Accidental and late parasitological diagnosis of Leishmania sp. in a dog from a low disease transmission area of Brazil: a case report

Canine Leishmaniasis diagnosis must be fast and accurate since dogs are urban reservoirs of the disease and earlier therapeutic intervention is more clinically effective. However, this still represents a challenge, particularly in low transmission areas. The present report describes the difficulties of clinical suspicion and the late diagnosis of a dog infected with Leishmania sp

O HIPOTÁLAMO DORSOMEDIAL E A ORGANIZAÇÃO DA RESPOSTA CARDIOVASCULAR AO ESTRESSE EMOCIONAL: UMA PERSPECTIVA FUNCIONAL

Emotional stress results in activation of specific pathways into central nervous system, which produces autonomic, behavioral and endocrine responses. It is known that repetitive or continuous exposition to stress situations may result in various pathologic states, for example, arterial hypertension. Classically, the hypothalamus plays an essential role in the integration of physiological responses to emotional stress. Recent studies demonstrate that a specific nucleus from hypothalamus, the dorsomedial hypothalamus (DMH), is an essential component of central pathways that mediate the cardiovascular response to emotional stress. Inhibition of neurons in this area reduces the increases in heart rate and blood pressure in rats submitted to emotional stress paradigms. Conversely, pharmacological activation of DMH neurons evokes increases on heart rate, blood pressure, adrenocorticotrophic hormone, locomotor activity and sympathetic activity. The similarity of this response with that produced during emotional stress suggests that this area is crucial in the integration of the physiological responses to emotional stress. The present review will discuss the central pathways used by DMH in the organization of the cardiovascular response to emotional stress.O estresse emocional resulta em ativação de vias específicas do sistema nervoso central, que produzem respostas autonômicas, comportamentais e endócrinas. Sabe-se que situações de estresse recorrentes ou prolongadas podem resultar em vários estados patológicos, como por exemplo, a hipertensão arterial. O Hipotálamo tem papel fundamental na integração das respostas fisiológicas ao estresse emocional. Particularmente, estudos têm mostrado que um núcleo específico do hipotálamo, o hipotálamo dorsomedial (DMH), é um componente fundamental das vias centrais mediadoras das respostas cardiovasculares ao estresse emocional. A inibição dos neurônios dessa área reduz os aumentos de freqüência cardíaca e de pressão arterial em ratos quando submetidos à situações de estresse emocional. Ao contrário, a ativação farmacológica dos neurônios do DMH produz aumento na frequência cardíaca, pressão arterial, hormônio adrenocorticotrópico (ACTH), atividade locomotora e na atividade simpática para diversos leitos vasculares. A similaridade dessa resposta com aquela produzida durante a situação real de estresse emocional sugere que esta área é fundamental na integração da resposta fisiológica ao estresse. A presente revisão tem como objetivo mostrar, através de resultados de estudos recentes, as vias centrais utilizadas pelo DMH na organização da resposta cardiovascular ao estresse emocional

Characterization of Cysticercus bovis lesions at postmortem inspection of cattle by gross examination, histopathology and polymerase chain reaction (PCR)

