Permanent tracheostomy in a horse: a case report / Traqueostomia permanente em equino: relato de caso

Problems related to the locomotor and gastrointestinal systems correspond to the highest percentage of clinical cases. However, diseases related to the respiratory system can result in low animal performance or even the animal's removal from athletic life. This paper aims to report a case of permanent tracheotomy in a horse. The animal was treated at the Jerônimo Dix-Huit Rosado Maia Veterinary Hospital - HOVET, with respiratory noise and dyspnea claims. In the anamnesis, the owner reported that the animal had been presenting respiratory difficulty for 20 days. On physical examination, respiratory noise and dyspnea were noted. Endoscopy was performed, from which a marked decrease in the arytenoid cartilage movement on the right and left sides was noted. It was possible to diagnose a stage IV case of bilateral laryngeal hemiplegia, combining clinical signs with endoscopy findings. Thus, the surgical treatment of permanent tracheostomy was chosen. After surgery, drug therapy using antibiotics and anti-inflammatory drugs was performed. In addition, a nº 6 metal tracheostomy cannula was inserted. After 36 days of hospitalization, the animal was discharged with regression of clinical signs.(AU)

Problemas relacionados aos sistemas locomotor e gastrointestinal correspondem ao maior percentual de casos clíni-cos. No entanto, doenças relacionadas ao sistema respiratório podem resultar em baixo desempenho do animal ou mesmo na retirada do animal da vida atlética. Este trabalho tem como objetivo relatar um caso de traqueotomia permanente em um cavalo. O animal foi atendido no Hospital Veterinário Jerônimo Dix-Huit Rosado Maia - HOVET, com queixas de ruído respiratório e dispneia. Na anamnese, o proprietário relatou que o animal apresentava dificuldade respiratória há 20 dias. Ao exame físico, notou-se ruído respiratório e dispneia. Foi realizada endoscopia, a partir da qual foi notada diminuição acentuada do movimento da cartilagem aritenoide nos lados direito e esquerdo. Foi possível diagnosticar um caso em estágio IV de hemiplegia laríngea bila-teral, combinando os sinais clínicos com os achados endoscópicos. Assim, optou-se pelo tratamento cirúrgico da traqueostomia definitiva. Após a cirurgia, foi realizada terapia medicamentosa com antibióticos e anti-inflamatórios. Além disso, uma cânula de traqueostomia de metal nº 6 foi inserida. Após 36 dias de internação, o animal recebeu alta com regressão dos sinais clínicos.(AU)

Chemodectoma in a bitch

Background: Chemodectomas, better known as tumors of the base of the heart, arise from aortic bodies, respiratory chemoreceptors located near or inside the aortic arch or originate from receptors located in the carotid arteries. Relatively rare, they affect dogs and, to a lesser extent, cats. They gain great importance when they influence the function of the cardiovascular system, with animals showing clinical signs related to congestive heart failure. Clinical diagnosis is based on symptomatology and complementary tests such as radiography, electrocardiography and echocardiography, while the definitive diagnosis is obtained by cytological and histopathological exams. This study aims to reports a case of malignant chemodectoma in a bitch, whose main symptomatology was neurological and not cardiovascular. Case: A 1-year-old Rottweiler bitch was attended with neurological alterations compatible with vestibular syndrome, hyporexia, dysphagia, apathy, melena, emesis, and purulent nasal discharge on the right nostril. On physical examination, the animal showed depressed level of consciousness, poor body condition, bilateral quemosis, paralysis of the right eye, inspiratory dyspnea and muffling of cardiac auscultation, besides a subcutaneous nodule between the scapulae. On neurological evaluation, horizontal nystagmus, head tilt to the right side, ventromedial strabismus and facial nerve paralysis on the right side were observed so that the localization of the lesion was set in peripheral vestibular system. During anesthesia for esophageal tube placement, a mass from the hard palate to the oropharynx was noted, making endotracheal intubation impossible to perform. Biopsy of this nodule was performed, and tracheostomy was indicated, but the owner opted for euthanasia before the procedure. Necropsy revealed white soft masses in the bilateral retromandibular region, on the subcutaneous tissue near the scapulae, in the right ear and since nasopharynx to the soft palate, in addition to sparse white nodules in the heart, lung, carotid artery, kidneys, right ovary, mesentery near to the spleen, and axillary lymph node. Histologically, the nodules were characterized by neoplastic cells population organized in short bundles or cords, arranged around small blood vessels surrounded by delicate connective tissue. Neoplastic cells infiltrated muscles and blood and lymphatic vessels were filled by multiple neoplastic emboli. The histological pattern of the cells allowed the diagnosis of chemodectoma. Discussion: The bitch from this case had 1-year-old when diagnosed with chemodectoma, differently from most cases from literature, that are between 7 to 15 years old. Furthermore, primarily cardiac tumors are considered rare, being chemodectoma the most common, often reported in Boxer and Boston Terrier dogs, but unusual in Rottweilers. Despites some articles mentioning seizure and Horner's Syndrome secondary to a carotid body chemodectoma, neurological signs are not commonly observed in these cases. The presence of the tumor in the middle ear region of the right side supports the occurrence of peripheral vestibular syndrome and facial nerve paralysis on the same side. Because it is a neoplasm that is usually detected late during the course of the disorder, most patients either cannot obtain diagnosis in vivo, as in this reported animal, which was in such a critical condition that underwent euthanasia, or there are no more possible therapeutic choices. In the patient described, there were numerous metastatic masses and nodules spread throughout the body. Although the typical clinical signs in animals with chemodectomas are often related to heart disease, neurological signs may also be present. This report emphasizes the importance of chemodectoma being included as a differential diagnosis in young dogs and even in breeds such as Rottweiler.

