Analysis of the presence of FLT3 gene mutation and association with prognostic factors in adult and pediatric acute leukemia patients

When the FLT3 gene is mutated, it originates a modified receptor with structural changes, which give survival advantage and malignant hematopoietic cell proliferation. Thus, the presence of mutations in this gene is considered an unfavorable prognostic factor. A total of 85 consecutive samples of newly diagnosed untreated patients with AL were included in the study after they provided their informed consent. FLT3 gene mutations were detected by PCR. For the pediatric group, a positive correlation was observed between WBC count and the presence of FLT3-ITD in patients with AML and ALL. Furthermore, children with AML who had the FLT3-ITD mutation showed a tendency to express CD34 in blast cells. In the adult group, the AML patients with FLT3-ITD who expressed CD34 in blast cells had a tendency to worse progression. The present data indicate no association between the prognostic factors evaluated and FLT3 gene mutations in adult with AL. Yet, the presence of FLT3-ITD mutation was significantly related with WBC count in the pediatric group. These findings demonstrate that FLT3 gene mutations can be considered as independent poor prognostic factors

Green Anaconda (Eunectes murinus) with Bacterial Clinical Stomatitis

Background: Stomatitis is an infectious disease common in serpents and responsible for high mortality rates. It is characterized by the infection of the oral mucosa and neighboring tissues, related to the opportunistic character of bacteria present in the normal microbiota, pathogenic in stressful situations. Few studies have described the profile of sensibility of these agents in serpents of the Brazilian fauna. Therefore, this study has aimed at describing the isolation and identification of the infectious agents involved in the clinic stomatitis in a specimen of green anaconda (Eunectes murinus), and the profile of susceptibility to antimicrobial agents.Case: The serpent has been rescued in an urban environment, without previous records and featured erosive injuries in its oral cavity, with the presence of secretion. In a clinical evaluation, it has been assessed that the specimen had erosive injuries in its oral cavity, with hyperemic points in its mucosa and serous secretion. Then the specimen went through a collection of the secretion from its oral cavity for microbiological analysis. Typical colonies of Enterococcus, Citrobacter and Enterobacter were identified by the colony morphology and their typical odor. The results of these tests were able to confirm and identify the Citrobacter freundii, Enterobacter spp. and Enterococcus spp. The profile of sensibility to antimicrobials of the isolated microorganisms has been determined through the method of diffusion in the disk of Kirby-Bauer. There was not any sensitive antimicrobial drug for the three agents.Discussion: Immunodepression, malnutrition, and temperatures and humidity outside the animal thermal comfort zone, are predisposing factors for the development of bacterial diseases in reptiles. Little information about pathogen agents affecting constrictor serpents in their native area is available. Most reports on stomatitis in serpents approach cases occurred in captive animals, differently from what has been presented in this case, which is about a free animal rescued when invading an urban area. The bacteria isolated from the oral cavity of the serpent here reported belong to the normal microbiota of the oral cavity of these animals. Notwithstanding, these bacteria may become pathogenic in certain circumstances. Conditions of undernutrition, stress and oral trauma are considered as predisposing factors to the occurrence of stomatitis in serpents, what can be correlated to the occurrence of the disease in this case. The gram-negative agents causing bacterial diseases in serpents are generally resistant to medicines of the most common spectrum used in the clinical routine of wild animals. This way, veterinarians often deal with these diseases in reptiles empirically, using a wide range of antibiotics. This practice might result in the development of resistant bacterial stumps, what stands out due to the potential that resistant bacteria have to generate infections and zoonoses in humans

Dermatopathy Caused by Enterobacter aerogenes and Pseudomonas aeruginosa in Boa constrictor amarali

