Comparison between noninvasive mechanical ventilation and standard oxygen therapy in children up to 3 years old with respiratory failure after extubation: a pilot prospective randomized clinical study

Objectives: The effectiveness of noninvasive positive-pressure ventilation in preventing reintubation due to respiratory failure in children remains uncertain. A pilot study was designed to evaluate the frequency of extubation failure, develop a randomization approach, and analyze the feasibility of a powered randomized trial to compare noninvasive positive-pressure ventilation and standard oxygen therapy post extubation for preventing reintubation within 48 hours in children with respiratory failure.Design: Prospective pilot study.Setting: PICU at a university-affiliated hospital.Patients: Children aged between 28 days and 3 years undergoing invasive mechanical ventilation for greater than or equal to 48 hours with respiratory failure after programmed extubation.Interventions: Patients were prospectively enrolled and randomly assigned into noninvasive positive-pressure ventilation group and inhaled oxygen group after programmed extubation from May 2012 to May 2013.Measurements and Main Results: Length of stay in PICU and hospital, oxygenation index, blood gas before and after tracheal extubation, failure and reason for tracheal extubation, complications, mechanical ventilation variables before tracheal extubation, arterial blood gas, and respiratory and heart rates before and 1 hour after tracheal extubation were analyzed. One hundred eight patients were included (noninvasive positive-pressure ventilation group, n = 55 and inhaled oxygen group, n = 53), with 66 exclusions. Groups did not significantly differ for gender, age, disease severity, Pediatric Risk of Mortality at admission, tracheal intubation, and mechanical ventilation indications. There was no statistically significant difference in reintubation rate (noninvasive positive-pressure ventilation group, 9.1%; inhaled oxygen group, 11.3%; p > 0.05) and length of stay (days) in PICU (noninvasive positive-pressure ventilation group, 3 [116]; inhaled oxygen group, 2 [1-25]; p > 0.05) or hospital (noninvasive positive-pressure ventilation group, 19 [7-141]; inhaled oxygen group, 17 [8-80]).Conclusions: The study indicates that a larger randomized trial comparing noninvasive positive-pressure ventilation and standard oxygen therapy in children with respiratory failure is feasible, providing a basis for a future trial in this setting. No differences were seen between groups. The number of excluded patients was high.

Hypertension and its correlation with renal lesions in dogs with leishmaniosis

To evaluate the prevalence of hypertension and its correlation with the severity of renal injury and proteinuria in dogs with leishmaniosis, sixty-six dogs were divided into two groups. Group 1 (G1) was composed of 54 dogs included in stage 1 of chronic kidney disease (CKD), and group 2 (G2) of twelve dogs in stages 2 and 3 of CKD. Prevalence of hypertension was 28.8%, comprising 22.2% of the dogs from G1 and 58.3% from G2 (P=0.011). The mean arterial blood pressure (BP) of dogs from G1 (135.7 +/- 20.5) was lower than from G2 (170.0 +/- 26.3) (P <0.001). Urine proteincreatinine ratio (UP/C) revealed values above 0.5 in 75.7% of the dogs, with 34% presenting hypertension. All dogs with hypertension had histopathological and laboratory evidence of glomerular disease. Although there was no statistically significant correlation between elevated BP and the severity of glomerular lesions (P=0.408), there was a statistically significant correlation between elevated BP and increased UP/C in the studied population (P=0.002). Thus, dogs with leishmaniosis and renal disease must be screened for the presence of hypertension so that treatment may be instituted as early as possible, in countries where treatment is allowed, to prevent the progression of renal damage.

Occurrence of socransky red complex in pregnant women with and without periodontal disease

Purpose: To verify the presence of Socransky Red Complex (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia) and P. intermedia using polymerase chain reaction (PCR) in periodontally healthy pregnant women and pregnant women with periodontal disease, as well as its relation to arterial blood pressure and capillary glycaemia.Materials and Methods: This case control study included 86 pregnant women, including 50 pregnant women with healthy periodontium, 27 with gingivitis and 9 with periodontitis. Arterial blood pressure and glycaemia were evaluated and recorded. Clinical specimens from the gingival crevice or periodontal pockets were gathered with sterile absorbent paper cones. DNA extraction was accomplished using the Easy-DNA Kit test and the presence of bacteria was detected by PCR with primers and specific probes for each microorganism.Results: The arterial pressure of all pregnant women was found to be within normal levels and 51% presented with hyperglycaemia, these two variables were not associated with periodontal conditions and/or presence of microorganisms. Socransky Red Complex was not present in pregnant women with healthy periodontium; however, it was present in pregnant women with gingivitis (3.7%) and in a higher percentage of pregnant women with periodontitis (33.3%).Conclusion: Socransky Red Complex was found only in cases of periodontal diseases and is not related to blood pressure and/or high levels of blood glucose.

Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of protein supplementation frequency on physiological responses associated with reproduction in beef cows

The objective of this experiment was to determine if frequency of protein supplementation impacts physiological responses associated with reproduction in beef cows. Fourteen nonpregnant, nonlactating beef cows were ranked by age and BW and allocated to 3 groups. Groups were assigned to a 3 x 3 Latin square design, containing 3 periods of 21 d and the following treatments: 1) soybean meal supplementation daily (D), 2) soybean meal supplementation 3 times/week (3WK), and 3) soybean meal supplementation once/week (1WK). Within each period, cows were assigned to an estrus synchronization protocol: 100 mu g of GnRH + controlled internal drug release device (CIDR) containing 1.38 g of progesterone (P-4) on d 1, 25 mg of PGF(2 alpha) on d 8, and CIDR removal + 100 mu g of GnRH on d 11. Grass-seed straw was offered for ad libitum consumption. Soybean meal was individually supplemented at a daily rate of 1 kg/cow (as-fed basis). Moreover, 3WK was supplemented on d 0, 2, 4, 7, 9, 11, 14, 16, and 18 whereas 1WK was supplemented on d 4, 11, and 18. Blood samples were collected from 0 (before) to 72 h after supplementation on d 11 and 18 and analyzed for plasma urea-N (PUN). Samples collected from 0 to 12 h were also analyzed for plasma glucose, insulin, and P-4 (d 18 only). Uterine flushing fluid was collected concurrently with blood sampling at 28 h for pH evaluation. Liver biopsies were performed concurrently with blood sampling at 0, 4, and 28 h and analyzed for mRNA expression of carbamoyl phosphate synthetase I (CPS-I; h 28) and CYP2C19 and CYP3A4 (h 0 and 4 on d 18). Plasma urea-N concentrations were greater (P < 0.01) for 1WK vs. 3WK from 20 to 72 h and greater (P < 0.01) for 1WK vs. D from 16 to 48 h and at 72 h after supplementation (treatment x hour interaction, P < 0.01). Moreover, PUN concentrations peaked at 28 h after supplementation for 3WK and 1WK (P < 0.01) and were greater (P < 0.01) at this time for 1WK vs. 3WK and D and for 3WK vs. D. Expression of CPS-I was greater (P < 0.01) for 1WK vs. D and 3WK. Uterine flushing pH tended (P <= 0.10) to be greater for 1WK vs. 3WK and D. No treatment effects were detected (P >= 0.15) on expression of CYP2C19 and CYP3A4, plasma glucose, and P-4 concentrations, whereas plasma insulin concentrations were greater (P <= 0.03) in D and 3WK vs. 1WK. Hence, decreasing frequency of protein supplementation did not reduce uterine flushing pH or plasma P-4 concentrations, which are known to impact reproduction in beef cows.

Sedative and cardiopulmonary effects of xylazine alone or in combination with methadone, morphine or tramadol in sheep

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

Postoperative pain control in cats: clinical trials with pre-emptive lidocaine epidural co-administered with morphine or methadone

To evaluate the effectiveness of epidural lidocaine in combination with either methadone or morphine for postoperative analgesia in cats undergoing ovariohysterectomy. Under general anesthesia, 24 cats that underwent ovariohysterectomy were randomly allocated into three treatments groups of eight each. Treatment 1 included 2% lidocaine (4.0 mg/kg); treatment 2 included lidocaine and methadone (4.0 mg/kg and 0.3 mg/kg, respectively); and treatment 3 included lidocaine and morphine (4.0 mg/kg and 0.1 mg/kg, respectively). All drugs were injected in a total volume of 0.25 ml/kg via the lumbosacral route in all cats. During the anesthetic and surgical periods, the physiological variables (respiratory and heart rate, arterial blood pressure and rectal temperature) were measured at intervals of time zero, 10 mins, 20 mins, 30 mins, 60 mins and 120 mins. After cats had recovered from anesthesia, a multidimensional composite pain scale was used to assess postoperative analgesia at 2, 4, 8, 12, 18, and 24 h after epidural. The time to first rescue analgesic was significantly (P <0.05) prolonged in cats that received both lidocaine and methadone or lidocaine and morphine treatments compared with those that received the lidocaine treatment. All cats that received lidocaine treatment alone required rescue analgesic within 2 h of epidural injections. All treatments had significant cardiovascular and respiratory changes but they were within acceptable range for healthy animals during the surgical period. The two combinations administered via epidural allowed ovariohysterectomy with sufficient analgesia in cats, and both induced prolonged postoperative analgesia.