Considerando a necessidade do conhecimento da cisticercose bovina e do aperfeiçoamento dos métodos de diagnóstico desta doença, objetivou-se verificar a ocorrência do Cysticercus bovis nos diversos locais anatômicos, tais como: cabeça, coração, esôfago, diafragma, língua, fígado e carcaça, examinados pelo Serviço de Inspeção Federal. O diagnóstico foi feito por macroscopia, microscopia e PCR com extração de DNA por fervura para a identificação do metacestóide. Dos 22043 bovinos abatidos, 713 (3,23%) estavam infectados. O coração foi o sítio anatômico mais afetado, com 1,90% (420/22043), seguido da cabeça, 1,11% (245/22043), do esôfago, 0,08% (18/22043), da carcaça, 0,07% (15/22043), do diafragma, 0,03% (7/22043), do fígado, 0,02% (5/22043) e da língua, 0,01% (3/22043). Dos cistos obtidos, 58,35% (416/713) estavam mortos e 41,65% (297/713), vivos. As diferenças entre os sítios anatômicos e a condição morfológica dos cistos foram significativas (p < 0,05). Dos 416 cistos mortos, 253 foram examinados por apresentarem características de: lesões nodulares firmes, brancacentas, com material amarelado, por vezes com aspecto calcário, no interior. O exame microscópico revelou granulomas comumente representados por centro necrótico e/ou mineralizado, envolto por histiócitos dispostos em paliçada, células gigantes multinucleadas, infiltrado misto, predominantemente de mononucleares, e fibrose. Por vezes, a periferia das lesões tinha características de tecido de granulação e mineralização em forma de lâminas lineares. Os restos parasitários foram identificados como um material hialino acelular, contendo elementos ovais e circulares, basofílicos, acidófilos e incolores, denominados corpúsculos calcários. Em algumas lesões foram observados raros corpúsculos, dispersos na reação inflamatória. Nódulos fibrosos, ricos em infiltrado linfóide ou crônico ativos, foram frequentemente visualizados. Dos cistos vivos examinados, 65% (13/20) foram positivos para C. bovis , confirmando o diagnóstico ambulatorial e a eficácia do método de PCR utilizado. Em virtude da positividade observada para C. bovis nos exames histopatológico e PCR, particularmente em fígado e esôfago, sugere-se que seja reformulado o artigo 176 do Regulamento de Inspeção Industrial e Sanitária de Produtos de Origem Animal, incluindo estes locais na rotina de inspeção nos matadouros.Considering the importance of improving methods for diagnosis of bovine Cysticercosis, this study aimed to verify Cysticercus bovis occurrence in different anatomical sites, as head, heart, esophagus, diaphragm, tongue, liver and carcass, examined by federal inspection service. Diagnosis was performed by gross examination, histopatholgy and PCR with boiling DNA extraction for metacestode identification. Of 22043 slaughtered cattle, 713 (3.23%) were infected. The heart was mostly affected with 1.90% (420/22043), followed by head, 1.11% (245/22043), esophagus, 0.08% (18/22043), carcass, 0.07% (15/22043), diaphragm, 0.03% (7/22043), liver, 0.02% (5/22043) and tongue, 0.01% (3/22043). Of the cysts obtained, 58.35% (416/713) were dead and 41.65% (297/713) were alive. The differences among anatomical sites and cysts status were significant (p<0.05). Of the 416 dead cysts 253, characterized by nodular firm whitish lesions, containing yellowish material, some times in calcareous aspect were examined for histopathology. The histological exams of these cysts yielded granulomatous lesions, whose centers were characterized by caseous and/or calcareous material, multinucleate giant cells, histiocytes in palisade and infiltrate composed predominantly by lymphoid cells, wrapped up by fibrosis. Some times the lesions peripheries had granulation tissue and mineralized areas, like linear blade. The parasite debris were like a hyaline, non cellular material with spherical and ovoid, basophilic, eosinophilic and colorless corpuscles. These corpuscles were seen rarely, some times, among inflammatory reaction. Fibrous nodules, rich in lymphoid or mixed infiltrates, were frequently seen. Of the live cysts subjected to PCR with boiling DNA extraction, 65% (13/20) were positive for C. bovis, confirming the ambulatory diagnosis and the efficacy of the PCR procedure used. Due to microscopic and PCR diagnostic exams of C. bovis, mainly in the liver and esophagus, it is suggested changes in the 176 article of the regulatory inspection, by including these sites in the bovine routine inspection at the slaughterhouses

Carros de emergência: disponibilidade dos itens essenciais em um hospital de urgência norteriograndense

