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Purpose: To investigate the clinical characteristics of symptomatic cholecystolithiasis and laparoscopic cholecystectomy complications in pediatric patients. Methods: The medical records of 50 children and adolescents who underwent laparoscopic cholecystectomy were analyzed. We evaluated gender, age, body mass index, preoperative clinical aspects, perioperative complications, and gallstone composition. Results: Among the patients, 33 (66%) were female, and 17 (34%) were male. The mean age was 11.4 ± 3.6. All patients were diagnosed with cholecystolithiasis by abdominal ultrasonography. Twelve patients (24%) had hematological disease: eight (16%) with sickle cell anemia and four (8%) with hereditary spherocytosis. Thirteen patients (26%) were obese. Twelve patients (24%) had complicated biliary disease. During the intraoperative period, three patients (6%) had excessive bleeding in the hepatic hilum, and one had an accidental injury to the common bile duct. Three (6%) postoperative complications (acute pancreatitis, common bile duct stenosis, and intestinal obstruction) were observed. Among 28 patients (56%), 25 (50%) had cholesterol gallstones, and three (6%) had bile pigment gallstones. Conclusions: The evolution of cholecystolithiasis in the pediatric population can present serious complications, emphasizing the need to avoid temporizing cholecystolithiasis in children and adolescents because laparoscopic cholecystectomy in this group is safe, with low complication rates.

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There are no reported estimates of normal or abnormal bleeding in dogs during the hemilaminectomy and intervertebral disc fenestration procedures (HF), and that makes it difficult to study intraoperative complications, hemostasis methods, and the impact of bleeding on surgical performance. This prospective study estimated blood loss during HF procedures in dogs with intervertebral disc extrusion (IVDE). Blood loss was quantified by weighing gauzes during the surgical procedure, in addition to measuring the aspirated blood. Total blood volume was estimated according to body weight, and blood loss as a percentage of the total blood volume. The surgeon also subjectively classified the procedures, dividing them into intraoperative difficulty due to bleeding (G1) and absence of intraoperative difficulty (G2). Thirty-two dogs that underwent HF due to IVDE were included. The median blood loss (%) of dogs submitted to HF was 3.9 ± 9.67 of the total blood volume. There was a weak correlation between blood loss and weight, age, incision size, and procedure time.

Não existem valores estimados de sangramento normal ou anormal durante procedimentos de hemilaminectomia e fenestração do disco intervertebral (HF), o que torna difícil o estudo de complicações transoperatórias, métodos de hemostasia e o impacto do sangramento na performance cirúrgica. Este estudo prospectivo objetiva estimar a perda sanguínea durante os procedimentos cirúrgicos de HF em cães com extrusão do disco intervertebral (EDIV). A perda sanguínea foi quantificada pela pesagem de gazes usadas durante o procedimento, além da mensuração do sangue aspirado. O volume de sangue total foi estimado de acordo com o peso do animal, e a perda de sangue como porcentagem do volume de sangue total. O cirurgião também classificou os procedimentos subjetivamente, dividindo-os em dificuldade transoperatória devido ao sangramento (G1) e ausência de dificuldade transoperatória (G2). Trinta e dois cães submetidos a HF devido a EDIV foram incluídos. A perda sanguínea mediana (%) dos cães submetidos a HF foi de 3,9 ± 9,67 do volume de sangue total. Houve uma fraca correlação entre perda sanguínea e peso, idade, tamanho da incisão e tempo de procedimento.

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Purpose: This study evaluated the prevalence of complications in the postoperative period of esophagogastric oncological surgeries. Methods: We conducted a retrospective cross-sectional study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study size implied 163 patients who underwent surgical treatment for esophageal and gastric cancer and experienced postoperative complications between January 2018 and December 2022. These patients were treated at the Liga Norte Riograndense Contra o Câncer, a high-complexity oncology center and a reference for cancer treatment in Northeast Brazil. Results: The prevalence found was 88.3%. The most prevalent complications were Clavien-Dindo I and II, and infection was the most common. According to our statistics analysis, hypoalbuminemia showed a positive correspondence with the occurrence of postoperative complications (odds ratio = 8.60; 95% confidence interval 1.35-54.64, p = 0.0358). Conclusions: Postoperative complications of gastroesophageal surgeries increase patient morbidity and mortality.

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Purpose: To determine the effect of gallic acid or its combination with glibenclamide on some biochemical markers and histology of the cornea of streptozotocin (STZ) induced diabetic rats. Methods: Following induction of diabetes, 24 male albino rats were divided into four groups of six rats each. Groups 1 and 2 (control and diabetic) received rat pellets and distilled water; group 3 (gallic acid) received rat pellets and gallic acid (10 mg/kg, orally) dissolved in the distilled water; and group 4 (gallic acid + glibenclamide) received rat pellets, gallic acid (10 mg/kg, orally), and glibenclamide (5 mg/kg, orally) dissolved in the distilled water. The treatments were administered for three months after which the rats were sacrificed after an overnight fast. Blood and sera were collected for the determination of biochemical parameters, while their eyes were excised for histology. Results: STZ administration to the rats induced insulin resistance, hyperglycemia, microprotenuria, loss of weight, oxidative stress, inflammation, and alteration of their cornea histology, which was abolished following supplementation with gallic acid or its combination with glibenclamide. Conclusions: The study showed the potentials of gallic acid and glibenclamide in mitigating systemic complication and histological changes in the cornea of diabetic rats induced with STZ.

