Anestesia para separação de gêmeos isquiópagos no período neonatal: relato de caso

JUSTIFICATIVA E OBJETIVOS: A separação de gêmeos unidos causa grande interesse devido à complexidade da anestesia e cirurgia, à raridade da patologia e às poucas chances de sobrevida. O objetivo desta descrição é o de contribuir para a literatura existente, relatando os desafios encontrados por nossa equipe no atendimento à cirurgia-anestesia de separação de gêmeos isquiópagos. RELATO do CASO: Pacientes gêmeos, nascidos a termo, de parto cesariano, pesando juntos 5.100 g, classificados como isquiópagus tetrapus. Duas equipes anestésico-cirúrgicas estavam presentes, sendo o procedimento anestésico esquematizado com aparelho de anestesia, cardioscópio, capnógrafo, oxímetro de pulso, termômetro elétrico, estetoscópio esofágico, todos em dobro. Realizou-se indução anestésica com halotano e fentanil, com os gêmeos em posição lateral e com rotação da cabeça em 45º para facilitar a intubação traqueal. Os recém-nascidos foram mantidos em ventilação controlada manualmente, utilizando o sistema de Rees-Baraka. A anestesia foi mantida com halotano, oxigênio e fentanil. Durante o per-operatório, foram encontrados órgãos abdominais duplos, com exceção do cólon, que era único. As bexigas e os ísquios estavam ligados. Ao final da cirurgia as duas crianças apresentavam-se com sinais vitais estáveis. Os gêmeos permaneceram na Unidade de Terapia Intensiva (UTI) Neonatal por quatro semanas e receberam alta em bom estado geral. CONCLUSÕES: Ressalta-se a importância do entrosamento da equipe, do estudo retrospectivo multidisciplinar, da monitorização adequada e acurada observação clínica; todos esses fatores contribuíram para a boa evolução e alta dos gêmeos.

Cryopreservation and fertility of ejaculated and epididymal stallion sperm

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

Advances in stallion's epididymal sperm technology

Freezing epididymal sperm is a method to preserve germplasm from animals with not only high genetic potential but also endangered species. In the equine some owners have chosen this possibility in cases of either severe illness or death of stallions. However, the lack of knowledge and poor published results of such technique hampers its propagation. New procedures have allowed some improvement on fertility rates of frozen sperm from the epididymis of stallions. The aim of this study is to report the advances on processing and cryopreservation of samples from the stallion's epididymal semen.

Avaliação preliminar do potencial turístico do município de rifaina (SP) e os impactos decorrentes do uso público de seus atrativos paisagísticos

This paper attempts to assess both the touristic potential of scenic attractions and the environmental impacts resulting from the public use of such attractions in the Rifaina Municipality, State of São Paulo, Southeastern Brazil. In the recent past, this municipality had its economy concentrated in rural activities (livestock, corn, rice and bean crops) and in the ceramic industry (production of bricks, tiles and shackles),which was largely developed in the floodplain of the Rio Grande before the construction of the Jaguara Power Plant Dam. The impacts resulting from touristic activities were evaluated by applying the VIM - Visitor Impact Management method, with emphasis on biophysical indicators. The main touristic attractions analyzed were: (1) Rifaina artificial beach; (2) Jaguara Reservoir; (3) Morro do Chapéu (scenic hill); (4) Touristic railroad; and (5) Cuestas cliffs. Attractions (1) and (2) are the most exploited ones, including, in the second case, nautical sports, sportive and craft fishing, and summer lodging. Although currently disabled, the touristic railroad presents potential conditions to be re-explored. Attractions (3) and (5), despite keeping high landscape and ecological ecotouristic potential, are the least visited places. In the present paper, a preliminary characterization of the major issues of tourism industry in the Rifaina municipality is made, including suggestions for the sustainable exploitation of tourism resources. The final results of the environmental impact evaluation of the tourism activities include small impacts in attractions (4) and (5) and moderate impacts to the three first attractions. In order to keep the sustainable touristic potential for that municipality this study proposes the improvement of the following measures: to foster research projects on technical or scientific aspects of the touristic attractions, improvement of tourism infrastructure and the creation of an Environmental Protection Area (APA) of the cuestas' scarps.

Evaluation of Sperm Kinetics and Plasma Membrane Integrity of Frozen Equine Semen in Different Storage Volumes and Freezing Conditions