Background: Bacterial diseases are the main cause of the high mortality rates of snakes, especially those caused by gramnegative agents. However, studies on dermatopathy caused by these bacterial agents in snakes are scarce; and no reports have been found on Enterobacter aerogenes as causative agent of dermatopathy in snake species. Thus, the objective of this study was to describe the clinical signs, and lesion evolution of a dermatopathy in a male snake (Boa constrictor amarali) specimen of approximately seven years old; and to describe the isolation and identification of the Enterobacter aerogenes and Pseudomonas aeruginosa agents involved in the cause of this disease.Case: The Boa constrictor amarali evaluated presented blackened cutaneous lesions in the dorsal, snout-vent and tail regions; and well-defined subcutaneous nodules of 2.0-3.0 cm diameter, with soft consistency, reddish color, cutaneous flaccidity, and areas of scale ulceration in the dorsolateral region. The clinical evaluation of the animal showed dehydration signs and pale mucous membranes. The blackened lesions were subjected to mycological analysis - after procedure of deep scale scraping - which showed presence of septate hyphae. The nodule was punctured for microbiological and biochemical analysis. The sample was collected with a sterilized alginate cotton tip swab, and was stored in a plastic tube containing a semi-solid Stuart transport medium, for microbiological analysis. Then, this sample was incubated in a bacteriological oven at 37°C for 24 h. Typical colonies of Pseudomonas and Enterobacter grew on MacConkey agar medium; these bacteria were identified by the colony morphology and their typical odor. The colonies grown in MacConkey agar were also identified through biochemical tests in the mediums: Phenol red, Lysine, Phenylalanine, Citrate, Urea and SIM (Sulfide, Indole, Motility). The results of these tests were able to confirm and identify the P. aeruginosa and E. aerogenes species. The animal died within 36 h, before the identification of the causative agents of the disease, thus, no pharmacological interference was possible.Discussion: Immunodepression, malnutrition, and temperatures and humidity outside the animal thermal comfort zone, are predisposing factors for the development of bacterial diseases in reptiles. Little information about pathogen agents affecting Boa constrictor specimens in their native area is available; however, captive snakes are subject to a wide variety of diseases - most of which caused or intensified by the captivity conditions. Among the bacteria involved in reptile diseases, few are primary causative agents. In general, clinical bacterial infections tend to be secondary to viral infections. The bacterial agents found in this study are commonly described in scientific literature with location in the oral cavity, differently from the results found in this study. Moreover, the bacterium E. aerogenes has not yet been described in other studies as a causative agent of dermatopathy. Reptiles are considered reservoirs of important zoonotic microorganisms, such as P. aeruginosa, which can be transmitted by fecal contact, bites and wounds. However, the little information on P. aeruginosa in captive reptiles indicates the need for further studies to establish its zoonotic potential. A most adequate management conditions for the snake species could have decreased the severity of the lesions. The occurrence of P. aeruginosa and E. aerogenes found in this work may alert professionals for future clinical suspicions and adequate therapeutic management

Assessment of genotoxicity and depuration of anthracene in the juvenile coastal fish Trachinotus carolinus using the comet assay

Ambientalmente, o antraceno é considerado persistente, bioacumulativo e tóxico para organismos aquáticos. A biotransformação de substâncias xenobióticas, como o antraceno, produz espécies reativas de oxigênio que podem agir sobre o DNA. O objetivo deste trabalho foi avaliar o dano ao DNA em T. carolinus expostos a diferentes concentrações de antraceno (8, 16 e 32 µg.L-1) por 24 h no escuro e subsequentemente mantidos em água limpa para depuração por três diferentes períodos de tempo (48, 96 e 144 h) através de ensaio cometa. Os resultados obtidos demonstram que o antraceno é genotóxico para T. carolinus e o dano ao DNA foi dose- e tempo de depuração- dependente. A genotoxicidade do antraceno foi detectada nas três concentrações utilizadas. A depuração pareceu ser mais eficiente nos peixes expostos a menor concentração de antraceno e mantidos por 96 h em água limpa.In the environment, anthracene is characterized as being persistent, bioaccumulative and toxic to aquatic organisms. Biotransformation of xenobiotic substances, such as anthracene, produces reactive oxygen species that may induce DNA strand breaks. The aim of the present study was to evaluate the DNA damage in juvenile T. carolinus exposed to different concentrations (8, 16 and 32 µg.L-1) of anthracene for 24 h in the dark then subsequently allowed to depurate in clean water for different periods of time (48, 96 or 144 h) using the comet assay. Our results show that anthracene is genotoxic to T. carolinus and that DNA damage was dose- and depuration/time- dependent. Anthracenegenotoxicity was observed in all experimental concentrations. Depuration seemed to be more efficient in fish exposed to thelowest anthracene concentration and maintained in clean water for 96 h

O enfermeiro no pré-natal na Estratégia Saúde da Família com gestantes portadoras de sífilis

The aim was to describe how the nurse of a family health strategy unit has conducted prenatal care for pregnant women with syphilis and their partner. It was qualitative research through field research with semi-structured interviews applied to nurses who work in the family health strategy in the west side of RJ, after authorization by committee number CER4.876.196. Nine nurses participated in a unit, where prenatal care is carried out as recommended by the Ministry of Health, access to services and medication are offered, however, there is a difficulty in prenatal counseling for the couple, due to resistance on the part of of the partner to carry out the treatment. There is a need for nurses to develop a strategy to encourage the presence of the partner in prenatal care, facilitate the coming of this man to the health unit and awareness of the couple's treatment.Objetivou-se descrever como o enfermeiro de uma unidade da estratégia de saúde da família tem conduzido o pré-natal nas gestantes com sífilis e seu parceiro. Tratou-se de uma pesquisa qualitativa através de pesquisa de campo com entrevistas semiestruturada aplicada a enfermeiros que atuam na estratégia saúde da família na zona oeste RJ, após autorização comitê número CER4.876.196. Participaram nove enfermeiros de uma unidade, onde é realizado o pré-natal conforme preconizado pelo ministério da saúde, o acesso aos serviços e a medicação são oferecidos, porém, existe uma dificuldade no aconselhamento no pré-natal para o casal, pela resistência por parte do parceiro de realizar o tratamento. Observa-se a necessidade de o enfermeiro desenvolver uma estratégia para estimular a presença do parceiro no pré-natal, facilitar a vinda desse homem na unidade de saúde e conscientização de realização do tratamento do casal

