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PURPOSE: We analyzed results of percutaneous endopyelotomy for treatment of recurrent ureteropelvic junction obstruction in children with failed primary pyeloplasty. MATERIALS AND METHODS: We retrospectively studied all patients treated at our department for recurrent ureteropelvic junction obstruction between 2009 and 2013. All procedures were performed using a 12Fr miniperc approach with the patient in the supine position. A high pressure balloon was inflated at the ureteropelvic junction obstruction. To improve the exposure of the cutting area, the ureteropelvic junction was introduced into the renal pelvis by pushing the high pressure balloon. Modified percutaneous endopyelotomy was done with monopolar electrocautery over it to avoid damaging nearby structures. Medical data and imaging studies before and after the first surgery and percutaneous endopyelotomy were reviewed. RESULTS: Seven boys and 2 girls (mean ± SD age 5.8 ± 4.9 years) with recurrent ureteropelvic junction obstruction were treated at our hospital between July 2009 and July 2013. Three patients had a solitary kidney. Three children had previously undergone 2 procedures. Mean ± SD operative time was 61.0 ± 17.9 minutes, postoperative hospital stay was 3.8 ± 1.9 days and followup after modified percutaneous endopyelotomy was 39.3 ± 25.2 months. All patients were rendered symptom-free. Postoperative ultrasound and renogram revealed that modified percutaneous endopyelotomy was successful in 7 renal units. In 2 patients hydronephrosis improvement was not significant. Three patients suffered postoperative complications, consisting of hematuria, obstruction of Double-J® stent and paralytic ileus in 1 each. CONCLUSIONS: Modified percutaneous endopyelotomy is a fairly effective technique to treat recurrent ureteropelvic junction obstruction after failed pyeloplasty in children. However, in some cases potentially serious complications can occur.
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Hidronefrose/congênito , Pelve Renal/cirurgia , Rim Displásico Multicístico/cirurgia , Obstrução Ureteral/cirurgia , Pré-Escolar , Feminino , Humanos , Hidronefrose/cirurgia , Lactente , Masculino , Recidiva , Estudos Retrospectivos , Procedimentos Cirúrgicos Urológicos/instrumentação , Procedimentos Cirúrgicos Urológicos/métodosRESUMO
Soursop possesses the largest fruit size of the Annona genus. However, this species is threatened by the Annonaceae fruit weevil (Optatus palmaris), which can cause the destruction of whole soursop fruits. Recently, the potential of semiochemicals for the management of this insect is highlighted, and its aggregation pheromone has been elucidated. This pheromone works well only when mixed with soursop volatiles. Thus, the aim of this research was to determine specific kairomone components to potentiate the aggregation pheromone of this Annonaceae fruit weevil. This task was carried out via volatilome analysis of soursop fruits, which was correlated with the biological activity of the identified volatiles. The GC-MS analysis of aroma collections of mature soursop fruits and flowers, determined using multivariate data analysis, confirmed a volatile differentiation between these organs. The volatile variation between fruits and flowers was reflected in weevils' preference for mature fruits instead of flowers. Moreover, weevils' response to soursop fruits increased with more mature fruits. This was correlated with volatile changes throughout the phenological stages of soursop fruits. The two volatiles most correlated with weevils' attraction were benzothiazole and (E)-ß-caryophyllene. These volatiles only evoked a response when mixed and potentiated the attraction of the aggregation pheromone. Thus, these two volatiles are active kairomone components with the potential for being used in combination with the aggregation pheromone of Annonaceae fruit weevils in field trials.
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BACKGROUND & AIMS: Home parenteral nutrition (HPN) is a lifesaving treatment for people with chronic intestinal failure and its cost has been reported to be very high. The purpose of the present paper was to study the direct healthcare and non-healthcare costs associated with the HPN programme managed by a tertiary hospital. METHODS: Observational, retrospective study of all adult patients on HPN from 11.1.2014 to 10.31.2015 treated at Gregorio Marañón University Hospital (Madrid, Spain). An economic evaluation was undertaken to calculate the direct healthcare (HPN provision, outpatient monitoring and management of complications) and non-healthcare costs (transportation process) of the HPN programme. The variables were collected from medical records, the dispensary and the hospital's financial services. The unit costs were taken from official price lists. RESULTS: Thirty-two patients met the inclusion criteria. Total direct healthcare and non-healthcare costs amounted to 13,363.53 per patient (124.02 per patient per day). The direct healthcare costs accounted for 98.32% of overall costs, while the non-healthcare costs accounted for the remaining 1.68%. HPN provision accounted for the majority of the costs (74.25%), followed by management of complications (21.85%) and outpatient monitoring (2.23%). CONCLUSIONS: The direct healthcare costs accounted for the majority of HPN expenditure, specifically HPN provision was the category with the highest percentage.