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Purpose: Pre-eclampsia (PE) is a pregnancy-related complication. Eucommia is effective in the treatment of hypertensive disorders in pregnancy, but the specific effects and possible mechanisms of Eucommia granules (EG) in PE remain unknown. The aim of this study was to investigate the effects and possible mechanisms of EG in PE rats. Methods: Pregnant Sprague Dawley rats were divided into five groups (n = 6): the control group, the model group, the low-dose group, the medium-dose group, and the high-dose group of EG. The PE model was established by subcutaneous injection of levonitroarginine methyl ester. Saline was given to the blank and model groups, and the Eucommia granules were given by gavage to the remaining groups. Blood pressure and urinary protein were detected. The body length and weight of the pups and the weight of the placenta were recorded. Superoxide dismutase (SOD) activity and levels of malondialdehyde (MDA), placental growth factor (PIGF), and soluble vascular endothelial growth factor receptor-1 (sFIt-1) were measured in the placenta. Pathological changes were observed by hematoxylin-eosin staining. Wnt/ß-catenin pathway-related protein expression was detected using Western blot. Results: Compared with the model group, the PE rats treated with EG had lower blood pressure and urinary protein. The length and weight of the pups and placental weight were increased. Inflammation and necrosis in the placental tissue was improved. SOD level increased, MDA content and sFIt-1/PIGF ratio decreased, and Wnt/ß-catenin pathway-related protein expression level increased. Moreover, the results of EG on PE rats increased with higher doses of EG. Conclusions: EG may activate the Wnt/ß-catenin pathway and inhibit oxidative stress, inflammation, and vascular endothelial injury in PE rats, thereby improving the perinatal prognosis of preeclamptic rats. EG may inhibit oxidative stress, inflammation, and vascular endothelial injury through activation of the Wnt/ß-catenin pathway in preeclampsia rats, thereby improving perinatal outcomes in PE rats.

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Emergências obstétricas são comuns na rotina clínica de cães e gatos. Dentre as emergências obstétricas uma das mais importantes é a distocia. De modo geral, a distocia ocorre quando há falha no momento do parto ou na expulsão do feto, sendo que a causa mais comum de distocia nas duas espécies é a inércia uterina primária. Outra emergência obstétrica de ocorrência frequente em cadelas e gatas é a piometra. Esta doença é uma infecção que ocorre no útero, causada por alterações hormonais na fase do diestro dos animais. As duas enfermidades (distocia e piometra) podem ter o envolvimento de anticoncepcionais, tanto nas cadelas como nas gatas. Em relação ao tratamento, na maioria das vezes, as distocias em cadelas e gatas são abordadas por meio da realização de cesarianas. Em piometra, a terapêutica mais efetiva é a realização de ovariohisterectomia. Neste estudo, 43 cadelas e 20 gatas com emergências obstétricas foram monitoradas durante 90 dias. Entre as cadelas, 29 (67,44%; 29/43) apresentaram piometra e 13 (30,23%; 13/43) distocia. Além disso, uma cadela apresentou prolapso vaginal. Entre as gatas, 13 apresentaram distocia (65%; 13/20) e sete (35%; 7/20) piometra. Algumas dessas emergências obstétricas foram relacionadas ao uso de anticoncepcional. Assim, os clínicos veterinários devem desencorajar esta prática e incentivar a castração das fêmeas.

Obstetric emergencies are common in the clinical routine of dogs and cats. One of the most important obstetric emergencies is dystocia. In general, dystocia occurs when there is a failure at the parturition time or expulsion of the fetus, and the most common cause of dystocia in both species is primary uterine inertia. Another frequently occurring obstetric emergency in bitches and cats is piometra. This disease is an infection that occurs in the uterus caused by hormonal changes in the diestrus phase of animals. In both diseases (dystocia and pyometra), contraceptives can be involved in female dogs and cats. Regarding the treatment, most of the time, dystocias in bitches and cats are addressed through cesarean sections. In pyometra, the most effective therapy is to perform ovariohysterectomy. In the present study, 43 female dogs and 20 female cats with emergency obstetric were monitored during 90 days. Among bitches, 29 (67.44%; 29/43) had pyometra, and 13 (30.23%; 13/43) showed dystocia. In addition, one female dog presented vaginal prolapse. Among the cats, 13 had dystocia (65%; 13/20) and seven (35%; 7/20) pyometra. Some of these obstetric emergencies were related to contraceptive use. Thus, veterinary clinicians must discourage this practice and encourage the neutering of females.