O enfermeiro no pré-natal na Estratégia Saúde da Família com gestantes portadoras de sífilis

The aim was to describe how the nurse of a family health strategy unit has conducted prenatal care for pregnant women with syphilis and their partner. It was qualitative research through field research with semi-structured interviews applied to nurses who work in the family health strategy in the west side of RJ, after authorization by committee number CER4.876.196. Nine nurses participated in a unit, where prenatal care is carried out as recommended by the Ministry of Health, access to services and medication are offered, however, there is a difficulty in prenatal counseling for the couple, due to resistance on the part of of the partner to carry out the treatment. There is a need for nurses to develop a strategy to encourage the presence of the partner in prenatal care, facilitate the coming of this man to the health unit and awareness of the couple's treatment.Objetivou-se descrever como o enfermeiro de uma unidade da estratégia de saúde da família tem conduzido o pré-natal nas gestantes com sífilis e seu parceiro. Tratou-se de uma pesquisa qualitativa através de pesquisa de campo com entrevistas semiestruturada aplicada a enfermeiros que atuam na estratégia saúde da família na zona oeste RJ, após autorização comitê número CER4.876.196. Participaram nove enfermeiros de uma unidade, onde é realizado o pré-natal conforme preconizado pelo ministério da saúde, o acesso aos serviços e a medicação são oferecidos, porém, existe uma dificuldade no aconselhamento no pré-natal para o casal, pela resistência por parte do parceiro de realizar o tratamento. Observa-se a necessidade de o enfermeiro desenvolver uma estratégia para estimular a presença do parceiro no pré-natal, facilitar a vinda desse homem na unidade de saúde e conscientização de realização do tratamento do casal

The identifying depression early in adolescence risk stratified cohort (IDEA-RiSCo) : rationale, methods, and baseline characteristics

Background: The characterization of adolescents at high risk for developing depression has traditionally relied on the presence or absence of single risk factors. More recently, the use of composite risk scores combining information from multiple variables has gained attention in prognostic research in the field of mental health. We previously developed a sociodemographic composite score to estimate the individual level probability of depression occurrence in adolescence, the Identifying Depression Early in Adolescence Risk Score (IDEA-RS). Objectives: In this report, we present the rationale, methods, and baseline characteristics of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo), a study designed for in-depth examination of multiple neurobiological, psychological, and environmental measures associated with the risk of developing and with the presence of depression in adolescence, with a focus on immune/inflammatory and neuroimaging markers. Methods: Using the IDEA-RS as a tool for risk stratification, we recruited a new sample of adolescents enriched for low (LR) and high (HR) depression risk, as well as a group of adolescents with a currently untreated major depressive episode (MDD). Methods for phenotypic, peripheral biological samples, and neuroimaging assessments are described, as well as baseline clinical characteristics of the IDEA-RiSCo sample. Results: A total of 7,720 adolescents aged 14-16 years were screened in public state schools in Porto Alegre, Brazil. We were able to identify individuals at low and high risk for developing depression in adolescence: in each group, 50 participants (25 boys, 25 girls) were included and successfully completed the detailed phenotypic assessment with ascertainment of risk/MDD status, blood and saliva collections, and magnetic resonance imaging (MRI) scans. Across a variety of measures of psychopathology and exposure to negative events, there was a clear pattern in which either the MDD group or both the HR and the MDD groups exhibited worse indicators in comparison to the LR group. Conclusion: The use of an empirically-derived composite score to stratify risk for developing depression represents a promising strategy to establish a risk-enriched cohort that will contribute to the understanding of the neurobiological correlates of risk and onset of depression in adolescence

Preditores clínicos de mortalidade Intra-Hospitalar em pacientes com traumatismo Cranioencefálico grave no Hospital de Urgências de Sergipe / Clinical predictors of in-hospital mortality in patients with severe traumatic brain injuries at the Hospital de Urgências de Sergipe