Linfoma de células T na cavidade nasal de caprino / T-cell lymphoma in the nasal cavity in goat

Background: Lymphomas are considered uncommon in goats, being the multicentric form with the highest number of cases for the species. Primary intranasal lymphomas are often diagnosed in dogs, cats, and humans. In the literature, there is only a description of a multicentric case involving the frontal sinuses and mucosa of the nasal cavity in a goat; therefore, it is important to describe unusual cases of this disease for the inclusion of new clinical and pathological characteristics in the ruminant clinic medicine. The objective of this work is to describe a case of T-cell lymphoma in the nasal cavity of a young goat. Case: The animal had dyspnea and respiratory noise for 15 days. Clinical examination showed nodulation in the right nasal cavity associated with serosanguinous secretion. Tracheostomy was performed; however, after 30 days the animal was euthanized. A sagittal plane of the head showed a pinkish-gray mass in the right and left nasal cavity, with a smooth, multilobulated surface, smooth adhering to the rostral portion of the dorsal concha and occluding the dorsal nasal meatus. Submandibular lymph nodes were slightly enlarged. Histopathological examination of the nasal cavity revealed a non-encapsulated, poorly delimited and ulcerated tumor composed of round cells arranged in a mantle supported by a discrete fibrovascular stroma extending the mucosa and lamina propria. Cells were round with sparse, eosinophilic and poorly delimited cytoplasm. Nuclei varied from round to elongated with condensed chromatin and evident nucleoli. Occasionally, aberrant nuclei, reniform shape and multinucleated cells were seen. Pleomorphism was moderate characterized by anisocytosis and anisocariosis. Typical and atypical mitosis were frequent (0-4 per field of highest magnification [400x]). Amidst the neoplasm, there were multifocal areas of necrosis and hemorrhage associated with a mild lymphocytic inflammatory infiltrate. Immunohistochemistry showed positive immunostaining for Vimentin antibodies and CD3, and negative for pan CK and CD20. Discussion: The lymphomas immunophenotyping is little used when it comes to farm animals, and there are few studies that use this technique for the definitive diagnosis of these neoplasms for small ruminants. The use of this technique must be considered in each case, in order to determine the pathogenesis, the accurate diagnosis and the origin of the neoplastic lymphocytes. In goats, T-cell lymphomas are the most diagnosed, although cases of multicentric B-cell lymphomas with ocular involvement have been diagnosed. In view of the clinical picture of the case described, infectious rhinitis already described in goats, such as aspergillosis and protothecosis, should be included as differential diagnoses. However, the anatomopathological findings facilitate the direction of the diagnosis, since infectious rhinitis presents as nodules / ulcerated masses or focal areas of necrosis associated with purulent secretion and in the histopathological examination it is possible to observe the intralesional etiological agents. In addition, the enzootic ethmoidal tumor must be included, as it has similar clinical signs and affects young animals, but they are adenomas/adenocarcinomas that affect the ethmoidal nasal shells induced by a retrovirus. Lymphomas in the caprine species are rare in the Northeastern semi-arid, but that in the present diagnostic routine occasionally occurs, being important the first description of its nasal shape for its inclusion in the differential diagnoses of diseases that present with clinical obstruction and dyspnea for the species.

Manejo da via aérea difícil em um gato com tonsilite / Management of difficult airway in a cat with tonsillitis

Background: Tracheal intubation is performed in an anesthetized patient in order to optimize oxygenation and to allow the administration of volatile anesthetics. Some patients have characteristics that make intubation a challenge. Therefore, an adequate pre-anesthetic evaluation enables the anesthesiologist to define the best management. There are reports of the impossibility of performing conventional intubation attributed to the lack of pre-anesthetic consultation in Medicine, which motivates and justifies the discussion of these aspects in Veterinary Medicine. Therefore, this study aims to report a case of difficult airway management in a feline with tonsillitis. Case: A 3-year-old male NDB cat weighing 3.5 kg was admitted to the Veterinary Hospital, Federal University of Pampa (UNIPAMPA) - Uruguaiana, for consultation. After physical examination, total tooth extraction and tonsillectomy was recommended. On the day of the procedure, a physical evaluation of the patient was performed, and he was classified as ASA II. Zolazepam and tiletamine [Zoletil® - 5 mg/kg, i.m] associated with morphine [Dimorf® - 0.3 mg/kg, i.m] was given as premedication. Given the difficulty of intubation in a previous procedure reported by the tutor, a thoughtful conduct was planned for the intubation of the patient, considering the possibility of tracheostomy. The patient was pre-oxygenated, and subsequently, propofol [Propovan® - 4 mg/kg, i.v] was administered to promote anesthetic induction. The first attempt at intubation was done by laryngoscopy, but despite the use of a 6 cm blade, it was too large in relation to the hyperplastic tissue; then swabs and a flashlight were subsequently used. With the help of 2 people, the experienced anesthesiologist was able to position the endotracheal tube correctly approximately 25 min after the first attempt, requiring supplemental doses of propofol [Propovan® to the effect, i.v] and oxygenation between the attempts. Anesthetic maintenance was achieved with isoflurane [Isoforine® vaporized in 100% oxygen] in a system without gas rebreathing. Locoregional block of the maxillary nerve and inferior branch of the mandibular nerve was performed with lidocaine 2% [0.1 mL/kg]. During the transoperative, the vital parameters remained stable and there was no need for analgesic rescue. After the end of the procedure and extubation, the patient received oxygen therapy via facemask until he regained consciousness and had no complications. Discussion: The mortality of dogs and cats related to anesthetic procedures is substantially higher when compared to humans. Studies have shown that most anesthetic-related complications in humans are predictable. The lack of adequate pre-anesthetic evaluation or anesthetic consultation are factors that can cause losses in the transoperative period. Therefore, sharing information that can mitigate these situations is critical. The scarcity of reports on pre-anesthetic evaluation in veterinary medicine allows the identification of a gap on the role of the anesthesiologist in this important stage of anesthesia, and how it is performed in the hospital routine or in veterinary clinics. The success in managing the difficult airway in the case reported here can be attributed to the procedures adopted in all stages of the procedure, especially the planning based on information obtained during the pre-anesthetic period. It is worth mentioning that the owner was a veterinarian and we believe this also contributed to the outcome, since he informed the anesthesiologist about the difficulties encountered during the previous procedure. This case motivated the implementation of a pre-anesthetic consultation service in the hospital in question. In addition to the physical examination, a complete anamnesis carried out with the owner may reveal relevant details for determining the most appropriate and safe anesthetic conduct for the patient.

Paralisia de laringe em cão: relato de caso / Laryngal paralysis in dog: case report

A paralisia de laringe consiste na perda da capacidade de abdução das cartilagens aritenóides durante a inspiração. Pode ser congênita ou adquirida, secundária a trauma, neoplasia, polineuropatia ou endocrinopatia. O diagnóstico tem como base os sinais clínicos e exame de imagem da laringe. Uma cadela, de 9 anos de idade, da raça Labrador Retriever foi atendida no hospital veterinário com quadro de dispnéia inspiratória, intolerância ao exercício, sobrepeso, inquietação e taquicardia. Após oxigenoterapia, foram solicitados hemograma, perfil bioquímico, hemogasometria e exame radiográfico do tórax, porém, o diagnóstico definitivo de paralisia de laringe foi obtido por meio da ultrassonografia da região cervical ventral e laringoscopia. Nestes exames foram observados movimentos assimétricos das cartilagens aritenóides durante a inspiração. Desta forma, foi instituído o tratamento emergencial de traqueostomia. Após quatro dias foi realizada a técnica de lateralização aritenóide unilateral. Ao longo de 14 dias de internação, o padrão respiratório da paciente foi restaurado, resultando na alta do animal.

