Topografia do cone medular da preguiça

A anestesia caudal foi proposta pela primeira vez em 1926 e diversas técnicas foram desenvolvidas para anestesiar os nervos espinhais lombares e sacrais. Os métodos para anestesia epidural exigem conhecimento da anatomia da região envolvida. Desta forma, objetivou-se determinar a topografia do cone medular da preguiça (Bradipus variegatus), para fornecer recursos aos profissionais da área clínica para que, desta forma, seja possível a realização de anestesia epidural nesta espécie silvestre de nossa fauna. Foram dissecados quatro exemplares adultos de preguiça, dois machos e duas fêmeas que foram a óbito por causas naturais e obtidos junto ao Parque Zoobotânico do Museu Paraense Emilio Goeldi, Belém/Pará. Após a dissecação observou-se que o cone medular encontra-se entre as vértebras L3 e S1 com comprimento médio de 2,7cm, e a intumescência lombar apresentou comprimento médio de 1,0cm, estando localizada entre L1 e L3 nos quatro animais estudados. Desta forma, conclui-se que o melhor local para a realização de anestesia epidural na preguiça está entre as vértebras L1 e L3

Spinal cord compression in cattle after the use of an oily vaccine

An outbreak of compressive myelopathy in cattle associated with the improper use of an oil vaccine is described. Neurological signs were observed in 25 out of 3,000 cattle after 60 days of being vaccinated against foot and mouth disease. The clinical picture was characterized by progressive paralysis of the hind limbs, difficulty in standing up, and sternal recumbency during the course of 2-5 months. A filling defect between the L1 and L3 vertebrae was seen through myelography performed in one of the affected animals. A yellow-gray, granular and irregular mass was observed in four necropsied animals involving the spinal nerve roots and epidural space of the lumbar (L1-L4) spinal cord; the mass was associated with a whitish oily fluid. This fluid was also found in association with necrosis of the longissimus dorsi muscle. Microscopic changes in the epidural space, nerve roots, and spinal musculature were similar and consisted of granulomas or pyogranulomas around circular unstained spaces (vacuoles). These spaces were located between areas of severe diffuse hyaline necrosis of muscle fibers and resembled the drops of oil present in the vaccine.

The Effects of Anesthetic Induced Loss of Consciousness on Quantitative Electroen Cephalogram, and Bispectral and Spectral Entropy Indices. Studies on Healthy Male

Changes in the electroencephalography (EEG) signal have been used to study the effects of anesthetic agents on the brain function. Several commercial EEG based anesthesia depth monitors have been developed to measure the level of the hypnotic component of anesthesia. Specific anesthetic related changes can be seen in the EEG, but still it remains difficult to determine whether the subject is consciousness or not during anesthesia. EEG reactivity to external stimuli may be seen in unconsciousness subjects, in anesthesia or even in coma. Changes in regional cerebral blood flow, which can be measured with positron emission tomography (PET), can be used as a surrogate for changes in neuronal activity. The aim of this study was to investigate the effects of dexmedetomidine, propofol, sevoflurane and xenon on the EEG and the behavior of two commercial anesthesia depth monitors, Bispectral Index (BIS) and Entropy. Slowly escalating drug concentrations were used with dexmedetomidine, propofol and sevoflurane. EEG reactivity at clinically determined similar level of consciousness was studied and the performance of BIS and Entropy in differentiating consciousness form unconsciousness was evaluated. Changes in brain activity during emergence from dexmedetomidine and propofol induced unconsciousness were studied using PET imaging. Additionally, the effects of normobaric hyperoxia, induced during denitrogenation prior to xenon anesthesia induction, on the EEG were studied. Dexmedetomidine and propofol caused increases in the low frequency, high amplitude (delta 0.5-4 Hz and theta 4.1-8 Hz) EEG activity during stepwise increased drug concentrations from the awake state to unconsciousness. With sevoflurane, an increase in delta activity was also seen, and an increase in alpha- slow beta (8.1-15 Hz) band power was seen in both propofol and sevoflurane. EEG reactivity to a verbal command in the unconsciousness state was best retained with propofol, and almost disappeared with sevoflurane. The ability of BIS and Entropy to differentiate consciousness from unconsciousness was poor. At the emergence from dexmedetomidine and propofol induced unconsciousness, activation was detected in deep brain structures, but not within the cortex. In xenon anesthesia, EEG band powers increased in delta, theta and alpha (8-12Hz) frequencies. In steady state xenon anesthesia, BIS and Entropy indices were low and these monitors seemed to work well in xenon anesthesia. Normobaric hyperoxia alone did not cause changes in the EEG. All of these results are based on studies in healthy volunteers and their application to clinical practice should be considered carefully.

