Pulmonary and cardiovascular syndrome due to hantavirus: clinical aspects of an emerging disease in southeastern Brazil

A síndrome pulmonar e cardiovascular por hantavírus é doença causada pela aspiração de aerossóis dos dejetos de roedores silvestres contaminados por vírus da família Bunyaviridae. Estudamos manifestações clínicas e laboratoriais de 70 casos ocorridos de 1998 a 2007 na região de Ribeirão Preto, SP. A freqüência de sintomas foi dispnéia (87%), febre (81%), tosse (44%), cefaléia (34%), taquicardia (81%), hipotensão arterial (56%), hipóxia (49%), acidose metabólica (57%), linfocitopenia (51%), hematócrito >45% (70%), leucocitose com desvio à esquerda (67%), creatinina (51%) e uréia (42%) séricas elevadas. A letalidade (54,3%) ocorreu principalmente no 4o dia. Insuficiência respiratória, hipotensão arterial e choque ocorreu 24-48 horas; o hematócrito elevado e a plaquetopenia são sinais fortemente sugestivos da doença. A hipótese diagnóstica de pneumonia atípica associada a bom prognóstico (p:0,0136); a infusão hídrica >2.000ml e hipotensão arterial associadas a mau prognóstico (p:0,0286 e p:0,0453).Pulmonary and cardiovascular syndrome due to hantavirus is a disease caused by inhalation of aerosols from the excreta of wild rodents contaminated by viruses of the Bunyaviridae family. We studied the clinical and laboratory manifestations of 70 cases that occurred in the region of Ribeirão Preto, SP, Brazil, between 1998 and 2007. The frequency of symptoms was as follows: dyspnea (87%), fever (81%), coughing (44%), headache (34%), tachycardia (81%), low arterial blood pressure (56%), metabolic acidosis (57%), lymphocytopenia (51%), hematocrit > 45% (70%), leukocytosis with left deviation (67%), creatinine (51%) and urea (42%). Mortality (54.3%) occurred mainly on the fourth day. Respiratory insufficiency, low arterial blood pressure and shock occurred after 24 to 48 hours. High hematocrit and decreased platelet levels were signs strongly suggestive of the disease. The diagnostic hypothesis of atypical pneumonia was associated with a good prognosis (p = 0.0136). Fluid infusion greater than 2,000 ml and arterial hypotension were associated with a poor prognosis (p = 0.0286 and p = 0.0453)

PHYSICOCHEMICAL AND MICROBIAL ANALYSIS OF FECES FROM HORSES FED DIETS CONTAINING CITRUS PULP

This study aimed to evaluate the effect of diets containing increasing levels of citrus pulp on the physicochemical and microbiological characteristics of horses feces. Five mares, at an average age of 3.5 years old and body weight of 492 ± 44.5 kg were arranged in a 5 x 5 Latin Square. The experimental diet consisted of 60% coast-cross hay and 40 % of concentrate with increasing levels of citrus pulp (0, 7, 14, 21, and 28 %). To determine the fecal pH, samples were collected directly from the floor, immediately after defecation, in the first feces of the day at 07:00 a.m., and color and fecal consistency were evaluated. For microbiological analysis, an aliquot was reserved in plastic bags, frozen, and sent to the microbiological laboratory for further analysis. Lactic acid bacteria were counted for Lactobacillus spp. and Streptococcus spp. from fecal samples under anaerobic conditions. The diet produced differences (P0.05) on pH and on the number of Lactobacillus spp. and Streptococcus spp. The inclusion of up to 28% citrus pulp concentrates for horses did not promote change in the physicochemical characteristics and on the population of lactic acid-producing bacteria in feces. Keywords: byproducts; lactobacillus; nutrition; pH

What a Neurosurgeon Should Know About the Endolymphatic Sac: Part 2 – Diagnosis and Management of the Endolymphatic Sac Tumors

Objective This article is divided into three parts. In the second part of this review, the authors focus on describing the endolymphatic sac tumor and presenting illustrative cases. Methods A review of previous studies, from 1957 to 2021, from basic and translational research using human and animal endolymphatic sac (ES) tissue or cells, as well as other reviews on this theme. Results The ES is an inner ear structure, which is responsible for the homeostatic regulation, as well as endolymphatic fluid volume control, immune response etc. One of the possible alterations of the ES is the ELST, a low-grade malign neoplasm that originates from the epithelium of the endolymphatic duct and sac. The clinical presentation of the ELST includes hearing loss, tinnitus, headache, and vertigo. The diagnosis in the early stages is rare, given that this group of symptoms is very similar to other, more common, diseases such as the Meniere syndrome. Its diagnosis is made by computed tomography (CT), magnetic resonance imaging (MRI), immunohistochemistry, and confirmed by histopathology. However, none of these examinations are part of the pathological guidelines for ELST. The treatment for ELST in the early stages has a high rate of success. Conclusion The ELST is a very difficult diagnosis due to its presentation. Furthermore, the interactions between ELST and the Von Hippel-Lindau disease usually result in a more aggressive condition. Despite the difficulty of the diagnosis, doing it early increases the chances of successful treatment

What a Neurosurgeon Should Know About the Endolymphatic Sac: Part 1–Anatomy and Physiology

Objective To describe the microsurgical anatomy and the physiology of the endolymphatic sac (ES) that a neurosurgeon should know

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Comentários a uma sentença anunciada : o processo Lula

“Comentários a uma sentença: o Caso Lula” é talvez o mais importante documento jurídico publicado no Brasil em décadas. A presente coletânea de artigos nasceu de um movimento espontâneo e bastante significativo de juristas brasileiros e estrangeiros que examinaram cuidadosamente a sentença proferida no âmbito do processo que tramitou na 13ª Vara Federal de Curitiba, no caso que ficou conhecido na mídia como o do “tríplex do Guarujá”. <br>De la presentación de Geraldo Prad

Comentarios a una sentencia anunciada : el proceso Lula

El centenar de textos que conforman este libro -escritos por un movimiento de prestigiosos/as juristas y abogados- desgranan el procedimiento al que fue sometido Lula. En la opinión de las y los autores de los artículos las normas no fueron observadas, y su inobservancia llevó a que se dictaminase una decisión injusta. Frases del estilo "Voy a tomar una decisión revolucionaria, dejando de lado la ley, porque por la ley no se puede condenarlo de ninguna manera”, dichas en los juicios por las más altas autoridades judiciales militares y civiles, hoy son conocidas gracias a quienes se abocaron al trabajo de escuchar los audios de aquellas sesiones, nutriendo las reflexiones que argumentan sobre el imperativo de la hora: restablecer el estado de derecho y absolver al presidente Lula Da Silva