The effect of probiotics on ntestinal motility in an experimental short bowel model

Purpose To investigate the effect of probiotics on spontaneous contractions of smooth muscle isolated from jejunum and ileum of rat model. Methods Four rat groups were created (n=8, in each) including control (Group 1), control+probiotic (Group 2), short bowel (Group 3), and short bowel+probiotic (Group 4). Groups 1 and 2 underwent sham operation, Groups 3 and 4 underwent massive bowel resection. Bifidobacterium Lactis was administered in Groups 2 and 4 daily (P.O.) for three weeks. On postoperative week 3, rats were sacrificed, and jejunum and ileum smooth muscle were isolated for organ bath. Muscle contraction changes were analyzed before and after addition of antagonists. Results Short bowel group exhibited increased amplitude and frequency of spontaneous contractions. The addition of probiotics significantly decreased enhanced amplitude and frequency of bowel contraction in short bowel group and returned to control values. L-NNA increased amplitude and frequency of contractions in all groups. While indomethacin and nimesulide increased the amplitude in all groups, the frequency was only increased in jejunum. Hexamethonium and tetrodotoxin did not change the contraction characteristics in all groups. Conclusion We suggest that early use of probiotics may significantly regulate bowel motility, and accordingly improve absorption of nutrients in short bowel syndrome.(AU)

Laparoscopic bowel resection of deep infiltrating endometriosis: comparative outcomes of a public teaching hospital and a referral private hospital

Purpose To compare the operative outcomes of laparoscopic surgical treatment for bowel endometriosis in a public teaching hospital versus in a private referral hospital. Methods The indications for surgery, type and time of operation, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, and postoperative complications were evaluated. Results One hundred eighty-one patients were included (150 patients, 82.9%, in a private hospital). In the private hospital, there were more patients with infertility [56% vs. 29%; P=0.01] as an indication for surgery) and segmental resection was more common in the private hospital (48% vs. 29%, p=0.05). The average operative time (211.9±83.4 minutes vs. 128 ± 55 minutes, p 0.001) as well as the length of hospital stay (3.97±1.7 days vs. 1.56±0.85 days, p 0.001) was higher in the public hospital; the rate of conversion to open surgery was significantly lower in the private hospital (2% vs. 32.3%, p 0.001). Operations performed at the public hospital were associated with higher rates of postoperative complications (Clavien-Dindo II and II) (38.7% x 11.3%, p=0.021; OR 3.2, CI 95% 1.2-8.0). Conclusion Laparoscopic surgery in private centers was associated with reductions in major complications, surgical times, lengths of stay and rates of conversion to open surgery compared to that in public teaching hospitals.(AU)

Colectomia subtotal em gato com megacólon / Cat subtotal colectomy with megacolon

Megacólon consiste em um aumento persistente do diâmetro do cólon. Nos gatos, a forma idiopática é a mais observada. Relata-se um caso de megacólon em um felino fêmea, sem raça definida, de quatro anos, com histórico de constipação intermitente, cauda flácida e incontinência urinária. Os exames de imagem evidenciaram a presença de grande conteúdo fecal em cólon e peristaltismo lento. O paciente foi submetido a tratamento clínico. Devido a resposta insatisfatória a terapêutica, optou-se por colectomia subtotal, preservando-se a válvula íleo-cecólica. Após 30 dias do procedimento, o animal ainda apresentava quadro de constipação e incontinência urinária, não retornando para consulta. A etiologia do megacólon está relacionada com o prognóstico do animal, em que desordens neurológicas fazem parte do diagnóstico diferencial.

Megacolon consists of a persistent increase in the diameter of the colon. In cats, the idiopathic form is the most observed. We report a case of megacolon in a four-year-old female, feline, with a history of intermittent constipation, flaccid tail and urinary incontinence. Imaging exams showed the presence of large fecal content in the colon and slow peristalsis. The patient underwent clinical treatment. Due to the unsatisfactory response to therapy, we opted for subtotal colectomy, preserving the ileocecolic valve. After 30 days of the procedure, the animal still had constipation and urinary incontinence, not returning for consultation. The etiology of megacolon is related to the prognosis of the animal, in which neurological disorders are part of the differential diagnosis.

Botulinum toxin as a treatment for short bowel syndrome in rats

Purpose: The denervation of the intestine with benzalkonium chloride (BAC) reduces mortality and improves weight gain in rats with short bowel syndrome (SBS). Nevertheless, translating these promising findings from bench to bedside is not feasible because BAC promotes peritonitis and irreversible denervation which may be followed by an uncontrolled dilatation of the viscera. The use of botulinum toxin (BT) instead of BAC to achieve the denervation of the remaining small intestine in SBS could be an interesting option because it leads to a mild and transient denervation of the intestine. Methods: Here we evaluated the effects of the ileal denervation with BT in rats with SBS by verifying the body weight variation and intestinal morphological parameters. Four groups with 6 animals each were submitted to enterectomy with an ileal injection of saline (group E) or BT (group EBT). Control groups were submitted to simulated surgery with an ileal injection of BT (group BT) or saline (group C control). Results: We observed that the treatment of the remaining ileum with BT completely reversed the weight loss associated to extensive small bowel resection. Conclusion: This may provide a new promising approach to the surgical treatment of SBS.(AU)

Colectomia subtotal em gato com megacólon / Cat subtotal colectomy with megacolon