Laryngeal paralysis consists of the loss of the capacity of abduction of arytenoid cartilages during inspiration. The etiology may be congenital or acquired, secondary to trauma, neoplasia, polyneuropathy or endocrinopathy. The diagnosis is based on clinical signs and on the examination of the larynx. A 9-year-old Labrador Retriever was treated at the veterinary hospital, with symptoms of inspiratory dyspnea, exercise intolerance, overweight, restlessness and tachycardia. After oxygen therapy, complete blood count, biochemicals, hemogasometry and chest radiography were requested. The definitive diagnosis of laryngeal paralysis was obtained by ultrasonography of the ventral cervical region and laryngoscopy. Asymmetric movements of the arytenoid cartilages were observed during inspiration. Therefore, emergency tracheostomy treatment was instituted. After the assessment of the operative risks, it was chosen to perform the unilateral laryngeal lateralization procedure. Throughout 14 days of hospitalization, the patient's respiratory pattern was restored, resulting in the discharge of the animal.

Paralisia de laringe em cão: relato de caso / Laryngal paralysis in dog: case report

A paralisia de laringe consiste na perda da capacidade de abdução das cartilagens aritenóides durante a inspiração. Pode ser congênita ou adquirida, secundária a trauma, neoplasia, polineuropatia ou endocrinopatia. O diagnóstico tem como base os sinais clínicos e exame de imagem da laringe. Uma cadela, de 9 anos de idade, da raça Labrador Retriever foi atendida no hospital veterinário com quadro de dispnéia inspiratória, intolerância ao exercício, sobrepeso, inquietação e taquicardia. Após oxigenoterapia, foram solicitados hemograma, perfil bioquímico, hemogasometria e exame radiográfico do tórax, porém, o diagnóstico definitivo de paralisia de laringe foi obtido por meio da ultrassonografia da região cervical ventral e laringoscopia. Nestes exames foram observados movimentos assimétricos das cartilagens aritenóides durante a inspiração. Desta forma, foi instituído o tratamento emergencial de traqueostomia. Após quatro dias foi realizada a técnica de lateralização aritenóide unilateral. Ao longo de 14 dias de internação, o padrão respiratório da paciente foi restaurado, resultando na alta do animal.(AU)

Laryngeal paralysis consists of the loss of the capacity of abduction of arytenoid cartilages during inspiration. The etiology may be congenital or acquired, secondary to trauma, neoplasia, polyneuropathy or endocrinopathy. The diagnosis is based on clinical signs and on the examination of the larynx. A 9-year-old Labrador Retriever was treated at the veterinary hospital, with symptoms of inspiratory dyspnea, exercise intolerance, overweight, restlessness and tachycardia. After oxygen therapy, complete blood count, biochemicals, hemogasometry and chest radiography were requested. The definitive diagnosis of laryngeal paralysis was obtained by ultrasonography of the ventral cervical region and laryngoscopy. Asymmetric movements of the arytenoid cartilages were observed during inspiration. Therefore, emergency tracheostomy treatment was instituted. After the assessment of the operative risks, it was chosen to perform the unilateral laryngeal lateralization procedure. Throughout 14 days of hospitalization, the patient's respiratory pattern was restored, resulting in the discharge of the animal.(AU)

A biotecnologia e o biodireito como estratégias de aperfeiçoamento na saúde a partir da tradução de um manual de traqueostomia em neopediatria

A dignidade da vida tornara-se conteúdo fundamental no meio da medicina preventiva e no ordenamento jurídico no Estado Moderno. Deve-se assegurar que a vida seja entendida como inerente ao ser humano e a ciência disponibiliza técnicas, procedimentos e avanços que em consonância com o direito formam o biodireito, a biotecnologia e a bioética. O progresso da biotecnologia provoca inquietação pública originada em concepções errôneas sobre a natureza e os usos das novas pesquisas nesse campo devem ser avaliados em face do ônus do sofrimento presente. A traqueostomia é um exemplo dos recursos que pode ser usado associando a biotecnologia em benefício do paciente, sendo indicada para facilitar a chegada do ar aos pulmões quando existe alguma obstrução no trajeto natural. Deste modo optou-se pelo uso da tradução utilizando-se do Manual of Care for the Pediatric Trach da UNC Health Care, elaborado no ano de 2002 pela equipe médica da Universidade da Carolina do Norte, tendo intuito de informar a comunidade científica, especialmente fisioterapeutas, bem como familiares e cuidadores as vertentes da escolha de uma traqueostomia, assim elaborou-se a presente tradução para a língua portuguesa associada a revisão bibliográfica, a sua associação ao biodireito quando se determina de modo precoce a realização da técnica, minimizando o risco físico e biológico para a criança. Através deste estudo, pode-se perceber que os cuidados direcionados a crianças traqueostomizadas nos Estados Unidos são bastante individualizados e que é de suma importância o treinamento e o fornecimento de informações para os cuidadores, sendo o manual do cuidador um instrumento de grande valia e distribuição. A realização de estudos mais aprofundados que envolvam o direito a vida, o biodireito e a medicina preventiva fomentam a instrumentaçao cada

vez mais aprimorada, a elaboração de manuais com maior tecnologia e

principalmente permite que haja incremento na qualidade e na expectativa de

vida da populaçao neopediátrica em decorrencia de uma assistencia hospitalar

The dignity of life become key contents in the middle of preventive medicine and the legal system in the Modern State. It must be ensured that life is understood as inherent to human nature and science provides techniques, procedures and advances in accordance with the law form the biolaw, biotechnology and bioethics. The progress of biotechnology causes restlessness originated in public misconceptions about the nature and uses of new research in this field should be evaluated in light of the burden of this suffering. Tracheostomy is an example of resources that can be used associating biotechnology for the benefit of the patient, is indicated to facilitate the arrival of air to the lungs when there is some obstruction in the natural way. We chose to use the translation using the Manual of Pediatric Trach Care for the UNC Health Care , established in 2002 by the medical team at the University of North Carolina , with a view to inform the scientific community , especially physiotherapists as well as family caregivers and the aspects of choosing a tracheotomy, so we prepared this translation to Portuguese language associated with the literature review, its association with the biolaw when determining early so the technique, minimizing physical risk and biologically to the child. Through this study, it can be noticed that the tracheotomy care directed at children in the United States are very individualized and that is of paramount way training and provision of information to carers, and the caregiver's manual an instrument of great value and distribution. Conducting further studies involving the right to life, and preventive medicine biolaw foster increasingly improved instrumentation, developing manuals and especially with higher technology allows for an increase in the quality and life expectancy of the population in pediatric due to a suitable hospital or home assistance.

