RESUMO CONTEXTO: A lesão renal aguda (LRA) é uma complicação comum e grave na cirrose. OBJETIVO: Avaliar o impacto dos estágios da LRA na mortalidade em 30 dias de pacientes com cirrose. MÉTODOS: Realizou-se um estudo de coorte retrospectivo com pacientes com cirrose hospitalizados. LRA foi diagnosticada de acordo com as recomendações do International Club of Ascites e o estadiamento foi feito de acordo com as recomendações da European Association for the Study of the Liver. Comparações entre os grupos foram feitas por análise de variância unidirecional e teste de Tukey. O teste do qui-quadrado foi calculado para variáveis categóricas. Comparações quanto à lesão renal entre os pacientes foram realizadas com estatísticas de Kaplan-Meier, e diferenças entre os grupos foram analisadas pelo teste de log-rank. Um P-valor <0,05 foi considerado estatisticamente significativo. RESULTADOS: Duzentos e trinta e dois pacientes foram incluídos no estudo. O diagnóstico de LRA foi realizado em 98 (42,2%) deles. A mortalidade geral em 30 dias foi de 19,8% (46/232). A mortalidade aumentou de acordo com a progressão dos estágios de LRA. Entre pacientes sem LRA, a mortalidade foi de 5,2% (7/134). Quando comparados aos pacientes sem LRA, pacientes diagnosticados com LRA estágio 1a tiveram mortalidade de 12,1% (4/33, P=0,152); pacientes com LRA estágio 1b tiveram mortalidade de 45% (18/40, P<0,001); e pacientes com LRA estágios 2 ou 3 tiveram mortalidade de 68% (17/25, P<0,001). Além disso, é importante ressaltar que a resposta completa ao tratamento associou-se à menor mortalidade quando comparada à ausência de recuperação completa da função renal (14,3% vs 57,9%, P<0,001). CONCLUSÃO: LRA estágios 1b ou superior, mas não estágio 1a, estão associadas à maior mortalidade em 30 dias de pacientes com cirrose.

ABSTRACT BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cirrhosis. OBJECTIVE: To evaluate the impact of AKI staging on 30-day mortality of patients with cirrhosis. METHODS: We performed a retrospective cohort study of hospitalized patients with cirrhosis. Acute kidney injury (AKI) was diagnosed according to the International Club of Ascites recommendations and staged according to the European Association for the Study of the Liver guidelines. Comparisons between groups were made by one-way analysis of variance and Tukey test. Chi-square was calculated for dichotomous variables. Comparisons of renal impairment status among patients were performed using Kaplan-Meier statistics and differences between groups were analyzed using the log-rank test. A P-value <0.05 was considered to be statistically significant. RESULTS: Two hundred and thirty-two patients were included in the study. The diagnosis of AKI was performed in 98 (42.2%) of them. The overall 30-day mortality was 19.8% (46/232). Mortality increased as the degree of AKI progressed. Among patients who did not have AKI, mortality was 5.2% (7/134). When compared to patients without AKI, patients diagnosed with AKI stage 1a had mortality of 12.1% (4/33, P=0.152); patients with AKI stage 1b had mortality of 45% (18/40, P<0.001); and patients with AKI stages 2 or 3 had mortality of 68% (17/25, P<0.001). Moreover, it is noteworthy that full response to treatment was associated to a decreased mortality when compared to patients who did not show complete recovery of renal function (14.3% vs 57.9%, P<0.001). CONCLUSION: AKI stages 1b or greater, but not AKI stage 1a, are associated to higher 30-day mortality of patients with cirrhosis.

RESUMEN Objetivo. El objetivo evaluar la ocurrencia de protozoos gastrointestinales en terneros lecheros y de identificar posibles factores de riesgo para infección. Materiales y métodos. Se recogieron 243 muestras de heces de terneros de hasta 60 días de edad en 43 granjas lecheras ubicadas en la región del oeste del estado de Santa Catarina, Brasil. Las muestras fueron examinadas por la técnica de centrifugación-flotación. Resultados. Como resultado, Giardia estaba presente en 26.75% (65/243) de todas las muestras, Eimeria en 21.81% (53/243), y Cryptosporidium en 20.99% (51/243). Además, 46.50% (113/243) de las muestras fueron negativas para cualquier protozoos, mientras que 39.10% (95/243) y 14.40% (35/208) mostraron infecciones simples y mixtas, respectivamente. Hubo una mayor asociación entre Cryptosporidium y Giardia (6.99%) en los casos de infecciones mixtas. Sin embargo, la asociación de triple protozoos tenía la menor prevalencia de infecciones mixtas (2.06%). Epidemiológicamente, se aplicó un cuestionario para determinar los factores de riesgo para estas infecciones parasitarias. Se han identificado algunos factores de riesgo de infecciones por Cryptosporidium, destacando manejo de la alimentación, periodo de tiempo que los terneros permanecieron con sus madres (vacas), y el contacto con los perros; el riesgo de contraer Giardia incrementado en función de la fuente de la leche, mientras que el tipo de suelo de las camas, y la edad fueron nombrados como los riesgos de factores de Eimeria. Conclusiones. Es posible confirmar que Giardia, Cryptosporidium y Eimeria pueden infectar a terneros lecheros, y el conocimiento de algunos factores de riesgo asociados a la infección en terneros.