Megacólon consiste em um aumento persistente do diâmetro do cólon. Nos gatos, a forma idiopática é a mais observada. Relata-se um caso de megacólon em um felino fêmea, sem raça definida, de quatro anos, com histórico de constipação intermitente, cauda flácida e incontinência urinária. Os exames de imagem evidenciaram a presença de grande conteúdo fecal em cólon e peristaltismo lento. O paciente foi submetido a tratamento clínico. Devido a resposta insatisfatória a terapêutica, optou-se por colectomia subtotal, preservando-se a válvula íleo-cecólica. Após 30 dias do procedimento, o animal ainda apresentava quadro de constipação e incontinência urinária, não retornando para consulta. A etiologia do megacólon está relacionada com o prognóstico do animal, em que desordens neurológicas fazem parte do diagnóstico diferencial.(AU)

Megacolon consists of a persistent increase in the diameter of the colon. In cats, the idiopathic form is the most observed. We report a case of megacolon in a four-year-oldfemale, feline, with a history of intermittent constipation, flaccid tail and urinary incontinence. Imaging exams showed the presence of large fecal content in the colon and slow peristalsis. The patient underwent clinical treatment. Due to the unsatisfactory response to therapy, we opted for subtotal colectomy, preserving the ileocecolic valve. After 30 days of the procedure, the animal still had constipation and urinary incontinence, not returning for consultation. The etiology of megacolon is related to the prognosis of the animal, in which neurological disorders are part of the differential diagnosis.(AU)

A new experimental model of intrinsic denervation in ileum from wistar rats through intramural microinjections of benzalkonium chloride / Um novo modelo experimental de desnervação intrínseca em íleo de ratos wistar através de micro injeções intramurais de cloreto de benzalcônio

Extensive literature is available about the intrinsic denervation of segments of the digestive tube through the application of CB in the serosa of the viscera. However, this technique has some disadvantages like causing peritonitis, flanges and high mortality, limiting its use in humans. The aim of the present study was to evaluate the feasibility of benzalkonium chloride (CB) to induce intrinsic chemical denervation, through applications of CB in the intramural ileum of wistar rats, as well as deepen the knowledge about the evolution of neuronal injury caused in the process. We used 40 rats, divided into two groups (control-GC and benzalkonium-GB) of 20 animals each, divided into four sub-groups according to the time of postoperative assessment of 24, 48 hours, 30 and 90 days. The animals were submitted to intramural microinjections of sterile saline solution 0.9% (GC) or benzalkonium chloride (GB) in ileal portion, and subsequent histopathological analysis and immunohistochemistry for evaluation of neuronal injury. A significant decrease (p<0.05) was found of the neuronal myenteric count over time in groups, GB3, GB4 and GB2. The specific positive immunolabeling for H2AX and Caspase-3 confirmed the results obtained in the histopathological evaluation, denoting the ignition of irreversible cell injury in 24 hours, evolving into neuronal apoptosis in 48 hours after application of the CB 0.3%. Under the conditions in which this work was conducted, it can be concluded that the application of CB 0.3% by means of microinjections intramural in the ileal wall is able to induce intrinsic chemical denervation of the diverticulum of wistar rats and that the main mechanism of neuronal death is induction of apoptosis.(AU)

Existe vasta literatura sobre a desnervação intrínseca de segmentos do tubo digestório através da aplicação de CB na serosa da víscera. Entretanto, essa técnica tem a desvantagem de causar peritonite, formação de bridas e alta mortalidade, não sendo factível para eventuais utilizações em humanos. O objetivo do presente estudo foi avaliar a viabilidade do Cloreto de benzalcônio (CB) induzir desnervação química intrínseca, por meio de aplicações intramurais em íleo de ratos wistar, além de aprofundar o conhecimento sobre a evolução da lesão neuronal causada neste processo. Foram utilizados 40 ratos, distribuídos em dois grupos (controle- GC e benzalcônio- GB) de 20 animais cada, subdivididos em quatro subgrupos de acordo com o tempo de avaliação pós-operatória de 24, 48 horas, 30 e 90 dias. Os animais foram submetidos à microinjeções intramurais de solução salina estéril 0,9% (GC) ou de cloreto de benzalcônio (GB) em porção ileal, e posterior análise histopatológica e imuno-histoquímica, para avaliação da lesão neuronal. Houve diminuição significativa (p<0,05) na contagem neuronal mientérica ao longo do tempo nos grupos GB2, GB3 e GB4. A imunomarcação específica positiva para H2AX e Caspase-3 confirmou os resultados obtidos na avaliação histopatológica, denotando início da lesão celular irreversível em 24 horas, evoluindo para apoptose neuronal em 48 horas após a aplicação do CB 0,3%. Nas condições em que este trabalho foi conduzido, é possível concluir que a aplicação de CB 0,3% por meio de microinjeções intramurais na parede ileal é capaz de induzir desnervação química intrínseca da porção ileal de ratos wistar e que o principal mecanismo de morte neuronal é a indução de apoptose.(AU)

A new experimental model of intrinsic denervation in ileum from wistar rats through intramural microinjections of benzalkonium chloride / Um novo modelo experimental de desnervação intrínseca em íleo de ratos wistar através de micro injeções intramurais de cloreto de benzalcônio

