Effect of a single acupuncture treatment on surgical wound healing in dogs: a randomized, single blinded, controlled pilot study

Background: The aim of the study was to investigate the effect of acupuncture on wound healing after soft tissue or orthopaedic surgery in dogs.Methods: 29 dogs were submitted to soft tissue and/or orthopaedic surgeries. Five dogs had two surgical wounds each, so there were totally 34 wounds in the study. All owners received instructions for post operative care as well as antibiotic and pain treatment. The dogs were randomly assigned to treatment or control groups. Treated dogs received one dry needle acupuncture treatment right after surgery and the control group received no such treatment. A veterinary surgeon that was blinded to the treatment, evaluated the wounds at three and seven days after surgery in regard to oedema (scale 0-3), scabs (yes/no), exudate (yes/no), hematoma (yes/no), dermatitis (yes/no), and aspect of the wound (dry/humid).Results: There was no significant difference between the treatment and control groups in the variables evaluated three and seven days after surgery. However, oedema reduced significantly in the group treated with acupuncture at seven days compared to three days after surgery, possibly due the fact that there was more oedema in the treatment group at day three (although this difference was nor significant between groups).Conclusions: The use of a single acupuncture treatment right after surgery in dogs did not appear to have any beneficial effects in surgical wound healing.

Surgical treatment of gynaecomastia in a Saanen goat

Background: Gynaecomastia in male goats is characterized by abnormal development of the mammary gland. Enlarged udder may be observed cranially to the scrotum, which can occasionally reach the size of the testicles. The udder may carry functional glands and impair the animal's reproductive performance and welfare. The case of a successful surgical treatment of gynaecomastia in a high reproductive performance Saanen buck-goat is reported in the present study.Material, Methods & Results: The animal was admitted presenting significant augmentation of the mammary glands, which was clinically diagnosed as gynaecomastia. The male goat owned optimal phenotypic characteristics for the Saanen breed, which had been producing high performance descendents. The mammary glands had been impairing the goat's locomotion and sexual performance. Manual milking resulted in great amount of milk secretion. The animal presented anorexia and impaired sexual performance. After clinical and laboratorial evaluation, the animal was submitted to radical mastectomy. An elliptic skin incision was performed around each mammary gland. Subcuticular blunt dissection was accomplished to isolate the mammarian tissue from the abdominal muscular layer and the spermatic chord. The excised mass was sampled for histological assessment. Subcuticular layer and skin closure was carried in a routine fashion. Hygienization of the surgical wound was performed with 2,5% PVP-I solution for ten days. Additionally, an association of penicillin G benzathine and streptomycin, and fluxinin meglumine were also given. The surgical procedure was successfully accomplished without any peroperative complication. The excised mass was sampled for anatomic/histological assessment. Macroscopically, the left mammary gland presented 22 cm in length, 12 cm wide and 26 cm in diameter. The right gland presented 16 cm in length, 7 cm wide and 13,5 cm in diameter. The microscopic assessment revealed hyperplasia of the glandular ducts. No abnormalities resembling malignant mammary neoplasms or degeneration were observed. At the end of the treatment, the animal was completely recovered. The animal convalesced satisfactorily and surgical wound healed completely within the first 10 days post-op. The goat was not culled and returned to normal reproductive activity. Within 12 months of follow-up, the animal was able to produce high milk yield performance progenies.Discussion: This case report presented relevant aspects of the surgical management of gynaecomastia, especially to veterinary practitioners dealing with milk goats. Gynaecomastia is not as common as other reproductive disorders in domestic animals. In opposition to the findings of the present study, other trials revealed that gynaecomastia usually does not affect fertility, libido, ejaculate parameters and sexual performance of goats. However, it is important to consider that neoplasic disorders such as mammary adenocarcinoma may be present, even though these are rare complications. Last but not least, the decision making on mastectomy in the present study was crucial in order to reestablish the animal's welfare and its functionality in the farms reproduction program.

