BACKGROUND Dengue is a disease caused by dengue virus (DENV-1 through -4). Among the four serotypes, DENV-4 remains the least studied. Acute kidney injury is a potential complication of dengue generally associated with severe dengue infection. OBJECTIVES The goal of this study was to investigate the alterations caused by experimental dengue infection in the kidney of adult BALB/c mice. METHODS In this study, BALB/c mice were infected through the intravenous route with a DENV-4 strain, isolated from a human patient. The kidneys of the mice were procured and subject to histopathological and ultrastructural analysis. FINDINGS The presence of the viral antigen was confirmed through immunohistochemistry. Analysis of tissue sections revealed the presence of inflammatory cell infiltrate throughout the parenchyma. Glomerular enlargement was a common find. Necrosis of tubular cells and haemorrhage were also observed. Analysis of the kidney on a transmission electron microscope allowed a closer look into the necrotic tubular cells, which presented nuclei with condensed chromatin, and loss of cytoplasm. MAIN CONCLUSIONS Even though the kidney is probably not a primary target of dengue infection in mice, the inoculation of the virus in the blood appears to damage the renal tissue through local inflammation.

ABSTRACT Purpose The aim of the study was to verify the level of satisfaction of CI users with long periods of hearing deprivation, highlighting the positive and negative aspects of the use of the device and their quality of life. Methods This is a analytical research, of the type observational cross-sectional study. The study was performed with 24 patients from a private Institute of Otorhinolaryngology. Three surveys were applied: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory - Cochlear Implant (IOI - CI) to assess cochlear implant satisfaction and WHOQOL- bref to assess the quality of life. The results in the pre and post lingual groups were compared. Results The highest degree of satisfaction was reported with regard to personal image, positive effects, and how the users feel about their CI. The lowest degree of satisfaction was reported regarding the cost-benefit of the CI and the competitive noise. In the WHOQOL-bref assessment, the highest scores were found in physical, psychological and social relations domains. When comparing the results of the surveys, the pre and post-lingual groups showed no difference in relation to the achieved scores. Conclusion The participants had a high level of satisfaction with the use of cochlear implants. The longer the sensory deprivation time, the greater the degree of satisfaction with the device. The use of the CI electronic device reflects on the individual's quality of life.

RESUMO Objetivo Verificar o nível de satisfação de usuários de IC com longos períodos de privação auditiva, destacando os aspectos positivos e negativos do uso do dispositivo e avaliar a qualidade de vida desses indivíduos. Método Trata-se de uma pesquisa analítica, do tipo estudo observacional transversal. O estudo foi realizado com 24 pacientes de um instituto privado de Otorrinolaringologia. Foram aplicados três questionários: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory- Implante Coclear (IOI - IC) para avaliar a satisfação com o implante coclear e WHOQOL-bref para avaliar a qualidade de vida. Os resultados nos grupos pré e pós-lingual foram comparados. Resultados O maior grau de satisfação foi relatado em relação à imagem pessoal, efeitos positivos e como os usuários se sentem em relação ao seu IC. O menor grau de satisfação ocorreu em relação ao custo-benefício do IC e ao ruído competitivo. Na avaliação do WHOQOL-bref, os maiores escores foram encontrados nos domínios físico, psicológico e relações sociais. Os grupos pré e pós-lingual não apresentaram diferença em relação aos escores alcançados. Conclusão Os participantes apresentaram alto nível de satisfação com o uso do implante coclear. Quanto maior o tempo de privação sensorial maior o grau de satisfação com o dispositivo. O uso do dispositivo eletrônico de IC reflete melhora na qualidade de vida do indivíduo.

Abstract Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.