Extensive literature is available about the intrinsic denervation of segments of the digestive tube through the application of CB in the serosa of the viscera. However, this technique has some disadvantages like causing peritonitis, flanges and high mortality, limiting its use in humans. The aim of the present study was to evaluate the feasibility of benzalkonium chloride (CB) to induce intrinsic chemical denervation, through applications of CB in the intramural ileum of wistar rats, as well as deepen the knowledge about the evolution of neuronal injury caused in the process. We used 40 rats, divided into two groups (control-GC and benzalkonium-GB) of 20 animals each, divided into four sub-groups according to the time of postoperative assessment of 24, 48 hours, 30 and 90 days. The animals were submitted to intramural microinjections of sterile saline solution 0.9% (GC) or benzalkonium chloride (GB) in ileal portion, and subsequent histopathological analysis and immunohistochemistry for evaluation of neuronal injury. A significant decrease (p<0.05) was found of the neuronal myenteric count over time in groups, GB3, GB4 and GB2. The specific positive immunolabeling for H2AX and Caspase-3 confirmed the results obtained in the histopathological evaluation, denoting the ignition of irreversible cell injury in 24 hours, evolving into neuronal apoptosis in 48 hours after application of the CB 0.3%. Under the conditions in which this work was conducted, it can be concluded that the application of CB 0.3% by means of microinjections intramural in the ileal wall is able to induce intrinsic chemical denervation of the diverticulum of wistar rats and that the main mechanism of neuronal death is induction of apoptosis.(AU)

Existe vasta literatura sobre a desnervação intrínseca de segmentos do tubo digestório através da aplicação de CB na serosa da víscera. Entretanto, essa técnica tem a desvantagem de causar peritonite, formação de bridas e alta mortalidade, não sendo factível para eventuais utilizações em humanos. O objetivo do presente estudo foi avaliar a viabilidade do Cloreto de benzalcônio (CB) induzir desnervação química intrínseca, por meio de aplicações intramurais em íleo de ratos wistar, além de aprofundar o conhecimento sobre a evolução da lesão neuronal causada neste processo. Foram utilizados 40 ratos, distribuídos em dois grupos (controle- GC e benzalcônio- GB) de 20 animais cada, subdivididos em quatro subgrupos de acordo com o tempo de avaliação pós-operatória de 24, 48 horas, 30 e 90 dias. Os animais foram submetidos à microinjeções intramurais de solução salina estéril 0,9% (GC) ou de cloreto de benzalcônio (GB) em porção ileal, e posterior análise histopatológica e imuno-histoquímica, para avaliação da lesão neuronal. Houve diminuição significativa (p<0,05) na contagem neuronal mientérica ao longo do tempo nos grupos GB2, GB3 e GB4. A imunomarcação específica positiva para H2AX e Caspase-3 confirmou os resultados obtidos na avaliação histopatológica, denotando início da lesão celular irreversível em 24 horas, evoluindo para apoptose neuronal em 48 horas após a aplicação do CB 0,3%. Nas condições em que este trabalho foi conduzido, é possível concluir que a aplicação de CB 0,3% por meio de microinjeções intramurais na parede ileal é capaz de induzir desnervação química intrínseca da porção ileal de ratos wistar e que o principal mecanismo de morte neuronal é a indução de apoptose.(AU)

Tratamento de estenose pélvica em gato com enxerto heterólogo e colectomia subtotal / Treatment of pelvic stenosis with heterologous graft and subtotal colectomy in a cat

Background: The management of malunion of pelvic fracture and its complications may require from conservative tosurgical methods, depending on the severity and temporal evolution. Thus, the aim of this present report is to describe thetreatments adopted in a cat with severe pelvic stenosis.Case: An approximately 3-year-old neutered male crossbreed cat, weighing 3 kg, was presented due to difficulty in defecation in the previous eight months. According to its tutor, the cat was adopted one year earlier, with a history of pelvicfracture due to a run over, which had been treated conservatively. The tutor also mentioned that since the appearance ofdyschezia, the cat had only been treated with enemas, but without success. In abdominal palpation, there was presence ofpain and a mass of firm content in descending colon topography. The radiographic examination of the pelvis presentedan exuberant bone callus, characterizing an old fracture, a consolidation with change of bone axis in the right ischium,together with megacolon and fecaloma. It was initially decided that a liquid glycerin-based enema would be performed,in conjunction with clinical treatment with administration of cisapride, dimethicone and lactulose. Although the medicaltreatment initially helped improve the clinical picture, the cat presented fecaloma two months later. Surgical treatment wasthen performed, in which distraction of the pubic symphysis with use of a heterologous cortical bone graft (canine tibiastored in glycerin 98%) was performed, as the tutor was not favorable to colectomy as the first option. However, after onemonth of intervention, despite good evolution, the animal again showed signs of dyschezia. At this point the tutor agreedto colectomy, which was subtotal with preservation of the ileocolic valve.Discussion: The...