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O objetivo deste trabalho foi realizar um estudo retrospectivo de cinco casos de cesarianas em éguas, atendidos no Hospital Veterinário da Universidade Estadual de Maringá, campus Umuarama (HVGA-UEM), no período de 2019 a 2021, em quatro éguas da raça Quarto de Milha e uma da Crioula, com queixa principal de parto prolongado e distocias por diferentes motivos. Destes, três casos (60%) tiveram alta médica (3/5), enquanto 40% (2/5) em consequência de complicações pós-operatórias e pela gravidade do quadro clínico evoluíram para o óbito. As distocias são raras em éguas, quando comparados com outras espécies e, essa particularidade, pode ser justificada pela conformação anatômica do sistema reprodutivo e a classificação placentária das éguas, que propiciam contrações rápidas e efetivas facilitando a progressão do parto normal. Dessa forma, nos casos de distocia, em que as manobras obstétricas são incapazes de corrigir o mau posicionamento fetal, a cesariana passa a ser o procedimento de eleição, no presente estudo, nenhuma égua apresentou dilatação suficiente para que fosse conduzida a fetotomia. Como medida complementar, norteada pelos princípios de bem-estar animal, foi sugerido aos proprietários, que não colocassem esses animais na estação reprodutiva seguinte, restringindo-se a sua utilização somente como doadoras de embriões. Portanto, foi possível concluir que a sobrevida das éguas submetidas a cesariana é de 60% nas condições deste estudo, o monitoramento das éguas gestantes é um fator determinante sobre os índices de mortalidade materno-fetal.

The objective of this study was to make a descriptive analysis of 5 cases of caesarean sections in mares. The five reported cases were treated at the Veterinary Hospital of the State University of Maringa, campus Umuarama (HVGA-UEM), from 2019 to 2021. Four Quarter Horse mares and one Crioula, complaining of prolonged delivery and dystocia due to different reasons. Of these, three cases were discharged 60% (3/5), while the other three 40% (2/5), due to postoperative complications and the severity of the clinical condition, progressed to death. Dystocia births are rare in mares, when compared to other species, this particularity, can be justified by the anatomical conformation of the reproductive system and the placental classification of mares, which provide rapid and effective contractions, which facilitate the progression of normal or eutocia birth. Thus, in cases of dystocia in mares, those in which obstetric maneuvers are unable to correct fetal malposition, cesarean section becomes the emergency procedure of choice. As a complementary measure, guided by the principles of animal welfare, owners were suggested not to place these animals in the next reproductive season, restricting their use only as embryo donors. Thus, it was possible to conclude that the survival of mares undergoing cesarean is 60% under the conditions of this study, uses had no vital signs at the time of the procedure and/or evolved to death during the post-surgical period immediate.

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Partial or complete bladder eversion is a rare condition of poor prognosis in cows, commonly associated with intense tenesmus observed in the peripartum period. A 14-year-old obese Nellore cow at 280 days of gestation was referred with 24-hour bladder prolapse. The bladder was complete eversion through the vulvar vestibule showing a thick congested wall and small residual urine volume. After clinical examination, the cow received scopolamine butylbromide and intercoccygeal epidural anesthesia, and the externalized bladder segment was partially reduced, remaining only 10 cm externalized. The cow was maintained with an intravesical human gastric tube number 16 and constant monitoring. The eversion was fully reduced after 12 hours of local treatment, and as the cow presented subclinical ketosis, hypocalcemia and cystitis, antibiotic, glucose, calcium and propylene glycol therapy were performed. We opted for induction of parturition, and after 24 hours, a healthy 52kg calf was born and the placenta was delivered 16 hours after calving. The cow and calf were discharged on the sixth day of hospitalization, with no recurrences or secondary complications after treatment.

A eversão vesical parcial ou completa é uma condição rara de mau prognóstico em vacas, comumente associada a tenesmo intenso observado no período periparto. Uma vaca Nelore obesa de 14 anos de idade, com 280 dias de gestação, foi encaminhada com prolapso de bexiga de 24 horas. A bexiga apresentava eversão completa por meio do vestíbulo vulvar apresentando parede espessa e congestionada e pequeno volume residual de urina. Após exame clínico, a vaca recebeu butilbrometo de escopolamina e anestesia peridural intercoccígea, e o segmento vesical exteriorizado foi parcialmente reduzido, permanecendo apenas 10cm exteriorizado. A vaca foi mantida com sonda gástrica humana número 16 por via intravesical e monitorada constantemente. A eversão foi totalmente reduzida após 12 horas de tratamento local, e, como a vaca apresentava cetose subclínica, hipocalcemia e cistite, foi realizada antibioticoterapia, glicose, cálcio e propilenoglicol. Optou-se pela indução do parto. Após 24 horas, nasceu um bezerro saudável de 52kg e a placenta foi expelida 16 horas após o parto. A vaca e o bezerro receberam alta no sexto dia de internação, sem recidivas ou complicações secundárias após o tratamento.