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Custos de Cuidados de Saúde/estatística & dados numéricos , Nutrição Parenteral no Domicílio/economia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/terapia , Feminino , Humanos , Enteropatias/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , EspanhaRESUMO
A dynamic ultrasound-assisted extraction procedure utilizing diluted nitric acid was developed for the determination of copper, iron, manganese and zinc in human hair taken from workers in permanent contact with a polluted environment. The extraction unit of the dynamic ultrasound-assisted extraction system contains a minicolumn into which a specified amount of hair (5-50 mg) is placed. Once inserted into the continuous manifold, trace metals were extracted at 3 mL min(-1) with 3 mol L(-1) nitric acid under the action of ultrasound for 2 min for zinc and 3 min for copper, iron and manganese determination, and using an ultrasonic water-bath temperature of 70 degrees C for zinc and 80 degrees C for copper, iron and manganese determination. The system permits the direct analysis of hair and yields concentrations with relative standard deviations of <3% (n = 11). The applicability of the procedure was verified by analysing human hair samples from workers exposed to welding fumes, and its accuracy was assessed through comparison with a conventional sample dissolution procedure and the use of a certified reference material (BCR 397, human hair).
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Cabelo/química , Metais Pesados/análise , Exposição Ocupacional/análise , Sonicação , Espectrofotometria Atômica/métodos , Cobre/análise , Análise de Injeção de Fluxo , Humanos , Ferro/análise , Manganês/análise , Padrões de Referência , Soldagem , Zinco/análiseRESUMO
Studies of the hemoglobin pattern in Brazilian reptiles are important for determining ecological and phylogenetic relationships, but they are scarce. Peripheral blood samples were obtained from 7 males and 18 females of Rhinoclemmys punctularia. The hematological profile was based on the total hemoglobin and hematocrit values. The hemoglobin profile was obtained using electrophoretic procedures at different pH, isoelectric focusing, globin chain electrophoresis, and HPLC. The hematocrit (31 +/- 2%) and total hemoglobin (7.5 +/- 0.2 g/dL) values did not indicate gender variations. Alkaline pH electrophoresis of the total blood samples treated with 1% saponin demonstrated the presence of four well-defined hemoglobin fractions, one major component (fraction I), showing cathodic migration and three others faster than fraction I with anodic migration. When the samples were precipitated with chloroform, only two hemoglobin fractions were observed, similar to fractions I and III from the first procedure. Isoelectric focusing and HPLC showed the same pattern. With acid and neutral pH electrophoresis, two fractions with anodic migration were observed. The globin chain identification at alkaline pH showed two fractions, but four fractions were observed at acidic pH, suggesting that different polypeptide chains are involved in the hemoglobin molecule. The chromatographic separation of the total blood sample demonstrated that the major fraction comprised 81.9% and the minor 18.1%. The results obtained demonstrated a similarity between these hemoglobin components and those of some Chelidae reported in the literature for both land and aquatic animals, reflecting the adaptation to environmental conditions.