INTRODUÇÃO: O trauma cranioencefálico (TCE) é um sério problema de saúde pública responsável por milhões de mortes e casos de incapacidade mundialmente. O objetivo do presente trabalho é portanto identificar preditores clínicos de mortalidade intra-hospitalar em pacientes admitidos por TCE severo no Hospital de Urgências de Sergipe.   METODOLOGIA: Trata-se um estudo de coorte retrospectivo com análise da sobrevida de 228 pacientes com trauma cranioencefálico severo. O método utilizado para estimar a sobrevida do paciente foi a regressão de Cox, sendo considerados significativos os valores de p < 0,05. RESULTADOS: A idade mediana dos 228 incluídos no estudo foi de 31 anos (14-94) anos , sendo 201 (88,2%) do sexo masculino. Sessenta pacientes (27,5%) tiveram como desfecho o óbito durante o internamento, sendo que a maioria dos óbitos (42, 60%) ocorreu nos primeiros 15 dias. Foi constatada uma letalidade de 21,9% nos primeiros 30 dias. O único preditor clínico independente para morte intra-hospitalar foi ausência do reflexo fotomotor direto (RFD ausente) (RR 3,4 e IC 95% 1,9-6,0). CONCLUSÃO: Foi constatada uma letalidade de 21,9% nos primeiros 30 dias e somente RFD ausente foi preditor clínico independente de mortalidade intra-hospitalar nos pacientes com TCE grave

Preditores tomográficos de mortalidade intra-hospitalar em TCE grave em um hospital terciário no Nordeste do Brasil / Tomographic predictors of in-hospital mortality in severe TBI in a tertiary hospital in Northeast Brazil

Introdução: O traumatismo cranioencefálico pode ser definido como uma disfunção do sistema nervoso central de origem traumática, responsável por substancial morbimortalidade sobretudo em países em desenvolvimento.  O objetivo desse trabalho é identificar preditores tomográficos de mortalidade intra-hospitalar em um hospital terciário do nordeste do Brasil. Metodologia: Trata-se de um estudo de coorte retrospectivo com análise da sobrevida de 187 pacientes, durante o período de fevereiro de 2017 a março de 2018, que foram admitidos com TCE grave e que tinham TC de crânio realizada à admissão no Hospital de Urgência de Sergipe. Resultados:  A idade média foi de 34,7 anos (14 a 94 anos), sendo 165 (88,2%) do sexo masculino. Do total de 187 pacientes com TCE grave, 56 (29,9%) tiveram como desfecho óbito no seguimento de 60 dias e, destes, 45 (80,3%) foram a óbito nos primeiros 15 dias de internamento. Foi identificado como fator preditor independente de mortalidade intra-hospitalar apenas o apagamento de cisternas da base com RR 3,7 (IC95% 1,9-6,9, p<0,001). Conclusão: somente o apagamento de cisternas foi identificado como preditor independente de mortalidade, aumentando em quase quatro vezes o risco de morte intra-hospitalar

Elevated Risk for HIV-1 Infection in Adolescents and Young Adults in São Paulo, Brazil

Background. Recent studies have sought to describe HIV infection and transmission characteristics around the world. Identification of early HIV-1 infection is essential to proper surveillance and description of regional transmission trends. In this study we compare people recently infected (RI) with HIV-1, as defined by Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS), to those with chronic infection. Methodology/Principal Findings Subjects were identified from 2002-2004 at four testing sites in São Paulo. Of 485 HIV-1-positive subjects, 57 (12%) were defined as RI. Of the participants, 165 (34.0%) were aware of their serostatus at the time of HIV-1 testing. This proportion was statistically larger (p<0.001) among the individuals without recent infection (n = 158, 95.8%) compared to 7 individuals (4.2%) with recently acquired HIV-1 infection. In the univariate analysis, RI was more frequent in <25 and >59 years-old age strata (p<0.001). The majority of study participants were male (78.4%), 25 to 45 years-old (65.8%), white (63.2%), single (61.7%), with family income of four or more times the minimum wage (41.0%), but with an equally distributed educational level. Of those individuals infected with HIV-1, the predominant route of infection was sexual contact (89.4%), with both hetero (47.5%) and homosexual (34.5%) exposure. Regarding sexual activity in these individuals, 43.9% reported possible HIV-1 exposure through a seropositive partner, and 49.4% reported multiple partners, with 47% having 2 to 10 partners and 37.4% 11 or more; 53.4% of infected individuals reported condom use sometimes; 34.2% reported non-injecting, recreational drug use and 23.6% were reactive for syphilis by VDRL. Subjects younger than 25 years of age were most vulnerable according to the multivariate analysis. ) Conclusions/Significance In this study, we evaluated RI individuals and discovered that HIV-1 has been spreading among younger individuals in São Paulo and preventive approaches should, therefore, target this age stratu