Perfuração gástrica secundária a tricobezoar gigante: descrição de caso e revisão da literatura

Gastric bezoars are impactations offoreign material in lhe stomach. When they are caused by hail; they are named tricho- bezoars. The complications oftrichobezoars are very rare. In this papel; we describe a case of a 16-year-old girl that had a previous history oftricophagia, and had an acute abdominal pain with a pneumoperitoneum in the abdomen radiography. An operation was performed and a gastric perforation was founded associated with a giant trichobezoa7: The trichobezoar was removed by traction through a gastrostomy which was performed in order to remove lhe trichobezoa7: Some fragments of the ulcer were obtained to histological study. The gastrostomy was treated by a gastrorraphy confection. In lhe post- operative period a left subfrenic abscess was revealed and has been drained by laparatomy 15 days after the fisrt operation. After the second surgical procedure the patient had a good evolution, and left the hospital in good health conditions.

Histoplasmose como causa de perfuração intestinal em paciente com síndrome da imunodeficiência adquirida

Thirty-four years old patient, female, husband died of AIDS (Acquired Immunodeficiency Síndrome). She's confined to Hospital Universitário João de Barros Barreto, with a positive tesT for AIDS, fever, 10 kg/month of weight loss, diarrhea with gummy faeces, productive cough, yellowish sputum. The therapy was initiated, symptomatic, associated to Epivir, Saquinavir and AZT. The searching exams for Alcohol Ácid Resistant Bacili and fungi in the sputum were negative. At the hemogram was shown a pancytopenia, the esophagogastroduodenunscopy showed light esophago moniliasis. During commitment presented a perforating acute abdomen chart, the abdominal radiography showed hidroair levels, pneumoperitoneum, enlarced bowels with swollen wall. She was undertaken a surgery with diagnosis hypothesis of cytomegalovirus perforation, which accordin to literature is the most frequent cause of intestinal perforation in patients with AIDS.

Tuberculose entérica

The authors reports two patients with operated from enteric tuberculosis. Tuberculosis involving the intestinal tract may be due to either Mycobacterium tuberculosis or M. bovis. In the former situation, the disease is primary to the lungs and is carried to the intestinal tract by swallowing sputum. The latter organism produces infection associated with swallowed nonpasteurized milk. This condition is extremely unusual in most western countries, since pasteurization of milk is standardized. The diagnosis was performed through laparotomy because of symptoms suggestive of intestine obstruction. Inflammatory reactions were observed on the small intestine (jejunum-ileum) in both cases. The presence of tuberculosis of the lungs was observed in one patient. The chemotherapic treatment was estabilished after the histopathologic diagnosis. The distinction between tuberculosis and Crohn's disease may not be possible by radiography or endoscopy. Videolaparoscopy has been found to be an useful procedure for the early diagnosis of Enteric Tuberculosis. In spite of the epidemiology knowledge, clinical control and improvement in treatment, extra pulmonary tuberculosis rate from concealed focus has been increased, due to AIDS poverty in certain populational groups and immigration from Asia to wertern countries. Compared with immunocompetent patients, the proportion of extrapulmonary tuberculosis is much higher in patients with AIDS, justfying the increased frequency of reports of intestinal tuberculosis in these patients.

Enxerto autógeno de crista ilíaca na reconstrução do processo alveolar em portadores de fissura labiopalatina: estudo de 30 casos

A reconstrução do processo alveolar em pacientes portadores de fissuras labiopalatais (FLP) é fundamental para erupção de dentes permanentes e para o restabelecimento estético através de implantes osteointegrados. Assim, considerado o alto grau de reabsorção do enxerto de osso autógeno puro e triturado, optou-se no Centro de Atendimento Integral ao Fissurado Labiopalatino, Curitiba, Paraná (1997 a 1999), pelo estabelecimento de dois grupos de 15 pacientes. No primeiro, foi utilizada crista ilíaca triturada e no outro combinada com hidroxiapatita biorreabsorvível. Ao fim de seis meses, os resultados cirúrgicos foram avaliados através de radiografia periapical digital, determinando quatro linhas limites para a reconstrução óssea. A primeira linha foi traçada na região cervical do dente adjacente à fissura que apresentava menor distorção. As outras linhas foram traçadas paralelamente à linha 1, distando 3mm entre cada uma delas. O espaço entre as linhas 1 e 2 foi denominado de A, entre 2 e 3 de B e 3 e 4 de C. Para critérios de avaliação, quando o enxerto permaneceu no espaço A, foi considerado de sucesso, em contraposição aos espaços B e C, quando foram denominados de procedimentos malsucedidos. Como resultados finais, o espaço A foi constatado em 46,7% dos pacientes submetidos ao procedimento controle com crista ilíaca e 80% para o grupo experimental, quando o enxerto ósseo foi empregado conjuntamente com o material aloplástico (hidroxiapatita).

