Is oral nutritional therapy effective for the treatment of chylothorax? A case report

We report a case of a female patient who underwent corrective aortic coarctation surgery that progressed to chylothorax on the fifth postoperative day. Because the patient was clinically stable and had a functioning digestive tract, the nutritional team decided to treat her by oral nutritional support with a low-lipid diet, rich in medium-chain triacylglycerols. After 20 d, the patient returned to her habitual home diet and did not develop pleural spilling, showing full healing of the thoracic duct. (C) 2008 Elsevier B.V. All rights reserved.

Effect of passive pneumoperitoneum on oesophageal pressure, cardiovascular parameters and blood gas analysis in horses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Treatment of Pythiosis in Equine Limbs Using Intravenous Regional Perfusion of Amphotericin B

Objective To evaluate the effects of intravenous regional limb perfusion (IRLP) administration of amphotericin B in horses to treat pythiosis after surgical excision and thermocautery. Study Design Case series. Animals Horses (n = 12) with Pythium insidiosum infection of the distal aspect of the thoracic or pelvic limbs. Methods After surgical excision of granulation tissue and thermocautery, 50 mg amphotericin B was administered by IRLP through a catheter placed in a superficial vein of the affected limb next to the lesion after placing a tourniquet above the injection site. The lesions and locomotor system were evaluated before treatment and at 7, 14, 21, 28, 35, and 60 days. Results Ninety-two percent of horses treated with amphotericin B had complete lesion resolution 35 or 60 days after 1 or 2 IRLP treatments, respectively. IRLP induced limb edema and pain during regional palpation in 42%, and inflammation of the injection site in 33% of horses; however these signs resolved after 14 days. Conclusions IRLP administration of amphotericin B was effective for treating pythiosis in equine limbs, resolving infection with manageable side effects.

Estrutura, ultraestrutura e morfometria da aorta de paca (Cuniculus paca, Linnaeus, 1766) criada em cativeiro

The aim of this study was to describe the morphology, morphometry and ultrastructure of segments of thoracic and abdominal aorta portions in four male and female paca (Cuniculus paca). Parts of the segments were examined by light microscopy and part by scanning electron microscopy. Thickness measurements of the tunica intima and media complex and tunica adventitia of the aorta were taken. In all animals the thickness values for the tunica intima and media complex of the cranial thoracic aorta were significantly higher (mean: 702.19 mu m) when compared to the values of other aortic segments analyzed (means: 354.18 mu m; 243.55 mu m). The layers of the vessel walls show variations in structure and thickness, presumably due to an adaptation to functionaldemand.

Comparison of the effects of epidural or intravenous methadone on the minimum alveolar concentration of isoflurane in dogs

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

Congenital deformity of the paw in a captive tiger: case report

Background: The aim of this report was to describe the clinical signs, diagnostic approach, treatment and outcome in the case of a tiger with a deformity of the paw.Case presentation: A 1.5-year-old tiger (Panthera tigris) was presented with lameness of the left thoracic limb. A deformity involving the first and second metacarpal bones, and a soft tissue separation between the second and third metacarpal bones of the left front paw were observed. The second digit constantly struck the ground during locomotion. Based on the physical and radiographic evaluations, a diagnosis of ectrodactyly was made. A soft tissue reconstruction of the cleft with excision of both the second digit and distal portion of the second metacarpal bone was performed. Marked improvement of the locomotion was observed after surgical treatment, although the tiger showed a low degree of lameness probably associated with the discrepancy in length between the thoracic limbs.Conclusion: This report shows a rare deformity in an exotic feline that it is compatible to ectrodactyly. Reconstructive surgery of the cleft resulted in significant improvement of limb function.

Spondylothoracic dysplasia in two siblings

The spondylothoracic dysplasia syndrome is characterized by congenital malformations of vertebrae and ribs. As a consequence of the anomalous development of the vertebral column, the neck and thorax are short, and the normal head looks as if emerging from the shoulders. The thorax is short and asymmetric with an increased anteroposterior diameter. Dorsolumbar lordosis and a protuberant abdomen are present. The extremities though normal in length appear long relative to the shortened trunk. Short stature results from the vertebral abnormalities. The syndrome was seen in 2 siblings of nonconsanguineous parents.

