Thorax ultrasound in the management of pediatric pneumonias complicated with empyema

The aim of this work is to prospectively study the value of thoracic ultrasound (US) before pleural drainage in children with parapneumonic effusion (PPE). All children hospitalized for PPE, identified by thoracic radiography, underwent US to assess pleural loculation, echogenicity, and pleural fluid quantity. From August 2001 to July 2003, 52 children were examined. US was performed on 48 of these children, of whom 35 received chest tube drainage and 13 only received clinical treatment. US identified 38 patients with free flowing and 10 with loculated pleural fluid. About 25 of the free flowing (65.8%) and 10 (100%) of the loculated patients received chest tube drainage. Echogenicity was anechoic in 13, echoic without septations in 17 and echoic with septations in 18. Chest tube drainage was required in 6 anechoic (46.15%), 14 echoic without septations (82.35%), and 15 echoic with septations (83.33%). Quantity of fluid estimated by US varied from 20 to 860 ml. Effusion volume was higher in patients that were echoic with septations and loculated effusions. Pleural glucose and pH were lower, and LDH was higher in loculated PPE patients. In conclusion, US is an auxiliary exam for determining whether thoracic drainage is needed in parapneumonic effusion; loculated or echoic effusion should be drained, and free anechoic fluid needs further investigation.

O papel do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática dos membros inferiores

O diagnóstico da trombose venosa profunda sintomática está bem estabelecido com o uso do mapeamento dúplex, que apresenta sensibilidade de 100% e especificidade de 98%, para trombose venosa profunda proximal, e sensibilidade de 94% e especificidade de 75%, para distal. Na trombose venosa profunda recente e assintomática, o diagnóstico com o mapeamento dúplex ainda não está bem estabelecido, mostrando uma queda na acurácia desse método diagnóstico. Essa queda é devida ao fato de o trombo recente não ser oclusivo, apresentar a mesma ecogenicidade do sangue e uma consistência diminuída, prejudicando o teste da compressibilidade, que é o mais sensível para diagnóstico da trombose venosa profunda. Nesta revisão, serão revistos artigos publicados que avaliaram a acurácia do mapeamento dúplex no diagnóstico da trombose venosa profunda assintomática.

Could zinc prevent reproductive alterations caused by cigarette smoke in male rats?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Artificial oocyte activation using calcium ionophore in ICSI cycles with spermatozoa from different sources

The present study evaluated the effect of artificial oocyte activation (AOA) with calcium ionophore A23187 oil intracytoplasmic sperm injection (ICSI) cycles using spermatozoa from different sources. The 314 cycles evaluated were divided into three groups according to sperm origin, the ejaculated group (n = 92), the epididymal group (n = 82). and the testicular roup (n = 140). Each group was further split into experimental subgroups, depending oil whether or no AOA was performed. In additions the cycles of women younger than 36 years were evaluated separately. For each experimental group, ICSI outcomes were compared between subgroups. No significant difference was observed between subgroups for all sperm origin groups. When evaluating only the cycles of women younger than 36 years of age, AOA increased the percentage of high-quality embryos (74.5 versus 53.0%. P = 0.011) and the implantation rate (19.3 versus 10.5%, P = 0.0025) when it was used with ejaculated spermatozoa, and the percentage of high-quality embryos (64.4 versus 50.3%, P = 0.006) when epididymal spermatozoa were used. These results may suggest that both sperm maturity and oocyte quality play a role in oocyte activation. However. this study is to be continued to confirm these findings.

Artificial oocyte activation with calcium ionophore A23187 in intracytoplasmic sperm injection cycles using surgically retrieved spermatozoa

