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Preparamos este manual para que você fique por dentro de tudo que vai acontecer durante seu tratamento. Aqui você encontrará as rotinas e os cuidados necessários antes, durante e após a sua cirurgia, com todas as informações para passar por esse momento com tranquilidade. Fique atento aos documentos e exames necessários. Caso tenha alguma dúvida, entre em contato com o hospital!

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Hemoplasmas are bacteria able to adhere themselves loosely to the plasma membrane of erythrocytes and may parasitize several species of mammals. There are three known species of hemoplasmas that parasitize domestic and wild cats: Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and 'Candidatus Mycoplasma turicensis'. Dogs are infected by at least two species of hemoplasmas: 'Candidatus Mycoplasma haematoparvum' and Mycoplasma haemocanis. The hemoplasmoses are very important in veterinary clinics, either because of its worldwide distribution and severity of clinical signs, depending on parasite species and host immune competence, or due to its zoonotic potential and capability of infecting endangered species. This study set out to investigate which hemoplasmas species parasitize different captive wild carnivores in order to clarify the epidemiology of hemoplasmoses in wild animals. Furthermore, the research intended to characterize the hematological changes caused by different species of hemotropic mycoplasmas infection in order to establish their clinical importance to wild species and the capacity of these species to become a reservoir of studied agents. Samples of 33 wild felids and 18 wild canids were investigated using polymerase chain reaction (PCR) to detect hemoplasmas DNA and it was observed that the occurrence of infection in these species is 45.5% and 83.3%, respectively. Factors such as age, gender or anaemia are not more frequent in animals positive for the infection. Therefore, it is concluded that infection caused by hemoplasmas in wild carnivores has high prevalence, and either agent pathogenicity is low, or chronic stage is more frequent, resulting in a low rate of diagnosis.(AU)

Hemoplasmas são bactérias capazes de aderir frouxamente à membrana plasmática de eritrócitos e que podem parasitar diversas espécies de mamíferos. São conhecidas três espécies de hemoplasmas que parasitam felídeos domésticos e selvagens: Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and 'Candidatus Mycoplasma turicensis'. Cães são infectados por ao menos duas espécies de hemoplasmas: Candidatus Mycoplasma haematoparvum' and Mycoplasma haemocanis. As hemoplasmoses são de grande importância na clínica veterinária, tanto pela sua distribuição ubíqua e severidade dos sinais clínicos, a depender da espécie do parasita e imunocompetência do hospedeiro, quanto pelo seu potencial zoonótico e capacidade de infectar espécies ameaçadas. Este estudo visa investigar quais espécies de hemoplasmas parasitam diferentes carnívoros selvagens de cativeiro, a fim de esclarecer a epidemiologia das hemoplasmoses em animais selvagens. Além disso, o trabalho objetivou caracterizar as alterações hematológicas causadas pela infecção por diferentes espécies de micoplasmas hemotrópicos visando estabelecer sua importância clínica para espécies selvagens e a capacidade destas espécies de se tornar reservatórios dos agentes estudados. Amostras de 33 felídeos selvagens e de 18 canídeos selvagens foram investigadas por meio da reação em cadeia da polimerase (RCP) para detectar o DNA dos agentes e foi observado que a ocorrência da infecção por hemoplasmas nestas espécies é de 45,5% e 83,3%, respectivamente. Fatores como idade, sexo ou anemia não são mais frequentes em animais positivos para a infecção. Dessa forma, conclui-se que a infecção causada por hemoplasmas em carnívoros selvagens possui alta prevalência, no entanto ou a patogenicidade dos agentes é baixa ou o estágio crônico da infecção é mais frequente, resultando em uma baixa frequência diagnóstica.(AU)

