Tratamento cirúrgico das rupturas ureterais por ureterocoloanastomose

A implantação do ureter no cólon descendente advém da impossibilidade de reimplantá-lo na vesícula urinária, devido a perdas substanciais do tecido ureteral. O presente trabalho avaliou as alterações macroscópicas, microscópicas e laboratoriais em cães submetidos à ureterocoloanastomose esquerda. Foram utilizados 8 cães adultos, hígidos, de ambos os sexos. A técnica operatória consistiu na ligadura do coto distal do ureter próximo à bexiga e na implantação de um curto seg- mento do coto proximal, através de um túnel submucoso, na face antimesentérica do cólon. Realizou-se dosagens séricas de uréia, creatinina, sódio e potássio no pré-operatório, 2, 7, 15 e 30 dias após a cirurgia. Um total de 6 animais foram observados por 30 dias, e outros dois foram observados durante 7 e 180 dias, res- pectivamente. Todos apresentaram fezes moles durante o decorrer do experimento. Ao exame macroscópico, todos os animais apresentaram dilatação ureteral e pielonefrites. Azotemia transitória e hidronefrose foram observadas no animal mantido por 7 dias, e em mais quatro animais, mantidos por 30 dias, também se observou hidronefrose. O animal mantido por 180 dias demonstrou hidronefrose ao exame ultrasono gráfico aos 30 dias de evolução, mas a mesma não foi observada quando se realizou a necropsia. em um animal, mantido por 30 dias , houve um aumento nos níveis de creatinina nos dias 7, 15 e 30, entretanto estes permaneceram dentro dos limites fisiológicos. Nenhuma alteração foi observada no exame histológico da mucosa intestinal exposta à drenagem de urina. As poucas alterações encontradas nas análises laboratoriais não comprometeram a saúde dos animais, e, considerando que não foram encontradas lesões na mucosa intestinal analisada, é possível concluir que a ureterocoloanastomose é um procedimento viável para ser usada por um curto período de tempo.

Periodontal disease characterization in dogs with normal renal function or chronic renal failure

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

Acompanhamento laboratorial da função renal de cães sadios tratados experimentalmente com doses terapêuticas de anfotericina B

O presente trabalho objetivou avaliar a função renal de dez cães adultos saudáveis submetidos à administração de doses terapêuticas do antifúngico anfotericina B, cuja utilização tem sido limitada pelo seu elevado potencial nefrotóxico, e avaliar o método laboratorial mais sensível e precoce de diagnóstico de lesão renal. Foram realizadas, diariamente, urinálise, excreção fracionada de sódio e potássio, dosagem sérica de creatinina e uréia e atividade urinária de gama-glutamiltransferase (GGT). Concluiu-se que a anfotericina B provoca lesões nos túbulos proximal e distal, induzindo acidose tubular renal do tipo I e Diabetes insipidus nefrogênico em cães. Avaliação da função renal, preferencialmente por dosagens de creatinina, uréia e potássio séricos, é recomendada antes de cada aplicação do fármaco. A densidade urinária foi o parâmetro mais precocemente alterado pela lesão renal. A GGT urinária não foi eficaz para o diagnóstico precoce de lesão induzida por anfotericina B.

Avaliação laboratorial do uso de solução salina hipertônica e isotônica e de furosemida no tratamento da intoxicação por amônia em bovinos