Tratamento de estenose pélvica em gato com enxerto heterólogo e colectomia subtotal / Treatment of pelvic stenosis with heterologous graft and subtotal colectomy in a cat

Background: The management of malunion of pelvic fracture and its complications may require from conservative tosurgical methods, depending on the severity and temporal evolution. Thus, the aim of this present report is to describe thetreatments adopted in a cat with severe pelvic stenosis.Case: An approximately 3-year-old neutered male crossbreed cat, weighing 3 kg, was presented due to difficulty in defecation in the previous eight months. According to its tutor, the cat was adopted one year earlier, with a history of pelvicfracture due to a run over, which had been treated conservatively. The tutor also mentioned that since the appearance ofdyschezia, the cat had only been treated with enemas, but without success. In abdominal palpation, there was presence ofpain and a mass of firm content in descending colon topography. The radiographic examination of the pelvis presentedan exuberant bone callus, characterizing an old fracture, a consolidation with change of bone axis in the right ischium,together with megacolon and fecaloma. It was initially decided that a liquid glycerin-based enema would be performed,in conjunction with clinical treatment with administration of cisapride, dimethicone and lactulose. Although the medicaltreatment initially helped improve the clinical picture, the cat presented fecaloma two months later. Surgical treatment wasthen performed, in which distraction of the pubic symphysis with use of a heterologous cortical bone graft (canine tibiastored in glycerin 98%) was performed, as the tutor was not favorable to colectomy as the first option. However, after onemonth of intervention, despite good evolution, the animal again showed signs of dyschezia. At this point the tutor agreedto colectomy, which was subtotal with preservation of the ileocolic valve.Discussion: The...(AU)

Carcinoma prostático felino / Feline prostatic carcinoma

Background: Prostatic cancer is a rare condition in cats but should be included as a differential diagnosis whenever middleaged cats present lower urinary tract signs, such as dysuria and hematuria. Abdominal ultrasound can indicate the disease,but fine-needle aspiration cytology and histopathology are necessary to establish the neoplastic origin and the therapeuticplan. Because of the limited data, no standard-of-care treatment or prognostic information exists in cats with prostate carcinoma. This report describes the clinical signs, diagnosis and surgical approach in a case of prostatic carcinoma in a cat.Case: A 6-year-old, intact male, domestic short-haired cat was presented with a 3-day history of dysuria, hematuria, inappetence, constipation, lethargy and prostration. On physical examination, the cat was in a very poor general conditionand abdominal palpation revealed firm mass located caudally to the urinary bladder. The urinary bladder presented highrepletion degree, while the large bowel was distended and presented soft faecal content. Blood count, serum biochemistryand urinalysis showed neutrophilic leukocytosis, hypoalbuminemia and high creatinine level, and severe hematuria, respectively. Abdominal ultrasound showed a mass located in the prostatic area with hypoechogenic and slightly heterogeneousparenchyma, measuring 3.3 x 3.0 cm. Echo-guided trans-abdominal fine-needle aspiration of the prostate was performed.Microscopically, the cells were round with basophilic cytoplasm, and had round to ovoid nuclei, dense chromatin andprominent nucleoli. Some cells were binucleated and mild anisocytosis and marked anisokaryosis were documented. Thesefindings were compatible with malignant prostatic neoplasia. After initial clinical stabilization, the patient underwent anexploratory laparotomy for tumor resection...

Carcinoma prostático felino / Feline prostatic carcinoma

Background: Prostatic cancer is a rare condition in cats but should be included as a differential diagnosis whenever middleaged cats present lower urinary tract signs, such as dysuria and hematuria. Abdominal ultrasound can indicate the disease,but fine-needle aspiration cytology and histopathology are necessary to establish the neoplastic origin and the therapeuticplan. Because of the limited data, no standard-of-care treatment or prognostic information exists in cats with prostate carcinoma. This report describes the clinical signs, diagnosis and surgical approach in a case of prostatic carcinoma in a cat.Case: A 6-year-old, intact male, domestic short-haired cat was presented with a 3-day history of dysuria, hematuria, inappetence, constipation, lethargy and prostration. On physical examination, the cat was in a very poor general conditionand abdominal palpation revealed firm mass located caudally to the urinary bladder. The urinary bladder presented highrepletion degree, while the large bowel was distended and presented soft faecal content. Blood count, serum biochemistryand urinalysis showed neutrophilic leukocytosis, hypoalbuminemia and high creatinine level, and severe hematuria, respectively. Abdominal ultrasound showed a mass located in the prostatic area with hypoechogenic and slightly heterogeneousparenchyma, measuring 3.3 x 3.0 cm. Echo-guided trans-abdominal fine-needle aspiration of the prostate was performed.Microscopically, the cells were round with basophilic cytoplasm, and had round to ovoid nuclei, dense chromatin andprominent nucleoli. Some cells were binucleated and mild anisocytosis and marked anisokaryosis were documented. Thesefindings were compatible with malignant prostatic neoplasia. After initial clinical stabilization, the patient underwent anexploratory laparotomy for tumor resection...(AU)

Early parenteral nutrition in enterectomized dogs / Nutrição parenteral precoce em cães submetidos à enterectomia

