Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC.

Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond.

Resumo Este estudo explora o cotidiano das famílias com filhos de 0 a 6 anos, residentes em Fortaleza, no Ceará, durante o período de distanciamento físico, estipulado pelo Governo do Estado do Ceará. Esta pesquisa qualitativa se utilizou do referencial da teoria de formação de vínculos na adversidade. Foram entrevistadas 30 mães, entre os meses de julho e agosto de 2020, utilizando videochamadas ou telefonemas. Para análise do material empírico, recorreu-se à análise de conteúdo de Bardin, possibilitando a criação de duas categorias temáticas: (1) o exercício do cuidado parental em tempos de covid-19; (2) o cotidiano das crianças diante da pandemia. A interpretação das narrativas revelou que alguns cuidadores buscaram realizar brincadeiras e atividades manuais com os filhos, e explicavam o que estava acontecendo no cenário mundial, exercendo a parentalidade positiva. Ademais, o distanciamento físico favoreceu o aumento da tolerância dos pais no tempo em que os filhos ficaram expostos às telas. Percebeu-se que os pais influenciaram a prática de hábitos alimentares não saudáveis entre as crianças e a manifestação de mudanças no comportamento dos filhos. Como conclusão, destaca-se a necessidade de um acompanhamento contínuo dos aspectos referentes ao desenvolvimento dessas crianças e do retorno delas às atividades presenciais.

Abstract This study sought to explore the daily life of families with children aged 0 - 6 years old, living in Fortaleza, Ceará - Brazil, during the period of social distancing stipulated by the State Government. This qualitative research was conducted with data collected by means of video or phone interviews with thirty mothers, between July and August 2020. The empirical material was analyzed in the light of Bardin’s content analysis, generating two thematic categories: (1) the exercise of parental care in Covid-19 times; and (2) the daily life of children in the face of the pandemic. The narratives revealed that some caregivers tried to play games and practice arts and crafts with their children, besides explaining what was happening in the world scenario - thus exercising positive parenting. Moreover, the social distancing measures promoted parental tolerance during the time children were exposed to screens, and parents showed to influence the practice of unhealthy eating habits and the manifestation of behavior changes in their children. These findings highlight the need for a continuous monitoring of aspects related to these children’s development, as well as for their return to face-to-face activities.

Resumo Este estudo explora o cotidiano das famílias com filhos de 0 a 6 anos, residentes em Fortaleza, no Ceará, durante o período de distanciamento físico, estipulado pelo Governo do Estado do Ceará. Esta pesquisa qualitativa se utilizou do referencial da teoria de formação de vínculos na adversidade. Foram entrevistadas 30 mães, entre os meses de julho e agosto de 2020, utilizando videochamadas ou telefonemas. Para análise do material empírico, recorreu-se à análise de conteúdo de Bardin, possibilitando a criação de duas categorias temáticas: (1) o exercício do cuidado parental em tempos de covid-19; (2) o cotidiano das crianças diante da pandemia. A interpretação das narrativas revelou que alguns cuidadores buscaram realizar brincadeiras e atividades manuais com os filhos, e explicavam o que estava acontecendo no cenário mundial, exercendo a parentalidade positiva. Ademais, o distanciamento físico favoreceu o aumento da tolerância dos pais no tempo em que os filhos ficaram expostos às telas. Percebeu-se que os pais influenciaram a prática de hábitos alimentares não saudáveis entre as crianças e a manifestação de mudanças no comportamento dos filhos. Como conclusão, destaca-se a necessidade de um acompanhamento contínuo dos aspectos referentes ao desenvolvimento dessas crianças e do retorno delas às atividades presenciais.

Abstract This study sought to explore the daily life of families with children aged 0 - 6 years old, living in Fortaleza, Ceará - Brazil, during the period of social distancing stipulated by the State Government. This qualitative research was conducted with data collected by means of video or phone interviews with thirty mothers, between July and August 2020. The empirical material was analyzed in the light of Bardin’s content analysis, generating two thematic categories: (1) the exercise of parental care in Covid-19 times; and (2) the daily life of children in the face of the pandemic. The narratives revealed that some caregivers tried to play games and practice arts and crafts with their children, besides explaining what was happening in the world scenario - thus exercising positive parenting. Moreover, the social distancing measures promoted parental tolerance during the time children were exposed to screens, and parents showed to influence the practice of unhealthy eating habits and the manifestation of behavior changes in their children. These findings highlight the need for a continuous monitoring of aspects related to these children’s development, as well as for their return to face-to-face activities.

