Morfina nasal: Avaliacao da analgesia e dos efeitos colaterais no tratamento da dor pos-operatoria em criancas

Background and Objectives - Postoperative pain is one of the major discomforts but often under treated, especially in the pediatric patient. The aim of this study was to evaluate nasal morphine postoperative analgesia as an alternative drug administration route and show its applicability, effectiveness, tolerability and side effects. Methods - Participated in this study 20 patients aged 3 to 13 years, physical status ASA I and II sequentially submitted the different small and medium-size surgeries. Analgesia was obtained with nasal morphine hydrochloride in aqueous solution in variable concentrations of 2%, 1%, 0.5%, 0.25% and 0.125%. The dose for each instillation has been 0.1 mg.kg -1 at three-hour intervals for 36 postoperative hours. Quality of analgesia in pre-verbal age patients was evaluated by a pain intensity scale based on facial expression and crying, sleep, motor activity, sociability and food ingestion was used. Standardized evaluations were performed at 3-hour intervals. A four-grade scale was used to evaluate tolerability, where: 1) Good; 2) Regular; 3) Bad; 4) Very bad. Result - Postoperative analgesia results have proven to be good and safe, especially from the third evaluation on (6 hours). Drug tolerability has been good, although side effects were observed, especially nausea and vomiting. Conclusions - Patients and relatives accepted the method very well. The nasal route was considered an adequate way for opioid administration although more studies are needed to accept it as a routine for postoperative morphine analgesia.

Observações clínicas, anatomopatológicas e tratamento de seis casos de dermovilite exsudativa vegetante crônica (cancro da ranilha) de cqüinos

Chronic hypertrophic pododermatitis cases in six horses of different breeds, aging 14 months to 19 years are described. The lesion begun with a infiltrative tissue in the frog and sole regions of the hoof, characterized by a fast and disorganized growth, with a papillary aspect, white colored in the roots and dark on the extremity, with a necrotic secretion and an extremely fetid odor. Microscopically, an exuberant epidermic proliferative tissue was observed, intermingled with little connective tissue. The horses were divided into two treatment groups. In the first group, including three young mares and a foal, showing lesions in only one limb, a surgical resection of the invasive mass was performed, followed by cauterization of the remaining edges and subsequent daily local application of antiseptic substances. In three of these horses, recurrence of the initial lesion occurred, with fast growth of hyperplasic tissue, affecting almost all the frog and half of the sole. Two horses developed contraction deformities of the hoof. In the second group, one male and one female, each with lesions in two limbs, after surgical debridement of the tissue, the animals received daily applications of picric acid 5%, associated to local use of oxitetracyclin. Although one of these cases required a second surgical intervention for removal of the mass, the horses showed after a period of two to three months total absence of the infiltrative tissue. The use of local picric acid 5% and oxitetracyclin associated to previous surgical debridement showed to be more efficient than the use of antiseptic substances in the treatment of chronic hypertrophic pododermatitis.

Efeito de drogas utilizadas no tratamento de hipertensão arterial sistêmica sobre a pressão intra-ocular: Estudo experimental no cão

Purpose: To study the effects of two drugs (captopril and propranolol) used in the treatment of systemic hypertension, on the intraocular pressure (IOP) of anesthetized dogs. Methods: 24 dogs, divided into 3 groups of 8 each. In the first group, 1.5 mg/kg IV of captopril (an angiotensin converting enzyme inhibitor) was administered. In the second group, 1.5 mg/kg IV of propranolol (a beta-blocker) was administered. The third group was the control. IOP and blood pressure (BP) were measured by manometry. The perfusion pressure was calculated by the difference between BP and IOP (BP-IOP). The parameters were studied at 6 moments (0, 10, 30, 60, 90 and 120 minutes). Results: There was significant reduction of IOP (p<0.05) with captopril and propranolol, without difference between the drugs. With captopril the BP and PP decreased markedly at 10 and 30 minutes. With propranolol there was no reduction of BP or PP. Conclusions: Captopril and propranolol reduced IOP. However, the marked reduction of BP, and consequently of PP caused by captopril may be undesirable for irrigation of the optic nerve.

Valor nutritivo de macrófitas aquáticas flutuantes (Eichhornia crassipes, Pistia stratiotes e Salvinia molesta) utilizadas no tratamento de efluentes de aqüicultura

The aim of this study was to evaluate the nutritive value of free-floating aquatic macrophytes, Eichhornia crassipes (Mart.) Solms (Pontederiaceae), Pistia stratiotes (L.) (Araceae) and Salvinia molesta (Mitchell) (Salviniaceae) used in a Nile tilapia (Oreochromis niloticus) waste treatment, and these species biomass potential uses. The vegetal biomass samples were collected from 0.25 m 2 floating squares and divided in aerial and submerse parts, to determine the concentrations of cell wall fraction, soluble carbohydrates, polyphenols, lipids, crude protein and total phosphorus. The higher nutritive value was observed in E. crassipes and S. molesta aerial parts, and in P. stratiotes total biomass, due to their lower cell wall fraction mean rates (60.7; 64.2 and 56.9 % dry mass, respectively) and to the higher rates of: crude protein (10.1; 9.1 and 8.8 % dry mass, respectively), soluble carbohydrates (26.6; 18.7 and 12.4 mg.g -1 dry mass, respectively) and lipids (7.6; 4.5 and 4.4% dry mass, respectively). It may be concluded that P. stratiotes total biomass, and E. crassipes and S. molesta aerial biomass have nutritive values with potential use for ruminant feeding or as ration ingredients.