The aim of this study was to explore the role of early central parenteral nutrition support with and without lipid emulsion in enterectomized dogs undergoing small bowel partial resection. Enterectomized dogs often cannot be fed properly via an oral or enteral route immediately post-surgery. After enterectomy, the animals received parenteral nutrition or crystalloid solution until they were able to voluntarily take in an oral diet. All dogs were recruited at the University of Sao Paulo veterinary teaching hospital. Eighteen dogs with intussusception, a foreign intestinal body, linear foreign intestinal body, or intussusception associated with a foreign intestinal body underwent enterectomy surgery and were randomly assigned to receive one of three treatments: crystalloid solution (CS group), parenteral nutrition with a mix of glucose and amino acids (GA group) or parenteral nutrition with a mix of glucose, amino acids and lipids (GAL group). A serum chemistry panel and complete blood count were collected prior to surgery and at the end of the study. Albumin increased in the GA and GAL group (p=0.042 and p=0.038 respectively) after hospitalization, but no significant differences were identified among the groups. Body weight decreased by 4.9% (p=0.042) in the CS group, but there were no significant changes in the GAL and GA groups. There was a significant decrease in the recovery scores in the GA and GAL groups during hospitalization (p=0.039 in both groups). Early parenteral nutrition was beneficial for patient recovery in post-surgical small bowel partial resection, indicating better quality, and no major complications or side effects were observed during the hospitalization period in the studied dogs.(AU)

O objetivo desse estudo era estudar os efeitos da nutrição parenteral central precoce com e sem emulsão lipídica em cães submetidos à ressecção parcial do intestino delgado. Os cães enterectomizados frequentemente não conseguem ser adequadamente alimentados por via oral ou enteral no pós-cirúrgico imediato. Após a enterectomia, os animais receberam nutrição parenteral ou solução cristaloide até o momento em que fossem capazes de alimentar-se voluntariamente por via oral. Todos os animais foram selecionados no hospital veterinário da Universidade de São Paulo. Dezoito cães diagnosticados com intussuscepção, corpo estranho intestinal, corpo estranho linear ou intussuscepção associada com corpo estranho intestinal foram submetidos à enterectomia e aleatoriamente alocados para receber um dos três tratamentos: solução cristaloide (grupo CS), nutrição parenteral com mistura de glicose e aminoácidos (grupo GA) ou nutrição parental com mistura de glicose e lipídios (grupo GAL). Hemograma e bioquímica sérica foram coletados antes da cirurgia e no final do estudo. Houve aumento de albumina no grupo GA e GAL (p=0,042 e p=0,038 respectivamente) após a hospitalização, mas não houve diferença significativa entre grupos. O peso corpóreo diminuiu cerca de 4,9% (p=0,042) no grupo CS mas não houve alterações significativas no grupo GAL e GA. Houve uma diminuição significativa no escore de recuperação no grupo GA e GAL durante a hospitalização (p=0,039 em ambos os grupos). A nutrição parenteral precoce mostrou-se benéfica para a recuperação no pós-operatório dos cães submetidos à ressecção parcial do intestino delgado, sinalizando uma melhora na qualidade da recuperação e ausência de grandes complicações ou efeitos colaterais durante o período de hospitalização dos animais estudados.(AU)

Early parenteral nutrition in enterectomized dogs / Nutrição parenteral precoce em cães submetidos à enterectomia

The aim of this study was to explore the role of early central parenteral nutrition support with and without lipid emulsion in enterectomized dogs undergoing small bowel partial resection. Enterectomized dogs often cannot be fed properly via an oral or enteral route immediately post-surgery. After enterectomy, the animals received parenteral nutrition or crystalloid solution until they were able to voluntarily take in an oral diet. All dogs were recruited at the University of Sao Paulo veterinary teaching hospital. Eighteen dogs with intussusception, a foreign intestinal body, linear foreign intestinal body, or intussusception associated with a foreign intestinal body underwent enterectomy surgery and were randomly assigned to receive one of three treatments: crystalloid solution (CS group), parenteral nutrition with a mix of glucose and amino acids (GA group) or parenteral nutrition with a mix of glucose, amino acids and lipids (GAL group). A serum chemistry panel and complete blood count were collected prior to surgery and at the end of the study. Albumin increased in the GA and GAL group (p=0.042 and p=0.038 respectively) after hospitalization, but no significant differences were identified among the groups. Body weight decreased by 4.9% (p=0.042) in the CS group, but there were no significant changes in the GAL and GA groups. There was a significant decrease in the recovery scores in the GA and GAL groups during hospitalization (p=0.039 in both groups). Early parenteral nutrition was beneficial for patient recovery in post-surgical small bowel partial resection, indicating better quality, and no major complications or side effects were observed during the hospitalization period in the studied dogs.(AU)

O objetivo desse estudo era estudar os efeitos da nutrição parenteral central precoce com e sem emulsão lipídica em cães submetidos à ressecção parcial do intestino delgado. Os cães enterectomizados frequentemente não conseguem ser adequadamente alimentados por via oral ou enteral no pós-cirúrgico imediato. Após a enterectomia, os animais receberam nutrição parenteral ou solução cristaloide até o momento em que fossem capazes de alimentar-se voluntariamente por via oral. Todos os animais foram selecionados no hospital veterinário da Universidade de São Paulo. Dezoito cães diagnosticados com intussuscepção, corpo estranho intestinal, corpo estranho linear ou intussuscepção associada com corpo estranho intestinal foram submetidos à enterectomia e aleatoriamente alocados para receber um dos três tratamentos: solução cristaloide (grupo CS), nutrição parenteral com mistura de glicose e aminoácidos (grupo GA) ou nutrição parental com mistura de glicose e lipídios (grupo GAL). Hemograma e bioquímica sérica foram coletados antes da cirurgia e no final do estudo. Houve aumento de albumina no grupo GA e GAL (p=0,042 e p=0,038 respectivamente) após a hospitalização, mas não houve diferença significativa entre grupos. O peso corpóreo diminuiu cerca de 4,9% (p=0,042) no grupo CS mas não houve alterações significativas no grupo GAL e GA. Houve uma diminuição significativa no escore de recuperação no grupo GA e GAL durante a hospitalização (p=0,039 em ambos os grupos). A nutrição parenteral precoce mostrou-se benéfica para a recuperação no pós-operatório dos cães submetidos à ressecção parcial do intestino delgado, sinalizando uma melhora na qualidade da recuperação e ausência de grandes complicações ou efeitos colaterais durante o período de hospitalização dos animais estudados.(AU)