ABSTRACT Objective. This study aimed to evaluate the occurrence of gastrointestinal protozoa in dairy calves and to identify potential risk factors for this type of infection. Materials and methods. For this purpose, 243 fecal samples were collected from calves up to 60 days of age in 43 dairy farms located in the West region of Santa Catarina state, Brazil. Samples were examined by centrifugal-flotation technique. Results. As a result, Giardia was present in 26.75% (65/243) of all samples, Eimeria in 21.81% (53/243), and Cryptosporidium in 20.99% (51/243). Additionally, 46.50% (113/243) of the samples were negative for any protozoa, while 39.10% (95/243) and 14.40% (35/208) showed single and mixed infections, respectively. There was a higher association between Cryptosporidium and Giardia (6.99%) in cases of mixed infections. However, the triple protozoa association had the lowest prevalence in mixed infections (2.06%). Epidemiologically, a questionnaire was applied to determine risk factors for these parasitic infections. Based on the statistical model applied, some risk factors for Cryptosporidium infections were identified, highlighting feeding management, period of time that calves stayed with their mothers (cows), and contact with dogs; the risk of contracting Giardia increased according to the milk source, while the floor type bedding, and age were appointed as risks factors for Eimeria. Conclusions. Therefore, it is possible to confirm that Giardia, Cryptosporidium and Eimeria may infect dairy calves, and the knowledge of some risk factors associated to their infection in calves.

A osteonecrose induzida por bisfosfonatos tem sido associada a um efeito citotóxico destes medicamentos sobre as células da mucosa oral. Um estudo recente demonstrou que 5 µM de ácido zoledrônico (AZ), um potente bisfosfonato nitrogenado, foi a maior concentração encontrada na cavidade oral da pacientes em tratamento com este medicamento. Portanto, para simular esta condição in vivo, o objetivo deste estudo foi avaliar o efeito da aplicação desta concentração de AZ sobre células epiteliais (HaCaT) e fibroblasto de gengiva. As células foram semeadas (3×104 células/cm2) e incubadas por 48 h em placas de 24 compartimentos, utilizando meio de cultura completo (cDMEM). Após permanecer por 24 h em DMEM sem soro fetal bovino (DMEM-SFB), 5 µM do AZ foram adicionados a este meio de cultura, o qual foi incubado em contato com as células por 48 h. Após este período, foram avaliados o número de células viáveis (trypan blue), viabilidade celular (teste de MTT), produção de proteína total e a morfologia celular (MEV). Os dados obtidos foram submetidos aos testes estatísticos de Mann-Whitney e ANOVA complementada por testes de Tukey (p>0,05). Foi demonstrado que o AZ causou diminuição significativa no número de células viáveis, além de redução do metabolismo celular para ambos os tipos celulares avaliados. Porém, redução na produção de proteína total ocorreu apenas para as células epiteliais. Alterações morfológicas foram observadas em ambos os tipos celulares tratados com AZ. Estes dados científicos indicam que a concentração de AZ avaliada neste estudo (5 µM) apresenta ação citotóxica sobre células epiteliais e fibroblastos de gengiva, o que poderia estar associado, clinicamente, ao desenvolvimento da osteonecrose induzida por bisfosfonatos.

Bisphosphonate-induced osteonecrosis has been related to the cytotoxicity of these drugs on oral mucosa cells. A previous study showed that 5 µM of zoledronic acid (ZA), a nitrogen-containing bisphosphonate, is the highest concentration of this drug found in the oral cavity of patients under treatment. Therefore, in order to simulate an osteonecrosis clinical condition, the aim of this study was to evaluate the highest concentration of ZA applied on human epithelial cells (HaCaT) and gingival fibroblasts. For this purpose, cells (3×104 cells/cm2) were seeded in wells for 48 h using complete culture medium (cDMEM). After 48 h incubation, the cDMEM was replaced by fresh serum-free culture medium (DMEM-FBS) in which the cells were maintained for additional 24 h. Then, 5 µM ZA were added to the DMEM–FBS and the cells incubated in contact with the drug for 48 h. After this period, the number of viable cells (trypan blue), cell viability (MTT assay), total protein (TP) production and cell morphology (SEM analysis) were assessed. Data were analyzed statistically by Mann-Whitney, ANOVA and Tukey's test (α=0.05). ZA caused a significant reduction in the number of viable cells and decreased the metabolic activity of both cell lines. However, decrease of TP production occurred only in the epithelial cell cultures. Morphological alterations were observed in both cell types treated with ZA. In conclusion, ZA (5 µM) was cytotoxic to human epithelial cells and gingival fibroblast cultures, which could be associated, clinically, with the development of bisphosphonate-induced osteonecrosis.