Ocorrência de infecção hospitalar em idosos internados em hospital universitário

OBJETIVO: A infecção hospitalar é uma importante causa de morbidade e mortalidade na população idosa. O estudo realizado teve como objetivo avaliar a ocorrência e os fatores de risco da infecção hospitalar. MÉTODOS: Realizou-se estudo prospectivo em uma amostra de 322 idosos com 60 anos e mais, internados em um hospital universitário, entre setembro de 1999 e fevereiro de 2000. O cálculo da amostra foi feito pela fórmula de Fisher e Belle, com intervalo de confiança de 0,95%, de um total de 760 idosos internados, proporcionalmente ao número de pacientes em cada unidade de internação, no ano de 1997. Os critérios para definição da infecção hospitalar foram os do Center for Diseases and Prevention Control. Para a análise estatística dos dados foram utilizados o odds ratio e regressão logística. RESULTADOS: A taxa de infecção hospitalar encontrada foi de 23,6%. As topografias prevalentes de infecção hospitalar foram infecção respiratória (27,6%), do trato urinário (26,4%) e do sítio cirúrgico (23,6%). O tempo de internação dos pacientes sem infecção hospitalar foi de 6,9 dias e dos com infecção hospitalar foi de 15,9 (p<0,05). A taxa de mortalidade dos pacientes internados foi de 9,6% e a de letalidade dos pacientes com infecção hospitalar de 22,9% (p<0,05). Os fatores de risco encontrados para infecção hospitalar foram colangiografia (odds ratio (OR)=46,4, intervalo de confiança 95% (IC 95%)=4,4-485); diabetes melito (OR=9,9, IC 95%=4,4-22,3); doença pulmonar obstrutiva crônica (OR=8,3, IC 95%=2,9-23,7); cateterismo urinário (OR=5, IC 95%=2,7-11,8); internação com infecção comunitária (OR=3,9, IC 95%=1,7-8,9) e ventilação mecânica (OR=3,8, IC 95%=1,9-6,3). CONCLUSÕES: A infecção hospitalar apresentou incidência e letalidade elevadas e aumentou o tempo de internação dos idosos estudados.

Randomized controlled trial on prevention of postcesarean infection using penicillin and cephalothin in Brazil

Background. There is a need to assess the effects of different antibiotic administration models on infectious complications among women from low-income populations who undergo cesarean delivery, and the cost benefit. Design. Randomized, blinded controlled clinical trial study of a single preoperative dose of cephalothin, versus a postcesarean scheme for infection prophylaxis, versus no antibiotics. Methods. The setting was a tertiary Brazilian center with 1,500 deliveries annually. Pregnant women (n = 600) with an indication for emergency or elective cesarean section were randomly allocated consecutively to one of three groups and treated as follows: Group 1 (n = 200), no antibiotics; Group 2 (n = 200), the standard antibiotics scheme followed at this center; Group 3 (n = 200), a single dose of intravenous cephalothin 2 g, intraoperatively. Main outcome measurements. Prevalences of wound infection, puerperal and postcesarean infections, and costs of antibiotics used. Results. Antibiotics reduced the incidence of puerperal infection, but did not change the percentages of wound and postcesarean infections and no use of antibiotics increased the puerperal infection risk sixfold. Cephalothin reduced the relative risk of puerperal infection by 89% (95% confidence interval: 7-87%). Penicillin reduced it by 78%, but this was not statistically significant. No deaths occurred. The costs of the two schemes were similar (almost US$1.00). Conclusions. Prophylactic cephalothin use was associated with decreased postcesarean puerperal infection and presented a cost benefit.

A preliminary report on the effect of laser therapy on the healing of cutaneous surgical wounds as a consequence of an inversely proportional relationship between wavelength and intensity: Histological study in rats

Objective: The objective of the present investigation was to assess the histological effects of different wavelengths and intensities on the healing process of cutaneous wounds. Background Data: Tissue repair is a dynamic interactive process which involves mediators, cells and extra-cellular matrix. Several reports on the use of laser therapy have shown that the healing process is positively affected when the correct parameters are used. Methods: Eighteen standardized wounds were surgically created on the dorsum of male and female Wistar rats, which were subsequently divided into two experimental groups according to wavelength used λ.670 or λ685 nm) for lasertherapy (LLLT). Each group was divided into three subgroups of three animals according to the intensity of the applied irradiation (2,15, or 25 mW). Twelve animals were used as entreated controls and were not irradiated. The irradiation was carried out during seven consecutive days. The animals were sacrificed eight days after surgery. The specimens were removed, kept in 4% formaldehyde for 24 h, routinely prepared to wax, stained with H&E, and analyzed under light microscopy. Results: For both groups, light microscopy showed a substitution repair process; however, when LLLT was used, a positive biomodulatory effect was detectable, chiefly associated with shorter wavelength and low intensity. Conclusions: The results of the present study indicate that LLLT improved cutaneous wound repair and that the effect is a result of an inversely proportional relationship between wavelength and intensity, with treatment more effective when combining higher intensity with short wavelength or lower intensity with higher wavelength.

