ABSTRACT Dengue is a viral infection which is transmitted by the Aedes aegypti mosquito and has four serotypes (DENV-1 to DENV-4). The disease triggers a variety of clinical manifestations, ranging from mild forms without warning signs to severe lifethreatening forms. We present the case of a 5-year-old boy, from the province of Callao, whose first symptoms were fever, headache and general malaise. On the third day, the child had mild abdominal pain and little vomiting; subsequently, abdominal distension, jaundice and choluria. He was admitted to the pediatric intensive care unit being alert and with moderate dehydration, jaundice, edema, distended and tender abdomen, shifting dullness and liver 2 cm below the right costal margin. Complementary tests revealed liver failure, hepatosplenomegaly and pleural effusion in the bases. Using a reactive IgM ELISA, severe dengue was diagnosed, as well as a superinfection due to probable spontaneous bacterial peritonitis. He started treatment with antibiotics, furosemide, fresh frozen plasma, cryoprecipitate and metamizole. As the child did not get better, the diuretic was optimized, and human albumin was administered. Thereafter, he got better showing decreased ascites, edema, jaundice and pleural effusion; improvement of the liver and coagulation profile; and being afebrile. He unexpectedly presented respiratory distress due to congestive heart failure caused by dilated cardiomyopathy diagnosed by echocardiography; thus, he was treated with diuretics. The patient was discharged afebrile, without edema and with resolution of liver failure and coagulation disorder.

RESUMEN El dengue es una infección viral transmitida a través del mosquito Aedes aegypti y presenta cuatro serotipos (DENV-1 a DENV-4). La enfermedad desencadena una variedad de manifestaciones clínicas, desde formas leves sin signos de alarma hasta formas graves, potencialmente mortales. Se presenta el caso de un niño de cinco años, procedente de la provincia del Callao, cuyos síntomas iniciales fueron fiebre, cefalea y malestar general. Al tercer día, el niño manifiestó dolor abdominal leve y vómitos escasos; posteriormente, distensión abdominal, ictericia y coluria. Fue hospitalizado en la unidad de cuidados intensivos pediátricos con deshidratación moderada, ictericia, edemas, abdomen distendido y doloroso, matidez desplazable, hígado a 2 cm debajo del reborde costal derecho y lúcido. Por exámenes complementarios, se evidenció falla hepática, hepatoesplenomegalia y derrame pleural en bases. Se diagnosticó dengue grave a través de una prueba de ELISA Ig M reactivo más sobreinfección por probable peritonitis bacteriana espontánea. Se inició el tratamiento con antibióticos, furosemida, plasma fresco congelado, crioprecipitado y metamizol. Al no observarse mejoría, se optimizó el diurético y se administró albúmina humana. Mostró mejoría con disminución de ascitis, edemas, ictericia y efusión pleural; también mejora del perfil hepático y de la coagulación, además de encontrarse afebril. Presentó inesperadamente dificultad respiratoria por insuficiencia cardiaca congestiva debido a miocardiopatía dilatada según ecocardiografía; se manejó con diuréticos. Fue dado de alta en estado afebril, sin edemas y con resolución de falla hepática y trastorno de coagulación.

■ ABSTRACT Introduction: Fat grafting is an autologous graft of cells from subcutaneous tissue, which can be used as a complementary technique in breast reconstruction. Given this, the cryopreservation of adipose tissue-derived mesenchymal stem cells (ADMSCs) could be a way to collect them in one surgical procedure and after performing fractional fat grafting. Dimethyl sulfoxide (DMSO) is a cryopreservative used in cell research, but it is potentially toxic, which would make it impossible to use cryopreserved ADMSCs in clinical practice. New cellular cryopreservatives, without toxicity, have been described in the experimental scientific literature, such as the substances L-proline and trehalose. Therefore, this work aimed to evaluate the viability of ADMSCs cryopreserved with the combination of L-proline and trehalose over up to 90 days. Method: Experimental study in which lipoaspirate samples were obtained from 9 patients. The cellular fraction was processed and frozen with L-proline (1.5M) + trehalose (0.2M) or with DMSO + fetal bovine serum (FBS) as control. After 30 and 90 days, the samples were thawed, and cell viability was assessed using the MTT technique. Results: The analysis of ADMSCs, after 1 and 3 months of freezing, indicated that samples treated with L-proline + trehalose showed similar viability to those preserved with DMSO and SFB (p=0.444). Conclusion: The association of L-proline and trehalose kept ADMSC viable for 30 and 90 days of freezing, and could be an alternative as a cellular cryopreservative without toxicity and enabling the use of serial fat grafting.

