969 resultados para Biliary enteric fistula


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Platynosomiasis has been associated with cholangitis/cholangiohepatitis complex in domestic cats. Despite being typically asymptomatic, some individuals may develop severe disease resulting in hepatic cirrhosis. Definitive diagnosis by means of parasite eggs direct visualization is not always possible and complementary tests should be associated. This paper reports a case of a three-year-old female cat with anorexia and jaundice. Ultrasound and biochemistry laboratory findings as well as liver biopsy were not conclusive. Definitive diagnosis of intense Platynosomum fastosum infestation was only possible through direct examination of biliary fluid at necropsy, stressing the importance of including platynosomiasis, commonly an underdiagnosed disease, among differential diagnoses of feline liver diseases.

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Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

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Objective: evaluating the adequacy, prescription and energy supply of enteral nutrition therapy in hospitalized patients. Methods: was performed a retrospective survey of the evolution of TNE protocol of 59 patients hospitalized in a general hospital in Marília / SP / BR. Data collected included gender, age, clinical diagnosis, anthropometric and dietary data related to the prescribed dietary formula, route and method of administration of the enteral nutrition, the daily volume prescribed and administered, the daily amount of energy required and offered in the diet, as well as possible complications. Body mass index (BMI), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to establish the nutritional status of the patients. The adequacy of ENT was done according to the daily energy requirement compared to the average energy received during the daily use of ENT. Results: The average found to the BMI was 21.4 kg/m 2, and no differences were found comparing male and female. The data for TSF and AMC were different between genders (p<0.05) and suggest a more severe muscle mass in relation to adipose tissue. The averaged to the energy requirements was 1642 kcal/day but the average of energy prescribed was 1045 kcal/day and the amount offered was 1035 kcal/day. There was a significant difference between the necessity and the supplied energy offered through enteral nutrition (p=0.00) as well between the energy required and prescribed (p =0.00), both were shorter than the necessity. There was no significant difference (p>0.05) in energy supply, volume of enteral nutrition prescribed and administered among eutrophic, underweight or overweight patients. Conclusion: The results of this study indicate that the prescription and energy supply were not based on the needs of these patients, causing a significant energy deficit, which can lead to worsening of the nutritional status of the same. In hospitalized patients in use of ENT, the energy requirement must be made by a qualified professional within the multidisciplinary team, based on the needs of each patient.

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Oncidium varicosum is a species of orchid that is prevalent in South America. This species produces yellow flowers, which are commonly named golden shower, ballet dancer and Anita's flower. The study of the post-harvest physiology of flowers involves examination of factors related to quality loss of cut flowers, which is related not only to several physiological processes but also to interactions between the floral components and qualitative factors. In this context, our research involved the study of physiological aspects of the post-harvest physiology of cut inflorescences of Oncidium varicosum ('Samurai') after treatment with pulsing solutions containing silver salts, 8-HQC and sucrose. A reduction of relative water content of Oncidium flowers treated with pulsing STS (2 mM) was observed. The soluble carbohydrates and reducing sugars content decreased, and higher contents were measured in flowers treated with STS (2 mM). All parameters related to flower coloration were reduced in all treatments. Similar results were obtained for carotenoid content, except for the STS treatment (2 mM), which differed significantly from the other treatments on the 8th and 12th days of vase life. The inflorescences' longevity varied from 12 days (distilled water) to 15 days (STS 2 mM).