ABSTRACT OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7–48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13–2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08–3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.

ABSTRACT OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7–48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13–2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08–3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.

RESUMO O transplante de fígado é o tratamento de escolha para o estágio final da doença hepática e oferece a possibilidade ao paciente de retorno a uma vida ativa e longa. Uma avaliação dentária antes do transplante é recomendada como pre-requisito para a eliminação de infecções orais, as quais podem piorar o quadro do paciente. Este relato de caso se refere a uma fratura radicular de dente anterior em um paciente em tratamento odontológico prévio ao transplante de fígado. No exame clínico, o incisivo central superior direito (11) apresentava-se sem alteração na coloração mas com mobilidade no sentido vestíbulo-lingual, ligeira vestibularização e extrusão, e fístula na gengiva inserida na distal do 11. O paciente relatou ter sofrido traumatismo na região há mais de 30 anos. Ao exame radiográfico, foi identificada uma linha de fratura radicular horizontal no terço médio, associada à lesão óssea indicada por uma área radiolúcida na superfície distal do 11. O tratamento proposto para o caso envolveu procedimentos de raspagem e alisamento subgengival da superfície distal, o tratamento endodôntico radical da porção coronária radicular com posterior obturação com Agregado Trióxido Mineral e imobilização dental. O acompanhamento clínico e radiográfico, em intervalos de três meses, permitiu observar a regressão gradual da lesão, com formação de osso no local, contribuindo para manutenção do quadro de saúde geral e emocional do paciente, preservando seu sorriso e sua qualidade de vida.

ABSTRACT Liver transplantation is the treatment of choice for end-stage liver disease patients, and offers them the possibility of returning to active and longer life. A dental evaluation before transplantation is a recommended prerequisite to avoid oral infections, which can worsen the patient’s overall situation. This case report refers to the root fracture of an anterior tooth in a patient who was undergoing dental treatment prior to liver transplantation. On clinical examination, the maxillary right central incisor (11) presented without color change, but with mobility in the buccolingual direction, slight flaring and extrusion, and fistula in the attached gingiva on the distal side of tooth 11. The patient reported that he had suffered a trauma in that region 30 years before. The radiographic examination showed a horizontal fracture of the middle third of the root, associated with bone damage, indicated by a radiolucent area at the distal surface of 11. The proposed treatment consisted of: scraping procedure and straightening of the distal surface, radical endodontic treatment of the coronal portion of the root, subsequent filling with Mineral Trioxide Aggregate and dental immobilization. The clinical and radiographic follow-up at three-monthly intervals allowed us to observe gradual regression of the lesion with bone formation, contributing to maintenance of the patient’s general and emotional health, preserving his smile and quality of life.

Abstract The incidence of the species Candida albicans and non-albicans Candida was evaluated in a Brazilian Tertiary Hospital from the environment and health practitioners. In a 12-month period we had a total positivity of 19.65% of Candida spp. The most recurring non-albicans Candida species was C. glabrata (37.62%), generally considered a species of low virulence, but with a higher mortality rate than C. albicans. Subsequently, C. parapsilosis (25.74%) and C. tropicalis (16.86%) were the second and third most commonly isolated species. Considering the total samples collected from the emergency room and from the inpatient and the pediatric sector, 19.10% were positive for Candida spp., with the predominance of non-albicans Candida species (89.42%). The high percentage of positivity occurred in the hands (24.32%) and the lab coats (21.88%) of the health care assistants. No sample of C. albicans presented a profile of resistance to the drugs. All the non-albicans Candida species presented a decreased susceptibility to miconazole and itraconazole, but they were susceptible to nystatin. Most of the isolates were susceptible to fluconazole and amphotericin B. As expected, a high resistance rate was observed in C. glabrata and C. krusei, which are intrinsically less susceptible to this antifungal agent. The contamination of environmental surfaces by Candida spp. through hand touching may facilitate the occurrence of Candida infections predominantly in immunocompromised patients. In addition to that, the antifungal agents used should be carefully evaluated considering local epidemiologic trends in Candida spp. infections, so that therapeutic choices may be better guided.