It is a descriptive, exploratory and quantitative study that evaluates, by the standards of the Brazilian Society of Cardiology (SBC), the availability of the items of the Level I Emergency Cars (EC) of the largest emergency hospital in Rio Grande do Norte. Data were collected during the month of November 2010, the sample consists of 12 EC. All EC analyzed showed gaps in availability of essential items, being the greatest deficiencies related to materials intended for vascular access, circulation control and drugs aimed at treating the causes of cardiac arrest. It was felt institution, as well as a protocol, difficult routine check of the EC, the nurse assigned task.Se trata de una investigación descriptiva, exploratoria y cuantitativa con el objetivo de evaluar, bajo los patrones de la Sociedad Brasileña de Cardiología (SBC), la disponibilidad de los artículos de nivel I de los Carros de Emergencia (CE) del mayor hospital de urgencia de Rio Grande do Norte. Los datos fueron colectados durante el mes de noviembre de 2010, estando compuesta la muestra por 12 CE. Todos los CE analizados presentaron fallos en la disponibilidad de artículos esenciales, estando las mayores deficiencias relacionadas con los materiales destinados al acceso vascular, control circulatorio y medicamentos dirigidos al tratamiento de las causas de PCR. Se percibe que la falta de recursos humanos y materiales en la institución, así como de un protocolo, dificulta la rutina de comprobación del CE, tarea atribuída al enfermero.Trata-se de uma pesquisa descritiva, exploratória e quantitativa com o objetivo de avaliar, sob os padrões da Sociedade Brasileira de Cardiologia (SBC), a disponibilidade dos itens de nível I dos Carros de Emergência (CE) do maior hospital de urgência do Rio Grande do Norte. Os dados foram coletados durante o mês de novembro de 2010, sendo a amostra composta por 12 CE. Todos os CE analisados apresentaram falhas na disponibilidade de itens essenciais, estando as maiores deficiências relacionadas aos materiais destinados ao acesso vascular, controle circulatório e medicamentos voltados ao tratamento das causas de PCR. Percebeu-se que a falta de recursos humanos e materiais na instituição, bem como de um protocolo, dificulta a rotina de checagem do CE, tarefa atribuída ao enfermeiro

Assessment of the risk of burnout and its associated factors in healthcare professionals during the COVID-19 pandemic: A prospective cohort study

IntroductionThe COVID-19 pandemic resulted in tremendous physical and psychological pressure on healthcare professionals, especially on those working in intensive care units (ICUs) and Emergency Departments (EDs). The present study intended to characterize the profile of these professionals which is associated with burnout and determine the potential predictors of such condition.MethodsA Prospective cohort study was carried out in a tertiary hospital between March 2020 and March 2021, in Salvador, Brazil. A standardized and validated version of the Oldenburg Burnout inventory (OLBI) was applied to assess risk of burnout together with data forms designed to collect information on sociodemographic characteristics and religious beliefs. ICU and ED healthcare professionals were evaluated during off-hours at two distinct periods of the COVID-19 pandemic, in 2020 and in 2021. Differences in the results obtained from each study participant between the timepoints were compared. A binary logistic regression analysis was performed to identify the predictors of burnout development independent of other confounding factors.ResultsSeventy-seven healthcare professionals with a median age of 33 (interquartile range [IQR]: 31–37.5) years and predominantly female (72.7%; n = 56) were enrolled. There were 62 professionals at risk of developing burnout through the OLBI. Those had a median age of 33 (IQR: 31–37) and female predominance (71%, n = 44). Disengagement and burnout were the only features which frequencies significantly changed over time, with increasing detection at the latest timepoint. Alcohol consumption was found to be an important risk factor for burnout development [adjusted odds ratio (aOR): 10.8 (95% CI: 1.8–64.2)]. Importantly, working in the ICU [aOR: 0.04 (95%CI: 0.01–0.32)] and the habit of praying daily [aOR: 0.07 (95%CI: 0.01–0.41)] were characteristics linked to reduced odds of burnout.DiscussionDisengagement substantially increased during the COVID-19 pandemic in healthcare professionals. Alcohol consumption favors the onset of burnout whereas habit of praying daily and working in the ICU are protective against such outcome. Institutional policies aimed at minimizing etilism may positively impact mental health of these professionals

Chronic Treatment with Ivabradine Does Not Affect Cardiovascular Autonomic Control in Rats