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Mast cell tumor manifests as a localized proliferation of mast cells in the skin, or less frequently as a systemic disorder, which may be accompanied by the presence of neoplastic mast cells in the peripheral blood (mastocythemia). In some cases, the neoplastic circulating mast cells originate in the bone marrow, designated as mast cell leukemia, rarely observed in dogs, or the cells may arise from visceral mast cell tumors, characterizing systemic mastocytosis. The aim of this report was to describe a case of a six-year-old female German shepherd dog presenting with history of anorexia, hematemesis and diarrhea. The blood work revealed intense mastocythemia (43%), with degranulated mast cells, and anisocytosis. At necropsy, white nodular lesions in the thymic region and an infiltrative mass in mesenteric and abdominal lymph nodes were observed. Those lymph nodes were enlarged and off-white. Histopathological examination revealed neoplastic mast cells in the liver, spleen, lymph nodes, kidneys, lungs, gastric and enteric mucosae, and adrenal glands. The clinical, hematological and histopathological findings were compatible with mastocythemia, associated with a moderately differentiated visceral mast cell tumor.

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The liver of P. expansa was characterized morphohistologically. To this end, twenty livers from clinically healthy male and female Podocnemis expansa, weighing from 2.0 to 4,5 kg, supplied by the commercial breeder Fazenda Moenda da Serra, in Araguapaz, state of Goiás, Brazil, were analyzed macro-and microscopically. The coelomatic cavity was opened and the topography of the fresh organs was examined visually. After the histological preparation, the slides were stained with Hematoxylin and Eosin (HE), Periodic Acid-Schiff (PAS), Gomori Trichrome, Reticulin and Picrosirius. The liver of P. expansa is a voluminous organ with an approximately rectangular shape and brown coloration, varying from light to dark shades, and is divided into a right lobe, left lobe, and a central portion. The right lobe is the largest of the three portions. The gall bladder is located in a depression in the caudal portion of the right lobe, where the gall duct begins and empties into the duodenum. Histologically, the hepatocytes are arranged in the form of double cords surrounded by winding sinusoidal capillaries. In cross section, they resemble acini containing approximately two to five hepatocytes surrounding a probable central biliary canaliculus. The hepatocytes are polyhedral or pyramidal in shape, of uniform size, with a few central nuclei and others displaced peripherally, and the cytoplasm is little eosinophilic when analyzed by the HE staining technique. The parenchyma is supported by delicate reticular fibers surrounding hepatocytes and sinusoids. The parenchyma and perisinusoidal spaces contain large quantities of melanomacrophages, mainly close to the portal spaces.

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The aim of this study was evaluate the influence of physical exercise (marcha gait) on serum values of CK and AST The Ostrich (Struthio camelus) is originally from Africa and belongs to the ratite's family. Since its zootechnic value has been increasing, especially in the northwest region of the state of São Paulo, we studied the biliary system in the liver of this animal. To carry through it were used 20 ostrich livers, males and females, young and adults from place to production ostrich in the northwest region of the State of São Paulo. After the opening of the gastrointestinal tract and disposal of the bile through gentle massage, we cannulated the hepatic excretory duct with a flexible probe, compatible in size with the duct, and injected colored Neoprene latex 450 in the biliary system. Following this procedure, the livers were fixed in aqueous solution of formaldehyde to 10% dissected, schematized and photographed. The right main branch is derived from the right lateral, square lobe and the caudate process branches in 7 livers. In 13 livers, the right side branch is forned by the right side and caudate process branches. The left branch receives the components from the left lateral lobe and branch of the medial left lobe in 7 livers. It also receives component from the square lobe and from the caudate process in 13 and 7 livers, respectively.In conclusion, the ostrich liver has no gallbladder, causing the duct is the only route of excretion of bile, always resulting from the convergence of the right hepatic duct with the left hepatic duct.