A biotecnologia e o biodireito como estratégias de aperfeiçoamento na saúde a partir da tradução de um manual de traqueostomia em neopediatria

A dignidade da vida tornara-se conteúdo fundamental no meio da medicina preventiva e no ordenamento jurídico no Estado Moderno. Deve-se assegurar que a vida seja entendida como inerente ao ser humano e a ciência disponibiliza técnicas, procedimentos e avanços que em consonância com o direito formam o biodireito, a biotecnologia e a bioética. O progresso da biotecnologia provoca inquietação pública originada em concepções errôneas sobre a natureza e os usos das novas pesquisas nesse campo devem ser avaliados em face do ônus do sofrimento presente. A traqueostomia é um exemplo dos recursos que pode ser usado associando a biotecnologia em benefício do paciente, sendo indicada para facilitar a chegada do ar aos pulmões quando existe alguma obstrução no trajeto natural. Deste modo optou-se pelo uso da tradução utilizando-se do Manual of Care for the Pediatric Trach da UNC Health Care, elaborado no ano de 2002 pela equipe médica da Universidade da Carolina do Norte, tendo intuito de informar a comunidade científica, especialmente fisioterapeutas, bem como familiares e cuidadores as vertentes da escolha de uma traqueostomia, assim elaborou-se a presente tradução para a língua portuguesa associada a revisão bibliográfica, a sua associação ao biodireito quando se determina de modo precoce a realização da técnica, minimizando o risco físico e biológico para a criança. Através deste estudo, pode-se perceber que os cuidados direcionados a crianças traqueostomizadas nos Estados Unidos são bastante individualizados e que é de suma importância o treinamento e o fornecimento de informações para os cuidadores, sendo o manual do cuidador um instrumento de grande valia e distribuição. A realização de estudos mais aprofundados que envolvam o direito a vida, o biodireito e a medicina preventiva fomentam a instrumentaçao cada

vez mais aprimorada, a elaboração de manuais com maior tecnologia e

principalmente permite que haja incremento na qualidade e na expectativa de

vida da populaçao neopediátrica em decorrencia de uma assistencia hospitalar

ou domiciliar adequadas.(AU)

The dignity of life become key contents in the middle of preventive medicine and the legal system in the Modern State. It must be ensured that life is understood as inherent to human nature and science provides techniques, procedures and advances in accordance with the law form the biolaw, biotechnology and bioethics. The progress of biotechnology causes restlessness originated in public misconceptions about the nature and uses of new research in this field should be evaluated in light of the burden of this suffering. Tracheostomy is an example of resources that can be used associating biotechnology for the benefit of the patient, is indicated to facilitate the arrival of air to the lungs when there is some obstruction in the natural way. We chose to use the translation using the Manual of Pediatric Trach Care for the UNC Health Care , established in 2002 by the medical team at the University of North Carolina , with a view to inform the scientific community , especially physiotherapists as well as family caregivers and the aspects of choosing a tracheotomy, so we prepared this translation to Portuguese language associated with the literature review, its association with the biolaw when determining early so the technique, minimizing physical risk and biologically to the child. Through this study, it can be noticed that the tracheotomy care directed at children in the United States are very individualized and that is of paramount way training and provision of information to carers, and the caregiver's manual an instrument of great value and distribution. Conducting further studies involving the right to life, and preventive medicine biolaw foster increasingly improved instrumentation, developing manuals and especially with higher technology allows for an increase in the quality and life expectancy of the population in pediatric due to a suitable hospital or home assistance. (AU)

Comparative analysis of lung function of rats using a new intubation technique and tracheostomy / Análise comparativa da função pulmonar de ratos usando uma nova técnica de intubação e a traqueostomia

Several studies use intubation or tracheostomy for data collection in lung function of rats. Due to the difficulty of performing intubation, tracheostomy is most commonly used. Knowing this difficulty, this paper demonstrates a new way to perform the intubation technique and compares pulmonary function variables obtained using intubation or tracheostomy. For the analysis of our new technique of intubation, 30 rats were used, and the comparative analysis of lung function data obtained through the use of our technique of intubation and tracheostomy, 16 rats were used, divided into two groups. The T group underwent tracheostomy. The IT group underwent initial intubation and, awaiting recovery, a week later was again subjected to intubation group, which was then called IT-1W. Our intubation technique is performed with the aid of a wedge, inclined bed and percutaneous transillumination. No animals died during the intubation procedure, and about 77% of the animals were intubated at the first attempt. We did not obtain statistically significant differences in the pulmonary function variables between the groups. Our intubation technique is easily learned and reproduced. The implications of such a technique can be generalized to all laboratories dealing with intubation of rats.(AU)

Vários estudos utilizam a intubação orotraqueal ou traqueostomia para coleta de dados na função pulmonar de ratos. Devido à dificuldade de realização da intubação, a traqueostomia é mais comumente utilizada. Conhecendo esta dificuldade, este trabalho demonstra uma nova maneira de realizar a técnica de intubação e compara as variáveis de função pulmonar obtidas por intubação ou traqueostomia. Para a análise de nossa nova técnica de intubação, foram utilizados 30 ratos, e para a análise comparativa dos dados da função pulmonar obtidos pelo uso de nossa técnica de intubação e traqueotomia, 16 ratos foram utilizados, divididos em dois grupos. O grupo T foi submetido a traqueostomia. O grupo de IT foi submetido inicialmente a intubação e, esperada sua recuperação, uma semana depois foi novamente submetido a intubação, que foi então chamado de grupo IT-1W. Nossa técnica de intubação é realizada com a ajuda de uma cunha, cama inclinada e transiluminação percutânea. Nenhum animal morreu durante o procedimento de intubação, e cerca de 77% dos animais foram intubados na primeira tentativa. Não foram obtidas diferenças estatisticamente significativas nas variáveis de função pulmonar entre os grupos. Nossa técnica de intubação é facilmente aprendida e reproduzida. As implicações de tal técnica podem ser generalizadas para todos os laboratórios que lidam com a intubação de ratos.(AU)

Comparative analysis of lung function of rats using a new intubation technique and tracheostomy / Análise comparativa da função pulmonar de ratos usando uma nova técnica de intubação e a traqueostomia