Para testar a eficiência de vários tratamentos de intoxicação por amônia em bovinos, foram utilizados 25 garrotes que receberam cloreto de amônio por infusão intravenosa (iv) até o surgimento de quadro convulsivo. em seguida, os animais foram alocados em um dos cinco grupos experimentais e tratados da seguinte forma: 1) controle: infusão (iv) de 300mL de solução salina isotônica (SSI), no decorrer de 4h; 2) infusão (iv) de 30mL kg-1 PV de SSI no decorrer de 4h e administração de 4L de água intraruminal por meio de sonda esofágica (ASE); 3) mesmo tratamento do grupo 2 e dose única (iv) de furosemida (2mg kg-1 PV) (F); 4) injeção (iv) de 5mL kg-1 PV de solução salina hipertônica (SSH) 7,2% nos primeiros 30min, seguida de 20mL kg-1 PV de SSI e 4L de ASE; 5) mesmo tratamento do grupo 4 e dose única de F. No decorrer de 4h após a convulsão, foram determinados os teores plasmáticos de amônia e glicose, ureia, creatinina, potássio e sódio séricos, volume e gravidade específica da urina, e excreção urinária de amônio e ureia. No momento da convulsão, os teores de amônia plasmáticos foram muito altos e idênticos em todos os tratamentos, mas no 120°min, nos grupos tratados com associação de SSH+SSI+ASE (grupos 4 e 5), houve diminuição desse metabólito. O uso de furosemida (grupos 3 e 5) não aumentou a excreção total de urina. A terapia com associação de SSH+SSI+ASE aumentou ainda o volume urinário e a excreção percentual urinária de ureia e amônia durante o período crítico da 1ª hora de tratamento, mas o uso de SSI+ASE (grupos 2 e 3) teve resultados intermediários. A eficiência do tratamento com SSH+SSI+ASE ou SSI+ASE foi superior ao grupo controle. Embora com efeito menor que o observado com SSH+SSI+ASE, a SSI+ASE promoveu melhora no quadro clínico geral e, ao término do experimento, promoveu também uma adequada desintoxicação da amônia.

Glomerulonefrite lúpica: estudo da evolução a longo prazo

OBJETIVO: Estudar a apresentação clínica e a evolução de pacientes portadores de glomerulonefrite lúpica. CASUÍSTICA E MÉTODOS: Foram estudados 37 pacientes portadores de glomerulonefrite lúpica, atendidos pela Disciplina de Nefrologia - Faculdade de Medicina de Botucatu, com seguimento médio de 52,4 ± 13,3 meses. Os dados foram obtidos através do levantamento retrospectivo dos prontuários. RESULTADOS: A idade média foi de 26,05 ± 11,12 anos, com predomínio do sexo feminino (84%) sendo que a glomerulonefrite classe IV foi a mais freqüente (80%). No início do seguimento a média da creatinina sérica foi de 1,74 ± 1,15 mg/dl, e a da proteinúria de 24h foi de 2,62 ± 2.89 g. Cinqüenta e um porcento dos pacientes com creatinina sérica elevada apresentaram, durante o seguimento, diminuição desses valores. Dentre diferentes variáveis estudadas, à época da biopsia renal, (idade, sexo, proteinúria, presença de hipertensão arterial e creatinina sérica) a única que se associou com pior prognóstico foi a elevação da creatinina sérica. Remissão da síndrome nefrótica ocorreu em 65% das vezes. A sobrevida atuarial foi de 96%, 82%, 70% e 70% em 1, 5, 10 e 12 anos. Cinco pacientes desenvolveram insuficiência renal crônica terminal e sete morreram, sendo infecção a principal causa de óbito (57%) CONCLUSÃO: em pacientes com nefropatia lúpica, o aumento da creatinina sérica, à época da biópsia, se associou com o desenvolvimento de insuficiência renal crônica ao fim do seguimento e a principal causa de óbito foi processo infeccioso.

Cathodic stripping voltammetric determination of ceftazidime in urine at a hanging mercury drop electrode

A method was developed for the differential-pulse cathodic stripping voltammetric determination of ceftazidime with a hanging mercury drop electrode using its reduction peak at -0.43 V in Britton-Robinson buffer pH 4.0. The optimum accumulation potential and time were -0.15 V and up to 60 s, respectively. Linear calibration graphs were obtained from 1 x 10(-8) M and 1.5 x 10(-7) M. The limit of determination was calculated to be 5 x 10(-9) M. The coefficient of variation was 4% (n = 7) at 1 x 10(-7) M ceftazidime. The effect of various components of urine on the voltammetric response was studied, and creatinine, uric acid, urea, and glucose were shown to interfere in the method. Ceftazidime bound to human albumin gives a unique stripping peak at -0.48 V. Recoveries of 87% +/- 2% of the ceftazidime (n = 5) were obtained from urine spiked with 1.27 mu g ml(-1) using C-18 solid phase extraction cartridges. (C) 1997 Academic Press.

