ABSTRACT Introduction: Brazil has many inequities in the healthcare provided nationwide. Therefore, in order to access challenges in treatment, available resources and current practices, to identify barriers in delivering a good quality of care among Brazilian centers treating children and adolescents with Non-Hodgkin Lymphoma (NHL) and to generate a future prospective guideline, a customized online survey was distributed to pediatric hematologists and oncologists across the country. Results: A total of 97 surveys were completed (35% response rate), from 47 cities in all Brazilian regions and 79 units of care, with a median of 1 answer by the center (range 1 - 5). Most respondents work at an institution supported exclusively by public/philanthropic resources (58%), with an average of 5 to 9 new cases/year (49%), and 41% have 4 to 6 oncologists/centers. Additionally, 22% have no easy access to the intensive care unit, 26% have no access to Rasburicase, 28% have no access to Rituximabe as front-line therapy and 41% have unreliable methotrexate monitoring levels. Those differences cannot be explained thoroughly by regional wealth variances, nor by the financing model. Regarding the pathology service, 70% consider having reasonable quality assistance, but the timeframe to deliver diagnosis is satisfactory to 46%. There is no uniform management of care, with the current guideline from the Sociedade Brasileira de Oncologia Pediátrica being adopted by 54 to 59%, depending on the NHL subtype. Conclusion: This study provides insights into the heterogeneity of care among Brazilian centers. Recognizing those diversities will support the design of effective strategies and collaboration nationwide.

ABSTRACT This study aimed to evaluate the effect of the inclusion of spineless cactus (Opuntia stricta Haw) in the diet of sheep on the balance of macrominerals, renal function, and blood metabolites. Five sheep cannulated in the rumen (61.5±9.5kg body weight) were used in a 5 × 5 Latin square composed of five diets and five experimental periods. The experimental period lasted 105 days, with five periods of 21 days each. Four diets containing levels of spineless cactus (121, 245, 371, and 500g/kg of dry matter (DM)), and a control diet were evaluated. Samples of the ingredients, orts, feces, urine, and blood were collected. Spineless cactus inclusion in sheep diets increased the DM intake, ash, oxalate, and all macrominerals intake (P < 0.05), but did not affect the urinary and fecal excretion of P, as well as the concentration of P in the blood (P > 0.05). It is possible to verify that the inclusion of spineless cactus, up to the level of 500g/kg of DM in the sheep diets, does not appear to cause damage to the animal’s health. Its inclusion does not compromise kidney function or blood metabolites evaluated herein.

RESUMO O objetivo deste estudo foi avaliar o efeito da inclusão de palma forrageira (Opuntia stricta Haw) na dieta de ovinos sobre o balanço dos macrominerais, a função renal e os metabólitos sanguíneos. Cinco ovinos canulados no rúmen (61,5±9,5kg de peso corporal) foram distribuídos em um quadrado de 5 × 5 latinos, composto de cinco dietas e cinco períodos experimentais. O período experimental teve duração de 105 dias, sendo cinco períodos de 21 dias cada. Foram avaliadas quatro dietas contendo níveis de palma forrageira (121, 245, 371 e 500g/kg de matéria seca (MS)), e uma dieta controle. Foram coletadas amostras dos ingredientes, sobras, fezes, urina e sangue. A inclusão de palma forrageira na dieta dos ovinos aumentou o consumo de MS, cinzas, oxalato e todos os macrominerais (P<0,05), mas não afetou a excreção urinária e a fecal de P, bem como a concentração de P no sangue (P>0,05). É possível verificar que a inclusão de palma forrageira, até o nível de 500g/kg de MS na dieta de ovinos, não parece causar danos à saúde do animal. Sua inclusão não compromete a função renal ou os metabólitos sanguíneos avaliados.

Abstract Solid state fermentation is a promising technology largely used in biotechnology process and is a suitable strategy for producing low-cost enzymatic products. At the present study, a novel enzyme obtained through solid state fermentation using Aspergillus sydowii was herein purified and characterized. The fermentations used coffee ground residue as substrate and the crude enzyme was submitted through further purification steps of: acetonic precipitation, DEAE-Sephadex and Superdex G-75 column. Both crude and purified enzymes were submitted to biochemical characterization of their thermostability, optimal temperature and pH, effects of inhibitors and metal ions. A purified protease was obtained with yield of 5.9-fold and 53% recovery, with maximal proteolytic activity of 352.0 U/mL. SDS-PAGE revealed a band of protein at 47.0 kDa. The enzyme activity was abolished in the presence of phenyl-methyl sulfonyl fluoride and partially inhibited against Triton X-100 (78.0%). The optimal activity was found in pH 8.0 at 45°C of temperature. Besides, the enzyme showed stability between 35°C and 50°C. It was possible to determine appropriate conditions to the obtainment of thermostable proteases with biotechnological interest associated with a method that concomitantly shows excellent production levels and recovery waste raw material in a very profitable process.

