RESUMO
OBJECTIVE: The objective is to describe the HLA allelic frequency in PsA and correlate it with demographic and clinical variables. METHODS: Retrospective study of adult patients with a diagnosis of PsA (n=23) and healthy controls (n=46), all with a request for HLA-A, B, C, DR. Typing was performed using HLA-PCR/SSO LifeCodes and analyzed on the LUMINEX IS100/200 xMAP® system. (Ethics/Code HMC2022-014). RESULTS: One hundred thirty-eight alleles were included from 69 individuals, 43,5% women, aged 44,5±16,5 years in patients with PsA, with a mean age of disease onset of 33.4±14 years. Only 9.5% had a high Body Mass Index and dyslipidemia was the most frequent comorbidity (34.8%), followed by high blood pressure (26,1%). 82% debuted with skin manifestation and once the joint disease was established, the predominance was peripheral (74%) due to arthritis/arthralgia in 74%, enthesitis in 30% and dactylitis in 13%. The allele frequencies were for HLA*A 2402 (13%), 3201 (13%) and 2427 (8,7%), for HLA*B 1402 (17,4%), 4002 (17,4%), 3801 (13%) and HLA*DR 0404 (17,4%), 0407 (13%). No HLA*B27 was identified and HLA*C0602 was only 2,2%. HLA A*0201 and DR*1301 were less frequent in controls versus PsA (p=0.024 and 0,029, respectively), while HLA*B1302 was frequent in PsA (p=0,035). CONCLUSIONS: Curiously, there were no positive results for HLAB*27, which may be related to the population mix. HLA Cw6 is traditionally associated with psoriasis. However, its absence has been linked to nail disorders and PsA; consequently, in our study, it had a low frequency (2,2%). On the other hand, HLA*B1302 has been related to the disease and its early onset; in the healthy Colombian population, it has been described in 0,92%; in our group, it is found to be significant in patients without establishing a clinical association. Few previous studies report HLA results in PsA in Colombia.
OBJETIVO: Describir la frecuencia alélica de HLA en APs y asociarlo con variables demográficas y clínicas. MÉTODOS: Estudio retrospectivo de pacientes adultos con diagnóstico de APs (n=23), y controles sanos (n=46), todos con solicitud de HLA-A, B, C y DR. La tipificación se realizó por medio de HLA-PCR/SSO LifeCodes, y se analizó en el sistema LUMINEX IS 100/200 xMAP®. (Ética/Código HMC2022-014). RESULTADOS: Se incluyeron 138 alelos de 69 individuos, 43,5% mujeres, con edad 44,5±16,5 años, en pacientes con APs, con edad media de inicio de la enfermedad de 33,4±14 años. Solo el 9,5% tuvo Índice de Masa Corporal alto y la dislipidemia fue la comorbilidad más frecuente (34,8%), seguida de hipertensión arterial (26,1%). El 82% debutó con manifestación en piel y una vez establecida la enfermedad articular, el predominio fue periférico (74%), por artritis/artralgias en un 74%, entesitis en 30%, y dactilitis 13%. Las frecuencias alélicas fueron para HLA*A 2402 (13%), 3201 (13%) y 2427 (8,7%), para HLA*B 1402 (17,4%), 4002 (17,4%), 3801 (13%) y HLA*DR 0404 (17,4%), 0407 (13%). No se identificó HLA*B27 y HLA*C0602 fue solo del 2,2 %. HLA A*0201 y DR*1301 fueron menos frecuentes en controles versus APs (p=0,024 y 0,029, respectivamente), mientras que HLA*B1302 frecuente en APs (p=0,035). CONCLUSIÓN: Curiosamente no hubo resultados positivos para HLAB*27 y esto puede relacionarse con el mestizaje de la población. HLA Cw6 es tradicionalmente asociado a psoriasis, sin embargo, su ausencia se ha relacionado con mayor reporte de alteraciones ungueales y Aps; como consecuencia, en nuestro estudio tuvo una baja frecuencia (2,2%). Por otro lado, el HLA*B1302 ha tenido relación con la enfermedad y su inicio temprano, en población sana colombiana se ha descrito en 0,92%, en nuestro grupo se encuentra de manera significativa en los pacientes sin establecerse asociación clínica. Pocos estudios previos refieren resultados de HLA en APs en Colombia.
Assuntos
Alelos , Artrite Psoriásica , Frequência do Gene , Humanos , Feminino , Masculino , Colômbia , Adulto , Artrite Psoriásica/genética , Artrite Psoriásica/diagnóstico , Estudos Retrospectivos , Pessoa de Meia-Idade , Antígenos HLA/genéticaRESUMO
Surubim (Pseudoplatystoma corruscans, Pimelodidae) are migratory catfish native to the rivers in the La Plata and São Francisco basins. They are piscivores that attain considerable body sizes and are a valuable economic resource. Surubim exhibits extensive migrations during its life cycle that may affect the population structure at vast geographic scales. The authors examined the genetic diversity and population genetic structure of P. corruscans using microsatellite markers from a comprehensive sampling of 260 individuals from the Upper and Lower Paraná River. They identified two well-differentiated genetic clusters corresponding to a natural geographic barrier historically separating Upper and Lower Paraná regions. They also demonstrated temporal variation in population genetic structure at a site in Lower Paraná close to the confluence with the Paraguay River, most likely explained by the influx of migrant fishes at certain times of the year.