Amniocentesis and biochemical evaluation of amniotic fluid in ewes at 70, 100 and 145 days of pregnancy

The objectives of this study were to determine the technical viability of amniocentesis in sheep and to observe biochemical changes in the amniotic fluid components. Amniotic fluid samples were collected by puncture in the greatest curvature of the uterine hum at days 70, 100, and 145 of pregnancy. The surgical procedure for collection of amniotic fluid samples was safe and efficient. For three stages of pregnancy, the following results were obtained: pH values 8.36, 7.34 and 7.37; glucose concentrations, 16.06. 8.58, and 3.79 g/dl; urea values, 42.68, 33.53, and 25.49 mg/dl; creatinine, 0.85, 5.04, and 11.25 g/dl; Gama-GT enzyme, 12.58, 14.20, and 12.30 UI/l; sodium concentrations, 146.60, 129.42, and 103.8 mmol/l: potassium concentrations, 9.79, 6.15, and 8.65 mmol/l; chloride, 96.59, 85.28, and 65.35 mmol/l; total protein, 0.14, 0.23, and 0.24 g/dl, respectively. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Effects of genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 on urinary 1-hydroxypyrene levels in sugarcane workers

Sugarcane workers in Brazil are exposed to various genotoxic compounds, including polycyclic aromatic hydrocarbons (PAHs), derived from an incomplete combustion process of burnt sugarcane fields. The effects of the occupational exposure to sugarcane fields burning were measured in urine samples of sugarcane workers from the northwest of the State of São Paulo when exposed (harvesting) and when non-exposed (non-harvesting). The urinary levels of 1-hydroxypyrene (1-OHP) and the influence of the genetic polymorphisms CYP1A1, GSTM1, GSTT1 and GSTP1 were evaluated. Our results showed that the 1-OHP levels were significantly higher (P < 0.0000) in the exposed sugarcane workers (0.318 mu mol mol(-1) creatinine) than in the non-exposed workers (0.035 mu mol mol(-1) creatinine). In an unvaried analysis, no influence regarding the polymorphisms was observed. However, multivariate regression analysis showed that the CYP1A1*4 polymorphism in the exposed group, and age and the GSTP1 polymorphism in the non-exposed group significantly influenced urinary 1-OHP excretion levels (P < 0.10). The same group of sugarcane workers was significantly more exposed to PAHs during the harvesting period than during the non-harvesting period. (c) 2006 Elsevier B.V. All rights reserved.

High volume peritoneal dialysis for acute renal failure

Background. Peritoneal dialysis (PD) is still widely used for acute renal failure (ARF) in developing countries despite concerns about its inadequacy. Continuous PD has been evaluated in ARF by analyzing the resolution of metabolic abnormality and normalization of plasma pH, bicarbonate, and potassium.Methodology: A prospective study was performed on 30 ARF patients who were assigned to high-dose continuous PD (Kt/V = 0.65 per session) via a flexible catheter (Tenckhoff) and automated PD with a cycler. Fluid removal, pH and metabolic control, protein Loss, and patient outcome were evaluated.Results: Patients received 236 continuous PD sessions; 76% were admitted to ICUs. APACHE II score was 32.2 +/- 8.65. BUN concentrations stabilized after 3 sessions, creatinine after 4, and bicarbonate and pH after 2. Fluid removal was 2.1 +/- 0.62 L/day. Creatinine and urea clearances were 15.8 +/- 4.16 and 17.3 +/- 5.01 mL/minute respectively. Normalized creatinine clearance and urea Kt/V values were 110.6 +/- 22.5 L/week/1.73 m(2) body surface area and 3.8 +/- 0.6 respectively. Solute reduction index was 41% +/- 6.5% per session. Serum albumin values remained stable in spite of considerable protein tosses (median 21.7 g/day, interquartile range 9.1 - 29.8 g/day). Regarding ARF outcome, 23% of patients presented renal function recovery, 13% remained on dialysis after 30 days of follow-up, and 57% died.Conclusion: High-dose continuous PD by flexible catheter and cycler was an effective treatment for ARF. It provided high solute removal, allowing appropriate metabolic and pH control, and adequate dialysis dose and fluid removal. Continuous PD can therefore be considered an alternative to other forms of renal replacement therapy in ARF.