RESUMO Não uniões ósseas associadas à osteomielite crônica necessitam de um planejamento terapêutico muito bem realizado, demandando tratamento multimodal para conseguir atingir a consolidação óssea e eliminar a infecção. Relatou-se um caso de sucesso do uso da associação de retalho do omento maior com estabilização cirúrgica com haste intramedular bloqueada para tratamento de uma não união séptica de fêmur em cão. O paciente apresentou retorno funcional parcial do membro com 30 dias após a cirurgia, cultura bacteriana estéril com sinais radiográficos de consolidação óssea e retorno funcional total do membro aos 90 dias de pós-operatório.

ABSTRACT Chronic septic bone nonunion requires a well-designed therapeutic planning, demanding a multimodal treatment to achieve bone consolidation and elimination of infection. A successful case of an association of the major omentum flap with surgical stabilization with an interlocking nail for treatment of a femoral septic nonunion in dog is reported. The patient had partial functional return of the limb 30 days after surgery, negative bacterial culture with radiographic signs of bone healing and total functional return of the limb at 90th days after the surgical procedure.

RESUMO: Enquanto evidências indicam o sorgo sacarino [Sorghum bicolor (L.) Moench] como uma matéria-prima de etanol alternativa durante a entressafra da cana-de-açúcar (Saccharum officinarum L.), pouco se sabe sobre sua capacidade produtiva em condições adversas (sob competição com plantas daninhas, por exemplo). Portanto, o objetivo do presente estudo foi identificar a competição interespecífica mútua entre híbridos de sorgo sacarino e plantas daninhas em situações de alta infestação. O experimento foi conduzido em vasos, usando um esquema fatorial 5 x 6: (i) quatro híbridos de sorgo sacarino (CVSW 81198, CVSW 80007, CVSW 80147 e XBSW 82158), além de uma testemunha sem a presença de sorgo sacarino; e (ii) cinco espécies de plantas daninhas [(Cyperus rotundus L., Mucuna aterrima (Piper and Tracy) Holland, Brachiaria decumbens Stapf, Ipomoea hederifolia L. e Digitaria nuda Schumach.], além de uma testemunha sem a presença de plantas daninhas. M. aterrima foi a única espécie de planta daninha cuja massa seca não foi reduzida pela presença de sorgo sacarino. Os híbridos de sorgo sacarino não sofreram interferência no seu desenvolvimento com a presença de C. rotundus, I. hederifolia ou D. nuda. No entanto, tais plantas daninhas tiveram sua massa seca reduzida pela competição com sorgo sacarino. Em convivência com B. decumbens ou M. aterrima, o sorgo sacarino teve sua massa seca de parte aérea e de folhas reduzida. O sorgo sacarino mostrou-se uma planta altamente competitiva e robusta e, mesmo em alta densidade de plantas daninhas, a interferência interespecífica imposta por certas espécies destas plantas foi baixa.

ABSTRACT: While evidence is mounting that sweet sorghum [Sorghum bicolor (L.) Moench], an ethanol crop, may provide an alternative to sugarcane (Saccharum officinarum L.) on sugarcane lands under rehabilitation, little is known of its under production limiting factors (e.g., interspecific competition with weeds). Accordingly, the aim of the present study was to identify the initial mutual interspecific competition between sweet sorghum hybrids and weeds in high infestation situations. The experiment was carried out in pots, using a 5 × 6 factorial design: (i) a sorghum-free control and four sweet sorghum hybrids (CVSW 81198, CVSW 80007, CVSW 80147 and XBSW 82158), besides a control without sweet-sorghum, and (ii) five species of weeds [Cyperus rotundus L., Mucuna aterrima (Piper and Tracy) Holland, Brachiaria decumbens Stapf, Ipomoea hederifolia L. and Digitaria nuda Schumach.], besides a weed-free control. M. aterrima was the only weed whose dry mass was not reduced by the presence of sweet sorghum. The hybrids of sweet sorghum did not suffer developmental interference from C. rotundus, I. hederifolia or D. nuda. On the other hand, these weeds dry mass was reduced through competition with sweet sorghum. The sweet sorghum cohabiting with B. decumbens or M. aterrima has its aboveground and leaf dry mass reduced. Sweet sorghum is a high competitive and robust plant and, even when under a high weed density, suffers little interspecific interference from certain species of the weed community.

