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Coral reef atherosclerosis of the paravisceral aorta is a rare disease whose description is confined to before contemporary vascular surgical techniques. This study aims to describe the characteristics and outcomes of patients with coral reef aorta treated with trapdoor endarterectomy at a single high-volume quaternary referral center since 2010. From 2010 to 2022, 14 patients with coral reef aorta were treated with trapdoor endarterectomy. The patient data were obtained via a retrospective medical record review. The patients were predominantly women (79%) with a median age of 65 years (interquartile range [IQR], 60-70 years). The patients universally had a tobacco smoking history and hypertension. More than 85% had previously diagnosed carotid stenosis. Two patients (14%) had undergone prior aortofemoral reconstruction, and one patient (7%) had undergone prior axillobifemoral bypass. The most common presenting symptoms were claudication (71%), chronic mesenteric ischemia (50%), and renovascular hypertension (43%). Of the 14 patients, 8 (57%) underwent isolated endarterectomy and 6 (43%) underwent concomitant aortobifemoral bypass. In addition, 13 patients (93%) required a supraceliac aortic clamp position with a median clamp time of 23 minutes (IQR, 20-30 minutes). The median estimated blood loss was 1650 mL (IQR, 1025-3000 mL). A cell saver was used in 13 procedures (93%), with a median transfusion of 563 mL (IQR, 231-900 mL). The median operative time was 341 minutes (IQR, 315-416 minutes). Eight patients (57%) experienced acute kidney injury in the postoperative period with a peak creatinine of 1.96 mg/dL (IQR, 1.50-2.84 mg/dL). The median length of stay was 11 days (IQR, 6-16 days), with an intensive care unit stay of 4 days (IQR, 2-7 days). One patient (7%) required reoperation in the immediate perioperative period for a retroperitoneal hematoma. The postoperative ankle brachial index increased from a median of 0.58 (right) and 0.57 (left) bilaterally in the preoperative period to 1.09 (right) and 1.10 (left) postoperatively. Eight patients (57%) had follow-up data available for >2 years postoperatively, with five patients (36%) having follow-up data available for >3 years. Two major adverse cardiac events were reported at the last follow-up. One patient reported mild recurrent symptoms of chronic mesenteric ischemia during 3 years of postoperatively, with no concurrent imaging findings or loss of patency found on computed tomography angiography. Symptomatic coral reef atherosclerosis of the paravisceral aorta is a complex disease rarely encountered even at high-volume referral centers. These patients can be expected to experience short-term postoperative morbidity and require intensive care. Despite these challenges, trapdoor endarterectomy is a safe and effective procedure for coral reef aorta, and most patients achieve dramatic symptomatic improvement with durable results.

The tuning of the luminescent properties of PtII complexes for possible use in organic light-emitting diodes (OLEDs) and sensing applications is commonly achieved by altering the electronic properties of the ligands. Our group recently demonstrated that the trifluoropropynyl ligand is strongly electron-withdrawing and possibly useful for blueshifting emission. Herein, we report the synthesis of two complexes of this trifluoropropynyl ligand, namely PtLC2CF3 and PtLFC2CF3 (L = 1,3-di(2-pyridyl)benzene; LF = 4,6-difluoro-1,3-di(2-pyridyl)benzene). The PtLC2CF3 complex crystallized in the monoclinic space group P21/n with Z = 4. The PtLFC2CF3 complex crystalized in the triclinic space group P-1 with Z = 2. Changing the tridentate ligand from L to LF resulted in a change in the packing structure, with the latter showing a metallophilic interaction (Pt-Pt distance = 3.3341(3) Å). The solution photophysics of the trifluoropropynyl complexes is compared with that of the corresponding Cl complexes, PtLCl and PtLFCl. Replacement of the chloro ligand with the trifluoropropynyl ligand blueshifted the monomer emission by less than 5 nm but blueshifted the excimer emission peaks by 15–20 nm. The complexes of the trifluoropropynyl ligand also favor the excimer emission more than the complexes of the chloro ligand. The excimer emission is quenched by dissolved oxygen significantly more than the corresponding monomer emission. The excimer emission and monomer emission are well separated, and the ratio of monomer to excimer emission is strongly dependent on oxygen concentration.