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Purpose: Temporary arterial occlusion (TAO) is a widespread practice in the surgical treatment of intracranial aneurysms. This study aimed to investigate TAO's role during ruptured aneurysm clipping as an independent prognostic factor on short- and long-term outcomes. Methods: This prospective cohort included 180 patients with ruptured intracranial aneurysms and an indication of microsurgical treatment. Patients who died in the first 12 hours after admission were excluded. Results: TAO was associated with intraoperative rupture (IOR) (odds ratio ­ OR = 10.54; 95% confidence interval ­ 95%CI 4.72­23.55; p < 0.001) and surgical complications (OR = 2.14; 95%CI 1.11­4.07; p = 0.01). The group with TAO and IOR had no significant difference in clinical (p = 0.06) and surgical (p = 0.94) complications compared to the group that had TAO, but no IOR. Among the 111 patients followed six months after treatment, IOR, number of occlusions, and total time of occlusion were not associated with Glasgow Outcome Scale (GOS) in the follow-up (respectively, p = 0.18, p = 0.30, and p = 0.73). Among patients who underwent TAO, IOR was also not associated with GOS in the follow-up (p = 0.29). Conclusions: TAO was associated with IOR and surgical complications, being the latter independent of IOR occurrence. In long-term analysis, neither TAO nor IOR were associated with poor clinical outcomes.

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Hemilaminectomy and intervertebral disc fenestration are commonly used to treat intervertebral disc extrusion (IVDE); however, they are associated with surgical complications. Sixty-four dogs were assessed during the intraoperative, immediate postoperative, and late postoperative periods to evaluate complications resulting from these surgical procedures. During this study, 15.62% (n=10) of the dogs presented with complications during at least one of the evaluations. Iatrogenic rhizotomy, access to the spinal canal contralateral to the lesion, and cardiorespiratory arrest were observed intraoperatively. Abdominal wall flaccidity, neurological worsening, hematoma, dehiscence, and superficial wound infections were observed during the immediate postoperative period. Adverse reactions to the surgical thread, scar adhesion, and superficial wound infection were the most frequent complications during the late postoperative period. Dogs that undergo hemilaminectomy and intervertebral disc fenestration because of IVDE may experience complications during the intraoperative, immediate postoperative, and late postoperative periods. However, these complications are often transitory and rarely cause death.

A hemilaminectomia e a fenestração do disco intervertebral são os procedimentos cirúrgicos geralmente empregados no tratamento da extrusão do disco intervertebral (EDIV), os quais podem desencadear complicações cirúrgicas. Foram avaliadas complicações em 64 cães nos períodos intra e pós-operatório imediato e tardio. Dos pacientes incluídos no estudo, 15,62% (n=10) apresentaram alguma ocorrência em pelo menos uma das etapas avaliadas. Das complicações, no período intraoperatório foram observadas rizotomia iatrogênica, abertura do canal vertebral contralateral e parada cardio-respiratória. No pós-operatório imediato foram verificadas a flacidez da parede abdominal lateral, piora neurológica, hematoma, deiscência de ferida cirúrgica e infecção superficial da ferida de pele. No pós-operatório tardio foram verificadas reação ao fio cirúrgico, aderência cicatricial e flacidez da parede abdominal lateral como problemas mais frequentes. Conclui-se que cães submetidos à hemilaminectomia e fenestração do disco intervertebral envolvido em decorrência da EDIV podem apresentar complicações nos períodos intraoperatório, pós-operatório imediato e tardio, sendo transitórias e com mínimas chances de ocasionar óbito.

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Background: Cystocentesis is a percutaneous aspiration of urine directly from the urinary bladder. It is a routine procedure in veterinary medicine for laboratory urine evaluation and bladder decompression in dogs and cats. Although considered simple and causing minimal discomfort, it remains invasive with potential risks of complications. These complications include bladder rupture leading to abdominal contamination and peritonitis, as well as aortic and vena cava laceration, abdominal wall injuries, seizures, and syncope. There is a scarcity of epidemiological studies assessing risk factors and associated complications and, in this context, we aimed in this study to correlate risk factors with the main complications of ultrasound-guided cystocentesis in dogs and cats. Materials, Methods & Results: It was a prospective and multicentric study involving 410 animals (267 dogs and 143 cats) with clinical indications for cystocentesis. The animals were positioned in dorsal recumbency and restrained by either owner, technical staff, or both. Temperament (calm/docile or agitated/difficult to restrain), along with various data such as species, breed, weight, age, sex, needle length, number of attempts, volume of urine collected, ultrasound findings, and any complications during the procedure, were recorded. Animals were categorized into 2 groups, group with complications (GCI) and group without complications (GSI). Of these, 31 animals (8%) experienced complications after ultrasound-guided urine collection. Compared to agitated animals, there was an 86% reduction in the likelihood of complications in animals classified as calm and easy to handle. Repeated urine collection attempts increased the chance of complications by 110%, even in calm individuals, and each additional millimeter of needle length used for puncture increased the possibility of complications by 30%. Agitated animals restrained by their owner had a 71% chance of complications compared to 7% when they were restrained by the technical staff. Discussion: The data reveals a low probability of complications (8%) during cystocentesis, but it is crucial to consider the risk factors for each patient, as catastrophic outcomes can occur. Interestingly, older animals had a 14% lower likelihood of complications, likely due to increased adaptability and calmness. Proper restraint by a specialized team significantly reduced complication risks, even for agitated animals, which is a noteworthy finding not previously reported. Repeated attempts at urine collection increased complication risks, as did using longer needles, which could damage tissues and puncture vessels near the bladder. In this study, data regarding bladder filling was not included, potentially impacting the results and procedure difficulty. The absence of behavioral assessment scales to measure agitation or anxiety resulted in subjective assessments, lacking standardization. Ultrasound guidance during cystocentesis is valuable to minimize risks and should be considered. While the probability of complications is low, owners should be informed of potential risks, and sedation may be necessary for very agitated or uncooperative animals. In conclusion, ultrasound-guided cystocentesis resulted in complications in approximately 8% of cases. These complications can be significant, such as puncturing large vessels and rupturing the urinary bladder.