Intestinal inflammatory and redox responses to the perioperative administration of teduglutide in rats

Purpose: To investigate the inflammatory and redox responses to teduglutide on an animal model of laparotomy and intestinal anastomosis. Methods: Wistar rats (n=62) were allocated into four groups: Ileal Resection and Anastomosis vs. Laparotomy, each one split into Postoperative Teduglutide Administration vs. No Treatment; and euthanized at the third or the seventh day. Ileal and blood samples were recovered at the baseline and at the euthanasia. Flow cytometry was used to study the inflammatory response (IL-1, MCP-1, TNF-, IFN- and IL-4 levels), oxidative stress (cytosolic peroxides, mitochondrial reactive species, intracellular glutathione and mitochondrial membrane potential) and cellular viability and death (annexin V/propidium iodide double staining). Results: Postoperative teduglutide treatment was associated with higher cellular viability index and lower early apoptosis ratio at the seventh day; higher cytosolic peroxides level at the third day and mitochondrial overgeneration of reactive species at the seventh day; higher tissue concentration of IL-4 and lower local pro-to-anti-inflammatory cytokines ratio at the seventh day. Conclusion: Those findings suggest an intestinal pro-oxidative and anti-inflammatory influence of teduglutide on the peri-operative context with a potential interference in the intestinal anastomotic healing.(AU)

Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect / Ultrassonografia intraoperatória em nove cães com suspeita de neoplasia intra-abdominal

Intraoperative ultrasonography (IOUS) is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel) based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.

A ultrassonografia intraoperatória (USIO) é usada na medicina como método de diagnóstico e orientação para procedimentos em cirurgia oncológica. Os objetivos desse estudo foram avaliar a performance, viabilidade, vantagens e dificuldades da técnica de USIO em cães com suspeita de neoplasia intra-abdominal. O estudo incluiu nove cães com suspeita de neoplasia intra-abdominal (baço, fígado ou intestino) baseada em exame ultrassonográfico transabdominal e que foram subsequentemente encaminhados para laparotomia exploratória. Durante o procedimento cirúrgico, a USIO foi realizada e os resultados da ultrassonografia transabdominal pré-operatória, inspeção e palpação realizada pelo cirurgião e USIO foram comparados com base em uma avaliação caso-a-caso. A USIO contribuiu para determinar a área de ressecção das lesões em todos os casos. Lesões detectadas somente pela USIO foram observadas em sete dos nove casos. A análise dos casos demostrou que a USIO pode auxiliar durante a cirurgia oncológica do fígado, baço e intestino. Cães com neoplasia hepática podem ter lesões pequenas intraparenquimatosas e não palpáveis pelo cirurgião, mas que podem ser verificadas pela USIO.

Intraoperative ultrasonography in nine dogs with intra-abdominal neoplasm suspect / Ultrassonografia intraoperatória em nove cães com suspeita de neoplasia intra-abdominal

Intraoperative ultrasonography (IOUS) is used in medicine for diagnosis and guidance during oncologic surgery. The aims of this study were to assess the performance, feasibility, advantages and difficulties of the IOUS technique in dogs with suspected intra-abdominal tumors. The study included nine client-owed dogs that had suspected intra-abdominal tumors (spleen, liver or bowel) based on transabdominal ultrasound examination and that were subsequently referred for exploratory laparotomy surgery. During surgery, IOUS was performed; results of preoperative transabdominal ultrasonography, inspection by the surgeon and IOUS were compared on a case-by-case basis. IOUS was helpful in determining lesion resection in all cases. Lesions detected solely by the use of IOUS were observed in seven out of nine cases. Analysis of these cases demonstrated that IOUS can be a tool to assist during oncology surgery on the liver, spleen or bowel. Dogs with hepatic tumors can have small non-palpable intraparenchymal nodules, which may be visible by IOUS.(AU)

A ultrassonografia intraoperatória (USIO) é usada na medicina como método de diagnóstico e orientação para procedimentos em cirurgia oncológica. Os objetivos desse estudo foram avaliar a performance, viabilidade, vantagens e dificuldades da técnica de USIO em cães com suspeita de neoplasia intra-abdominal. O estudo incluiu nove cães com suspeita de neoplasia intra-abdominal (baço, fígado ou intestino) baseada em exame ultrassonográfico transabdominal e que foram subsequentemente encaminhados para laparotomia exploratória. Durante o procedimento cirúrgico, a USIO foi realizada e os resultados da ultrassonografia transabdominal pré-operatória, inspeção e palpação realizada pelo cirurgião e USIO foram comparados com base em uma avaliação caso-a-caso. A USIO contribuiu para determinar a área de ressecção das lesões em todos os casos. Lesões detectadas somente pela USIO foram observadas em sete dos nove casos. A análise dos casos demostrou que a USIO pode auxiliar durante a cirurgia oncológica do fígado, baço e intestino. Cães com neoplasia hepática podem ter lesões pequenas intraparenquimatosas e não palpáveis pelo cirurgião, mas que podem ser verificadas pela USIO.(AU)

MICROINJEÇÕES INTRAMURAIS DE CLORETO DE BENZALCÔNIO NA SÍNDROME DO INTESTINO CURTO EM RATOS WISTAR APÓS ENTERECTOMIA EXTENSA.