Topical application of the lectin Artin M accelerates wound healing in rat oral mucosa by enhancing TGF-β and VEGF production

The lectin Artin M has been shown to accelerate the wound-healing process. The aims of this study were to evaluate the effects of Artin M on wound healing in the palatal mucosa of rats and to investigate the effects of Artin M on transforming growth factor beta (TGF-β) and vascular endothelial growth factor (VEGF) secretion by rat gingival fibroblasts. A surgical wound was created on the palatal mucosa of 72 rats divided into three groups according to treatment: C - Control (nontreated), A - Artin M gel, and V - Vehicle. Eight animals per group were sacrificed at 3, 5, and 7 days postsurgery for histology, immunohistochemistry and determination of the levels of cytokines, and growth factors. Gingival fibroblasts were incubated with 2.5 μg/mL of Artin M for 24, 48, and 72 hours. The expression of VEGF and TGF-β was determined by enzyme-linked immunosorbent assay. Histologically, at day 7, the Artin M group showed earlier reepithelialization, milder inflammatory infiltration, and increased collagen fiber formation, resulting in faster maturation of granular tissue than in the other groups (p < 0.05). Artin M-induced cell proliferation in vivo and promoted a greater expression of TGF-β and VEGF in both experiments (p < 0.05). Artin M was effective in healing oral mucosa wounds in rats and was associated with increased TGF-β and VEGF release, cell proliferation, reepithelialization, and collagen deposition and arrangement of fibers. © 2013 by the Wound Healing Society.

Zinc sulphate administered by transdermal iontophoresis improves breaking strength of surgical wounds in skin of alloxan-induced diabetic rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito do selante de fibrina derivado de peçonha de serpente associado a células-tronco mesenquimais na cicatrização de ferida cirúrgica em ratos

Pós-graduação em Doenças Tropicais - FMB

Avaliação dos dados obtidos em um programa de esterilização cirúrgica de gatos em Araçatuba, SP no período de 1996 a 2010

Cats are gradually occupying a more important position as pets and this preference is a result of how easy cat maintenance in an urban environment is, even though they are very prolific and need surgical sterilization. This paper aims at evaluating obtained data within 15 years of research in a university service program that offers free cats sterilization surgery. We carried out a statistical analysis of data shown in the records of animals treated by the program. Surgical sterilization was performed on 647 animals (409 females – 63% and 238 males – 37%). Unilateral cryptorchidism was observed in 9 (3.8%) male cats. Forty (10%) female cats were pregnant at the time of the surgery and the treatment with contraceptives was observed in 67 (16.4%) female cats. One death occurred during anesthesia recovery and 2 cats were euthanized because of wound infection, totalizing an amount of 0.5% of severe complications. From 1996 to 2004, 212 female cats were spayed (122 adults and 90 prepubertal) and during that time two different approaches for ovariohysterectomy were compared: flank laparotomy and ventral midline celiotomy. The flank laparotomy approach was used in only 46 female cats (21.7%) due to some disadvantages observed – the need of an incision on each flank in prepubertal or nulliparous animals and the difficulty or impossibility of total uterus removal. In the same period, 105 male cats underwent orchiectomy via an open technique in which the spermatic cord was linked with nylon thread. From 2005 to 2010, 197 females (106 adults and 91 prepubertal) were spayed. The minilaparotomy technique was used to perform ovariohysterectomy on 139 female cats (70.6%). In this procedure, ovaries and uterus were exteriorized in a blind fashion with a hook through a small midline incision. The traditional midline ovariohysterectomy, which incision length permits direct visualization of the ovaries and uterus, had to be performed in 58 (29.4%) female cats due to advanced pregnancy, full urinary bladder during surgery or obesity. Over the past 6 years, 133 male cats (48 adults and 85 prepubertal) were castrated by means of an open technique in which the spermatic cord was tied to itself. The demand for surgeries during the project demonstrated that people are becoming aware concerning the importance of sterilization when facing cat overpopulation and abandonment.

