944 resultados para Venous thromboembolism


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Food base excess (BE, mEq/kg) can be calculated from the diet macroelements, together with either the sulfur amino acids methionine and cysteine (BEaa) or total sulfur (BEs) concentrations. The present study compared the use of sulfur or methionine and cysteine for calculating the food BE (experiment 1) and investigated the influence of food BE on blood gas analysis and the urine pH of cats, and proposes a prediction equation to estimate the urine pH of cats fed kibble diets based on the calculated food BE (experiments 2 and 3). In experiment 1, nine healthy, adult cats were used in a change-over design and fed with nine commercial dry cat foods. The cats were housed in metabolism cages over seven days for adaptation and three days for total urine collection. All of the urine produced over 24h was pooled by cat and diet. The cats' acid-base status was assessed through blood gas analysis after 10 days of diet consumption. A mean difference of -115mEq/kg between BEs and BEaa was observed, which could be explained by a greater concentration of sulfur in the whole diet than in methionine and cysteine. Urine pH presented a stronger correlation with food BEs (R2=0.95; P<0.001) than with food BEaa (R2=0.86; P<0.001). Experiment 2 included 30 kibble diets, and each diet was tested in six cats. The food BEs varied between -180 and +307mEq/kg, and the urine pH of the cats varied between 5.60 and 7.74. A significant correlation was found between the measured urine pH and the food BEs (urinary pH=6.269+[0.0036×BEs]+[0.000003×BEs2]; R2=0.91; P<0.001). In experiment 3, eight kibble diets were tested (food BEs between -187mEq/kg and +381mEq/kg) to validate the equation proposed in experiment 2 and to compare the obtained results with previously published formulae. The results of the proposed formula presented a high concordance correlation coefficient (0.942) and high accuracy (0.979) with the measured values, and the estimates of urine pH did not differ from the values obtained in cats (P>0.05). The cats' venous blood pH, bicarbonate, and blood BE were correlated with food BEs (P<0.001); the consumption of diets with low food BEs induced a reduction in these parameters. In conclusion, food macroelement composition has a strong influence on cats' acid-base equilibrium and food BEs calculation is a useful tool to formulate and balance kibble diets for felines. © 2013 Elsevier B.V.

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Introduction. Cerebral Venous Thrombosis has a highly variable clinical presentation. Four major syndromes had been described in patients with cerebral venous thrombosis: isolated intracranial hypertension, focal neurological deficits, focal or generalized seizures and disturbances of consciousness and cognitive dysfunction. Method. We describe five consecutive patients admitted to our service with a diagnosis of cerebral venous thrombosis, highlighting the different possibilities of clinical presentation and prognosis. Discussion. The diagnosis of cerebral venous thrombosis should be considered in patients with acute, subacute or chronic headache, with or without signs of intracranial hypertension or focal deficits, even in the absence of cerebrovascular risk factors. Treatment should be started as soon as the diagnosis is confirmed and consists of reversal of the underlying cause when known, control of seizures and intracranial hypertension, and antithrombotic therapy.

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Background: Tumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications.Results: The heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation.Conclusions: Compared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing. © 2013 Credie et al.; licensee BioMed Central Ltd.

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Pós-graduação em Anestesiologia - FMB

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

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Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)