Clinicopathological and immunohistochemical evaluation of oesophageal leiomyosarcoma in a dog

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

Protein-energy malnutrition as a consequence of the hospitalization of gastroenterologic patients

The effects of the clinical and dietetics in patient managements on the protein-energy status of hospitalized patients were retrospectively (four yr) investigated in 243 adult (49 +/- 16 yr), male (168) and female (75) patients suffering from chronic liver diseases (42%), intestinal diseases with diarrhea (14%), digestive cancers (11%), chronic pancreatitis (10%), stomach and duodenum diseases (7%), acute pancreatitis (7%), primary protein-energy malnutrition (3%), esophagus diseases (3%), intestinal diseases with constipation 14 (2%) and chronic alcoholism (2%). The protein-energy nutritional status assessed by combinations of anthropometric and blood parameters showed 75% of protein energy malnutrition at the hospital entry mostly (4/5) in severe and moderate grades. The overall average of hospitalization was 20 +/- 15 days being the shortest (13 +/- 5,7 days) for esophagus diseases and the longest (28 +/- 21 days) for the intestinal diseases with diarrhea patients which also received mostly (42%) of the enteral and/or parenteral feedings followed by acute pacreatitis (41%) and digestive cancers (31%) patients. When compared to the entry the protein-energy malnutrition rate at the discharge decreased only 5% despite the increasing of 30% found on the protein-energy intake. The main improvement of the protein-energy nutritional status were attained to those patients showing protein-energy malnutrition milder degrees at the entry which belonged mostly to primary protein-energy malnutrition, acute pancreatitis and intestinal diseases with diarrhea diseases. The later two groups showed protein-energy nutritional status improvement only after the second week of hospitalization. The digestive cancers patients had their protein-energy nutritional status worsened throughout the hospitalization whereas it happened only in the first week for the intestinal diseases with diarrhea and chronic liver diseases patients, improving thereafter up to the discharge. The protein-energy nutritional status improvement found in few patients could be attributed to some complementary factors such as theirs mild degree of protein-energy malnutrition at entry and/or non-invasive propedeutics and/or enteral-parenteral feddings and/or longer hospitalization staying. The institutional causes for the unexpected lack of nutritional responses by the patients were probably the high demand for the few available beds which favour the hospitalization of the most severed patients and the university-teaching pressure for the high rotation of the available beds. Both often resulting in early discharging. In persisting the current physical area and attendance demand one could suggest an aggressive support early at the entry preceding and/or accompanying the more invasive propedeutical procedures.

Direct restorative treatment of dental erosion caused by gastroesophageal reflux disease associated with bruxism: a case report

Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach acids are chronically regurgitated into the esophagus and oral cavity. Continual exposure of the teeth to these acids can cause severe tooth wear. Dentists are often the first healthcare professionals to diagnose dental erosion in patients with GERD. This article presents a case report of a 27-year-old male smoker with tooth wear and dentin sensitivity caused by GERD associated with bruxism. After diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow-up with counseling on dietary and smoking habits, as well as management of the gastric disorders with medication. GERD management and the dental treatment performed for the eroded dentition are described, including diagnosis, treatment planning, and restorative therapy.

Improvement of an enzyme immunosorbent assay for detecting antibodies against Dioctophyma renale

An available enzyme-linked immunosorbent assay (ELISA) was studied for the detection of anti-Dioctophyma renale antibodies in the sera of dogs using, detection of parasite eggs in urine sediment as a reference test. ELISA uses a soluble antigenic preparation of esophagus of D. renale and the optimal dilutions of the antigen, serum and conjugate were determined by means of checker board titration, using positive (n=13) and negative (n=27) reference serum. The specificity and sensitivity of the ELISA were 93.8% and 92.3% respectively and the kappa index was good (0.76). These results suggest that ELISA described may prove to be an effective serological test for detecting dogs infected and exposed to this parasite mainly dogs that are not eliminating parasite eggs through their urine.

Ultrastructure of the digestive tract in neotropical carnivorous catfish Hemisorubim platyrhynchos (Valenciennes, 1840) (Siluriformes, Pimelodidae)