Assuntos
Peixes-Gato , Animais , Peixes-Gato/genética , Genética Populacional , Rios , Brasil , Repetições de Microssatélites , Variação GenéticaRESUMO
Several studies show that many water bodies in developing countries are increasingly affected by anthropogenic pressure, such as agricultural activities, domestic and industrial wastewater. However, data is scarce in several of such countries, including Panama. Thus, in this work, the ecotoxicological status of selected rivers in Panama with distinct input sources were evaluated using the zebrafish (Danio rerio) embryo bioassays combined with a liquid chromatography-high resolution mass spectrometry screening of contaminants of emerging concern (CECs), using a library of over 3200 chemicals. A total of 68 CECs, including pharmaceuticals and metabolites, pesticides and several industrial chemicals, could be tentatively identified. Additionally, the zebrafish embryo bioassays showed a significant increase (p < 0.05) in embryo mortality/abnormalities when incubated with water samples from two rivers, Matasnillo and Curundú (47.5% and 32%, respectively). Importantly, a positive correlation between ecotoxicological endpoints and some of the detected CECs was observed. The findings demonstrate that both rivers are under strong anthropogenic pressure, and therefore, management actions are urgently needed to decrease their level of contamination. Overall, this study further supports the use of the zebrafish embryo bioassay as a fast, high throughput approach for screening the toxicity of water samples, and highlights the advantages of combining ecotoxicological assays with high-resolution mass spectrometry to an expedite assessment of the ecotoxicological status of water bodies.
Assuntos
Rios , Poluentes Químicos da Água , Animais , Bioensaio , Monitoramento Ambiental , Espectrometria de Massas , Panamá , Água , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade , Peixe-ZebraRESUMO
Objetivo: abordar, de forma crítica e reflexiva, desafios e perspectivas da prática profissional da enfermagem, da formação e da integração ensino-serviço no cenário da pandemia da Covid-19. Método: as atividades práticas de uma disciplina, que aborda a gestão do Sistema Único de Saúde, foram suspensas durante a pandemia. Diante desse fato, constituiu-se um grupo para discutir a prática profissional, assegurando a integração ensino-serviço. A partir dos diálogos e dos textos produzidos elaborou-se essa reflexão, tendo como referencial teórico a Análise Institucional. Resultados: alguns analisadores revelaram desafios como a influência e o difícil acesso às tecnologias digitais no ensino e no processo de trabalho, além do medo e da insegurança vivenciados pelas autoras. O grupo analisou suas implicações, compartilhando sentimentos e angústias, sem perder de vista as mudanças necessárias nos processos de trabalho. Conclusão e implicações para a prática: a Análise Institucional contribuiu para realizar este estudo "à quente", nesse contexto de pandemia, trazendo à tona questionamentos e contradições vivenciadas nos serviços de saúde e na universidade, fortalecendo a integração ensino-serviço. Mas, mediante o recorte de tempo, práticas e cenários este estudo traz limitações quanto aos impactos para o ensino e para a assistência prestada, possibilitando a realização de outras pesquisas
Objective: critically and reflexively address challenges and perspectives of professional nursing practice, training, and teachingservice integration in the context of the Covid-19 pandemic. Method: the practical activities of a discipline that addresses the management of the Unified Health System were suspended during the pandemic. In view of this fact, a group was formed to discuss the professional practice, ensuring the teaching-service integration. From the dialogues and texts produced, this reflection was elaborated, using Institutional Analysis as a theoretical framework. Results: some analyzers revealed challenges such as the influence and difficult access to digital technologies in teaching and in the work process, as well as the fear and insecurity experienced by the authors. The group analyzed their implications, sharing feelings and anguish, without losing sight of the necessary changes in the work processes. Conclusion and implications for the practice: the Institutional Analysis contributed to carry out this study "in the heat of the moment", in this pandemic context, bringing to light questions and contradictions experienced in health services and in the university, strengthening the teaching-service integration. But, due to the cut-off of time, practices and scenarios, this study has limitations regarding the impacts on teaching and the care provided, making it possible to carry out other research