Objective: To evaluate the effect of artificial oocyte activation (AOA) on intracytoplasmic sperm injection (ICSI) cycles using surgically retrieved sperm.Design: Laboratory study.Setting: Fertility/assisted fertilization center.Patient(s): Couples undergoing surgical sperm retrieval for ICSI (n = 204).Intervention(s): Application of calcium ionophore A23187 for AOA.Main Outcome Measure(s): Cycles were divided into experimental groups according to the origin of the sperm used for injection and the type of azoospermia: [1] testicular sperm aspiration in nonobstructive-azoospermic patients (TESA-NOA group, n = 58), [2] TESA in obstructive-azoospermic patients (TESA-OA group, n = 48), [3] and percutaneous epididymal sperm aspiration in obstructive-azoospermic patients (PESA-OA, n = 98). For each experimental group, cycles where AOA was applied (subgroup: activation) were compared with cycles in which AOA was not applied (Subgroup: control). The fertilization, high-quality embryo, implantation, and pregnancy rates were compared among the subgroups.Result(s): For patients undergoing TESA, AOA did not improve ICSI outcomes for either type of azoospermia. However, for cases in which the injected sperm were retrieved from the epididymis, a statistically significantly increased rate of high-quality embryos was observed with AOA.Conclusion(s): Artificial oocyte activation may improve ICSI outcomes in azoospermic patients when epididymal, but not testicular spermatozoa, are injected. (Fertil Steril (R) 2009;92:131-6. (C)2009 by American Society for Reproductive Medicine.)

Vitamin C partially attenuates male reproductive deficits in hyperglycemic rats

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Short- and long-term reproductive effects of prenatal and lactational growth restriction caused by maternal diabetes in male rats

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

Glutamate-induced obesity leads to decreased sperm reserves and acceleration of transit time in the epididymis of adult male rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Hiperoxalúria primária com insuficiência renal crônica terminal em lactente

Objetivo: descrever caso clínico de um lactente com insuficiência renal crônica terminal, causada por hiperoxalúria primária.Método: após revisão da literatura, verifica-se a raridade da doença; na França, a prevalência é de 1,05/milhão, com taxa de incidência de 0,12/milhão/ano. Pesquisa abordando centros especializados mundiais detectou, em 1999, 78 casos em lactentes; destes, em 14% o quadro inicial foi de uremia. A gravidade e a raridade da doença sugerem o relato deste caso.Resultados: criança de sexo feminino, com quadro de vômitos e baixo ganho de peso desde os primeiros meses de vida, desenvolveu insuficiência renal terminal aos 6 meses de idade, sendo mantida em tratamento dialítico desde então. Aos 8 meses, foi encaminhada para esclarecimento diagnóstico, apresentando déficit pôndero-estatural grave e os seguintes exames laboratoriais: uréia= 69 mg/dl, creatinina=2,2 mg/dl e clearance de creatinina= 12,5 ml/min/1.73m²SC. O exame de urina foi normal, a ultra-sonografia renal revelou tamanho normal e hiperecogenicidade de ambos os rins. A dosagem de oxalato urinário foi de 9,2mg/kg/dia ou 0,55 mmol/1.73m²SC, e a relação oxalato:creatinina, de 0,42. A biópsia renal diagnosticou presença de grande quantidade de depósitos de cristais de oxalato de cálcio no parênquima renal. A radiografia de ossos longos evidenciou sinais sugestivos de osteopatia oxalótica, e a fundoscopia indireta, sinais de retinopatia por oxalato. A criança foi mantida em diálise peritoneal ambulatorial contínua, tendo sido iniciado tratamento com piridoxina.Conclusões: a hiperoxalúria primária deve ser considerada como um dos diagnósticos diferenciais de insuficiência renal crônica em lactentes, especialmente na ausência de história sugestiva de outras patologias.

EFFECTS of DIURON on MALE RAT REPRODUCTIVE ORGANS: A DEVELOPMENTAL and POSTNATAL STUDY

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

Comparação de diferentes doses de colagenase em modelo de indução de tendinite para eqüinos: estudo clínico e ultra-sonográfico

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

Efeito da inclusão do farelo e da farinha de semente de algodão em rações para reprodutores de tilápia do Nilo (Oreochromis niloticus)

Este experimento foi realizado para avaliar o efeito do farelo e da farinha de algodão no comportamento reprodutivo e na atividade testicular de reprodutores de tilápia do Nilo. Vinte e cinco peixes receberam dietas contendo 0; 2; 4; e 6% de semente de algodão descorticada e moída e 24,0% de farelo de algodão. O comportamento reprodutivo foi observado e a construção de ninhos, corte e desova, avaliadas. Aos 90 dias, as gônadas dos machos foram avaliadas microscopicamente. O grupo controle (farelo de algodão) obteve maior número de desovas. Os peixes alimentados com semente ou farelo de algodão, apesar de não terem apresentado o mesmo número de desovas, construíram ninhos e fizeram a corte. A análise histológica dos testículos demonstrou que a adição de 24,0% de farelo ou níveis de 2,0% ou superiores da farinha influiu na atividade testicular. O gossipol presente na farinha ou farelo de algodão teve efeito negativa nas gônadas destes animais.