The study focuses on storytelling techniques applied in prime-time radio magazines in Argentina. The article analyzes the four leading audience programs at the beginning of this decade. Argentina has a concentrated market, radio penetration reaches 70% and prime time is between 10:00 and 12:00 AM. By means of content analysís of 160 hours of radio programming, use of different radio genres is analyzed in a wide range of prime time programs from news and opinion to fiction and entertainment, including audience participation. The comparative study of frequency and length of each genre, in different programs and different broadcast bands, shows the relative importance of each and the level of use along the continuity which define magazine as a radio formal.

El presente artículo estudia los modos de contar de los programas magacines de máxima audiencia de la radio argentina. Se analizan los contenidos de los cuatro programas más escuchados y de fuerte competencia entre ellos al inicio de la presente década. Argentina tiene un mercado radiofónico consolidado, con una penetración del 70% y cuyo pico de audiencia o prime time se localiza entre las 10.00 Y las 12.00 horas. Mediante el análisis de contenidos de 160 horas de programación de radio se persigue estudiar el uso de los géneros en los programas líderes del prime time de la radio argentina, según sean de información y opinión, ficción y entretenimiento, o participación de la audiencia. A partir de la frecuencia de aparición y la duración, se mostrará la importancia asignada en la OM/AM y la FM a cada uno de los géneros radiofónicos, así como el grado de integración en el discurso de continuidad que caracteriza a los magacines.

ABSTRACT The organic extracts from stems, roots and leaves of Tephrosia egregia Sandwith, Fabaceae, provided a new flavone, 5-hydroxy-8-(1",2"-epoxy-3"-hydroxy-3"-methylbutyl)-7-methoxyflavone (1), in addition to eleven known compounds: pongaflavone (2), praecansone B (3), 12a-hydroxyrotenone (4), praecansone A, 2',6'-dimethoxy-4',5'-(2",2"-dimethyl)-pyranochalcone, pongachalcone, maackiain, β-sistosterol and its glucoside, p-cumaric acid and cinnamic acid. The structures of all compounds were established on the basis of spectroscopic methods, mainly 1D and 2D NMR and HRESIMS, involving comparison with literature data. Cytotoxicity of compounds 1–4 was evaluated against AGP-01 (cancerous ascitic fluid), HCT-116 (colon adenocarcinoma), HL-60 (leukemia), PC-3 (prostate carcinoma), SF-295 (glioblastoma) and SKMEL 28 (melanoma) cell lines.

RESUMO Apesar dos inúmeros protocolos disponíveis, o uso da quimioterapia permanece empírico para o mastocitoma canino e faltam critérios para escolha do protocolo e da definição dos pacientes que poderiam se beneficiar do tratamento. O objetivo deste estudo foi avaliar o resultado de cães com mastocitoma após a quimioterapia adjuvante, de acordo com o risco de recorrência ou metástase proposto na literatura. Este estudo prospectivo incluiu 89 cães com acompanhamento clínico e avaliação prognóstica, incluindo características clínicas, histológicas, imuno-histoquímicas e genéticas dos mastocitomas. Os pacientes foram agrupados segundo o risco de recorrência ou metástase, sendo recomendado tratamento com lomustina seguida de clorambucila, se considerados sob alto risco, ou vimblastina seguida de clorambucila, se estivessem sob risco intermediário. O resultado final foi definido pelo intervalo livre de doença (ILD) e pela sobrevida global (SG), estimados pela curva de Kaplan-Meier. Na adjuvância, a lomustina foi útil no controle do mastocitoma canino de alto risco, mas apenas quando associada ao clorambucila, com um ILD de 686 dias, sem atingir a mediana para SG. Não houve diferença no grupo de risco intermediário, independentemente do tratamento escolhido. Pacientes de risco intermediário podem não necessitar de tratamentos adjuvantes, mesmo na ausência de margens cirúrgicas livres.