BACKGROUND The impact of arbovirus cocirculation in Brazil is unknown. Dengue virus (DENV) reinfection may result in more intense viraemia or immunopathology, leading to more severe disease. The Zika virus (ZIKV) epidemic in the Americas provided pathogenicity evidence that had not been previously observed in flavivirus infections. In contrast to other flaviviruses, electron microscopy studies have shown that ZIKV may replicate in viroplasm-like structures. Flaviviruses produce an ensemble of structurally different virions, collectively contributing to tissue tropism and virus dissemination. OBJECTIVES AND METHODS In this work, the Aedes albopictus mosquito cell lineage (C6/36 cells) and kidney epithelial cells from African green monkeys (Vero cells) were infected with samples of the main circulating arboviruses in Brazil [DENV-1, DENV-2, DENV-3, DENV-4, ZIKV, Yellow Fever virus (YFV) and Chikungunya virus (CHIKV)], and ultrastructural studies by transmission electron microscopy were performed. FINDINGS We observed that ZIKV, the DENV serotypes, YFV and CHIKV particles are spherical. ZIKV, DENV-1, -2, -3 and -4 presented diameters of 40-50 nm, and CHIKV presented approximate diameters of 50-60 nm. Viroplasm-like structures was observed in ZIKV replication cycle. MAIN CONCLUSIONS The morphogenesis of these arboviruses is similar to what has been presented in previous studies. However, we understand that further studies are needed to investigate the relationship between viroplasm-like structures and ZIKV replication dynamics.

RESUMO: Embora o Nordeste do Brasil seja considerado livre de Febre Aftosa (FA) com a vacinação, ainda são registrados vários prejuízos econômicos e sanitários devido à ocorrência de síndromes vesiculares que precisam ser adequadamente avaliadas, como Estomatite Vesicular (EV). Portanto, este estudo teve como objetivo confirmar a ocorrência desta doença e determinar o sorotipo viral predominante em casos suspeitos notificados ao Serviço Veterinário Oficial do Ceará no ano de 2013 realizando protocolos oficiais de diagnóstico recomendados pela Organização Mundial de Saúde Animal. Após investigação clínica e epidemiológica em 46 propriedades rurais, foram considerados 32 casos prováveis de propriedade foco de EV com 78 animais amostrados, sendo 65 bovinos e 13 equídeos. Amostras de soro (54) e epitélio (24) foram coletadas. Análises sorológicas de 6 (14,6%) de 41 bovinos e 8 (61,5%) de 13 equídeos apresentaram soroconversão ao Vesiculovírus Indiana (VVI) por neutralização viral. O VVI foi detectado em 15 (62,5%) de 24 epitélios bovinos usando ELISA indireto sanduíche. Por fim, amostras de epitélio positivas foram submetidas a subtipagem viral por fixação do complemento que identificou a ocorrência do sorotipo Indiana III (Alagoas/VVI-3) em 11 (73,3%) de bovinos. Estes foram os primeiros casos confirmados de EV no estado do Ceará com diagnóstico oficial de VVI-3 confirmando o caráter endêmico atribuído ao Estado por meio de levantamentos sorológicos não oficiais anteriores. A presença de EV é um desafio diagnóstico contínuo, dado o risco de possíveis incursões de FA. A Estomatite Vesicular é recorrente e preocupante nesta área livre de FA com vacinação pois, além de prejuízos aos produtores, traz um alerta máximo aos Órgãos de Defesa Sanitária diante de um caso provável de síndrome vesicular.

ABSTRACT: Although Northeast Brazil is considered free of foot and mouth disease (FMD) with vaccination, several economic and health damages are still recorded due to the occurrence of vesicular syndromes that can be evaluated, such as Vesicular Stomatitis (VS). Therefore, this study aimed to confirm the occurrence of this disease and to determine the predominant viral serotype in suspected cases notified to the Official Veterinary Service of Ceará in 2013 performing official diagnostic protocols recommended by the World Organization for Animal Health. After clinical and epidemiological investigation in 46 farms, 32 probable cases of VS were considered with 78 sampled animals, 65 bovines and 13 equines. Serum (54) and epithelium (24) samples were collected. Six (14.6%) of 41 bovines and 8 (61.5%) of 13 equines described seroconversion to Indiana Vesiculovirus (IVV) by viral neutralization. The IVV was detected in 15 (62.5%) of 24 bovines epithelia using the indirect sandwich ELISA. Finally, positive epithelium underwent complement fixation test viral subtyping that identified the occurrence of Indiana III serotype (Alagoas/IVV-3) in 11 (73.3%) of 15 previous positives cattle. These were the first confirmed cases of VS in Ceará with an official diagnosis of IVV-3, confirming the endemic character attributed to the state through previous unofficial serological surveys. The presence of VS is a continuing diagnostic challenge, given the risk of possible incursions of FMD. Vesicular stomatitis is recurrent and is a worrying in this area free of foot and mouth disease with vaccination that bring damage to producers and a maximum alert to the Sanitary Defense Organs in the face of a probable case of vesicular syndrome.