O plasma rico em plaquetas (PRP) é um produto derivado da centrifugação do sangue total, sendo rico em fatores bioativos, como os de crescimento. Apesar da ampla utilização em processos cicatriciais, há controvérsia sobre a eficácia da terapia na cicatrização cutânea. O objetivo desse estudo foi quantificar e comparar a concentração dos fatores TGF-β1 e PDGF-BB no PRP, plasma sanguíneo e pele, durante diferentes fases do processo de cicatrização da pele tratada ou não com PRP. Foram utilizados sete equinos machos castrados, mestiços, hígidos, com idade entre 16 e 17 (16,14±0,63) anos. Três lesões em formato quadrangular (6,25cm²) foram produzidas cirurgicamente nas regiões glúteas direita e esquerda de todos os animais. Doze horas após indução das feridas, 0,5mL do PRP foi administrado em cada uma das quatro extremidades das feridas de uma das regiões glúteas (Grupo tratado = GT), escolhida aleatoriamente. A região contralateral foi utilizada como controle (GC). As feridas foram submetidas à limpeza diária com água Milli Q, e amostras foram obtidas mediante biópsias realizadas com Punch de 6mm. Foram obtidas seis biópsias de pele, sendo a primeira realizada logo após a produção da ferida (T0), e as demais com 1 (T1) 2 (T2) 7 (T3) e 14 (T4) dias após a indução da lesão. A sexta biópsia (T5) foi obtida após completo fechamento da pele, que ocorreu aproximadamente aos 37 dias (36,85±7,45, GC; 38,85±6,46, GT). Também foram obtidas amostras de sangue com EDTA em todos os tempos mencionados. A quantificação dos fatores de crescimento TGF-β1 e PDGF-BB na pele, PRP e plasma sanguíneo foi realizada pela técnica ELISA. Os dados foram analisados estatisticamente pelo teste t, correlação de Pearson e regressão, utilizando nível de significância de 5%. Não houve diferença entre os grupos, nos valores dos dois fatores de crescimento mensurados na pele, nos diferentes tempos. Também não houve correlação entre a quantidade dos fatores de crescimento presentes na pele e no plasma. Por outro lado, correlação positiva foi observada entre PRP e pele no grupo tratado, para os fatores de crescimento TGF-β1 (r=0,31) e PDGF-BB (r=0,38), bem como entre ambos os fatores de crescimento presentes no PRP (r=0,81). Considerando as concentrações dos fatores de crescimento no T0, os maiores valores cutâneos (p<0,05) do TGF-β1, em ambos os grupos, ocorreram nos tempos T3 e T5. Valores mais elevados (p<0,05) do PDGF-BB ocorreram no T4 (GT) e T5 (GC). No plasma não houve alteração nas concentrações desses fatores em relação ao T0, o que sugere que o PRP não acarreta efeito sistêmico, quando os procedimentos adotados na presente pesquisa são utilizados. A administração local de PRP no volume estudado, 12 h após indução cirúrgica de ferida cutânea na região glútea de equinos não ocasiona maiores concentrações dos fatores de crescimento TGF-β1 e PDGF-BB no plasma sanguíneo e pele, durante o processo de cicatrização.