ABSTRACT In spite of the many available protocols, the use of chemotherapy for the management of canine mast cell tumours (MCT) remains empirical, and there is lack of criteria for the choice of protocol and definition of patients who may benefit from treatment. The objective of this study was to evaluate the outcome of dogs with MCT after adjuvant chemotherapy according to the risk of recurrence or metastasis proposed on the literature. This prospective study included 89 followed up dogs with prognosis assesment including clinical, histological, immunohistochemical and genetic features of canine MCT. Patients were grouped according to risk of recurrence and metastasis and recommended treatment with lomustine followed by chlorambucil if considered at high-risk, or vinblastine followed by chlorambucil if a patient was at intermediate risk. Outcome was defined by disease-free interval (DFI) and overall survival (OS) estimated by Kaplan-Meier curve. Adjuvant lomustine was useful for control of canine MCT of high-risk of recurrence or metastasis, but only when sequentially associated to chlorambucil with a DFI of 686 days and not reached OS. There was no difference in outcome in the intermediate-risk group despite choosen treatment. Patients at intermediate-to-low risk may not require adjuvant treatments, even in the absence of free surgical margins.

RESUMO P34 é um peptídeo antimicrobiano produzido pelo Bacillus sp. P34, isolado do conteúdo intestinal de um peixe na Bacia Amazônica. Esse peptídeo demonstrou propriedades antibacterianas contra bactérias Gram-positivas e Gram-negativas e foi caracterizado como uma substância do tipo bacteriocina. Foi demonstrado que o peptídeo P34 exibiu atividade antiviral contra o herpesvírus felino tipo 1 in vitro. O objetivo deste trabalho foi avaliar o P34 in vitro, em cultivo de células RK 13, contra o vírus da arterite equina, uma vez que não há tratamento específico e uma variável proporção de garanhões pode permanecer persistentemente infectada. Os resultados obtidos mostram que o peptídeo exerce atividade antiviral e virucida contra o vírus da arterite equina, agindo provavelmente no envelope viral. Os ensaios antivirais realizados demonstraram que o P34 reduz significativamente os títulos do vírus nas células infectadas e tratadas. O mecanismo de ação do P34 parece ser tempo/temperatura dependente. Esse peptídeo tende a ser um antiviral promissor para o tratamento e a prevenção das infecções por arterivírus, tendo em vista que ele possui um alto índice terapêutico. Contudo, estudos mais detalhados devem ser realizados para precisar a etapa exata da infecção viral em que o P34 age, para que ele possa ser usado como antiviral in vivo no futuro.

ABSTRACT P34 is an antimicrobial peptide produced by Bacillus sp. P34, isolated from the intestinal contents of a fish from the Amazon basin. This peptide showed antibacterial properties against Gram-positive and Gram-negative bacteria and was characterized as a bacteriocin like substance. It was demonstrated that the peptide P34 exhibited antiviral activity against feline herpesvirus type 1 in vitro. The aim of this work was to evaluate P34 for its antiviral properties in vitro, using RK 13 cells, against the equine arteritis virus, since it has no specific treatment and a variable proportion of stallions may become persistently infected. The results obtained show that P34 exerts antiviral and virucidal activities against equine arteritis virus, probably in the viral envelope. The antiviral assays performed showed that P34 reduces significantly the viral titers of treated cell cultures. The mechanism of action of P34 seems to be time/temperature-dependent. This peptide tends to be a promising antiviral compound for the prevention and treatment of arteriviral infections since it has a high therapeutic index. However, more detailed studies must be performed to address the exact step of viral infection where P34 acts, in order to use this peptide as an antiviral drug in vivo in the future.