The surface of the digestive tract of Hemisorubim platyrhynchos was analyzed by scanning electron microscopy. Morphometric studies by transmission electron microscopy were performed to analysis the intestinal microvilli. H. platyrhynchos is a Neotropical carnivorous freshwater catfish featuring a short digestive tract composed of a short esophagus, saccular stomach, and intestine with four regions: anterior, middle, posterior, and rectal. The esophageal surface is constituted by fingerprint-like microridges that anchor the mucosubstances secreted by goblet cells facilitating the passage of food. Goblet cells present the opening to the esophageal lumen, between the microridges. Club cells are in basal epithelium and they do not present the opening to the lumen. The gastric luminal surface shows polygon-shaped epithelial cells which secrete granules by exocytose to protect the gastric surface. The intestinal luminal surface reveals folds that are thicker in the anterior intestine than in the posterior intestine, increasing the absorptive surface area. The intestinal surface presents the microvilli of enterocytes and the opening of goblet cells. The morphometric analysis showed that the microvilli are longer in the anterior intestine, significantly decreasing towards the posterior intestine. The microvilli surface area significantly is greater in the anterior and middle intestine than in the posterior intestine. Numerous openings of goblet cells were observed in the posterior intestine acting in epithelial protection and lubrication. SCANNING 9999:1-8, 2015. © 2015 Wiley Periodicals, Inc.

Morfologia e histoquímica do tubo digestivo de Mapará Hypophthalmus marginatus

Pós-graduação em Aquicultura - FCAV

Ultraestrutura e citoquímica do tubo digestivo de Hemisorubim platyrhynchos (Teleostei, Siluriformes, Pimelodidae)

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

Diagnosis and management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

Severe distal cytomegalovirus esophagitis with aerodigestive symptoms in an immunocompetent infant

We report a case of an immunocompetent infant, with no evidence of neurological disorders, which developed clinical manifestation of recurrent crisis of choking, dysphagia, laryngeal stridor and sub costal retractions since the first day of life. Direct laryngoscopy was unremarkable. Upper gastrointestinal series showed a dilated tortuous esophagus with severe peristalsis impairment and reflux episodes till the proximal third of the esophagus. An upper gastrointestinal endoscopy showed a moderately dilated esophagus with erosive lesions in the distal esophagus. Esophageal biopsy specimens revealed CMV inclusion bodies associated to moderate inflammation and immunohistochemistry was positive for CMV early antigen. Prolonged 24 h esophageal pH metry was within normal limits. Antiviral therapy with intravenous ganciclovir was introduced and was associated with rapid improvement of the symptoms. Child gradually increased oral intake and weight gain, and there were no side effects related to therapy. Thus, the respiratory symptoms could have been a supra esophageal manifestation of a non-acid reflux disease related to the CMV esophagitis.

Densidade mineral óssea de perus de corte vacinados e não vacinados contra coccidiose

It was evaluated bone mineral density of turkeys submitted the vaccination against coccidiosis. Used 420 turkeys of one day, divided in 4 treatments with 5 repetitions: T1 – control diet; T2 - diet and anti coccidiosis drugs; T3 - diet and commercial vaccine; T4 - diet and recombinant vaccine. To the 28 days the birds had been submitted to the challenge of coccidiosis, carried through inoculation of oocisty talked back directly in the esophagus of the birds. The bone quality was evaluated to the 21, 35, 49 and 72 days of age. For this, 8 birds for treatment had been collected, in each age of collection that had been sacrificed by cervical displacement. The tibiae and femura had been radiographed and tomographed for evaluation of the bone density, had been later evaluated texts of dry substance, bone ashes, calcium and of phosphorus. It had differences only between the ages, being that the treatments had not caused alterations of the bone characteristics. To the 56 days the birds had presented bone quality worse. The treatments had not influenced the studied parameters. What it allows to conclude that the vaccination against coccidiosis promotes good mineralization of the bones.

Margolisianum bulbosum n. gen., n. sp. (Nematoda: Philometridae) from the Southern Flounder, Paralichthys lethostigma (Pisces: Bothidae), in Mississippi Sound, USA

A new species of a philometrid nematode, Margolisianum bulbosum, is described from the subcutaneous tissue in the mouth (larvigerous females), head (males, ovigerous, and larvigerous females), and eye (preovigerous females) of the southern flounder, Paralichthys lethostigma, from Mississippi Sound. It is placed in a new genus diagnosed by the combination of 8 large, paired but separate cephalic papillae; no inner cephalic papillae; an esophagus with a separate, muscular anterior bulb; a prominent mononuclear esophageal gland; and variable, irregularly distributed cuticular bosses in the females, as well as a vestigial rectum, particularly in larvigerous females. Some female specimens exhibit rows of lateral grooves and longitudinal ridges near the posterior end. Males have two small slightly subequal spicules, a barbed gubernaculum, 4 pairs of small cephalic papillae, and a bipartite hypodermal extension within a membranous cuticle on the posterior end. Males, ovigerous females, and larvigerous females appear to be present year round in this sporadic infection in Mississippi.

