Acesso vascular para hemodiálise com cateter temporário de duplo lúmen em cães com insuficiência renal aguda

A hemodiálise é uma modalidade terapêutica que pode sustentar a vida do paciente com insuficiência renal aguda (IRA), enquanto este recupera a função renal. Para sua realização, é necessário estabelecer circulação extracorpórea, para que seja realizada a filtração do sangue, impondo a necessidade de um acesso vascular viável e eficiente. O objetivo deste estudo foi avaliar a eficiência e as complicações do acesso vascular para hemodiálise (HD), com cateter temporário de duplo lúmen inserido na veia jugular externa. Foram estudados 10 cães com IRA induzida por gentamicina, submetidos a sessões diárias de HD, com duração de uma hora, até a recuperação da função renal ou óbito. Foram realizadas 104 sessões de HD nos animais estudados, observando-se necessidade de troca do cateter em sete sessões (6,7%), devido à obstrução do lúmen do cateter em seis sessões (5,8%) ou por saída acidental do mesmo em uma sessão (1,0%). Não se observou migração do cateter, infecção, hemorragia ou hematoma no local de entrada do cateter na pele, obtendo-se fluxo sanguíneo patente em 90,4% das sessões. Concluiu-se que o acesso vascular na veia jugular externa com cateter temporário de duplo-lúmen mostrou-se viável, com ocorrência de poucas complicações, sendo, portanto, indicado como forma de acesso para a circulação extracorpórea para HD em cães com IRA.

Traumatic surdural hygroma - Five cases with changed density and spontaneous resolution

Thirty-four consecutive adult patients with subdural traumatic hygroma were analysed for clinical evolution, serial computed tomography scan (CT), and magnetic resonance imaging (MRI) over a period of several months. Five of the patients presented CT scan and MRI evolution data showing increasing density over a period of 11 days to 6 months post trauma. In these five patients, final clinical and CT scan data were benign, with complete spontaneous resolution. Descriptions in literature of evolving traumatic subdural hygroma have presented CT scan density modifications changing into chronic subdural hematoma. Our patients show another possibility, density transformation, which sometimes show as subdural hematoma in CT scan and MRI, but with final evolution where clinical condition and CT scan return to normal.

CDX2, a highly sensitive and specific marker of adenocarcinomas of intestinal origin - An immunohistochemical survey of 476 primary and metastatic carcinomas

CDX2 is a recently cloned homeobox gene that encodes an intestine-specific transcription factor, expressed in the nuclei of epithelial cells throughout the intestine, from duodenum to rectum. While expression of CDX2 protein in primary and metastatic colorectal carcinomas has been previously documented, neither the sensitivity nor the specificity of CDX2 expression, as determined by immunohistochemistry, for colorectal adenocarcinoma has been determined. We performed an immunohistochemical survey of 476 tumors with a monoclonal antibody, CDX2-88, including 89 tumors from the colon and duodenum and 95 tumors from other gastrointestinal sites, including the esophagus, stomach, pancreatobiliary system, gastrointestinal carcinoids, and liver. CDX2 was expressed uniformly (that is, in 76-100% of tumor cells) in all but one of the evaluated colorectal and duodenal tumors. High-level expression of CDX2 was also found, however, in mucinous ovarian carcinomas and adenocarcinomas primary to the urinary bladder of which 64% and 100% were positive, respectively. Gastric, gastroesophageal, and pancreatic adenocarcinomas and cholangiocarcinomas all showed similar, heterogeneous patterns of CDX2 expression. Most tumors in each group showed CDX2 expression by a minority of cells, whereas a substantial minority of cases in each group was completely negative and a smaller minority was uniformly positive. Gastrointestinal carcinoids gave similarly varied results, but the majority (58%) was negative. Hepatocellular carcinomas showed no expression of CDX2. Only very rare examples of carcinomas of the genitourinary and gynecologic tracts, breast, lung, and head and neck showed significant levels of CDX2 expression. In this study of primary and metastatic epithelial tumors, uniform CDX2 expression is demonstrated to be an exquisitely sensitive and highly, but incompletely, specific marker of intestinal adenocarcinomas. Compared with villin, a previously described marker of GI adenocarcinomas, CDX2 demonstrated superior sensitivity and comparable specificity. CDX2 expression can be seen, however, in selected non-GI adenocarcinomas such as mucinous ovarian carcinomas and adenocarcinomas of the urinary bladder.

