Prostatic abscess in dogs: report of 15 cases

Fifteen cases of dogs with prostatic abscesses are reported. The animals were underwent to physical examination prioritizing the digital rectal exam with transabdominal palpation of the prostate gland followed by blood cell count, measurement of serum urea, creatinine, alanine aminotransferase and alkaline phosphatase levels, abdominal's radiographic and ultrasound exams, and culture of the prostate. The animals were underwent to different treatments being related to the animal's general state, location, size and quantity of prostatic abscesses. This description reiterates the importance of prostatic disease in canine medicine once the detailed physical examination associated with specific complementary tests, particularly x-ray and ultrasound, are valuable for the detection of dog's prostatic diseases. Surgical procedures used here are effective to the treatment of prostatic abscesses with low mortality rate.

Avaliação do perfil hematológico de portadores de talassemia alfa provenientes das regiões Sudeste e Nordeste do Brasil

A talassemia alfa é uma anemia hereditária resultante da síntese deficiente de cadeias alfa, provocando um excesso relativo de cadeias beta, que vão formar tetrâmeros identificados como hemoglobina H (Hb H) no indivíduo adulto. Para direcionar o diagnóstico laboratorial desta anemia, a análise dos índices eritrocitários, a eletroforese em acetato de celulose em pH neutro e a pesquisa de corpos de inclusão de Hb H são essenciais. O objetivo deste estudo foi traçar o perfil hematológico, por meio dos índices eritrocitários, dos portadores de talassemia alfa das regiões Sudeste e Nordeste do Brasil. Foram analisadas 1.010 amostras de sangue periférico após consentimento informado. Os índices eritrocitários como contagem de glóbulos vermelhos (RBC), dosagem de hemoglobina (HGB), hematócrito (HCT), volume corpuscular médio (VCM), hemoglobina corpuscular média (HCM) e concentração de hemoglobina corpuscular média (CHCM) foram fornecidos por aparelhos automatizados com controle de qualidade interno e externo. Para o diagnóstico de talassemia alfa foram utilizados testes de triagem e complementares para talassemias, como eletroforese em pH neutro e pesquisa de corpos de inclusão de Hb H com coloração de azul cresil brilhante. Comparando-se os valores hematológicos observados nos dois grupos, notou-se que, em ambas as regiões, os índices com valores discrepantes foram os níveis de HGB e HCT, sendo a maior freqüência de variação observada entre as mulheres. Nos portadores do fenótipo alfa talassêmico da região Nordeste, todos os índices eritrocitários estavam abaixo dos valores de normalidade. Estes resultados evidenciam a necessidade de melhor avaliação do perfil hematológico de talassemia alfa em diferentes regiões, considerando-se os interferentes ambientais para um diagnóstico mais preciso.

Relação da taxa de gestação com sêmen bovino congelado e testes de avaliação espermática in vitro

Avaliou-se a relação entre os testes complementares (teste hiposmótico, teste de termorresistência lento e teste de reação acrossômica) e os testes de avaliações convencionais (aspectos físicos e morfológicos) de sêmen bovino congelado/descongelado e os índices de prenhez. Os valores médios da motilidade espermática progressiva retilínea avaliados pelo teste de termorresistência foram de 53,48 (pós-descongelamento), 43,69 (60 minutos), 35,88 (120 minutos) e 33,04% (180 minutos) e a porcentagem de células reativas ao teste hiposmótico foi de 37,89%. Correlação positiva e de média intensidade foi encontrada para a motilidade espermática progressiva retilínea pós-descongelamento e o teste hiposmótico (0,21). Entretanto, a correlação da motilidade aos 180 minutos com o teste hiposmótico foi alta (0,64). A porcentagem de células que tiveram acrossoma reagido pós-descongelamento foi de 9,85%, apresentando correlações negativas de média e alta intensidade (-0,25 e -0,46, respectivamente) com a motilidade espermática progressiva retilínea pós-descongelamento e após 3 horas de incubação. Não houve correlação dos testes complementares e da motilidade pós-descongelamento com a taxa de gestação. Nenhum parâmetro considerado isoladamente serviu para avaliar a capacidade fertilizante do sêmen congelado/descongelado.

Feline cholangitis/ chonlangiohepatitis complex secondary to Platynosomum fastosum infection in a cat.