A síndrome do intestino curto (SIC) representa uma condição clínica grave, caracterizada pela deficiente absorção intestinal de nutrientes, causada pela perda extensa do intestino delgado, culminando em altas taxas de mortalidade tanto em pacientes humanos quanto veterinários. Os tratamentos disponíveis não possuem, até então, resultados satisfatórios para resolução desta importante afecção e consistem em terapias paliativas. Diversos estudos demostraram que o método de desnervação intestinal intrínseca, com utilização do Cloreto de Benzalcônio (CB), consiste em promissora esperança na busca de terapias menos invasivas e eficazes no tratamento da SIC, permitindo melhora nas condições pós-cirúrgicas e prognóstico dos pacientes, por aumentar a área absortiva do intestino. Objetivou-se, com esse trabalho, avaliar a população de células neuroendócrinas, caliciformes e serotoninérgicas na Síndrome do Intestino Curto, a fim de compreender de que maneira a desnevação mientérica com Cloreto de Benzalcônio 0,3% no íleo poderia influenciar no tratamento de pacientes portadores de SIC. Foram utilizados 18 ratos, distribuídos em três grupos (GC - Grupo Controle; GE Grupo Enterectomia-enteroanastomose e GECB - Grupo enterectomia/enteroanastomose com uso do CB) contendo seis animais cada. Os animais do GC receberam microinjeções intramurais de solução salina estéril 0,9%, os animais do GE foram submetidos à ressecção intestinal extensa e os animais do GECB foram submetidos também à ressecção intestinal extensa, porém, receberam microinjeções intramurais de CB. Posteriormente, foi realizada a análise histopatológica, histoquímica e imunoistoquímica, para avaliação da população de células neuroendócrinas no jejuno e íleo. Houve aumento significativo (p<0,05) na contagem de células serotoninérgicas no GECB nos dois segmentos intestinais estudados e não houve alteração significativa na população de células caliciformes nos diferentes grupos. Os resultados obtidos foram possíveis por meio da avaliação da marcação específica positiva para PAS na histoquímica para as células caliciformes e Anticorpo anti-serotoninérgico na imunoistoquímica para as células serotoninérgicas. Nas condições em que este trabalho fora conduzido é possível concluir que o tratamento com microinjeções intramurais de CB 0,3% no íleo de ratos Wistar não foi suficiente para alterar a população de células caliciformes nos segmentos jejunais e ileais. Conclui-se também que o CB foi capaz de promover aumento da população de células serotoninérgicas, o que por sua vez, pode auxiliar no aumento das funções promovidas pela serotonina no intestino, auxiliando no trânsito intestinal de pacientes com SIC.

Short bowel syndrome (SBS) represents a serious clinical condition in medicine, characterized by deficient intestinal absorption of nutrients, caused by extensive loss of the small intestine, culminating in high mortality rates in both human and veterinary patients. The available treatments do not have, until then, satisfactory results for the resolution of this important condition and consist of palliative therapies. Several studies have shown that the intrinsic intestinal denervation method, with the use of Benzalconium Chloride (BC), consists of promising hope in the search for less invasive and effective therapies in the treatment of SBS, allowing improvement in the post-surgical conditions and prognosis of patients, by increasing the absorptive area of the intestine. The objective of this work was to evaluate the population of neuroendocrine, callic and serotonergic cells in SBS, in order to understand how myenteric destination with 0.3% BC in the ileum may influence the treatment of patients with SBS. 18 rats were divided into three groups (CG - Control Group; EGEnterectomy-enteroanastomosis group and GEBC - Enterectomy/enteroanastomosis group using BC) containing six animals each. The animals of the CG received intramural microinjections of 0.9% sterile saline solution, the eg animals were submitted to extensive intestinal resection and the GEBC animals were also submitted to extensive intestinal resection, but received intramural microinjections of BC. Subsequently, histopathological, histochemistry and immunohistochemical analysis was performed to evaluate the population of neuroendocrine cells in the jejunum and ileus. There was a significant increase (p<0.05) in the count of serotonergic cells in the GEBC in the two intestinal segments studied and there was no significant change in the population of goblet cells in the different groups. The results obtained were possible by evaluating the specific positive marking for SBP in histochemistry for the goblet cells and anti-serotonergic antibody in immunohistochemistry for serotonin cells. Under the conditions in which this study was conducted, it is possible to conclude that treatment with intramural microinjections of 0.3% BC in the ileum of Wistar rats was not sufficient to alter the population of goblet cells in the jejunal and ileasegments. It is also concluded that it was able to promote an increase in the population of serotonergic cells, which in turn can help in increasing the functions promoted by serotonin in the intestine, assisting in the intestinal transit of patients with SIC.