Abstract Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent tomild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap.

The lack of an experimental animal model for the study of dengue pathogenesis is a limiting factor for the development of vaccines and drugs. In previous studies, our group demonstrated the susceptibility of BALB/c mice to infection by dengue virus (DENV) 1 and 2, and the virus was successfully isolated in several organs. In this study, BALB/c mice were experimentally infected intravenously with DENV-4, and samples of their saliva were collected. Viral RNA extracted from the saliva samples was subjected to qRT-PCR, with a detection limit of 0.002 PFU/mL. The presence of DENV-4 viral RNA was detected in the saliva of two mice, presenting viral titers of 109 RNA/mL. The detection of DENV RNA via saliva sampling is not a common practice in dengue diagnosis, due to the lower detection rates in human patients. However, the results observed in this study seem to indicate that, as in humans, detection rates of DENV RNA in mouse saliva are also low, correlating the infection in both cases. This study reports the first DENV detection in the saliva of BALB/c immunocompetent mice experimentally infected with non-neuroadapted DENV-4.

RESUMO INTRODUÇÃO: O implante coclear tem a capacidade de medir o potencial de ação composto eletricamente evocado do nervo auditivo (ECAP). Para esta verificação utiliza-se uma medida chamada telemetria de respostas neurais. OBJETIVO: Analisar o potencial de ação composto evocado eletricamente, por meio da neurotelemetria de respostas neurais, em crianças usuárias de implante coclear bilateral. MÉTODO: Trata-se de um estudo analítico, prospectivo, de coorte histórica longitudinal. Foram recrutadas seis crianças, com idades entre de 1-4 anos, usuárias de implante coclear bilateral. Estas crianças foram avaliadas em cinco momentos durante o primeiro ano de uso do implante coclear. RESULTADOS: Houve diferença significativa no tempo de acompanhamento (p = 0,0082) e posição do eletrodo (p = 0,0019) na medida de T-NRT. Houve diferença significativa na interação entre tempo de acompanhamento e posição do eletrodo (p = 0,0143) na medida da amplitude das ondas N1-P1 entre os três eletrodos a cada tempo de acompanhamento. CONCLUSÃO: A mensuração do ECAP por meio da NRT nas crianças com implante coclear bilateral durante o primeiro ano de acompanhamento foi uma medida importante para apresentar o desenvolvimento bilateral da via auditiva periférica de forma sincronizada nesta população estudada.

ABSTRACT INTRODUCTION: The cochlear implant device has the capacity to measure the electrically evoked compound action potential of the auditory nerve. The neural response telemetry is used in order to measure the electrically evoked compound action potential of the auditory nerve. OBJECTIVE: To analyze the electrically evoked compound action potential, through the neural response telemetry, in children with bilateral cochlear implants. METHODS: This is an analytical, prospective, longitudinal, historical cohort study. Six children, aged 1-4 years, with bilateral cochlear implant were assessed at five different intervals during their first year of cochlear implant use. RESULTS: There were significant differences in follow-up time (p = 0.0082) and electrode position (p = 0.0019) in the T-NRT measure. There was a significant difference in the interaction between time of follow-up and electrode position (p = 0.0143) when measuring the N1-P1 wave amplitude between the three electrodes at each time of follow-up. CONCLUSION: The electrically evoked compound action potential measurement using neural response telemetry in children with bilateral cochlear implants during the first year of follow-up was effective in demonstrating the synchronized bilateral development of the peripheral auditory pathways in the studied population.