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OBJECTIVES: The objectives of this study were to estimate the prevalence of feline haemoplasma infections in Northern Serbia, identify potential risk factors and perform molecular subtyping of feline immunodeficiency virus (FIV). METHODS: PCR analysis for feline haemoplasmas was performed on surplus EDTA blood samples from 373 cats from the Belgrade region, Serbia. An ELISA was used to determine the prevalence of feline leukaemia virus (FeLV) and FIV; PCR was performed on a subpopulation of these cats. FIV subtyping was performed using PCR. RESULTS: Within this population, 64/373 cats (17.2%) were infected with one or more haemoplasma species. Mycoplasma haemofelis was detected in 20/373 cats (5.4%), 'Candidatus Mycoplasma haemominutum' in 47/373 cats (12.6%) and 'Candidatus Mycoplasma turicensis' in 23/373 cats (6.2%). Coinfections were observed in 21/373 cats (5.6%). Based on ELISA serological retroviral testing, 4/310 cats (1.3%) were infected with FeLV, whereas 78/331 (23.6%) were infected with FIV. Multivariable analysis identified significant associations between haemoplasma infection and anaemia (anaemic/non-anaemic, odds ratio [OR] 2.7, 95% confidence interval [CI] 1.04-7.1; P = 0.041]), male gender (male/female, OR 4.5, 95% CI 2.22-9.03; P <0.0005), outdoor access (yes/no, OR 5.2, 95% CI 2.28-11.92; P <0.0005), non-pedigree breed (non-pedigree/pedigree, OR 5.5, 95% CI 1.24-24.84; P = 0.025) and FIV seropositive status (positive/negative, OR 2.4, 95% CI 1.21-4.83; P = 0.012). PCR analysis of the FIV ELISA-positive samples revealed clade D as being the most prevalent. CONCLUSIONS AND RELEVANCE: All three known species of feline haemoplasma were detected, confirming their presence in Serbia; 'Candidatus Mycoplasma haemominutum' was the most prevalent. We found a high prevalence of FIV-infected cats and FIV clade D was most prevalent.

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Mycoplasma haemofelis is the agent of feline infectious anemia, although Candidatus M. haemominutum can also be associated. This study evaluated the frequency and hematological alterations caused by hemoplasma infections and co-infections with FeLV, FIV and Toxoplasma gondii in domestic cats from two distinct areas (urban - G1 and periurban - G2) of Brasília, Brazil. One hundred cats were evaluated, 51 from the G1 area and 49 from G2. No cats were positive for T. gondii. Hemoplasma infection was diagnosed in 33% cats from G1 and 32.6% from G2 (p>0.05). In G1 35.3% of the positive cats were infected with Mycoplasma haemofelis, 47.06% with Candidatus Mycoplasma haemominutum and 17.64% with mixed hemoplasma species infection; 12.5% of the cats identified as PCR positive in G2 were infected with Mycoplasma haemofelis, 18.75% with Candidatus Mycoplasma haemominutum and 68.75% with mixed infection. Cats from the periurban area had higher mixed hemoplasmas infection rates than those from urban area, and most of them were asymptomatic carriers. Cytology results were positive in only 5% of cats from G1. Mycoplasma haemofelis infected cats had normocytic normochromic anemia while the cats infected with Candidatus Mycoplasma haemominutum or with both species did not. 37.2% of G1 cats were co-infected with Mycoplasma haemofelis and FeLV, and presented lower PCV and hemoglobin concentration than those infected only with Mycoplasma haemofelis. The co-infection with Candidatus Mycoplasma haemominutum and FeLV produced lower WBC, segmented cells and platelets, and increased total protein concentration.(AU)