Subcolectomy and symphyseal distraction-osteotomy using a spacer of spirally fashioned orthopedic wire: a treatment option for cats with pelvic canal stenosis, megacolon and obstipation / Subcolectomia e distração da sínfise púbica com espaçador de fio ortopédico espiralado: uma opção de tratamento para gatos com estenose do canal pélvico, megacolon e obstipação

The use of two cerclages with wire spirals as distractor spacers was evaluated for the correction of pelvic stenosis in felines. A three-year-old, mixed-breed, male feline was taken to the Veterinary Hospital of the UFRJ. It presented symptoms of constipation, dyschezia, hyporexia and mild apathy. On radiographic examination, a deformation of the pelvic bones and a narrowing of the pelvic canal were detected. The patient underwent pelvic stenosis correction surgery. Two spirals were made with cerclage wire and 2.0-mm diameter Steinmann pins; coupled to the chuck of a drill, the pins were wrapped with cerclage wire, running laps around the pin. Then, the coils were positioned in the space formed by separating the hemipelves and stabilized by keeping them separated to the desired opening. Effectiveness of the technique was evidenced by measurements made using new radiographic images in comparison with the images obtained before the surgical procedure. There were evident decreases in the sacro-ischium line and pubic line of 3.98 and 3.18, demonstrating an increase of approximately 21% in the pelvic canal diameter. The animal showed no apparent macroscopic or radiographic reaction. The preliminary clinical application of the adapted pelvic distraction technique is relevant for allowing the appropriate correction of a stenosis of the pelvic girdle and its consequences, representing a major technical and scientific innovation in the correction.(AU)

Avaliou-se o uso de duas espirais confeccionadas com fio de cerclagem como preenchimento distrator para correção de estenose pélvica em felinos. Foi atendida no Hospital Veterinário da UFRJ um felino macho, sem raça definida com idade de 3 anos, apresentando sintomas de constipação, disquezia, hiporexia e apatia leve. Ao exame radiográfico, observou-se deformação de ossos da pelve com estreitamento do canal pélvico. O animal foi operado para correção da estenose pélvica. Foram confeccionados dois espirais com fio de cerclagem e um pino de Steinmann de 2,0mm de diâmetro acoplado ao mandril de uma perfuratriz, envolveu-se este pino com o fio de cerclagem, executando voltas ao redor do pino. Em seguida, os espirais foram posicionados no espaço formado pela separação das hemipelves, e estabilizados, mantendo-as separadas com a abertura desejada. A efetividade da técnica foi evidenciada por medições feitas através de novas imagens radiográficas, permitindo assim uma comparação com a imagem obtida anteriormente ao procedimento cirúrgico. A aplicação clínica da técnica é relevante por permitir que a correção apropriada da estenose da cintura pélvica e suas consequências representa uma importante inovação técnica e científica na correção dessa condição.(AU)

Outcome of pigs with short gut syndrome submitted to orthotopic intestinal transplantation

PURPOSE: To evaluate the current model of small bowel resection and intestinal transplantation in pigs. METHODS: Forty two Large White pigs were distributed in five groups: G1(n=6), G2(n=6) and G3(n=6) were submitted to 80%,100% and 100% plus right colon resection respectively and G4(n=7) and G5(n=5) to 100% SBR plus IT without and with immunosuppressionbased on Tacrolimus and Mycophenolic acid. Evaluation included weight control, clinical status, biochemical analysis and endoscopies for graft biopsies. Follow-up in G1 and 2 was 84 days, while in G3, four and five was ± three weeks. RESULTS: G1 increased weight suggesting adaptation while G2 and 3 loused weight and inadequate adaptation. G4 and 5 died of acute cellular rejection (ACR) and sepses respectively. Overall survival in G1, 2, 3, 4 and 5 at 30 days was 100, 100, 0 and 20 %, respectively. Medium survival in G4 and 5 was 14 and 16 days. CONCLUSIONS: The resection of 80% of small intestine in pigs is not suitable for short bowel syndrome induction. Intestinal transplantation with the proposed immunosuppression protocol was effective in prevent the occurrence of severe acute rejection, but inappropriate to increase recipients survival.(AU)

The ileum as a determinant organ of the functional liver cell mass in rats

PURPOSE: To evaluate if the ileum resection changes the functioning liver cell mass, the hepatic metabolism and the biodistribution of radiopharmaceutical in rats. METHODS: Twelve Wistar rats weighing 285g±34g were randomly divided into the ileum resection group (n = 6) and sham group rats (n = 6). After 30 days, they were anesthetized and 0.1mL of 99m-Tc-phytate (0.66MBq) was injected via femoral vein. After 30 minutes, blood samples were collected for red blood cells radioactive labeling and serum ALT, AST and gammaGT. Liver samples were used for 99m-Tc-phytate percentage of radioactivity/gram of tissue and histopathology. Student 's t test was used with significance 0.05. RESULTS: There was a higher uptake of 99m-Tc-phytate in the liver of sham rats, compared to the ileum resection group (p<0.05). GammaGT, ALT and AST were increased in ileum resection rats compared to sham (p<0.05). The he patocytes count was significantly lower in ileum resection group than in sham (p<0.05). Liver: body mass ratio was lower in experimental animals than in sham group (p<0.05). CONCLUSION: These data support that the ileum has important role in liver function and liver mass regulation, and they have potential clinical implications regarding the pathogenesis of liver injury following lower bowel resection.(AU)