Bronchoscopic sampling techniques in the era of technological bronchoscopy

n/

Associação entre Mycoplasma spp. e ácaros do conduto auditivo de bovinos

Esse estudo foi realizado com o objetivo de verificar a associação entre micoplasmas e ácaros (Raillietia auris e R. flechtmanni) no conduto auditivo de bovinos. Foram realizadas lavagens no conduto auditivo externo de 60 bovinos abatidos no Estado do Rio de Janeiro, Brasil. Para a lavagem dos condutos auditivos foi utilizada solução salina tamponada (PBS, pH 7.2) em seringas estéreis de 60mL. Para o isolamento de micoplasmas foram utilizados pools de ácaros por animal, lavados sucessivamente em 1mL de meio Hayflick modificado. Os lavados dos ácaros foram diluídos de 10-1 até 10-5 e repicados em meio Hayflick modificado, sólido e líquido e incubados a 37°C por 48-72 horas em microaerofilia. A identificação das espécies de micoplasmas foi realizada pelo teste da imunoperoxidase indireta (IPI). Verificou-se alta prevalência de ácaros do gênero Raillietia spp. 76,7% (46/60). O parasitismo por ácaros e micoplasmas foi verificado em 40 animais (74,1%), sendo esta associação significativa (p<0,001). Dos ácaros processados para isolamento de micoplasmas, 193 foram fêmeas e 25 machos. A frequência de Mycoplasma em Raillietia spp. foi de 81,2% (177/218) (p<0.001). Das fêmeas identificadas, 52,3% (101/193) foram R. auris e 47,7% (92/193) R. flechtmanni. A frequência de Mycoplasma nas fêmeas de R. auris foi de 75,2% (76/101) e na espécie R. flechtmanni foi de 88% (81/92) (P<0.05). As espécies de micoplasmas tipificadas pela IPI nos ácaros Raillietia auris foram: M. alkalescens 6,9%, M. arginini 3,4%, M. bovirhinis 9,2%, M. conjunctivae 18,4%, M. mycoides mycoides LC 8,0%, M. capricolum 5,7%. Em R. flechtmanni as espécies de micoplasmas identificadas foram: M. alkalescens 12,2%, M. arginini 1,0%, M. bovirhinis 18,9%, M. bovis 2,2%, M. conjunctivae 21,0%, M. mycoides mycoides LC 11,0% e M. capricolum 4,4%. As espécies de micoplasmas identificadas no conduto auditivo externo dos bovinos foram as mesmas presentes nos ácaros R. auris e R. flechtmanni. Os resultados confirmam que o conduto auditivo externo de bovinos é um habitat de Mycoplasma spp., incluindo espécies potencialmente patogênicas para os rebanhos, além dos ácaros R. auris e R. flechtmanni estarem associados com esses molicutes carreando-os em seu organismo

Severe asthma: One disease and multiple definitions

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Cardiopulmonary exercise testing and second-line pulmonary function tests to detect obstructive pattern in symptomatic smokers with borderline spirometry

BACKGROUND: The need for additional research on symptomatic smokers with normal spirometry has been recently emphasized. Albeit not meeting criteria for Chronic obstructive pulmonary disease (COPD) diagnosis, symptomatic smokers may experience activity limitation, evidence of airway disease, and exacerbations. We, therefore, evaluated whether symptomatic smokers with borderline spirometry (post-bronchodilator FEV1/FVC ratio between 5th to 20th percentile of predicted values) have pulmonary function abnormalities at rest and ventilatory constraints during exercise. METHODS: 48 subjects (aged 60 \ub1 8 years, mean \ub1 SD, 73% males, 16 healthy, and 17 symptomatic smokers) underwent cardiopulmonary exercise testing (CPET), body plethysmography, nitrogen single-breath washout test (N2SBW), lung diffusion for carbon monoxide (DLCO), and forced oscillation technique (FOT). RESULTS: Compared to healthy subjects, symptomatic smokers showed: 1) reduced breathing reserve (36 \ub1 17 vs. 49 \ub1 12%, P = 0.050); 2) exercise induced dynamic hyperinflation (-0.20 \ub1 0.17 vs. -0.03 \ub1 0.21 L, P = 0.043); 3) higher residual volume (158 \ub1 22 vs. 112 \ub1 22%, P < 0.001); 4) phase 3 slope at N2SBW (4.7 \ub1 2.1 vs. 1.4 \ub1 0.6%, P < 0.001); 5) no significant differences in DLCO and FOT results. CONCLUSIONS: In smokers with borderline spirometry, CPET and second-line pulmonary function tests may detect obstructive pattern. These subjects should be referred for second line testing, to obtain a diagnosis, or at least to clarify the mechanisms underlying symptoms. Whether the natural history of these patients is similar to COPD, and they deserve a similar therapeutic approach is worth investigating

The role of phenotype on ventilation and exercise capacity in patients affected by COPD : a retrospective study