Platynosomiasis has been associated with cholangitis/cholangiohepatitis complex in domestic cats. Despite being typically asymptomatic, some individuals may develop severe disease resulting in hepatic cirrhosis. Definitive diagnosis by means of parasite eggs direct visualization is not always possible and complementary tests should be associated. This paper reports a case of a three-year-old female cat with anorexia and jaundice. Ultrasound and biochemistry laboratory findings as well as liver biopsy were not conclusive. Definitive diagnosis of intense Platynosomum fastosum infestation was only possible through direct examination of biliary fluid at necropsy, stressing the importance of including platynosomiasis, commonly an underdiagnosed disease, among differential diagnoses of feline liver diseases.

Tratamento experimental de cães naturalmente infectados com vírus da cinomose na fase neurológica com uso da Ribavirina e Dimetil-sulfóxido(DMSO)

Pós-graduação em Medicina Veterinária - FMVZ

Toxoplasmose aguda em gestantes de Araraquara-SP: avaliação da aplicabilidade do teste de avidez de IgG anti-toxoplasma

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito da utilização de antioxidante no diluidor para a criopreservação de sêmen bovino avaliado através de testes complementares, inseminação artificial e fecundação in vitro

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

Medicina defensiva: uma prática necessária?

We discuss the reasons why Defensive Medicine is widely used in Brazil and worldwide. The Defensive Medicine is characterized by excessive use of complementary tests, the use of supposedly safer therapeutic procedures, the frequent referral of patients to other specialists and by the refusal to care for critically ill patients and with greater potential for complications. This is a practice that aims to defend the doctor from legal suits. The way the processes are conducted by the judiciary certainly contributes to the consolidation of this foolish practice. The slow pace of justice in our country, associated with the unpreparedness of judges and legal experts in the analysis of cases, leads to an emotional exhaustion of the parties involved. Furthermore, poor training of doctors in our country values the use of sophisticated diagnostic and treatment methods, rather than a thorough clinical examination and appropriate communication with the patient. Besides inefficient in protecting the doctor, Defensive Medicine has severe consequences to the patient and to society, since it generates an additional invaluable cost to medical practice, determines greater suffering to the patient and causes deterioration of the doctor-patient relationship, which has always been marked by trust, respect and personhood.

Impaired protamination and sperm DNA damage in a Nellore bull with high percentages of morphological sperm defects in comparison to normospermic bulls

The routine semen evaluation assessing sperm concentration, motility and morphology, does not identify subtle defects in sperm chromatin architecture. Bulls appear to have stable chromatin, with low levels of DNA fragmentation. However, the nature of fragmentation and its impact on fertility remain unclear and there are no detailed reports characterizing the DNA organization and damage in this species. The intensive genetic selection, the use of artificial insemination and in vitro embryo production associated to the cryopreservation process can contribute to the chromatin damage and highlights the importance of sperm DNA integrity for the success of these technologies. Frozen-thawed semen samples from three ejaculates from a Nellore bull showed high levels of morphological sperm abnormalities (55.8±5.1%), and were selected for complementary tests. Damage of acrosomal (76.9±8.9%) and plasma membranes (75.7±9.3%) as well as sperm DNA strand breaks (13.8±9.5%) and protamination deficiency (3.7±0.6%) were significantly higher compared to the values measured in the semen of five Nellore bulls with normospermia (24.3±3.3%; 24.5±6.1%; 0.6±0.5%; 0.4±0.6% for acrosome, plasma membrane, DNA breaks and protamine deficiency, respectively) (P<0.05). Motility and percentage of spermatozoa with low mitochondrial potential showed no differences between groups. This study shows how routine semen analyses (in this case morphology) may point to the length and complexity of sperm cell damage emphasizing the importance of sperm function testing.

Pure red cell aplasia and primary antiphospholipid syndrome: a unique association

Pure red cell aplasia (PRCA) is a disease with important relationships to autoimmune mechanisms. Although some autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus, have been associated with PRCA, until this point no studies have described the association between PRCA and primary antiphospholipid syndrome (APS). This is the first case report of PRCA associated with primary APS in a 39-year-old man with acute heart failure secondary to an anaemic condition that was diagnosed as pure red cell aplasia. The patient was later diagnosed with retinal artery and vein thromboses and bilateral deep venous thromboses of the femoral and popliteal veins. The most common causes of PRCA and other thrombophilias were ruled out in this investigation through complementary tests. This association with APS adds a new possibility to the study of PRCA pathophysiology.

Brazilian guidelines for the application of transcranial ultrasound as a diagnostic test for the confirmation of brain death

Neurosonological studies, specifically transcranial Doppler (TCD) and transcranial color-coded duplex (TCCD), have high level of specificity and sensitivity and they are used as complementary tests for the diagnosis of brain death (BD). A group of experts, from the Neurosonology Department of the Brazilian Academy of Neurology, created a task force to determine the criteria for the following aspects of diagnosing BD in Brazil: the reliability of TCD methodology; the reliability of TCCD methodology; neurosonology training and skills; the diagnosis of encephalic circulatory arrest; and exam documentation for BD. The results of this meeting are presented in the current paper.