Hyperlipidemia as a risk factor of renal allograft function impairment

In this study, the graft outcome in renal allograft recipients with [high cholesterol group (HCG), n = 30] or without [normal cholesterol group (NCG), n = 42] hypercholesterolemia and with [high triglyceride group (HTG), n = 33] or without [normal triglyceride group (NTG), n = 36] hypertriglyceridemia were prospectively compared. At 6 months post-transplantation, no significant difference was observed between the groups (NTG compared with HTG, and NCG compared with HCG) regarding age, presence of arterial hypertension, kind of donor (living related or cadaveric), immunosuppressive therapy, number of rejection episodes per patient, frequency of patients with acute cellular rejection, prevalence of patients with diabetes mellitus or proteinuria > 3 g/24 h, and mean serum creatinine. The probability of doubling serum creatinine during follow-up was statistically different between NTG and HTG (12 months: NTG = 0.03, HTG = 0.15; 36 months: NTG = 0.08, HTG = 0.33; 60 months: NTG = 0.08, HTG = 0.48; and 120 months: NTG = 0.18, HTG = 0.48), but not between NCG and HCG (12 months: NCG = 0.05, HCG = 0.13; 36 months: NCG = 0.13, HCG = 0.24; 60 months: NCG = 0.19, HCG = 0.31; 84 months: NCG = 0.27, HCG = 0.31). There was no significant difference in actuarial graft survival between HCG and NCG or between NTG and HTG. Hypertriglyceridemia, but not hypercholesterolemia, was associated with loss of graft function.

Magnesium supplementation alleviates premenstrual symptoms of fluid retention

We investigated the effect of a daily supplement of 200 mg of magnesium (as MgO) for two menstrual cycles on the severity of premenstrual symptoms in a randomized, double-blind, placebo-controlled, crossover study. A daily supplement of 200 mg of Mg (as MgO) or placebo was administered for two menstrual cycles to each volunteer, who kept a daily record of her symptoms, using a 4-point scale in a menstrual diary of 22 items. Symptoms were grouped into six categories: PMS-A (anxiety), PMS-C (craving), PMS-D (depression), PMS-H (hydration), PMS-O (other), and PMS-T (total overall symptoms). Urinary Mg output/24 hours was estimated from spot samples using the Mg/creatinine ratio. Analysis of variance for 38 women showed no effect of Mg supplementation compared with placebo in any category in the first month of supplementation. In the second month there was a greater reduction (p = 0.009) of symptoms of PMS-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating) with Mg supplementation compared with placebo. Compliance to supplementation was confirmed by the greater mean estimated 24-hour urinary output of Mg (p = 0.013) during Mg supplementation (100.8 mg) compared with placebo (74.1 mg). A daily supplement of 200 mg of Mg (as MgO) reduced mild premenstrual symptoms of fluid retention in the second cycle of administration.

Differential/combined effect of water contamination with cadmium and nickel on tissues of rats

The contamination of water by metal compounds is a worldwide environmental problem. Concentrations of metals are widely related to biochemical values which are used in disease diagnosis due to environmental toxicity. The acute combined effects of cadmium and nickel on biochemical parameters were determined and compared with those of Cd2+ or Ni2+ alone in rats. Male adult rats were given drinking solutions of CdCl2 [Cd(II) cation, 100 mg/liter] or NiSO4 [Ni(II) cation, 100 mg/liter]. For the combined treatment, the animals (Ni+Cd) received both Ni(II)) cation (100 mg/liter) and Cd(II) cation (100 mg/liter). Nickel treatment induced increased alanine transaminase (ALT) activity and hepatotoxicity, but not renal injury. In contrast, cadmium exposure produced hepatic, renal and myocardial damage, characterized by increased creatinine, total and direct bilirubin concentrations and increased ALT and lactate dehydrogenase (LDH) activities. The combined effect Ni-Cd is less toxic than cadmium alone, suggesting antagonism between these toxicants. The toxicity of nickel and cadmium, alone and in combination, decreased Cu-Zn superoxide dismutase (SOD) activity and increased lipoperoxide formation. (C) 1998 Elsevier B.V. Ltd. All rights reserved.