Mycoplasma haemofelis é o principal agente causador da anemia infecciosa felina, apesar de outras espécies de hemoplasmas, Candidatus M. haemominutum e Candidatus M. turicensis, também estarem associadas à hemoplasmose felina. O presente estudo avaliou a frequência de hemoplasmas, as principais alterações hematológicas associadas com a infecção e co-infecções com FeLV, FIV e Toxoplasma gondii em gatos domésticos de duas áreas diferentes (urbana - G1 e periurbana - G2) de Brasília, Brasil. 100 gatos foram avaliados, 51 de G1 e 49 de G2. Nenhum gato foi positivo para T. gondii. Hemoplasmose foi diagnosticada em 33% dos gatos de G1 e 32,6% de G2 (p>0,05). Em G1, 35.3% dos gatos hemoplasma positivos estavam infectados por Mycoplasma haemofelis, 47,06% por Candidatus Mycoplasma haemominutum e 17,64% apresentaram infecção concomitante por Mycoplasma haemofelis e Candidatus Mycoplasma haemominutum. Em G2, 12,5% dos gatos hemoplasma positivos estavam infectados por Mycoplasma haemofelis, 18,75% por Candidatus Mycoplasma haemominutum e 68,75% apresentaram infecção concomitante por Mycoplasma haemofelis e Candidatus Mycoplasma haemominutum. Gatos da região periurbana eram, em sua maioria, assintomáticos e apresentaram mais infecção concomitante por duas espécies de hemoplasmas do que gatos da região urbana. Os resultados da citologia foram positivos apenas em 5% dos gatos de G1. Gatos com infectados apenas com Mycoplasma haemofelis apresentaram anemia normocítica normocrômica e gatos com infecção única com Candidatus Mycoplasma haemominutum ou em combinação com Mycoplasma haemofelis não apresentaram alterações hematológicas. 37,2% dos gatos de G1 estavam co-infectados por Mycoplasma haemofelis e FeLV, e apresentaram VG e concentração de hemoglobina menores do que os gatos infectados apenas por Mycoplasma haemofelis. A co-infecção por Candidatus Mycoplasma haemominutum e FeLV resultou em baixo número de leucócitos, segmentados e plaquetes, além de aumento das concentrações de proteínas totais.(AU)

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Mycoplasma haemofelis is the agent of feline infectious anemia, although Candidatus M. haemominutum can also be associated. This study evaluated the frequency and hematological alterations caused by hemoplasma infections and co-infections with FeLV, FIV and Toxoplasma gondii in domestic cats from two distinct areas (urban - G1 and periurban - G2) of Brasília, Brazil. One hundred cats were evaluated, 51 from the G1 area and 49 from G2. No cats were positive for T. gondii. Hemoplasma infection was diagnosed in 33% cats from G1 and 32.6% from G2 (p>0.05). In G1 35.3% of the positive cats were infected with Mycoplasma haemofelis, 47.06% with Candidatus Mycoplasma haemominutum and 17.64% with mixed hemoplasma species infection; 12.5% of the cats identified as PCR positive in G2 were infected with Mycoplasma haemofelis, 18.75% with Candidatus Mycoplasma haemominutum and 68.75% with mixed infection. Cats from the periurban area had higher mixed hemoplasmas infection rates than those from urban area, and most of them were asymptomatic carriers. Cytology results were positive in only 5% of cats from G1. Mycoplasma haemofelis infected cats had normocytic normochromic anemia while the cats infected with Candidatus Mycoplasma haemominutum or with both species did not. 37.2% of G1 cats were co-infected with Mycoplasma haemofelis and FeLV, and presented lower PCV and hemoglobin concentration than those infected only with Mycoplasma haemofelis. The co-infection with Candidatus Mycoplasma haemominutum and FeLV produced lower WBC, segmented cells and platelets, and increased total protein concentration.

Mycoplasma haemofelis é o principal agente causador da anemia infecciosa felina, apesar de outras espécies de hemoplasmas, Candidatus M. haemominutum e Candidatus M. turicensis, também estarem associadas à hemoplasmose felina. O presente estudo avaliou a frequência de hemoplasmas, as principais alterações hematológicas associadas com a infecção e co-infecções com FeLV, FIV e Toxoplasma gondii em gatos domésticos de duas áreas diferentes (urbana - G1 e periurbana - G2) de Brasília, Brasil. 100 gatos foram avaliados, 51 de G1 e 49 de G2. Nenhum gato foi positivo para T. gondii. Hemoplasmose foi diagnosticada em 33% dos gatos de G1 e 32,6% de G2 (p>0,05). Em G1, 35.3% dos gatos hemoplasma positivos estavam infectados por Mycoplasma haemofelis, 47,06% por Candidatus Mycoplasma haemominutum e 17,64% apresentaram infecção concomitante por Mycoplasma haemofelis e Candidatus Mycoplasma haemominutum. Em G2, 12,5% dos gatos hemoplasma positivos estavam infectados por Mycoplasma haemofelis, 18,75% por Candidatus Mycoplasma haemominutum e 68,75% apresentaram infecção concomitante por Mycoplasma haemofelis e Candidatus Mycoplasma haemominutum. Gatos da região periurbana eram, em sua maioria, assintomáticos e apresentaram mais infecção concomitante por duas espécies de hemoplasmas do que gatos da região urbana. Os resultados da citologia foram positivos apenas em 5% dos gatos de G1. Gatos com infectados apenas com Mycoplasma haemofelis apresentaram anemia normocítica normocrômica e gatos com infecção única com Candidatus Mycoplasma haemominutum ou em combinação com Mycoplasma haemofelis não apresentaram alterações hematológicas. 37,2% dos gatos de G1 estavam co-infectados por Mycoplasma haemofelis e FeLV, e apresentaram VG e concentração de hemoglobina menores do que os gatos infectados apenas por Mycoplasma haemofelis.[...]