Squamous Cell Carcinoma of Mammary Gland in Domestic Cat

Background: In the feline species, 80% to 93% of neoplasias in the mammary gland are malignant, being the majority carcinomas. Among them, there is the mammary squamous cell carcinoma, which amounts to a very rare neoplasm in the domestic cat, with considerable potential for malignancy. This study aimed to report a case of squamous cell mammary carcinoma in the feline species. Case: A female cat, mixed breed, ten years old, presented history of skin lesion. The cat had been spayed two years before, but with previous administration of contraceptives. At the physical examination, it was observed ulcer between the caudal abdominal mammary glands. The occurrence of skin or mammary neoplasia was conceived. The following complementary tests were requested: complete blood count, serum biochemical profile (renal and hepatic), chest radiographs, abdominal ultrasound, and incisional biopsy of the ulcerated region periphery, followed by classic histopathology. The lesion histopathology was compatible with squamous cell carcinoma of the mammary gland. Due to such a diagnosis, bilateral mastectomy was recommended. The material obtained during the surgical procedure was sent for anatomopathological analysis. Microscopically, surgical margins infiltration and a regional lymph node were verified. The owner was advised of the need for complementary therapies and medical monitoring of the cat. However, there was no return. It is noteworthy that the animal's physical and laboratory examinations showed no neoplasia in other regions, being the squamous cell carcinoma of the mammary gland considered primary. Discussion: The malignant mammary neoplasia genesis in feline species, in general, seems to be related to steroid hormones. The ovariectomized females are less likely to develop the disease when compared to intact cats, but there is no protective effect of surgery on those spayed after two years of age regarding the appearance of the neoplasia. Thus, at the time the reported patient was ovariectomized, this effect no longer occurred. The synthetic progestins regularly used to prevent estrus increase by three times the risk of breast carcinomas onset. In humans, there is no clear definition of the etiology and pathogenesis of mammary squamous cell carcinoma. However, it has been suggested its association with extreme forms of squamous metaplasia present in pre-existing mammary adenocarcinoma, besides cysts, chronic inflammations, abscesses and mammary gland adenofibromas. In a hypothetical way, this etiology could also be related to the feline mammary carcinoma, although, for the case at issue, the exogenous and endogenous hormonal influence should not be excluded. It has been reported that mammary squamous cell carcinomas in cats are classified in grades II and III (ie, moderately and poorly differentiated, respectively). Thus, they are considered tumors with more unfavorable prognosis. However, the monitoring of the clinical course, in order to evaluate possible recurrence of the neoplasia and metastases to distant sites, was not possible as the animal under discussion did not return. The squamous cell carcinoma is the most common skin tumor in feline species, despite the primary location in the mammary gland. It is, therefore, important to differentiate squamous cell carcinoma originated in the breast from histological types derived from skin. The description of this special and rare feline mammary carcinoma is important due to its particular characteristics and potential for malignancy.

Fatores causais e aplicação de provas complementares relacionadas à gravidade no transtorno fonológico

OBJETIVO: Verificar se o índice de gravidade, que mede a porcentagem de consoantes corretas, distingue as crianças com transtorno fonológico em relação às medidas de estimulabilidade e inconsistência de fala, bem como à presença dos históricos familial e de otite média. MÉTODOS: Participaram da pesquisa 15 sujeitos com idades entre 5 e 7 anos e 11meses, com diagnóstico de transtorno fonológico. O índice Porcentagem de Consoantes Corretas - Revisado (PCC-R) foi calculado para as provas de imitação de palavras e de nomeação de figuras, separadamente. A partir destas provas também foi computada a necessidade de aplicação da prova de estimulabilidade, de acordo com os critérios propostos em pesquisas anteriores. A prova de inconsistência de fala permitiu classificar os sujeitos como consistentes ou inconsistentes. Os dados foram submetidos à análise estatística. RESULTADOS: Na comparação entre os valores do PCC-R medido na prova de nomeação e de imitação foi observada diferença em relação à necessidade da aplicação da estimulabilidade. Em relação à prova de inconsistência de fala, não houve evidência desta relação. Não foi verificada diferença no PCC-R considerando-se a presença dos históricos de otite média e familial. CONCLUSÃO: O estudo indica que as crianças que precisaram da aplicação da prova de estimulabilidade apresentaram valores mais baixos de PCC-R. Entretanto, em relação à prova de inconsistência de fala e aos históricos de otite ou familial, o PCC-R não determinou diferenças entre as crianças.