Biological differences between reflux stimulated proliferative stomal lesions and N-methyl-N '-nitro-N-nitrosoguanidine induced carcinomas in Wistar rats.

The morphology and evolution of epithelial lesions that developed at a gastrojejunal stoma due to reflux of duodenal contents were compared with MNNG-induced carcinomas in the pyloric mucosa of rats in a long term experiment. Random bred male Wistar rats were given MNNG in drinking water (100 mg/l) for 12 weeks and then one group was submitted to a gastrojejunal anastomosis at the greater curvature in the oxyntic mucosa, Untreated rats underwent either gastrojejunostomy or gastrotomy. The animals were killed at the 24th and 66th weeks of the experiment. The lesions obtained in the pyloric mucosa and in the mucosa of the gastrojejunal stoma were analyzed histologically using hematoxylin and eosin staining and immunohistochemistry for pepsinogen isoenzyme 1. Duodenal reflux induced proliferative lesions at the gastrojejunal junction that increased in incidence and size with time. Histologically they consisted of benign epithelial proliferation of gastric type. No evidence of malignant transformation within the gastric components of the proliferative lesions at the gastrojejunal stoma was observed even at the 66th week, Adenocarcinomas induced by MNNG in the pyloric mucosa increased in size during the experiment and were morphologically and histochemically distinct from the proliferative lesions at the gastrojejunal junction. In conclusion, proliferative lesions at the gastrojejunal stoma stimulated by duodenal reflux are biologically distinct from adenocarcinomas induced by MNNG in the pyloric mucosa. They do not seem to be precursor lesions of gastric carcinogenesis, as they do not undergo malignant transformation even after long-term, up to 66 weeks, follow-up. (C) 1999 Elsevier B.V. Ireland Ltd. All rights reserved.

Retroperitoneoscopic renal biopsy in children

OBJECTIVE: We present our experience in a series of 17 consecutive pediatric patients submitted to retroperitoneal laparoscopic renal biopsy. MATERIALS and METHODS: Retroperitoneal laparoscopic renal biopsy (LRB) was performed in 5 boys and 12 girls. Mean age was 8.1 years and age range from 2 to 12. Two or three trocars were used to expose the inferior pole of the kidney, remove enough cortical parenchymal specimen and fulgurate the biopsy site. Assessment included surgical time, estimated blood loss, hospitalization period, analgesia requirements, complications and number of glomeruli present in the specimen. RESULTS: LRB was successfully performed in all 15 patients (88%). In two cases, LRB was not possible to be performed. One patient was converted to a transperitoneal laparoscopy due to tear in the peritoneum. The other patient had had previous abdominal surgery and, during retroperitoneal balloon dilation, the peritoneum was opened and the open biopsy was performed. A third patient had postoperatively a perirenal hematoma, which was solved spontaneously. Complication rate was 17.6% (3/17 cases). Mean operative time was 65 minutes, while mean estimated blood loss was 52 mL, mean hospital stay was 2.2 days and mean analgesic requirement was 100 mg of tramadol. The mean number of glomeruli present in the specimen was 60. CONCLUSION: Retroperitoneal laparoscopic renal biopsy in children is a simple, safe. Bleeding is still the most common complication. However, direct vision usually allows a safe control of this drawback. In our institution, laparoscopic approach is the chosen procedure in pediatric patients older than one - year - old.

Lesions (ulcers and/or erosions) and desquamations location in the gastric mucosa from asymptomatic Quarter Horse foals: endoscopic survey

A úlcera gástrica figura como uma importante causa de desconforto abdominal em eqüinos jovens. de acordo com a localização das lesões na mucosa gástrica, a presença ou ausência de sinais clínicos e possíveis complicações resultantes de sua ocorrência, quatro síndromes clínicas são freqüentemente descritas em potros: 1) Úlceras assintomáticas ou silenciosas; 2) Úlceras sintomáticas ou ativas; 3) Úlceras perfuradas; e 4) Obstruções gástrica ou duodenal. Com o objetivo de se verificar a distribuição de lesões gástricas (úlceras e/ou erosões) e descamações do epitélio aglandular no estômago de eqüinos jovens assim como uma possível relação entre as alterações mencionadas (lesão/descamação) sessenta potros da raça Quarto de Milha não-portadores de sinais clínicos compatíveis com úlceras gástricas foram submetidos à gastroscopia. Os potros foram divididos em quatro faixas etárias de 15 animais cada uma, sendo: 1 a 30 dias, 31 a 60 dias, 61 a 90 dias e 91 a 120 dias de idade. As lesões ocorreram em ordem decrescente de freqüência nas regiões aglandular próximo ao margo plicatus ao longo da curvatura maior, aglandular próximo à cárdia ao longo da curvatura menor, fundo glandular e aglandular e antro. As descamações do epitélio aglandular ocorreram de forma similar nas regiões de fundo e margo plicatus. Não houve associação entre a ocorrência de lesões e descamações.