Abstract Aging alters the amplitude and phase of centrally regulated circadian rhythms. Here we evaluate whether peripheral circadian rhythmicity in the plasma lipidome is altered by aging through retrospective lipidomics analysis on plasma samples collected in 24 healthy individuals (9 females; mean ± SD age: 40.9 ± 18.2 years) including 12 younger (4 females, 23.5 ± 3.9 years) and 12 middle-aged older, (5 females, 58.3 ± 4.2 years) individuals every 3 h throughout a 27-h constant routine (CR) protocol, which allows separating evoked changes from endogenously generated oscillations in physiology. Cosinor regression shows circadian rhythmicity in 25% of lipids in both groups. On average, the older group has a ~14% lower amplitude and a ~2.1 h earlier acrophase of the lipid circadian rhythms (both, p ≤ 0.001). Additionally, more rhythmic circadian lipids have a significant linear component in addition to the sinusoidal across the 27-h CR in the older group (44/56) compared to the younger group (18/58, p

Summary: The memory B cell response consists of phenotypically distinct subsets that differ in their ability to respond upon antigen re-encounter. However, the pathways regulating the development and function of memory B cell subsets are poorly understood. Here, we show that CD62L and CD44 are progressively expressed on mouse memory B cells and identify transcriptionally and functionally distinct memory B cell subsets. Bcl6 is important in regulating memory B cell subset differentiation with overexpression of Bcl6 resulting in impaired CD62L+ memory B cell development. Bcl6 regulates memory B cell subset development through control of a network of genes, including Bcl2 and Zeb2. Overexpression of Zeb2 impairs the development of CD62L+ memory B cells. Importantly, CD62L is also differentially expressed on human memory B cells following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and identifies phenotypically distinct populations. Together, these data indicate that CD62L expression marks functionally distinct memory B cell subsets.

Understanding large-scale solar eruptions requires detailed investigation of the entire system’s evolution, including the magnetic environment enveloping the source region and searches for precursor activity prior to event onset. We combine stereoscopic observations from the Solar Dynamics Observatory (SDO) and STEREO-B spacecraft for several hours before a filament ejection, M1.2-class eruptive flare, and coronal mass ejection (CME) originating in NOAA active region (AR) 11305 on 2011 October 1. Two episodes of significant preeruption coronal dimming that occurred well to the southeast of the ejected filament are identified. The CME subsequently took off with a substantial component of velocity toward the dimming, which became very pronounced during eruption. We used SDO/Helioseismic and Magnetic Imager (HMI) data to reconstruct the magnetic environment of the system and found that it contains a null point near the dimming region. AR 11305 had quite complex connections to nearby ARs 11302 and 11306, as well as to other regions of decayed AR flux. The intensifying and spatially expanding precursor dimming was accompanied by southeastward rising motions of loops toward the null point and northeastward and southwestward motions of loops retracting away. These motions and the dimming are consistent with persistent magnetic reconnection occurring at the null point as it moved upward and southeastward, thereby removing a strapping magnetic field high above AR 11305. Eventually, the filament was ejected explosively toward the null point. We conclude that the breakout model for solar eruptions provides a compelling account of this event. Furthermore, we conjecture that preeruption dimmings may be much more frequent than currently recognized.

Abstract Spatially separating electrons of different spins and efficiently generating spin currents are crucial steps towards building practical spintronics devices. Transverse magnetic focusing is a potential technique to accomplish both those tasks. In a material where there is significant Rashba spin–orbit interaction, electrons of different spins will traverse different paths in the presence of an external magnetic field. Experiments have demonstrated the viability of this technique by measuring conductance spectra that indicate the separation of spin-up and spin-down electrons. However the effect that the geometry of the leads has on these measurements is not well understood. By simulating an InGaAs-based transverse magnetic focusing device, we show that the resolution of features in the conductance spectra is affected by the shape, separation and width of the leads. Furthermore, the number of subbands occupied by the electrons in the leads affects the ratio between the amplitudes of the spin-split peaks in the spectra. We simulated devices with random onsite potentials and observed that transverse magnetic focusing devices are sensitive to disorder. Ultimately we show that careful choice and characterisation of device geometry are crucial for correctly interpreting the results of transverse magnetic focusing experiments.

