Epidermal growth factor receptor (EGFR) signaling and components of the fibrinolytic system, including urokinase-type plasminogen activator (uPA) and thrombomodulin (TM), have been implicated in tumor progression. In the present study, we employed cBioPortal platform (http://www.cbioportal.org/), cancer cell lines, and an in vivo model of immunocompromised mice to evaluate a possible cooperation between EGFR signaling, uPA, and TM expression/function in the context of cervical cancer. cBioPortal analysis revealed that EGFR, uPA, and TM are positively correlated in tumor samples of cervical cancer patients, showing a negative prognostic impact. Aggressive human cervical cancer cells (CASKI) presented higher gene expression levels of EGFR, uPA, and TM compared to its less aggressive counterpart (C-33A cells). EGFR induces uPA expression in CASKI cells through both PI3K-Akt and MEK1/2-ERK1/2 downstream effectors, whereas TM expression induced by EGFR was dependent on PI3K/Akt signaling alone. uPA induced cell-morphology modifications and cell migration in an EGFR-dependent and -independent manner, respectively. Finally, treatment with cetuximab reduced in vivo CASKI xenografted-tumor growth in nude mice, and decreased intratumoral uPA expression, while TM expression was unaltered. In conclusion, we showed that EGFR signaling regulated expression of the fibrinolytic system component uPA in both in vitro and in vivo settings, while uPA also participated in cell-morphology modifications and migration in a human cervical cancer model.

RESUMO O presente trabalho teve por objetivo relatar um caso de linfoma leucemizado em um felino coinfectado com os vírus da imunodeficiência felina (FIV) e o da leucemia felina (FeLV). Foram realizados exames de hemograma, contagem de reticulócitos, mielograma, bioquímica, teste de imunocromatografia para FIV e FeLV, imunofluorescência indireta (IFA) para FeLV, radiografia torácica e citologia renal. Esse último exame revelou um linfoma extranodal. Foi determinante para a conclusão diagnóstica a associação dos sinais clínicos corroborados com a infiltração de elevada quantidade de células linfoblásticas na medula óssea, exibindo critérios citomorfológicos de malignidade, como mitoses atípicas, relacionadas à presença de corpúsculos linfoglandulares e material hematopoiético inter-relacionado. O linfoma é uma neoplasia relativamente comum em felinos, entretanto, a apresentação leucemizada é rara, podendo representar um desafio diagnóstico clínico, o que torna fundamental a inclusão da citologia medular na prática clínica dessa espécie.

ABSTRACT The present study aimed to report a case of lymphoma in leukemic phase in feline coinfected with feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Blood counts, reticulocyte counts, bone marrow avaluation, biochemistry, immunochromatography assay for FIV and FeLV, indirect immunofluorescence (IFA) for FeLV, thoracic radiography and renal citology were performed. This last examination revealed extranodal lymphoma. The association of the clinical signs with the infiltration of a high number of lymphoblastic cells in the bone marrow with cytomorphological criteria of malignancy, atypical mitoses, lymphoglandular corpuscles and hematopoietic material were determinant for the diagnostic conclusion. Lymphoma is a relatively common neoplasm in felines, however the leukemic phase is rare and may represent a clinical diagnostic challenge, making it essential to include bone marrow cytology in the clinical practice of this species.

Resumo Objetivo: Investigar se há associação entre níveis de senso de coerência e desmame precoce. Método: O presente estudo tem natureza quantitativa e delineamento transversal. Foram investigados fatores associados ao desmame precoce (interrupção da oferta do leite materno à criança) em uma amostra de 425 mulheres com idade superior a 18 anos, sem distinção de etnia ou classe social, mães de crianças com até 36 meses, que não fossem gêmeos ou apresentassem deficiências sensoriais ou motoras. Foi feito o teste de qui-quadrado, com nível de significância de 5%, para testar a associação entre a variável dependente (desmame precoce) e as variáveis independentes (socioeconômicas, demográficas e nível de senso de coerência). As variáveis que apresentaram p ≤ 0,20 foram testadas no modelo de regressão logística múltipla. Os odds ratio e os respectivos intervalos de 95% de confiança foram estimados. Todos os testes estatísticos foram feitos com o programa SAS 9.2. Resultados: Os resultados apontaram que mães com maior senso de coerência possuem 1,82 vez mais chance de manter o aleitamento por mais tempo (p = 0,02). Conclusões: A identificação de mães com baixo senso de coerência permite a intervenção precoce dos profissionais de saúde, contribui para diminuir as taxas de desmame precoce na população.