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Cromatografia/métodos , Eletroforese/métodos , Hemoglobinas/genética , Hemoglobinas/metabolismo , Polimorfismo Genético , Tartarugas/genética , Animais , Ecologia/métodos , Feminino , Hematócrito , Humanos , Masculino , Modelos Genéticos , Filogenia , RépteisRESUMO
The cytosine-cytosine (C-C) pair is one of the least stable DNA mismatch pairs. The bases of the C-C mismatch are only weakly hydrogen bonded, and previous work has shown that, in certain sequence contexts, they can become unstacked from the core helix, and adopt an 'extrahelical' location. Here, using DNA duplexes with d[GCC](n).d[GCC](n) fragments containing C-C mismatches in a 1,4 bp relationship, we show that cytosine bases of different formal mismatch pairs can be crosslinked by mechlorethamine. For example, in the duplex d[CTCTCGCCGCCGCCGTATC].d[GATACGCCGCCGCCGAGAG], where underlined cytosine bases are present as the formal C-C mismatch pairs C(7)-C(32), C(10)-C(29) and C(13)-C(26), we show that two mechlorethamine crosslinks form between C(13) and C(29) and between C(10) and C(32), in addition to crosslinks at C(7)-C(32), C(10)-C(29) and C(13)-C(26) (we have reported previously the crosslinking of formal C-C pairs by mechlorethamine). We interpret the formation of the C(13)-C(29) and C(10)-C(32) crosslinks as evidence of an extrahelical location of the crosslinkable cytosines. Such extrahelical cytosine bases have been observed previously for a single C-C mismatch pair (in the so-called E-motif conformation). In the E-motif, the extrahelical cytosines are folded back towards the 5'-end of the duplex, consistent with our crosslinking data, and also consistent with the absence of C(7)-C(29) and C(10)-C(26) crosslinks in the current work. Hence, our data provide evidence for an extended E-motif DNA (eE-DNA) conformation in short d[GCC](n).d[GCC](n) repeat fragments, and raise the possibility that such structures might occur in much longer d[GCC](n).d[GCC](n) repeat tracts.
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Citosina/química , DNA/química , Repetições de Trinucleotídeos , Pareamento Incorreto de Bases/genética , Sequência de Bases , Reagentes de Ligações Cruzadas , DNA/genética , Eletroforese em Gel de Poliacrilamida , Cinética , Mecloretamina/química , Conformação de Ácido NucleicoRESUMO
UNLABELLED: Peritoneal drainage (PD) has been proposed as a temporizing procedure for perforated necrotizing enterocolitis (NEC) in very low birth weight neonates. This operation was designed for patients considered too unstable to undergo laparotomy (LAP). Since the introduction of PD some investigators have suggested that it may serve as a definitive therapy. The aim of our study is to determine the efficacy of PD for the stabilization of patients with complicated NEC and its utility as a definitive surgical treatment. METHODS: We review the clinical records from all the patients treated in our unit because of NEC that required surgical therapy. We analyze the mean blood pressure, cardiac and respiratory rate, inspired oxygen concentration, mean airway pressure, diuresis, and arterial blood gases measured 6 and 12 hours after the initial surgical treatment. We divide patients in two different groups according to the initial surgical procedure, peritoneal drainage (PD) or laparotomy group (LAP). Data is shown as media +/- standard deviation, statistical analyses were performed using analysis of variance (ANOVA) for repeated measures and Mann-Withney test. RESULTS: From January 1997 to January 2001 we treated 13 patients with necrotizing enterocolitis that required surgical treatment. Among this group 6 patients were managed initially with PD and 7 with LAP. The gestational age media was 29.07 +/- 3.81 weeks and the birth weight mean 1199.76 +/- 521 gr., without any significant differences between the two groups DP and LAP. All patients improved haemodynamically and respiratory 6 and 12 hours after the surgical treatment. Nevertheless, the mean blood pressure improved even more in the DP group (p<0.005). The DP group showed an improvement in all parameters 6 hours after the drainage was placed, but this effect wasn't maintained for the next 12 hours onwards. From the 12 hours after PD all patients suffered a steady worsening that required further surgical procedures. The overall mortality was 3 patients (23%), without differences between the two groups. The surgical techniques performed (bowel resection, diversion) were similar for both groups. DISCUSSION: DP allows the stabilization for very critically ill patients with complicated NEC. However, this stabilization is temporary. This improvement lasts for a few hours providing a better status for the definitive surgical treatment for the perforated NEC. In our experience DP could not be considered as a definitive surgical treatment.
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Enterocolite/cirurgia , Sucção/métodos , Pré-Escolar , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo PesoRESUMO
The direct metal-free borylation of diaryliodonium salts with diboron reagents is now demonstrated to be a feasible process toward formation of aryl boronic esters without any additive or catalysts, and it can be extended to a two-step C-C coupling of both aryl groups of the initial diaryliodonium reagent.
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The enzymology of anthranilate synthase (EC 5.4.99.6) in microorganisms and plants is reviewed. Aminoacid sequences of the enzyme subunits in different species are compared, and the mechanism of reaction is discussed.