The cervical lymphatic system in newborn rats

In the present work the authors studied the morphology of the cervical lymphatic system using 26 new-born white rats of both sexes. The studies were performed by injecting China-ink under the skin of the angle of mouth and dorsal region of the auricle in order to visualize and then to proceed the dissection of lymph vessels and nodes under stereoscopic microscope. Morphological descriptions of superficial and deep lymph vessels and lymph nodes were made, recording: a dense capillary network of the superficial system that joins to larger branches going to the submaxillary lymph nodes, generally the only ones on each side; those lymph nodes send efferent branches to deep cervical lymph nodes generally also the only ones on each side; those lymph nodes give efferent branches which form the jugular lymphatic sac that joins the jugulo-subclavian junction; the jugular lymphatic sac may receive branches from the plexus, which accompany the omocervical and external jugular veins and branches coming from the thoracic limb, as well as may join the branches coming from the thorax and the branches in most of the cases form plexus branches and seldom appear by themselves.

Influência da elevaçáo transitória e da elevaçáo sustentada da pressáo arterial sobre a primeira derivada temporal da pressáo ventricular.

PURPOSE--To analyze the influence of transient and sustained elevations of arterial pressure (AP) on the rate of rise of the left ventricular pressure (dp/dt). METHODS--Thirteen anesthetized, thoracotomized and mechanically ventilated dogs, submitted to pharmacological autonomic block (oxprenolol-3 mg/kg plus atropine-0.5 mg/kg). The AP elevation was obtained by mechanical constriction of the descending thoracic aorta. Two protocols were applied to all animals: Transient Arterial Hypertension (TAH) and Sustained Arterial Hypertension (SAH) and the following variables were evaluated: heart rate (HR), systolic (LVSP) and end diastolic (LVEDP) left ventricular pressure and dp/dt. In TAH the variables were analyzed in the basal condition (To) and at the maximal value of AP attained during the transient pressure elevation (TM). In the protocol SAH the variables were evaluated in the conditions: Control (Ho), hypertension 1 (H1) and hypertension 2 (H2). RESULTS--Considering all conditions, there were no significant differences among the values of HR. In the protocol TAH, the LVSP varied from 133 +/- 22 mmHg to 180 +/- 27 mmHg, whereas in SAH the values of LVSP were as follow: HO = 129 +/- 25 mmHg; H1 = 152 = 23 mmHg; H2 = 182 +/- 24 mmHg. LVEDP changed in both protocols: To = 7 +/- 2 mmHg; TM = 13 +/- 2 mmHg (p < 0.05); Ho = 7 +/- 2 mmHg; H1 = 10 +/- 2 mmHg; H2 = 14 +/- 3 mmHg (p < 0.05). During TAH there was no difference between the values of dp/dt (To = 3.303 +/- 598 mmHg/s; TM = 3.350 +/- 653 mmHg/s; p > 0.05), however, there were increases of the dp/dt during SAH (Ho = 3.233 +/- 576 mmHg/s; H1 = 3.831 +/- 667 mmHg/s; H1 = 4.594 +/- 833 mmHg/2; p < 0.05). CONCLUSION--The values of dp/dt are not influenced by transient elevation of AP. Sustained increase of AP activates cardiac adjustments, which results in elevation of dp/dt, by stimulation of contractile state. Probably, the inotropic intervention mechanism is the length dependent activation due to the Frank-Starling mechanism.

Influencia da elevacao sustentada da pressao arterial sobre a dP/dt do ventriculo esquerdo mantendo-se constante a pressao diastolica do ventriculo esquerdo