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A cirurgia minimamente invasiva se tornou mais utilizada no campo da ginecologia oncológica. O objetivo deste texto é abordar o seu uso, descrevendo suas indicações, vantagens e desvantagens em relação à laparotomia. As técnicas laparoscópicas continuam a evoluir e novos meios de abordagem como a laparoscopia roboticamente assistida e a laparoscopia por portal único estão também se difundindo. No câncer de endométrio, esse tipo de cirurgia vem sendo utilizada para estadiamento ou mesmo para tratamento de casos em estágios iniciais. No câncer de ovário, destaca­se seu uso para avaliação, diagnóstico e tratamento dos estádios iniciais, tratamento cirúrgico de casos avançados, avaliação da viabilidade de uma cirurgia citorredutora, abordagem após remissão completa com o tratamento primário e citorredução em caso de recorrência da doença. No câncer de colo uterino, vem sendo realizadas histerectomia radical, linfadenectomia e até mesmo alguns casos de exenteração. De uma maneira geral, os benefícios da cirurgia minimamente invasiva são: menores problemas relacionados com a ferida operatória, maior conforto da paciente, melhor visualização do campo cirúrgico, menor perda sanguínea durante o procedimento, recuperação em menor período de tempo, diminuição da necessidade de analgésicos, menor tempo de hospitalização, recuperação precoce e melhora da qualidade de vida. Porém, o tempo de cirurgia por via aberta ainda é menor quando comparado à laparoscópica e robótica

Minimally invasive surgery is increasingly being used in the field of gynecologic oncology. The objective of this paper is to describe its indications, advantages and disadvantages compared to laparotomy. Laparoscopic techniques continue to evolve and new approaches as robotically assisted laparoscopy and single incision laparoscopy had emerged. In endometrial cancer, laparoscopy has been used for staging or definitive treatment of selected cases. In ovarian cancer, it is used for assessment, diagnosis and treatment of early stages, surgical treatment of advanced cases, and to assess the viability of a cytoreductive surgery approach. In cervical cancer, it has been used for radical hysterectomy, lymphadenectomy and even some cases of pelvic exenteration. In general, the benefits of minimally invasive surgery are minor problems with the wound, increased patient comfort, better visualization of the surgical field, less blood loss during the procedure, shorter recovery time, reducing the need of painkillers, shorter hospital stay, early recovery, and improved quality of life. However, the surgical time of laparotomy is still shorter when compared to laparoscopic and robotic approaches

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A ocorrência de sintomas neurológicos agudos em gestantes ou puérperas não é incomum. Podem ser causados tanto pela exacerbação de uma doença neurológica pré-existentes quanto por doenças relacionadas com a própria gravidez. O diagnóstico preciso é essencial para o tratamento adequado. Sendo assim, é recomentado acompanhamento multidisciplinar antes, durante e após a gravidez. O objetivo do presente estudo é realizar uma revisão da literatura sobre as principais síndromes neurológicas durante a gravidez, descrevê-las e elucidar como é feito o diagnóstico adequado. Para isso, foi realizada uma busca de artigos na base de dados do Medline, via Pubmed, sendo selecionados artigos publicados nos últimos 10 anos, nas línguas inglesa ou portuguesa. Desse modo, o presente estudo demonstra a importância de saber reconhecer e tratar adequadamente cada uma dessas síndromes, bem como de um acompanhamento em centro de referência, uma vez que as síndromes neurológicas estão relacionadas com morbidade e mortalidade materna.(AU)