In the present study, different freezing systems (Styrofoam box and Mini Digitcool ZH 400) and storage volumes (0.5- and 0.25-mL straws) were compared with regard to sperm kinetics and plasma membrane integrity of frozen and thawed semen. For that, three ejaculates from four animals were frozen in Styrofoam box and Mini Digitcool ZH 400 machine. The 0.5-mL straws were thawed at 46°C for 20 seconds, and the 0.25-mL straws were thawed at 46°C for 12 seconds. Statistical analysis was performed using program R of descriptive analysis box plot, followed by analysis of variance using PROC MIXED of SAS 9.1 package. Variances of 5% were considered as different. There was no interaction between the straw sizes and volumes; however, statistical differences were observed between the semen storage volumes. The 0.5-mL straws had higher total motility (%), progressive motility (%), average path velocity (μm/s), straight-line velocity (μm/s), curvilinear velocity (μm/s), and rapid sperm percentage (%) than the 0.25-mL straws. However, plasma membrane integrity analysis did not differ between the two straws. Thus, it is possible to conclude that equine sperm cryopreserved in 0.5-mL straws has better sperm kinetics than when stored in 0.25-mL straws. Additionally, it is possible to conclude that automated systems that enable faster freezing rates result in a seminal quality that is similar to the one obtained by the conventional system using Styrofoam boxes. © 2013 Elsevier Inc.

Effect of Storage Time and Temperature of Equine Epididymis on the Viability, Motion Parameters, and Freezability of Epididymal Sperm

The recovery of sperm from the epididymal cauda may be the last chance to obtain genetic material when sudden death or serious injuries occur in valuable stallions. However, the lack of technical knowledge regarding the storage and transportation of the epididymis often prevents the preservation of the sperm. Therefore, the aim of this study was to compare sperm parameters of sperm obtained immediately after orchiectomy with sperm recovered from epididymal cauda at different times after storage at 5°C and at room temperature (RT). For that, 48 stallions of different breeds were used. In group 1 (control group), eight stallions were used, and the harvest of the epididymal sperm was performed immediately after orchiectomy. In group 2, 40 stallions were used, which were divided into five groups according to the storage time of the epididymis after orchiectomy (6, 12, 18, 24, or 30 hours), making a total of eight stallions per group. One epididymis of each stallion was stored at 5°C, and the contralateral epididymis was stored at RT, both for the same period. The sperm parameters of total motility, progressive motility, progressive linear velocity, curvilinear velocity, percentage of rapid sperm, and plasma membrane integrity were evaluated in all the groups after sperm recovery, resuspension in a sperm freezing diluent, and thawing. In conclusion, the storage of the testis-epididymis complex at 5°C provided better preservation of epididymal sperm than the storage at RT, and regardless of the temperature, the progressive motility is the sperm parameter that is most sensitive to storage time. © 2013 Elsevier Inc.

Effects of Pentoxifylline on Equine Epididymal Sperm

This study evaluated whether pentoxifylline (PTX) present in the flushing extender influenced the function of equine epididymal spermatozoa after recovery and after thawing. For this experiment, 58 testicles from 29 Brazilian Jumping Horses were used. Cauda epididymides of each stallion were separated and flushed with a skim milk extender, with or without 7.18 mM PTX and then subjected to the freezing process. Samples flushed with the extender containing PTX showed a significant increase in total motility, progressive motility, straight line velocity, curvilinear velocity, and percentage of rapid sperm immediately after the recovery of epididymal sperm and after 15 minutes of incubation at 37°C (P < .05). However, the presence of PTX in the flushing extender did not affect the post-thaw motility parameters or plasma membrane integrity (P > .05). The results of this study showed that the PTX present in the flushing extender improved motility parameters of recently recovered epididymal sperm and had no deleterious effects on plasma membrane integrity and freezability of equine epididymal sperm. © 2013 Elsevier Inc. All rights reserved.

Cooling of ejaculated and epididymal stallion sperm

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

Equine Perineal and Vulvar Conformation Correction Using a Modification of Pouret's Technique

An incompetent vulvar seal leads to reproductive failure, and a surgical intervention might be required. The present paper describes modifications to Pouret's surgery. We suggest the use of a simple interrupted vertical mattress suture, which avoids seroma. Eighteen Brazilian Jumping Horse mares, older than 20 years and barren for 3-5 consecutive years, underwent modified Pouret's surgery. A horizontal skin incision of 3-4 cm was made half way between the anus and upper commissure of the vulva. The submucosal and connective tissue were dissected, and the rectovaginal shelf was split horizontally by sectioning the muscular and ligamentous connections between the anus, vulva, caudal portion of the rectum, and vagina until the vulva was oriented vertically. The wound was changed from a horizontal plane to a vertical plane by placing the suture vertically using approximately eight interrupted U sutures distributed in two layers with polyamide thread. The modified Pouret's surgical technique provided a perfect coaptation of the vulvar lips and a correct perineal position. Those mares that presented with horizontally tipped vulvar lips due to advanced age and stretching of the pelvic tissues by multiple foaling had their vulvas replaced. Also, the surgical procedure was easy to perform. As to fertility, of the 18 initial mares, 14 were inseminated, and all became pregnant. Thus, it was possible to conclude that the anatomical changes performed throughout the surgical procedure predisposed to a better vulvar coaptation, correcting the pneumovagina. © 2013 Elsevier Inc. All rights reserved.

Vale de ferro: estudo histórico e estético das estações ferroviárias do Vale do Paraíba Paulista

Pós-graduação em Artes - IA