RESUMO No Brasil, estudos apontam a circulação de Neorickettsia risticii em equinos, contudo não estão claros quais os possíveis vetores intermediários dessa bactéria no país. O objetivo do presente estudo foi analisar a presença de N. risticii, utilizando-se técnicas moleculares, em caramujos e estágios larvais de trematódeos em propriedades rurais de uma região com histórico de equinos sororreativos para essa bactéria, no Rio de Janeiro, Brasil. Uma amostragem por conveniência foi utilizada na região de estudo. Os caramujos coletados foram expostos à luz incandescente (60W) durante duas-quatro horas para a investigação de trematódeos nas formas larvais. A extração de ácido desoxirribonucleico (DNA) foi realizada em tecidos de caramujos e trematódeos. A técnica de PCR em tempo real (qPCR) foi utilizada para investigar a presença de um fragmento do gene 16S rRNA de N. risticii. Foram coletados 410 espécimes de caramujos de 11 propriedades com criações de equinos, sendo identificadas as seguintes espécies: Melanoides tuberculata, Pomacea sp., Biomphalaria tenagophila, Physa acuta, Drepanotrema anatinum e Biomphalaria straminea. Apenas 3,17% (n=13/410) dos caramujos identificados estavam infectados por trematódeos. As cercárias obtidas desses caramujos foram classificadas em Megalourous cercariae, Pleurolophocercus cercariae e Furcocercous cercariae. Não foi observada a amplificação do DNA-alvo de N. risticii, por meio da qPCR, em nenhuma das amostras de caramujos e trematódeos testadas. Com base nesses dados, a transmissão de N. risticii por trematódeos que utilizam as espécies de caramujos nessa região parece não ocorrer ou ocorre a taxas muito reduzidas. Portanto, novos estudos são necessários para elucidar quais espécies de hospedeiros invertebrados se infectam por essa bactéria e potencialmente participam da cadeia de transmissão da neorickettsiose equina no estado do Rio de Janeiro, Brasil.

ABSTRACT In Brazil, some studies have indicated that Neorickettsia risticii circulates in horses, but it is unclear which are the possible intermediate vectors of this bacterium in the country. The aim of this study was to use molecular techniques in order to analyze the presence of N. risticii in snails and larval stages of trematodes in farms in a region with a history of seroreactive horses towards this bacterium, in Rio de Janeiro, Brazil. Convenience sampling was used in the studied region. The collected snails were exposed to incandescent light (60W) for 2-4 hours in order to investigate trematodes in larval forms. Deoxyribonucleic acid (DNA) was extracted from snail tissue and trematode. Real-time PCR (qPCR) technique was used to investigate the presence of a 16S rRNA gene fragment of N. risticii. Snail specimens (n=410) were collected from 11 horse-breeding farms, and the following species were identified: Melanoides tuberculata, Pomacea sp., Biomphalaria tenagophila, Physa acuta, Drepanotrema anatinum and Biomphalaria straminea. Only 3.17% (n=13/410) of the collected snails were infected by trematodes. The cercariae obtained from these snails were classified as Megalourous cercariae, Pleurolophocercus cercariae and Furcocercous cercariae. There was no amplification of the target DNA of N. risticii in the snail and trematode samples tested by qPCR. Based on these data, the transmission of N. risticii by trematodes using these snail species in this region does not appear to occur or occurs at very low rates. Thus, further studies are needed in order to clarify which species of invertebrate hosts are infected by this bacterium and potentially participate in the transmission chain of equine neorickettsiosis in the state of Rio de Janeiro, Brazil.

ABSTRACT The objective of this study was to evaluate the antiproliferative, cytotoxic and genotoxic potential of salty liquid synthetic flavorings of Butter, Cheddar Cheese and Onion. The antiproliferative potential (2.9-1500 µg/mL) was assessed by MTT assay after 72h using the human tumor lines SF-295 (glioblastoma), OVCAR-8 (ovarian), HCT-116 (colon) and HL-60 (promyelocytic leukemia) and primary cultures of murine Sarcoma 180 (S180) and peripheral blood mononuclear cells (PBMC). Allium cepa bulbs were exposed to growing respective doses (1 mL and 2 mL). Only Butter and Cheddar flavorings revealed cytotoxic activity on cancer cells, with IC50 values ranging from 125.4 µg/mL (Cheddar - HCT-116) to 402.6 µg/mL (Butter - OVCAR-8). Butter flavoring was the most cytotoxic on PBMC (136.3 µg/mL) and increased cell division rate in relation to the mitotic index but did not cause cellular aberrations. Onion and Cheddar flavorings reduced the mitotic index after 24h and 48h exposure, but only Onion flavoring resulted in cellular aberrations and mitotic spindle abnormalities, such as anaphase and telophase bridges, micronucleated cells, conchicine-metaphases and amplifications. So, Butter, Onion and/or Cheddar flavorings caused significant changes in the division of meristematic cells of A. cepa and presented cytotoxic action even on decontrolled proliferating human tumor cells.