■ RESUMO Introdução: A lipoenxertia é um enxerto autólogo de células do tecido celular subcutâneo, que pode ser utilizada como técnica complementar na reconstrução mamária. Diante disso, a criopreservação de células-tronco mesenquimais provenientes de tecido adiposo (CTDAs) poderia ser uma maneira de realizar a coleta em um tempo cirúrgico e após realizar a lipoenxertia de forma fracionada. O dimetilsulfóxido (DMSO) é um criopreservante utilizado em pesquisas com células, porém é potencialmente tóxico, o que impossibilitaria a utilização de CTDAs criopreservadas na prática clínica. Novos criopreservantes celulares, sem toxicidade, vêm sendo descritos na literatura científica experimental, como as substâncias L-prolina e trealose. Com isso, esse trabalho teve como objetivo avaliar a viabilidade de CTDAs criopreservadas com a combinação de L-prolina e trealose, em um período de até 90 dias. Método: Estudo experimental, no qual foram obtidas amostras de lipoaspirado provenientes de 9 pacientes. A fração celular foi processada e congelada com L-prolina (1,5M) + trealose (0,2M), ou com DMSO + soro fetal bovino (SFB), como controle. Após 30 e 90 dias, as amostras foram descongeladas e a viabilidade celular foi avaliada pela técnica de MTT. Resultados: A análise das CTDAs, após 1 e 3 meses de congelamento, indicou que as amostras tratadas com L-prolina + trealose apresentaram viabilidade semelhante àquelas preservadas com DMSO e SFB (p=0,444). Conclusão: A associação de L-prolina e trealose manteve CTDA viáveis por 30 e 90 dias de congelamento, podendo ser uma alternativa como criopreservante celular sem toxicidade e viabilizando o uso de lipoenxertia seriada.

Abstract Roadkill is one of the most direct impacts on fauna, leading to numerous direct and indirect impacts. Road-killed animals could serve as a resource for research and teaching purposes, but first, they need to have their tissues preserved by some technique. Plastination is one of the most modern techniques for the conservation of biological tissues, its principle is the replacement of body fluids by a curable polymer, resulting in a non-toxic, odorless, and manipulable material. So the main aim of this work was to compose a collection of plastinated roadkill victims from the Biological Reserve Sooretama region, adapting the standard protocol to the different taxa worked here (Avialae, Reptilia, Amphibia, and Mammalia). For this, 42 animals were used, previously frozen and stored in the Sooretama Biological Reserve and Vale Natural Reserve until they were sent for processing. Upon arriving at the Plastination laboratory at the Federal University of Espírito Santo, the animals underwent the 4 stages of plastination: fixation, dehydration, forced impregnation, and chemical cure; some adaptations were made to improve the final specimens. The results proved that the plastination of these animals is extremely viable in generating satisfactory results. Given the results obtained, it becomes clear how plastination can become an alternative to implement in the composition of biological collections using roadkill animals. The animals prepared in this work comprise an unprecedented collection available for different applications, such as exhibitions, practical classes, and research.

