Many viruses have been associated with runting and stunting syndrome (RSS). These viral infections mainly affect young chickens, causing apathy, depression, ruffled feathers, cloacal pasting, and diarrhea. Chicken Parvovirus (ChPV) is such an infection and has been detected in chickens showing signs of enteric diseases worldwide. Therefore, the present study aims to develop a sensitive real-time fast-qPCR assay based on SYBR® Green for detection and quantification of ChPV. A 561-bp non-structural (NS) gene was amplified and cloned, and a pair of primers was designed based on conserved nucleotide sequences on the NS gene of ChPV, the intercalating DNA reagent SYBR® Green was employed, and the Fast mode of a thermocycler was used. The assay detects 109 to 101 copies of the genome (CG). The limit of detection (LoD) was estimated to five CG, and the limit of quantification (LoQ) was estimated at ten CG. The standard curve efficiency was 101.94%, and the melting curve showed a unique clean peak and a melting temperature of 79.3 °C. The assay was specific to amplify the ChPV NS gene, and no amplification was shown from other viral genomes or in the negative controls. A total of 141 samples were tested using the assay, of which 139 samples were found positive. The highest CG value of ChPV was 5.7 × 106 CG/uL of DNA without apparent clinical signs of enteric disturbance, and 4.6 × 106 CG/uL DNA were detected in chickens with RSS.

Objective To analyze data related to surgical treatment in patients with congenital heart defects (CHD) and Down syndrome (DS) based on information from International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). Methods Between July 1, 2010 and December 31, 2017, 139 patients with CHD and DS underwent surgery at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto (FUNFARME)/Faculdade de Medicina de São José do Rio Preto - SP (FAMERP). A quantitative, observational and cross-sectional study was performed in which the pre, intra and postoperative data were analyzed in an IQIC database. The data included gender, age, prematurity, weight, preoperative procedures, diagnosis, associated cardiac and non-cardiac anomalies, Risk Adjustment for Congenital Heart Surgery (RACHS-1), type of surgery, cardiopulmonary bypass (CPB), perfusion time, aortic clamping time and CPB temperature, bacterial sepsis, surgical site infection and other infections, length of stay in intensive care unit (ICU), length of hospital stay and in-hospital mortality. Results The most prevalent procedures were complete atrioventricular septal defect repair (58 - 39.45%), followed by closure of ventricular septal defect (36 - 24.49%). The RACHS-1 categories 1, 2, 3 and 4 were distributed as 22 (15%); 49 (33.3%); 72 (49%) and 4 (2.7%), respectively. There were no procedures classified as categories 5 or 6. Bacterial sepsis occurred in 10.2% of cases, surgical site infection in 6.1%, other infections in 14.3%. The median length of ICU stay was 5 days and the median length of hospital stay was 11 days. In-hospital mortality was 6.8%. Conclusion Surgical treatment in patients with CHD and DS usually does not require highly complex surgical procedures, but are affected by infectious complications, resulting in a longer ICU and hospital length of stay with considerable mortality.

Background: Aiming at fostering local development of cardiology and cardiovascular surgery centers in developing countries, the nonprofit organization Children's HeartLink (CHL) encourages centers to participate in the International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). The definition of parameters and data to evaluate patient treatment provides an opportunity to improve quality of care, reducing morbidity and mortality. The objective of the study was to analyze the outcomes of the partnership between CHL and IQIC database with a single pediatric cardiology and cardiovascular surgery center for seven years providing continuous follow-up to guide actions aiming at morbidity and mortality reduction in patients with pediatric and congenital heart diseases. Methods: Data were collected from January 2011 to December 2017 independently and with external audits and included preoperative information (demographic data, nutritional status, chromosomal abnormalities), Risk Adjustment for Congenital Heart Surgery (RACHS-1) score, and postoperative information such as infections or complications within the first 30 days or until hospital discharge and/or death. Results: In the preoperative period, there was a trend toward an increase in the number of newborn patients. The postoperative period showed significant surgical procedure variations between groups for RACHS-1 risk category (P ¼ .003), prevalence of risk categories 2 and 3, and an increase in risk categories 4, 5, and 6, mainly in the last two years. Decreases in surgical site infection (P ¼ .03), bacterial sepsis, and other infections (both P < .001) were observed. At the 30-day postoperative follow-up, there was a decrease of inhospital (P ¼ .16) and 30-day (P ¼ .14) mortality. Conclusion: The partnership between CHL and this seven-year analysis of IQIC database demonstrated structural and human flaws, whose resolution led to significant decrease in infection and reduction in mortality despite an increase in the complexity of our pediatric and congenital heart disease population.

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Objective: To evaluate the evolution of under 15-year-old patients suffering from mitral valve reflux submitted to mitral valve repair surgery. Method: A total of 117 under 15-year-old patients, submitted to mitral valvuloplasty from May 1980 to November 2001 were evaluated. Their ages ranged from 1 to 15 years old, with a mean age of 10 years. Seventy-four patients (63.2%) were female. The most common etiology was rheumatic disease (81.2%). Eighty-seven patients (74.4%) presented with mitral valve reflux and 30 (25.6%) also suffered from stenosis. Other diseases were associated in 28 patients (23.9%) with aortic valve disease being the most common (13.7%). Several techniques were employed for valve repair such as the shortening or lengthening of the chordae tendineae and papillectomy. Results: Late evolution demonstrated that 96.6% of the patients survived and 88.9% retained their native valves. Fifteen patients (12.8%) underwent reoperations. The mitral valve was remodeled in all patients, with Gregori-Braile rings used in 69 (58.9%) and Carpentier rings in 35 (29.9%). The most commonly used techniques were shortening of the chordae tendineae in 66 patients (56.4%), and commissurotomy and/or papillectomy in 30 patients (25.6%). There was 1 hospital death (0.9%) and 3 late deaths (2.6%). Conclusions: Reconstruction surgery to treat reflux of the mitral valve is possible, presenting results that support its use in under 15-year-old patients. Descriptors: Mitral valve, children. Mitral reflux, repair techniques. Resumo Objetivo: Avaliar a evolução dos pacientes portadores de regurgitação valvar mitral menores de 15 anos submetidos à operação reconstrutora da valva mitral. Método: Cento e dezessete pacientes com idade inferior a 15 anos, submetidos à plastia valvar mitral, no período de maio de 1980 a novembro de 2001. A idade variou de 1 a 15 anos, com média de 10 anos. Setenta e quatro pacientes (63,2%) eram do sexo feminino. A etiologia mais freqüente foi a doença reumática (81,2%). Oitenta e sete pacientes (63,2%) apresentavam regurgitação mitral e 30 (25,6%) Resultados da operação reconstrutora da valva mitral em pacientes com idade inferior a 15 anos Outcomes of mitral valve repair surgery in under 15-year-old patients 116 CORDEIRO, CO ET AL-Outcomes of mitral valve repair surgery in under 15-year-old patients