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Catheter-related bacteremia (CRB) is one of the various complications related to hemodialysis (HD). As a result of this high rate of infection, the antibiotic lock technique (ALT) has been recommended to prevent CRB. However, adverse effects of ALT such as increased emergence of strains resistant to antibiotics and increased mechanical dysfunction catheter were poorly evaluated. We prospectively evaluated the efficacy of catheter-restricted filling using an antibiotic lock solution in preventing CRB. A total of 233 HD patients requiring 325 new tunneled catheters while waiting for placement and maturation of an arteriovenous fistula or graft were enrolled in this study. Patients with a tunneled catheter were assigned to receive either an antibiotic-heparin lock solution (antibiotic group: cefazolin 10 mg/ml, gentamicin 5 mg/ml, heparin 1,000 U/ml) or a heparin lock solution (no-antibiotic group: heparin 1,000 U/ml) as a catheter lock solution during the interdialytic period. The present study aimed to assess the efficacy of ALT using cefazolin and gentamicin in reducing CRB in patients undergoing HD with tunneled central catheter and to identify its adverse effects. CRB developed in 32.4 % of patients in the no-antibiotic group and in 13.1 % of patients in the antibiotic group. CRB rates per 1,000 catheter-days were 0.57 in the antibiotic group versus 1.74 in the no-antibiotic group (p < 0.0001). Kaplan-Meier analysis also showed that mean CRB-free catheter survival was significantly higher in the antibiotic group than in the no-antibiotic group (log-rank statistic 17.62, p < 0.0001). There was statistically significant difference between the two groups in causative organisms of CRB, with predominance of negative culture in both groups, but this prevalence was higher in ALT group (57.9 vs 90.1 %, p < 0.0001), and the two groups also were different in prevalence of gram-positive bacteria as causing organisms (ALT group 21.05 vs = 0 % in control group, p < 0.0001). There was no statistically significant difference between the two groups in drug-resistant germs. There were statistically significant differences between the two groups in the catheter removal causes, with higher rate of infectious cause in control group (12.32 vs 2.22 %, p < 0.0001) and mechanical cause in ALT group (28.26 vs 37.78 %, p < 0.0001). The results suggest that ALT may be a beneficial means of reducing the CRB rate in HD patients with tunneled catheter, without association between ALT and emergence of strains resistant. However, mechanical complications were more prevalent in antibiotic group. Further studies are required to determine the optimal drug regimen, concentrations for ALT, and its adverse effects. © 2012 Springer Science+Business Media Dordrecht.

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Sponge spicules are siliceous microfossils that are especially useful for analysis of sandy fluvio-lacustrine sediments. Sponge spicules in a long sediment core (~550 cm below surface), consisting of fine sand, sandy silt, and organic-rich mud, recovered from the floodplain of the Nabileque River, southern Pantanal, Brazil (S20°16′38. 3″/W57°33′00. 0″), form the basis of a novel paleoenvironmental interpretation for this region. Optically stimulated luminescence dates constrain the timing of deposition to the middle-late Holocene and all spicules identified are typical of the Brazilian cerrado biome. The base of the section is dominated by Oncosclera navicella Carter 1881, Metaniaspinata Carter 1881, and Corvospongilla seckti Bonetto and Ezcurra de Drago 1966, which indicate a lotic to semi-lotic environment strongly influenced by an actively meandering river channel at ~6. 7-5. 7 ka BP. The appearance of Heterorotula fistula Volkmer-Ribeiro and Motta 1995, Dosilia pydanieli Volkmer-Ribeiro 1992 and Radiospongilla amazonensis Volkmer-Ribeiro and Maciel 1983 at ~340 cm downcore suggests a reduction in flowing water and a more stable lentic environment, consistent with deposition in an oxbow lake. This oxbow lake environment existed during an interval of regional aridity between ~4. 5 and 3. 9 ka BP. Spicules, as well as phytoliths and diatoms, are highly variable moving up-section, with species from both lotic and lentic ecosystems present. Above ~193 cm, the total abundance of spicules declines, consistent with wetter climate conditions and development of an underfit river similar to the modern floodplain. Results support hypotheses related to migration of the Paraguay River inferred from geomorphological studies and add a key southern-region dataset to the emerging Holocene database of paleoenvironmental records from the Pantanal wetlands. © 2012 Springer Science+Business Media Dordrecht.