Abstract To solve the problem that the mechanical behavior of undisturbed loess in seasonally frozen soil area is affected by freeze-thaw action, triaxial shear tests of undisturbed loess under freeze-thaw condition were carried out. The results show that the mechanical properties of undisturbed loess are greatly affected by factors including freeze-thaw process, water content, natural density and confining pressure. Freeze-thaw action has a certain impact on the failure surface shape and stress-strain curve. Before and after freeze-thaw, the shape of the shear failure surface is complex, including single oblique failure surface, double oblique failure surface, vertical failure surface, X-shaped failure surface, bulging failure, etc. And under the conditions of low water content, low confining pressure and high dry density, the stress-strain curve tends to be softened. Conversely, the curve tends to harden. Freeze-thaw action can make the stress-strain curve transition from softening to hardening. In addition, the freeze-thaw action significantly weakens the failure strength, shear strength, cohesion, initial tangent modulus and failure ratio of undisturbed soil, but does not change the internal friction angle obviously. Also, the heterogeneity of natural soil is also an important factor affecting the mechanical parameters, failure surface shape and stress-strain curve of undisturbed loess. freezethaw freeze thaw out process content Freezethaw Freeze stressstrain stress strain freezethaw, thaw, complex Xshaped X shaped etc softened Conversely harden hardening addition strength cohesion obviously Also parameters

Reactive oxygen species at supra-physiological levels trigger oxidative stress during cryopreservation, which can be neutralised by incorporating suitable antioxidants into the semen extender medium. This study was intended to explore the effect of asiatic acid (AA) as an antioxidant in semen extender on frozen-thawed sperm quality and in vivo fertility of bull sperm. Semen was collected from Holstein Friesian bulls for 10 consecutive weeks (total ejaculates = 60). Semen was cryopreserved with a Tris citric acid egg yolk-based extender supplemented with 0 (control), 20, 40, 60, and 100 μM AA. The supplementation of the extender with 40 and 60 μM AA improved (p < 0.05) post-thaw motility kinematics, plasma membrane integrity, acrosome integrity, sperm viability, and DNA integrity of bull sperm. Mitochondrial membrane potential was high (p < 0.05) with 60 μM of AA concentration in extender media. The catalase activity in seminal plasma was maintained (p < 0.05) when semen was added with 20, 40, and 60 μM of AA. The in vivo fertility was found to be significantly high with the semen extended with 60 μM AA. Conclusively, this study showed that AA supplementation in semen extender significantly improved sperm motility kinematics and cell integrity, conserved antioxidant enzyme activity, and improved in vivo fertility.

ABSTRACT In this article, we present the case of a 47-year-old man who underwent Bentall-Bono procedure and frozen elephant trunk prosthesis implantation due to severe aortic regurgitation and aortic dilatation with a second-time endovascular stent-graft repair in descending aorta. Over eight years, a subacute graft infection by Propionibacterium acnes was developed, culminating in cardiogenic shock secondary to severe aortic regurgitation due to a complete aortic root dehiscence because of multiple aortic pseudoaneurysms. The patient underwent emergency surgery in which the replacement of the graft by a biological valve tube was performed accompanied by a complete debranching of the three supra-aortic vessels.

The application of deep learning algorithms for fault identification in wind turbine components is contingent on extensive data. Such data is often scarce, especially in the faulty category. While adversarial data augmentation helps, biases from the original data persist, and larger datasets strain computational resources. As a solution, experts are turning to transfer learning. Leveraging insights from related domains, transfer learning enables machine learning models to circumvent the exigency oftraining from scratch with extensive data. This study proposed a transfer learning strategy for fault identification in high-speed wind turbine shaft bearings. Two-dimensional matrices extracted from vibration signals sampled from the turbine bearings are employed to train ResNet50 and VGG16 convolutional neural network models with frozen weights based on transfer learning. While both models performed well on the normal test samples, they showed differing robustness when evaluated with noise-induced test samples. Contrarily, the ResNet50 had an accuracy, F-score, and training time of 82.21 %, 78.34%, and 26.3 s, respectively, while the VGG16 model had an accuracy and F-score of 95.55 % and 95.35 %, respectively, but trained for 46 s. The ResNet50 may have converged quickly due to "skip connection" in its architecture, typical of residual learning models. While the VGG16 is computationally intensive, its superior performance and resilience to noise make it suited for vibration-based defect detection in the high-speed shaft bearing, where severe background noise is prevalent.

