Tratamento da endometrite puerperal com antibioticoterapia parenteral exclusiva

OBJETIVO: analisar a efetividade e segurança da antibioticoterapia parenteral hospitalar exclusiva para tratamento da endometrite puerperal, em população de baixo nível socioeconômico. MÉTODOS: estudo clínico prospectivo, que avaliou 21 puérperas com diagnóstico de endometrite puerperal, cujas gestações foram resolvidas em hospital universitário por cesárea (52,4%) ou parto normal (47,6). A amostra caracterizou-se por baixo nível socioeconômico e de escolaridade. Foram submetidas ao regime de antibioticoterapia parenteral exclusiva, apenas durante o período de internação (grupo ATP-EX). Os resultados foram comparados com aqueles obtidos de série histórica do mesmo serviço (20 casos) submetidas a antibioticoterapia parenteral hospitalar, complementada por terapia via oral ambulatorial (grupo ATP+VO). As pacientes foram avaliadas clinicamente em retornos periódicos visando identificar casos de recidivas e complicações infecciosas. RESULTADOS: uma paciente do grupo ATP+VO necessitou de reinternação no 6º dia após a alta por recrudescência da endometrite. Não foi observada nenhuma complicação entre as pacientes do grupo ATP-EX. CONCLUSÃO: para o tratamento de endometrite puerperal, não foi observado benefício adicional com a adição da antibioticoterapia oral complementar após a alta. Os resultados com o uso da antibioticoterapia parenteral exclusiva durante a internação indicam que esse esquema pode ser utilizado com segurança em população de baixo nível socioeconômico.

Parenteral administration of vitamins A, D and E on the oxidative metabolism and function of polymorphonuclear leukocytes in swine

The weaning period of piglets is characterized by physiological alterations, such as decreased weight gain, increased reactive oxygen species (ROS) and increased serum cortisol levels with possible effects on the immune response. The effect of parenteral administration of vitamins A, D and E on production performance, oxidative metabolism, and the function of polymorphonuclear leukocytes (PMNLs) was assessed in piglets during the weaning period. The sample was comprised of 20 male piglets that were given an injectable ADE vitamin combination (135,000 IU vitamin A, 40,000 IU vitamin D and 40mg vitamin E/ animal) at 20 and 40 days of age. Weight gain, concentration of reduced glutathione (GSH), malondialdehyde (MDA), superoxide dismutase (SOD) and the microbicidal and phagocytic activity of PMNLs were assessed. No difference was observed in the average piglet weight during the study; however, a greater percentage of weight gain was observed after weaning in the treated group. The concentrations of GSH and SOD did not differ between groups, although lipid peroxidation was greater in the control group at 60 days of age. The investigated variables of oxidative metabolism were correlated as follows: -0.41 for GSH and MDA, -0.54 for GSH and SOD and 0.34 for MDA and SOD. The intensity of intracellular ROS production, the percentage of ROS-producing PMNLs and the intensity of phagocytosis by PMNLs did not differ between treatment groups. Administration of the injectable ADE combination improved the percentage of weight gain between 20 and 40 days of age, decreased oxidative stress at 60 days of age and did not influence the function of PMNLs in piglets.

Peroxidação lipídica em cabras com anemia e doença respiratória tratadas com ferro por via parenteral

Objetivou-se avaliar a progressão da doença e o dano oxidativo em cabras com anemia e doença respiratória mediante aplicação de ferro parenteral. Foram estudadas seis cabras, adultas, com parâmetros eritrocitários indicativos e anemia e manifestações de doença respiratória (tosse, espirros e secreção nasal). O grupo controle foi composto por seis cabras adultas, sadias. As cabras de ambos os grupos após serem submetidos à avaliação clínica receberam dose similar (0,5g) de hidróxido férrico em complexo dextrânico, por via intramuscular. Amostras de sangue colhidas com EDTA, antes da aplicação do ferro e 48 horas depois foram utilizadas para determinação da concentração de substâncias reativas ao ácido tiobarbitúrico (TBARS). Nas cabras doentes antes da aplicação do ferro os valores de TBARS foram equivalentes aos valores mensurados nos controles antes e após a aplicação do ferro (p>0,05). Os valores mensurados nas cabras doentes foram muito mais elevados (p<0,001) no mesmo grupo de animais depois da aplicação do ferro e nos controles antes e após a aplicação. A aplicação do ferro agravou a condição clinica dos animais com doença respiratória, sendo evidenciada uma condição de toxidade refletida pelo estresse oxidativo. Assim sendo, não se deve recomendar tal suplementação nos caprinos acometidos de doenças do aparelho respiratório.

Growth and mineral nutrition Of Ipomoea quamoclit

A greenhouse experiment was carried out from November 2006 to April 2007 at FCAV/UNESP, Brazil, aiming to study the dry mass production and the accumulation and distribution of macronutrients in Ipomoea quamoclit, an important weed for annual and perennial crops in Brazil. The plants were grown in seven liter pots with sand substrate, daily irrigated with Hoagland & Arnon nutrient solution. The experimental design was completely randomized with four replicates. The treatments corresponded to evaluation times at 14 day intervals, beginning 21 days after emergence (DAE). In each evaluation, the plants of four pots were analyzed in function of dry mass production and macronutrient content. I. quamoclit had a small dry mass and macronutrient accumulation at the beginning of the experimental stage, increasing after 77 DAE and reaching the maximum theoretical value at 146, 143, 140, 149, 142, 153, and 124 DAE, for dry mass, N, P, K, Ca, Mg, and S, respectively. K and N were the macronutrients most accumulated by I. quamoclit plants.