Evaluation of ophthalmic and hemodynamic parameters in capuchin monkeys (Sapajus sp.) submitted to dissociative anesthetic protocols

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Expression of estrus modifies the gene expression profile in reproductive tissues on Day 19 of gestation in beef cows

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Sodium intake, brain c-Fos protein and gastric emptying in cell-dehydrated rats treated with methysergide into the lateral parabrachial nucleus

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Variações diurnas da temperatura corporal, proteínas plasmáticas e eritrograma de cabras não prenhes

Hemogram values may have variations caused by intrinsic or extrinsic factors, which can take healthy animals to present values outside of the normal reference ranges and it is important to the veterinarian to know these variation factors for a correct results interpretation. The influence of the period of the day is among them. The objective of this study was to test the hypothesis that there are hematological parameters variations, such as erythrogram and plasmatic proteins during the day. The study was carried out with 10 non-pregnant adult goats in Araçatuba/SP/Brazil. The blood sampling and physical exam occurred at three moments between 07:00 and 08:00 a.m. (M1), 12:30 and 01:30 p.m. (M2), 5:00 and 6:00 p.m. (M3). We noted differences in the values of packed cell volume (PCV), hemoglobin, and rectal temperature through the moments, with reduction of PCV and hemoglobin were related to increase in rectal and air temperature, leading to water intake increase and, consequently, decreasing blood concentration. These variations could lead to an error of interpretation of the results due to values below the reference ranges.

Ropivacaína isolada ou associada à morfina, butorfanol ou tramadol pela via peridural em cadelas para realização de Ovariosalpingohisterectomia

The aim of this study was to investigate the use of ropivacaine combined or not with different opioids, for epidural anesthesia in bitches submitted to elective ovariosalpingohisterectomy (OSH). Thirty two mixed-breed female dogs, adults were used with medium weigh of 10.5kg. The animals were premedicated with acepromazine (0.05mg.kg-1, IM) and midazolam (0.2mg.kg-1, IM) and allocated in four experimental groups: group 1(n=8): ropivacaine: 0.3 mL.kg-1; group 2(n=8): ropivacaine + morphine (0.1 mg.kg-1); group 3(n=8): ropivacaine + butorphanol (0.1 mg.kg-1); and group 4(n=8): ropivacaine + tramadol (0.5 mg.kg-1) administered epidurally. Heart and respiratory rate; systolic arterial pressure; rectal temperature; arterial blood gas partial pressures; blood pH; sedation and muscular relaxation degree were evaluated at different experimental moments. The data were submitted to ANOVA and compared by Kruskal Wallis, Friedman, Dunn, Tukey and Chi-square test (p≤0.05). Minimum cardiorespiratory alterations were observed and the group of the ropivacaíne combined with the butorphanol (G3) presented a more cranial blockage, what allowed the accomplishment of OSH without induction in six animals (75%) whereas most of the others needed anesthetic rescue. The results allow us to conclude that the use of ropivacaine sole or combinated with morphine, butorphanol or tramadol, for epidural anesthesia, didn't promote significant cardiorrespiratory depression and the ropivacaine associated to the butorphanol allowed the accomplishment of OSH in bitches.

Comparação entre índices dinâmicos e volumétricos de pré-carga em cães submetidos à hemorragia moderada seguida de reposição volêmica

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

Acidose láctica ruminal aguda induzida experimentalmente em ovinos: estudo clínico e laboratorial

Pós-graduação em Medicina Veterinária - FCAV

Effects of selenium supplementation on serum cortisol in repeatedly handled cattle

This study evaluated the relationship between Se supplementation and serum cortisol in repeatedly handled cattle. Sixty Nellore calves were randomly distributed into four experimental groups, which were fed a mineral-protein mixture added with Se to achieve individual daily supplementation of 0 (Gc), 3.6 (G3.6), 5.4 (G5.4) and 6.4 (G6.4) mg Se. Stressful handling procedures and blood sampling were performed on days 0, 15, 30, 60, 90 and 120. Serum cortisol increased until day 90 and decreased on day 120, irrespective of Se supplementation. This finding shows that cattle reached a stress state but adapted. Cortisol and Se levels were not markedly correlated. Serum Se increased over the course of the experiment in the supplemented groups. However, because serum Se decreased in Gc, it may have mobilized to form the selenoproteins needed to remove metabolic wastes from handling-related oxidative stress.