Topografia do cone medular da irara (Eira barbara) e sua relevância em anestesias epidurais

Encontrada principalmente na América do Sul, a irara é um carnívoro pertencente à família Mustelidae, a qual pouco se tem informações sobre sua morfologia de forma geral. Diante disso, objetivou-se conhecer melhor parte do sistema nervoso desta espécie, mais precisamente a topografia do cone medular, a fim de subsidiar intervenções anestésicas peridurais nesta, uma vez que a clínica de animais selvagens vem crescendo a cada dia. Foram estudados três exemplares machos, adultos, provenientes da área de Mina Bauxita, Paragominas, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA), Universidade Federal Rural da Amazônia (UFRA), Belém, os quais foram radiografados e dissecados ao nível lombossacral, seguido de exposição do cone medular. Este, por sua vez, situou-se entre L4-L6 possuindo comprimento médio de 4,31cm, o que nos levou a sugerir a região sacrococcígea como ponde ideal para prática de anestesias epidurais nesta espécie.

Lactated Ringer's solution or 0.9% sodium chloride as fluid therapy in pigeons (Columba livia) submitted to humerus osteosynthesis

The study aimed to compare the effects of intraosseous infusion of lactated Ringer's and 0.9% sodium chloride solutions on the electrolytes and acid-base balance in pigeons submitted to humerus osteosynthesis. Eighteen pigeons were undergoing to isoflurane anesthesia by an avalvular circuit system. They were randomly assigned into two groups (n=9) receiving lactated Ringer's solution (LR) or 0.9% sodium chloride (SC), in a continuous infusion rate of 20mL/kg/h, by using an intraosseous catheter into the tibiotarsus during 60-minute anesthetic procedure. Heart rate (HR), and respiratory rate (RR) were measured every 10 min. Venous blood samples were collected at 0, 30 and 60 minutes to analyze blood pH, PvCO2, HCO3 -, Na+ and K+. Blood gases and electrolytes showed respiratory acidosis in both groups during induction, under physical restraint. This acidosis was evidenced by a decrease of pH since 0 min, associated with a compensatory response, observed by increasing of HCO3 - concentration, at 30 and 60 min. It was not observed any changes on Na+ and K+ serum concentrations. According to the results, there is no reason for choosing one of the two solutions, and it could be concluded that both fluid therapy solutions do not promote any impact on acid-base balance and electrolyte concentrations in pigeons submitted to humerus osteosynthesis.

Macroscopic description of the external and middle ear of paca (Cuniculus paca Linnaeus, 1766)

Abstract: Paca (Cuniculus paca), one of the largest rodents of the Brazilian fauna, has inherent characteristics of its species which can conribute as a new option for animal experimantation. As there is a growing demand for suitable experimental models in audiologic and otologic surgical research, the gross anatomy and ultrastructural ear of this rodent have been analyzed and described in detail. Fifteen adult pacas from the Wild Animals Sector herd of Faculdade de Ciências Agrárias e Veterinárias, Unesp-Jaboticabal, were used in this study. After anesthesia and euthanasia, we evaluated the entire composition of the external ear, registering and ddescribing the details; the temporal region was often dissected for a better view and detailing of the tympanic bulla which was removed and opened to expose the ear structures analyzed mascroscopically and ultrastructurally. The ear pinna has a triangular and concave shape with irregular ridges and sharp apex. The external auditory canal is winding in its path to the tympanic mebrane. The tympanic bulla is is on the back-bottom of the skull. The middle ear is formed by a cavity region filled with bone and membranous structures bounded by the tympanic membrane and the oval and round windows. The tympanic membrane is flat and seals the ear canal. The anatomy of the paca ear is similar to the guinea pig and from the viewpoint of experimental model has major advantages compared with the mouse ear.