Resumen Introducción. La congelación isocórica (a volumen constante) es una tecnología novel que ha sido evaluada en diferentes investigaciones para demostrar los posibles beneficios para la industria alimentaria. Objetivo. Presentar un resumen general sobre el mercado de alimentos congelados, las tecnologías de congelación utilizadas, así como las emergentes, y estudiar a profundidad los fundamentos teóricos de la congelación isocórica y las ventajas en la industria alimentaria con respecto a los sistemas tradicionales de congelación y evidenciar los posibles campos de investigación relacionados con dicha tecnología. Desarrollo. Este trabajo fue realizado en Costa Rica entre febrero de 2022 y junio del 2022, y se describe el contexto general del mercado de alimentos congelados, las tecnologías utilizadas en la industria, el principio termodinámico de la tecnología isocórica, las ventajas fisicoquímicas, microbiológicas y energéticas, y finaliza con los posibles campos de investigación y desventajas hasta ahora encontradas. Conclusión. La congelación isocórica presenta ventajas importantes respecto a los procesos de congelación actuales en la industria de alimentos, sin embargo, es necesario realizar más estudios respecto a aspectos microbiológicos, así como optimizar los parámetros de proceso y equipos para generar un cambio en el sistema de congelación a nivel mundial.

Abstract Introduction. Isochoric freezing (at constant volume) is a novel technology that has been evaluated in different studies to demonstrate the possible benefits for the food industry. Objective. To present an overall summary about the frozen food market, the freezing technologies currently used, as well as the emerging ones, and delve into the fundamental theories of isochoric freezing and the advantages in the food industry compared to traditional freezing systems and to show the possible fields of research related to this technology. Development. This work was carried out in Costa Rica between February 2022 and June 2022, it describes the general context of the frozen food market, the technologies used in the industry, the thermodynamic principles of the isochoric technology, the physicochemical, microbiological and energetical advantages, and ends with the possible fields of research and disadvantages recently found. Conclusion. Isochoric freezing presents important advantages compared to the current freezing processes in the food industry, however, it is necessary to perform more research related to microbiological aspects, as well as to optimize the process parameters and equipment to generate a change in the global food freezing system.

RESUMEN En el procesamiento del café se generan residuos orgánicos, como la cáscara y pulpa de cereza de café, que no son aprovechados y, consecuentemente, impactan en el medio ambiente. Considerando el aprovechamiento de estos residuos, el objetivo de este trabajo fue evaluar la presencia de componentes bioactivos en pigmentos extraídos de la pulpa y cáscara de cerezas de café, de las variedades Catimor y Typica, así también, comparar el impacto de métodos de conservación de estos residuos (in natura, seco y congelado), sobre el contenido de antocianinas totales (CAT), polifenoles totales (PFT) y la capacidad antioxidante. Los pigmentos de la cáscara y pulpa de café fueron extraídos con metanol acidificado, y posteriormente, fueron determinados los espectros que corresponden a compuestos antociânicos, por espectroscopia UV-Visible y FTIR-ATR. Valores de CAT fueron determinados mediante el método pH diferencial, los PFT a través del método Folin-Ciocalteu, y la capacidad antioxidante con el método 2,2-Difenil-1-Picrilhidrazilo (DPPH). Los resultados obtenidos para cáscara y pulpa: in natura, seca y congelada, de las variedades Catimor y Typica, revelan que el CAT muestra un rango de 35,16-10,16 mg cianidina 3-G/100g, el contenido de PFT de 1971,10-247,12 mg ácido gálico/100 g y la capacidad antioxidante por DPPH de 33,73-16,07 µmol trolox/g respectivamente. Los residuos secos de la variedad Catimor presentaron mayor actividad antioxidante, seguido de residuos in natura y congelados sin diferencia significativa entre ambos. De esta manera, los residuos del procesamiento del café poseen alto potencial agroindustrial como fuente de colorante natural.