INTRODUÇÃO: A reabilitação auditiva em crianças com deficiência auditiva neurossensorial severa a profunda bilateral com o Implante Coclear foi consagrado nas últimas décadas, contudo, ainda permanece um desafio para a otorrinolaringologia e a fonoaudiologia a reabilitação do portador de paralisia cerebral. OBJETIVO: Verificar a efetividade do Implante Coclear no desenvolvimento das habilidades auditivas e de linguagem em crianças com paralisia cerebral. MÉTODO: Estudo analítico prospectivo. Foram aplicados testes padronizados que avaliam e quantificam o desenvolvimento das habilidades auditivas e de linguagem. Foram analisadas as filmagens das terapias fonoaudiológicas e os registros descritos ao término de cada sessão de terapia. RESULTADOS: As crianças analisadas apresentaram desenvolvimento auditivo e de linguagem satisfatório quando comparado às demais crianças que alcançaram níveis mais complexos nas categorias de audição e evolução significativa no desenvolvimento da linguagem oral. CONCLUSÃO: O uso do Implante Coclear favoreceu o alcance de etapas avançadas das habilidades de audição e linguagem em três das cinco crianças com paralisia cerebral desse estudo. Esse dispositivo eletrônico tem sido uma opção terapêutica viável para que crianças com paralisia cerebral alcancem etapas complexas no que se refere às habilidades auditivas e de linguagem.

INTRODUCTION: Auditory rehabilitation in children with bilateral severe-to-profound sensorineural hearing loss with cochlear implant has been developed in recent decades; however, the rehabilitation of children with cerebral palsy still remains a challenge to otolaryngology and speech therapy professionals. OBJECTIVE: To verify the effectiveness of cochlear implants in the development of auditory and language skills in children with cerebral palsy. METHODS: A prospective analytical study. The evaluation of auditory responses to speech test was applied to the children in this study at regular intervals following implantation. Standardized tests that assess and quantify the development of auditory and language skills were administered and speech therapy video records and speech therapy files were analyzed. All children went through individually tailored intensive audiological rehabilitation programs following cochlear implantation. RESULTS: Two participants had gradual auditory and language development when compared to other participants who reached advanced levels in hearing and oral language classifications. CONCLUSION: The use of the Cochlear implant enabled participants to reach advanced stages of hearing and language skills in three of the five participants with cerebral palsy in this study. This electronic device is a viable therapeutic option for children with cerebral palsy to help them achieve complex levels of auditory and language skills.

Quatro novilhos da raça Holandesa (450 kg) portadores de cânula ruminal e duodenal, recebendo dietas com níveis de proteína degradável no rúmen (PDR) de 50, 60, 65 e 70%, associadas a uma fonte de amido de alta degradabilidade ruminal (farinha de varredura de mandioca), foram distribuídos em quadrado latino 4 × 4 para se avaliarem as digestibilidades total e parcial dos nutrientes, a concentração de amônia e o pH ruminal. Foi utilizada, como indicador do fluxo duodenal e fecal, a cinza insolúvel em ácido. Não foi observado efeito do nível de PDR sobre o coeficiente de digestibilidade total, digestibilidade ruminal e digestibilidade intestinal da matéria seca, matéria orgânica, fibra em detergente neutro, carboidratos não-estruturais e energia bruta. O aumento do nível de PDR na dieta elevou o coeficiente de digestibilidade total e ruminal da proteína bruta e reduziu a digestibilidade intestinal desse nutriente como porcentagem do digerido. Não houve efeito dos níveis de PDR no pH ruminal, no entanto, maior concentração ruminal de amônia foi observada para as dietas com maior teor de PDR. Os resultados obtidos indicaram que o aumento no teor de PDR acarretou maior produção de nitrogênio na forma de amônia, independentemente da presença da fonte de amido de alta degradabilidade ruminal, contudo, o aporte de proteína intestinal foi semelhante para todas as dietas.

