Hepatic bleeding induced by streptokinase and heparin in a patient with acute myocardial infarction

Although rare, major bleeding is the most important side effect of thrombolytic therapy in acute myocardial infarction (AMI) (Levine et al., 1995). Spontaneous hepatic bleeding in normal liver after thrombolytic administration has rarely been reported in literature. To our knowledge, there are only three cases of hepatic bleeding related to thrombolytic therapy in AMI. In these, the used drugs were anisolylated plasminogen streptokinase activator complex (APSAC) (Garcia-Jiménez et al., 1997; Fox et al., 1991) and rt-PA (Garcia-Jiménez et al., 1997). We report a case of hepatic bleeding after streptokinase followed by units over 60 minutes). The next day, the patient developed third-degree atrioventricular block and a temporary pacemaker was inserted. Twenty-seven hours after streptokinase infusion, the patient complained of refractory chest pain that was interpreted as post-myocardial infarction angina; clotting screen was normal and intravenous heparin was started (80 U/kg followed by 18 U/kg/hour). After four hours of heparin administration, the patient presented abdominal pain and distension, and his blood pressure and hematocrit level dropped. Abdominal ultrasonography revealed free fluid in the peritoneal cavity (about 3,000 mL). A laparotomy disclosed blood in the abdominal cavity with bleeding from the right lateral hepatic segment, which was removed. The remaining abdominal viscera were normal and there was no other evidence of hemorrhage. The partial liver resection presented subcapsular hemorrhage with small parenchymal hemorrhage. Histopathological examination also revealed focal areas of ischemic centrilobular necrosis. The patient died of multiple organ system failure 21 days after admission. Copyright © 2002 By PJD Publications Limited.

Plesiomonas shigelloides: Um enteropatógeno emergente?

Plesiomonas shigelloides is a Gram-negative rod-shaped bacterium, of the family Enterobacteriaceae, which has been isolated from freshwater and salt water, freshwater fish, shellfish and many species of animals. Most human P. shigelloides infections are suspected to be waterborne. The organism can be found in untreated water used as drinking water, in recreational water, or in water used to rinse food that is consumed without cooking or heating. The ingestion of P. shigelloides does not always cause illness in the host animal, and the organism may be present temporarily as a transient, noninfectious member of the intestinal flora. It has been isolated from the stools of patients with diarrhea,but it is also sometimes isolated from healthy individuals. P. shigelloides has been implicated in gastroenteritis, usually a self-limiting disease characterized by fever, chills, abdominal pain, nausea, diarrhea or vomiting; in severe cases the diarrhea may be yellowish-green, foamy and tinged with blood. The bacteria may also cause extra-intestinal infection. Furthermore, it can produce toxins and may be invasive. The evidence in favor of considering P. shigelloides as an enteropathogen is not totally convincing. Although it has been isolated from patients with diarrhea and incriminated in some outbreaks involving contaminated water and food, it was not possible, in many P. shigelloides samples associated with gastrointestinal infections, to identify a definite mechanism of virulence.

Adverse drug reaction as cause of hospital admission of elderly people: a pilot study

The objective of this study was to estimate the prevalence of adverse drug reactions (ADR) related to hospital admission of elderly people, identifying the use of potentially inappropriate medication (PIM), the ADR and the risk factors associated with the hospitalization. A cross-sectional study was conducted in a private hospital of São Paulo State, Brazil. All patients aged ≥ 60 years, admitted in the general practice ward in May 2006 were interviewed about the drugs used and the symptoms/complaints that resulted in hospitalization. More than a half (54.5 %) of elderly hospitalizations were related with ADR. The therapeutic classes involved with ADR were: cardiovascular (37.7 %), central nervous (34.6 %) and respiratory (5.7 %). The ADR observed were disorders in circulatory (28.4 %), digestive (20.0 %) and respiratory (18.9 %) tracts. 27 elderly had made PIM and in 20 of them this was the cause of hospitalization. Polypharmacy was an ADR risk factor (p = 0.021).These data allows the healthcare professionals upgrade, qualifying them in pharmcovigilance.

Anti-nociceptive effects of Carpolobia lutea G. Don (Polygalaceae) leaf fractions in animal models

Leaves from Carpolobia lutea (Polygalaceae) were screened to establish the antiulcer ethnomedicinal claim and to quantitatively isolate, elucidate the active compounds by semi-preparative HPLC. The anti-nociceptive effects of Carpolobia lutea (CL) G. Don (Polygalaceae) organic leaf extracts were tested in experimental models in mice. The anti-nociceptive mechanism was determined using tail-flick test, acetic acid-induced abdominal constrictions, formalin-induced hind paw licking and the hot plate test. The fractions (ethanol, ethyl acetate, chloroform, n-hexane) and crude ethyl acetate extract of CL (770 mg/kg, i.p.) produced significant inhibitions of both phases of the formalin-induced pain in mice, a reduction in acetic acid-induced writhing as well as and an elevation of the pain threshold in the hot plate test in mice. The inhibitions were greater to those produced by indomethacin (5 mg/kg, i.p.). Ethyl acetate fraction revealed cinnamic and coumaric acids derivatives, which are described for the first time in literature. These cinnamalglucosides polyphenols characterised from CL may in part account for the pharmacological activities. These findings confirm its ethnomedical use in anti-inflammatory pain and in pains from gastric ulcer-associated symptoms. © 2011 Springer Basel AG.