ABSTRACT In the processing of coffee, organic residues are generated, such as coffee peel and cherry pulp, which are not used and, consequently, have an impact on the environment. Considering that these residues contain antioxidants, the objective of this research was to obtain natural colorants from Arabica coffee peels and pulp of the Catimor and Typica varieties, as well as to evaluate the impact of the conservation methods of these residues (in natura, dry and frozen) on the total anthocyanin content (CAT), total polyphenols (PFT) and antioxidant capacity. The colorants of the coffee peel and pulp were extracted with acidified methanol and the spectra corresponding to anthocyanin compounds were determined by UV-Visible and FTIR-ATR spectroscopy. The CAT was determined by the differential pH method, the PFT by the Folin-Ciocalteu method, and the antioxidant capacity by the 2,2-Diphenyl-1-Picrylhydrazyl (DPPH) method. The results obtained for peel and pulp: in natura, dry and frozen, of Catimor and Typica varieties, reveal that the CAT content shows a range of 35.16-10.16 mg cyanidin 3-G/100g, the PFT content of 1971.10-247.12 mg gallic acid/100 g and th6e antioxidant capacity by DPPH of 33.73-16.07 µmol trolox/g respectively. Thus, coffee processing residues have a high agroindustrial potential as a source of natural colorant, resulting that the dried residues of the Catimor variety have a higher antioxidant activity, followed by in natura and frozen residues, with no significant difference between the two.

ABSTRACT Global advances in reproductive biotechnology have allowed for the transfer of embryos from donor females with high genetic merit to recipients using the cryopreservation technique, which preserves an embryo of excellent quality and viability, thereby achieving a feasible pregnancy rate. The objective of this study was to evaluate the quality and viability of Holstein embryos that have been cryopreserved for more than 40 years under glycerol freezing. The embryos were transferred to the recipient heifers using a non-surgical method. Two 17-month-old Holstein heifers (360 kg live weights) which were clinically healthy and reproductively active were used as the recipients. Two bovine embryos of Grade 1 quality were thawed and evaluated for their morphology. Of the two embryo transfers, one pregnancy was achieved, resulting in the birth of a calf. Therefore, embryos frozen in liquid nitrogen and glycerol as a cryopreservative for more than 40 years maintained their quality and viability to produce a live calf.

RESUMO Os avanços globais em biotecnologia reprodutiva permitiram a transferência de embriões de fêmeas doadoras com alto mérito genético para receptoras, usando-se a técnica de criopreservação, que preserva um embrião de excelente qualidade e viabilidade, alcançando, assim, uma taxa de gravidez viável. O objetivo deste estudo foi avaliar a qualidade e a viabilidade de embriões Holstein, criopreservados por mais de 40 anos, sob congelamento de glicerol. Os embriões foram transferidos para as novilhas receptoras, usando-se um método não cirúrgico. Duas novilhas Holstein de 17 meses de idade (360kg de peso vivo), que eram clinicamente saudáveis e reprodutivamente ativas, foram utilizadas como receptoras. Dois embriões bovinos de qualidade Grau 1 foram descongelados e avaliados quanto à sua morfologia. Das duas transferências embrionárias, uma gravidez foi obtida, resultando no nascimento de um bezerro. Portanto, os embriões congelados em nitrogênio líquido e glicerol como criopreservante por mais de 40 anos mantiveram sua qualidade e viabilidade para produzir um bezerro vivo.