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Antranilato Sintase/metabolismo , Bactérias/enzimologia , Fungos/enzimologia , Isoenzimas/metabolismo , Plantas/enzimologia , Sequência de Aminoácidos , Dados de Sequência MolecularRESUMO
BACKGROUND: Minor facial anomalies in 14-33% of exposed fetuses have been associated with the teratogenic effect of antiepileptic drugs (AED) since 1968. The purpose of this article is to describe the facial characteristics of offspring of epileptic mothers with and without exposure to AED by means of 22 anthropometric measurements, for the purpose of comparison with the measurements of offspring of non-epileptic women previously described in the literature, and to correlate the facial anomalies with the specific drug. METHODS: An interval was defined where 95% of the central values were considered as "common values" and the remaining 5% as "uncommon values" (UV) or as being in the "alert zone"; the odds ratio with Wolf modification was used and then Fisher's test for comparison with healthy newborns. Full-term eutrophic newborns of epileptic mothers who received attention at the epilepsy clinic of a gyneco-obstetric center were included. RESULTS: During the study period, 72 eutrophic, full-term newborns were included; in 70 cases at least one measurement was found in the alert zone, with a predominance of the mid-line area. No differences were found between neonates who received monotherapy vs. polytherapy. The groups exposed to phenobarbital, clonazepam and multiple AED showed more uncommon values (p < 0.05), identified as minor dysmorphisms by other authors. It seems to be a particular susceptibility of the mid-line of the face to show the effects of AED and, additionally, of environmental agents. CONCLUSIONS: No differences were found in the facial values among the different AED used in monotherapy form. It is suggested that the choice of drug used during pregnancy must be decided on according to the clinical diagnosis of each mother's epilepsy, and not on the basis of potential teratogenic risk.
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Anormalidades Induzidas por Medicamentos/diagnóstico , Epilepsia/patologia , Face/anormalidades , Mães , Antropometria , Estudos de Casos e Controles , Epilepsia/tratamento farmacológico , Feminino , Humanos , Recém-Nascido , GravidezRESUMO
Hyskon, a distension medium composed of dextran 70 in 10% dextrose in water, is often used during hysteroscopic procedures. Coagulopathy and pulmonary edema are the most commonly reported side effects encountered during its use. We present the first case report in which a healthy patient developed pulmonary hemorrhage from Hyskon use. The major side effects of Hyskon are discussed, as are the possible etiologies of the reported complication and the implications for anesthesiologists.
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Dextranos/efeitos adversos , Hemoptise/induzido quimicamente , Anestesia , Contagem de Células Sanguíneas , Dilatação e Curetagem , Feminino , Humanos , Histeroscopia , Pessoa de Meia-Idade , Edema Pulmonar/induzido quimicamente , Edema Pulmonar/complicaçõesRESUMO
In the present work the role of nursing in peripheric parenteral nutrition (PPN) is described. The main role is framed within the Unit of Nutritional Support along with the design of the corresponding protocols. The outstanding difference in the composition of our PPN vs those manufactured by the pharmaceutical industry, is the inclusion of glucose as the sole source of carbohydrates. These protocols secure similar nursing care in all patients. With respect to the local venous tolerance to our PPN, it was significantly better than that found in the group infused with a commercial PPN. By contrast, no differences in glycosuria were observed. The economical savings were of 1,980 pesetas per nutrition/day.
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Manipulação de Alimentos , Alimentos Formulados , Nutrição Parenteral/enfermagem , Protocolos Clínicos , HumanosRESUMO
The education and assistance strategies aimed al preserving oral health must play an important role in the overall care of the pregnant woman. It has been demonstrated that there are beliefs and practices in our culture that relegate, odontologic care in this stage, where attitudes and behaviors on the health-disease process are influenced by the prevailing medical culture, which includes the physician's opinion. The objective was To obtain the physician's opinion on the odontologic care during pregnancy. A previously validate survey which included 15 questions, was applied to a randomly selected sample of 700 physicians. Of the 650 surveys analyzed, 57% were applied to general practitioners, 24% to gynecologists and obstetrician, and 19% to other medical specialist regularly consulted by women during their prenatal care. There is low referral of pregnant women to the regularly check their patients teeth of gums 53% physicians said that the odontologist did not need to consult them about dental treatment, while 593 thought otherwise, 362 surveyed practitioners point out the convenience of using the lead apron when taking periapical x-ray. These results point out the importance of establishing a good communication channel between the physician and dentist. It is clear that there is a lack of truth in the oral health specialist's ability to provide treatment to pregnant patients, and that the physician ignores many of the odontological procedures and their low risk.
