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PURPOSE: The spleen is relevant in blood purification, hematopoiesis, metabolism, and immune response to antigens, in addition to the storage and control on the release of metals and amino acids. Its functions concerning reproduction characteristics are still unknown. The objective was to study the influence of splenectomies on reproduction. METHODS: This study analyzed 25 mice couples, distributed into five groups: group 1 - control, no surgery: group 2 - control, submitted to laparotomy and laparorrhaphy only; group 3 - splenectomy in male mice; group 4 - splenectomy in female mice; group 5 - splenectomy in male and female mice. The animals were studied as regards the number of gestations and offspring generated in each gestation. RESULTS: A decrease in both the number of gestations and the number of offspring was verified in the male mice that had received a splenectomy when coupled with normal female mice. It is important to emphasize lower reproduction level when paired asplenic males with normal females, otherwise, the couples in which both mice had been splenectomized did not present change in the reproduction pattern. CONCLUSIONS: A reduction in the number of pregnancies and litters occurs in mice couples when the male mice were previously splenectomized.

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Purpose The spleen is relevant in blood purification, hematopoiesis, metabolism, and immune response to antigens, in addition to the storage and control on the release of metals and amino acids. Its functions concerning reproduction characteristics are still unknown. The objective was to study the influence of splenectomies on reproduction. Methods This study analyzed 25 mice couples, distributed into five groups: group 1 control, no surgery: group 2 control, submitted to laparotomy and laparorrhaphy only; group 3 splenectomy in male mice; group 4 splenectomy in female mice; group 5 splenectomy in male and female mice. The animals were studied as regards the number of gestations and offspring generated in each gestation. Results A decrease in both the number of gestations and the number of offspring was verified in the male mice that had received a splenectomy when coupled with normal female mice. It is important to emphasize lower reproduction level when paired asplenic males with normal females, otherwise, the couples in which both mice had been splenectomized did not present change in the reproduction pattern. Conclusions A reduction in the number of pregnancies and litters occurs in mice couples when the male mice were previously splenectomized.(AU)

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JUSTIFICATIVA E OBJETIVOS: A doença de Steinert é a forma de distrofia muscular mais comum no adulto. Devido ao seu caráter multissistêmico o manuseio perioperatório é um desafio ao anestesiologista. O objetivo deste relato foi apresentar um caso de hemorroidectomia em paciente portador de distrofia muscular e discutir as várias implicações anestésicas envolvidas. RELATO DO CASO: Paciente do sexo masculino, 58 anos, portador de doença de Steinert, submetido a hemorroidectomia. A conduta anestésica foi raquianestesia com bupivacaína hiperbárica (punção L3-L4,com bupivacaína a 0,5 por cento [5 mg] em sela) associada à sedação com propofol (alvo de 1 'g.mL-1 em bomba de infusão alvo controlada). A analgesia pós-operatória foi realizada com dipirona (1,5 g) e infiltração local de ropivacaína a 0,5 por cento (150 mg). O paciente desenvolveu, no intra-operatório, crise miotônica (10 minutos após ser colocado em posição de litotomia) que foi controlada com sedação (aumento da concentração-alvo para 1,5 'g.mL-1 e bolus de 40 mg). Permaneceu estável e teve alta hospitalar no dia seguinte. CONCLUSÕES: O conhecimento da doença e o planejamento anestésico são de fundamental importância no manuseio de pacientes portadores de doença de Steinert.