Four ruminally and duodenally cannulated Holstein steers (450 kg) were fed diets with rumen degradable protein (RDP) levels of 50.0 60.0 65.0 and 70.0% associated with a high ruminal degradability starch (cassava by-product meal) were allotted to a 4 × 4 Latin square design for the evaluation of total and partial digestibility of the nutrients, ruminal ammonia concentration and pH. The acid insoluble ash was used as a marker of the duodenal and fecal flow. No effects were observed on the level of RDP on total digestibility coefficient, ruminal digestibility and intestinal digestibility coefficients of dry matter, organic matter, crude protein, neutral detergent fiber, non structural carbohydrates and gross energy. The increase of the RDP levels in the diet increased the coefficients of total and ruminal digestibility of crude protein and reduced the intestinal digestibility of this nutrient as a percentage of the digested. There was no effect of RDP levels on the ruminal pH, however, higher ammonia concentration was observed for the diets with higher level of RDP. The results indicated that the increase in the level of PDR cause a higher production of nitrogen in the ammonia form, independently of the presence of the source of high ruminal degradability starch, however the contribution of intestinal protein was similar for all the diets.

O objetivo neste trabalho foi avaliar a digestibilidade aparente de rações com diferentes teores de proteína degradável no rúmen (PDR) e fonte de amido de baixa degradabilidade ruminal (milho moído) em ovinos. Utilizaram-se quatro ovinos castrados, sem raça definida (SRD), com peso vivo médio de 38,5 kg, em um delineamento experimental quadrado latino 4 x 4. As quatro rações experimentais utilizadas foram compostas de 75% de volumoso (feno de aveia) e 25% de concentrado à base de milho moído (MM), farelo de soja (FS), farelo de algodão (FA), farinha de peixe (FP), uréia e sal mineral, compostas com quatro teores de PDR (46, 50, 54 e 58% de PDR nas rações). Determinaram-se a digestibilidade aparente total dos nutrientes e o balanço de nitrogênio nos animais alimentados com as rações experimentais. Os consumos de MS, MO, PB, amido, FDN e FDA não diferiram entre as rações testadas. Da mesma forma, o nitrogênio ingerido (NI), o N excretado nas fezes e na urina, em g/dia, o balanço de nitrogênio (%NI) e os coeficientes de digestibilidade da MS, MO, PB, FDN e FDA não diferiram entre as rações experimentais, sendo estimados valores médios de 31,68; 6,34; 11,31 g/dia e 44,27% NI, respectivamente, e de 71,90; 73,00; 79,70; 61,10; e 52,00%, respectivamente. Independentemente dos teores de PDR em rações contendo milho como fonte de amido de baixa degradabilidade ruminal, não houve efeitos sobre a digestibilidade aparente dos nutrientes e o balanço de nitrogênio em ovinos.

Four castrated sheep averaging 38.5 kg of body weight were randomly assigned to a 4 x 4 Latin square to evaluate the apparent digestibility of nutrients and nitrogen balance (NB) on diets containing different levels of rumen degradable protein (RDP): 46, 50, 54, and 58% and ground corn. The four experimental diets were composed by 75% of forage (oat hay) and 25% of concentrate containing ground corn (GC), soybean meal (SM), cottonseed meal (CM), fish meal (FM), urea, and mineral salt. No significant differences were observed on the intakes of DM, OM, CP, starch, NDF, and ADF by increasing the dietary RDP levels. Nitrogen intake (NI), urinary N excretion, fecal N excretion, and NB expressed as % NI averaged, respectively, 31.68 g/d, 6.34 g/d, 11.31 g/d, and 47.27% and did not differ across diets. Similarly, apparent total tract digestibilities of DM, OM CP, NDF, and ADF averaged, respectively, 71.90, 73.00, 79.70, 61.10, and 52.00% and did not differ when the RDP level was increased in the diet. It can be concluded that both digestibility of nutrients and NB were not affected by different dietary RDP levels under the conditions of this trial.