Abordagem initial do paciente com mielopatia aguda não compressiva

Acute myelopathy are characterized by spinal cord dysfunction, developing sensitive, motor and autonomic signs and symptons. Since they are relatively rare, there are some difficulties to early diagnosis and to the beginning of the treatment. So, literature was reviewed to describe the main aetiologies of acute non compressive myelopathy: 1) demyelinating diseases; 2) systemic disease; 3) parainfectious; 4) delayed radiation myelopathy; 5) vascular myelopathy; 6) idiopatic and 7) vitamin B12 deficiency. Besides, we suggest an algorithm to initial approach of these patients and further aethiologic investigation. © Copyright Morelra Jr. Editora.

Doença pulmonar obstrutiva crônica

Chronic obstructive pulmonary disease (COPD) is considered the forth cause of death in the world. The present review summarizes the epidemiologic and risk factors to the disease. Emphasizing the diagnostic, pulmonary function, radiological alterations and blood gases. According to the current guideline recommendations, the authors reviewed the classification and treatment. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Teníase: Uma causa rara de apendicite aguda

Acute appendicitis is the most common surgical condition of acute abdomen. Approximately 7 percent of the population will have appendicitis during their lifetime, with the peak incidence occurring between 10 through 30 years-old Obstruction of the appendix lumen with subsequent bacterial infection initiates the pathophysiological sequence of acute appendicitis. Obstruction may have multiple causes, including fecalith, lymphoid hyperplasia (related to viral illnesses, including upper respiratory infection, mononucleosis, and gastroenteritis), foreign bodies, carcinoid tumor and parasites. In Asia, Africa and Latin America, Enterobius vermicularis has been reported as the main parasite that causes appendix obstruction. Rarely, Taenia sp., has been pointed as a cause of parasitic appendicitis. We reported a 30 years-old patient clinically diagnosed with acute appendicitis. The appendectomy was performed through a McBurney incision. The patient's convalescence was uneventful, and he was discharged from hospital 48 hours after operation. Histological examination of the appendix showed acute appendicitis, and it was found aparasite (Taenia sp.) lying inside of the appendix lumen at a transverse section. He has received 10 mg/Kg weight of praziquantel for taeniasis treatment.

Edema agudo pulmonar associado à obstrução das vias aéreas. Relato de caso

BAKGROUND AND OBJECTIVES: Negative pressure pulmonary edema has been defined as non-cardiogenic edema, with transudation of fluid to the interstitial space of the lungs due to an increase in negative intrathoracic pressure secondary to obstruction of the upper airways. This is the case of a healthy patient who underwent general anesthesia and developed acute pulmonary edema after extubation. CASE REPORT: A 23-year old female patient, physical status ASA II, underwent gynecologic videolaparoscopy under general anesthesia. The procedure lasted 3 hours without intercurrence. After extubation the patient developed laryngeal spasm and reduction in oxygen saturation. The patient improved after placement of an oral cannula and administration of oxygen under positive pressure with a face mask. Once the patient was stable she was transferred to the recovery room where, shortly after her arrival, she developed acute pulmonary edema with elimination of bloody serous secretion. Treatment consisted of elevation of the head, administration of oxygen via a face mask, furosemide and fluid restriction. Chest X-ray was compatible with acute pulmonary edema and normal cardiac area. Electrocardiogram (ECG), echocardiogram and cardiac enzymes were normal. The condition of the patient improved and she was discharged from the hospital the following day, asymptomatic. CONCLUSIONS: Acute pulmonary edema associated with obstruction of the upper airways can aggravate surgical procedures with low morbidity, affecting mainly young patients. Early treatment should be instituted because it has a fast evolution and, in most cases, resolves without lasting damages. © Sociedade Brasileira de Anestesiologia, 2008.