Background: Polygenic risk testing examines variation across multiple genes to estimate a risk score for a particular disease, including risk scores for many common, chronic health conditions. Although polygenic risk information (PRI) may be a promising tool for enhancing preventive counseling and facilitating early identification of disease, its potential impact on primary-care encounters and disease prevention efforts has not been well characterized. Methods: We conducted in-depth, semi-structured interviews of patients to assess their understandings of PRI and their beliefs about its relevance to disease prevention. Results: We completed interviews with 19 participants. Participants described enthusiasm for the generation of PRI and recognized its utility for disease prevention. Participants also described the value of PRI as limited if not corroborated by non-genetic risk factors. Finally, participants noted that PRI, by itself, would be insufficient as a trigger for initiating many preventive interventions. Conclusion: PRI has the potential to become an important tool in primary care. However, patient views about PRI as well as the complexities of disease prevention in the primary care context may limit the impact of PRI on disease prevention.

BackgroundAlthough SARS-CoV-2 vaccines have proven effective in eliciting a protective immune response in healthy individuals, their ability to induce a durable immune response in immunocompromised individuals remains poorly understood. Primary antibody deficiency (PAD) syndromes are among the most common primary immunodeficiency disorders in adults and are characterized by hypogammaglobulinemia and impaired ability to mount robust antibody responses following infection or vaccination.MethodsHere, we present an analysis of both the B and T cell response in a prospective cohort of 30 individuals with PAD up to 150 days following initial COVID-19 vaccination and 150 days post mRNA booster vaccination.ResultsAfter the primary vaccination series, many of the individuals with PAD syndromes mounted SARS-CoV-2 specific memory B and CD4+ T cell responses that overall were comparable to healthy individuals. Nonetheless, individuals with PAD syndromes had reduced IgG1+ and CD11c+ memory B cell responses following the primary vaccination series, with the defect in IgG1 class-switching rescued following mRNA booster doses. Boosting also elicited an increase in the SARS-CoV-2-specific B and T cell response and the development of Omicron-specific memory B cells in COVID-19-naïve PAD patients. Individuals that lacked detectable B cell responses following primary vaccination did not benefit from booster vaccination.ConclusionTogether, these data indicate that SARS-CoV-2 vaccines elicit memory B and T cells in most PAD patients and highlights the importance of booster vaccination in immunodeficient individuals.

Abstract Background Proton pump inhibitors (PPIs) are among the most prescribed medications and are often used unnecessarily. PPIs are used for the treatment of heartburn and acid-related disorders. Emerging evidence indicates that PPIs are associated with serious adverse events, such as increased risk of Clostridioides difficile infection. In this study, we designed and piloted a PPI de-implementation intervention among hospitalized non-intensive care unit patients. Methods Using the Systems Engineering Initiative for Patient Safety (SEIPS) model as the framework, we developed an intervention with input from providers and patients. On a bi-weekly basis, a trainee pharmacist reviewed a random sample of eligible patients’ charts to assess if PPI prescriptions were guideline-concordant; a recommendation to de-implement non-guideline-concordant PPI therapy was sent when applicable. We used convergent parallel mixed-methods design to evaluate the feasibility and outcomes of the intervention. Results During the study period (September 2019 to August 2020), 2171 patients with an active PPI prescription were admitted. We randomly selected 155 patient charts for review. The mean age of patients was 70.9 ± 9 years, 97.4% were male, and 35% were on PPIs for ≥5 years. The average time (minutes) needed to complete the intervention was as follows: 5 to assess if the PPI was guideline-concordant, 5 to provide patient education, and 7 to follow-up with patients post-discharge. After intervention initiation, the week-to-week mean number of PPI prescriptions decreased by 0.5 (S

Bis[η5-(tert-butoxycarbonyl)cyclopentadienyl]dichloridotitanium(IV), [Ti(C10H13O2)2Cl2], was synthesized from LiCpCOOt-Bu using TiCl4, and was characterized by single-crystal X-ray diffraction and 1H NMR spectroscopy. The distorted tetrahedral geometry about the central titanium atom is relatively unchanged compared to Cp2TiCl2. The complex exhibits elongation of the titanium–cyclopentadienyl centroid distances [2.074 (3) and 2.070 (3) Å] and a contraction of the titanium–chlorine bond lengths [2.3222 (10) Å and 2.3423 (10) Å] relative to Cp2TiCl2. The dihedral angle formed by the planes of the Cp rings [52.56 (13)°] is smaller than seen in Cp2TiCl2. Both ester groups extend from the same side of the Cp rings, and occur on the same side of the complex as the chlorido ligands. The complex may serve as a convenient synthon for titanocene complexes with carboxylate anchoring groups for binding to metal oxide substrates.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein is the main target for neutralizing antibodies. These antibodies can be elicited through immunization or passively transferred as therapeutics in the form of convalescent-phase sera or monoclonal antibodies (MAbs).