Obstrução intestinal por volvo de ceco, relato de caso

Cecal volvulus (CV) establishes the main appearance of the anomalies related to intestinal malrotation. Diagnosis is based on signs and symptoms compatible to intestinal obstructions and complementary examinations as: single radiography form abdomen, opaque enema, computerized tomography and colonoscopy. Therapeutics modalities include: colonoscopy reducing, cecopexy and right colectomy. This article reports a CV case giving emphasis in different diagnosis and therapeutics behaviors.

Prevalence of radiographic markers of femoroacetabular impingement in asymptomatic adults

OBJECTIVE: to determine the prevalence of radiographic signs of femoroacetabular impingement (FAI) in asymptomatic adults and correlate them with data from physical examinations. METHODS: We conducted a cross-sectional study with 82 asymptomatic volunteers, 164 hips, between 40 and 60 years of age, selected by convenience. They were submitted to anamnesis and clinical examination of the hip, anteroposterior (AP) pelvis radiographs with three incidences, Dunn 45° and Lequesne false profile of each hip, to measure the variables. We measured the alpha angle, anterior offset of the femoral neck, cervical diaphyseal angle, CE angle of Wiberg, acetabular index, Sharp angle, and the crossing, ischial spine and posterior wall signs. RESULTS: our sample consisted of 66% women, mean age of 50.4 years. The average alpha angle was 45.10°, SD=8.6. One quarter of the hips showed alpha angle greater than or equal to 50°; among men the prevalence was 34%, and among women, 11%. We found indicative radiographic signs of femoroacetabular impingement in 42.6% of hips, whether femoral or acetabular, and the increased alpha angle was related to the decrease in hip internal rotation (p<0.001). CONCLUSION: the radiographic findings of femoroacetabular impingement in asymptomatic patients were frequent in the studied sample. The increase in alpha angle was associated with decreased internal rotation.

The effect of timing temporary cements to treat induced pulp necrosis in the teeth of dogs

During endodontic therapy (pulpectomy, root canal debridement and root canal filling) microbiological management is a major concern. Bacteria present in dentine tubules, apical foramina and apical delta are causally related to failure of the procedure. Studies have shown that during single session endodontic treatment bacteria remain within dental structures. The aim of the present study was to evaluate endodontic treatment performed as two sessions, using temporary endodontic dressing materials for different periods in four groups of experimental dogs. A total of 80 roots of second and third upper premolar teeth and second, third and fourth lower premolar teeth were divided into four groups. The pulp chamber was opened with burrs and the pulp exposed for 60 days to induce pulpal inflammation and necrosis. Groups II, III and IV were treated with calcium hydroxide plus camphorated paramono-chlorophenol (PMCC) for 7, 15 and 30 days, respectively. In all groups, the root canals were filled with zinc oxide-eugenol and gutta-percha cones. Clinical and radiographical measurements were performed every 2 weeks. After 60 days a small block section containing the teeth, surrounding periapical tissues and the periodontium was removed for histological and microbiological study. Histological analysis revealed intense inflammatory response in all groups. Microbiological analysis showed microbial reduction inversely proportional to the period of time that the intracanal temporary medicament was left in place.

