Is telephone follow-up useful in preventing post-extraction bleeding in patients on antithrombotic treatment?

Background: The aim of the study was to investigate the usefulness of telephone follow-up in preventing post-extraction bleeding and improving wound healing in patients on chronic antithrombotic treatment. Material and Methods: A prospective randomized clinical trial was carried out on 256 patients (test group = 128; control group = 128). The exact two-tailed Fisher test and the two-tailed non-parametric Mann-Whitney test were used for statistical analysis. Results: The incidence of post-extraction bleeding was 15.6% and there was no difference between test and control groups. However, the study group was significantly, though weakly, associated with the severity of bleeding. Patient satisfaction with post-operative follow-up differed significantly between patients who had and those who did not have post-extraction bleeding. Conclusions: Telephone follow-up after tooth extraction may play a role in the prevention of severe post-operative bleeding as well as in monitoring and managing the surgical wound

TWO WEEKLY SESSIONS OF COMBINED AEROBIC AND RESISTANCE EXERCISE ARE SUFFICIENT TO PROVIDE BENEFICIAL EFFECTS IN SUBJECTS WITH TYPE 2 DIABETES MELLITUS AND METABOLIC SYNDROME

none10noThis study was performed to establish whether only 2 sessions per week of combined aerobic and resistance exercise are enough to reduce glycated hemoglobin (HbA(1c) and to induce changes in skeletal muscle gene expression in Type 2 diabetes mellitus (DM2) subjects with metabolic syndrome. Eight DM2 subjects underwent a 1-yr exercise program consisting of 2 weekly sessions of 140 min that combined aerobic [at 55-70% of maximal oxygen uptake (VO(2max))] and resistance circuit training [at 60-80% of 1 repetition maximum (RM)]. The training significantly improved VO(2max) (from 33.5 +/- 3.8 ml/kg/min to 38.2 +/- 3.5 ml/kg/min, p=0.0085) and muscle strength (p<0.05). Changes over baseline were significant for HbA(1c), reduced by 0.45% (p=0.0084), fasting blood glucose (from 8.8 +/- 1.5 to 6.9 +/- 2.2 mmol/l, p=0.0132), waist circumference (from 98.9 +/- 4.8 to 95.9 +/- 4.6 cm, p=0.0054), body weight (from 87.5 +/- 10.7 to 85.7 +/- 10.1 kg, p=0.0375), systolic blood pressure (from 137 +/- 15 to 126 +/- 8 mmHg, p=0.0455), total cholesterol (from 220 +/- 24 to 184 +/- 13 mg/dl, p=0.0057), and LDL-cholesterol (from 150 +/- 16 to 105 +/- 15 mg/dl, p=0.0004). Mitochondrial DNA/nuclear DNA ratio at 6 and 12 months did not change. There was a significant increase of mRNA of peroxisome proliferator-activated receptor (PPAR)-gamma after 6 months of training (p=0.024); PPAR alpha mRNA levels were significantly increased at 6 (p=0.035) and 12 months (p=0.044). The mRNA quantification of other genes measured [mitochondrially encoded cytochrome c oxidase subunit II (MTCO2), cytochrome c oxidase subunit Vb (COX5b), PPAR gamma coactivator l alpha (PGC1 alpha), glucose transporter 4 (GLUT 4), forkhead transcription factor BOX O1 (FOXO-1), carnitine palmitoyltransferase 1 (CPT-1), lipoprotein lipase (LPL), and insulin receptor substrate 1 (IRS-1)] did not show significant changes at 6 and 12 months. This study suggests that a twice-per-week frequency of exercise is sufficient to improve glucose control and the expression of skeletal muscle PPAR gamma and PPAR alpha in DM2 subjects with metabolic syndrome.openC. FATONE; M. GUESCINI; S. BALDUCCI; S. BATTISTONI; A. SETTEQUATTRINI; R. PIPPI; L. STOCCHI; M. MANTUANO; V. STOCCHI; P. DE FEOC., Fatone; Guescini, Michele; S., Balducci; S., Battistoni; A., Settequattrini; R., Pippi; L., Stocchi; Mantuano, Michela; Stocchi, Vilberto; P., DE FE