Growth and mineral nutrition of Solanum americanum

A greenhouse trial was carried out from November 1995 to April 1996 at FCAV/UNESP, Brazil, aiming to study the dry matter production and the accumulation and distribution of macronutrients in Solanum americanum, an important weed for annual and perennial crops in Brazil. The plants were grown in seven liter pots with sand substrate, irrigated daily with Hoagland & Arnon nutrient solution. The experimental design was completely randomized with four replicates. The treatments corresponded to evaluation times at 14 day intervals, beginning 21 days after emergence (DAE). In each evaluation, the plants of four pots were analyzed for dry matter production and macronutrient content. S. americanum had a small dry matter and macronutrient accumulation at the beginning of the experimental stage, increasing after 77 DAE and reaching the maximum theoretical value at 142, 142, 164, 149, 140, 149 and 152 DAE, for dry matter, N, P, K, Ca, Mg, and S, respectively. K and N were the most accumulated macronutrients for S. americanum plants.

Encapsulated specialty oils commercialized in São Paulo state, Brazil: evaluation of identity (fatty acid profile) and compliance of fatty acids and Vitamin E contents with nutrition labeling

Encapsulated specialty oils commercialized in São Paulo state, Brazil, were evaluated for their identity (fatty acids profile) and compliance with nutrition labeling (fatty acids and Vitamin E (alpha tocopherol) contents). Twenty one samples [flaxseed oil (6), evening primrose (5), safflower (8), borage (1), and black currant (1)] purchased from local markets or collected by the health surveillance agency were analyzed. The fatty acids and vitamin E contents were analyzed by gas chromatography with flame ionization detector and liquid chromatography with UV detector, respectively. Nine samples were adulterated (5 samples of safflower oil, 3 of flaxseed oil, and one of evening primrose). Among them, 3 flaxseed and 2 safflower oil samples were probably adulterated by the addition of soybean oil. Conjugated linoleic acid (CLA) was found in two safflower oils samples although the sale of oils with conjugated linoleic acid (CLA) is not permitted by the National Health Surveillance Agency in Brazil (ANVISA). Only two samples presented all values in compliance with nutrition labeling (one safflower oil sample and one borage oil sample). The results show that a continuous monitoring of encapsulated specialty oils commercialized in Brazil is necessary including a greater number of samples and sanitary surveillance.

Evaluation of hygienic-sanitary conditions of hospital nutrition and dietary services from the perspectives of internal and external auditors

The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition and dietary services using external and internal auditors. Eleven hospitals were evaluated for their nutrition and dietary services using an evaluation checklist based on food safety requirements in the current legislation. The checklist was applied by an internal auditor (a technical supervisor) and an external auditor (a professional with experience in food services) between August and October 2011. According to the number of items on the evaluation checklist that were considered adequate, the hospital facilities were ranked as excellent, good, regular, bad, or very bad. The results obtained by the auditors were compared. According to these results, it can be said that most of the hospital nutrition and dietary services were rated as good for overall quality by the internal auditor, while the external auditor classified them as Regular. There was a clear difference between the evaluations of the auditors, both in terms of the number of items considered adequate and the overall requirements' average score. It can be concluded that hospital nutrition and dietary services should meet safety requirements in order to provide food. These facilities should have external audits conducted as a way to prevent routine problems from being perpetuated.

Hypercalcemia and acute kidney injury caused by abuse of a parenteral veterinary compound containing vitamins A, D, and E

A previously healthy 19 year-old male presented to the hospital with anorexia, nausea, and vomiting. Laboratory studies were significant for hypercalcemia (peak calcium value of 14.8 mg/dL) and acute kidney injury (peak serum creatinine of 2.88 mg/dL). He admitted to using a parenteral formulation of vitamins A, D and E restricted for veterinary use containing 20,000,000 IU of vitamin A; 5,000,000 IU of vitamin D3; and 6,800 IU of vitamin E per 100 mL vial. The patient stated to have used close to 300 mL of the product over the preceding year. Interestingly, the young man was not interested in the massive amounts of vitamins that the product contained; he was only after the local effects of the oily vehicle. The swelling produced by the injection resulted in a silicone-like effect, which gave the impression of bigger muscles. Nevertheless, the product was absorbed and caused hypervitaminosis. The serum level of 25(OH) vitamin D was clearly elevated at 150 ng/mL (reference range from 30 to 60 ng/mL), but in most published cases of vitamin D toxicity, serum levels have been well above 200 ng/mL. His PTH level was undetectable and other potential causes of hypercalcemia were excluded. Therefore, we posit that the severity of the hypercalcemia observed in this case was the result of a synergistic effect of vitamins A and D. The patient was treated with normal saline, furosemide and zolendronic acid, with rapid normalization of calcium levels and renal function.