Efeito do Tratamento com Hidróxido de Sódio sobre a Fração Fibrosa, Digestibilidade e Tanino do Feno de Jurema-Preta (Mimosa tenuiflora. Wild)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Monitoramento sanitário de um sistema integrado de tratamento de águas residuárias da suinocultura

Objective. To assess the potential for contamination of wastewaters from pig farming. Methods. Wastewaters from pig farming were stored in a tank. After 0, 30, 60, 90, and 120 days of hydraulic retention, they were added to lysimeters filled with argillaceous, sandy, or medium soil. Finally, these lysimeters were submitted to simulations of either a rainy season or a dry season. The number of colony-forming units (CFUs) of total coliforms, fecal coliforms, and fecal streptococci was measured in the effluents of the storage tank (for the various periods of hydraulic retention), in the percolate from the lysimeters, and in the three types of soil. The microbiological analyses were carried out using the membrane filter technique. The pH analyses were done potentiometrically. Results. For the three microorganisms, the largest decrease in bacterial counts in the storage tanks occurred with 90 or 120 days of retention. There was a marked decrease in the bacterial count in the percolates of the three soils. For the three soil types the greatest reduction in bacterial counts was found in medium soil, due to its acidity (pH < 7.0). Hydraulic retention was not sufficient to ensure the sanitary adequacy of the wastewaters and their use for irrigation, given that fecal coliform values were above 1 000 CFU per 100 mL. Therefore, adding the residues to the soil was considered a second stage of treatment. Conclusions. The retention of wastewaters followed by adding them to soil was effective in minimizing the contaminating effect of pig farming residues. The storage time for wastewaters from pig farming could be decreased from 120 to 90 days.

Tratamento do carcinoma metastático

The renal cell carcinoma (RCC) is the seventh most common malignancy, accounting for more than 3% of cancer incidence in the United States. RCC is more common in males, occurring primarily in the 5 th to 7 th decades of life. At the time of presentation one third of the patients have advanced disease and about 50% of the patients that underwent radical nephrectomy have recurrence. With the mainstream implementation of imaging modalities, such as ultrasound, the incidental detection of RCC has dramatically increased in recent years. Patients with metastatic RCC without treatment have na average survival of 6 to 10 months, and only 10 to 20% can be expected to survive 2 years. Treatment for patients with advanced disease remains unsatisfactory and the metastatic renal cancer continue to present a therapeutic challenge systemic therapies employed in patients with this tumor include chemotherapy, hormonal therapy, and immunotherapy. The authors review the treatment strategies of the metastatic renal cell carcinoma (RCC).

Produtos naturais como candidatos a fármacos úteis no tratamento do mal de Alzheimer

Alzheimer's disease (AD) is a progressive neurodegenerative pathology with severe economic and social impact. There is currently no cure, although cholinesterase inhibitors provide effective temporary relief of symptoms in some patients. Nowadays drug research and development are based on the cholinergic hypothesis that supports the cognition improvement by regulation of the synthesis and release of acetylcholine in the brain. There are only four commercial medicines approved for treatment of AD and natural products have played an important role in the research for new acetylcholinesterase inhibitors.

Injeção subaracnóidea inadvertida de corticoíde em tratamento de dor crônica da coluna lombar. Relato de caso

BACKGROUND AND OBJECTIVES: Before epídural steroids were used in chronic lumbar pain, subarachnoid injection of these agents was the treatment of choice. Although still preconized by some authors, this technique may lead to severe complications with neurological sequelae. This report aimed at describing a case of accidental subarachnoid injection of steroid associated to local anesthetics during epidural puncture to treat lumbar pain. CASE REPORT: Male patient, 46 years old, followed byneuro-surgery for presenting right sciatic pain for 9 month, refractory to clinical treatment due to L 4-L 5 disk protrusion confirmed by CT scan, without neurological deficit. Epidural puncture for pain treatment was performed in L 4-L 5 with 17G needle and 10 mL solution were injected containing 4 mL of 0.25% bupivacaine, 80 mg methylprednisolone and 4 mL of 0.9% saline. Although there has not been CSF reflux, 5 minutes after injection there were sensory block in T 4 and motor block in T 6, associated to blood pressure and heart rate decrease. CONCLUSIONS: Accidental subarachnoid injections with the association of steroids for pain relief may cause adverse effects. There are several risks, varying from mild transient symptoms to nervous injuries, including spinal cord injuries. Our patient had no sequelae from the accidental subarachnoid injection, probably because it has been a single injection.