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In this work pellets containing chitosan for colonic drug delivery were developed. The influence of the polysaccharide in the pellets was evaluated by swelling, drug dissolution and intestinal permeation studies. Drug-loaded pellets containing chitosan as swellable polymer were coated with an inner layer of Kollicoat® SR 30 D and an outer layer of the enteric polymer Kollicoat® MAE 30 DP in a fluidized-bed apparatus. Metronidazole released from pellets was assessed using Bio-Dis dissolution method. Swelling, drug release and intestinal permeation were dependent on the chitosan and the coating composition. The drug release data fitted well with the Weibull equation, indicating that the drug release was controlled by diffusion, polymer relaxation and erosion occurring simultaneously. The film coating was found to be the main factor controlling the drug release and the chitosan controlling the drug intestinal permeation. Coated pellets containing chitosan show great potential as a system for drug delivery to the colon. © 2012 Elsevier Ltd.

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Purpose: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. Methods: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. Results: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. Conclusion: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin. © 2013 Springer-Verlag France.

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The 2,4 dichlorophenoxyacetic acid (2,4-D) is a systemic herbicide whose effects in animal organic systems have been examined in previous studies, being the neurotoxicity considered the predominant effect. However, the studies that detect the 2,4-D neurotoxicity have merely focused in the central nervous system, and therefore, little is known about the effect of this herbicide in the enteric nervous system. This study aimed to verifying the 2,4-D effects on the myenteric neurons in duodenum of Wistar rats. Ten 60-day-old male Wistar rats (Rattus norvegicus) were divided in two groups: control group (C) that did not receive 2,4-D and experimental group (E) that received 5.0 mg of 2,4-D/kg for 15 days. At the end of experimental period, the animal were euthanized, the duodenum was collected and processed for NADPH-diaphorase histochemical analysis in order to expose the nitrergic myenteric neurons (NADPH-dp). In the light microscopy analysis, the whole-mount preparation obtained from duodenum of each animal were image-captured in 120 and 40 fields, for quantitative and morphometric analyses of myenteric neurons, respectively. The neuronal density was not affected when comparing the two groups, but an increase (p > 0.05) of 8.5% was observed in the cell body area of neurons in the E group. In conclusion, the ingestion of 2,4-D at a dosage of 5.0 mg/kg body weight for 15 days does not change the neuronal density, but promotes the hypertrophy of NADPH-dp myenteric neurons in duodenum of the rats of this study.

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In vitro production and somatic cell nuclear transfer are biotechnologies widely used for breeding cattle, although may result in congenital anomalies. This paper aims to report a set of congenital anomalies in two Nelore calves, a male and a female, produced through in vitro fertilization. The major anomalies revealed at necropsy were hypospadias, bifid scrotum, atresia ani and rectum ending in blind pouch in the male calf. In the female calf accessory spleen, atresia ani, underdevelopment of extern genitalia and urethral orifice, and rectum ending in blind pouch forming a uterus-rectum fistula were observed.

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The aim of this paper was to report the diagnosis and evaluation of periradicular bone repair by using computed tomography and digital subtraction radiography in an endodontic surgery case treated with mineral trioxide aggregate (MTA). The patient had local swelling and fistula 7years after trauma in the upper jaw. Periapical lesion on tooth #12 and root resorption of tooth #11 were detected radiographically. Endodontic therapy and placement of intracanal medication were carried out. After 3months, with no improvement in the clinical signs and symptoms, computed tomography was performed, showing extensive apical bone resorption on tooth #12 and dental resorption promoting communication of the root canal with the periodontium of tooth #11. The patient was referred to endodontic surgery. After surgery and postoperative periods of 15, 30, 60, 90, and 120days, standardized radiographs were taken, digitized, and subjected to digital subtraction of the images using Adobe Photoshop CS software. Four years later, a cone-beam computed tomography was performed, showing bone repair and absence of root resorption at tooth #11. In this clinical case, digital subtraction radiography was effective for early detection of new bone formation and evolution of repair. © 2011 John Wiley & Sons A/S.