Retrospective study of pre-anesthetic electrocardiogram examination of 700 dogs conducted at the Veterinary Hospital of UFMG (2013-2014)

Abstract: Pre-operative electrocardiograms performed in 700 dogs were analyzed in order to establish correlation between sex, age, indication for surgery, body condition score, breed and weight. Initially a clinical questionnaire was filled out from each owner, including age, breed, sex, weight, clinical history and surgical indication. Dogs above 6 years of age or those showing any kind of cardiac auscultation disturbances were referred to electrocardiogram (ECG) evaluation. All ECG were performed and analyzed by the same veterinary specialist. Abnormalities at ECG were founnd in 364 of 700 (52%) evaluated dogs, and the most frequent variation was sinus arrhythmia, observed in 293 dogs (25.4%). No significant correlation was found between the electrocardiographic alterations with weight, sex and age of the animals. Therefore ECG should be conducted routinely regardless of age, sex, breed or surgical indication, highlighting its value for determining a safe anesthetic protocol that promotes minimal cardiopulmonary depression and allows rapid post-surgical recovery.

I hälsans spelrum : lek på vårdandets scen

With caring science as its foundation and by means of the perioperative dialogue, the intended contribution and overall aim of this present thesis is to describe what play is and could be in the caring reality, an ideal model. The perioperative dialogue is the nurse anaesthetists’ pre-, intra- and post-operative dialogues with the children they care for in connection with anesthesia. The thesis is composed according to Schopenhauer’s notion that the road to science presupposes the world seen as performances, and has an all-pervading hermeneutic approach. The performances of the thesis are: the performance of all performances, the empirical performance, the transcendental performance and the universal performance. The performance of all performances originates in the theoretical perspective of the thesis and describes what play and its characteristics are. This performance is realized through the hermeneutic interpretation of the etymology and original meaning of the word play along with texts from caring science, philosophy, anthropology and the history of religion. The empirical performance originates in four empirical studies where caring is organized as a perioperative dialogue. In study I, the material was collected with the help of participating observations and semi-structured interviews, in study II, with the help of the critical incident method and in study III, with the help of conversation interviews. In study IV, play develops into a clinical caring science research method. The research participants consist of children with special needs, children with a pronounced fear of anaesthesia, parents of children with severe autism and nurse anaesthetists. The empirical performance relates in what way play manifests in a perioperative child context by interpreting the results from the empiric in the light of the characteristics of play. The transcendental performance is enacted in the playhouse of health and presents a picture of the essence of play, the playing. In the playhouse of health, the light, winged movement of play is actualized when what was previously too difficult, too heavy and pinioned instead is as easy as anything. The eye of love and compassion knows the art of deciphering the secret script where the Other’s holiness resides, even if mere glimpses of it appear. The universal performance depicts three caring acts where the entrance consists of entering play, the ideal of which is realized in the unmasked openness face to face, that which protects the playing human being against encroachment and an unwanted audience. In the second caring act, entering play plays on to the finely-tuned interplay between human beings in the winged play of beauty and dignity. In the third caring act, the world’s deepest plays are staged on the stage of caring, in the sense that the innermost being of each individual, the universal will joins in and allows individuals to live as playing human beings who are at home with themselves and the world. The captivating, graceful and friendly play works from within itself, as long as it illumined by the light of claritas can play undisturbed on the stage of caring where it – like an unclouded mirror of its own ideal watches over children’s health.