Clinical evaluation of the bicoronal flap in the treatment of facial fractures. Retrospective study of 132 patients

The aim of the present study was to evaluate the postoperative complications of bicoronal flaps used to treat facial fractures. One hundred and thirty two patients that received bicoronal flaps for the treatment of upper and middle third facial fractures were called for clinical and radiographic examination. Minimum follow-up was 1 year and all patients had charts with adequate information about their perioperative care pertinent to the study. Results showed as complications hypoesthesia (17%), partial unilateral frontal motor deficit (11%), infection (3%), hypertrophic scars (3%), varying degrees of alopecia (18%), seroma or hematoma in the immediate postoperative period (5%). The flap provided wide surgical access to the upper and middle facial thirds with very few serious complications, most frequently allowing good aesthetic results. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.

Study on Cranial and Caudal Mesenteric Arteries in Opossum (Didelphis albiventris)

The objective of this study is to describe the cranial and caudal mesenteric arteries in 10 opossuns after Neoprene latex injection. The cranial mesenteric artery arises from the abdominal aorta, caudally to the celiac trunk, originating the caudal duodenal pancreatic artery, middle and right colic, jejunal and ileocecocolic arteries. The caudal mesenteric artery arises from the aorta, cranially to the external iliac arteries, originating the cranial rectal and left colic arteries.

Multiple bradykinin-related peptlides from the capture web of the spider Nephila clavipes (Araneae, Tetragnatidae)

Three bradykinin-related peptides (nephilakinins-I to -III) and bradykinin itself were isolated from the aqueous washing extract of the capture web of the spider Nephila clavipes by gel permeation chromatography on a Sephacryl S-100 column, followed by chromatography in a Hi-Trap Sephadex-G25 Superfine column. The novel peptides occur-red in low concentrations and were sequenced through ESI-MS/MS analysis: nephilakinin-I (G-P-N-P-G-F-S-P-F-R-NH2), nephilakinin-Il (E-A-P-P-G-F-S-P-F-R-NH2) and nephilakinin-III (P-S-P-P-G-F-S-P-F-R-NH2)- Synthetic peptides replicated the novel bradykinin-related peptides, which were submitted to biological characterizations. Nephilakinins were shown to cause constriction on isolated rat ileum preparations and relaxation on rat duodenum muscle preparations at amounts higher than bradykinin; apparently these peptides constitute B-2-type agonists of ileal and duodenal smooth muscles. All peptides including the bradykinin were moderately lethal to honeybees. These bradykinin peptides may be related to the predation of insects by the webs of N. clauipes. (c) 2005 Elsevier B.V. All rights reserved.

Úlcera gastroduodenal em potros

Dentre as inúmeras patologias que acometem os eqüinos jovens, as úlceras gástricas situam-se como uma das mais importantes. MURRAY et al. (1987) trabalhando com potros clinicamente normais, constatou uma prevalência de úlceras da ordem de 51%. O mesmo autor realizando gastroscopia em 45 equinos com idade entre 1 e 24 anos, observou a presença de úlceras em 93% dos animais (MURRAY, 1988). de etiologia não completamente definida, acredita-se que inúmeros fatores estejam envolvidos na gênese das úlceras gastroduodenais, sendo o estresse um dos mais importantes. Um desequilíbrio entre os fatores de agressão e proteção da mucosa gástrica é sugerido, onde uma vez ocorrendo o predomínio dos fatores de agressão, a formação das úlceras estaria determinada. de acordo com o tipo, presença ou ausência de sinais clínicos, localização das lesões na mucosa gástrica e possíveis complicações de sua ocorrência, quatro síndromes clínicas são reconhecidas em potros: 1) úlceras assintomáticas ou silenciosas; 2) úlceras sintomáticas ou ativas; 3) úlceras perfuradas e, 4) obstrução gástrica ou duodenal. O diagnóstico deve ser baseado na história clínica, sinais clínicos, resposta à terapia e principalmente nos achados do exame gastroscópico. O tratamento pode ser feito utilizando-se drogas inibidoras da secreção ácida, protetores de mucosas, anti-ácidos, análogos da prostaglandina e estimulantes de motilidade intestinal. Quando indicado emprega-se o tratamento cirúrgico.

