Estudo epidemiológico pré-cirúrgico de cadelas portadoras de neoplasias mamárias

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Differences between acute exacerbations of idiopathic pulmonary fibrosis and other interstitial lung diseases.

Interstitial lung diseases (ILDs) comprise a wide group of pulmonary parenchymal disorders. These patients may experience acute respiratory deteriorations of their respiratory condition, termed “acute exacerbation” (AE). Incidence of AE-ILD seems to be lower than idiopathic pulmonary fibrosis (IPF), but prognosis and prognostic factors are largely unrecognized. We retrospectively analyzed a cohort of 158 consecutive adult patients hospitalized for AE-ILD in two Italian University hospitals from 2009 to 2016. Patients included in the analysis has been divided into two groups: non-IPF (62%) and IPF (38%). Among ILDs included in the non-IPF group, the most frequent diagnoses were non-specific interstitial pneumonia (NSIP) (42%) and connective tissue disease (CTD)-ILD (20%). Mortality during hospitalization was significantly different between the two groups, respectively 19% in non-IPF group and 43% in IPF group. AEs of ILDs are difficult-to-predict events and are burdened by relevant mortality. Increased inflammatory markers with neutrophilia on differential blood cell count (HR 1.02 [CI 1.01 – 1.04]), presence of pulmonary hypertension (HR 1.85 – [CI 1.17 – 2.92]) and diagnosis of IPF (HR 2.31 [CI 1.55 – 3.46]) resulted negative prognostic factors in our analysis, while lymphocytosis on differential count seemed to act as a protective prognostic factor (OR 0.938 [CI 0.884 – 0.995]). Further prospective, large-scale, real-world data are needed to support and confirm the impact of our findings

Uso de membrana amniótica homógena para correção de úlcera de córnea perfurada em equino

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Feasibility and clinical impact of a portable bi-level ventilation device in patients with severe chronic obstructive pulmonary disease and exertional dyspnea: preliminary results from a clinical series

We explore home use of a portable bi-level ventilation device among patients with severe chronic obstructive pulmonary disease (COPD), and describe changes in the patients\u2019 physical activity levels, perceived dyspnea, anxiety and depression, as well as their satisfaction with the device, after one month of use. Methods. Forty patients with severe COPD and exertional dyspnea were instructed to use VitaBreath\uae device (Philips, Respironics) during efforts or activities of daily living for 4 weeks, and agreed to answer questionnaires on anxiety, depression, dyspnea and physical activity. Results. Twenty-six (65%) patients used the VitaBreath\uae device for four weeks, while 14 patients (35%) stopped early for various reasons. Among patients who completed the 4-week course, no differences in dyspnea and physical activity were observed between baseline and follow-up (p-values 0.41 and 0.19, respectively). Thirteen (50%) and 15 (57%) patients experienced reduced anxiety and depression, respectively. Patients with greater functional impairment and less autonomy in activities of daily living tended to view the device more positively. Conclusion. Home use of portable bi-level positive-pressure ventilation devices by patients with COPD may alleviate disease-related anxiety and depression, particularly in more severe cases of COPD. Future portable device design should feature adjustable inspiratory/expiratory pressures

Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia.

OBJECTIVE: To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Twenty client-owned healthy horses aged 5 +/- 2 years, weighing 456 +/- 90 kg. METHODS: In the control group (CG; n = 10) weaning was performed by a gradual decrease in respiratory rate (fR ) and in the PSV group (PSVG; n = 10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2 > 50 mmHg, arterial pH 50 mmHg or PaO2 10 L (p = 0.0001), fR /VT ratio 18.5 mL kg(-1) (p = 0.0001) and PaO2 /FiO2 > 298 (p = 0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT /= 0.60 breaths minute(-1) L(-1) (p = 0.0001) and Pe'CO2 >/= 38 mmHg (p = 0.0001) at weaning. CONCLUSIONS AND CLINICAL RELEVANCE: Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT , VT /body weight, PaO2 /FiO2 ratio and a lower fR /VT ratio and Pe'CO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia

Effect of ephedrine and phenylephrine on cardiopulmonary parameters in horses undergoing elective surgery.