Toxicidade aguda do sulfato de cobre e do extrato aquoso de folhas secas de nim para o caramujo (Pomacea canaliculata)

Snails can become an environmental and economic problem, causing substantial losses. The objective of this work was to estimate the acute toxicity of copper sulfate pentahydrate (CuSO4.5H2O) and the aqueous extract of dried neem leaves on snails (P. canaliculata) under laboratory conditions. In order to estimate the lethal concentration 50% (LC (I)50;96h), snails were exposed to six increasing copper sulfate concentrations (0.0; 0.01; 0.03; 0.05; 0.07 and 0.1 mg L-1) and six increasing concentrations of aqueous extract of dried neem leaves 0.0; 100; 125; 150; 175 and 200 mL aqueous extract of dried neem leaves L-1 water, equivalent to (0.0; 1.18; 1.47; 1.77; 2.06 and 2.36 mg azadirachtin L -1), in triplicate and one control treatment in an entirely random delineation. Estimated LC (I)50;96h, of copper sulfate was 0.02 mg copper sulfate L-1, with a 0.01 mg L-1 lower limit and a 0.03 mg L-1 upper limit. Estimated lethal concentration 50% of the aqueous extract of dried neem leaves was 142.75 mL L-1, equivalent to 1.68 mg L-1 of azadirachtine, with a 130.89 mL L-1 (1.54 mg L-1) low limit and 155.69 mL L-1 (1.83 mg L -1) as the upper limit.

Perfil eletroforético das proteínas de fase aguda em caprinos experimentalmente infectados com Trypanosoma evansi

Considered as one of the main agents of the tripanossomiases, Trypanosoma evansi causes a disease generically know as surra, with wide geographic occurence. This work has the aim to study the electrophoretic profile of the acute phase proteins of goats, experimentally infected with T. evansi. Ten crossbread female goats, around 4 months of age, clinically healthy and serum negative for the presence of antibodies anti-T. evansi (IFAT) were used. The animals were divided in two groups: six were inoculated (G1) intravenously with 2,38 × 10 6 tripomastigotes of T. evansi and four were kept as noninfected controls. The blood for serum was collected daily until the 14 days after inoculation (DAI), weekly up to the 98 th DAI and every two weeks up to the 364 th DAI. The serum proteins were separacted by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDSPAGE). Twenty-one proteins were found in the serum of the goats, eight were nominally identified; phosphorylase, transferrin, albumin, antitrypsin, acid glicoprotein, haptoglobin, hemoglobin, and light chain immunoglobulin.

Doença pulmonar obstrutiva crônica

The present review summarizes the clinical aspects, diagnostics criteria and treatment of Chronic Obstructive Pulmonary Disease (COPD). Besides, will be reviewed the systemic manifestations associated with COPD and its clinical relevance in the patient's follow up. © Copyright Moreira Jr. Editora.

Efeitos da prática da natação adaptada sobre o perfil bioquímico e o estado de condicionamento físico de indivíduos com lesão medular

Introduction: The lack of physical exercises generated by immobilization of the lower limbs leads to changes in body composition that are generally associated with the imbalance of metabolic rate coupled with a sedentary status, which can result in obesity, diabetes mellitus and cardiovascular disease. Therefore, the improvement of physical fitness can contribute to promoting health and quality of life for these patients. As there is a very small number of research in this direction, our purpose was to investigate the effects of an adapted swimming program in protocol interval, for people with spinal cord injury, aiming to verify the improvement of your fitness and, consequently, some biochemical variables important for health. Methodology: The study included 17 subjects with spinal cord injury, sedentary, divided into two groups: 11 participants in the training group (TG) and 6 in control group (CG). TG was applied by a protocol of interval training in swimming for eight consecutive weeks, three times a week. The protocol employed a stroke of breaststroke in work periods of moderate to severe, and stroke in the backstroke, in periods of active recovery. The CG has not participated in any physical activity. Both groups were collecting blood for biochemical analysis, before (evaluation) and after (revaluation) the swimming program. Results and Discussion: The concentrations of triglycerides, total cholesterol and LDL-cholesterol showed no significant changes in assessment for reassessment in both groups. However the TG, the level of HDL-cholesterol were significant differences (p=0,0110), showing an improvement in posttraining, which did not occur in the CG. With respect to the state of fitness, the results revealed a significant difference in relation to time and distance covered in water when compared with the pre-training (p<0,001), showing a great improvement in the ability to shift with the stroke of breaststroke and a significant improvement in cardiorespiratory function. Conclusion: The swimming program interval used, with moderate to severe intensity, can even in a short period of time, promote positive changes in HDLcholesterol in individuals with spinal cord injury studied, and substantially improve your fitness.