Cucullanus palmeri n. sp. (Nematoda: Cucullanidae) from the Batfish Ogcocephalus nasutus in the Gulf of Mexico

Cucullanus palmeri n. sp. is described from the shortnose batfish, Ogcocephalus nasutus, in the Gulf of Mexico. This species is anatomically most similar to Cucullanus gendrei but differs from it in having a shorter esophagus and longer tail. Males differ in having a smaller gubernaculum and a different arrangement of a lateral caudal papilla. Cucullanus palmeri is readily distinguished from Cucullanus lophii, also from a lophiform fish host, in that the deirids and excretory pore are not posterior to the posterior end of the esophagus like in C. lophii.

DESIGN AND ANALYSIS OF MULTIFUNCTIONAL ROBOT FOR NOTES

The elimination of all external incisions is an important step in reducing the invasiveness of surgical procedures. Natural Orifice Translumenal Endoscopic Surgery (NOTES) is an incision-less surgery and provides explicit benefits such as reducing patient trauma and shortening recovery time. However, technological difficulties impede the widespread utilization of the NOTES method. A novel robotic tool has been developed, which makes NOTES procedures feasible by using multiple interchangeable tool tips. The robotic tool has the capability of entering the body cavity through an orifice or a single incision using a flexible articulated positioning mechanism and once inserted is not constrained by incisions, allowing for visualization and manipulations throughout the cavity. Multiple interchangeable tool tips of the robotic device initially consist of three end effectors: a grasper, scissors, and an atraumatic Babcock clamp. The tool changer is capable of selecting and switching between the three tools depending on the surgical task using a miniature mechanism driven by micro-motors. The robotic tool is remotely controlled through a joystick and computer interface. In this thesis, the following aspects of this robotic tool will be detailed. The first-generation robot is designed as a conceptual model for implementing a novel mechanism of switching, advancing, and controlling the tool tips using two micro-motors. It is believed that this mechanism achieves a reduction in cumbersome instrument exchanges and can reduce overall procedure time and the risk of inadvertent tissue trauma during exchanges with a natural orifice approach. Also, placing actuators directly at the surgical site enables the robot to generate sufficient force to operate effectively. Mounting the multifunctional robot on the distal end of an articulating tube provides freedom from restriction on the robot kinematics and helps solve some of the difficulties otherwise faced during surgery using NOTES or related approaches. The second-generation multifunctional robot is then introduced in which the overall size is reduced and two arms provide 2 additional degrees of freedom, resulting in feasibility of insertion through the esophagus and increased dexterity. Improvements are necessary in future iterations of the multifunctional robot; however, the work presented is a proof of concept for NOTES robots capable of abdominal surgical interventions.

Unusual anatomy of the ectoparasitic muricid Vitularia salebrosa (King and Broderip, 1832) (Neogastropoda: Muricidae) from the Pacific coast of Panama

The morphology and anatomy of Vitularia salebrosa, a muricid ectoparasitic on other mollusks, are investigated based on study of specimens from western Panama. Distinctive characters of this species include the small size of the buccal mass and radular apparatus, simplification of the odontophore muscles and diminished lateral teeth of the radula; all elongated, narrow proboscis; narrow digestive tract and a differentiable glandular region at the beginning of the posterior esophagus. These traits are consistent with adaptive specialization for an ectoparasitic life history.

Morfologia e topografia do fígado e pâncreas de emas Rhea americana

As emas são aves ratitas nativas do continente sul americano, são consideradas aves primitivas do ponto de vista filogenético que constituem um grupo altamente especializado. Este estudo buscou caracterizar macro e microscopicamente o fígado e pâncreas de emas. O material foi coletado no Centro de Multiplicação de Animais Silvestres (CEMAS), na cidade de Mossoró-RN, Brasil, (Registro IBAMA n° 14.78912). Utilizaram-se 20 animais jovens com idade entre dois e seis meses independente do sexo. Em emas, o fígado se relacionava cranialmente com o ápice do coração, dorsalmente com os pulmões, esôfago e o proventrículo gástrico, caudalmente, com o ventrículo gástrico, o baço, o duodeno e parte do jejuno. Apresentava coloração vermelha escura e possuía apenas dois lobos, sendo o direito ligeiramente menor que o esquerdo. Histologicamente, era revestido por uma cápsula de tecido conjuntivo delgada e cada lóbulo hepático pôde ser identificado pela presença evidente de veias centrais, com muitos sinusoides comunicando-se com elas. O pâncreas, ventralmente, apresentava-se como uma fita fina, formado por um lobo dorsal e um lobo ventral. Longitudinalmente o pâncreas em emas localiza-se no mesentério dorsal desde o fígado até a flexura cranial do duodeno, mantendo-se preso às alças duodenais por ligamentos. Histologicamente, era composto por uma cápsula delgada de tecido conjuntivo denso, com discretos lóbulos separados por tecido conjuntivo capsular, compostos por estruturas tubuloalveolares e ductos. O fígado e pâncreas de emas apresentam padrão morfológico similar ao descrito para aves domésticas.