. Maior número de embriões globulares e cordiformes foi obtido utilizando-se 8 mg.L-1 de BAP associado a 60 mg.L-1 de sacarose, proporcionando um total de 247 e 182 embriões por explante, respectivamente

Cholecystoduodenostomy for Treatment of Biliary Obstruction Secondary to Feline Platinossomosis

Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection is acquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable. The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. The treatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the Uberaba Veterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodes of vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased values of ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease and steatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomy were then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described, besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patient was treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorized cholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adult form. After four days, a new blood count was done and the animal was still anemic and the blood transfusion was chosen. The patient died within moments of the transfusion procedure.Discussion: Platynosomum spp. it is a trematode whose ultimate host is the domestic felines and inhabits liver, gallbladder and bile ducts causing biliary obstruction and even fibrosis. In the present report, the tutor reports that the cat had several episodes of vomiting and reduced appetite. Feline jaundice is normal in cases where cholestasis causes a two to three-fold increase in bilirubinemia from normal values. The increase was verified in the analyzed feline. Physical examination revealed jaundice and abdominal palpation suggestive of hepatomegaly. Ultrasound suggested cholangiohepatitis. Without improvement, liver biopsy and cholecystoduodenostomy were suggested, with tutor refusal. After repeated ultrasound, the images suggested cholangitis and the stool examination was negative for Platynosomum spp. The definitive diagnosis for this disease is through liver biopsy, visualization of the operated eggs or the adult form of the parasite in feces or bile as suggested in this case. However, in cases where there is total obstruction of the bile ducts, the eggs are not eliminated in the digestive system and the examination may be false negative as in this case. After the exams, the cat was submitted to cholecystoduodenostomy surgery where gallbladder puncture was performed for microscopic evaluation, and the parasite Platynosomum spp. in adult form. Most cats have blood type A, but even when the donor has the same blood type, cross-reaction may occur, so compatibility testing should be performed prior to any transfusion, thus reducing the risk of transfusion reactions. The patient died within moments of the transfusion procedure.