The occurrence of acute neurological symptoms in pregnant women and during puerperium is not uncommon. This symptoms can be caused both by the exacerbation of a preexisting neurological disease and illnesses related to the pregnancy itself. The accurate diagnosis is essential for proper treatment. Therefore, it is recommended that a multidisciplinary monitoring before, during and after pregnancy. The aim of this study is to conduct a review of the literature on the main neurological syndromes during pregnancy, describe them and elucidate how is made the proper diagnosis. For this, a search for articles on Medline database, via Pubmed was performed, being selected articles published in the last 10 years, in English or Portuguese languages. Thus, the present study demonstrates the importance of knowing recognize and properly handle each of these syndromes, as well as a follow-up in tertiary centers, once the neurologicalsyndromes are related to maternal morbidity and mortality.(AU)

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Mycoplasma haemofelis (Mhf), 'Candidatus Mycoplasma haemominutum' (CMhm) and 'Candidatus Mycoplasma turicensis' (CMt) are agents of feline haemoplasmosis and can induce anaemia in cats. This study aimed to determine the prevalence and phylogeny of haemoplasma species in cats from Brazil's capital and surrounding areas, and whether correlation with haematological abnormalities existed. Feline haemoplasmas were found in 13.8% of 432 cats. CMhm was the most prevalent species (in 13.8% of cats), followed by Mhf (11.1%) and CMt (4.4%). Over 80% of haemoplasma-infected cats harboured two or more feline haemoplasma species: 7.1% of cats were co-infected with Mhf/CMhm, 0.4% with CMhm/CMt and 3.9% with Mhf/CMhm/CMt. Male gender was significantly associated with haemoplasma infections. No association was found between qPCR haemoplasma status and haematological variables, however CMhm relative copy numbers were correlated with red blood cell (RBC) numbers and packed cell volume (PCV). Haemoplasma 16S rRNA gene sequences (> 1 Kb) were derived from co-infected cats using novel haemoplasma species-specific primers. This allowed 16S rRNA gene sequences to be obtained despite the high level of co-infection, which precluded the use of universal 16S rRNA gene primers. Within each species, the Mhf, CMhm and CMt sequences showed > 99.8%, > 98.5% and > 98.8% identity, respectively. The Mhf, CMhm and CMt sequences showed > 99.2%, > 98.4% and > 97.8% identity, respectively, with GenBank sequences. Phylogenetic analysis showed all Mhf sequences to reside in a single clade, whereas the CMhm and CMt sequences each grouped into three distinct subclades. These phylogeny findings suggest the existence of different CMhm and CMt strains.

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Background: central nervous system (CNS) hyperperfusion is one of the events that constitute the pathophysiological basis for the clinical manifestations and complications of pre-eclampsia (PE). Detecting the increased flow in the CNS through Doppler flowmetry of the ophthalmic artery might precede the clinical onset of PE and could be used as a marker for subsequent development of PE. Objective: to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE. Objective: to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE. Methods: a total of 73 patients with risk factors for the development of PE were selected from the prenatal service at the HC-UFMG. They were submitted to ophthalmic artery Doppler flowmetry between 24 and 28 weeks of pregnancy and monitored until the end of the pregnancy to verify the occurrence of PE. ROC curves were created to determine the predictive characteristics of the OARI. Results: fourteen of the patients selected developed PE and 59 remained normotensive until the postpartum period. Patients with subsequent development of PE presented OARI values lower than patients that remained normotensive (0.682±0.028 X 0.700±0.029, p=0.044). Considering the development of PE as an outcome, the area under the OARI curve was 0.694 (CI 0.543 to 0.845), with no points obtaining good values of sensitivity or specificity. Conclusion: Doppler flowmetry of ophthalmic arteries between 24 and 28 weeks of pregnancy did not present itself as a good exam for predicting PE. .

