Placental mesenchymal dysplasia and intrauterine fetal growth restriction with doppler velocimetry alterations - a case report

Placental mesenchymal dysplasia (PMD) is a rare placental abnormality. We report a case of PMD associated with intrauterine growth restriction (IUGR), which was diagnosed by an ultrasound scan during the second trimester of pregnancy. A 36-year-old primiparous woman with signs of placental chorioangioma was referred to our hospital at the 23th gestational week. An ultrasonography revealed a small-for-gestational-age fetus with a large multicystic placenta. A serial Doppler sonographic assessment of umbilical and uterine artery blood flow showed a compromised fetus. A female, small-for-gestational-age baby was delivered by c-section at 28 weeks, and PMD was histopathologically confirmed

Placental mesenchymal dysplasia and intrauterine fetal growth restriction with doppler velocimetry alterations - a case report

Placental mesenchymal dysplasia (PMD) is a rare placental abnormality. We report a case of PMD associated with intrauterine growth restriction (IUGR), which was diagnosed by an ultrasound scan during the second trimester of pregnancy. A 36-year-old primiparous woman with signs of placental chorioangioma was referred to our hospital at the 23th gestational week. An ultrasonography revealed a small-for-gestational-age fetus with a large multicystic placenta. A serial Doppler sonographic assessment of umbilical and uterine artery blood flow showed a compromised fetus. A female, small-for-gestational-age baby was delivered by c-section at 28 weeks, and PMD was histopathologically confirmed

The prevalence and adequacy of antibiotic prescriptions in Hospital de Clínicas de Porto Alegre

Durante o dia 30 de julho de 1987, foram estudados alguns aspectos envolvendo o uso de antibióticos no Hospital de Clínicas de Porto Alegre. De 432 pacientes internados, 182 (42%) estavam utilizando antibióticos,e destes, 42% recebiam a medicação de forma inadequada. Dos antibióticos usados terapeuticarhente, os mais prescritos foram ampicilina, penicilina, cefalosporinas e amicacina. Entre os usados profilaticamente, destacaram-se cefa/osporinas, gentamicina e ampicilina. O trabalho sugere que o controle do uso de antibióticos pode reduzir a adoção inapropriada destes agentes.On July 30th 1987 there was made a survey to evaluate the antibiotic use in the Hospital de Clínicas de Porto Alegre. 432 patients were investigated and 182 (42%) were under antimicrobial therapy. This group showed 42% o f patients receiving antimicrobians inappropriately. The antibiotics most used therapeuticaly were ampicillin, penicillin, cefalosporin and amikacin. For prophylaxis the most used were cefalosporin, gentamicin and ampicillin. This paper suggests that contra/ procedures can reduce the inappropriate use of antimicrobial agents in our hospital

Placental mesenchymal dysplasia and intrauterine fetal growth restriction with doppler velocimetry alterations - a case report

Placental mesenchymal dysplasia (PMD) is a rare placental abnormality. We report a case of PMD associated with intrauterine growth restriction (IUGR), which was diagnosed by an ultrasound scan during the second trimester of pregnancy. A 36-year-old primiparous woman with signs of placental chorioangioma was referred to our hospital at the 23th gestational week. An ultrasonography revealed a small-for-gestational-age fetus with a large multicystic placenta. A serial Doppler sonographic assessment of umbilical and uterine artery blood flow showed a compromised fetus. A female, small-for-gestational-age baby was delivered by c-section at 28 weeks, and PMD was histopathologically confirmed

Anesthetic protocol for videolaparoscopic surgery in rabbits Protocolo anestésico para cirurgia videolaparoscópica em coelhos