Mandioca e Resíduos das Farinheiras na Alimentação de Ruminantes: pH, Concentração de N-NH3 e Eficiência Microbiana

O objetivo do presente trabalho foi avaliar a concentração de N-NH3, o pH do líquido ruminal e a eficiência de síntese microbiana de rações que continham diferentes fontes energéticas: milho (MI), milho + casca de mandioca desidratada (MC), raspa de mandioca (RM) e farinha de varredura de mandioca (FV). Foram utilizados quatro novilhos da raça Holandesa (270 kg), portadores de cânulas ruminal e duodenal, distribuídos em um delineamento Quadrado Latino 4x4. A cinza insolúvel em ácido foi utilizada como indicador do fluxo duodenal e fecal. Não houve efeito das rações experimentais no pH ruminal. No entanto, menor concentração de N-NH3 foi observada para a ração com FV. O fluxo duodenal de matéria orgânica e nitrogênio e a composição química das bactérias ruminais não foram influenciados pelas rações experimentais. A maior eficiência microbiana aparente foi obtida para a ração com FV. Nas condições do presente experimento a FV, possivelmente apresentou uma melhor sincronização com a fonte protéica (farelo de soja), diminuindo a perda de nitrogênio na forma de N-NH3 e aumentando a eficiência microbiana.

Extrato de orégano como aditivo em rações para frangos de corte

Os objetivos neste experimento foram avaliar os efeitos da inclusão de extrato de orégano (EO) como aditivo promotor de crescimento nas rações sobre o desempenho, o sistema imune (peso e tamanho da bursa de Fabricius, peso do baço e do timo), as características anatomo-fisiológicas do trato gastrointestinal (altura de vilosidade, profundidade de cripta e suas relações), a microbiologia do ceco e o pH do duodeno e do ceco de frangos de corte. Foram utilizados 1.440 pintos de corte machos Cobb 500, em duas fases de criação (1 a 21 e 1 a 42 dias de idade), distribuídos em delineamento inteiramente casualizado, com seis tratamentos e oito repetições de 30 aves. Utilizou-se ração basal (RB) para as três fases de criação (1 a 21, 22 a 35 e 36 a 42 dias de idade), constituindo os seguintes tratamentos: T1 - RB; T2 - RB com antibiótico (25 ppm de bacitracina de zinco); T3 - RB com 0,025% EO; T4 - RB com 0,050% EO; T5 - RB com 0,075% EO; e T6 -RB com 0,100% EO. Observou-se que os tratamentos não influenciaram o desempenho e os pHs dos conteúdos duodenal e cecal das aves nas duas fases de criação. As variáveis de imunidade e avaliação anatomo-fisiológica do trato gastrointestinal aos 21 dias não apresentaram diferenças. Apenas o peso do baço e a altura de vilosidade aos 42 dias de idade foram influenciados pelos tratamentos. Houve redução no número de bactérias no ceco das aves à medida que se elevou o conteúdo do extrato de orégano nas rações, indicando que houve ação antimicrobiana dos componentes deste extrato. Na condição em que foi realizado o experimento, o uso do extrato de orégano como aditivo promotor de crescimento não ocasionou efeito diferente dos demais tratamentos (antibiótico e testemunha).