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This report described temporary hyperpigmentation occurring in a cat after use of the FreeStyle® Libre sensor by applying three different adhesive glues. The device was continuously used as an aid for the treatment of diabetes mellitus. Histopathological examination revealed mild focal chronic active dermatitis. While the coat color change occurred due to inflammation and did not affect the device functioning, owners should be alerted to the possibility of this complication.

Este relato de caso descreveu a hiperpigmentação temporária que ocorreu em um gato após o uso do sensor FreeStyle® Libre, no qual foram aplicadas três colas adesivas diferentes. O dispositivo foi usado continuamente como auxiliar no tratamento do diabetes mellitus. O exame histopatológico revelou dermatite crônica ativa focal leve. Embora a mudança de cor da pelagem tenha ocorrido devido à inflamação e não tenha afetado o funcionamento do dispositivo, os proprietários devem ser alertados para a possibilidade dessa complicação.

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A diabetes mellitus é uma endocrinopatia comum em cães e gatos que possui como principal complicação a cetoacidose diabética (CAD). A CAD é uma alteração metabólica grave, caracterizada por hiperglicemia/ glicosúria, cetose/cetonúria e acidose metabólica. A deficiência de insulina, associada ao aumento de hormônios contrarreguladores, resulta em acúmulo de corpos cetônicos e, consequentemente, acidose metabólica. A hiperglicemia e a cetose induzem o desenvolvimento de diurese osmótica, que irá ocasionar maior excreção de eletrólitos através da urina, além de desidratação. Dessa forma, podem ser observadas diversas alterações eletrolíticas nesses pacientes, como hipocalemia, hipofosfatemia, hipocalcemia e hipomagnesemia. Por se tratar de uma complicação possivelmente fatal, requer tratamento imediato. A abordagem terapêutica dessa emergência endócrina visa à restauração do equilíbrio hídrico, normalização do metabolismo de glicose, correção da acidemia e distúrbios eletrolíticos, além da identificação e do tratamento de comorbidades, que frequentemente estão envolvidas na patogênese da doença.(AU)

Diabetes mellitus is a common endocrinopathy in dogs and cats, and its main complication is diabetic ketoacidosis (DKA). DKA is a severe metabolic disorder characterized by hyperglycemia/glycosuria, ketosis/ketonuria and metabolic acidosis. Insulin deficiency, associated with an increase in counter-regulatory hormones, results in the accumulation of ketone bodies and, consequently, metabolic acidosis. Hyperglycemia and ketosis induce the development of osmotic diuresis, which will lead to increased excretion of electrolytes through the urine, in addition to dehydration. Thus, several electrolyte alterations can be observed in these patients, such as hypokalemia, hypophosphatemia, hypocalcemia and hypomagnesemia. As this is a potentially fatal complication, it requires immediate treatment. The therapeutic approach to this endocrine emergency aims at restoring water balance, normalizing glucose metabolism, correcting acidemia and electrolyte disturbances, in addition to identifying and treating comorbidities, which are often involved in the pathogenesis of the disease.(AU)

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ABSTRACT: Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.

RESUMO: A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.