Cesarean section - short term maternal complications related to the mode of delivery

Cesarean section (CS) is the most common major surgery performed on women worldwide. CS can save the life of the mother or the fetus, but is associated with the typical complications of any major surgery: hemorrhage, infection, venous thromboembolism and complications of anesthesia, sometimes leading to maternal death. Recently there have been several reports from well resourced countries on increased severe maternal morbidity and even mortality. Increased rates of CS, obesity and older mothers may explain this rise. The aim of this thesis is to study the rates and risk factors of short term maternal complications associated with CS. Also, we compared maternal morbidity by mode of delivery and over time. The complication rates were assessed in a prospective study involving 2496 CS performed in the 12 largest delivery units in Finland in 2005. The rates of severe complications were studied by mode of delivery in a register-based study comparing national cohorts in 1997 and 2002. The impact of several risk factors on severe maternal morbidity by mode of delivery was studied in a register-based study of all singleton deliveries in 2007-2011. In the prospective study, 27% of the women who underwent CS had one or more intraoperative or postoperative complications during their hospital stay, and 10% had a severe complication. In the register-based study the incidence of life-threatening maternal complications was 7.6 in 1000 deliveries. The incidence was lowest for vaginal delivery (VD), followed by instrumental VD and elective CS, and highest in emergency CS. An attempt of VD, including the risks associated with emergency CS, seems to be the safest mode of delivery, even for most high-risk women.

Potilaan tiedollinen yksityisyys heräämössä

Tutkielman tarkoituksena oli kuvata potilaan kokemuksia tiedollisesta yksityisyydestään sekä tiedollista yksityisyyttä edistäviä ja estäviä tekijöitä heräämössä. Tämän tiedon pohjalta on mahdollista kehittää heräämön hoitotyötä potilaiden tiedollisen yksityisyyden osalta. Tutkimus toteutettiin kuvailevana haastattelututkimuksena. Aineisto kerättiin puolistrukturoidun teemahaastattelun avulla. Tutkimuksessa haastateltiin yhden suomalaisen yliopistosairaalan korva-, nenä- ja kurkkutautien (KNK) klinikan heräämössä hoidettuja aikuispotilaita 1-2 tunnin kuluessa heräämöhoidon päättymisestä. Haastatteluaineisto koostui 17:stä päiväkirurgisen – tai vuodeosastopotilaan haastattelusta. Tallennetut haastattelut litteroitiin ja aineisto analysoitiin induktiivisella sisällönanalyysillä. Potilaat kuvasivat tiedollista yksityisyyttä potilaan tietojen hallintana: potilaan tietojen luottamuksellisena käsittelynä ja oikeutena omiin tietoihin. Tiedollista yksityisyyttä pidettiin tärkeänä, mutta potilaat eivät olleet erityisen huolissaan tämän toteutumisesta heräämössä. Tiedollinen yksityisyys toteutui potilaiden mielestä melko hyvin heräämössä lukuun ottamatta tilanteita, joissa henkilökunta vaihtoi suullisesti tietoja potilaasta keskenään. Suurin osa potilaista totesi KNK-vaivojen olevan niin neutraaleja, ettei niiden joutuminen ulkopuolisten tietoon ollut heistä merkityksellistä. Tieto leikkauksesta kiinnosti potilaita ja he olivat tyytyväisiä saatuaan siitä tietoa heräämössä. Tiedollisen yksityisyyden toteutumista edistivät potilaan uppoutuminen omaan maailmaansa, mahdollisuus kontrolloida ja saada tietoa asioistaan, kahdenkeskinen vuorovaikutus, tieto tiedollisesta yksityisyydestä, heräämön tilajärjestelyt ja tiedollista yksityisyyttä koskevien sääntöjen noudattaminen. Muiden potilaiden uteliaisuus, potilaan kyvyttömyys suojata omia tietojaan ja ulkopuolisuus omissa asioissaan, kahdenkeskeisen vuorovaikutuksen mahdottomuus, yksityisen tilan puute ja tiedollista yksityisyyttä koskevan sääntelyn noudattamattomuus koettiin tietojen luottamuksellisen käsittelyn esteiksi heräämössä. Potilaiden tietojen luottamuksellista käsittelyä voitaisiin parantaa kiinnittämällä huomiota raportointimenetelmiin ja -paikkaan heräämössä. Käytettävissä olevia keinoja, kuten sermejä ja potilaiden sijoittelu heräämössä, kannattaa käyttää hyödyksi potilaan tiedollisen yksityisyyden suojaamiseksi. Tiedollisen yksityisyyden määritelmää tulisi jatkossa täsmentää käsiteanalyysin avulla. Lisäksi tiedollista yksityisyyttä olisi hyvä tutkia hoitotyön ympäristöissä, joissa potilaiden hoitoon liittyy mahdollisesti arkaluonteisempia tietoja kuin KNK- potilailla.