Resumo:Os trematódeos da família Eucotylidae, incluindo Tanaisia(Paratanaisia)bragaiSantos, 1934, são parasitos de rins e ureteres de várias espécies de aves domésticas e silvestres. Tanaisia bragai é considerada uma espécie pouco patogênica, mas que pode determinar complicações clínicas como apatia, perda de peso, diarreia e morte, quando em cargas parasitárias elevadas. No presente trabalho, descreve-se o primeiro relato de T. bragai parasitando pavões (Pavo cristatusLinnaeus, 1758), incluindo os achados parasitológicos e patológicos associados à infecção. A ausência de sinais clínicos evidencia uma infecção moderada, na qual, ao exame macroscópico dos órgãos internos, verificou-se a presença de pequenas manchas amareladas no fígado. Ao exame histopatológico, foram verificados espécimes de T. bragai nos ductos coletores dos rins, que se apresentavam marcadamente dilatados e com adelgaçamento das paredes. Verificou-se também moderada reação inflamatória (por vezes ausente) na parede dos ductos e pequenos pontos de calcificação ao redor dos mesmos. No interior do órgão foram recuperados parasitos de corpo alongado, com ventosa oral subterminal e bem desenvolvida, ventosa acetabular, faringe, esôfago curto, cecos intestinais em fundo cego, testículos simétricos e equatoriais e irregulares, glândulas vitelínicas presentes nas regiões pré e pós-ovarianas, útero longo e contendo grande quantidade de ovos. O presente achado sugere a necessidade de novos estudos diagnósticos a fim de determinar a prevalência e a importância deste parasito para pavões. Além disso, os pavões demonstraram ser hospedeiros definitivos de T. bragai,podendo servir de fonte de infecção para o ambiente, contribuindo para a dispersão do parasito.

Abstract:Trematodes belonging to the family Eucotylidae, including Tanaisia(Paratanaisia)bragaiSantos, 1934are parasites of the kidney and ureter that affect several species of domestic and wild birds. Tanaisia bragaiis considered a low pathogenic parasite, but high worm burdens may determine clinical complications, including signs of apathy, weight loss, diarrhea and death. This paper describes the first report of infection by T. bragai in peacocks (Pavo cristatus), which constitutes a new host record and offers data on the lesions associated to this parasitism, although the degree of pathogenicity and parasite load may be considered mild. These birds did not exhibit clinical signs of parasitism. The macroscopic exam revealed discreet yellow spots on the liver. In the histological sections of the kidney, specimens of T. bragai were found in the collecting ducts, which were markedly dilated, with a thickened wall. Other findings included a mild inflammatory reaction in the wall of the ducts (but sometimes absent), flattening of lining epithelial cells and small, multifocal points of calcification around the collecting ducts. The microscopic examination of the parasites revealed trematodes with an elongated body, well-developed sub terminal oral sucker, pharynx present, short esophagus, cecum somewhat undulating or not, with blind end, testes symmetrical, equatorial, irregular in shape or slightly lobed, vitelline fields extending in both pre-ovarian and post ovarian fields, uterus very long, intercecal or sometimes overlapping the cecum and containing large quantities of eggs. The present findings suggest the need for further diagnostic studies on the prevalence of this trematode in peacocks as well as pathologic studies for the determination of the potential pathogenicity of this parasite in this species of bird. Moreover, infected peacocks could serve as carriers of T. bragai to be transferred to other bird species, thereby contributing to the dispersion of the parasite.

Introdução:A dissecção endoscópica da submucosa (ESD) já é procedimento consagrado no tratamento do câncer gástrico e esofagiano em suas fases precoces. As lesões colorre-tais, inicialmente abordadas por mucossectomia, em bloco ou em fragmentos, são o foco atual para a abordagem submucosa, principalmente para os tumores de crescimento lateral superficial a partir de 20 mm de diâmetro. A experiência de centros japoneses, referências em endoscopia terapêutica, demonstram redução no índice de recidiva da doença com esta abordagem e, segundo critérios histopatológicos específicos, podem evitar uma colectomia em alguns casos de neoplasia maligna.1-3Relato de caso:Trata-se de paciente de 50 anos, submetida à dissecção endoscópica da submucosa de lesão de crescimento lateral, com 50 mm, localizada no reto, a 8 cm da margem anal. O procedimento foi realizado sem maiores intercorrências, com apenas dois pontos de afastamento da muscular, sem perfuração grosseira, fechados com clipe. Entretanto, a paciente evoluiu com escape aéreo para peritônio, retroperitônio, mediastino e subcútis, sendo tratada sem intervenção adicional, apenas com manejo clínico.Conclusão:É de fundamental importância conhecer e saber aplicar a técnica da ESD, além de abordar suas complicações, uma vez que, mesmo repleta de benefícios em relação à cirurgia, ela pode apresentar desfechos graves.4,5

