The “timed inspiratory effort” (TIE) index, a new predictor of weaning outcome, normalizes the maximal inspiratory pressure with the time required to reach this value up to 60 s, incorporating the time domain into the assessment of inspiratory muscle function. The objective of this study was to determine whether the TIE predicts successful extubation at a similar rate as the T-piece trial with less time required. A non-inferiority randomized controlled trial was performed with ICU subjects eligible for weaning. The participants were allocated to the TIE or the T-piece groups. The primary outcome was successful weaning, and the main secondary outcome was ICU mortality. Eighty participants of each group were included in the final analysis. Time from the start of a successful test to effective extubation was significantly lower in the TIE group than in the T-piece group, 15 (10 to 24) vs 55 (40 to 75) min, P<0.001. In the Kaplan-Meier analysis, no significant differences were found in successful weaning (79.5 vs 82.5%, P=0.268) or survival rate (62.9 vs 53.8%, P=0.210) between the TIE and T-piece groups at the 30th day. In this preliminary study, the TIE index was not inferior to the T-piece trial as a decision-making tool for extubation and allowed a reduction in the decision time. timed effort (TIE 6 s function Tpiece T piece noninferiority non inferiority mortality analysis 1 10 (1 24 5 40 (4 75 min P0001 P 0 001 P<0.001 KaplanMeier Kaplan Meier 79.5 795 79 (79. 825 82 82.5% P=0.268 P0268 268 62.9 629 62 9 (62. 538 53 8 53.8% P=0.210 P0210 210 th day decisionmaking making ( 2 4 7 P000 00 P<0.00 79. (79 82.5 P=0.26 P026 26 62. (62 53.8 P=0.21 P021 21 P00 P<0.0 (7 82. P=0.2 P02 (6 53. P0 P<0. P=0. P<0 P=0 P< P=

The aim of this randomized controlled trial was to analyze the effects of an inspiratory muscle training (IMT) program on apnea and hypopnea index (AHI), inspiratory muscle strength, sleep quality, and daytime sleepiness in individuals with obstructive sleep apnea (OSA), whether or not they used continuous positive airway pressure (CPAP (+/−) therapy. The intervention group underwent IMT with a progressive resistive load of 40-70% of the maximum inspiratory pressure (PImax) for 30 breaths once a day for 12 weeks. The control group was submitted to a similar protocol, but with at a minimum load of 10 cmH2O. Changes in the AHI were the primary outcome. PImax was measured with a digital vacuometer, daytime somnolence was measured by the Epworth sleepiness scale (ESS), and the quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). CPAP use was treated as a confounder and controlled by stratification resulting in 4 subgroups: IMT−/CPAP−, IMT−/CPAP+, IMT+/CPAP−, and IMT+/CPAP+. Sixty-five individuals were included in the final analysis. Significant variations were found in the 4 parameters measured throughout the study after the intervention in both CPAP− and CPAP+ participants: PImax was increased and AHI was reduced, whereas improvements were seen in both ESS and PSQI. The twelve-week IMT program increased inspiratory muscle strength, substantially reduced AHI, and had a positive impact on sleep quality and daytime sleepiness, whether or not participants were using CPAP. Our findings reinforce the role of an IMT program as an adjunct resource in OSA treatment.

This study was designed to evaluate the nutrient intake, digestibility, degradability, and ruminal characteristics of Sindhi heifers fed diets that contained a combined total of 75% oldman saltbush hay (hereafter saltbush hay) and prickly pear cactus. Eight 12-month old intact male red Sindhi calves (four fistulated and four non-fistulated) with an initial mean weight of 170 ± 5 kg were assigned to 4 * 4 Latin squares, where factors consisted of four diets, namely 15% hay and 60% cactus; 30% hay and 45% cactus; 45% hay and 30% cactus; and 60% hay and 15% cactus, and four times at which rumen fluid was collected. Neutral detergent fibre (NDF) and acid detergent fibre (ADF) intakes in kg/day and NDF in percentage live weight (LW), water intake, salinity, and conductivity increased with hay level. Intake and digestibility of non-fibrous carbohydrates were curvilinear with higher values in diets containing 30% saltbush hay. The apparent digestibility of dry matter (DM) and organic matter decreased linearly as the concentration of saltbush hay increased in the diet. The pH of the rumen fluid was within the acceptable range for favourable microbial growth. The low temperature and high salinity and conductivity indices in the diets should be viewed with caution at higher concentrations of saltbush hay, because of a possible decrease in nutrient absorption and the development of health problems in the animals. Apparent degradability coefficients of DM and NDF were affected significantly by inclusion of prickly pear and saltbush hay in the diets.

Brazilian spotted fever is caused by the bacterium Rickettsia rickettsii, which is the most pathogenic species of the spotted-fever rickettsiae group and is transmitted by the bite of infected ticks. Amblyomma cajennense is the most important tick species involved in the cycle of this zoonosis in Brazil as it presents low host specificity, great number of natural reservoirs and wide geographic distribution. It was first described in the state of São Paulo in 1929 and later in Rio de Janeiro, Minas Gerais and Bahia. The number of cases decreased in the 1940's with the development of new plague control techniques and antibiotics. In the last decades, the number of new cases has increased. The current review aimed at reporting some of the epidemiological and public health aspects of this reemergent disease with new foci, mainly in the southeastern region of Brazil.