Effects of ouabain on vascular reactivity

Ouabain is an endogenous substance occurring in the plasma in the nanomolar range, that has been proposed to increase vascular resistance and induce hypertension. This substance acts on the a-subunit of Na+,K+-ATPase inhibiting the Na+-pump activity. In the vascular smooth muscle this effect leads to intracellular Na+ accumulation that reduces the activity of the Na+/Ca2+ exchanger and to an increased vascular tone. It was also suggested that circulating ouabain, even in the nanomolar range, sensitizes the vascular smooth muscle to vasopressor substances. We tested the latter hypothesis by studying the effects of ouabain in the micromolar and nanomolar range on phenylephrine (PE)-evoked pressor responses. The experiments were performed in normotensive and hypertensive rats in vivo, under anesthesia, and in perfused rat tail vascular beds. The results showed that ouabain pretreatment increased the vasopressor responses to PE in vitro and in vivo. This sensitization after ouabain treatment was also observed in hypertensive animals which presented an enhanced vasopressor response to PE in comparison to normotensive animals. It is suggested that ouabain at nanomolar concentrations can sensitize vascular smooth muscle to vasopressor stimuli possibly contributing to increased tone in hypertension

Validation of transit-time flowmetry for chronic measurements of regional blood flow in resting and exercising rats

The objective of the present study was to validate the transit-time technique for long-term measurements of iliac and renal blood flow in rats. Flow measured with ultrasonic probes was confirmed ex vivo using excised arteries perfused at varying flow rates. An implanted 1-mm probe reproduced with accuracy different patterns of flow relative to pressure in freely moving rats and accurately quantitated the resting iliac flow value (on average 10.43 ± 0.99 ml/min or 2.78 ± 0.3 ml min-1 100 g body weight-1). The measurements were stable over an experimental period of one week but were affected by probe size (resting flows were underestimated by 57% with a 2-mm probe when compared with a 1-mm probe) and by anesthesia (in the same rats, iliac flow was reduced by 50-60% when compared to the conscious state). Instantaneous changes of iliac and renal flow during exercise and recovery were accurately measured by the transit-time technique. Iliac flow increased instantaneously at the beginning of mild exercise (from 12.03 ± 1.06 to 25.55 ± 3.89 ml/min at 15 s) and showed a smaller increase when exercise intensity increased further, reaching a plateau of 38.43 ± 1.92 ml/min at the 4th min of moderate exercise intensity. In contrast, exercise-induced reduction of renal flow was smaller and slower, with 18% and 25% decreases at mild and moderate exercise intensities. Our data indicate that transit-time flowmetry is a reliable method for long-term and continuous measurements of regional blood flow at rest and can be used to quantitate the dynamic flow changes that characterize exercise and recovery