Importância da criptosporidiose como zoonose

The protozoa of the genus Cryptosporidium sp. are parasites that complete their life cycle on the surface of epithelial cells of the respiratory, gastrointestinal and urinary tracts of mammals, birds, reptiles and fish. Affected animals generally are asymptomatic but gastrointestinal disorders sometimes can be present. Criptoporidiosis is considered a zoonosis. Infected animals, especially cattle, are a source of infection for the environment and humans, because they eliminate large numbers of oocysts in their feces. The symptoms when present is characterized by watery diarrhea, dehydration, abdominal pain, weight loss and death, especially in immunosuppressed individuals, and especially in patients with human immunodeficiency virus (HIV) and children. Therapeutic methods effective to eliminate this agent in animals and humans has not been developed but it is necessary to applied support treatment. Criptosporidiosis is considered by the World Health Organization as an emerging disease. Basic sanitation, use of appropriate methods for the inactivation of oocysts and security of personal hygiene are recommended as Prophylactic methods to minimize the spread of Cryptosporidium. This literature review was aimed at describing the importance of cryptosporidiosis in public health.

Intussuscepção ileocólica associada a torção mesentérica em um cão: Relato de caso

Mesenteric torsion is a rare disease in dogs whereas it is more common to affect large animals. The main clinical signs observed are acute, such as prostration and abdominal distension which evolve to a state of shock and death. This paper reports the mesenteric torsion in a dog that was presented to veterinary care with generalized acute abdominal pain of sudden onset. At the physical examination, signs of acute abdomen, rectal temperature of 35 oC, moderate dehydration, congested mucous membrane, and prostration were detected. Emergency therapy was instituted and radiographic and ultrasound examinations were requested. The radiography showed increase in the bowel diameter and an image suggestive of intussusception. The patient was referred to emergency exploratory laparotomy and obtained a definite diagnosis of ileocolic intussusception associated to mesenteric torsion. Due to the extent of intestinal dysfunction, the patient was euthanized on the operating table.

Intrascrotal testicular torsion and seminoma in a dog with chronic renal failure

A 10-year-old mongrel dog was presented with signs of vomiting, prostration, anorexia, abdominal pain, dyspnea, dysuria, and enhanced scrotal volume. Clinical, laboratory, and radiological examinations showed intrascrotal testicular pathology and chronic renal failure. Emergency treatment was carried out; however, the patient died. Necropsy diagnosed an intrascrotal testicular torsion and seminoma. The aim of the present report is to describe an intrascrotal testicular torsion associated with chronic renal failure in a dog. © Tübïtak.

Efeitos do tramadol no modelo de dor induzida por obstrução intestinal em eqüinos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da reatividade peritoneal de equinos submetidos à enterotomia de cólon menor e tratados com heparina pela via subcutânea

Pós-graduação em Medicina Veterinária - FMVZ

Intoxicação experimental de cães com folhas verdes de Nerium oleander e uso da frutose 1,6 difosfato e da glicose como tratamentos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Valores hematológicos bioquímicos e exame de líquido peritoneal de eqüinos(Equus caballus, Linnaeus, 1758) durante síndrome cólica

Pós-graduação em Medicina Veterinária - FMVZ

Obstrução intestinal experimental em equinos: parâmetros clínicos e laboratoriais

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Inhibition of inducible nitric oxide synthase-derived nitric oxide as a therapeutical target for acute pancreatitis induced by secretory phospholipase A(2)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alterações ultrassonográficas na pancreatite aguda canina

Pancreatitis is a predominantly disease of the exocrine pancreas, which occurs commonly in dogs. Acute pandreatitis is reversible, with the removal of the primary cause, whereas chronic pancreatitits is irreversible, with histopathological changes, such as atrophy and fibosis that occurs from persistent inflammation. In dogs, clinicl signs ranging among abdominal pain and anorexia until potential insufficiency of various organs and Disseminated Intravascular Coagulation. In general, dogs with acute illness presents vomiting, anorexia, abdominal pain and several degrees of dehydration, collapse and shock. The caim of this monograph is evaluate ultrassound changes in dogs with panceatitis. Ultrassound is a valuable technique to evaluate exocrine pancreas, with association with another diagnostic modalities will be able to increase the preciosion of the diagnosis

Avaliação da infusão contínua de lidocaína em equinos submetidos à distensão ileal

Pós-graduação em Cirurgia Veterinária - FCAV