Abscessos dentários periapicais em leitões com síndrome multissistêmica do definhamento

Duzentos e oitenta leitões, entre 40 e 70 dias de idade, afetados pela sindrome multissistêmica do definhamento (SMD) foram examinados após eutanásia para pesquisa de lesões dentárias. Pelo menos um abscesso periapical foi observado em 58 leitões (20,7%), dos quais 12 apresentaram abscessos múltiplos. Terceiros incisivos superiores, 3os incisivos inferiores, caninos superiores, caninos inferiores e outros dentes apresentaram respectivamente 22 (31,4%), 16 (22,9%), 4 (5,7%), 23 (32,9%) e 5 (7,1%) abscessos periapicais. A maior prevalência de abscessos observada nos dentes 3os incisivos e caninos inferiores está provavelmente associada com a maior área de corte ou desgaste que sofrem esses dentes. Entre as bactérias isoladas de amostras de 65 abscessos, Streptococcus sp. foi a mais prevalente e esteve presente em 21,48% e 27,7% dos isolados em aerobiose e anaerobiose, respectivamente. Na segunda posição em prevalência estiveram as bactérias corineformes, as quais foram mais freqüentemente isoladas em atmosfera anaeróbica do que aeróbica. Houve preponderância de isolamentos de bactérias Gram-positivas. Não foi possível determinar se as co-infecções bacterianas predispuseram às lesões características de SMD ou foram conseqüentes à imunossupressão causada pela infecção com PCV2.

Ultrasonographic and radiographic determination of egg development of jurarás (Kinosternon scorpioides) in captivity

Kinosternon scorpioides (Linnaeus, 1766), with its common name of jurará, is a quite variable species of turtles, and many different names have been applied to populations throughout its range. Currently, however, four subspecies are considered valid as K. scorpioides arises from southern Panama over most of northern South America and is found in Ecuador, northern Peru, southern Bolivia, northern Argentina, eastern Guyana and Brazil. Thus, an ultrasonographic and radiographic study was performed in order to describe the morphology and development of eggs of 20 female jurará mud turtles K. scorpioides, from September 2005 to August 2006. In the first month, the ovarian cycle was characterized by absence of vitellogenic follicles, atresic follicles or oviduct eggs. From October 2005 to March 2006 on, ultrasonographic scanning allowed to establish the growing vitellogenic follicles. Vitellogenic follicles were observed with spherical to ovoid shapes, with a surrounding echogenic yolk, a nonechogenic albumin layer, and a high echogenic shell. The oviduct eggs were identified by radiography just 180 days after beginning the experiment, when the shell became enough mineralized to impress the radiographic film. This experiment allowed to obtain by means of the 7.5 MHz linear probe images with adequate resolution and penetration for visualization of follicles. Successive ultrasonographic examinations of 20 K. scorpioides females allowed to access initial stages of vitellogenic follicles and oviduct eggs, and radiographic examination revealed to be an easy technique to assess oviduct eggs and to allow evaluation of egg development in jurarás, from 6 months on.

Clinical evaluation of enalapril maleate and furosemide usage in dogs with degenerative myxomatous mitral valve, CHF functional class Ib

Degenerative myxomatous mitral valve (DMMV) is a heart disease of high incidence in small animal clinical medicine, affecting mainly older dogs and small breeds. Thus, a scientific investigation was performed in order to evaluate the clinical use of the medicines furosemide and enalapril maleate in dogs with this disease in CHF functional class Ib before and after the treatment was established. For this purpose 16 dogs with the given valve disease were used, separated into two groups: the first received furosemide (n=8) and the second received enalapril maleate (n=8) throughout 56 days. The dogs were evaluated in four stages (T0, T14, T28 and T56 day) in relation to clinical signs, hematological, biochemical and serum assessment, which included serum angiotensin converting enzyme (ACE) and aldosterone, as well as radiography, electrocardiography, Doppler-echocardiography and blood pressure. The results regarding the clinical, hematological and serum chemistry evaluations revealed no significant changes in both groups, but significant reductions in the values of ACE and aldosterone in the group receiving enalapril maleate were verified. The radiographic examination revealed reductions of VHS values and variable Pms wave of the electrocardiogram in both groups, but no changes in blood pressure values were identified. The echocardiogram showed a significant decrease of the variables LVDd/s in the studied groups and the FS% in animals that received only enalapril. Therefore, analysis of results showed that monotherapy based on enalapril maleate showed better efficiency of symptoms control in patients with CHF functional class Ib.