Abstract Objective Testing an experimental model for ischemic necrosis of the femoral head in Legg-Calvé-Perthes disease by evaluating gait, imaging and morphohistology. Methods The operation was done in 11 piglets. Necrosis by cerclage in the right femoral neck was induced. Piglets were divided into group A, with 8 animals, euthanizing two in the 2nd, 4th, 6th, and 8th weeks, respectively; and group B, with 2 animals (sham), submitted to the surgical procedure without cerclage of the right femoral neck. The gait classification used was that of Etterlin. The frozen femurs were submitted to digital radiography and computed tomography. The height and width of the epiphysis and epiphysary coefficient were measured at study times. Light microscopy and immunohistochemistry with TGF-β1 were performed. Results One animal died of sepsis in Group A. In this group, claudication was observed in all animals. On digital radiography and computed tomography, bone sclerosis, enlargement of the right femoral neck, flattening, collapse, and fragmentation of the right femoral head were observed. All epiphysis height and epiphysary coefficient values of the right femoral head were lower than the contralateral ones, in which were observed chondrocytes disordered and separated by gaps. A reduction in TGF-β1 expression was observed at 2 and 6 weeks in the right femoral head and at eight in the left. In group B, there were no signs of necrosis and gait was normal. Conclusions The model presented reproduced macroscopic necrosis on digital radiography, computed tomography, and microscopy. Gait evaluation showed a good correlation with other ischemia findings. Level of EvidenceV. Diagnostic studies.

Resumo Objetivo Testar um modelo experimental para necrose isquêmica da cabeça femoral na doença de Legg-Calvé-Perthes avaliando a marcha, exames de imagens e morfohistologia. Métodos Operaram-se 11 leitões. Induziu-se a necrose por cerclagem no colo femoral direito. Dividiram-se os leitões em grupo A com 8 animais, sacrificando-se dois na 2ª, 4ª, 6ª e 8ª semanas, respectivamente; e grupo B, com 2 animais (sham), submetidos ao procedimento cirúrgico sem a cerclagem do colo femoral direito. A classificação da marcha utilizada foi a de Etterlin. Os fêmures congelados foram submetidos à radiografia digital e tomografia computadorizada. Mediram-se a altura e largura da epífise e o coeficiente epifisário nos tempos de estudo. Realizou-se, microscopia de luz e imunohistoquímica com TGF-β1. Resultados Um animal morreu por sepse no grupo A. Neste grupo, observou-se claudicação em todos os animais. Na radiografia digital e tomografia computadorizada observaram-se: esclerose óssea, alargamento do colo femoral direito, achatamento, colapso e fragmentação da cabeça femoral direita. Todos os valores da altura da epífise e coeficiente epifisário da cabeça femoral direita foram menores que os contralaterais, nos quais observaram-se condrócitos desordenados e separados por lacunas. Observou-se redução da expressão do TGF-β1 com 2 e 6 semanas nas cabeças femorais direitas e nas esquerdas com oito. No grupo B, não ocorreram sinais de necrose e a marcha foi normal. Conclusões O modelo apresentado reproduziu a necrose macroscopicamente, na radiografia digital, tomografia computadorizada e microscopia. A avaliação da marcha demonstrou boa correlação com os demais achados de isquemia. Nível de EvidênciaV. Estudos diagnósticos.

Resumo As lesões da cartilagem articular são comuns e levam à deterioração precoce da articulação e ao desenvolvimento da osteoartrite. As técnicas de reparo da cartilagem articular visam a formação de um neo-tecido cartilaginoso capaz de suportar carga articular e evitar a progressão da degeneração. Há várias técnicas disponíveis para esse fim, como a microfratura e o transplante de condrócitos. Entretanto muitas vezes o desfecho do procedimento é a formação de fibrocartilagem, que não possui a mesma resistência mecânica do tecido cartilaginoso. Em outros procedimentos, nos quais é realizado enxerto osteocondral autólogo, há risco de morbidade associada ao procedimento, além da disponibilidade limitada de tecido. Por esse motivo, o transplante osteocondral, utilizando enxertos a fresco ou congelados tem sido utilizado para lesões de maior volume. Por fim, novas técnicas utilizando fragmentos de cartilagem picada ou particulada, assim como o uso de células tronco mesenquimais se apresentam como promissores. O objetivo desse artigo é realizar uma atualização dos procedimentos para tratamento das lesões condrais do joelho. osteoartrite neotecido neo degeneração fim condrócitos fibrocartilagem autólogo motivo volume particulada promissores joelho