Objetivo: abordar de manera crítica y reflexiva, los desafíos y perspectivas de la práctica profesional de enfermería, de la formación y la integración enseñanza-servicio en el escenario de la pandemia Covid-19. Método: las actividades prácticas de una disciplina, que aborda la gestión del Sistema Único de Salud, fueron suspendidas durante la pandemia. Ante este hecho, se formó un grupo para discutir la práctica profesional, asegurando la integración entre enseñanza y servicio. A partir de los diálogos y textos producidos, se elaboró esta reflexión, teniendo como marco teórico el Análisis Institucional. Resultados: algunos analizadores revelaron desafíos como la influencia y el difícil acceso a las tecnologías digitales en la enseñanza y en el proceso de trabajo, además del miedo y la inseguridad vivenciados por las autoras. El grupo analizó sus implicaciones, compartiendo sentimientos y ansiedades, sin perder de vista los cambios necesarios en los procesos de trabajo. Conclusión e implicaciones para la práctica: El Análisis Institucional contribuyó a realizar este estudio "en caliente", en este contexto de pandemia, planteando interrogantes y contradicciones vividas en los servicios de salud y en la universidad, fortaleciendo la integración enseñanza -servicio. Pero, a través del recorte de tiempo, prácticas y escenarios, este estudio trae limitaciones en cuanto a los impactos para la enseñanza y la asistencia brindada, permitiendo la realización de otras investigaciones
Assuntos
Humanos , Prática Profissional , Serviços de Integração Docente-Assistencial/tendências , Enfermagem/métodos , COVID-19 , Centros de Saúde , Educação a Distância/métodos , Educação em Enfermagem/métodosRESUMO
BACKGROUND: Central Nervous System (CNS) depressants like antipsychotics, opioids, benzodiazepines and zolpidem are frequently used by patients of a wide range of ages. Uncertainty remains about their effect in very old adults (>80 years old) and their potential for pharmacodynamic and pharmacokinetic drug-drug interactions in this population. OBJECTIVE: To assess if the use of CNS depressants is associated with a higher risk of hospitalization due to community-acquired pneumonia (CAP) in very old patients. METHODS: In this prospective study, 362 patients over 80 years of age who had been consequently admitted to the general ward of a teaching hospital were examined. Each patient was assessed, by our pharmacovigilance team within 24 hours of admission, to identify outpatient medication use and potential drug-drug interactions. RESULTS: The overall use of CNS depressants as a group was not associated with a higher risk of admission due to CAP in very old patients (55% vs. 49%; OR=1.28 [0.76-2.16], p=0.34). However, the use of antipsychotics was associated with a higher rate of admissions due to CAP in this population (OR=1.98 [1.10-3.57], p=0.02). No association was seen between opioids (p=0.27), zolpidem (p=0.83), or benzodiazepines (p=0.15) and the rate of admissions due to CAP in these patients. Moreover, pharmacodynamic or pharmacokinetic interactions leading to CNS depression were equally found in patients admitted for CAP and those admitted for other reasons. CONCLUSION: The use of antipsychotics in very old adults was associated with an increased risk of hospital admission due to CAP. This suggests that the use of these medications in this population should be done with caution. No association was observed with opioids, benzodiazepines and zolpidem with the latter outcome.
Assuntos
Depressores do Sistema Nervoso Central/efeitos adversos , Infecções Comunitárias Adquiridas/epidemiologia , Pneumonia/epidemiologia , Idoso de 80 Anos ou mais , Analgésicos Opioides , Antipsicóticos , Benzodiazepinas , Feminino , Hospitalização , Humanos , Masculino , Estudos Prospectivos , ZolpidemRESUMO
Introducción: La alimentación inadecuada en la etapa neonatal se asocia con la aparición de enfermedades metabólicas en períodos ontogenéticos posteriores. Objetivo: Asociar la lactancia materna y el destete con el sobrepeso y obesidad en niños y adolescentes de la Unidad Educativa César Dávila Andrade, Cuenca, Ecuador, en el período de octubre de 2016 a marzo de 2017. Materiales y Métodos: Se realizó un estudio observacional de tipo descriptivo durante el período noviembre 2016 a enero 2017 en el Cantón Cuenca, provincia Azuay, Ecuador. El muestreo probabilístico por conglomerados de iguales proporciones seleccionó 137 niños y adolescentes entre 5 y 18 años de edad. Se aplicó un cuestionario que recogió datos sociodemográficos, de lactancia materna y destete. Se realizaron mediciones de peso y talla, y el cálculo del índice de Masa Corporal. Se procesaron los datos mediante estadística descriptiva (media y desviación estándar), inferencial (Prueba T y X2) y correlaciones bivariada (X2, odds ratio) y multivariada (regresión logística binaria) mediante SPSS 23.0. Resultados: La lactancia materna por menos de 6 meses, la introducción de alimentos de manera temprana y la actividad física leve incrementan el riesgo de sobrepeso y obesidad en más de 3 veces cada una en niños y adolescentes. Conclusiones: La lactancia materna y el destete están asociadas al sobrepeso y obesidad desde etapas tempranas del desarrollo humano. El valor explicativo que tienen en niños y adolescentes es relevante, y sugiere su empleo en programas educativos y preventivos en salud(AU)