A efetividade dos testes complementares no acompanhamento da intervenção terapêutica no transtorno fonológico

O planejamento e a evolução terapêutica de crianças com transtorno fonológico estão diretamente relacionados à avaliação inicial e aos testes complementares aplicados. Acompanhar a evolução do caso por meio de verificações regulares acrescenta informações importantes à avaliação diagnóstica, o que permite fortalecer achados iniciais a respeito da dificuldade subjacente identificada na avaliação inicial. Assim, no presente estudo de caso verificou-se a efetividade e a eficiência da aplicação do índice de porcentagem de consoantes corretas revisado (PCC-R) bem como dos testes complementares de inconsistência de fala, de estimulabilidade e de habilidades metafonológicas no acompanhamento da intervenção terapêutica em crianças com transtorno fonológico. Participaram deste estudo três crianças do gênero masculino. Na data da avaliação inicial o Caso 1 tinha 6 anos e 9 meses de idade, o Caso 2, 8 anos e 10 meses, e o Caso 3, 9 anos e 7 meses. Além da avaliação específica da fonologia, foram aplicados testes complementares que auxiliaram na verificação da dificuldade subjacente específica em cada um dos casos. Desta forma, os sujeitos foram submetidos à avaliação de habilidades metafonológicas, à prova de inconsistência de fala e de estimulabilidade. A análise conjunta dos dados permitiu constatar que os testes selecionados foram efetivos e eficientes tanto para complementar o diagnóstico como para indicar mudanças nos três casos de crianças com transtorno fonológico.

Carcinoma de células escamosas em glândula mamária de gata doméstica

Background: In the feline species, 80% to 93% of neoplasias in the mammary gland are malignant, being the majority carcinomas. Among them, there is the mammary squamous cell carcinoma, which amounts to a very rare neoplasm in the domestic cat, with considerable potential for malignancy. This study aimed to report a case of squamous cell mammary carcinoma in the feline species. Case: A female cat, mixed breed, ten years old, presented history of skin lesion. The cat had been spayed two years before, but with previous administration of contraceptives. At the physical examination, it was observed ulcer between the caudal abdominal mammary glands. The occurrence of skin or mammary neoplasia was conceived. The following complementary tests were requested: complete blood count, serum biochemical profi le (renal and hepatic), chest radiographs, abdominal ultrasound, and incisional biopsy of the ulcerated region periphery, followed by classic histopathology. The lesion histopathology was compatible with squamous cell carcinoma of the mammary gland. Due to such a diagnosis, bilateral mastectomy was recommended. The material obtained during the surgical procedure was sent for anatomopathological analysis. Microscopically, surgical margins infi ltration and a regional lymph node were verifi ed. The owner was advised of the need for complementary therapies and medical monitoring of the cat. However, there was no return. It is noteworthy that the animal’s physical and laboratory examinations showed no neoplasia in other regions, being the squamous cell carcinoma of the mammary gland considered primary. Discussion: The malignant mammary neoplasia genesis in feline species, in general, seems to be related to steroid hormones. The ovariectomized females are less likely to develop the disease when compared to intact cats, but there is no protective effect of surgery on those spayed after two years of age regarding the appearance of the neoplasia. Thus, at the time the reported patient was ovariectomized, this effect no longer occurred. The synthetic progestins regularly used to prevent estrus increase by three times the risk of breast carcinomas onset. In humans, there is no clear defi nition of the etiology and pathogenesis of mammary squamous cell carcinoma. However, it has been suggested its association with extreme forms of squamous metaplasia present in pre-existing mammary adenocarcinoma, besides cysts, chronic infl ammations, abscesses and mammary gland adenofi bromas. In a hypothetical way, this etiology could also be related to the feline mammary carcinoma, although, for the case at issue, the exogenous and endogenous hormonal infl uence should not be excluded. It has been reported that mammary squamous cell carcinomas in cats are classifi ed in grades II and III (ie, moderately and poorly differentiated, respectively). Thus, they are considered tumors with more unfavorable prognosis. However, the monitoring of the clinical course, in order to evaluate possible recurrence of the neoplasia and metastases to distant sites, was not possible as the animal under discussion did not return. The squamous cell carcinoma is the most common skin tumor in feline species, despite the primary location in the mammary gland. It is, therefore, important to differentiate squamous cell carcinoma originated in the breast from histological types derived from skin. The description of this special and rare feline mammary carcinoma is important due to its particular characteristics and potential for malignancy.