Platelet-rich plasma (PRP) is a product derived from total blood centrifugation, rich in bioactive factors, such as growth factors. Despite largely used in healing processes, there is a controversy whether the therapy is effective in promoting skin healing. The objective of this study was to quantify and compare the concentrations of the factors TGF-β1 and PDGF-BB in PRP, blood plasma and skin, at different phases of the healing process of skin treated or not with PRP. Seven healthy crossbred 16 to 17-year-old geldings (16.14±0.63) were used. Three quadrangular-shaped lesions (6.25cm²) were surgically induced into the right and left gluteal regions of all animals. Twelve hours after induction of the wounds, 0.5mL of the PRP was administered in each of the four edges of the wound in one of the gluteal regions (Treated group = TG) randomly chosen. The contralateral region was used as control (CG). The wounds were submitted to daily cleaning with Milli-Q water, and samples were obtained with a 6mm diameter biopsy Punch. Six skin biopsies were obtained, the first carried out immediately after the production of the wound (T0), and the others 1 (T1), 2 (T2), 7 (T3), and 14 (T4) days after the lesion was induced. The sixth biopsy (T5) was obtained after complete healing of the skin, which occurred at about day 37 (36.85±7.45, CG; 38.85±6.46, TG). EDTA blood samples were also obtained, at all the times mentioned. Quantification of TGF-β1 and PDGF-BB growth factors on the skin, PRP, and blood plasma was carried out by the ELISA technique. Data were statistically analyzed by the t test, Pearson correlation and regression, at a significance level of 5%. No difference was found between the groups in the values of the two growth factors measured on the skin, at the different times. Also, no correlation was found between the amount of growth factors present in the skin and plasma. On the other hand, a positive correlation was observed between PRP and skin in the treated group, for the growth factors TGF-β1 (r=0.31) and PDGF-BB (r=0.38), as well as between both growth factors present in PRP (r=0.81). Considering the growth factor concentrations at T0, the highest skin values (p<0.05) of TGF-β1, in both groups, occurred at T3 and T5. Higher values (p<0.05) of PDGF-BB occurred at T4 (TG) and T5 (CG). No plasma changes occurred at the concentration of these factors in relation to T0, suggesting that PRP does not cause a systemic effect when the procedures adopted in this research are used. Local administration of PRP in the volume studied, 12 h after surgical induction of cutaneous wound gluteal equine does not cause higher concentrations of the growth factors TGF-β1 and PDGF-BB in the plasma and skin during the healing process.

Na América do Sul, alguns canídeos silvestres são considerados reservatórios naturais da Leishmania chagasi. A resposta imunológica desses animais à Leishmania é pouco conhecida, havendo a necessidade de métodos diagnósticos adequados para esse fim. No presente estudo, é descrita a padronização do ensaio imunoenzimático indireto (ELISA) para o diagnóstico sorológico de leishmaniose visceral em canídeos silvestres brasileiros. Foram estudadas amostras de soro e plasma de 12 canídeos cativos: sete lobos-guará (Chrysocyon brachyurus), três raposinhas (Lycalopex vetulus) e dois cachorros-do-mato (Cerdocyon thous). As amostras de um C. brachyurus e uma L. vetulus, cativos em área endêmica para LV, que apresentavam doença clínica e positividade em testes de Imunofluorescência Indireta e Reação em Cadeia de Polimerase, foram utilizadas como controles positivos. Foram comparados os conjugados anti-IgG de cão e proteína A, ambos ligados a peroxidase, cujos testes detectaram quatro (04/12) e três (03/12) C. brachyurus soropositivos para anticorpos anti-Leishmania sp., respectivamente. As médias das densidades ópticas (DOs) das amostras negativas foram nitidamente mais baixas do que as médias das DOs dos positivos tanto no ELISA com anti-IgG de cão (4,8 vezes) como com proteína A (15,5 vezes). Os soros de três C. brachyurus positivos no ELISA indireto foram avaliados por Western blotting e identificaram 22 bandas, sendo imunodominantes as de peso molecular de 19, 22, 24, 45 e 66 kDa. Os testes ELISA com a proteína A e o conjugado anti-IgG de cão apresentaram respectivamente concordância excelente (Kappa = 1; p<0,001) e moderada (Kappa = 0,8; p<0,0015), com o Western blotting. Ambos foram, portanto, considerados adequados a avaliações de triagem de animais cuja resposta humoral de anticorpos indica contato com o parasito, úteis para subsidiar estudos para adequação de metodologias específicas para os canídeos silvestres.