BACKGROUND AND OBJECTIVES: Steinert disease is the most common muscular dystrophy of the adult. Due to its multisystem characteristic, the perioperative management of these patients is a challenge to the anesthesiologist. The aim of this report was to present a case of hemorrhoidectomy in a patient with muscular dystrophy and to discuss the several anesthetic implications involved. CASE REPORT: A man patient, 58 years old, with Steinert disease, who underwent hemorrhoidectomy. Subaracnoid block with hyperbaric bupivacaine (saddle block with puncture at L3-L4 with 0.5 percent bupivacaine [5 mg]) associated with sedation with propofol (1 'g.mL-1 target using a target-controlled infusion pump). Dypirone (1.5 g) and local infiltration with 0.5 percent ropivacaine (150 mg) were used for the postoperative analgesia. Intraoperatively, the patient developed myotonic crisis (10 minutes after being placed on the litothomy position) that was controlled by sedation (the target concentration was increased to 1.5 'g.mL-1 and given a bolus of 40 mg). The patient remained stable and was discharged the following day. CONCLUSIONS: The knowledge about the disease and the proper anesthetic planning are extremely important when managing patients with Steinert disease.

JUSTIFICATIVA Y OBJETIVOS: La enfermedad de Steinert es la forma de distrofía muscular más común en el adulto. Debido a su carácter multisistémico el manoseo perioperatorio es un reto para el anestesiólogo. El objetivo de este relato fue el de presentar un caso de hemorroidectomía en paciente portador de distrofía muscular y discutir las varias implicaciones anestésicas que involucra. RELATO DEL CASO: Paciente del sexo masculino, 58 años, portador de enfermedad de Steinert, sometido la hemorroidectomía. La conducta anestésica fue raquianestesia con bupivacaína hiperbara (punción L3-L4,con bupivacaína a 0,5 por ciento (5 mg) en silla de montar, asociada a la sedación con propofol (blanco de 1 ìg.mL-1 en bomba de infusión blanco controlada). La analgesia postoperatoria fue realizada con dipirona (1,5 g) e infiltración local de ropivacaína a 0,5 por ciento (150 mg). El paciente desarrolló, en el intraoperatorio, crisis miotónica (10 minutos después ser colocado en posición de litotomía), que fue controlada con sedación (aumento de la concentración blanco para 1,5 ìg.mL-1 y bolus de 40 mg). Permaneció estable y tuvo alta hospitalaria al día siguiente. CONCLUSIONES: El conocimiento de la enfermedad y la planificación anestésica son de fundamental importancia en el manoseo de pacientes portadores de la enfermedad de Steinert.

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BACKGROUND AND OBJECTIVES: Steinert disease is the most common muscular dystrophy of the adult. Due to its multisystem characteristic, the perioperative management of these patients is a challenge to the anesthesiologist. The aim of this report was to present a case of hemorrhoidectomy in a patient with muscular dystrophy and to discuss the several anesthetic implications involved. CASE REPORT: A man patient, 58 years old, with Steinert disease, who underwent hemorrhoidectomy. Subaracnoid block with hyperbaric bupivacaine (saddle block with puncture at L3-L4 with 0.5% bupivacaine [5 mg]) associated with sedation with propofol (1 microg.mL-1 target using a target-controlled infusion pump). Dypirone (1.5 g) and local infiltration with 0.5% ropivacaine (150 mg) were used for the postoperative analgesia. Intraoperatively, the patient developed myotonic crisis (10 minutes after being placed on the litothomy position) that was controlled by sedation (the target concentration was increased to 1.5 microg.mL-1 and given a bolus of 40 mg). The patient remained stable and was discharged the following day. CONCLUSIONS: The knowledge about the disease and the proper anesthetic planning are extremely important when managing patients with Steinert disease.

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Implantes com carga imediata são aqueles que recebem carga mastigatória logo após os estágios cirúrgicos e protéticos, que são realizados num mesmo momento. Nesse caso, não há necessidade da espera pelo processo de osseointegração, pois o mesmo ocorre normalmente, sem nenhum comprometimento posterior. Este trabalho visa a ressaltar as técnicas indicadas para o caso e os fatores de risco envolvidos nessa técnica, além de mostrar, principalmente, seu índice de sucesso quando comparado a implantes sem carga imediata. Para tanto, vale-se de uma revisão da literatura ilustrada por um caso clínico.

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