This study examined whether killings of George Floyd, Ahmaud Arbery, and Breonna Taylor by current or former law enforcement officers in 2020 were followed by shifts in public sentiment toward Black people. Methods: Google searches for the names “Ahmaud Arbery,” “Breonna Taylor,” and “George Floyd” were obtained from the Google Health Application Programming Interface (API). Using the Twitter API, we collected a 1% random sample of publicly available U.S. race-related tweets from November 2019–September 2020 (N = 3,380,616). Sentiment analysis was performed using Support Vector Machines, a supervised machine learning model. A qualitative content analysis was conducted on a random sample of 3,000 tweets to understand themes in discussions of race and racism and inform interpretation of the quantitative trends. Results: The highest rate of Google searches for any of the three names was for George Floyd during the week of May 31 to June 6, the week after his murder. The percent of tweets referencing Black people that were negative decreased by 32% (from 49.33% in November 4–9 to 33.66% in June 1–7) (p

Olduvai Gorge (northern Tanzania) is one of the best known and most iconic palaeontological and archaeological sites in the world. In more than a century of research it has yielded an impressive record of fossils and stone tools which stands as a compendium of human evolution in the context of environmental changes of East Africa in the last 2 Ma. Recent field work in the DK site at Olduvai lead to the retrieval of a partial crocodile cranium nicknamed Black Sun because it was discovered during an annular solar eclipse. The specimen is here described and compared with extinct and extant African crocodylids. The new cranium can be referred to Crocodylus anthropophagus, a Pleistocene species hitherto found only in Olduvai Gorge. Thanks to the good preservation of the skull table, its morphology is here characterised for the first time. Black Sun represents to date the earliest (ca. 1.9–1.85 Ma) and the most informative cranium of C. anthropophagus in the fossil record. Our phylogenetic analysis supports a strict relationship between C. anthropophagus and Crocodylus thorbjarnarsoni, a large species from the Plio-Pleistocene of the Turkana Basin (Kenya). These two sister taxa share a combination of characters which places them at the base of Crocodylus, providing an intriguing element to the debate on the African or extra-African origin of this genus.

Abstract Background Chlorhexidine gluconate (CHG) bathing of hospitalized patients may have benefit in reducing hospital-acquired bloodstream infections (HABSIs). However, the magnitude of effect, implementation fidelity, and patient-centered outcomes are unclear. In this meta-analysis, we examined the effect of CHG bathing on prevention of HABSIs and assessed fidelity to implementation of this behavioral intervention. Methods We undertook a meta-analysis by searching Medline, EMBASE, CINAHL, Scopus, and Cochrane’s CENTRAL registry from database inception through January 4, 2019 without language restrictions. We included randomized controlled trials, cluster randomized trials and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator for prevention of HABSIs in any adult healthcare setting. Studies of pediatric patients, of pre-surgical CHG use, or without a non-CHG comparison arm were excluded. Outcomes of this study were HABSIs, patient-centered outcomes, such as patient comfort during the bath, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of the delivery, participant responsiveness, and program differentiation. Three authors independently extracted data and assessed study quality; a random-effects model was used. Results We included 26 studies with 861,546 patient-days and 5259 HABSIs. CHG bathing markedly reduced the risk of HABSIs (IRR = 0.59, 95% confidence interval [CI]: 0.52–0.68). The effect of CHG bathing was consistent within subgroups: randomized (0.67, 95% CI: 0.53–0.85) vs. non-randomized studies (0.54, 95% CI: 0.44–0.65), bundled (0.66, 95% CI: 0.62–0.70) vs. non-bundled interventions (0.51, 95% CI: 0.39–0.68), CHG impregnated wipes (0.63, 95% CI: 0.55–0.73) vs. CHG solution (0.41, 95% CI: 0.26–0.64), and intensive care unit (ICU) (0.58, 95% CI: 0.49–0.68) vs. non-ICU settings (0.56, 95% CI: 0.38–0.83). Only three studies reported all five measures of fidelity, and ten studies did not report any patient-centered outcomes. Conclusions Patient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies did not report fidelity to the intervention or patient-centered outcomes. For sustainability and replicability essential for effective implementation, fidelity assessment that goes beyond whether a patient received an intervention or not should be standard practice particularly for complex behavioral interventions such as CHG bathing. Trial registration Study registration with PROSPERO CRD42015032523.