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Assistência Odontológica , Saúde Bucal , Gravidez , Adulto , Feminino , HumanosRESUMO
Introducción: La resonancia magnética es un método de imagen ideal para el diagnóstico de enfermedades cardiovasculares; sin embargo, la mayoría de los pacientes refieren enfrentarse a un ambiente desconocido, lo cual les provoca ansiedad y cambios en sus constantes vitales. Objetivo: Comparar el nivel de ansiedad (NA) del adulto cardiópata posterior a una intervención de musicoterapia, en un estudio de resonancia magnética. Material y métodos: Estudio comparativo, prospectivo y transversal. Muestra probabilística aleatoria simple (N = 31) para dos grupos: G1 n = 14 y G2 n = 17; incluyó pacientes >15 años, ambos sexos. Se aplicó el instrumento STAI antes y después de musicoterapia; 10 ítems para datos demográficos, signos vitales y sintomatología; 20 ítems para NA con respuesta tipo Likert: nada = 0 hasta mucho = 3 puntos; bajo NA <24, NA medio 24-38 y alto NA >38 puntos. Intervención musical: G1 escuchó música clásica y G2 de su preferencia por 30 minutos entre 15 y 24 decibeles antes del estudio y el tiempo que duró este (> 20 minutos). Datos analizados con estadística descriptiva, prueba Pearson, Spearman, U Mann Whitney, t de Student y T pareada, p <0.05 significativo. Resultados: La musicoterapia reduce la frecuencia cardiaca (74.36 vs. 69.07, p = 0.01), frecuencia respiratoria (16.29 vs. 12.93, p = 0.001) y tensión arterial sistólica (127.21 vs. 117.21, p = 0.01), tanto en el G1 como en el G2. Los pacientes del G2 mostraron mayor disminución del NA comparado con el G1 (26.88 vs. 23.24, p=0.037). Conclusiones: La musicoterapia seleccionada por el paciente sometido a resonancia magnética ha mostrado ser una intervención efectiva para conseguir un cambio específico en el estado fisiológico, emocional y conductual.
Introduction: Magnetic resonance is an ideal imaging method in the diagnosis of cardiovascular diseases; however, the majority of patients refer this process as if they were in an unknown environment which provokes them anxiety, resulting in constant changes in their vitals. Objective: To compare the level of anxiety (AL) of the heart-ill adult after an intervention with music-therapy following a magnetic resonance study. Materials and methods: This is a comparative, prospective and transversal study, with a simple aleatory probabilistic sample (N = 31) divided in two groups: G1 with n = 14, and G2 with n = 17, including patients >15 years old of both sexes. The STAI instrument was applied before and after the music-therapy session using 10 items for demographic data, vital signs, and symptomatology, and 20 items to estimate the AL, with answers based on a Likert-type scale with: 0 = not at all, to 3 = a lot, and a total scale score where, <24 = low level of anxiety, 24-38 = medium level of anxiety, and >28 = high level of anxiety. The group G1 listened to classical music, while the group G2 listened to the music of their choice for 30 minutes the sound level was kept between 15 and 24 decibels before the study and the duration of the study (> 20 minutes). Data were analyzed using descriptive statistics, and Pearson, Spearman, U Mann Whitney, Student's t, and paired T test, p < .05. Results: Music-therapy reduced the cardiac frequency (74.36 vs. 69.07, p = .01), the respiratory frequency (16.29 vs. 12.93, p = .001), and the systolic arterial tension (127.21 vs. 117.21, p = .01), in both groups. Patients in G2 showed a greater AL reduction compared to those in G1 (26.88 vs. 23.24, p = .037). Conclusions: Selected music-therapy in patients undergoing magnetic resonance has shown to be an effective intervention method to modify specific physiological, emotional, and behavioral states of these patients.