OBJETIVO: Identificar o comprimento normal médio dos metatarsais e as fórmulas metatarsais mais comuns, através de um método de mensuração simples, fornecendo substrato ao cirurgião para o planejamento do tratamento dos portadores sintomáticos de alterações biométricas do pé. MÉTODOS: Avaliamos e mensuramos radiografias de adultos com pés normais na incidência dorso-plantar com carga, sendo 83 do sexo masculino e 83 do feminino. RESULTADOS: Encontramos o valor relativo médio do comprimento metatarsal para os homens e para as mulheres, respectivamente, de 125,4mm e 115,1mm para o I metatarsal; de 127,8mm e 117,3mm para o II metatarsal; de 123,4mm e 113,5mm para o III metatarsal; de 114,2mm e 105,3mm para o IV metatarsal e de 99,5mm e 91,7mm para o V metatarsal. A largura média do antepé para os homens foi de 87,1mm e para as mulheres, 80,8mm. CONCLUSÃO: Pés com Index minus em ambos os sexos foram mais frequentes, embora as três fórmulas metatarsais devam ser consideradas normais. O padrão médio normal para homens e para mulheres respectivamente foi o seguinte: o I metatarsal 2,4mm e 2,2mm menor que o II. O III foi menor que o II em 4,4mm e 3,8mm. O IV metatarsal foi 9,2mm e 8,2mm menor que o III. O V foi 14,7mm e 13,6mm menor que o IV.

OBJECTIVE: To identify the mean normal length of the metatarsals and the most common metatarsal formulas through a simple measurement method, thereby providing surgeons with data for planning treatment on symptomatic individuals with biometric abnormalities of the foot. METHODS: We evaluated and measured dorsoplantar weight-bearing radiographs of normal adult feet (83 males and 83 females). RESULTS: We found relative mean lengths for metatarsus I of 125.4 mm for males and 115.1 mm for females; for metatarsus II, 127.8 mm for males and 117.3 mm for females; for metatarsus III, 123.4 mm for males and 113.5 mm for females; for metatarsus IV, 114.2 mm for males and 105.3 mm for females; for metatarsus V, 99.5 mm for males and 91.7 mm for females. The mean forefoot width was 87.1 mm for males and 80.8 mm for females. CONCLUSION: Feet with index minus occurred most frequently in both sexes, although all three metatarsal formulas can be considered to be normal patterns. The mean normal pattern for males and females respectively was the following: metatarsus I 2.4 mm and 2.2 mm shorter than metatarsus II; metatarsus III 4.4 mm and 3.8 mm shorter than metatarsus II; metatarsus IV 9.2 mm and 8.2 mm shorter than metatarsus III; metatarsus V 14.7 mm and 13.6 mm shorter than metatarsus IV.

The aim of this work was to study foraging trip duration and body size of male and female Magellanic Penguins during the breeding season and to determine the association of these parameters with both reproductive success and clutch quality in a colony located in the Beagle Channel, Tierra del Fuego. Trip duration differed significantly between sexes and between breeding stages. Females performed longer trips than males during incubation. We suggest that this could be due to differences in body reserves and foraging capabilities related with their body condition. In both sexes, foraging trips during incubation were longer than in the other stages, while the shortest trips were observed during early chick rearing. Trips were shorter when chicks were smaller and required greater parental care. A high value of reproductive success (1.51 chicks per nest) was recorded in comparison to that observed in colonies from the Malvinas Islands and Punta Tombo. These results could be related to differences in food availability in nearby waters. Body size of parents was not associated with reproductive success. Notwithstanding, larger females produced larger chicks at early moult and clutches of higher quality. The correlation between female body size and chick size at early moult suggests an important contribution of females on chick's development.

En este estudio se estimó la duración de los viajes de alimentación y el tamaño corporal de machos y hembras del Pingüino Patagónico durante el período reproductivo en una colonia del Canal Beagle, Tierra del Fuego, y se determinaron las implicancias de estos parámetros sobre el éxito reproductivo y la calidad de la nidada. La duración de los viajes difirió significativamente entre sexos y entre las distintas etapas reproductivas. Las hembras realizaron viajes más extensos que los machos durante la etapa de incubación. Esto podría deberse a diferencias en las reservas corporales y en capacidades de alimentación relacionadas con su condición corporal. En ambos sexos, los viajes realizados durante la etapa de incubación fueron más prolongados, mientras que los realizados durante el cuidado temprano de pichones fueron más cortos. Los viajes de alimentación tuvieron menor duración cuando los pichones eran más pequeños y necesitaban de un mayor cuidado parental. Se registró un alto valor de éxito reproductivo (1.51 pichones por nido) comparado con el de colonias de las Islas Malvinas y Punta Tombo. Estos resultados podrían explicarse por diferencias en la disponibilidad de alimento en aguas cercanas a la colonia. El tamaño corporal de los padres no se relacionó con el éxito reproductivo. No obstante, las hembras con mayor tamaño corporal produjeron pichones de mayor tamaño al comienzo de la muda y nidadas de mayor calidad. La correlación positiva entre el tamaño de la hembra y el tamaño de los pichones al comienzo de la muda sugiere un aporte importante de las hembras en el desarrollo del pichón.