Prolonged shedding of viral RNA occurs in some individuals following SARS-CoV-2 infection. We perform comprehensive immunologic evaluation of one individual with prolonged shedding. The case subject recovered from severe COVID-19 and tested positive for SARS-CoV-2 viral RNA repeatedly as many as 87 days after the first positive test, 97 days after symptom onset. The subject did not have any associated rise in anti-Spike protein antibody titers or plasma neutralization activity, arguing against re-infection. This index subject exhibited a profoundly diminished circulating CD8+ T cell population and correspondingly low SARS-CoV-2-specific CD8+ T cell responses when compared with a cohort of other recovering COVID-19 subjects. CD4+ T cell responses and neutralizing antibody responses developed as expected in this individual. Our results demonstrate that detectable viral RNA shedding in the upper airway can occur more than 3 months following infection in some individuals with COVID-19 and suggest that impaired CD8+ T cells may play a role in prolonged viral RNA shedding.

Background Microvascular free tissue transfer (FTT) is a reliable method for reconstruction of complex soft tissue defects. The goal of this study was to utilize time-driven activity-based cost (TDABC) accounting to measure the total cost of care of FTT and identify modifiable cost drivers. Methods A retrospective review was performed on patients requiring FTT at a single, level-I academic trauma center from 2013 to 2019. Patient and surgical characteristics were collected, and six prospective FTT cases were observed via TDABC to collect direct and indirect costs of care. Results When stratified by postoperative stay at intensive care units (ICUs), the average cost of care was $21,840.22, while cases without ICU stay averaged $6,646.61. The most costly category was ICU stay, averaging $8,310.99 (40.9% of nonstratified overall cost). Indirect costs were the second most costly category, averaging $4,388.07 (21.6% of nonstratified overall cost). Overall, 13 of 100 reviewed cases required some form of revision free-flap, increasing cumulative costs to $7,961.34 for cases with non-ICU stay and $22,233.85 for cases with ICU stay, averaging up to $44,074.07 for patients who stayed in the ICU for both procedures. An increase in cumulative cost was also observed within the timeframe of the investigation, with average costs of $8,484.00 in 2013 compared to $45,128 for 2019. Conclusion Primary drivers for cost in this study were ICU stay and revision/reoperation. Better understanding the cost of FTT allows for cost reduction through the development of new protocols that drive intraoperative efficiency, reduce ICU stays, and optimize outcomes.

Summary: CD137 is a costimulatory receptor expressed on natural killer cells, T cells, and subsets of dendritic cells. An agonistic monoclonal antibody (mAb) against CD137 has been used to reduce tumor burden or reverse autoimmunity in animal models and clinical trials. Here, we show that mice treated with an agonistic anti-CD137 mAb have reduced numbers of germinal center (GC) B cells and follicular dendritic cells (FDCs) in lymphoid tissues, which impair antibody responses to multiple T-cell-dependent antigens, including infectious virus, viral proteins, and conjugated haptens. These effects are not due to enhanced apoptosis or impaired proliferation of B cells but instead correlate with changes in lymphoid follicle structure and GC B cell dispersal and are mediated by CD137 signaling in CD4+ and CD8+ T cells. Our experiments in mice suggest that agonistic anti-CD137 mAbs used in cancer and autoimmunity therapy may impair long-term antibody and B cell memory responses.

The Beringian Coevolution Project (BCP), a field program underway in the high northern latitudes since 1999, has focused on building key scientific infrastructure for integrated specimen-based studies on mammals and their associated parasites. BCP has contributed new insights across temporal and spatial scales into how ancient climate and environmental change have shaped faunas, emphasizing processes of assembly, persistence, and diversification across the vast Beringian region. BCP collections also represent baseline records of biotic diversity from across the northern high latitudes at a time of accelerated environmental change. These specimens and associated data form an unmatched resource for identifying hidden diversity, interpreting past responses to climate oscillations, documenting contemporary conditions, and anticipating outcomes for complex biological systems in a regime of ecological perturbation. Because of its dual focus on hosts and parasites, the BCP record also provides a foundation for comparative analyses that can document the effects of dynamic change on the geographic distribution, transmission dynamics, and emergence of pathogens. By using specific examples from carnivores, eulipotyphlans, lagomorphs, rodents, ungulates, and their associated parasites, we demonstrate how broad, integrated field collections provide permanent infrastructure that informs policy decisions regarding human impact and the effect of climate change on natural populations.