Background: The idea of phenotype in chronic obstructive pulmonary disease (COPD) has evolved in the last decades, and the importance of peculiar treatment strategies has now been acknowledged. Although dyspnea and exercise limitation are hallmarks of COPD, this aspect has never been fully explored in literature in terms of disease phenotype. The aim of the present study was to explore the relevance of clinical COPD phenotypes on exercise ventilation and maximal capacity.Methods: In this observational cohort retrospective study we analyzed the data of 50 COPD patients who underwent cardiopulmonary exercise test, categorized as emphysematous (n=29), and non-emphysematous (n=21) according to a previously validated model.Results: We found a significant difference in terms of VE/VCO2 slope (median values 32.4 vs 28.0, p=0.015) and VE/VCO2 ratio at nadir (median values 37 vs 33, p=0.004), which resulted higher in emphysematous patients, who also presented lower PETCO2 values (median values 32.6 vs 35.6, p=0.008). In a subgroup of 31 tests which met the maximality criteria, emphysematous patients presented a significantly lower work rate at peak (median value 51 vs 72 % predicted, p=0.016), and showed a lower peak oxygen consumption, although at the limit of significance (median values of 63 vs 85 % predicted, p=0.051).Conclusions: This study extends our knowledge about the characterization of the COPD phenotypical expression of disease, showing that patients affected by emphysema are more prone to ventilatory inefficiency during exercise, and that this is likely to be an important cause of their overall reduced exercise capacity

Soropositividade e fatores de risco para leptospirose, toxoplasmose e neosporose na população canina do Estado da Paraíba

RESUMO: Objetivou-se com este trabalho determinar a frequência de animais soropositivos para Leptospira spp., Toxoplasma gondii e Neospora caninum em cães do Estado da Paraíba, Nordeste do Brasil, bem como identificar fatores de risco. Foram amostrados 1.043 soros de cães procedentes de cinco centros urbanos considerados polos regionais: João Pessoa, Campina Grande, Patos, Sousa e Cajazeiras. Para o diagnóstico sorológico da infecção por Leptospira spp. foi utilizada a soroaglutinação microscópica (SAM) enquanto que para detecção de anticorpos anti-T. gondii e N. caninum empregou-se a reação de imunofluorescência indireta (RIFI). Noventa e sete cães apresentaram aglutininas anti-Leptospiraspp., resultando em frequência de 9,3% (IC 95% = 7,5-11,1%). Os sorovares de maior frequência foram Icterohaemorragiae (47,4%), Copenhageni (16,5%), Bratislava (11,3%), Canicola (10,3%) e Pomona (6,2%). Observou-se soropositividade de 22,1% (231/1.043; IC 95% = 19,6-24,7%) e 7,7% (80/1.043; IC 95% = 6,1-9,3%) para T. gondii e N. caninum, respectivamente. Idade >48 meses (OR=2,92), raça não definida (OR=1,94) e criação com acesso à rua (OR=1,57) foram apontados como fatores de risco para infecção por Leptospira spp. Para toxoplasmose, as categorias idade >48 meses (OR=1,74), alimentação com comida caseira (OR=2,24), alimentação com ração e comida caseira (OR=2,34) e contato com gatos (OR=1,57) foram consideradas fatores de risco, enquanto que a criação com acesso à rua (OR=2,62) foi fator de risco para N. caninum. Conclui-se que cães de cinco centros urbanos do Estado da Paraíba estão expostos às infecções por Leptospiraspp., T. gondii e N. caninum, evidenciadas pela detecção de anticorpos, bem como sugere-se melhor manejo alimentar, controle no acesso a ambientes externos e destino adequado das fezes de gatos

Caracterização morfológica e química de frutos de rambutan Morphologic and chemical characterization of rambutan fruits

Com a procura de alternativas por parte dos produtores e de novas opções pelos consumidores, o mercado de frutas exóticas tem ganhado cada vez mais espaço no Brasil. O rambutan encontra-se entre as frutíferas com potencial de mercado, sendo, no entanto, necessário maior conhecimento sobre a cultura, como adequada escolha de genótipos para cada região e manejo do pomar. Diante disso, realizou-se o presente trabalho, na Faculdade de Ciências Agrárias e Veterinárias - UNESP, Câmpus de Jaboticabal-SP, que teve por objetivo as caracterizações morfológica e química de frutos de rambutan, verificando a distinção de genótipos e distância genética entre os materiais. Foram avaliados: tamanho do fruto, comprimento dos filamentos, espessura da casca, tamanho da semente, peso do fruto, peso da casca, peso da semente, porcentagem de polpa, teores de sólidos solúveis (ºBrix), ácido ascórbico e acidez titulável. Realizaram-se ainda observações quanto a: coloração da casca, filamentos e polpa, aderência da polpa à casca, aderência da polpa à semente e presença de tegumento da semente na polpa. Com base nos resultados obtidos neste trabalho, pode-se concluir que os materiais A51 e B03 apresentam maior conjunto de características desejáveis, sendo promissores aos produtores na instalação de novos plantios da cultura.<br>With the increase in the search of alternatives by the producers, and of new options for the consumers, the market of exotic fruits has been gainig more space in Brazil. The rambutan is among the fruits with market potential, however it is necessary more knowledge about the culture, appropriate genotype choice for each area and handling of the orchard. Considering that, the present research was accomplished at the Faculdade de Ciências Agrárias e Veterinárias - UNESP, Campus of Jaboticabal, São Paulo State, Brazil, aiming to study the morphologic and chemical characterization of rambutan fruits, verifying the genotype distinction and the genetic distance among the materials. It was evaluated: fruit size, filament length, peel thickness, seed size, fruit, peel and seed weight, pulp percentage, soluble solid contents (ºBrix), ascorbic acid and titrable acidity. Morever, the following observations were conducted: peel coloration, filaments and pulp, adherence of the pulp to the peel, adherence of the pulp to the seed and presence of tegument of the seed in the pulp. Based on the obtained results in this research, it can be concluded that the materials A51 and B03 present a better group of desirable characteristics, revealing to be promising for the producers in the installation of new culture plantings