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Since the first reports of boar castration, the anesthesia, surgery, and especially the restraint for surgical wound management of large and strong boars may be challenging. Most frequent complications include hemorrhage, excessive edema, infection, abscess, scirrhous cord, inguinal hernia, seroma, hematoma, and death. In order to diminish those complications, we hypothesized that the pre-scrotal approach would be a successful method for orchiectomy in boars and that the complication rate would be low, facilitating post-surgical handling on the commercial swine breeding farms by the owners or handlers. Therefore, the present study aimed to describe our experience performing castration in boars using a pre-scrotal approach on farm-setting. Thirty commercial-breed male boars (weighing 255-410kg) were submitted to dissociative anesthesia protocol and local anesthesia. An 8-10cm skin incision was made cranially to the hemiscrotum, and subcutaneous tissue was bluntly dissected, reaching the tunica dartos, fascia, and vaginal tunica. Mesorchium was bluntly dissected to separate, and a double size-0 transfixion ligature was placed around the spermatic cord that was sharply transected. The procedure was repeated on the contralateral testis using the same skin incision. Short-term complication was restricted to mild scrotal edema in 12 (40%) boars. No wound exudate, surgical site infection or death related to the surgery was recorded. On the long-term follow-up (≥4 months' post-surgery), all owners stated that the boar was subsequently used as intended (slaughter after the proper boar taint withdrawal time) and their satisfaction with the low degree of difficulty in handling the post-operative care. Herein, the overall complication rate was considered low, the mortality rate was zero, and the pre-scrotal castration approach was successfully performed in all boars. These features confirm the technique as a safe procedure for orchiectomy in boars. Additionally, abolishing the daily dressing of surgical wounds required in open castration techniques, especially when surgical site infection occurs, may provide better welfare for the boars.

Desde os primeiros relatos de castração de cachaços, a anestesia, a cirurgia, e, principalmente, a contenção para manejo de feridas cirúrgicas de cachaços grandes e fortes podem ser desafiadoras. As complicações mais frequentes incluem hemorragia, edema excessivo, infecção, abscesso, funiculite, hérnia inguinal, seroma, hematoma e morte. A fim de diminuir tais complicações, levantamos a hipótese de que a abordagem pré-escrotal seria um método bem-sucedido para orquiectomia em cachaços e que a taxa de complicações seria baixa, facilitando o manejo pós-cirúrgico pelos proprietários ou tratadores. Portanto, o presente estudo objetivou descrever nossa experiência na castração de cachaços por abordagem pré-escrotal nas granjas comerciais de suínos. Trinta cachaços machos de raças comerciais (variação de peso de 255-410kg) foram submetidos ao protocolo de anestesia dissociativa e anestesia local. Uma incisão cutânea de 8 a 10cm foi feita cranialmente ao hemiscroto, e o tecido subcutâneo divulsionado de forma romba atingindo a túnica dartos, fáscia e túnica vaginal. O mesórquio foi separado por divulsão, e, uma ligadura de transfixação dupla com fio 0 realizada ao redor do cordão espermático, que foi seccionado. O procedimento foi repetido no testículo contralateral usando a mesma incisão na pele. A complicação de curto prazo foi restrita a leve edema escrotal em 12 (40%) cachaços. Nenhuma infecção incisional, exsudato ou morte relacionada à cirurgia foi registrada. No acompanhamento a longo prazo (≥4 meses pós-cirúrgico), todos os proprietários afirmaram que o cachaço foi posteriormente utilizado como pretendido (abate após o tempo adequado de retirada do odor de macho inteiro), e sua satisfação com o baixo grau de dificuldade nos cuidados pós-operatórios. Aqui, a taxa geral de complicações foi considerada baixa, a taxa de mortalidade foi zero e a castração por abordagem pré-escrotal foi realizada com sucesso em todos os cachaços. Essas características confirmam a técnica como um procedimento seguro para orquiectomia em cachaços. Além disso, a abolição do curativo diário das feridas cirúrgicas exigido nas técnicas de castração aberta, principalmente quando ocorre infecção, pode proporcionar melhor bem-estar aos cachaços.

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Purpose: To compare laparoscopic gynecological surgery training between a developed country's reference center (host center) and a public reference service in a developing country (home center), and use the technicity index (TI) to compare outcomes and to determine the impact of laparoscopic gynecological surgery fellowship training on the home center's TI. Methods: The impact of training on the home center was assessed by comparing surgical performance before and after training. TI was assessed in 2017 in the host center, and before and after training in the home center. Epidemiological and clinical data, and information on reason for surgery, preoperative images, estimated intraoperative bleeding, operative time, surgical specimen weight, hospital stay length, complication and reintervention rates were collected from both institutions. Home center pre-training data were retrospectively collected between 2010 and 2013, while post-training data were prospectively collected between 2015 and 2017. A two-tail Z-score was used for TI comparison. Results: The analysis included 366 hysterectomies performed at the host center in 2017, and 663 hysterectomies performed at the home center between 2015 and 2017. TI in the host center was 82.5%, while in the home center it was 6% before training and 22% after training. There were no statistical differences in length of hospital stay, preoperative uterine volume, surgical specimen weight and complication rate between centers. However, significantly shorter mean operative time and lower blood loss during surgery were observed in the host center. Conclusions: High-quality laparoscopic training in a world-renowned specialized center allowed standardizing laparoscopic hysterectomy procedures and helped to significantly improve TI in the recipient's center with comparable surgical outcomes.