Introduction: Inadequate feeding in the neonatal stage is associated with the appearance of metabolic diseases in further ontogenetic periods. Objective: To associate breastfeeding and weaning with overweight and obesity in children and adolescents in the Educational Unit César Dávila Andrade in the Cuenca region, Ecuador, from October 2016 to March 2017. Material and Methods: A descriptive, associative, and empirical study was conducted during the period of November 2016 - January 2017 in Cuenca, province of Azuay, Ecuador. The probability sampling by conglomerates of equal proportions selected 137 children and adolescents from 5 to 18 years of age. A questionnaire that collected sociodemographic data about breastfeeding and weaning was applied. Measurements of weight and height were made, as well as the calculation of the Body Mass Index. The data were processed by descriptive statistics (mean, standard deviation); inferential statistics (T Test, X2); bivariate correlations (X2, odds ratio), and binary logistic regression, using SPSS 23.0. Results: Breastfeeding for less than six months, the introduction of food at an early stage of the life, and mild physical activity are factors that increase the risk of overweight and obesity more than 3 times in children and adolescents. Conclusions: Breastfeeding and weaning are associated with overweight and obesity from early stages of human development. The explanatory value that children and adolescents have is relevant, suggesting its implementation in educational and preventive health programs(AU)
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Aleitamento Materno/efeitos adversos , Transtornos da Nutrição do Lactente/metabolismo , Obesidade Infantil/complicações , Metabolismo/fisiologia , Atividade Motora , Desmame , Epidemiologia Descritiva , Equador , Estudo ObservacionalRESUMO
Although uric acid is not part of any definition of metabolic syndrome, a number of studies have shown strong associations between the concentration of uric acid and metabolic syndrome or its components. The purpose of this systematic review with meta-analysis was to evaluate, using prospective interventional studies, the effects of allopurinol therapy and uric acid normalization on serum concentrations of triacylglycerol, total-cholesterol, LDL-cholesterol and HDL-cholesterol in hyperuricemic subjects. A systematic search of the PubMed and Scopus databases was performed following the guidelines described in the PRISMA statement. Seven studies were included in the meta-analysis, including six randomized controlled trials and one controlled before-and-after study. Despite differences in the follow-up periods (4, 12 and 24weeks) and allopurinol dose (100-300mg/day), all the studies showed decreases in the mean serum uric acid level (95% confidence interval: -2.61 to -1.55 (4weeks), -2.94 to -1.09 (12weeks) and -2.59 to -1.22 (24weeks); p<0.05). However, no effect was observed based on differences in mean serum triacylglycerol and total- and LDL-cholesterol concentrations, independent of the follow-up period. Allopurinol therapy during weeks 4 and 12 induced a decrease in the mean HDL-cholesterol level (95% confidence interval: -7.22 to -0.47 (4weeks) and -7.18 to -0.32 (12weeks); p<0.05). This review suggests that allopurinol and uric acid normalization does not improve serum lipid levels, although larger and longer trials of higher quality are needed to confirm this.
Assuntos
Alopurinol/uso terapêutico , Hiperuricemia/sangue , Hiperuricemia/tratamento farmacológico , Lipídeos/sangue , Ácido Úrico/sangue , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de TempoRESUMO
The aim of this study was to evaluate whether oxidative stress occurs in rats experimentally infected by Sporothrix schenckii, and its possible effect on disease pathogenesis. Thirty rats were divided into two groups: the group A (uninfected, n = 18) and the group B (infected by S. schenckii, n=21). Blood samples were collected on days 15, 30 and 40 post-infection (PI). At each sampling time, six rats of the group A, and seven of the group B were bled. TBARS (thiobarbituric acid reactive substances) levels in serum samples were measured to evaluate lipid peroxidation. In addition, catalase (CAT) and superoxide dismutase (SOD) activities, known as biomarkers of antioxidants levels, were verified in whole blood. Seric pro-inflammatory cytokine levels were measured (IFN-γ, TNF-α, and IL-6), which showed that these inflammatory mediators were at higher levels in the infected rats (P < 0.001). In comparison to uninfected animals, rats with sporotrichosis showed significantly higher (p < 0.01) levels of TBARS on day 40 PI; CAT activity was significantly increased (p < 0.01) on days 30 and 40 PI; and SOD activity was increased (p < 0.01) on day 40 PI. Infected rats showed larger testicles and granulomas in the testicular capsule, as well as hepatic granulomas and splenic follicular hyperplasia. All tissues (testicle, spleen, and liver) showed inflammation associated with numerous fungal structures. These results demonstrated that the intense inflammatory response (seric and tissue) in sporotrichosis is a likely mechanism for redox imbalance, and consequently cause the oxidative stress in experimentally infected rats.