Postangioplasty restenosis: a practical model in the porcine carotid artery

Transluminal coronary angioplasty is a routine therapeutic intervention in coronary heart disease. Despite the high rate of primary success, restenosis continues to be its major limitation. Porcine models have been considered to be the most adequate experimental models for studying restenosis. One limitation of porcine models is the need for radiological guidance and the expenses involved. The objective of the present study was to adapt an experimental model of angioplasty in the porcine carotid artery that does not require radiological equipment. Eight animals were used to develop the technique of balloon injury to the common carotid artery by dissection without radiological guidance. This technique was then employed in six other animals. Under anesthesia, the left common carotid artery was dissected and incised at the carotid sinus for insertion of an over-the-wire angioplasty balloon towards the aorta. Overstretch injury of the carotid artery was performed under direct visualization. After 30 days, the arteries were excised and pressure-fixated. Uninjured carotid arteries from 3 additional animals were used as controls. A decreased luminal area associated with intimal hyperplasia and medial reaction was observed in all injured arteries. Immunohistochemistry identified the intimal hyperplastic cells as smooth muscle cells. Computerized morphometry of the ballooned segments revealed the following mean areas: lumen 2.12 mm2 (± 1.09), intima 0.22 mm2 (± 0.08), media 3.47 mm2 (± 0.67), and adventitia 1.11 mm2 (± 0.34). Our experimental model of porcine carotid angioplasty without radiological guidance induced a vascular wall reaction and permitted the quantification of this response. This porcine model may facilitate the study of vascular injury and its response to pharmacological interventions

Cardiovascular responses to microinjection of trans-(±)-ACPD into the NTS were similar in conscious and chloralose-anesthetized rats

The changes in mean arterial pressure (MAP) and heart rate (HR) in response to the activation of metabotropic receptors in the nucleus tractus solitarii (NTS) with trans-(±)-1-amino-1,3-cyclopentanedicarboxylic acid (trans-(±)-ACPD) were evaluated in conscious and anesthetized Wistar, male rats weighing 240-260 g (N = 8). The responses obtained with trans-(±)-ACPD were compared with the responses to L-glutamate (1 nmol/100 nl), since in a previous study we showed that anesthesia converted a pressor response to L-glutamate microinjected into the NTS of conscious rats to a depressor response in the same rats under urethane or chloralose anesthesia. Microinjection of 3 doses of trans-(±)-ACPD (100, 500 and 1000 pmol/100 nl) produced a dose-dependent fall in MAP (range, -20 to -50 mmHg) and HR (range, -30 to -170 bpm) under both conscious and chloralose anesthesia conditions. These data indicate that the cardiovascular responses to the activation of metabotropic receptors by trans-(±)-ACPD are not affected by chloralose anesthesia while the cardiovascular responses to the activation of excitatory amino acid (EAA) receptors by L-glutamate are significantly altered

Diverse effects of renal denervation on ventricular hypertrophy and blood pressure in DOCA-salt hypertensive rats

Cardiac hypertrophy that accompanies hypertension seems to be a phenomenon of multifactorial origin whose development does not seem to depend on an increased pressure load alone, but also on local growth factors and cardioadrenergic activity. The aim of the present study was to determine if sympathetic renal denervation and its effects on arterial pressure level can prevent cardiac hypertrophy and if it can also delay the onset and attenuate the severity of deoxycorticosterone acetate (DOCA)-salt hypertension. DOCA-salt treatment was initiated in rats seven days after uninephrectomy and contralateral renal denervation or sham renal denervation. DOCA (15 mg/kg, sc) or vehicle (soybean oil, 0.25 ml per animal) was administered twice a week for two weeks. Rats treated with DOCA or vehicle (control) were provided drinking water containing 1% NaCl and 0.03% KCl. At the end of the treatment period, mean arterial pressure (MAP) and heart rate measurements were made in conscious animals. Under ether anesthesia, the heart was removed and the right and left ventricles (including the septum) were separated and weighed. DOCA-salt treatment produced a significant increase in left ventricular weight/body weight (LVW/BW) ratio (2.44 ± 0.09 mg/g) and right ventricular weight/body weight (RVW/BW) ratio (0.53 ± 0.01 mg/g) compared to control (1.92 ± 0.04 and 0.48 ± 0.01 mg/g, respectively) rats. MAP was significantly higher (39%) in DOCA-salt rats. Renal denervation prevented (P>0.05) the development of hypertension in DOCA-salt rats but did not prevent the increase in LVW/BW (2.27 ± 0.03 mg/g) and RVW/BW (0.52 ± 0.01 mg/g). We have shown that the increase in arterial pressure level is not responsible for cardiac hypertrophy, which may be more related to other events associated with DOCA-salt hypertension, such as an increase in cardiac sympathetic activity