In South America, some wild canids are considered natural reservoirs of Leishmania chagasi. The immunological response of wild canids to Leishmania is not well understood, and the development of diagnostic methods is necessary for such purpose. In the present study, the standardization of an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of visceral leishmaniasis (VL) in Brazilian species of wild canids is described. Serum and plasma samples from 12 captive wild canids were studied: seven from maned wolves (Chrysocyon brachyurus), three from hoary foxes (Lycalopex vetulus), and two from crab-eating foxes (Cerdocyon thous). Samples from C. brachyurus and L. vetulus, both captive in an endemic area for VL, presenting clinical disease and positivity in Indirect Immunofluorescence Reaction and Polymerase Chain Reaction tests were used as positive controls. The antibody anti-dog IgG and Protein A, both conjugated with horseradish peroxidase, were compared in indirect ELISA tests which detected four (04/12) and three (03/12) seropositive C. brachyurus for anti-Leishmania antibodies, respectively. The ELISA tests were able to clearly distinguish negative from positive samples, as the mean optical density (OD) of the negative samples was 4.8 and 15.5 times lower than those of the positive ones either using anti-dog IgG and Protein A, respectively. Samples from three ELISA - positive C. brachyurus were analyzed by Western blotting and identified immunodominant bands of 19, 22, 24, 45 and 66 kDa, among 22 protein bands detected. The ELISAs with protein A and anti-dog IgG showed respectively excellent (Kappa = 1.0; p<0.001) and moderate (Kappa = 0.8; p<0.0015) agreement with the Western blotting assay. The ELISA tests showed to be adequate for screening studies to identify antibody responses, thus indicating contact with Leishmania infection by wild canids.

A compatibilidade HLA é o fator mais valorizado na escolha do doador de medula óssea voluntário, preconizando-se a realização de HLA de alta resolução nos locos HLA-A,B,C, DRB1 e DQB1. Tem sido dado preferência para o doador com consanguinidade alélica 8x8 (A,B,C, DRB1). Na presença de incompatibilidade na classe-I sugere-se a busca de doador com compatibilidade DQB1 (9x10). Já as incompatibilidades dos locos DPB1 não constituem critério de exclusão de doador, exceto quando existir presença de anticorpo contra o loco HLA-DP do doador.

The HLA system is considered the most important factor in choosing a volunteer bone marrow donor with the recommendation of performing high resolution HLA tests for the HLA-A, B, C, DRB1 and DQB1 loci. A preference has been given for donor 8x8 (A, B, C, DRB1) allele matching. In the presence of class-I incompatibility a search for DQB1 (9x10) donor compatibility is suggested. The incompatibility of the DPB1 locus does not constitute exclusion of the donor, except when there is the presence of antibodies against the HLA-DP locus of the donor.

Apesar da presença de anticorpos anti-HLA em transplantes de órgãos sólidos estar associada à rejeição, essa correlação não havia sido pesquisada em transplante alogênico de células progenitoras hematopoéticas (TCPH). Estudos mais recentes na literatura têm demonstrado que a falência da enxertia no TCPH pode ser mediada por aloanticorpos anti-HLA doador especifico (DSA). A especificidade desses anticorpos pode ser evidenciada pelas técnicas de fase sólida, onde os antígenos HLA únicos são aderidos a pérolas de poliestireno, que permite a realização da prova cruzada virtual. Na presença de DSA, é recomendável selecionar outro doador ou realizar as estratégias de remoção dos anticorpos.

In spite of Anti-HLA antibodies being associated to rejection in solid organs transplantation, this correlation has not been well established yet in allogenic bone marrow transplantation.Recent studies in the literature have demonstrated that engraftment failure in hematopoietic cell transplantation (HCT) can be mediated by donor specific anti-HLA antibodies (DSA). These antibodies specificity can be detected by solid-phase techniques, where single HLA antigens are adhered to microbeads, which allows the interpretation of host reactivity by "virtual crossmatch". In the presence of DSA, it is advisable to either search for another donor or remove the antibodies prior to transplantation.

A frequente utilização de sangue de cordão umbilical - SCU como fonte de células- tronco hematopoéticas - CTH, tanto em crianças, como em adultos, que não dispõem de doador na família, tem levado ao estabelecimento da padronização de critérios em sua seleção, objetivando a obtenção de melhores resultados. A escolha da unidade de SCU deve basear-se no número total de células nucleadas e no número de diferenças de antígenos leucocitários humanos (HLA). Diante de uma unidade com celularidade mínima, deve-se considerar a possibilidade da utilização de duplo cordão. Frente a mais de uma unidade com características semelhantes, a realização da contagem de células CD34 e da compatibilidade ABO, assim como a qualidade e a rapidez para obtenção da unidade, podem definir a escolha.