Abstract Articular cartilage injuries are common and lead to early joint deterioration and osteoarthritis. Articular cartilage repair techniques aim at forming a cartilaginous neo-tissue to support the articular load and prevent progressive degeneration. Several techniques are available for this purpose, such as microfracture and chondrocyte transplantation. However, the procedural outcome is often fibrocartilage, which does not have the same mechanical resistance as cartilaginous tissue. Procedures with autologous osteochondral graft have a morbidity risk, and tissue availability limits their use. As such, larger lesions undergo osteochondral transplantation using fresh or frozen grafts. New techniques using minced or particulate cartilage fragments or mesenchymal stem cells are promising. This paper aims to update the procedures for treating chondral lesions of the knee. osteoarthritis neotissue neo degeneration purpose However fibrocartilage risk use grafts promising knee

Abstract Introduction: Adhesive capsulitis is a condition defined by thickening of the shoulder joint capsule, which clinically translates into discomfort and progressive loss of range of motion, with conservative therapy being the initial option. In this study, we evaluate the use of intra-articular corticosteroid injections for the treatment of this condition. Materials and Methods: A retrospective analysis was conducted between 2015 and 2020, assessing the outpatient records of patients diagnosed with adhesive capsulitis or frozen shoulder and treated with corticosteroids either orally or intra-articularly. Results: A total of 19 patients were analyzed, 8 received oral treatment and 11 received intra-articular injection, with both groups showing considerable improvement, with the difference that the patients in the articular corticosteroid group reported long-term improvement. Conclusion: Corticosteroids have been found to be effective in the treatment of adhesive capsulitis both orally and by intra-articular injection; however, intra-articular corticosteroids have proved to be more effective in the long term.

Resumen Introducción: La capsulitis adhesiva es una enfermedad que se caracteriza por el engrosamiento de la cápsula articular del hombro, lo que se traduce clínicamente en dolor y una pérdida progresiva de la movilidad. El tratamiento conservador es la primera opción. En este estudio, se evaluó el uso de corticoesteroides articulares para el manejo de este cuadro. Materiales y Métodos: Se llevó a cabo un estudio retrospectivo entre 2015 y 2020. Se evaluaron los registros de consulta externa de pacientes con diagnóstico de capsulitis adhesiva u hombro congelado, que recibieron tratamiento con corticoesteroides por vía oral o articular. Resultados: Se analizó a 19 pacientes, 8 recibieron tratamiento por vía oral y 11, por vía articular. Hubo una mejoría importante en ambos grupos, pero los pacientes que recibieron corticoesteroides articulares comunicaron una mejoría a largo plazo. Conclusiones: La administración de corticoesteroides tanto por vía oral como articular para tratar la capsulitis adhesiva fue eficaz; sin embargo, a largo plazo, los corticoesteroides articulares resultaron más eficaces.

ABSTRACT The objective of this study was to evaluate the clinical biochemistry behavior of Black-Tufted Marmosets (Callithrix penicillatta) submitted to blood collection without sedation and after general anesthesia with anesthetics isoflurane or sevoflurane. Blood collections were performed on (M1) day before anesthesia by physical restraint, and (M2) after anesthesia. There were four groups: Isoflurane (GI) and Sevoflurane (GS) using an anesthetic box. GIM: isoflurane induction with mask for a shorter period. Control group (GP): physical restraint in both moments. Plasma was separated and frozen to measure clinic biochemistry values. Urea was higher at M2 in groups GI and GP. AST was higher in M2 in GI, GS, and GP and only GI showed an increase in CK in M2. Glucose was higher in M1 in the GI, GS, and GP groups and fructosamine was higher in M2 in the GI. Stress caused by physical restraint can cause biochemical changes and these must be considered when interpreting the exams. Both the inhalational anesthetic isoflurane and sevoflurane did not cause clinically significant changes in clinical biochemistry results.