Desempenho e espermatogênese de alevinos de tilápia alimentados com farelo ou farinha de semente de algodão

Este trabalho avaliou o efeito do farelo e da farinha de semente de algodão no ganho de peso e na atividade testicular de alevinos de tilápia-do-nilo (Oreochromis niloticus). Cento e cinqüenta alevinos com peso médio inicial de 1,26 g foram mantidos em aquários de 45 L, com renovação contínua d'água, e alimentados por 120 dias com dietas isoprotéicas (28% PB) e isocalóricas (4.030 kcal EB/kg de ração) contendo 0%, 2%, 4% e 6% de semente de algodão descorticada e moída, e 24% de farelo de algodão. Foi observado que os níveis avaliados interferem na atividade testicular, diminuindo a espermatogênese, embora não tenham comprometido de forma significativa o ganho de peso dos alevinos.

Ovarian activity and plasma concentrations of progesterone and estradiol during pregnancy in jennies

The objectives of this study were to determine ovarian activity (with ultrasound) and plasma concentrations of progesterone and estradiol during pregnancy in jennies. There was considerable ovarian activity during the second month of pregnancy. Secondary corpora lutea (total of 2 to 7 per jenny) were formed (mainly by luteinization) starting on Day 41.8 +/- 1.0 (range Days 38 to 46; ovulation = Day 0). The echogenicity of the primary and secondary corpora lutea gradually decreased during pregnancy. Plasma progesterone concentrations increased between Days 0 and 10 (0.9 and 19.9 ng/mL, respectively), gradually decreased to Day 30 (12.1 ng/mL), increased between Days 30 and 40 (plateau, at approximately 17 ng/mL), gradually declined from Days 110 to 160 (nadir of approximately 6 ng/mL), and remained nearly constant until increasing again just before parturition. Plasma estradiol concentrations increased gradually from Day 65, peaked (1.2 ng/mL) on Day 165 (greater than or equal to 1 ng/mL on Days 150 to 210), and decreased thereafter, with very low concentrations during the last 20 d before parturition. Ovarian function and hormone profiles were generally similar to those previously reported during pregnancy in mares. (C) 1998 by Elsevier B.V.

Gonadic Sperm Reserve in Buffaloes Created under Tropical Conditions

The objective of the present study was quantifying the spermatic production per gram and daily rate of the testicular parenchyma. Testis of 12 crossbred Murrah buffaloes aged 24 to 48 months created under extensive conditions in the State of São Paulo/Brazil were analyzed. Animals were divided into groups based on the testicular shape (long and long-moderate) and testicular sides (right and left) and the studied parameters were: length and testicular width, weight and volume of the albuginea and mediastinum and net weight of the testicular parenchyma, gonadic sperm reserves, spermatic production/g of testicular parenchyma, daily spermatic production/g, total daily spermatic production, resulting into the values: 8.16 +/- 0.87 and 4.29 +/- 0.50 cm; 9.09 +/- 1.91 g and 8.77 +/- 1.88 mL; 0.97 +/- 0.39 g and 0.90 +/- 0.38 mL; 112.91 +/- 18.85 g; 14.32 x 10(9) +/- 0.15; 13.42 x 10(6) +/- 0.17; 27.40 x 10(6) +/- 0.35 and 2.92 x 10(9) +/- 0.30, registering no difference between right and left testis in relation to the parameters (P>0.05). There was no relation between testicular biometry and spermatic production (P>0.05). According to the obtained values, all animals were considered sexually mature and presented an efficient spermatic production per gram of testicular parenchyma and total daily production.