PURPOSE: To describe the anesthetic protocol and the intubation technique without visualizing the trachea in rabbits, in order to enable the videolaparoscopic surgical procedure. METHODS: The experiment was performed on 33 female rabbits (Oryctolagus cuniculus), aged from 5 to 7 months. It consisted of general anesthesia and endotracheal intubation by manual palpation of the trachea of the rabbits, without using the laryngoscope, orally, for later videolaparoscopic surgical access to the abdominal cavity. RESULTS: The mean values and standard deviation of vital parameters of the animals were 223.8±15.61 beats per minute for heart rate; 35±9 movements per minute for respiratory rate; 96.94±0.99% of oxymetry and 42.82±4.02 mmHg for capnometry; 16.7±4.3 minutes for pneumoperitoneum (duration of surgery) and 1 hour and 14±8.52 minutes for time of observation (from induction to recovery from anesthesia). All animals were intubated in at most three attempts. No animals were lost after the introduction of this anesthetic technique. CONCLUSION: This protocol proved adequate, safe and easy to perform, on rabbits submitted to videolaparoscopic surgery.<br>OBJETIVO: Descrever o protocolo anestésico e a técnica de intubação sem visualização da traqueia em coelhos, para viabilização de procedimento cirúrgico videolaparoscópico. MÉTODOS: O experimento foi realizado em 33 coelhas (Oryctolagus cuniculus), com idade entre 5 e 7 meses. Consistiu de anestesia geral e intubação endotraqueal por meio de palpação manual da traquéia das coelhas, sem o uso de laringoscópio, pela via oral, para posterior acesso cirúrgico videolaparoscópico da cavidade abdominal. RESULTADOS: Os valores médios e desvio padrão dos parâmetros vitais dos animais foram de 223,8±15,61 batimentos por minuto para freqüência cardíaca; 35±9 movimentos por minuto para frequência respiratória; 96,94±0,99% de oximetria e 42,82±4,02 mmHg para capnometria; 16,7±4,3 minutos para o pneumoperitônio (tempo de cirurgia) e 1 hora e 14±8,52 minutos para o tempo de observação (desde a indução até a recuperação anestésica). Todos os animais foram intubados em, no máximo, três tentativas. Não houve perda de animais após a introdução dessa técnica anestésica. CONCLUSÃO: Este protocolo mostrou-se adequado, seguro e de fácil realização, para a aplicação em coelhos submetidos à cirurgia videolaparoscópica

Experimental model of the formation of pelvic adhesions by videolaparoscopic in female rabbits Modelo experimental de formação de aderências pélvicas por videolaparoscopia em coelhas

PURPOSE: To verify the frequency of postsurgical pelvic adhesion formation in an experimental animal model using videolaparoscopy. METHODS: Experimental study in a sample of 11 non-pregnant female rabbits, aged 5 to 7 months. After general anesthesia, access to the abdominal cavity was performed by an open puncture technique, with 10mm optics, placing two other 5 mm trochars under direct visualization, in the iliac fossae. Then a fragment of peritoneum was resected, followed by electrocauterization. In 21 days, the videolaparoscopy was repeated, and adhesion formation and score was looked at, with biopsies at the surgical site. RESULTS: 54 % of adhesion formation was observed, and the median score of adhesions was 6 (minimum of 3 and maximum of 10), all of them found in the bladder and the anterior abdominal wall. CONCLUSION: The method used presents a high frequency of intra-abdominal adhesion formation.<br>OBJETIVO: Verificar a freqüência da formação de aderências pélvicas pós-cirúrgicas, em um modelo experimental animal, por videolaparoscopia. MÉTODOS: Estudo experimental, em uma amostra de 11 coelhas, não prenhas, com idade entre cinco e sete meses. Após anestesia geral, o acesso da cavidade abdominal foi efetuado por técnica de punção aberta, com óptica de 10 mm, colocando-se outros dois trocateres de 5 mm, sob visão direta, nas fossas ilíacas. Realizou-se, então, ressecção de fragmento de peritônio, seguida de cauterização com eletrocautério. Em 21 dias, foi repetida a videolaparoscopia, verificando-se a formação e escore de aderências e realizando-se biópsias do local da cirurgia. RESULTADOS: Observou-se 54,5% de formação de aderências, sendo o escore total mediano de aderências seis (mínimo de três e máximo de 10), todas encontradas na bexiga e na parede abdominal anterior. CONCLUSÃO: O procedimento utilizado apresentou alta freqüência de formação de aderências intra-abdominais