Several studies use intubation or tracheostomy for data collection in lung function of rats. Due to the difficulty of performing intubation, tracheostomy is most commonly used. Knowing this difficulty, this paper demonstrates a new way to perform the intubation technique and compares pulmonary function variables obtained using intubation or tracheostomy. For the analysis of our new technique of intubation, 30 rats were used, and the comparative analysis of lung function data obtained through the use of our technique of intubation and tracheostomy, 16 rats were used, divided into two groups. The T group underwent tracheostomy. The IT group underwent initial intubation and, awaiting recovery, a week later was again subjected to intubation group, which was then called IT-1W. Our intubation technique is performed with the aid of a wedge, inclined bed and percutaneous transillumination. No animals died during the intubation procedure, and about 77% of the animals were intubated at the first attempt. We did not obtain statistically significant differences in the pulmonary function variables between the groups. Our intubation technique is easily learned and reproduced. The implications of such a technique can be generalized to all laboratories dealing with intubation of rats.(AU)

Vários estudos utilizam a intubação orotraqueal ou traqueostomia para coleta de dados na função pulmonar de ratos. Devido à dificuldade de realização da intubação, a traqueostomia é mais comumente utilizada. Conhecendo esta dificuldade, este trabalho demonstra uma nova maneira de realizar a técnica de intubação e compara as variáveis de função pulmonar obtidas por intubação ou traqueostomia. Para a análise de nossa nova técnica de intubação, foram utilizados 30 ratos, e para a análise comparativa dos dados da função pulmonar obtidos pelo uso de nossa técnica de intubação e traqueotomia, 16 ratos foram utilizados, divididos em dois grupos. O grupo T foi submetido a traqueostomia. O grupo de IT foi submetido inicialmente a intubação e, esperada sua recuperação, uma semana depois foi novamente submetido a intubação, que foi então chamado de grupo IT-1W. Nossa técnica de intubação é realizada com a ajuda de uma cunha, cama inclinada e transiluminação percutânea. Nenhum animal morreu durante o procedimento de intubação, e cerca de 77% dos animais foram intubados na primeira tentativa. Não foram obtidas diferenças estatisticamente significativas nas variáveis de função pulmonar entre os grupos. Nossa técnica de intubação é facilmente aprendida e reproduzida. As implicações de tal técnica podem ser generalizadas para todos os laboratórios que lidam com a intubação de ratos.(AU)

Comparative analysis of lung function of rats using a new intubation technique and tracheostomy / Análise comparativa da função pulmonar de ratos usando uma nova técnica de intubação e a traqueostomia

Several studies use intubation or tracheostomy for data collection in lung function of rats. Due to the difficulty of performing intubation, tracheostomy is most commonly used. Knowing this difficulty, this paper demonstrates a new way to perform the intubation technique and compares pulmonary function variables obtained using intubation or tracheostomy. For the analysis of our new technique of intubation, 30 rats were used, and the comparative analysis of lung function data obtained through the use of our technique of intubation and tracheostomy, 16 rats were used, divided into two groups. The T group underwent tracheostomy. The IT group underwent initial intubation and, awaiting recovery, a week later was again subjected to intubation group, which was then called IT-1W. Our intubation technique is performed with the aid of a wedge, inclined bed and percutaneous transillumination. No animals died during the intubation procedure, and about 77% of the animals were intubated at the first attempt. We did not obtain statistically significant differences in the pulmonary function variables between the groups. Our intubation technique is easily learned and reproduced. The implications of such a technique can be generalized to all laboratories dealing with intubation of rats.

Vários estudos utilizam a intubação orotraqueal ou traqueostomia para coleta de dados na função pulmonar de ratos. Devido à dificuldade de realização da intubação, a traqueostomia é mais comumente utilizada. Conhecendo esta dificuldade, este trabalho demonstra uma nova maneira de realizar a técnica de intubação e compara as variáveis de função pulmonar obtidas por intubação ou traqueostomia. Para a análise de nossa nova técnica de intubação, foram utilizados 30 ratos, e para a análise comparativa dos dados da função pulmonar obtidos pelo uso de nossa técnica de intubação e traqueotomia, 16 ratos foram utilizados, divididos em dois grupos. O grupo T foi submetido a traqueostomia. O grupo de IT foi submetido inicialmente a intubação e, esperada sua recuperação, uma semana depois foi novamente submetido a intubação, que foi então chamado de grupo IT-1W. Nossa técnica de intubação é realizada com a ajuda de uma cunha, cama inclinada e transiluminação percutânea. Nenhum animal morreu durante o procedimento de intubação, e cerca de 77% dos animais foram intubados na primeira tentativa. Não foram obtidas diferenças estatisticamente significativas nas variáveis de função pulmonar entre os grupos. Nossa técnica de intubação é facilmente aprendida e reproduzida. As implicações de tal técnica podem ser generalizadas para todos os laboratórios que lidam com a intubação de ratos.

Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

PURPOSE: In the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro- and macrocirculatory changes. METHODS: In 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x106 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h. RESULTS: In Control group parameters were stable, while six animals in the Sepsis group died before the 4th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour. CONCLUSION: During bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.(AU)

Morfologia e morfometria da traqueia da preguiça (Bradypus variegatus): conhecimentos para procedimentos de emergência / Morphological and morphometric trachea sloth (Bradypus variegatus): knowledge for emergency procedures

Por ser uma espécie pouco estudada, principalmente do ponto de vista morfológico, objetivou-se conhecer a anatomia da traqueia da preguiça (Bradypus variegatus) a fim de fornecer informações para facilitar a eleição de tubo endotraqueal adequado, máscara laríngea ou cânula de traqueostomia para anestesia e procedimentos de emergência, uma vez que a mesma revelou-se possuidora de uma morfologia especial. Foram investigados 11animais jovens de idades diferentes, sendo quatro machos e sete fêmeas, provenientes do Museu Emilio Goeldi e doados a UFRA. Os exemplares foram perfundidos via intramuscular com solução aquosa de formol a 10% para fins de conservação e posteriormente foram dissecados em nível cervico-torácico, por meio de mesoscopia, expondo-se desde a laringe até os brônquios principais direito e esquerdo ao nível do hilo pulmonar. As traqueias foram divididas em cinco regiões (região cervical, região da primeira flexura, região da segunda flexura, região da terceira flexura e região da carina) as quais foram mensuradas altura e largura, assim como o comprimento traqueal total e parte do material foi submetido à técnicas de rotina histológica. Macroscopicamente, destacou-se a presença de sinuosidades acentuadas em porção médio caudal, contemplando a carina. O comprimento médio traqueal foi de 14,6cm. Microscopicamente, a traqueia era constituída por placas separadas de cartilagem hialina constituindo cada anel, sendo revestido por epitélio estratificado ciliado. Apesar da traqueia da preguiça comum apresentar revestimento padrão encontrado na traqueia de outros animais, na literatura não há registros de outras espécies que tenham morfologia macroscópica nas condições descritas, o que nos leva a sugerir, quando necessário acesso para ventilação de emergência, a prática da IOT e não a de traqueostomia.(AU)