Abstract Objective: To investigate whether there is an association between sense of coherence levels and early weaning. Method: This study had a quantitative nature and a cross-sectional design. Factors associated with early weaning (interruption of maternal breastfeeding) were investigated in a sample of 425 women older than 18 years, mothers of children up to 36 months of age who were not twins, with no sensory or motor deficiencies, without distinction of ethnicity or social class. The chi-squared test, with a significance level of 5%, was used to evaluate the association between the dependent variable (early weaning) and the independent variables (socioeconomic, demographic factors and sense of coherence level). Variables with p ≤ 0.20 were tested by the multiple logistic regression model. Odds ratio and the respective 95% confidence intervals were estimated. All statistical tests were performed using the SAS 9.2 software. Results: The results showed that mothers with greater sense of coherence were 1.82 times more likely to maintain breastfeeding for longer periods (p = 0.02). Conclusions: The identification of mothers with low sense of coherence allows the early intervention of health professionals, contributing to decrease the rates of early weaning in the population.

ABSTRACT A 6-month-old female, 1.0kg, uncastrated female Persian cat was brought to the Veterinary Hospital at State University of Ceara, with a history of dyspnea, prostration, hyporexia and progressive weight loss for a month. On physical examination, systolic cardiac murmur, cyanosis and dyspnea were detected. Unfortunately, the cat died during oxygen therapy. Necropsy examination revealed an increase in cardiac silhouette and ventricular septal defect of 2cm in diameter. Macroscopically the lungs were collapsed, with absent and diffusely reddish blackish crepitus, and the liver with blackish red coalescent multifocal areas, interspersed with lighter areas and lobular pattern with irregular brownish multifocal areas intercepted by brownish areas. Thus, the necropsy results together with the history and physical examination of the animal confirmed the diagnosis of Eisenmenger Syndrome, becoming the report of the first case, in a cat, in Brazil.

RESUMO O rebanho de suínos brasileiro é constituído por diversas raças naturalizadas, entre elas a raça Piau, que é conhecida por sua rusticidade e pela grande deposição de toucinho. As raças naturalizadas, em comparação com as linhagens comerciais, podem ter uma maior resistência a doenças que circulam em seu território. Dessa forma, o presente estudo teve como objetivo verificar se existem diferenças no perfil sorológico contra o Porcine circovirus 2 (PVC2) entre suínos da raça Piau e de uma linhagem comercial de uma granja naturalmente infectada pelo PCV2. Foram realizadas mensurações da carga viral sérica por qPCR e dos níveis de anticorpos anti-PCV2 por meio da técnica de ELISA. Os resultados mostraram que a carga viral sérica se manteve homogênea em todos os animais e que os leitões da raça Piau apresentaram níveis de anticorpos superiores em comparação com os leitões da linhagem comercial (P=0,05), enquanto as porcas de linhagem comercial apresentaram níveis superiores aos da raça Piau (P<0,01). Este trabalho fornece indícios de que a raça Piau apresenta uma resposta imune humoral distinta diante de uma infecção natural pelo PCV2, quando comparada com a resposta desenvolvida pela linhagem comercial. Os resultados obtidos reforçam a importância da conservação das raças nativas.

ABSTRACT Brazilian pig population is made up of several naturalized breeds; among them the Piau breed is known for its rusticity and large fat stores. The naturalized breeds, in comparison with commercial ones, may have an increased resistance to diseases circulating in their territory. Thus, this study aimed to verify if there are differences between the serologic profile against Porcine circovirus 2 (PCV2) of Piau pigs and that of a commercial breed from a farm naturally infected by PCV2. The serum viral load was measured by qPCR, and levels of anti-PCV2 antibodies were measured by ELISA. The results showed that the serum viral load was similar across all animals. However, Piau piglets showed higher levels of antibodies compared to commercial piglets (P= 0.05), while sows of the commercial breed showed higher levels than the Piau breed (P< 0.01). There was not a statistical difference between pigs of different production stages in the seroprevalence of PCV2 or the blood viral load. This work demonstrates that, with regard to a natural PCV2 infection, the Piau breed has a different humoral immune response compared to the response developed by the commercial pigs. The results support the importance of conservation of native breeds.

Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).

The hypothesis that exposure to silica might be associated with a wide range of autoimmune diseases including SLE (Systemic Lupus Erythematosus) has been discussed over the last decade, but only few cases of silicosis and SLE were described in the literature. We report the case of a male patient in his fifth decade of life, with previous exposure to silica, who worked as a well digger for ten years. The patient’s clinical picture started with articular symptoms, sporadic peaks of fever, anemia, positive anti-nuclear factor, peripheral (1/10) and homogeneous (1/500) standard, and productive cough. Computed tomography of the chest showed a diffuse interstitial process, bilateral nodules, para-aortic and para-tracheal hilar calcifications, compatible with pulmonary and ganglial silicosis. He developed acute respiratory distress syndrome (ARDS) and died.

OBJETIVO: Uma modalidade de tratamento que capta muito a atenção da mídia é a cirurgia espiritual, que, entretanto, tem sido pouco estudada cientificamente. Uma questão que se impõe é sobre a veracidade ou não de tais fenômenos, porém pesquisas nesse sentido são escassas. MÉTODO: Apresentamos o relato de uma investigação sobre um dos mais famosos cirurgiões espirituais do Brasil, o Sr. João Teixeira de Farias. Foram acompanhadas por volta de 30 "cirurgias", sendo que em seis dos pacientes foram realizados a anamnese, o exame físico e coletados os tecidos extraídos para exames anatomo-patológicos. RESULTADOS: O "cirurgião" verdadeiramente incisa a pele ou o epitélio ocular, além de realizar raspados corneanos sem nenhuma técnica anestésica ou antisséptica identificável. Apesar disso, apenas um paciente queixou-se de dor moderada quando teve a mama incisada. Os pacientes foram examinados até três dias depois da cirurgia sem nenhum sinal de infecção, bem como os relatos posteriores dos pacientes não continham informações de infecção. O exame histopatológico evidenciou que os tecidos extraídos eram compatíveis com o local de origem e, com exceção de um lipoma de 210 gramas, eram tecidos normais, sem particularidades patológicas. Foi realizada revisão da literatura e discussão do efeito placebo. CONCLUSÕES: As cirurgias são reais, mas, apesar de não ter sido possível avaliar a eficácia do procedimento, aparentemente não teriam efeito específico na cura dos pacientes. Sem dúvida, nossos achados são mais exploratórios que conclusivos. São necessários posteriores estudos para lançar luz sobre esse heterodoxo tratamento.

BACKGROUND: A very popular modality with the media is psychic surgery which has received little scientific evaluation though. Such phenomena always raise the issues of fakery and deceit. Research has been scarce. METHODS: We report an investigation on one of the most famous psychic surgeons in Brazil, João Teixeira de Farias. 30 surgical interventions with cutting were studied, 6 patients undergoing history-taking, physical examination and analysis of the materials supposedly extracted from them. RESULTS: We were struck by the fact that the surgeon really incisions skin or ocular epithelium in addition to scraping the cornea without identified anaesthetics or antiseptics being used. Just one woman complained of pain as she had her breast incised. Longer follow up of patients failed to notice any infection in the surgical sites. Histopathology found the specimens to be compatible with their site of origin and, apart from a 210g. lipoma, were healthy tissues without discernible pathology. CONCLUSIONS: The surgerical procedures are real but we couldn't evaluate the efficacy. It didn't appear to have any specific effect. Our findings are undoubtedly more of an exploratory kind than conclusive ones. Further studies are clearly necessary to cast light on this unorthodox treatment.

Symptomatic involvement of the gastrointestinal (GI) tract as a prominent symptom in Langerhans' cell histiocytosis (LCH) is uncommon, occurring in less than 1 to 5% of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7%), protein-losing enteropathy (33.3%) and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management.