B-cell encounter with antigen is thought to result in anergy, cell death, or a productive B-cell response. Here the authors show that transient antigen acquisition can enable B-cell recruitment into productive responses or a return to a naive-like state, depending on availability of T-cell help.

Previous studies and our findings suggest upregulated expression of proinflammatory chemokines CCL3/4 in germinal center (GC) centrocytes. However, the role of CCL3/4 for centrocyte interactions with follicular T cells and regulation of humoral immunity is poorly understood. We found that CCL3 promotes chemotaxis of Tfr cells ex vivo. Two-photon imaging revealed that B cells-intrinsic production of CCL3 promotes their probing by follicular regulatory T cells (Tfr) within GCs of murine lymph nodes. Overall this study suggests that CCL3 facilitates direct interactions of foreign antigen-specific GC B cells and their negative regulation with Tfr cells in vivo.

Neste trabalho descrevem-se, em bovinos, um surto de intoxicação por Palicourea aeneofusca no município de Jacaraú e um surto de intoxicação por Mascagnia rigida, no município de Sapé. Ambos os surtos ocorreram na zona da Mata Paraibana, onde não havia, anteriormente, informação sobre intoxicação por plantas que causam mortes súbitas associadas ao exercício. A toxicidade de ambas as plantas frescas recém coletadas foi testada em coelhos, sendo a dose letal de 3g por kg de peso animal (g/kg) para P. aeneofusca e de 10g/kg para M. rigida. Na fazenda onde ocorreu o surto de intoxicação por P. aeneofusca foi encontrada, também M. rigida e o produtor informava que esta tinha causado, anteriormente, mortes de bovinos. M. rigida coletada nesta última fazenda foi tóxica na dose de 10g/kg da planta seca. Anteriormente a intoxicação por P. aeneofusca tinha sido diagnosticada na Zona da Mata e Agreste Pernambucano e leste da Bahia. Há também numerosos históricos da ocorrência desta intoxicação na Zona da Mata Alagoana, o que sugere sua ocorrência no litoral do nordeste, desde a Bahia até Paraíba. M. rigida é a planta tóxica mais conhecida e mais importante do nordeste ocorrendo no sertão e no agreste. Este trabalho comprova que, pelo menos na Paraíba, a intoxicação ocorre, também, na Zona da Mata.This paper reports an outbreak of poisoning by Palicourea aeneofusca in cattle, in the municipality of Jacaraú, and another by Mascagnia rigida in the municipality of Sapé. Both outbreaks occurred in the Zona da Mata of Paraíba, where there are no previous reports of poisoning by toxic plants causing sudden death associated to exercise. The toxicity of both plants was tested in rabbits. The lethal dose was of 3g per kg body weight (g/kg) for fresh P. aeneofusca and 10g/kg for fresh Mascagnia rigida. On the farm where the poisoning by P. aeneofusca was observed, M. rigida also was found. The farmer reported that this plant also caused sudden death previously. M. rigida collected on that farm and given dried to rabbits caused death at the dose of 10gkg. The poisoning by P. aeneofusca in cattle had been previously reported in the Zona da Mata and Agreste of Pernambuco and east of Bahia. There are also numerous farmers' reports about the occurrence of the poisoning in the Zona da Mata of Alagoas, suggesting that it occurs in the whole coastal region, from Bahia to Paraíba. M. rigida is the most important toxic plant for cattle in the Brazilian semiarid. The results of this paper demonstrate that this plant poisoning also occurs in the tropical wet climate of the Zona da Mata.