As the sloth (Bradypus variegatus) is a little studied species, especially from a morphological point of view, this research aimed to define the anatomy of its trachea. The information would facilitate the selection of a proper endotracheal tube, laryngeal mask or tracheostomy tube for anesthesia and emergency procedures, since it appeared to have a special morphology. Eleven young animals of different ages were investigated, four males and seven females, obtained from the Emilio Goeldi Museum and donated to UFRA. The specimens were infused intramuscularly with 10% aqueous formaldehyde for preservation and were later dissected at the cervico-thoracic level, by mesoscopia, exposing the area from the larynx to the right and left primary bronchi at the hilum. The tracheae were divided into five regions (cervical, first flexure, second flexure, third flexure, and carina) for which length and width were measured, as well as the total tracheal length. Sharp windings were seen in the middle caudal portion, including the carina. The average tracheal length was 14.6 cm. Microscopically, the trachea was made up of separate plates of hyaline cartilage forming each ring, lined with ciliated epithelium. Despite the trachea of the common sloth displaying the same lining pattern found in other animals, there are no reports in the literature of other species having a macroscopic morphology as described here, which leads us to suggest, where appropriate access to emergency ventilation, the practice of IOT and not tracheostomy.(AU)

Reparação cirúrgica de fenda palatina em potro com a utilização de pericárdio bovino: relato de caso / Surgical correction of cleft palate in foal using bovine pericardium: case report / Corrección quirúrgica del paladar hendido en potro con pericardio bovino: reporte de un caso

Este artigo tem como objetivo relatar o caso de reparação cirúrgica de uma fenda palatina congênita em uma potra com a utilização de pericárdio bovino conservado em glicerina a 98%. Um equino, fêmea, com 6 dias de vida foi atendido em uma propriedade apresentando dificuldade de deglutição e refluxo de leite pelas narinas, o qual foi diagnosticado com fenda palatina secundária. O animal foi submetido a palatoplastia com acesso cirúrgico por bucotomia lateral, porém 5 dias após o procedimento, houve deiscência da sutura. Optou-se então pela utilização de membrana biológica para a reconstrução do palato. O acesso a cavidade bucal por bucotomia possibilitou a sutura da fenda palatina e a colocação de pericárdio bovino com adesivo tecidual de etil-cianoacrilato. A técnica utilizada mostrou-se eficiente, uma vez que o animal apresentou boa adaptação e não houve deiscência de pontos após a segunda intervenção. A utilização de pericárdio bovino mostrou-se viável nesse caso palatoplastia, visto que a não realização da reconstrução torna-se incompatível a manutenção da vida.

This paper aims to report a case of surgical repair of congenital cleft palate in foal using bovine pericardium preserved in glycerin 98%. One female horse, with 6 days of life examined at the property with difficulty swallowing and milk reflux nostrils, which was diagnosed with secondary cleft palate. The animal was subjected to palatoplasty with surgical access by bucotomia, but five days after the procedure, there was suture dehiscence. It was then decided by the use of biological membrane for the reconstruction of the palate. Access to the oral cavity by bucotomia possible suturing the cleft palate and placement of bovine pericardium with tissue adhesive the basis of ethyl-cyanoacrylate. The technique used was efficient, since the animal showed good adaptation and no dehiscence points after the second intervention. Thus demonstrating a use a viable option bovine pericardium in palatoplasty surgeries since missing the reconstruction becomes inconsistent maintenance of life.

Este artículo tiene como objetivo informar el caso de reparación quirúrgica de un paladar hendido congénito en un potro utilizando pericardio bovino preservado con glicerina 98%. Una potra de 6 días de edad fue tratada en una granja con dificultad para tragar y reflujo de leche a través de las fosas nasales, que fue diagnosticada como paladar hendido secundario. El animal se sometió a una palatoplastia con acceso quirúrgico por bucotomía lateral, pero 5 días después del procedimiento, hubo dehiscencia de sutura. Luego se decidió utilizar una membrana biológica para la reconstrucción del paladar, el acceso a la cavidad bucal por bucotomía permitió suturar el paladar hendido y colocación de pericardio bovino con adhesivo tisular de cianoacrilato de etilo. La técnica utilizada demostró ser eficiente, una vez que el animal mostró una buena adaptación y no hubo dehiscencia de puntos después de la segunda intervención. EI uso de pericardio bovino fue viable eneste caso de palatoplastia, ya que la realización de la reconstrucción se vuelve incompatible con el mantenimiento de la vida.

Reparação cirúrgica de fenda palatina em potro com a utilização de pericárdio bovino: relato de caso / Surgical correction of cleft palate in foal using bovine pericardium: case report / Corrección quirúrgica del paladar hendido en potro con pericardio bovino: reporte de un caso

Este artigo tem como objetivo relatar o caso de reparação cirúrgica de uma fenda palatina congênita em uma potra com a utilização de pericárdio bovino conservado em glicerina a 98%. Um equino, fêmea, com 6 dias de vida foi atendido em uma propriedade apresentando dificuldade de deglutição e refluxo de leite pelas narinas, o qual foi diagnosticado com fenda palatina secundária. O animal foi submetido a palatoplastia com acesso cirúrgico por bucotomia lateral, porém 5 dias após o procedimento, houve deiscência da sutura. Optou-se então pela utilização de membrana biológica para a reconstrução do palato. O acesso a cavidade bucal por bucotomia possibilitou a sutura da fenda palatina e a colocação de pericárdio bovino com adesivo tecidual de etil-cianoacrilato. A técnica utilizada mostrou-se eficiente, uma vez que o animal apresentou boa adaptação e não houve deiscência de pontos após a segunda intervenção. A utilização de pericárdio bovino mostrou-se viável nesse caso palatoplastia, visto que a não realização da reconstrução torna-se incompatível a manutenção da vida.(AU)

This paper aims to report a case of surgical repair of congenital cleft palate in foal using bovine pericardium preserved in glycerin 98%. One female horse, with 6 days of life examined at the property with difficulty swallowing and milk reflux nostrils, which was diagnosed with secondary cleft palate. The animal was subjected to palatoplasty with surgical access by bucotomia, but five days after the procedure, there was suture dehiscence. It was then decided by the use of biological membrane for the reconstruction of the palate. Access to the oral cavity by bucotomia possible suturing the cleft palate and placement of bovine pericardium with tissue adhesive the basis of ethyl-cyanoacrylate. The technique used was efficient, since the animal showed good adaptation and no dehiscence points after the second intervention. Thus demonstrating a use a viable option bovine pericardium in palatoplasty surgeries since missing the reconstruction becomes inconsistent maintenance of life.(AU)