Infecção do trato urinário adquirida em ambiente hospitalar em idosos

Introduction: Hospital-acquired urinary tract infection (HAUTI) is an important cause of morbidity in the elderly population. Objective: Evaluate the occurrence of HAUTI and risk factors associated with it. Method: This is a prospective study of a sample of 332 elderly people, interned in a university hospital. Criteria for defining infection were established by the Center for Diseases and Prevention Control. Statistical analysis of data used calculation of frequencies, odds ratio and logistic regression. The rate of hospital infection was 23.6%. The prevalent topographies of infection were respiratory infections (27.6%), urinary tract infections (26.4%) and surgical wound infections (23.6%, with 21, 20 and 19 episodes, respectively. The HAUTI incidence density associated with urinary catheterization was 24.2 infections by 1,000 catheter-days. The length of hospital stay of patients without nosocomial infection was 6.9 days and with HAUTI was increased in 10.4 (p<0.05).The rate of mortality of patients with HAUTI was 20%. Pathogens were isolated in 75% of episodes of HAUTI and the prevalent were: Escherichia coli (33%) and Pseudomonas aeruginosa (20%). Risk factors found for HAUTI were urinary catheterization implementation (odds ratio (OR) = 43.1; 95% confidence interval (95 CI%) = 3.9 – 311.1), hospitalization with community infection (OR= 21.9; 95% CI = 4.9 – 97.9); vascular diseases (OR=14; 95% CI = 2 – 98); diabetes mellitus (OR= 5.5; 95% CI = 1.4 – 21) and urinary catheterization by more than three days (OR=3.7; 95% CI = 1 – 13.8). Conclusions: HAUTI presented elevated incidence and it increased the length of hospital stay.

Eficácia e segurança do Sirolimus associado a tacrolimus em baixas doses em paciente idoso transplantado renal

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Anastomotic healing in ileum and colon of alloxan-induced diabetic rats

OBJETIVO: Investigar se o diabetes mellitus pode alterar a força de ruptura (FR) e o conteúdo de colágeno em anastomoses realizadas no íleo e cólon de ratos. MÉTODOS: 300 ratos Wistar foram distribuídos por sorteio em 5 grupos experimentais com 60 animais cada: controle normal manipulado cirurgicamente (G1); normais controles submetidos a anastomoses no íleo (G2) e cólon (G3); ratos diabéticos submetidos a anastomoses no íleo (G4) e cólon (G5). Cada grupo foi dividido em 6 subgrupos com 10 ratos cada para sacrifícios com 0, 4, 7, 14, 21 e 30 dias após as operações. Os procedimentos cirúrgicos foram realizados 3 meses após a indução do diabetes com aloxana. A FR foi medida em todas anastomoses intestinais. Fragmentos de anastomoses do íleo e cólon foram retirados para dosagens de hidroxiprolina (HP) e proteína tecidual total (PT). RESULTADOS: A FR teve significante redução (P<0,05) nos grupos diabéticos G4 e G5, até 7 e 14 dias após a operação, respectivamente, quando comparada à observada nos grupos controles G2 e G3. Não foram observadas diferenças significantes nas dosagens de HP e PT em ratos diabéticos e controles, tanto operados no íleo como no cólon, em todos os momentos de avaliação. CONCLUSÃO: O diabetes conduz a alterações da força de ruptura de anastomoses intestinais durante a fase inicial da reparação da ferida cirúrgica, porém, este fato parece não estar relacionado à capacidade de sintetizar colágeno.

Refinement and initial validation of a multidimensional composite scale for use in assessing acute postoperative pain in cats

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

Evaluation of tissue response to periodontal dressings: Histological study in tooth sockets of rats

Although the use of periodontal dressings is currently limited, there are some indications for their use. Selection of any material that will have direct contact with live tissues, such as periodontal dressings, should be careful in order to allow surgical wound healing. The aim of this study was to evaluate the intensity of inflammatory response and bone formation in tooth sockets of rats after implantation of three periodontal dressings. After removal of the right maxillary incisors of 84 male rats, each tooth socket received implantation of a polyethylene tube, 63 of which were filled with non-eugenol periodontal dressing and the remaining 21 tubes remained empty (control group). Histological evaluation assessed the intensity of inflammatory response and presence and location of bone tissue formation at postoperative periods of 7, 14 and 28 days. Statistical analysis was performed by the Kruskal-Wallis test at 5% significance level. Regarding the inflammatory infiltrate, at 28 days, there was statistically significant difference between one of periodontal dressings and control group (p < 0.05). Analysis of postoperative periods, showed that the control group presented statistically significant reduction in the inflammatory infiltrate comparing the 14- and 28-day periods (p < 0.05). Regarding bone tissue formation, there was difference in control group between the 7- and 28-day periods (p < 0.05). Within the experimental conditions, it may be concluded that no differences were found in the inflammatory response among the groups at 7 and 14 days and that Voco pac (TM) dressing induced a more intensive inflammatory reaction at 28 days.