Purpose - To evaluate the influence of sustained elevations of arterial pressure on dP/dt values, which the left ventricular end diastolic pressure was kept constant. Methods - Thirteen anesthetized dogs, mechanically ventilated and submitted to thoracotomy and pharmacological autonomic block (atropine - 0.5 mg/kg IV + oxprenolol - 3 mg/kg IV) were studied. The arterial pressure elevation was obtained by mechanical constriction of the descending thoracic aorta. Analyses were made in control (C) situation and after two successives increments of arterial pressure, sustained for 10min, called hypertension 1 (H1) and hypertension 2 (H2), respectively. The end diastolic left ventricular pressure was kept constant by utilization of a perfusion system connected to the left atria. Results - Heart rate did not change (C: 125 ± 13.9bpm; H1: 125 ± 13.5bpm; H2: 123 ± 14.1bpm; p > 0.05); the LVSP increased (C: 119 ± 8.1mmHg; H1: 142 ± 7.9mmHg; H2: 166 ± 7.7mmHg; p < 0.01); the AoDP increased (C: 89 ± 11.6mmHg; H1: 99 ± 9.5mmHg; H2: 120 ± 11.8mmHg; p < 0.01); the LVEDP (C: 6.2 ± 2.48mmHg; H1: 6.3 ± 2.43mmHg; H2: 6.1 ± 2.51mmHg; p > 0.05) and the dP/dt (C: 3068 ± 1057.1mmHg/s; 3112 ± 995.7mmHg/s; H2: 3086 ± 979.5mmHg/s; p > 0.05) did not change. Conclusion - dP/dt values are not influenced by a sustained elevation of arterial pressure, when the end diastolic left ventricular pressure is kept constant.

Influence of different routes of flush perfusion on the distribution of lung preservation solutions in parenchyma and airways

Objective: The present study was performed to investigate the influence of different routes of perfusion on the distribution of the preservation solutions in the lung parenchyma and upper airways. Methods: Pigs were divided into four groups: control (n = 6), pulmonary artery (PA) (n = 6), simultaneous PA + bronchial artery (BA) (n = 8), and retrograde delivery (n = 6). After preparation and cannulation, cardioplegia solution and Euro- Collins solution (ECS) for lung preservation were given simultaneously. After removal of the heart, the double lung bloc was harvested. Following parameters were assessed: total and regional perfusion (dye-labeled microspheres), tissue water content, PA, aorta, left atrial and left ventricular pressures, cardiac output and lung temperature. Results: Our data show that flow of the ECS in lung parenchyma did not reach control values (9.4 ± 1.0 ml/min per g lung wet weight) regardless of the route of delivery (PA 6.3 ± 1.5, PA + BA 4.8 ± 0.9, retrograde 2.7 ± 0.9 ml/min per g lung wet weight). However, flow in the proximal and distal trachea were significantly increased by PA + BA delivery (0.970 ± 0.4, respectively, 0.380 ± 0.2 ml/min per g) in comparison with PA (0.023 ± 0.007, respectively, 0.024 ± 0.070 ml/min per g), retrograde (0.009 ± 0.003, respectively, 0.021 ± 0.006 ml/min per g) and control experiments (0.125 ± 0.0018, respectively, 0.105 ± 0.012 ml/g per min). Similarly the highest flow rates in the right main bronchus were achieved by PA + BA delivery (1.04 ± 0.4 ml/min per g) in comparison with 0.11 ± 0.03 in control, 0.033 ± 0.008 in PA, and 0.019 ± 0.005 ml/min per g in retrograde group. Flows in the left main bronchus were 0.09 ± 0.02 ml/min per g in control, 0.045 ± 0.012 ml/min per g in PA, and 0.027 ± 0.006 ml/min per g in retrograde group. The flow rates were significantly (P = 0.001) increased by PA + BA delivery of the storage solution (0.97 ± 0.3 ml/min per g). Conclusions: Our data show that the distribution of ECS for lung preservation is significantly improved in airway tissues (trachea and bronchi) if a simultaneous PA + BA delivery is used.

Effects of contrast material on computed tomographic measurements of lung volumes in patients with acute lung injury

Background. Intravenous injection of contrast material is routinely performed in order to differentiate nonaerated lung parenchyma from pleural effusion in critically ill patients undergoing thoracic computed tomography (CT). The aim of the present study was to evaluate the effects of contrast material on CT measurement of lung volumes in 14 patients with acute lung injury. Method. A spiral thoracic CT scan, consisting of contiguous axial sections of 10 mm thickness, was performed from the apex to the diaphragm at end-expiration both before and 30 s (group 1; n=7) or 15 min (group 2; n=7) after injection of 80 ml contrast material. Volumes of gas and tissue, and volumic distribution of CT attenuations were measured before and after injection using specially designed software (Lungview®; Institut National des Télécommunications, Evry, France). The maximal artifactual increase in lung tissue resulting from a hypothetical leakage within the lung of the 80 ml contrast material was calculated. Results. Injection of contrast material significantly increased the apparent volume of lung tissue by 83 ± 57 ml in group 1 and 102 ± 80 ml in group 2, whereas the corresponding maximal artifactual increases in lung tissue were 42 ± 52 ml and 31 ± 18 ml. Conclusion. Because systematic injection of contrast material increases the amount of extravascular lung water in patients with acute lung injury, it seems prudent to avoid this procedure in critically ill patients undergoing a thoracic CT scan and to reserve its use for specific indications.