Este artículo tiene como objetivo informar el caso de reparación quirúrgica de un paladar hendido congénito en un potro utilizando pericardio bovino preservado con glicerina 98%. Una potra de 6 días de edad fue tratada en una granja con dificultad para tragar y reflujo de leche a través de las fosas nasales, que fue diagnosticada como paladar hendido secundario. El animal se sometió a una palatoplastia con acceso quirúrgico por bucotomía lateral, pero 5 días después del procedimiento, hubo dehiscencia de sutura. Luego se decidió utilizar una membrana biológica para la reconstrucción del paladar, el acceso a la cavidad bucal por bucotomía permitió suturar el paladar hendido y colocación de pericardio bovino con adhesivo tisular de cianoacrilato de etilo. La técnica utilizada demostró ser eficiente, una vez que el animal mostró una buena adaptación y no hubo dehiscencia de puntos después de la segunda intervención. EI uso de pericardio bovino fue viable eneste caso de palatoplastia, ya que la realización de la reconstrucción se vuelve incompatible con el mantenimiento de la vida.(AU)

Comparison between transsylvian-transinsular and transcortical-transtemporal approach for evacuation of intracerebral hematoma

PURPOSE: Hypertensive cerebral hemorrhage in the basal ganglia is a potentially life-threatening cerebrovascular disease with high mortality. Surgical evacuation is an important treatment for intracerebral hemorrhage. However, little is reported about the comparison on the efficacy of various approaches on the prognosis. METHODS: Clinical data of 80 cases of intracerebral hemorrhage which surgically treated via transsylvian-transinsular approach or transcortical-transtemporal approach were collected. The proportion of post-surgery tracheostomy, incidence of digestive tract hemorrhage, revision surgery, the average length of hospital stay, and the six-month efficacy (defined by an ADL score) rate between these two groups were compared. RESULTS: The six-month efficacy rates were 75% and 50% in patients receiving transsylvian-transinsular and transcortical-transtemporal surgery, respectively (p<0.05). Compared to the transcortical-transtemporal group, the proportion of revision surgery was statistically significantly lower in the transsylvian-transinsular group, (p<0.05). The proportion of post-surgery tracheostomy, the incidence of digestive tract hemorrhage, and the average length of hospital stay were lower in the transsylvian-transinsular group, compared to the transcortical-transtemporal group, but no statistically significant differences were noted in them between the two groups. CONCLUSION: The transsylvian-transinsular approach for evacuation of intracerebral hematoma demonstrates limited complications, shorter length of hospital stay, and improved long-term efficacy and prognosis. These findings suggest this operative approach has potential for wider application.(AU)

Retorno à função esportiva de um cavalo submetido à aritenoidectomia e ventriculectomia para tratamento de hemiplegia laríngea direita não responsiva à aritenoidepexia - relato de caso / Racing performance recovery of a horse submitted to arytenoidectomy and ventriculectomy for the treatment of right laryngeal hemiplegia not responsive to laryngoplasty - case report

Um equino macho, de 11 anos, da raça Quarto de Milha, utilizado em competições de três tambores, apresentando ruídos inspiratórios foi encaminhado para atendimento. O histórico revelou que os ruídos iniciaram 20 dias antes e que o animal havia sido medicado com meloxican, dexametasona e ceftiofur sódico. Por endoscopia respiratória, diagnosticou-se hemiplegia laríngea direita (grau IV) e esquerda (grau II), condrite das aritenóides e deslocamento rostral do arco palato faríngeo. Oito dias após endoscopia, o equino apresentou dificuldade respiratória, sendo necessária a realização de traqueostomia de emergência. O animal foi encaminhado para o Hospital Veterinário da PUC – Betim, MG, onde foi submetido à cricoaritenoidepexia direita. Cinco dias após constatou-se persistência dos sinais clínicos e por endoscopia observou-se que a assimetria da aritenóide direita não havia sido totalmente corrigida. Em novo procedimento cirúrgico, a aritenoidepexia foi desfeita e realizou-se aritenoidectomia direita associada à ventriculectomia. Uma semana depois, por endoscopia, observou-se obstrução parcial do lúmen da laringe por tecido de granulação exuberante, que foi controlado por tratamento tópico com dexametasona duas vezes ao dia. O equino ficou hospitalizado 88 dias. Cinco meses após a última cirurgia o animal retornou às competições com desempenho semelhante ao que apresentava anteriormente. Foi possível concluir que a associação de aritenoidectomia e ventriculectomia foi eficiente para o tratamento de hemiplegia laríngea direita após insucesso da aritenoidepexia, com retorno do animal a sua função atlética.

An 11 year-old Quarter Horse stallion, a participant of three barrel racings, was admitted for clinical evaluation because of inspiratory noises. The wheezing had begun 20 days earlier and the animal was treated with meloxican, dexamethasone and sodium ceftiofur. Respiratory endoscopy revealed grade IV right and grade II left laryngeal hemiplegia, arytenoid chondritis and rostral displacement of the cricopharyngeal arch. Eight days after endoscopy, the horse received an emergency tracheostomy because its respiratory problems worsened. The animal was admitted at the Hospital Veterinário of PUC – Betim, MG, Brazil, where it was submitted to a right laryngoplasty. Five days later, clinical signs remained the same and endoscopy revealed that the right arytenoid asymmetry was not totally treated. In a new surgical procedure, the laryngoplasty was undone and the horse was submitted to a right arytenoidectomy associated with ventriculectomy. One week later, endoscopy revealed a partial obstruction of the laryngeal lumen caused by exuberant granulation tissue, which was controlled by topical application of dexamethasone twice a day. The animal remained hospitalized for 88 days. Five months after the last surgical procedure, the horse returned to competitions with an athletic performance similar to its previous one. It was possible to conclude that the association of arytenoidectomy and ventriculectomy was efficient for the treatment of right laryngeal hemiplegia after laryngoplasty failure and the associated techniques also lead to the return of athletic functionality.