Mascagnia rigida é a planta tóxica mais importante para bovinos na região Nordeste, causando morte súbita associada ao exercício. O presente trabalho teve como objetivos descrever três surtos de intoxicação por M. rigida em ovinos e um surto em caprinos no semi-árido da Paraíba, reproduzir experimentalmente a intoxicação em ovinos e caprinos, e comprovar a passagem do princípio ativo de M. rigida pelo colostro destes pequenos ruminantes. Os surtos ocorreram no início do período chuvoso, quando a planta brota antes do que outras forrageiras ou após o final desse período, quando após secarem algumas forrageiras, M. rigida permanece verde. Na reprodução experimental da intoxicação por M. rigida, doses de 10 e 20g/kg de peso animal, com as planta proveniente de duas regiões diferentes, foram letais para três caprinos e três ovinos. Um caprino que ingeriu 20g/kg da planta um ovino que ingeriu 10g/kg, se recuperaram. Dois ovinos e dois caprinos que ingeriram 5g/kg tiveram sinais discretos e se recuperaram. Tanto os casos experimentais quanto os espontâneos apresentaram ingurgitamento das veias jugulares, relutância em caminhar, decúbito externo abdominal, incoordenação, respiração ofegante, depressão, instabilidade e tremores musculares. A morte ocorreu após um curso clínico de alguns minutos a 27h40 min. As principais lesões foram edema pulmonar e vacuolização e necrose de células epiteliais dos túbulos renais. Para testar se o princípio ativo de M. rigida é eliminado pelo leite causando morte súbita nas crias foi realizado um experimento com duas cabras e cinco ovelhas que ingeriram, diariamente, 2g/kg de M. rigida, nos 15 dias anteriores ao parto. Uma ovelha que tinha gestação gemelar abortou depois de ter ingerido a planta por 10 dias. Os cordeiros das demais ovelhas mamaram normalmente o colostro sem aprestar sinais clínicos. O cabrito de uma cabra mamou o colostro e 5 minutos após morreu subitamente. A outra cabra pariu um cabrito que morreu imediatamente após o parto, sem ter ingerido colostro. Estes resultados sugerem que o princípio ativo da planta foi eliminado pelo leite em doses tóxicas. Recomendamse medidas de controle da intoxicação.Mascagnia rigida is the most important toxic plant for cattle in the Northeastern region of Brazil, causing sudden death during exercise. The objectives of this research were to report three outbreaks of poisoning by M. rigida in sheep and one in goats in the semiarid of the state of Paraíba, to reproduce experimentally the disease, and to determine if the active principle of the plant is eliminated through the milk. The outbreaks occurred at beginning of the raining season, when the plant sprouts ahead other forages, or after the end of the raining season, when M. rigida stayed green and other forages had dried. In the experimental reproduction of the poisoning doses of 10 and 20g of M. rigida per kg body weight from two different regions were lethal to 3 goats and 3 sheep. One goat that ingested 20g/kg and a sheep that ingested 10g/kg recovered. Two sheep and two goats that ingested 5g/kg had mild clinical signs and recovered. Clinical signs of experimental and spontaneous cases were ingurgitation of the jugular veins, reluctance to move, sternal recumbence, incoordination, respiratory distress, depression, instability, and muscular tremors. Death occurred after a clinical manifestation period of about 4 min to 27h40min. The main lesions were pulmonary edema and vacuolization and necrosis of epithelial cells in some renal tubules. To test if the active principle of M. rigida causes sudden deaths in newborn lambs and kids, 2g/kg of the plant were given daily to two goats and five sheep in the 15 days previous to parturition. One sheep aborted two lambs, 5 days before parturition. The four lambs of the other four sheep ingested the colostrum without problems. The kid from one goat ingested the colostrum and died suddenly 5 minutes after. The kid from the other goat died immediately after parturition before ingestion of colostrum. These results suggest that the active principle of M. rigida was eliminated through the milk at toxic doses for the kids. Management measures to prevent the poisoning are recommended.

A urolitíase é uma doença freqüente no semi-árido em ovinos e caprinos alimentados com grãos, principalmente quando a relação Ca:P não é corrigida e são utilizadas grandes quantidades de concentrado. De 28 ovinos com urolitíase atendidos no Hospital Veterinário da UFCG, 19 morreram e 9 receberam alta, dos 15 caprinos 12 morreram e 3 receberam alta. As alterações mais freqüentes foi presença de cálculos na uretra e bexiga, uretrite hemorrágica difusa severa, uretrite purulenta, ruptura de uretra com presença de urina no tecido subcutâneo, cistite hemorrágica necrosante, ruptura de bexiga, hidronefrose, nefrite necrosante difusa, abscesso renal, pielonefrite, hemorragia renal e ruptura renal. A gravidade das lesões observadas justifica a alta letalidade apesar dos tratamentos medicamentosos e cirúrgicos. A medida preventiva mais importante é a correção dos níveis de Ca e P. Recomenda-se, também, a administração de volumosos em boa quantidade e qualidade e, nos casos em que a quantidade de concentrados seja superior a 1,5% do peso vivo, a administração de cloreto de amônia a 1% no concentrado e a administração de cloreto de sódio em concentrações de 0,5 até 4%. Deve ser administrada água de boa qualidade à vontade. É necessário abolir a prática, extremamente utilizada em caprinos e ovinos, de administrar sal mineral em animais alimentados com grãos e subprodutos dos mesmos.Urolithiasis is a common disease in the Brazilian semiarid in rams and bucks fed with grains, mainly with low C:P ratio. From 28 rams with urolithiasis sent to the Veterinary Hospital of the Federal University of Campina Grande, Paraíba, 19 died and 9 survived, and from the bucks, 13 died and 3 survived At necropsy the main lesions were presence of calculi in the urethra and urinary bladder, diffuse purulent urethritis, hemorrhagic necrotizing urethritis, rupture of the urethra with presence of urine in the subcutaneous tissue, hydronephrosis, urinary bladder rupture, necrotizing diffuse nephritis, pyelonephritis, renal hemorrhage, and renal rupture. The severity of the lesions is responsible for the high case fatality rate despite medical and chirurgic treatment. The most important preventive measure is the correction of the Ca:P ratio to at least 2:1. The administration of good quality roughage in the food is also necessary. In cases in which the amount of concentrate food is higher than 1.5% live weight, the addition of 1% ammonium chloride and 0.5-4% of sodium chloride in the diet could be also necessary. Water had to be offered ad libitum. It is necessary to abolish the use of ad libitum mineral supplementation in sheep and goats fed grains or their byproducts.