Assuntos
Estresse Oxidativo/fisiologia , Sporothrix/patogenicidade , Esporotricose/sangue , Esporotricose/metabolismo , Animais , Antioxidantes/análise , Biomarcadores/sangue , Catalase/sangue , Citocinas/sangue , Modelos Animais de Doenças , Granuloma/patologia , Hiperplasia , Inflamação/patologia , Interferon gama/sangue , Interleucina-6/sangue , Peroxidação de Lipídeos , Fígado/patologia , Masculino , Ratos , Soro/enzimologia , Baço/patologia , Esplenopatias , Esporotricose/patologia , Superóxido Dismutase/sangue , Testículo/patologia , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Fator de Necrose Tumoral alfa/sangueRESUMO
This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each). Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon. (AU)
Este estudo avaliou a utilização da eletrocirurgia bipolar e do clipador laparoscópico em relação à perda sanguínea e resposta inflamatória durante a ovariohisterectomia videoassistida com dois portais (dois grupos com 10 animais). O tempo cirúrgico, assim como o volume de sangue perdido foram significativamente menores no Grupo Bipolar. Não houve mudanças significativas no hematócrito entre os grupos, mas entre os tempos avaliados houve redução de 10% do valor inicial até quatro horas após o procedimento. A resposta inflamatória foi significativamente maior durante todo o período de avaliação após a cirurgia, mas sem manifestações clínicas diferentes daquelas apresentadas pelo Grupo Clipador. Ambas as técnicas têm boa execução pelo procedimento videoassistido, contudo, o uso da eletrocirurgia bipolar permite tempos cirúrgicos menores, perda de sangue mínima e menor curva de aprendizado para o cirurgião. (AU)
Assuntos
Animais , Feminino , Cães , Eletrocirurgia , Eletrocirurgia/veterinária , Instrumentos Cirúrgicos , Hemostasia Cirúrgica , Cirurgia Vídeoassistida , CãesRESUMO
This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each). Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon.
Este estudo avaliou a utilização da eletrocirurgia bipolar e do clipador laparoscópico em relação à perda sanguínea e resposta inflamatória durante a ovariohisterectomia videoassistida com dois portais (dois grupos com 10 animais). O tempo cirúrgico, assim como o volume de sangue perdido foram significativamente menores no Grupo Bipolar. Não houve mudanças significativas no hematócrito entre os grupos, mas entre os tempos avaliados houve redução de 10% do valor inicial até quatro horas após o procedimento. A resposta inflamatória foi significativamente maior durante todo o período de avaliação após a cirurgia, mas sem manifestações clínicas diferentes daquelas apresentadas pelo Grupo Clipador. Ambas as técnicas têm boa execução pelo procedimento videoassistido, contudo, o uso da eletrocirurgia bipolar permite tempos cirúrgicos menores, perda de sangue mínima e menor curva de aprendizado para o cirurgião.
Assuntos
Feminino , Animais , Cães , Cirurgia Vídeoassistida , Cães , Eletrocirurgia , Eletrocirurgia/veterinária , Hemostasia Cirúrgica , Instrumentos CirúrgicosRESUMO
ABSTRACT: This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each). Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon.
RESUMO: Este estudo avaliou a utilização da eletrocirurgia bipolar e do clipador laparoscópico em relação à perda sanguínea e resposta inflamatória durante a ovariohisterectomia videoassistida com dois portais (dois grupos com 10 animais). O tempo cirúrgico, assim como o volume de sangue perdido foram significativamente menores no Grupo Bipolar. Não houve mudanças significativas no hematócrito entre os grupos, mas entre os tempos avaliados houve redução de 10% do valor inicial até quatro horas após o procedimento. A resposta inflamatória foi significativamente maior durante todo o período de avaliação após a cirurgia, mas sem manifestações clínicas diferentes daquelas apresentadas pelo Grupo Clipador. Ambas as técnicas têm boa execução pelo procedimento videoassistido, contudo, o uso da eletrocirurgia bipolar permite tempos cirúrgicos menores, perda de sangue mínima e menor curva de aprendizado para o cirurgião.
RESUMO
ABSTRACT: This study evaluated the use of bipolar electrosurgery and laparoscopic clipping, and their effects on blood loss and the inflammatory response, during a two portal video-assisted ovariohysterectomy technique (two groups with 10 animals each). Surgical time and blood loss volume were significantly lower in the electrosurgery group. There were no significant changes in haematocrit between groups; however, haematocrit did differ between evaluated times, and decreased 10% from the initial measurement to four hours after the procedure. The inflammatory response was significantly higher throughout the post-surgical period, but without any different clinical signs between the two groups. Both techniques had good application for the two portal video-assisted procedure; however, the bipolar electrosurgery allowed for shorter surgical times, reduced blood loss and a minimal learning curve for the surgeon.
RESUMO: Este estudo avaliou a utilização da eletrocirurgia bipolar e do clipador laparoscópico em relação à perda sanguínea e resposta inflamatória durante a ovariohisterectomia videoassistida com dois portais (dois grupos com 10 animais). O tempo cirúrgico, assim como o volume de sangue perdido foram significativamente menores no Grupo Bipolar. Não houve mudanças significativas no hematócrito entre os grupos, mas entre os tempos avaliados houve redução de 10% do valor inicial até quatro horas após o procedimento. A resposta inflamatória foi significativamente maior durante todo o período de avaliação após a cirurgia, mas sem manifestações clínicas diferentes daquelas apresentadas pelo Grupo Clipador. Ambas as técnicas têm boa execução pelo procedimento videoassistido, contudo, o uso da eletrocirurgia bipolar permite tempos cirúrgicos menores, perda de sangue mínima e menor curva de aprendizado para o cirurgião.