Ultramorfologia e Histologia da Glândula Salivar do Tórax de Polistes versicolor (Olivier) (Vespidae), Comparada com a de Outros Hymenoptera

The salivary system of the Hymenoptera consists of the mandible, hypopharynx and thoracic salivary glands. It is very important because it is related to various aspects of the life of the insects, such as pheromone production, feeding the young, food digestion and nest building. Adult Polistes versicolor (Olivier) individuals were dissected, the thoracic salivary glands removed and processed for scanning electronic microscopy and histological examination. The P. versicolor thoracic salivary gland presents alveolar secretory units, consists of pseudoacines and does not have a reservoir. Four types of cells are present in the gland. The T1 and T2 cells make up the pseudoacines and differ mainly by the many secretory vessels in T2. There is a cluster of T3 cells at the base of the gland duct collectors, also with secretory characteristics. The secretion produced in the pseudoacines is conducted by canals and ducts to the outside, and the latter are made of T4 cells. The comparison of these characteristics with those of different Hymenoptera species, already studied, showed that the thoracic salivary gland cannot be used as a single comparison factor in evolutionary studies.

Perfil da atividade de pesquisa publicada nos anais dos congressos brasileiros de pneumologia e tisiologia nos últimos vinte anos

Objective: To increase the knowledge base regarding pulmonology research in Brazil. Methods: A retrospective, observational study of the abstracts published in the Annals of the Brazilian Pulmonology and Phthisiology Conferences held from 1986 to 2004, quantifying the institutions of origin by geographic distribution and type, as well as categorizing the abstracts by study design and topic. Results: A total of 6467 abstracts were published. The institutions of origin were located, variously, in the Southeast (3870 abstracts), South (1309), Northeast (783), Central-West (267) and North (84). There were 94 abstracts originating from foreign institutions, especially from institutions in Portugal (56.3%) and the United States (13.8%). Most of the studies (5825) were conducted in public Brazilian institutions. There were 4234 clinical studies, 1994 case reports and 239 original research articles. A marked, progressive increase was observed in the number of clinical studies and case reports during the period evaluated. Overall, the most common themes were tuberculosis and other infections diseases (25.2%), following by oncology (11.6%), interstitial lung diseases (8.8%) and thoracic surgery (8.5%). Nevertheless, the number of abstracts on each topic varied widely from year to year. Conclusion: Public Brazilian institutions are the principal sources of pulmonology research in Brazil. Such research activity is concentrated in the southeastern part of the country. Case reports account for one-third of this activity. Although there was great variability in the subjects addressed, diseases that are highly prevalent in Brazil, such as tuberculosis and other infections diseases, were the most common topics.

Pelvimetria em macacos-da-noite (Aotus azarai infulatus - KUHL, 1820)

Related data to the diameters of the pelvis from 72 Aotus azarai infulatus, owl monkeys, 42 adult males and 30 adult non-pregnant females, were obtained in vivo by ventrodorsal projection radiographic exams, correlated with sex, the measures of the body and their origin. The mean values of the body length (30.94 cm), tail length (35.63 cm), thoracic perimeter (18.97 cm), hip perimeter (17.11 cm) and the weight (0.96 Kg) were verified. The radiographic images were digitalized and measured, and the mean values were 1.41 cm for the superior biiliac diameter; 1.58 cm for the inferior biiliac diameter; 1.97 cm for the medium biiliac diameter; 2.64 cm for the right diagonal diameter; 2.66 cm for the left diagonal diameter; 2.48 cm for the sacrum-pubic diameter; 3.85 cm 2 for the inlet pelvic area. In conclusion, the pelvis from males and females Aotus azarai infulatus can be classified as dolicopelvic and there is pelvic sexual dimorphism in adult owl monkeys (Aotus azarai infulatus).