OBJECTIVE: To assess the cardiopulmonary effects of ephedrine and phenylephrine for management of isoflurane-induced hypotension in horses. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Fourteen isoflurane-anesthetized horses undergoing digital palmar neurectomy. METHODS: Ephedrine (EPH group; 0.02 mg kg(-1) minute(-1); n = 7) or phenylephrine (PHE group; 0.002 mg kg(-1) minute(-1); n = 7) was administered to all horses when mean arterial pressure (MAP) was <60 mmHg. The infusions were ended when the target MAP was achieved, corresponding to a 50% increase over the pre-infusion MAP (baseline). The horses were instrumented with an arterial catheter to measure blood pressure and allow the collection of blood for pH and blood-gas analysis and a Swan-Ganz catheter for measurement of cardiac output using thermodilution. Cardiopulmonary parameters were recorded at baseline and at 5, 30, 60 and 90 minutes after achieving the target MAP. RESULTS: In both groups, the MAP and systemic vascular resistance (SVR) increased significantly at 5, 30, 60 and 90 minutes post infusion compared to baseline (p < 0.05). The EPH group had a significant increase in cardiac index (CI) and systemic oxygen delivery index at 5, 30, 60 and 90 minutes post infusion compared to baseline (p < 0.05) and compared to the PHE group (p < 0.05). The PHE group had significantly higher SVR and no decrease in oxygen extraction compared with the EPH group at 30, 60 and 90 minutes post infusion (p < 0.05). No significant differences in ventilatory parameters were observed between groups after the infusion. CONCLUSIONS: Ephedrine increased the MAP by increasing CI and SVR. Phenylephrine increased MAP by increasing SVR but cardiac index decreased. Ephedrine resulted in better tissue oxygenation than phenylephrine. CLINICAL RELEVANCE: Ephedrine would be preferable to phenylephrine to treat isoflurane-induced hypotension in horses since it increases blood flow and pressure

Effect of postoperative xylazine administration on cardiopulmonary function and recovery quality after isoflurane anesthesia in horses.

OBJECTIVE: To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. STUDY DESIGN: Randomized, blinded, prospective, clinical study. ANIMALS: Horses (n = 20). METHODS: During recovery after 3 hours of isoflurane anesthesia for arthroscopic surgery, horses were administered either 0.25 mg/kg (G25, n = 10) or 0.50 mg/kg (G50, n = 10) xylazine intravenously. Vital signs and arterial blood samples were obtained during recovery before sedation (baseline), 5, 10, 20, 30, and 45 minutes after xylazine and 30 minutes after standing. The quality of recovery scores ranged from 10 to 72 (10 = best, 72 = worst). RESULTS: G25 horses recovered faster (mean +/- SD, 33 +/- 5 min) than G50 horses (50 +/- 7 min, P < .0001). Mean maximal decrease in arterial oxygen tension was 55 +/- 11 mmHg in G25 (at 10 minutes; P < .05) and 54 +/- 7 mmHg in G50 (at 20 minutes; P < .01). G25 group had a total recovery score (23 [range 18-29]) and number of attempts to stand (4 +/- 2) greater than the G50 group (18 [10-23] and 1 +/- 1, respectively; P < .001). CONCLUSIONS: Both doses of xylazine promoted a moderate and transient hypoxemia during recovery; however, the 0.5 mg/kg dose produced a longer and improved quality of recovery from anesthesia

Evaluation of the Biocompatibility and Osteoconduction of the Carbon Nanotube, Chitosan and Hydroxyapatite Nanocomposite with or without Mesenchymal Stem Cells as a Scaffold for Bone Regeneration in Rats

Background: Bone substitutes have been developed to assist bone regeneration in orthopedic surgeries. Mesenchymal stem cells can be added to these biomaterials to enhance bone regeneration. This study aimed to evaluate the biocompatibility and osteoconduction of a carbon nanotube, chitosan, and hydroxyapatite nanocomposite (CNCHN) that had either been enriched or not enriched with sheep bone marrow mesenchymal stem cells (BM-MSCs) in rats. Methods: A total of sixty rats were divided into groups, and an implant with or without BM-MSCs was performed subcutaneously in 20 animals (euthanized after 7 and 30 days), comparing them to 10 control animals, and in the calvaria of 20 animals (euthanized after 20 and 60 days), comparing to with 10 control animals. Subcutaneous and calvaria histologies were performed after euthanasia. Results: The subcutaneous tissue showed that CNCHN did not prompt an exacerbated inflammatory response or signs of necrosis. The histomorphological analysis by the calvaria score of the rats showed that the control group had lower scores at 20 and 60 days for bone neoformation, relative to the CNCHN groups, which showed no significant statistical differences, suggesting that the nanocomposite assisted in the regenerative process of defects in the calvaria, but with no repair potentiation when using BM-MSCs. Conclusion: CNCHN has biocompatibility and osteoconductive potential, showing promising results in bone defects