RESUMO
The aim of this study was to evaluate the cholinesterase activity in serum, whole blood, and lymphocytes, as well as to verify its relation to immune response in rats experimentally infected by Sporothrix schenckii. For this study, 63 Wistar rats (Rattus norvegicus), male, adult were divided into three groups: the negative control group (GC: n = 21), the group infected subcutaneously (GSC: n = 21), and the group infected intraperitoneally (GIP: n = 21). The groups were divided into subgroups and the following variables were evaluated at 15, 30, and 40 days post-infection (PI): acetylcholinesterase (AChE) activity in lymphocytes and whole blood, butyrylcholinesterase (BChE) activity in serum, cytokines levels (IL-1, IL-6, TNFα, and INF-γ), immunoglobulins levels (IgA, IgG, IgM, and IgE), and protein profile by electrophoresis. Both infected groups showed increased levels of inflammatory parameters (P < 0.05) in tissue and inflammatory infiltrates. The activities of AChE in lymphocytes and BChE in serum increased (P < 0.05) significantly in animals from the GSC group on day 40 PI compared to the GC group. Regarding the GIP, there was a marked increase in the AChE activity in lymphocytes on days 30 and 40 PI, and in whole blood on days 15, 30, and 40 PI compared to GC. Furthermore, IL-10, an anti-inflammatory cytokine, was also present in high levels during chronic systemic S. schenckii infections in animals. Therefore, it is concluded that cholinesterase has an important modulatory role in the immune response during granulomatous infection by S. schenckii.
Assuntos
Colinesterases/análise , Inflamação/patologia , Sporothrix/crescimento & desenvolvimento , Esporotricose/patologia , Animais , Anticorpos Antifúngicos/sangue , Citocinas/análise , Modelos Animais de Doenças , Linfócitos/enzimologia , Masculino , Proteínas/análise , Ratos Wistar , Soro/enzimologiaRESUMO
Background: Pulmonary aspiration of gastric content can result in intraoperative and postoperative complications, such as regurgitation, gastro-esophageal reflux and esophagitis. There are variations among authors about the ideal period of solid and liquid fasting. Determination of the appropriate amount of food abstinence in surgical patients is important, because of the metabolic disorders that interfere in response to anesthetic protocol or surgical intervention. Thereby, this research aimed to evaluate the appropriate period of fasting for elective anesthesia and surgical procedures in cats, by analysis of gastric emptying time based on the daily energy requirement. Materials, Methods & Results: Seven cats of mixed breed, health and with an average weight of 2.857 ± 0.3780 were evaluated by gastroscopy for the presence of food and obtaining tissue samples. To evaluate the gastric emptying time, dry and moist food were offered at two different times, 8 h and 4 h before each evaluation, with an interval of seven days between each food treatment (dry and moist). There was no significant difference in all biochemical parameters evaluated (cholesterol, glucose, and lactate) in both fasting times and food types (P > 0.05). All animals underwent gastric biopsy for histological evaluation and urease test, to discard morphological changes. After 4 h it was observed dry food [...](AU)
Assuntos
Animais , Gatos , Esvaziamento Gástrico/fisiologia , Jejum , Anestesia/veterinária , Gastroscopia/veterinária , Aspiração Respiratória de Conteúdos Gástricos/veterinária , Endoscopia/veterináriaRESUMO
Background: Pulmonary aspiration of gastric content can result in intraoperative and postoperative complications, such as regurgitation, gastro-esophageal reflux and esophagitis. There are variations among authors about the ideal period of solid and liquid fasting. Determination of the appropriate amount of food abstinence in surgical patients is important, because of the metabolic disorders that interfere in response to anesthetic protocol or surgical intervention. Thereby, this research aimed to evaluate the appropriate period of fasting for elective anesthesia and surgical procedures in cats, by analysis of gastric emptying time based on the daily energy requirement. Materials, Methods & Results: Seven cats of mixed breed, health and with an average weight of 2.857 ± 0.3780 were evaluated by gastroscopy for the presence of food and obtaining tissue samples. To evaluate the gastric emptying time, dry and moist food were offered at two different times, 8 h and 4 h before each evaluation, with an interval of seven days between each food treatment (dry and moist). There was no significant difference in all biochemical parameters evaluated (cholesterol, glucose, and lactate) in both fasting times and food types (P > 0.05). All animals underwent gastric biopsy for histological evaluation and urease test, to discard morphological changes. After 4 h it was observed dry food [...]
