Metamizol and Scopolamine for Conventional or Two-Port Laparoscopic-Assisted Ovariohysterectomy in Dogs

Background: Ovariohysterectomy (OVH) is one of the most appliedtechniques in Veterinary Medicine. Although some analgesic protocols are used after this procedure in order to control post operatory pain, there is a lack of knowledge of the efficacy after conventional and two port laparoscopic-assisted techniques in dog female. Although the combined formulation of metamizol and scopolamine is used, there is no knowledge about the efficacy and collateral effects in a 6 h regimen after OVH. The aim of this research was to evaluate the efficacy of metamizol and scopolamine to analgesia after two techniques of OVH in dog female.Materials, Methods & Results: Fifteen adults and healthy dog female were submitted to OVH, being eight to the conventional procedure and seven to video assisted technic with two ports. The patients received a combination of metamizol and scopolamine, 6-6 h during 48 h and were evaluated before surgery, 60 min after extubation and on 1 h interval during the first 8 h, and at 12, 18, 24, 36, 48 and 72 h after surgery. For this, the University of Melbourne Pain Scale (UMPS) and the short-form of the Glasgow Composite Measure Pain Scale (CMPS-SF) were applied by three evaluators blinded to surgical technic. Glucoses measurement was realized at 1, 6, 12, 24, 48 and 72 h after surgery. Analgesic rescue was not necessary for any animal. Punctuation of UMPS in GC decreases at 8 h and at 5 h, and to GV at 12 and 24 h. Difference between groups happened at 3 h with larger average to GV; at 48 h the punctuation in GC was lager. Considering CMPS-SF to CG, higher average was observed at 1 h and decreased at 2, 3, 8 and 18. At GV highest average points was verified at 1, 2 and 3 h and decreased at 5, 8 and 18 h. Correlation was strong and positive between each two evaluators. Animals of both groups had increased average glucose concentrations from baseline to after surgery and the values reduced to baseline after 24 h; difference between groups were observed at 1 h after surgery, with bigger average to GC. Three animals from the GC had postoperative emesis and one patient vomited after 3 h; other at 6 h and another at 36 and 48 h and owners related no vomiting or changes following hospital discharge. The time to first spontaneous food intake was earlier to GV and time to first defecation was no different between groups. Discussion: For the evaluation it was used the UMPS and CMPS-SF since it is know that pain assessment is better performed when multidimensional or composite scales are used. Considering the UMPS, 27 points is considered the most painful condition. In our study it was observed bigger average to GC at 1 h (4,5) and to GV at 2 and 3 h (5,0). According to CMPS-SF, higher punctuation to GC (7.0) was observed than GV (6,0) in a maximum of 24 points. Considering both scales, it could be suggested that the combination of metamizol and scopolamine promote good analgesic effect. The glucoses measurements and the first spontaneous food intake suggested that laparoscopic approaches results in less stress than the traditional procedures, as observed in other studies. Three animals of GC had postoperative emesis, and it signal can be associated to abdominal pain, as well nausea, vomiting, diarrhea and abdominal distention, probably because it is accepted that video surgery promotes less pain and stress than open procedures. The protocol was efficient to control pain after elective conventional and laparoscopic assisted OHV technique in dog female.

OVÁRIO-HISTERECTOMIA VIDEOASSISTIDA EM UMA CADELA COM HEMATOMETRA

A piometrite canina é uma enfermidade da cadela adulta, caracterizada por inflamação do útero com acúmulo de exsudatos. A hematometra é uma consequência da piometrite, porém caracteriza-se por diapese de eritrócitos para a luz uterina, modificando a coloração da secreção.   A terapia deve ser imediata e agressiva. Ovário-histerectomia é o tratamento de escolha para animais gravemente acometidos. O presente trabalho descreve a ovário-histerectomia videoassistida no tratamento de hematometra em uma cadela da raça Akita, com seis anos de idade e 34 kg de massa corporal. Utilizou-se o acesso com três portais, os quais permitiram a ligadura dos vasos ovarianos e a secção do mesométrio. Já  o útero e os vasos uterinos foram manipulados por meio de miniceliotomia pré-púbica. Não se constataram complicações transoperatórias ou recidiva da doença, o que demonstra a eficácia do procedimento em cães, pois a evolução pós-operatória sete meses após o procedimento respalda a conduta cirúrgica adotada. PALAVRAS-CHAVES: Cadelas, cirurgia, laparoscopia, piometrite, tratamento

Effect of Lactoferrin on Clinical Outcomes of Hospitalized Patients with COVID-19: The LAC Randomized Clinical Trial

: As lactoferrin is a nutritional supplement with proven antiviral and immunomodulatory abilities, it may be used to improve the clinical course of COVID-19. The clinical efficacy and safety of bovine lactoferrin were evaluated in the LAC randomized double-blind placebo-controlled trial. A total of 218 hospitalized adult patients with moderate-to-severe COVID-19 were randomized to receive 800 mg/die oral bovine lactoferrin (n = 113) or placebo (n = 105), both given in combination with standard COVID-19 therapy. No differences in lactoferrin vs. placebo were observed in the primary outcomes: the proportion of death or intensive care unit admission (risk ratio of 1.06 (95% CI 0.63-1.79)) or proportion of discharge or National Early Warning Score 2 (NEWS2) ≤ 2 within 14 days from enrollment (RR of 0.85 (95% CI 0.70-1.04)). Lactoferrin showed an excellent safety and tolerability profile. Even though bovine lactoferrin is safe and tolerable, our results do not support its use in hospitalized patients with moderate-to-severe COVID-19

Osso bovino esponjoso inorgânico liofilizado em bloco no reparo de fístula oronasal induzida em cães Lyophilized inorganic bovine bone cancellous block for iatrogenic oronasal fistula repair in dogs

O reparo de fístulas oronasais representa um desafio para o cirurgião, devido à freqüente ocorrência de recidivas. Com o intuito de avaliar o emprego de osso bovino esponjoso inorgânico liofilizado em bloco (OBEILB) no tratamento dessa afecção, foi realizado um experimento utilizando dez cães sem raça definida, fêmeas com peso variando entre 8-17kg, submetidos à indução de fístulas oronasais após exodontia dos caninos. O procedimento cirúrgico foi realizado em duas etapas: na fístula do lado esquerdo, foi feito reparo imediato após realização do defeito, e, no lado direito, o reparo foi efetuado após sete dias, ambos preenchidos com OBEILB e recobertos com retalho de mucosa de origem gengival. Os animais foram avaliados clínica e radiograficamente, semanalmente, entre sete e 120 dias. O material usado é eficaz no reparo de fístulas oronasais do alvéolo do dente canino maxilar, não apresentando evidências de rejeição e recidivas.The oronasal fistula repair still represents a challenge to the surgeons, due to the high incidence of recidivation. An experiment using 10 adult mongrel dogs weighting between 8 and 17 kilograms was performed in order to evaluate the in block lyophilized inorganic bovine bone cancellous (BLIBBC) in the treatment of this disease. Each dog had an exodontic procedure of both canine teeth, in order to produce an oronasal fistula. The surgical procedure realized consisted in two different surgical steps: the left side defect was repaired right after the defect have been produced, while the right side defect was repaired seven days after the fistula induction; both sides were repaired using BLIBBC and covered with gengival flap. The animals were radiological and clinicaly evaluated every week for 120 days. The material used was effective in the repair of both fistulas, without rejection or recurrence