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Background: Thermography is a noninvasive, non-contact, painless, and non-ionizing imaging technique that records cutaneous thermal patterns generated by infrared emission of the surface. The surface heat is closely related to dermal microcirculation. Thromboembolism is responsible for important changes in the thermal pattern of the body surface due to physical obstruction of blood flow, being the main complication in immune-mediated hemolytic anemia. The aim of this paper is to report a dog with thrombus in his left forelimb secondary to idiopathic hemolytic anemia, whose diagnostic screening was performed through infrared thermography. Case: A 9-year-old mixed breed bitch was referred to a veterinary hospital with a history of emesis, diarrhea and dark-colored urine for 2 days. The complete blood count showed hypochromic macrocytic anemia (hematocrit [HTC] 28%, reference: 37 to 55%) with the presence of nucleated erythrocyte (14/100 leukocytes, reference: 0 to 5/100 leukocytes), polychromasia and spherocytes. Leukocytosis (28,300 mm³, reference: 6,000 to 17,000 mm³) by neutrophilia with left deviation and toxic granulations was also present, in addition to hemoglobinuria at urine exam. Therefore, treatment for immune-mediated hemolytic anemia (IMHA) was instituted. After 2 days, the animal returned with acute functional impairment of the left forelimb. Physical examination revealed that the limb was cold, without pulse, proprioception, reflexes, and deep pain. New blood analyses revealed decreased hematocrit (HTC 17%, reference: 37 to 55%), and increased total leukocyte number (57,000 mm3, reference: 6,000 to 17,000 mm³). Infrared thermography revealed an important temperature difference between the limbs, with the affected limb temperature considerably lower (31.3ºC) when compared to the contralateral limb (35.0ºC). Thermography showed the site of the thrombus in the medial portion of the limb (cephalic vein), where the catheter had been placed for fluid therapy. Due to the severity of the condition, the bitch was submitted to amputation surgery, which occurred without complications. The patient had a good response to treatment, with decreased signs of hemolysis and hypercoagulability. The medications were slowly withdrawn, and the clinical discharge occurred after 4 weeks. Discussion: In humans, thermography has been widely used in the assessment of thrombotic diseases, contributing to diagnosis, localization, and prognosis. In veterinary medicine, however, the use of this tool in the diagnosis of thromboembolism is still rare. The difference of 3.7°C between the affected and contralateral limb was objectively verified using thermography. A minimum difference of 2.4°C between limbs has high sensitivity and specificity for diagnosing thromboembolism and occurs due to the reduction in local blood flow. In the present case this tool was essential for the anatomical location of the thrombus, which was in the middle third of the forearm, and allowed an adequate surgical planning. It is known that the main complication of IMHA is thromboembolism. Its predisposing factors include venous stasis, endothelial damage, and hypercoagulability, being exacerbated by cage confinement, decubitus and presence of a peripheral venous catheter. The reported case corroborates at least one of these factors since it had a peripheral venous catheter in the left forelimb, which later showed absence of pulse, spinal reflexes, pain and proprioception. The thermography showed to be an objective, rapid and non-invasive tool to diagnose and precisely locate the thrombus, which allowed for adequate treatment and surgical planning for the case. To the best of our knowledge, this is the first report about use of thermography to diagnose thromboembolism secondary to immune-mediated hemolytic anemia in a dog.

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A infecção no sítio cirúrgico (ISC) é uma complicação grave que pode acontecer em decorrência das cirurgias ortopédicas que demandam a utilização de implantes nos equinos. Morbidade, tratamentos prolongados e, consequentemente, dispendiosos e até mesmo óbito, são decorrências desta complicação. O presente trabalho analisou de forma retrospectiva os equinos submetidos a osteossíntese ou artrodese, que apresentaram ISC no período pós-cirúrgico atendidos no Hospital Veterinário da FMVZ-USP no período de 2009 a 2021. Sessenta e sete equinos atenderam aos critérios de seleção e, destes, 13 (19,4%) apresentaram ISC no período pós-cirúrgico. Escherichia coli, Streptococcus sp. e Enterobacter cloacae complex foram os agentes mais comumente isolados e a remoção dos implantes foi realizada em 76,9% (10/13) dos pacientes. Aminoglicosídeos associados ou não aos beta-lactâmicos foram as classes de antimicrobianos utilizados na terapia prévia em 84,6% (11/13), houve alteração das drogas utilizadas depois do resultado da cultura e antibiograma em todos os casos, devido à resistência antimicrobiana identificada. A incidência de ISC foi similar ao relatado em outros trabalhos, a retirada dos implantes foi uma estratégia eficiente quando o tratamento clínico não surte melhora. A identificação dos agentes envolvidos e o antibiograma se mostraram decisivos para o manejo dos casos.(AU)