CIRURGIA TORÁCICA VIDEO-ASSISTIDA (CTVA) NA CORREÇÃO DE DUCTO ARTERIOSO PATENTE. ESTUDO EXPERIMENTAL EM CÃES

Fourteen adult mongrel dogs were used, 8 males and 6 females, weighting 10 to 20 kg,proceeding from the Federal University of Santa Maria, aiming to study a technique to correct patent arteriousductus (PDA) by video-assisted thoracic surgery. It was concluded that three work ports and the optics wereenough and adequately located for the correction of the PDA; surgical materials for vascular surgery can be usedfor the accomplishment of this technique; the positioning of the surgical team, the patient, the equipments andthe instruments were adequate; the Roeder knot was effective; this corrective technique is viable up to five daysafter the induction of the PDA; this technique is effective and can be used for training surgeons on the occlusionof the congenital PDA. The Ethic Commission from UFSM approved this study (012/2005). All animals wereadopted.Foram utilizados 14 cães adultos sem raça definida, sendo 8 machos e 6 fêmeas, cujos pesosvariaram de 10 a 20 kg, provenientes do Biotério Central da UFSM, objetivando-se estudar técnica de correçãode ducto arterioso patente (DAP) por cirurgia torácica vídeo-assistida (CTVA). Concluiu-se que: os três portaisde trabalho e a ótica foram suficientes e se localizaram adequadamente para a correção do DAP; materiais decirurgia vascular podem ser empregados para a realização desta técnica; o posicionamento da equipe cirúrgica,do paciente, dos equipamentos e dos instrumentais foi adequado; o nó de Roeder mostrou-se efetivo; oprocedimento proposto é viável no período de até cinco dias de pós-operatório; esta técnica se mostrou-seefetiva e pode ser empregada na correção de DAP e para o treinamento de cirurgiões na correção do DAPcongênito. Este estudo foi aprovado pela Comissão de Ética da UFSM sob número 012/2005. Todos os animaisforam encaminhados para adoção

Laceração lingual em um cão

O artigo não apresenta resumo

Acid-base and biochemical stabilization and quality of recovery in male cats with urethral obstruction and anesthetized with propofol or a combination of ketamine and diazepam

This study compared acid-base and biochemical changes and quality of recovery in male cats with experimentally induced urethral obstruction and anesthetized with either propofol or a combination of ketamine and diazepam for urethral catheterization. Ten male cats with urethral obstruction were enrolled for urethral catheterization and anesthetized with either ketamine-diazepam (KD) or propofol (P). Lactated Ringer's solution was administered by intravenous (IV) beginning 15 min before and continuing for 48 h after relief of urethral obstruction. Quality of recovery and time to standing were evaluated. The urethral catheter was maintained to measure urinary output. Hematocrit (Hct), total plasma protein (TPP), albumin, total protein (TP), blood urea nitrogen (BUN), creatinine, pH, bicarbonate (HCO3-), chloride, base excess, anion gap, sodium, potassium, and partial pressure of carbon dioxide in mixed venous blood (pvCO(2)) were measured before urethral obstruction, at start of fluid therapy (0 h), and at subsequent intervals. The quality of recovery and time to standing were respectively 4 and 75 min in the KD group and 5 and 16 min in the P group. The blood urea nitrogen values were increased at 0, 2, and 8 h in both groups. Serum creatinine increased at 0 and 2 h in cats administered KD and at 0, 2, and 8 h in cats receiving P, although the values were above the reference range in both groups until 8 h. Acidosis occurred for up to 2 h in both groups. Acid-base and biochemical stabilization were similar in cats anesthetized with propofol or with ketamine-diazepam. Cats that received propofol recovered much faster, but the ketamine-diazepam combination was shown to be more advantageous when treating uncooperative cats as it can be administered by intramuscular (IM) injection.Cette étude visait à comparer les changements biochimiques et acide-base ainsi que la qualité de la convalescence chez des chats mâles avec une\ud obstruction urétrale induite expérimentalement et anesthésiés avec soit du propofol ou une combinaison de kétamine et diazépam pour une\ud cathétérisation urétrale. Dix chats mâles avec une obstruction urétrale ont été recrutés pour cathétérisation urétrale et anesthésiés avec soit\ud une combinaison kétamine-diazépam (KD) ou du propofol (P). Une solution de lactate de Ringer a été administrée par voie intraveineuse (IV)\ud débutant 15 min avant et continuant 48 h après l’élimination de l’obstruction urétrale. La qualité de la convalescence et le délai avant de se\ud tenir debout ont été évalués. Le cathéter urinaire était laissé en place pour mesurer l’excrétion urinaire. Les valeurs des paramètres suivants\ud ont été mesurées avant l’obstruction urétrale, au début de la fluidothérapie (0 h) et à des intervalles subséquents : hématocrite (Hct), protéines\ud plasmatiques totales (TPP), albumine, protéines totales (TP), azotémie (BUN), créatinine, pH, bicarbonate (HCO3\ud 2), chlorure, excès de base,\ud trou anionique, sodium, potassium, pression partielle de dioxide de carbone dans le sang veineux (pvCO2). La qualité de la convalescence et\ud le temps avant de se tenir debout étaient respectivement de 4 et 75 minutes dans le groupe KD et de 5 et 16 minutes dans le groupe P. Les\ud valeurs de BUN étaient augmentées à 0, 2 et 8 h dans les deux groupes. La créatinine sérique augmenta à 0 et 2 h chez les chats recevant KD\ud et à 0, 2 et 8 h chez les chats recevant P, bien que les valeurs étaient supérieures à l’écart de référence dans les deux groupes jusqu’à 8 h. Une\ud acidose s’est produite pendant 2 h dans les deux groupes. L’équilibre acide-base et la stabilisation biochimique étaient similaires chez les chats\ud anesthésiés avec du propofol ou avec KD. Les chats qui ont reçu du propofol ont récupéré beaucoup plus rapidement, mais la combinaison KD\ud s’est avérée plus avantageuse pour traiter des chats non-coopératifs étant donné la possibilité d’administration par voie intra-musculaire