Introdução: A ressonância magnética (RM) é um método de imagem ideal para o diagnóstico de doenças cardiovasculares, porém, a maioria dos pacientes descrevem enfrentar-se a um ambiente desconhecido, o que lhes produz ansiedade e mudanças nos seus signos vitais. Objetivo: Comparar o nível de ansiedade (NA) do adulto cardiopata posterior a uma intervençãode musicoterapia em um teste de ressonância magnética. Material e métodos: Estudo comparativo, prospetivo e transversal. Amostra probabilística aleatória simples (N=31) para dois grupos: G1 n=14 y G2 n=17, incluiu pacientes >15 anos, ambos os sexos. Aplicou-se o instrumento STAI antes e depois de musicoterapia, 10 itens para dados demográficos, signos vitais e sintomatologia, 20 itens para NA com resposta tipo Likert: nada =0 até muito=3 pontos, sob NA <24, NA médio 24-38 e alto NA >38 pontos. Intervenção musical: G1 escutou música clássica e G2 de sua preferência por 30 minutos entre 15 e 24 decibéis antes do teste e o tempo que durou este (>20 minutos). Dados analisados com estatística descritiva, prova Pearson, Spearman, U Mann Whitney, T de Student e T pareada, p <0.05 significativo. Resultados: A musicoterapia reduz a frequência cardíaca (74.36 vs 69.07, p=0.01), frequência respiratória (16.29 vs 12.93, p=0.001) e tensão arterial sistólica (127.21 vs 117.21, p=0.01), tanto no G1 quanto no G2. Os pacientes do G2 mostraram maior diminuição do NA comparado com o G1 (26.88 vs 23.24, p=0.037). Conclusões: A musicoterapia selecionada pelo paciente submetido a RM mostrou ser uma intervenção efetiva para conseguir um cambio específico no estado fisiológico, emocional e comportamental.
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Humanos , Masculino , Feminino , AdolescenteRESUMO
OBJECTIVE: Transurethral puncture or endoscopic unroofing is the best treatment currently used for both orthotopic and ectopic ureteroceles. However, they have a high incidence of secondary vesicoureteral reflux and subsequent procedures in both groups. We present a new technique for treatment of orthotopic ureterocele. MATERIAL AND METHODS: We have analyzed 4 patients with orthotopic ureterocele (9.7 ± 6.2 months old) treated by dilatation of the meatus of the ureterocele. No patient had vesicoureteral reflux or duplicate systems. The indication was pyonephrosis in 2 children and progressive worsening of hydronephrosis in 2. Dilatation was performed with 5 or 6mm high-pressure balloon after inserting a stent with guidewire of 0.014" to the ureterocele. RESULTS: There were no intraoperative or postoperative complications, surgical time being 24 ± 9minutes. All patients were discharged at 24 postoperative hours. Ureterohydronephrosis disappeared in all the children and they continue asymptomatic after 35 ± 22.5 months of follow-up. There were no cases of secondary vesicoureteral reflux and renal scan was unchanged after treatment. CONCLUSIONS: High pressure balloon dilatation of the meatus in cases of orthotopic ureterocele is a fast, safe and successful surgical technique. We did not find any cases of secondary vesicoureteral reflux or subsequent procedures in our series, so we believe this may offer significant benefits over the transurethral puncture in such patients.
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Cateterismo/métodos , Ureterocele/terapia , Cistoscopia , Humanos , Hidronefrose/etiologia , Lactente , Complicações Pós-Operatórias , Diagnóstico Pré-Natal , Pressão , Pionefrose/etiologia , Ultrassonografia , Ureterocele/complicações , Ureterocele/diagnóstico , Ureterocele/diagnóstico por imagemRESUMO
The objective of this experiment was to determine if dietary inclusion of fish meal would increase plasma and luteal tissue concentrations of eicosapentaenoic and docosahexaenoic acids. Seventeen nonlactating Angus cows (2 to 8 yr of age) were housed in individual pens and fed a corn silage-based diet for approximately 60 d. Diets were supplemented with fish meal at 5% DMI (a rich source of eicosapentaenoic acid and docosahexaenoic acid; n = 9 cows) or corn gluten meal at 6% DMI (n = 8 cows). Body weights and jugular blood samples were collected immediately before the initiation of supplementation and every 7 d thereafter for 56 d to monitor plasma n-3 fatty acid composition and BW. Estrous cycles were synchronized using 2 injections of PGF(2α) administered at 14-d intervals. The ovary bearing the corpus luteum was surgically removed at midcycle (between d 10 and 12) after estrus synchronization, which corresponded to approximately d 60 of supplementation. The ovary was transported to the laboratory, and approximately 1.5 g of luteal tissue was stored at -80°C until analyzed for n-3 fatty acid content. Initial and ending BW did not differ (P > 0.10) between cows supplemented with fish meal and those with corn gluten meal. Plasma eicosapentaenoic acid was greater (P < 0.05) beginning at d 7 of supplementation and docosahexaenoic was greater (P < 0.05) beginning at d 14 of supplementation for cows receiving fish meal. Luteal tissue collected from fish meal-supplemented cows had greater (P < 0.05) luteal n-3 fatty acids and reduced (P < 0.05) arachidonic acid and n-6 to n-3 ratio as compared with tissue obtained from cows supplemented with corn gluten meal. Our data show that fish meal supplementation increases luteal n-3 fatty acid content and reduces available arachidonic acid content, the precursor for PGF(2α). The increase in luteal n-3 fatty acids may reduce PGF(2α) intraluteal synthesis after breeding resulting in increased fertility in cattle.