Macroscopic description of teeth of Azara's agouti (Dasyprocta azarae)

The teeth of Azara's agouti (Dasyprocta azarae) were described macroscopically in order to provide biological data on one of the largest wild rodents of the Americas. Radiography was taken on six heads and the teeth were described. Enamel surrounds the coronal dentin, projects to the roots and is present as parallel inner laminae in buccolingual direction. The dentin is located among the enamel laminae and surrounds the pulp horns. The cementum is located internally to the enamel laminae. On the lingual surface, the cementum and dentin are the outer elements.

Anatomical and radiographic appearance of the capuchin monkey thoracic cavity (Cebus apella)

The capuchin monkey is widespread both north and south of the Legal Amazon and in the Brazilian cerrado. Ten clinically healthy capuchin monkeys were submitted to an anatomical and radiographic study of their thoracic cavities. The radiographic evaluation allowed the description of biometric values associated with the cardiac silhouette and thoracic structures. Application of the VHS (vertebral heart size) method showed positive correlation (P<0.05) with depth of the thoracic cavity, as well as between the body length of vertebrae T3, T4, T5 and T6 and the cardiac length and width. The lung fields showed a diffuse interstitial pattern, more visible in the caudal lung lobes and a bronchial pattern in the middle and cranial lung lobes. The radiographic examination allowed preliminary inferences to be made concerning the syntopy of the thoracic structures and modification of the pulmonary patterns and cardiac anatomy for the capuchin monkey.

Anatomo-radiographic description of the axial skeleton of the crab-eating fox (Cerdocyon thous)

The aim of this study was to describe the axial skeleton of a wild Brazilian carnivorous, the crab-eating fox (Cerdocyon thous). Five specimens of crab-eating fox were previously unfrozen for radiographic exams and their bones went through dissection and chemical maceration. This animal presents seven cervical vertebrae, and from the third on, they become shorter and wider than the other ones e the spinous process was makeable from the fifth cervical vertebrae on. There are thirteen thoracic vertebrae and the spinous process of the lumbar vertebrae, which are seven, decreases from the fifth on. The sacrum is formed by two vertebrae and there are twenty or twenty one caudal vertebrae. It can be concluded that the crab-eating fox axial skeleton is similar to that of the domestic dog.

Experimental osteoarthritis in rabbits: lesion progression

The aim of this study was to evaluate the progression of lesions in different stages of osteoarthritis (OA) experimental by radiography (RX), computed tomography (CT), macroscopic and histopathology, linking these different diagnostic methods, helped to provide information that helps the best time for the therapeutic approach. Four experimental periods were delineated at 3, 6, 9 and 12 weeks after induction of OA, known as PI, PII, PIII and PIV, respectively, each with six animals. We evaluated the five compartments of the femorotibial joint: medial femoral condyle (MFC), lateral femoral condyle (LFC), medial tibial plateau (MTP), lateral tibial plateau (LTP) and femoral trochlea (FT). Therefore we established an index by compartment (IC) and by adding such an index was estimated joint femorotibial (IFT). It was observed that the CFM was the compartment with the highest IC also differed significantly (p<0.05) from other compartments. Compartments showed no significant difference (p>0.05) between the PI and PII, however contrary fact occurred between the PII and PIII (p<0.05), PIII and PIV (p<0.01) and between PI and PIV (p<0.001). Similarly the IFT, showed a significant difference in the animals of PIV compared to PI (p<0.001), PII (p<0.001) and PIII (p<0.01), and there was no statistical difference (p> 0.05) between the PI and PII. In the variation of the average interval between periods, there was a higher value between the PIII PIV and for the other intervals of time periods (PI, PII, and PIII-PII). However, these intervals showed no statistically significant difference (p>0.05). Through the RX, CT, macroscopic and histopathological findings, we found similar patterns among individuals within the same period demonstrating a gradual progression of the disease. These results show that between 3 and 6 weeks progression of the lesion is slower and probably also can be reversed in comparison to other ranges where proved further progression between 9 and 12 weeks after induction of trauma OA. These results may provide a better therapeutic approach aimed at reversing the lesions in early stages of OA. We conclude that the interconnection of the four diagnostic methods individually classified into scores, which were unified in both indices in the evaluation by the femorotibial joint compartment and may represent a diagnostic condition closer to the true condition of the injury and its progression.