A low resting heart rate (HR) would be of great benefit in cardiovascular diseases. Ivabradine a novel selective inhibitor of hyperpolarization-activated cyclic nucleotide gated (HCN) channels- has emerged as a promising HR lowering drug. Its effects on the autonomic HR control are little known. This study assessed the effects of chronic treatment with ivabradine on the modulatory, reflex and tonic cardiovascular autonomic control and on the renal sympathetic nerve activity (RSNA). Male Wistar rats were divided in 2 groups, receiving intraperitoneal injections of vehicle (VEH) or ivabradine (IVA) during 7 or 8 consecutive days. Rats were submitted to vessels cannulation to perform arterial blood pressure (AP) and HR recordings in freely moving rats. Time series of resting pulse interval and systolic AP were used to measure cardiovascular variability parameters. We also assessed the baroreflex, chemoreflex and the Bezold-Jarish reflex sensitivities. To better evaluate the effects of ivabradine on the autonomic control of the heart, we performed sympathetic and vagal autonomic blockade. As expected, ivabradine treated rats showed a lower resting (VEH: 362 +/- 16 bpm vs. IVA: 260 +/- 14 bpm, p = 0.0005) and intrinsic HR (VEH: 369 +/- 9 bpm vs. IVA: 326 +/- 11 bpm, p = 0.0146). However, the chronic treatment with ivabradine did not change normalized HR spectral parameters LF (nu) (VEH: 24.2 +/- 4.6 vs. IVA: 29.8 +/- 6.4p > 0.05)HF (nu) (VEH: 75.1 +/- 3.7 vs. IVA: 69.2 +/- 5.8p > 0.05), any cardiovascular reflexes, neither the tonic autonomic control of the HR (tonic sympathovagal indexVEH: 0.91 +/- 0.02 vs. IVA: 0.88 +/- 0.03, p = 0.3494). We performed the AP, HR and RSNA recordings in urethane-anesthetized rats. The chronic treatment with ivabradine reduced the resting HR (VEH: 364 +/- 12 bpm vs. IVA: 207 +/- 11 bpm, p < 0.0001), without affecting RSNA (VEH: 117 +/- 16 vs. IVA: 120 +/- 9 spikes/s, p = 0.9100) and mean arterial pressure (VEH: 70 +/- 4 vs. IVA: 77 +/- 6 mmHg, p = 0.3293). Our results suggest that, in health rats, the long-term treatment with ivabradine directly reduces the HR without changing the RSNA modulation and the reflex and tonic autonomic control of the heart.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao de Amparo a Pesquisa de Minas Gerais (FAPEMIG)Universidade Federal de Ouro Preto (UFOP)Universidade Federal do Triangulo Mineiro (UFTM), BrazilUniv Fed Ouro Preto, Inst Exact & Biol Sci, Dept Biol Sci, Lab Cardiovasc Physiol, Ouro Preto, BrazilUniv Fed Ouro Preto, CBIOL NUPEB, Grad Program Biol Sci, Ouro Preto, BrazilUniv Fed Minas Gerais, Inst Biol Sci, Dept Physiol & Biophys, Lab Hypertens, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, Inst Sci & Technol, Biomed Engn Lab, Sao Jose Dos Campos, BrazilUniv Uberaba, Dept Physiol, Uberaba, BrazilUniv Milan, Osped Maggiore Policlin, IRCCS Ca Granda Fdn, Dept Clin Sci & Community Hlth, Milan, ItalyFed Univ Trianaulo Pvlineiro, Inst Biol & Nat Sci, Dept Physiol, Uberaba, BrazilUniv Fed Sao Paulo, Inst Sci & Technol, Biomed Engn Lab, Sao Jose Dos Campos, BrazilCNPq: 400851/2014-8Web of Scienc

A comparison of two distinct murine macrophage gene expression profiles in response to Leishmania amazonensis infection

<p>Abstract</p> <p>Background</p> <p>The experimental murine model of leishmaniasis has been widely used to characterize the immune response against <it>Leishmania</it>. CBA mice develop severe lesions, while C57BL/6 present small chronic lesions under <it>L. amazonensis </it>infection. Employing a transcriptomic approach combined with biological network analysis, the gene expression profiles of C57BL/6 and CBA macrophages, before and after <it>L. amazonensis </it>infection in vitro, were compared. These strains were selected due to their different degrees of susceptibility to this parasite.</p> <p>Results</p> <p>The genes expressed by C57BL/6 and CBA macrophages, before and after infection, differ greatly, both with respect to absolute number as well as cell function. Uninfected C57BL/6 macrophages express genes involved in the deactivation pathway of macrophages at lower levels, while genes related to the activation of the host immune inflammatory response, including apoptosis and phagocytosis, have elevated expression levels. Several genes that participate in the apoptosis process were also observed to be up-regulated in C57BL/6 macrophages infected with <it>L. amazonensis</it>, which is very likely related to the capacity of these cells to control parasite infection. By contrast, genes involved in lipid metabolism were found to be up-regulated in CBA macrophages in response to infection, which supports the notion that <it>L. amazonensis </it>probably modulates parasitophorous vacuoles in order to survive and multiply in host cells.</p> <p>Conclusion</p> <p>The transcriptomic profiles of C57BL/6 macrophages, before and after infection, were shown to be involved in the macrophage pathway of activation, which may aid in the control of <it>L. amazonensis </it>infection, in contrast to the profiles of CBA cells.</p