Fondaparinux em intervenção coronária percutânea no tratamento da síndrome coronária aguda

Background: Fondaparinux is considered an agent with a well-established safety and efficacy profile in the treatment of non-ST segment elevation acute coronary syndromes, but when used alone, is associated to a higher incidence of thrombotic complications during invasive coronary procedures, requiring the supplementation of an anti-IIa agent. This study aimed to evaluate the efficacy and safety of percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndromes previously treated with fondaparinux. Methods: Prospective, controlled registry enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux, with supplementation of intravenous unfractionated heparin at a dose of 85 U/kg at the time of PCI. Results: The rate of the composite primary endpoint including death, acute myocardial infarction, stroke, stent thrombosis or emergency myocardial revascularization was 3.2%. The cumulative incidence of major bleeding and vascular complications was 3.2%. There were no cases of guidecatheter thrombosis or abrupt vessel closure. Conclusions: PCI in patients with acute coronary syndromes receiving fondaparinux is associated with a low rate of major adverse cardiovascular ischemic events and severe hemorrhagic complications. Supplementation of unfractionated heparin during the invasive procedures eliminates the risk of catheter-related thrombosis.

Lesão esportiva: Um estudo sobre a síndrome dolorosa femoropatelar

The patellofemoral pain syndrome (PFPS) is defined as a retropatellar or anterior knee pain, without another disease. It affects until 25% of the population, being more common in women and trained persons. As others pathologies, PFPS have been affected the training of elite and amateurs athletes. Thereby, the general purpose of this study was discuss the occurrence of PFPS as a sports injury, there prevention possibilities and the appropriate recovery training after injury. It had been developed a literature review addressing the specific characteristics of the syndrome, its diagnosis, its target population, its development, how it affects the training and which are their possibilities of prevention and treatment. © FTCD/FIP-MOC.

Atuação fisioterapêutica na lesão medular em unidade de terapia intensiva: Atualização de literatura

Objective. Collate and update knowledge in relation to physical therapy in spinal cord injury (SCI) in the intensive care unit (ICU). Method. We performed a literature update in the databases Lilacs, PubMed and Scielo, crossing the descriptors spinal cord injury, cinesiotherapy, physiotherapy, mobilization, rehabilitation, intensive care unit, respiratory therapy and electrotherapy in the period of 2005 to 2010. Results. We found 21 studies, however, only five articles met the inclusion criteria. Kinesiotherapy is essential since the phase of spinal shock, since it favors the maintenance of joint range of motion and flexibility, and to prevent circulatory complications caused/ resulted from prolonged immobilization in bed. Respiratory therapy promotes bronchial hygiene, correction of abnormal respiratory patterns and respiratory diseases. The electrotherapy is a feature still little used by physiotherapists in the intensive care units. Conclusions. The physical therapy in SCI in ICU is focused on motor rehabilitation through kinesiotherapy and intervention through the respiratory bronchial hygiene and training of respiratory muscles. New treatment modalities such as electrotherapy, there have been in intensive environment, there is a need for more studies to confirm benefits and risks of this feature in the spinal cord.

Aerocistite aguda induzida por tioglicolato, lipolisacarídeo e Aeromona hydrophila inativada em Piaractus mesopotamicus: Efeitos hematológicos

The effects of swim bladder injection with thioglycolate, Escherichia coli lipopolysaccharide (LPS) and heat-inactivated Aeromonas hydrophila were assessed on hematological responses in pacu, Piaractus mesopotamicus (Characidae). A quantitative assessment was done on erythrocytes, thrombocytes e leucocytes at 6, 24, and 48 h pos-injection of the inflammatory agents and compared with fish injected with saline solution (control). Fish injected with inactivated A. hydrophila showed a reduction of erythrocytes and hemoglobin, whereas the hematocrit increased 6 h pos-injection. The results show that thioglycolate and LPS also induced a reduction on hemoglobin and an increase on the hematocrit. The thrombocytes count decreased 6 h post A. hydrophila injection, whereas increased 48 hours post LPS injection. The leukocytes count increased after 6 h post A. hydrophila injection, while the lymphocytes and PAS-positive granular leukocytes (PAS-LG) count decreased after 24 h post injection. In fish injected with thioglycolate or with LPS showed an increase in the LG-PAS counts when compared to A. hydrophila or control groups. The monocytes count was not affected by the different inflammatory agents.

Análise histopatológica e ultraestrutural do esôfago distal de ratos com lesão cáustica submetidos à aplicação tópica de mitomicina C

Pós-graduação em Bases Gerais da Cirurgia - FMB

Toxicidade aguda e risco ambiental do diflubenzuron para Daphnia magna, Poecilia reticulata e Lemna minor na ausência e presença de sedimento

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)