REVERSIBILITY OF ADENOMATOUS HYPERPLASIA IN THE GASTRIC STUMP AFTER DIVERSION OF BILE REFLUX IN RATS

Morphological and phenotypical patterns of proliferative epithelial lesions induced in the gastric stump mucosa by duodenal content reflux after Billroth II partial gastrectomy (BII) were evaluated in rats. Control animals were either sham-operated or submitted at different times after BII to Roux-en-Y (RY) surgical procedure which prevents duodenal reflux. The lesions were analysed using routine haematoxylin and eosin staining, immunohistochemical staining for pepsinogen isoenzyme 1 and histochemical procedures for mucins (paradoxical Concanavalin A, galactose oxidase Schiff and sialidase galactose oxidase Schiff reactions). Mucosal hyperplasia (H) was observed in the group submitted to BII procedure 6 weeks after surgery. Adenomatous hyperplasia (AH) also appeared 6 weeks after induction of the reflux and its incidence and size increased until the 54th week of the experiment. RY procedure performed in the normal animals at the beginning of the experiment or at the 24th week after BII gastrectomy led to a significantly lower incidence of AH which was related to the moment of surgery. Most of H was due to pyloric mucosal hyperplasia. AH consisted mainly of gastric type glands but in some animals glands of the intestinal type Were present probably originating from the intestinal mucosa. Six mucinous adenocarcinomas were observed, all of them of intestinal type. This study demonstrates that AH induced by BII procedure is a reversible lesion and that the anomalous epithelial proliferation in the stoma may lead to adenocarcinomas.

Efeito de diferentes relações volumoso: concentrado no consumo, digestibilidade aparente e partição da digestão da dieta de bovinos

Three steers equipped with ruminal and duodenal cannulas were fed roughage:concentrate ratios 80:20, 60:40 and 40:60 in order to study intake and apparent, rumen and post-rumen digestibilities. The roughage was ''coast cross'' (Cynodon dactylon) hay (5.67% CP and 83.30% NDF). Undigestible neutral detergent fiber (NDF) was used as dry matter (DM) flow marker. DM intake means were 77.99, 91.03 and 91.81g DM/kg BW0.75, for the 20, 40 and 60% concentrate diets, respectively. DM intake for the 20% diet was statistically (P < 0.05) different from the other two diets. Apparent digestion coefficient (%) of DM (50.48, 57.32 and 61.33), organic matter (OM) (52.03, 58.91 and 62.76) and gross energy (GE) (48.95, 56.40 and 60.00) increased significantly with the increase in concentrate ratio of the diets. For the following components the apparent digestion coefficients were not statistically different: NDF (44.54, 45.28 and 42.53), ADF (40.69 44.39 and 43.60), cellulose (51.54, 54.34 and 52.03), hemicellulose (49.63, 46.78 and 39.18) and starch (86.59, 91.89 and 93.21). DM, OM, NDF, ATF, cellulose and starch ruminal and post-ruminal digestibilities were not statistically different. But the ruminal digestibilities of hemicellulose (94.81, 90.26 and 85.99) and EG (93.85, 83.30 and 78.77) decreased significantly as the concentrate ratio of the diets increased. The post-ruminal digestibility of hemicellulose (5.19, 9.74 and 14.03%) and GE (6.12, 16.20 and 21.23%) increased as the concentrate ratio of the diets increased.

Effects of tea from Turnera ulmifolia L. on mouse gastric mucosa support the Turneraceae as a new source of antiulcerogenic drugs

Turnera ulmifolia is a plant belonging to the family Turneraceae, popularly known in Brazil as chanana. This species is distributed from Guyana to southern Brazil where it is considered a weed. The plant occurs in tropical rain forest, fields, and gardens. Chanana tea is used in Brazilian folk medicine for the treatment of diseases related mainly to gastric dysfunction including gastric and duodenal ulcers. In this study, the ability of a lyophilized infusion, as an aqueous fraction (AqF) of the aerial parts of T. ulmifolia, was investigated for its ability to prevent ulceration of the gastric and duodenal mucosa was examined in mice and rats, respectively. The AqF significantly reduced the formation of lesions associated with HCl/ethanol administration by 39% and 46%, respectively, at doses of 500 mg/kg and 1000 mg/kg, p.o. The AqF also significantly reduced the incidence of gastric lesions induced by a combination of indomethacin and bethanechol by 58% and 72% at doses of 500 mg/kg and 1000 mg/kg, respectively. In stress-induced gastric ulcer, the inhibition by the AqF was 48%, 57%, and 58% at doses of 250 mg/kg, 500 mg/kg, and 1000 mg/kg, respectively (p<0.05). A pyloric ligature experiment showed that the highest dose of the AqF significantly affected the gastric juice parameters by increasing the pH from 2.5 (control) to 5.3 and decreasing the acid output from 11.3 (control) to 3.7 mEq/ml/4 h. The AqF had no significant effect on duodenal ulcers induced by cysteamine. Preliminary phytochemical screening confirmed that flavonoids were the major constituents of the AqF of T. ulmifolia. These results indicate that this extract has a significant antiulcerogenic effect, as popularly believed.