Surgical site infection (SSI) is a serious complication that can occur in orthopedic surgeries that require the use of implants in horses. Morbidity, prolonged and consequently expensive treatments, and even death are consequences of this complication. This paper retrospectively analyzed horses undergoing osteosynthesis or arthrodesis, which presented SSI in the post-surgical period, treated at the Veterinary Teaching Hospital of FMVZ-USP from 2009 to 2021. Sixty-seven horses met the selection criteria and of these, 13 (19.4%) had SSI in the postoperative period. Escherichia coli, Streptococcus sp, and Enterobacter cloacae complex were the most commonly isolated agents and implant removal was performed in 76.9% (10/13) of patients. Aminoglycosides associated or not with beta-lactams were the classes of antimicrobials used in previous therapy in 84.6% (11/13), and in all cases there was a change in the drugs used after the result of the culture and antibiogram, due to antimicrobial resistance identified. The incidence of SSI was similar as reported in other studies, and implant removal was an efficient strategy when clinical treatment fails to improve. The identification of the agents involved and the antibiogram was decisive for cases management.(AU)

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Background: The treatment of glaucoma often requires numerous therapeutic modalities to achieve the desired reduction in intraocular pressure (IOP). Cyclodestructive procedures or ciliary body destruction have been performed using techniques with considerable differences in efficacy and complication rates. Among these methods, cyclocryotherapy is non-invasive and simple for the management of uncontrolled glaucoma in dogs and cats. The objective of this case report is to describe the technique of carbon dioxide cyclocryotherapy to reduce intraocular pressure in dogs and cats with glaucoma. Cases: Nine canine patients and one cat with glaucoma were treated with cyclocryotherapy performed under general anaesthesia. Clinical signs patients included blepharospasm, ocular pain, episcleral congestion and ocular hypertension. The patients showed higher levels of IOP, higher than 30 mmHg. Surgical treatment with general anaesthesia was applied. The pre-anaesthesia protocol included acepromazine 0.05 mg/kg with methadone 0.2 mg/kg, followed by intravenous propofol and maintenance with isoflurane and oxygen. An ophthalmological cryocautery unit was used with carbon dioxide as the cryogenic agent and a retinal cryoprobe of 3.2 mm diameter tip for the procedure. The method used was a double cycle of freezing and thawing for 60 s in each site. The cryoprobe was centred approximately 5 mm posterior to the corneoscleral limbus over the ciliary body. The temperature of each cyclocryotherapy spot was between -60°C and -80°C and each site was maintained in place for 60 s; 4 to 6 spots of the double freeze-thaw cycle were made. This technique did not have any serious complications during or after the application of cryotherapy, but chemosis and hyperaemia of the bulbar conjunctiva developed. Subconjunctival anti-inflammatory steroids were injected to minimise swelling and patient discomfort. Satisfactory results were observed; in all cases, the intraocular pressure decreased, with the usual result being a cosmetic and painless eye. Discussion: Even with recent surgical and medical advances, pain and blindness are still common occurrences in glaucoma in human and veterinary practice. The cyclodestructive procedures included cyclodialysis, cyclodiathermy, cyclocryotherapy, and cyclophotocoagulation. The cryosurgery in veterinary ophthalmology has many indications for the treatment of ocular diseases and is effective at decreasing intraocular pressure in patients with persistent uncontrolled glaucoma. Cyclocryotherapy has been shown to reduce intraocular pressure in dogs, cats, rabbits and humans with normotensive and glaucomatous eyes. The application of a cryoprobe over the ciliary processes results in ablating ciliary tissue so that aqueous humour inflow is reduced to acceptable levels. In the clinical cases evaluated, there was a reduction in intraocular pressure reaching acceptable levels, with the usual result being cosmetic and painless eye. Medical therapy remains the predominant method for treating glaucoma in veterinary patients; therefore, cyclocryotherapy is an effective, simple way to lower IOP and is a reasonable treatment option for glaucoma management. Cyclocryotherapy has shown good results, with a low learning curve and it can also be repeated if necessary.

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Purpose: Diabetes mellitus is a serious health problem worldwide, and diabetic nephropathy is the complication. The diabetic nephropathy considerably enhances the oxidative stress, glycation, lipid parameters and inflammatory reaction. Ellipticine has potent free radical scavenging and anti-inflammatory effect. Methods: In the current study, our objectives were to thoroughly examine the renal protective effects of ellipticine in a rat model of streptozotocin (STZ)-induced diabetic nephropathy (DN) and to elucidate the underlying mechanisms involved. For the induction of diabetic nephropathy, streptozotocin (50 mg/kg) was used, and rats were separated into groups and given varying doses of ellipticine (2.5, 5 and 7.5 mg/kg). The body weight, and renal weight were estimated. The inflammatory cytokines, renal biomarkers, inflammatory antioxidant, and urine parameters were estimated. Results: Result showed that ellipticine considerably enhanced the body weight and reduced the renal tissue weight. Ellipticine treatment significantly (P < 0.001) repressed the level of blood urea nitrogen, serum creatinine, uric acid, blood glucose and altered the lipid parameters. Ellipticine significantly (P < 0.001) repressed the level of malonaldehyde and boosted the glutathione, catalase, superoxide dismutase, and glutathione peroxidase. Ellipticine treatment significantly (P < 0.001) reduced the inflammatory cytokines and inflammatory mediators. Conclusions: Ellipticine could be a renal protective drug via attenuating the inflammatory reaction, fibrosis and oxidative stress in streptozotocin induced rats.