ABSTRACT The indirect immunoperoxidase technique was evaluated comparatively to the silver impregnation technique (Warthin Starry) and bacterial isolation in hamster aiming at their use on tissues of leptospirosis-suspected animals. Sixty adult hamsters were divided in group A corresponding to animals inoculated with Leptospira pomona and group B to 20 non-infected animals. Kidneys of all animals were submitted to bacterial isolation, immunohistochemistry in paraffin embedded kidney section and glass slide imprints, and Warthin Starry and Hematoxilineosin staining. The immunohistochemistry techniques demonstrated high sensivity (100%) and specificity (100%). Compared to slide imprints, in tissue sections the preservation of the cellular architecture was maintained as well as the structural integrity of the antigen. High sensivity and specificity were also observed in the Whartin Starry technique although it is not considered to be a serovar specific technique. Positive culture results were obtained in 77.5% of the samples demonstrating lower sensivity compared to the other techniques. leptospirosissuspected leptospirosis suspected 2 noninfected non infected imprints staining 100% 100 (100% 100%. . antigen 775 77 5 77.5 10 (100 7 77. 1 (10 (1 (

RESUMO O presente trabalho teve por objetivo avaliar as técnicas de imunoperoxidase indireta comparativamente à impregnação pela prata (Warthin Starry), e isolamento bacteriano em hamsters, visando sua utilização em tecidos provenientes de animais suspeitos de leptospirose. Foram utilizados 60 hamsters adultos distribuídos em grupo A constituído por 40 hamsters inoculados com a Leptospira pomona e grupo B composto por 20 animais não inoculados. Os animais de ambos grupos foram submetidos ao isolamento bacteriano, imunohistoquímica em cortes e impressões em lâminas, coloração através da técnica de Warthin Starry e através da coloração pela Hematoxilina-Eosina. As técnicas imunohistoquímicas apresentaram elevada sensibilidade (100%) e especificidade (100%) em detectar o agente nos tecidos renais dos hamsters infectados, entretanto em cortes histológicos a preservação da arquitetura celular favoreceu a integridade estrutural do antígeno quando comparados as impressões em lâminas. A técnica de Warthin Starry também apresentou elevada sensibilidade, embora não seja considerada técnica sorovar específica. Com cerca de 77,5% de amostras positivas, resultados de cultivo apresentaram-se inferiores às técnicas descritas acima quanto à sensibilidade em detectar leptospiras provenientes de tecidos renais. Starry, , Starry) leptospirose 6 4 2 lâminas HematoxilinaEosina. HematoxilinaEosina Hematoxilina Eosina. Eosina Hematoxilina-Eosina 100% 100 (100% infectados específica 775 77 5 77,5 positivas apresentaramse se 10 (100 7 77, 1 (10 (1 (

RESUMO O presente trabalho teve como objetivo avaliar a prevalência de anticorpos anti-Brucella canis em cães da microrregião da serra de Botucatu, Estado de São Paulo, por meio de técnica de soroaglutinação rápida em cartão (SAR) e soroaglutinação rápida em cartão com 2-mercaptoetanol (SAR-2ME). A avaliação estatística dos resultados demonstrou não haver diferença significativa entre sexo e zona de procedência destes animais. Dos 1.072 soros de cães examinados no estudo, verificaram-se reações positivas em 19 na prova de SAR (1,77%) e nove na prova de SAR-2ME (0,84).. antiBrucella anti Brucella Botucatu Paulo (SAR 2mercaptoetanol mercaptoetanol 2 SAR2ME. SAR2ME SARME 2ME . ME (SAR-2ME) animais 1072 1 072 1.07 estudo verificaramse verificaram se 1,77% 177 77 (1,77% 0,84.. 084 0,84 .. 0 84 (0,84). (SAR-2ME 107 07 1.0 1,77 17 7 (1,77 0,84. 08 0,8 8 (0,84) 10 1. 1,7 (1,7 0, (0,84 1, (1, (0,8 (1 (0, ( (0

ABSTRACT The prevalence of anti-Brucella canis serum antibodies was studied in dogs of the microregion of the Botucatu mountain range, São Paulo State, Brazil, through the rapid slide agglutination test (SAT),and the modified 2mercaptoethanol rapid slide agglutination test (ME-SAT). No expressive divergence between animals sex and origin areas was observed. Positive results was verified in 19 dogs in the SAT (1.77%) and nine in the ME-SAT (0.84%).. antiBrucella anti Brucella range State Brazil SAT,and SATand ,and mercaptoethanol MESAT. MESAT ME . (ME-SAT) observed 1 1.77% 177 77 (1.77% 0.84%.. 084 0.84% .. 0 84 (0.84%). (ME-SAT 1.77 17 7 (1.77 0.84%. 08 0.84 8 (0.84%) 1.7 (1.7 0.8 (0.84% 1. (1. 0. (0.84 (1 (0.8 ( (0. (0