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Bovinos/sangue , Corpo Lúteo/química , Dieta/veterinária , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/metabolismo , Produtos Pesqueiros , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Peso Corporal , Dinoprosta , Sincronização do Estro , FemininoRESUMO
INTRODUCTION: bladder dysfunction causes urinary incontinence and kidney damage in children. When treatment with anticholinergics and intermittent bladder catheterization fails, the alternative therapy is bladder augmentation. PATIENTS AND METHODS: between 2005 and 2009, a prospective study was carried out with Botox(®) injected into the detrusor of children suffering from high-pressure bladder despite anticholinergic treatment. We assessed their urodynamic, clinical and radiological evolution prior to and at 4 weeks, 6 months and 1 year after the injection (10 u/kg of weight up to 300 u). Reinjection was indicated in the event of clinical or urodynamic worsening. We employed the Wilcoxom test to statistically analyze the urodynamic parameters. RESULTS: 12 patients were treated, 11 with neurogenic bladder (91.7%) and 1 with posterior urethral valves (8.4%). The mean age was 12.6 (4.3-17.8) years and follow-up took place after 40.8 (16.9-45-7) months. Bladder capacity, detrusor accommodation and pressure improved after 4 weeks in all the patients except in 2 (16.7%). This improvement decreased after 6 months, although successive injections produced similar changes. One patient (8.3%) received 1 dose, six (50%) two doses and five (41.7%) received three. Clinical and urodynamic improvement in 8 patients (66.7%) prevented bladder augmentation. CONCLUSIONS: repeated botulinum toxin injection in the detrusor is a therapeutic instrument for high pressure and low accommodation bladders in children. It could replace bladder augmentation in some cases, however further studies with long-term follow-up care are required to appropriately evaluate its safety and effectiveness.
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Toxinas Botulínicas Tipo A/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Bexiga Urinária Hiperativa/tratamento farmacológico , Administração Intravesical , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
INTRODUCTION: The closure of urinary diversions performed on newly born infants has a notable failure percentage in patients with bladder disease. We present the use of botulinum toxin as a useful and minimally invasive alternative to treat these patients. MATERIAL AND METHODS: We present two patients with a single kidney and with posterior urethral valves (PUV), in whom it was necessary to perform a ureterostomy due to chronic kidney disease. In both patients, the subsequent attempt to close the diversion failed. Aged 4 and 10 years respectively, they presented bladders commonly known as "dry bladders", with a low capacity (20 and 110 ml), bad adaptation (1.5 and 3.1 ml/ cm H(2)O) and high opening detrusor pressure. A 10 UI/Kg botulinum toxin A puncture was applied in the detrusor on one and two occasions respectively, prior to the closure of the diversion. RESULTS: Neither of the patients suffered clinical or ecographic worsening after the closure of the diversion and their kidney function continued without change with respect to the first diversion after one and four years of follow-up respectively. One year after the surgical procedure, video urodynamics showed a significant improvement in bladder capacity (451 and 250 ml), in adaptation (20.4 and 81.9 ml/ cmH(2)O) and in the opening detrusor pressure. CONCLUSIONS: The closure of high urinary diversions has a high failure percentage in infants with pathological high-pressure bladders. Botulinum toxin may be useful as bladder treatment prior to closure of the diversion, especially in patients with a single kidney.