As causas de mortalidade perinatal em ovinos foram estudadas de março de 2002 a outubro 2004 em 27 fazendas da região semi-árida da Paraíba. De 90 cordeiros necropsiados, 41,1% morreram de infecções neonatais, 23,3% por malformações, 10% por inanição/hipotermia, 10% por distocia, 2,2% por predação e 4,4% foram abortos sem causa identificada. Em relação ao momento da morte, 4,4% dos cordeiros morreram antes do parto, 10% durante o parto, 30% no primeiro dia de vida, 20% entre o 2º e 5º dia e 35,6% entre o 4º e 28º dia após o parto. A assistência das ovelhas durante o parto, a desinfecção do umbigo dos cordeiros, a ingestão de colostro 2 a 6 horas após o parto, e a manutenção das ovelhas em locais adequados durante e após o parto contribuiriam para diminuir as mortes perinatais por distocia e infecções neonatais. A alta freqüência de malformações, em diferentes raças, sugere que esses defeitos sejam causados por uma planta tóxica. Os principais defeitos observados foram a flexão permanente dos membros anteriores, braquignatismo, fenda palatina e outras alterações dos ossos da cabeça. Recentemente foi demonstrado o efeito teratogênico de Mimosa tenuiflora ("jurema-preta"), uma planta muito comum na região semi-árida, nas áreas de caatinga, que aparentemente é responsável pelas malformações. Os cordeiros mortos por inanição/hipotermia tiveram baixo peso ao nascimento (1,37 ± 0,7kg) o que sugere que a principal causa dessas mortes é a deficiente nutrição da mãe durante o último terço da gestação. Considerando-se que na região nordeste, na maioria das fazendas, os carneiros permanecem com as ovelhas durante todo o ano, a adoção de uma estação de monta definida contribuiria para a diminuição da mortalidade perinatal.The causes of perinatal lamb mortality were studied, from March 2002 to October 2004, on 27 farms in the semiarid region of Paraíba, northeastern Brazil. In 90 lambs necropsied the following frequency of different causes of death was found: neonatal infections (41.1%), malformations (23.3%), dystocia (10%), starvation/hypothermia (10%), abortion (4.4%), and predation (2.2%). Regarding the time of death, 4.4% of the lambs died before parturition, 10% during parturition, 30% on the first day after parturition, 20% between the second and the third day, and 35.6% between the 4th and the 28th day after parturition. The assistance during parturition, umbilical disinfection of the neonates, colostrum ingestion between 2 and 6 hours after parturition, and keeping the ewes in healthy environmental conditions during and after parturition could improve lamb surviving. The high frequency of malformations in different breeds suggests that malformations are due to a toxic plant. The main defects were permanent flexure of the front legs, brachygnathia, cleft palate, and other head malformations. In a recent report the authors demonstrated the teratogenic effects of Mimosa tenuiflora, a very common plant in the semiarid region, which is probably the cause of those malformations. Lambs which died due to starvation/hypothermia and had low birth weight (1.37 ± 0.70kg), suggesting that a better nutrition of the ewe during the last trimester of gestation is a way to control this cause of lamb mortality. Considering that in the northeastern region, in most farms, the rams stay with the ewes during the whole year, the adoption of a breeding season would help to control the different causes of perinatal lamb mortality.