The frequent use of umbilical cord blood as the source of hematopoietic stem cells, both in children and adults who do not have related donors, has led to the establishment of a better standardization of selection criteria aiming at improving the results. The choice of the umbilical cord blood unit should be based on the total number of nucleated cells and the number of differences in the human leukocyte antigen (HLA) system. When a unit has minimal cellularity, the use of a double cord blood transplant should be considered. When two or more units have similar characteristics, the choice may be determined by the CD34 count, ABO compatibility and the quality and speed to obtain the unit.

Anaplasmose bovina é uma doença com grande importância nas regiões tropicais e subtropicais do mundo por determinar perdas econômicas devido à mortalidade e redução da produtividade. É causada por Anaplasma marginale, uma riquétsia intraeritrocítica obrigatória cujo controle requer, além de uma vacina eficiente, uma acurada identificação de bovinos cronicamente infectados. Apesar de existirem atualmente diversos métodos de diagnóstico dessa riquétsia, os métodos sorológicos, em particular o ensaio de imunoadsorção enzimática-ELISAs, são os mais utilizados devido à sua versatilidade e praticidade. No entanto, devido ao grande número de antígenos disponíveis, atualmente torna-se necessária uma avaliação para definir quais antígenos apresentam um melhor desempenho no diagnóstico da anaplasmose. Soros de bovinos positivos e negativos para A. marginale por PCR, e soros de animais provenientes do Brasil e Costa Rica, foram testados em ELISAs baseados em MSP1a, MSP2 e MSP5 recombinantes, um pool das três proteínas recombinantes, e antígeno de lisado de corpúsculos iniciais da riquétsia (CI). Utilizando soro de bovinos positivos para A. marginale por PCR, uma maior sensibilidade foi observada no ELISA CI. No entanto, uma maior especificidade, com soro de bovinos negativos a PCR, foi observada com os ELISAs recombinantes. O porcentual de bovinos positivos do Brasil e Costa Rica foi maior com ELISA CI. Razões para essas diferenças são discutidas.

Bovine anaplasmosis is a major disease in tropical and subtropical regions of the world by determine economical loss due mortality and productive reduction. The disease is caused by Anaplasma marginale, an intraerythrocytic rickettsia whose control requires, besides an efficient vaccine, the accurate identification of chronically infected cattle. Although the existence of diverse methods of diagnosis of this rickettsia, the serological methods, in particular the enzyme immunosorbent assays (ELISAs), are the most used due to its versatility and practice. However, due to the high number of antigens currently available, an evaluation becomes necessary to define which antigens present the better performance in the diagnosis of anaplasmosis. Sera from cattle positive or negative to A. marginale by PCR, and sera from cattle proceeding from Brazil and Costa Rica, were tested by ELISAs based in recombinant MSP1a, MSP2, and MSP5, a pool of the three recombinant proteins, and initial body lisate antigen (CI). Using sera from A. marginale positive cattle by PCR, the highest sensitivity was shown by CI ELISA. Nevertheless, the highest specificity, with sera from negative cattle by PCR, was shown by recombinants ELISAs. The percentiles of positive cattle from Brazil and Costa Rica were higher with CI ELISA. Reasons for such differences were discussed.

In this study we investigated the prevalence of the oppA gene, encoding the oligopeptide binding protein (OppA) of the major bacterial oligopeptide uptake system (Opp), in different species of the genus Xanthomonas. The oppA gene was detected in two Xanthomonas axonopodis strains among eight tested Xanthomonas species. The generation of an isogenic oppA-knockout derivative of the Xac 306 strain, showed that the OppA protein neither plays a relevant role in oligopeptide uptake nor contributes to the infectivity and multiplication of the bacterial strain in leaves of sweet orange (Citrus sinensis) and Rangpur lime (Citrus limonia). Taken together these results suggest that the oppA gene has a recent evolutionary history in the genus and does not contribute in the physiology or pathogenesis of X. axonopodis.