RESUMO O objetivo desse estudo foi avaliar o comportamento da bioquímica clínica de saguis-do-tufo-preto (Callithrix penicillatta) submetidos à coleta sanguínea sem sedação e após anestesia geral, com os anestésicos isoflurano ou sevoflurano. As coletas de sangue foram realizadas: (M1) dia antes da anestesia por contenção física e (M2) após anestesia. Foram definidos quatro grupos: isoflurano (GI) e sevoflurano (GS), utilizando caixa anestésica; GIM: indução com isoflurano com máscara por um período menor; grupo controle (GCF): contenção física em ambos os momentos. O plasma com EDTA foi separado e congelado para realizar dosagem da bioquímica clínica. A ureia foi maior no M2 nos grupos GI e GCF. A AST foi maior no M2 nos GI, GS e GCF e somente o GI apresentou aumento de CK no M2. A glicose foi maior no M1 nos grupos GI, GS e GCF, e a frutosamina foi maior no M2 no GI. O estresse causado pela contenção física pode causar alterações bioquímicas e essas devem ser levadas em consideração na interpretação dos exames. Tanto o anestésico inalatório isoflurano quanto o sevoflurano não causaram alterações clinicamente significantes nos resultados da bioquímica clínica.

Resumen La deficiencia congénita de factor VII es uno de los desórdenes congénitos de la coagulación más comunes, con una prevalencia a nivel mundial de 1:300,000- 1:500,000. Se presenta el caso de un paciente masculino de 37 semanas y 5 días, nacido por cesárea intraparto y con el antecedente heredofamiliar de muerte de hermano a los 4 días de nacido por hemorragia intracraneal, quien a los 14 días de nacido es llevado a emergencias por sangrado umbilical que persistía después del desprendimiento del cordón. Su abordaje inicial incluyó la toma de tiempos de coagulación, lo que mostró alteración del tiempo de protrombina con tiempo de tromboplastina parcial y fibrinógeno normales. El sangrado, así como el tiempo de protrombina prolongado, persistió a pesar de que se administrara vitamina K en tres ocasiones y de transfundir plasma fresco congelado. Se sospechó defecto congénito de factor VII, que se confirmó con la cuantificación del factor. A los 2 meses y 10 días de edad, se le realizaron estudios moleculares basados en secuenciación masiva de nueva generación (NGS por sus siglas en inglés). El análisis determinó dos variantes heterocigotas: F7, intrón 5, c.430+1G>A y F7, intrón 8, c.805+1G>A. Actualmente, el paciente se maneja con profilaxis 5 días de la semana con factor VII recombinante 200 µg/día intravenoso (280 µg/kg) sin recurrencia de sangrados.

Abstract Factor VII congenital deficiency is one of the most common congenital deficiencies of the blood system, with a worldwide prevalence of 1:300,000- 1:500,000. Here we describe a male patient, born by C section, with the family history of death at 4 days old of a sibling caused by intracranial hemorrhage, who presented bleeding at the umbilical cord site at 14 days old, even after falling of the cord. The initial assessment included laboratory tests with coagulation times revealing prolonged prothrombin time, with normal partial thromboplastin time as well as fibrinogen. The bleeding and the prolonged prothrombin time persisted despite the administration of vitamin K in three doses as well as fresh frozen plasma. Congenital defect of factor VII was suspected and later confirmed by measuring the factor. At the age of 2 months and 10 days, molecular studies based on next-generation massive sequencing (NGS) were performed. The analysis exhibited two heterozygous variants: F7, intron 5, c.430+1G>A y F7, intron 8, c.805+1G>A. Currently the patient is receiving prophylaxis 5 days per week with recombinant factor VII 200 µg/ day intravenous (280 µg/kg) with no recurrent bleeding.