Assuntos
Animais , Gatos , Esvaziamento Gástrico/fisiologia , Jejum , Anestesia/veterinária , Aspiração Respiratória de Conteúdos Gástricos/veterinária , Endoscopia/veterinária , Gastroscopia/veterináriaRESUMO
The measurement of serum parameters during general anesthesia procedures are subject to variations due to differences in protocol, splenic storage, and by the instituted fluid therapy. The aim of this study was to assess the hematocrit changes promoted by controlled fluid therapy and general anesthesia. Six mongrel female dogs underwent an anesthetic protocol with acepromazine (0.03 mg kg-1) and tramadol (5 mg kg-1) for premedication, induction with propofol (3 mg kg-1), and maintained with isoflurane and mechanical ventilation for 120 minutes. After induction, they were infused with 10 ml kg hr-1 of Ringers lactate solution. Hematocrit measurements were performed from the start until 72 hours from anesthesia and evaluated statistically to check if there were significant changes over time. The fluid therapy, the acepromazine and propofol in the anesthetic protocol promotes a significant reduction of hematocrit up to four hours after general anesthesia.(AU)
A mensuração de parâmetros séricos durante procedimentos dependentes de anestesia geral são passíveis de variações devido a diferenças do protocolo utilizado, armazenamento esplênico e também da fluidoterapia instituída. O objetivo deste trabalho foi avaliar o hematócrito buscando evidenciar as alterações flutuantes promovidas por fluidoterapia controlada e anestesia geral em cães submetidos a ovariohisterectomia laparoscópica. Seis cadelas sem raça definida foram submetidas a um protocolo anestésico com acepromazina (0,03 mg kg-1) e tramadol (5,0 mg kg-1) como medicação pré-anestésica, indução com propofol (3,0 mg kg-1) e mantidas com isoflurano e ventilação mecânica durante 120 minutos. Após a indução, receberam a infusão de 10,0 ml kg hr-1 de solução Ringer com lactato. Foram realizadas aferições de hematócrito do início (ou antes?) até 72 horas após a anestesia, sendo avaliadas estatisticamente para verificar se houve alterações relevantes durante os tempos. A fluidoterapia e o uso de acepromazina e propofol no protocolo anestésico para esta técnica cirúrgica promoveram uma redução de hematócrito significativa até quatro horas após a anestesia geral.(AU)
Assuntos
Animais , Cães , Doenças do Cão , Lactato de Ringer/administração & dosagem , Anestesia Geral/veterinária , Hematócrito/veterináriaRESUMO
A adoção da Estratégia Saúde da Família (ESF) como modelo de reorientação da Atenção Básica tornou necessário um novo tipo de profissional médico. Este estudo objetiva analisar a formação médica adquirida na graduação em Medicina para o desenvolvimento das ações exigidas pela ESF e identificar lacunas dessa formação.Foram conduzidas entrevistas semiestruturadas com 37 médicos residentes de Medicina de Família e Comunidade de unidades de saúde de Fortaleza (CE)de setembro a dezembro de 2007. Os depoimentos foram categorizados e apreciados mediante a técnica de Análise de Conteúdo. Observou-se que já ocorrem mudanças na formação médica, embora ainda haja muitas lacunas a preencher. Novos currículos,mais voltados para a Atenção Básica, permitiram que os médicos recém-formados se sentissem mais preparados para atuar na ESF, ao contrário dos profissionais formados em currículos antigos.
The adoption of the Family Health Strategy (FHS) as a model for reorientation of primary care has demanded a new kind of medical professional. Our study aims to analyze undergraduate medical training in terms of developing the actions required by the FHS, and to identify gaps in undergraduate training. We conducted semi-structured interviews with 37 resident-doctors of Family and Community Medicine at health centers in Fortaleza-CE between September and December 2007, and their statements were categorized and assessed using the content analysis method. We observed that changes are already occurring in medical training, with many gaps still to be filled, and that new curricula more focused on primary care have allowed doctors to feel more prepared to act in the FHS, in contrast to the graduates in former curricula.
RESUMO
The measurement of serum parameters during general anesthesia procedures are subject to variations due to differences in protocol, splenic storage, and by the instituted fluid therapy. The aim of this study was to assess the hematocrit changes promoted by controlled fluid therapy and general anesthesia. Six mongrel female dogs underwent an anesthetic protocol with acepromazine (0.03 mg kg-1) and tramadol (5 mg kg-1) for premedication, induction with propofol (3 mg kg-1), and maintained with isoflurane and mechanical ventilation for 120 minutes. After induction, they were infused with 10 ml kg hr-1 of Ringers lactate solution. Hematocrit measurements were performed from the start until 72 hours from anesthesia and evaluated statistically to check if there were significant changes over time. The fluid therapy, the acepromazine and propofol in the anesthetic protocol promotes a significant reduction of hematocrit up to four hours after general anesthesia.