OBJETIVO: São descritos surtos de salmonelose notificados no período de julho de 1993 a junho de 1997 na região Noroeste do Estado de São Paulo, Brasil, tendo em vista os vários surtos de veiculação alimentar ocasionados por Salmonella nessa região. MÉTODO: Foram obtidos 19 inquéritos epidemiológicos para análise de dados, 87 amostras de fezes e 38 amostras de alimentos, incluindo 12 de ovos para análise microbiológica. Cepas de Salmonella foram submetidas a sorotipagem, fagotipagem e teste de sensibilidade a 13 agentes antimicrobianos. RESULTADOS: Foram acometidas 906 pessoas com 295 hospitalizações. Cepas de Salmonella Enteritidis Fagotipo 4 foram isoladas de 80,5% das coproculturas, de todas amostras de alimentose de 41,7% dos ovos. Em 22 (95,7%) surtos os a salmonela foi veiculada por alimentos contendo ovos crus ou semicrus. Os testes de sensibilidade a antimicrobianos revelaram sensibilidade à maioria das cepas. CONCLUSÕES: Considerando os resultados obtidos, torna-se necessária a implantação e intensificação de medidas de controle na produção e armazenamento dos ovos, além da orientação à população quanto aos riscos no consumo inadequado desse alimento.

OBJECTIVE: It is to describe outbreaks of salmonellosis reported from July 1993 through June 1997 in the Northwest region of S. Paulo State, Brazil, one of the areas where several foodborne outbreaks of salmonellosis have been recently detected. METHOD: Data of 19 epidemiological investigations were analysed; 87 stool specimens and 38 food samples (including 12 of shell eggs) were processed for microbiological analysis. Salmonella strains were identified by serotyping, phagetyping and antimicrobial susceptibility testing. RESULTS: There were 906 ill persons including 295 hospitalized patients. Phage type 4 (PT 4) Salmonella Enteritidis strains were isolated from 80.5% of stool samples, from all food samples and from 41.7% of eggs. Of the outbreaks, 95.7% were associated with the consumption of food containing raw or undercooked eggs. All strains were susceptible to the 13 antimicrobials, except the strains from the nosocomial outbreak. CONCLUSIONS: The results obtained show the need for the implementation of control measures regarding egg procdution and storage, as well as for guidance to the public as to the risks involved in the consumption of inadequately prepared eggs.

OBJETIVO: São descritos surtos de salmonelose notificados no período de julho de 1993 a junho de 1997 na região Noroeste do Estado de São Paulo, Brasil, tendo em vista os vários surtos de veiculação alimentar ocasionados por Salmonella nessa região. MÉTODO: Foram obtidos 19 inquéritos epidemiológicos para análise de dados, 87 amostras de fezes e 38 amostras de alimentos, incluindo 12 de ovos para análise microbiológica. Cepas de Salmonella foram submetidas a sorotipagem, fagotipagem e teste de sensibilidade a 13 agentes antimicrobianos. RESULTADOS: Foram acometidas 906 pessoas com 295 hospitalizações. Cepas de Salmonella Enteritidis Fagotipo 4 foram isoladas de 80,5% das coproculturas, de todas amostras de alimentose de 41,7% dos ovos. Em 22 (95,7%) surtos os a salmonela foi veiculada por alimentos contendo ovos crus ou semicrus. Os testes de sensibilidade a antimicrobianos revelaram sensibilidade à maioria das cepas. CONCLUSÕES: Considerando os resultados obtidos, torna-se necessária a implantação e intensificação de medidas de controle na produção e armazenamento dos ovos, além da orientação à população quanto aos riscos no consumo inadequado desse alimento.

OBJECTIVE: It is to describe outbreaks of salmonellosis reported from July 1993 through June 1997 in the Northwest region of S. Paulo State, Brazil, one of the areas where several foodborne outbreaks of salmonellosis have been recently detected. METHOD: Data of 19 epidemiological investigations were analysed; 87 stool specimens and 38 food samples (including 12 of shell eggs) were processed for microbiological analysis. Salmonella strains were identified by serotyping, phagetyping and antimicrobial susceptibility testing. RESULTS: There were 906 ill persons including 295 hospitalized patients. Phage type 4 (PT 4) Salmonella Enteritidis strains were isolated from 80.5% of stool samples, from all food samples and from 41.7% of eggs. Of the outbreaks, 95.7% were associated with the consumption of food containing raw or undercooked eggs. All strains were susceptible to the 13 antimicrobials, except the strains from the nosocomial outbreak. CONCLUSIONS: The results obtained show the need for the implementation of control measures regarding egg procdution and storage, as well as for guidance to the public as to the risks involved in the consumption of inadequately prepared eggs.