Introdução: a hiperperfusão do sistema nervoso central (SNC) é um dos eventos que constitui substrato fisiopatológico para as manifestações clínicas e complicações da pré-eclâmpsia (PE). O fluxo aumentado no SNC, detectado por meio da dopplerfluxometria de artérias oftálmicas, poderia anteceder as manifestações clínicas da PE e, consequentemente, ser utilizado como marcador de subsequente desenvolvimento de PE. Objectivo: avaliar os valores do índice de resistência das artérias oftálmicas (Irao) no segundo trimestre gestacional para a predição das manifestações clínicas da PE. Métodos: pacientes com fatores de risco para desenvolvimento de PE foram selecionadas no serviço de pré-natal do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG). Elas foram submetidas à dopplerfluxometria de artérias oftálmicas entre 24 e 28 semanas de gestação e acompanhadas até o final da gestação para averiguar a ocorrência de PE. Curvas ROC foram criadas para determinar as características preditivas do Irao. Resultados: das pacientes selecionadas, 14 desenvolveram PE e 59 mantiveram-se normotensas até o puerpério. Pacientes com subsequente desenvolvimento de PE apresentaram valores de Irao menores do que pacientes que se mantiveram normotensas (0,682±0,028 vs. 0,700±0,029, p=0,044). Ao considerar o desenvolvimento de PE como desfecho, a área sobre a curva do Irao foi de 0,694 (IC 0,543-0,845), sem pontos com bons valores de sensibilidade ou especificidade. Conclusão: a dopplerfluxometria de artérias oftálmicas entre 24 e 28 semanas de gestação não se demonstrou um bom exame para a predição de PE. .

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Autosomal-dominant polycystic kidney disease (ADPKD) is the most prevalent inherited genetic disease of cats, predominantly affecting Persian and Persian-related cats. A point mutation (C→A transversion) in exon 29 of the PKD1 gene causes ADPKD, and is the specific molecular target for genetic diagnosis in cats. The current study describes a newly developed touchdown polymerase chain reaction (PCR) to detect this single point mutation, using 2 primers specific for the mutant allele, adapted from an existing multiplex amplification refractory mutation system (ARMS PCR). Furthermore, correlations between the clinical outcomes of tested animals and the results of the genetic test were investigated. A total of 334 cats were tested, 188 from the Veterinary Hospital of Small Animals at the University of Brasilia, and 146 from an anti-rabies vaccine campaign of the Federal District. A total prevalence of 9% was evident among the samples, with 33% of the Persian cats testing positive, and 7% of the Brazilian long- and shorthaired cats testing positive. Prevalence was not correlated with gender or hemogram. Positive animals exhibited hyperglobulinemia ( P = 0.02). This research demonstrated that the mutation does not only occur in Persian and Persian-related cats, and that a touchdown PCR can be used to diagnose ADPKD.

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BACKGROUND: central nervous system (CNS) hyperperfusion is one of the events that constitute the pathophysiological basis for the clinical manifestations and complications of pre-eclampsia (PE). Detecting the increased flow in the CNS through Doppler flowmetry of the ophthalmic artery might precede the clinical onset of PE and could be used as a marker for subsequent development of PE. OBJECTIVE: to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE. OBJECTIVE: to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE. METHODS: a total of 73 patients with risk factors for the development of PE were selected from the prenatal service at the HC-UFMG. They were submitted to ophthalmic artery Doppler flowmetry between 24 and 28 weeks of pregnancy and monitored until the end of the pregnancy to verify the occurrence of PE. ROC curves were created to determine the predictive characteristics of the OARI. RESULTS: fourteen of the patients selected developed PE and 59 remained normotensive until the postpartum period. Patients with subsequent development of PE presented OARI values lower than patients that remained normotensive (0.682 ± 0.028 X 0.700 ± 0.029, p = 0.044). Considering the development of PE as an outcome, the area under the OARI curve was 0.694 (CI 0.543 to 0.845), with no points obtaining good values of sensitivity or specificity. CONCLUSION: Doppler flowmetry of ophthalmic arteries between 24 and 28 weeks of pregnancy did not present itself as a good exam for predicting PE.

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