A mensuração de parâmetros séricos durante procedimentos dependentes de anestesia geral são passíveis de variações devido a diferenças do protocolo utilizado, armazenamento esplênico e também da fluidoterapia instituída. O objetivo deste trabalho foi avaliar o hematócrito buscando evidenciar as alterações flutuantes promovidas por fluidoterapia controlada e anestesia geral em cães submetidos a ovariohisterectomia laparoscópica. Seis cadelas sem raça definida foram submetidas a um protocolo anestésico com acepromazina (0,03 mg kg-1) e tramadol (5,0 mg kg-1) como medicação pré-anestésica, indução com propofol (3,0 mg kg-1) e mantidas com isoflurano e ventilação mecânica durante 120 minutos. Após a indução, receberam a infusão de 10,0 ml kg hr-1 de solução Ringer com lactato. Foram realizadas aferições de hematócrito do início (ou antes?) até 72 horas após a anestesia, sendo avaliadas estatisticamente para verificar se houve alterações relevantes durante os tempos. A fluidoterapia e o uso de acepromazina e propofol no protocolo anestésico para esta técnica cirúrgica promoveram uma redução de hematócrito significativa até quatro horas após a anestesia geral.
Assuntos
Animais , Cães , Anestesia Geral/veterinária , Doenças do Cão , Hematócrito/veterinária , Lactato de Ringer/administração & dosagemRESUMO
Liposarcoma is an uncommon malignant tumor originated in the lipoblasts that usually does not produce metastases, but is locally invasive. The final diagnosis is made by histopathology and wide surgical excision is the treatment. A four years old male Pinscher, weighing 2.8 kg, which was previously submitted to seven therapeutic procedures for hepatoid adenoma, was brought to us. On clinical examination a large, soft consistency and painless tumor on lumbodorsal area, besides perineal hernia, was observed. The CT scan revealed an image of an extensive paravertebral intramuscular tumor, embracing retroperitoneal, pelvic canal and ad-anal region. After surgical resection, the material was sent for histopathological examination which confirmed it was a liposarcoma. Thus, chemotherapy protocol with doxorubicin was established. 12 months after the last application of chemotherapy, the patient shows no signs of tumor recurrence nor metastases.
O lipossarcoma é um tumor maligno incomum, originário dos lipoblastos que geralmente não produz metástases; entretanto, é localmente invasivo. O diagnóstico definitivo é obtido por exame histopatológico e o tratamento consiste na excisão cirúrgica ampla. Foi atendido um cão, da raça Pinscher, macho, com quatro anos de idade, pesando 2,8kg, que fora submetido anteriormente a sete procedimentos terapêuticos para adenoma hepatoide. Ao exame clínico o paciente apresentava uma grande tumoração na região dorsolombar, de consistência amolecida e indolor, além de hérnia perineal. O exame de tomografia computadorizada revelou imagem de uma massa intramuscular paravertebral extensa, invadindo retroperitônio, canal pélvico e região ad-anal. Após ressecção cirúrgica, o material foi encaminhado para análise histopatológica, que confirmou tratar-se de um lipossarcoma; dessa forma, foi instituído protocolo quimioterápico com doxorrubicina. Decorridos 12 meses da última aplicação do quimioterápico, o paciente não apresenta sinais de recidiva da neoplasia maligna, nem tampouco metástases.
Assuntos
Animais , Cães , Tratamento Farmacológico , Hérnia , LipossarcomaRESUMO
Liposarcoma is an uncommon malignant tumor originated in the lipoblasts that usually does not produce metastases, but is locally invasive. The final diagnosis is made by histopathology and wide surgical excision is the treatment. A four years old male Pinscher, weighing 2.8 kg, which was previously submitted to seven therapeutic procedures for hepatoid adenoma, was brought to us. On clinical examination a large, soft consistency and painless tumor on lumbodorsal area, besides perineal hernia, was observed. The CT scan revealed an image of an extensive paravertebral intramuscular tumor, embracing retroperitoneal, pelvic canal and ad-anal region. After surgical resection, the material was sent for histopathological examination which confirmed it was a liposarcoma. Thus, chemotherapy protocol with doxorubicin was established. 12 months after the last application of chemotherapy, the patient shows no signs of tumor recurrence nor metastases.(AU)
O lipossarcoma é um tumor maligno incomum, originário dos lipoblastos que geralmente não produz metástases; entretanto, élocalmente invasivo. O diagnóstico definitivo é obtido por exame histopatológico e o tratamento consiste na excisão cirúrgica ampla.Foi atendido um cão, da raça Pinscher, macho, com quatro anos de idade, pesando 2,8kg, que fora submetido anteriormentea sete procedimentos terapêuticos para adenoma hepatoide. Ao exame clínico o paciente apresentava uma grande tumoraçãona região dorsolombar, de consistência amolecida e indolor, além de hérnia perineal. O exame de tomografia computadorizadarevelou imagem de uma massa intramuscular paravertebral extensa, invadindo retroperitônio, canal pélvico e região ad-anal. Apósressecção cirúrgica, o material foi encaminhado para análise histopatológica, que confirmou tratar-se de um lipossarcoma; dessaforma, foi instituído protocolo quimioterápico com doxorrubicina. Decorridos 12 meses da última aplicação do quimioterápico, opaciente não apresenta sinais de recidiva da neoplasia maligna, nem tampouco metástases.(AU)