Long-term follow-up after traditional versus modified perineal approach in the management of female epispadias

Q2e1–497.e5Objective Isolated female epispadias (IFE) is a rare congenital anomaly. The defect extends to the bladder neck, which is usually incompetent. The traditional surgical approach includes urethral and genital reconstruction in the first year, followed by bladder neck reconstruction (Young-Dees-Leadbetter cervicoplasty (YDL)) at the age of social continence. An alternative single-stage technique includes urethral, bladder neck and clitoris repair by a perineal approach. The aim of the present study was to describe long-term follow-up of patients who underwent the traditional vs alternative approach. Materials and methods A retrospective review was performed of all female epispadias cases managed between 2000 and 2013. The YDL procedure (Group 1) vs single-stage perineal approach (Group 2) cases were followed and compared. Collected variables included: patients' demographics, age at diagnosis and surgery, presence of associated anomalies, clinical presentation, presence of vesicoureteral reflux (VUR), and pre-operative and postoperative continence. Results A total of 12 cases of female epispadias were managed and followed between 2000 and 2013. No major complications occurred in either group. Urinary continence evaluated in seven children showed that none (0/3) and 4/7 (57%) were continent following the initial procedure in Group 1 and Group 2, respectively. All patients in Group 1 failed to achieve continence and required re-intervention. Conclusions Female epispadias could be successfully repaired using a single-stage modified perineal approach that achieved good continence with volitional voiding, good cosmetic results and compared favorably with the ones repaired with the YDL technique. The additional step of performing bladder neck tailoring to achieve a funneling configuration seemed to be useful in improving continence

Determining the best sectioning method and intestinal segment for morphometric analysis in broilers

Brazilian poultry production is very efficient and demands maximum broiler performance. Therefore, digestive system pathologies have a relevant role. Considering it is difficult to obtain consistent information on intestinal morphometric analysis, this study aimed at establishing essential and clear criteria for the collection of intestinal segments for morphometric analysis. Fifteen 13-d-old broilers were sacrificed and three intestinal segments were collected per bird. Two 3-cm long sections were obtained from each of the intestinal segments. Samples were collected open or closed. The closed samples were transversely, hemicylindrically, or longitudinally sectioned. Samples were processed and stained with hematoxylin and eosin. The number of microscopic fields in each section was counted. Villi presenting the base clearly embedded in the submucosa, no damage or folds, and simple columnar epithelium at the tip were considered adequate for measurements. These villi were counted in each sample. The results shows that hemicylindrical sections presented the highest number of observation fields, with an average of 9.76 fields. Jejunum samples were among the three highest average villi counts, with 18.23 in longitudinal sections and 15.61 in hemicylindrical sections. The results of the present study indicate that hemicylindrical sectioning and jejunal samples were, respectively, the best sectioning method and the best intestinal segment for the morphometric analysis of the intestines of broilers