Dispersão de bioaerossóis por aeradores em uma estação de tratamento de esgoto sanitário

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

Avaliação histológica da hipoderme de suínos submetida a tratamento mesoterápico com tiratricol, cafeína e hialuronidase

The aim of this research was to evaluate histologically the skin of swines submitted to mesotherapy with tiratricol, caffeine and hyaluronidase. Histological processing was conducted in Hematoxilin and Eosin (HE) of the skin of swines treated being obtained measures of thickness of the hipodermis using a Zeiss ocular micrometer. It was verified that the treatments with tiratricol and caffeine provoked reduction of the thickness of the hipodermis (42.3% and 55.3%, respectively, p<0.05). The mesotherapy with hyaluronidase did not present significant results (17.5,p>0.05).

Proteína da matriz do esmalte associada a R.T.G. e vidro bioativo no tratamento de furca grau III em cães

This study investigated, both histologically and histometrically, the efficacy of enamel matrix derived proteins (EMD) associated with bioactive glass (BG) and an absorbable membrane in the treatment of class III furcation defects in mongrel dogs. After surgical defect creation and chronification, the lesions were randomly divided into three groups according to the treatment employed: Test Group 1 - EMD + BG + membrane, Test Group 2 - EMD + membrane and Control Group - BG + membrane. After a 90-day healing period, the dogs were sacrificed. The descriptive analysis and the histometric data showed similar results for the experimental groups in all studied parameters (MANOVA, p > 0.05). The association of Emdogain® with bioglass and GTR, or with GTR only, showed similar results when compared with the ones obtained with bioglass associated with membrane in the treatment of class III furcation defects in dogs. The three modalities of treatment showed partial filling of the furcations, with bone and cementum regeneration limited to the apical portion of the defects.

Eficácia e segurança da atorvastatina no tratamento de pacientes com hipercolesterolemia primária

Introduction: Hypercholesterolemia is an important risk factor for cardiovascular disease, the first cause of death and third reason for hospital admissions in Brazil. The reduction of serum cholesterol levels reduces morbidity and mortality from cardiovascular disease. The present study evaluated the efficacy and safety of atorvastatin in the treatment of Brazilian patients with primary hypercholesterolemia (types IIA and IIB dyslipidemias). Patients and methods: After a 4-week wash-out period, 152 patients were treated with atorvastatin at the initial dose of 10 mg/day. According to treatment efficacy within the first 8 weeks this dose could be increased to 20 mg/day. Treatment lasted for a total of 16 weeks, and its efficacy was evaluated by the reduction of serum levels of LDL-cholesterol, total cholesterol, HDL-cholesterol, and triglycerides, as well as by the propotion of patients that achieved the target levels recommended by the National Cholesterol Education Program - Adult Treatment Panel II (NCEP ATP II) Results: The analysis of efficacy was conducted in 145 patients. Atorvastatin led to significant reductions in the levels of LDL-cholesterol after 8 and 16 weeks of treatment (P<0.001 for both comparisons). The relative reduction of such levels was 38% (P<0.001 after 8 and 16 weeks). Atorvastatin also led to significant reductions of total cholesterol and triglycerides. At the end of the study, 81% of patients achieved the target LDL-cholesterol levels recommended by NCEP ATP II. Treatment was well tolerated, and was interrupted due to creatine phosphokinase elevation in only one patient. Conclusion: Atorvastatina is efficacious and safe in the treatment of patients with primary hypercholesteromia. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Efeito do tratamento com algumas vitaminas B na potencializaçã o do efeito antiinflamatório e antinociceptivo do diclofenaco e da talidomida

The effects of some B vitamins on chemical nociception in mice or paw edema in rats were investigated. A combination of thiamine (B1), pyridoxine (B6) and cyanocobalamin (B12), in doses of 100,100 and 5mg/kg, i.p., respectively, potentiated the inhibition by diclofenac or thalidomide of paw edema induced by carrageenin in rat. Antinociceptive effects of diclofenac and thalidomide inhibition of abdominal contortion were also potentiated by the combination of the vitamins B1, B6 and B12. Thiamine, pyridoxine and cyanocobalamin given singly were effective in potentiating antinociceptive effects of thalidomide, but only cyanocobalamin potentiated these effects of diclofenac, probably reflecting the differing mechanisms of action of the two drugs. The results document the positive influence of B vitamins on antinociceptive effects of diclofenac or thalidomide and support the use of B vitamins to shorten the treatment time and reduce the daily dose of anti-inflammatories.

Obstrução nasolacrimal congênita - Diagnóstico e tratamento

This article assembled the congenital lacrimal obstruction according embryology, clinical presentation, propedeutic exams and other differential anomalies.