Introduction:Endoscopic submucosal dissection (ESD) is an already established procedure in the treatment of gastric and esophageal cancer in its early stages. Colorectal lesions, initially approached by endoscopic mucosal resection en bloc or in fragments, are the current focus for submucosal approach, especially for superficial lateral spreading tumor of 20 mm-diameter. The experience of Japanese centers, which are reference in therapeutic endoscopy, demonstrates reduction in the rate of disease recurrence with this approach and, according to specific histopathological criteria, may avoid colectomy in some cases of malignant neoplasia.1-3Case report:The patient was 50-year-old female. She underwent endoscopic submucosal dissection of a rectal lateral spreading tumor measuring 50 mm, located 8 cm from the anal margin. The procedure was performed without major complications, with just two points for muscle layer detachment, without gross perforation and closed with metal clips. However, the patient developed air leakage to the peritoneum, retroperitoneum, mediastinum and subcutaneous tissue, being only treated with clinical procedures and without additional intervention.Conclusion:It is vital to know and be able to apply the technique of ESD, in addition to addressing its complications, since despite the numerous benefits compared to surgery, ESD can result in serious outcomes.4,5

O objetivo do presente trabalho foi utilizar métodos bacteriológicos e moleculares para a identificação do Mycobacteriumbovis em lesões observadas em carcaças de bovinos durante a inspeção post mortem de rotina em matadouros-frigoríficos com serviço de inspeção oficial. Foram acompanhados o abate e a inspeção de 825.394 bovinos, sadios, ao exame antemortem pelo serviço de inspeção oficial em 10 matadouros-frigoríficos do estado da Bahia, entre abril de 2009 e abril de 2012. Cento e oitenta bovinos apresentaram lesões sugestivas de tuberculose e outras linfadenites, as quais foram avaliadas quanto à presença de Mycobacterium bovis por exame bacteriológico e pela PCR multiplex. A maioria das lesões estava localizada em linfonodos do trato respiratório e 71% eram provenientes de bovinos machos com até 32 meses de idade. No isolamento bacteriano, 13,9% (25/180) das amostras apresentavam colônias pequenas, de superfície granular e de coloração creme-amareladas, em meio de cultura Stonebrink-Leslie, e o crescimento médio foi de 34 dias. Todos os esfregaços dos isolados evidenciaram BAAR, e, pela PCR multiplex, 56% (14/25) dos isolados foram identificados como M. bovis. A associação entre exame post mortem, bacteriológico e PCR multiplex permitiu a identificação do agente de forma rápida e em regiões com status sanitário de baixa prevalência, demonstrando ser importante para a detecção dos focos de tuberculose bovina e o auxílio nos programas de controle e erradicação da tuberculose.

The aim of the present study was to perform bacteriological and molecular methods for identification of Mycobacterium bovis in lesions derived from bovine carcasses detected during routine post-mortem examination in officially inspected slaughterhouses. We checked the slaughter and inspection of 825,394 bovines, health upon ante-mortem examination, by the official service in 10 slaughterhouses of Bahia state from April, 2009 to April 2012. Lesions suggestive of tuberculosis were collected from 180 bovines and further evaluated by bacteriology and multiplex PCR. The majority of lesions were located in the respiratory tract lymph nodes and 71% were from male bovines up to 32 months old. 13.9% of samples presented small, granular and creamy-yellowish colonies after being cultured in Stonebrink-Leslie with an average growth time of 34 days. All smears from the isolated samples were Acid Fast Bacilli (AFB) and among them 56% were identified by mPCR as M. bovis. Thus, the association between post-mortem examination, culture and multiplex PCR allowed the bacillus identification in a reduced time and in regions of low prevalence, pointing out its importance for bovine tuberculosis detection and as a supportive tool for the tuberculosis control and eradication program.