Retorno à função esportiva de um cavalo submetido à aritenoidectomia e ventriculectomia para tratamento de hemiplegia laríngea direita não responsiva à aritenoidepexia - relato de caso / Racing performance recovery of a horse submitted to arytenoidectomy and ventriculectomy for the treatment of right laryngeal hemiplegia not responsive to laryngoplasty - case report

Um equino macho, de 11 anos, da raça Quarto de Milha, utilizado em competições de três tambores, apresentando ruídos inspiratórios foi encaminhado para atendimento. O histórico revelou que os ruídos iniciaram 20 dias antes e que o animal havia sido medicado com meloxican, dexametasona e ceftiofur sódico. Por endoscopia respiratória, diagnosticou-se hemiplegia laríngea direita (grau IV) e esquerda (grau II), condrite das aritenóides e deslocamento rostral do arco palato faríngeo. Oito dias após endoscopia, o equino apresentou dificuldade respiratória, sendo necessária a realização de traqueostomia de emergência. O animal foi encaminhado para o Hospital Veterinário da PUC Betim, MG, onde foi submetido à cricoaritenoidepexia direita. Cinco dias após constatou-se persistência dos sinais clínicos e por endoscopia observou-se que a assimetria da aritenóide direita não havia sido totalmente corrigida. Em novo procedimento cirúrgico, a aritenoidepexia foi desfeita e realizou-se aritenoidectomia direita associada à ventriculectomia. Uma semana depois, por endoscopia, observou-se obstrução parcial do lúmen da laringe por tecido de granulação exuberante, que foi controlado por tratamento tópico com dexametasona duas vezes ao dia. O equino ficou hospitalizado 88 dias. Cinco meses após a última cirurgia o animal retornou às competições com desempenho semelhante ao que apresentava anteriormente. Foi possível concluir que a associação de aritenoidectomia e ventriculectomia foi eficiente para o tratamento de hemiplegia laríngea direita após insucesso da aritenoidepexia, com retorno do animal a sua função atlética.(AU)

An 11 year-old Quarter Horse stallion, a participant of three barrel racings, was admitted for clinical evaluation because of inspiratory noises. The wheezing had begun 20 days earlier and the animal was treated with meloxican, dexamethasone and sodium ceftiofur. Respiratory endoscopy revealed grade IV right and grade II left laryngeal hemiplegia, arytenoid chondritis and rostral displacement of the cricopharyngeal arch. Eight days after endoscopy, the horse received an emergency tracheostomy because its respiratory problems worsened. The animal was admitted at the Hospital Veterinário of PUC Betim, MG, Brazil, where it was submitted to a right laryngoplasty. Five days later, clinical signs remained the same and endoscopy revealed that the right arytenoid asymmetry was not totally treated. In a new surgical procedure, the laryngoplasty was undone and the horse was submitted to a right arytenoidectomy associated with ventriculectomy. One week later, endoscopy revealed a partial obstruction of the laryngeal lumen caused by exuberant granulation tissue, which was controlled by topical application of dexamethasone twice a day. The animal remained hospitalized for 88 days. Five months after the last surgical procedure, the horse returned to competitions with an athletic performance similar to its previous one. It was possible to conclude that the association of arytenoidectomy and ventriculectomy was efficient for the treatment of right laryngeal hemiplegia after laryngoplasty failure and the associated techniques also lead to the return of athletic functionality.(AU)

Effects of controlled and pressure support mechanical ventilation on rat diaphragm muscle / Efeitos da ventilação mecânica controlada e por pressão de suporte no músculo diafragma de ratos

PURPOSE: The objective of this study was to analyze the effects of Pressure Controlled Ventilation mode (PCV-C) and PSV mode in diaphragm muscle of rats. METHODS: Wistar rats (n=18) were randomly assigned to the control group or to receive 6 hours of PCV and PSV. After this period, animals were euthanized and their diaphragms were excised, frozen in liquid nitrogen and stored in at -80º C for further histomorphometric analysis. RESULTS: Results showed a 15 percent decrease in cross-sectional area of muscle fibers on the PCV-C group when compared to the control group (p<0.001) and by 10 percent when compared to the PSV group (p<0.05). Minor diameter was decreased in PCV-C group by 9 percent when compared with the control group (p<0.001) and by 6 percent when compared to the PSV group (p<0.05). When myonuclear area was analyzed, a 16 percent decrease was observed in the PCV-C group when compared to the PSV group (p<0.05). No significant difference between the groups was observed in myonuclear perimeter (p>0.05). CONCLUSION: Short-term controlled mechanical ventilation seems to lead to muscular atrophy in diaphragm fibers. The PSV mode may attenuate the effects of VIDD.(AU)

OBJETIVO: Avaliar os efeitos do modo ventilatório controlado por pressão controlada (PCV-C) e do modo PSV sobre o músculo diafragma de ratos. MÉTODOS: Ratos (n = 18) da linhagem Wistar foram distribuídos no grupo controle (RE) ou para receber AVM por 6 horas no modo PCV-C e no modo PSV. Após esse período, os animais foram eutanasiados, o diafragma retirado e encaminhado para a análise histológica e morfométrica. RESULTADOS: Os resultados revelaram uma redução da área das fibras musculares de 15 por cento no grupo PCV-C em comparação ao controle (p<0,001) e de 10 por cento quando comparado ao grupo PSV (p<0,05). Já com relação ao diâmetro menor observou-se uma redução de 9 por cento do grupo PCV-C em comparação ao controle (p<0,001) e de 6 por cento em relação ao grupo PSV (p<0,05). Quando avaliada a área dos mionúcleos, notou-se uma redução de 16 por cento desse parâmetro no grupo PCV-C, comparado ao PSV (p<0,05). Não houve diferença significativa no perímetro dos mionúcleos entre os grupos estudados (p>0,05). CONCLUSÃO: O grupo PCV-C apresentou atrofia muscular em um período curto de ventilação mecânica. O modo PSV parece atenuar os efeitos da DDIV.(AU)

Triple bothropic envenomation in horses caused by a single snake

In the present study, snakebites caused by a single Bothrops pauloensis simultaneously affecting three male adult horses are described. Whereas the first two affected horses were six years old, the third was 16 years old; they weighed respectively 555, 550 and 500 kg. All horses presented swollen muzzles. The first animal received an initial antivenom dose of 19 vials and adjuvant medication, it was also subjected to tracheostomy due to the progression of acute respiratory failure. The second and third horses respectively received 15 vials of antivenom each, in addition to adjuvant medication. Due to continuous changes in blood coagulation observed during hospitalization, the first and the second horses received five more vials of antivenom, respectively, in the second and third days of treatment. The first animal was discharged on 15th day and the other on the 8th day of hospitalization. Several factors including the main actions of Bothrops venom (coagulation, proteolytic and vasculotoxic activities), the importance of early diagnosis based on clinical history and clinical examination suggesting the diagnosis of Bothrops snakebite, the adequate doses of antivenom, and finally the immediate tracheostomy are herein discussed. The tracheostomy, required to save the life of the first horse, should only occur after the administration of antivenom and control measures for changes in blood coagulation.(AU)