Impact of an environmentally realistic intake of water contaminants and superoxide formation on tissues of rats

Water contaminants have a high potential risk for the health of populations and for this reason their toxic effects urgently should be established. The present study was carried out to determine whether an environmentally realistic intake of water contaminants can induce tissue lesions, and to clarify the contribution of superoxide radical (O-2(.-)) formation to this effect. Male Wistar rats were given drinking water from the Tiett River (group A) and from the Capivara River (group B). The increased creatinine, glucose, alanine transaminase and amylase levels in serum reflected the toxic effects of river-water contaminants to renal, pancreatic and hepatic tissues of rats. As changes in lipoperoxide were observed in rats after river-water intake while superoxide dismutase activities decreased in these animals, it is assumed that the superoxide anion elicits lipoperoxide formation and induces tissue damage. There is evidence that oxygen tension reflects water pollution, since river-water with a-low oxygen tension induced more elevated toxicity in rat tissues. (C) 1999 Elsevier B.V. Ltd. All rights reserved.

Constituintes sangüíneos de vacas das raças Nelore (Bos indicus) e Holandesa (Bos taurus) e de bubalinas (Bubalus bubalis) da raça Murrah durante a gestação, no dia do parto e no puerpério

Blood constituents of Nelore, Hosltein and buffalo cows were determined during pregnancy, at the time of calving and at post-partum. It was verified that. 1. The pregnancy and post-partum periods had no influence in the erythrocyte values, but at calving the red blood cell counts and hemoglobin levels of Holstein and buffalo cows were lower than for Nelore cattle; 2. leukocyte counts were similar among groups; 3. total protein levels of Nelore cows were lower than Holstein and buffalo. The albumin levels were rite lowest at rite time of calving compared to late pregnancy; 4. glicose levels were lower ill buffalo cows during pregnancy as compared with Holstein cows. The glicemia of Nelore cows was lower as compared to Holstein cow's irt late pregnancy; 5. urea and creatinine levels were higher in buffalo cows than cattle. The urea and creatinine levels were greater in buffalo cows with maximum values at the post-partum and at the parturition, respectively; 6. bilirrubin levels were higher in bovine than buffalo cows; 7. aspartate aminotransferase activity was greater in buffalo cows and increased at the time of calving; 8. alkaline phosphatase activity was increased during pregnancy and decreased after the time of calving; 9. gammnglutamyltransferase activity,vas the highest for buffalo cows after calving; IO. calcium levels were the highest for Holstein cows at the post-partum and the phosphorus levels were higher in buffalo cows, which had the highest magnesium levels at the parturation.

Diuron lacks promoting potential in a rat liver bioassay

The promoting activity of the herbicide Diuron was evaluated in a medium-term rat liver carcinogenesis bioassay that uses as endpoint immunohistochemically identified glutathione S-transferase positive (GST-P+) foci. Male Wistar rats were allocated to the following groups: G1 to G6 were initiated for liver carcinogenesis by a single dose of diethylnitrosamine (DEN, 200 mg/kg) while groups G7 and G8 received only 0.9% NaCl (DEN vehicle). From the 2nd week animals were fed a basal diet (G1 and G7) or a diet added with Diuron at 125, 500, 1250, 2500 and 2500 ppm (G2 to G5 and G8, respectively) or 200 ppm Hexaclorobenzene (HCB; G6). The animals were submitted to 70% partial hepatectomy at the 3rd week and sacrificed at the 8th week. The herbicide did not alter ALT or creatinine serum levels. No conspicuous GST-P+ foci development was registered in non-initiated rats fed Diuron at 2500 ppm. While DEN-initiated animals fed Diuron at 1250 or 2500 ppm developed mild centrilobular hypertrophy, DEN-initiated HCB-fed animals showed severe liver centrilobular hypertrophy and significant GST-P+ foci development. These findings indicate that the medium-term assay adopted in this study does not reveal any liver carcinogenesis initiating or promoting potential of Diuron in the rat.