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1.
Theriogenology ; 83(4): 491-6, 2015 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-25459029

RESUMO

Neospora caninum is an intracellular coccidian parasite causing abortion worldwide in dairy cattle. Studies have shown that N caninum infection modifies endocrine patterns and that beef cows or cows with a crossbreed pregnancy, especially for a greater maternal-paternal genetic distance, show a reduced risk of abortion when naturally infected compared with pure-breed Holstein Friesian (HF) pregnancies. This study examined the effects of crossbreeding on plasma progesterone (P4), pregnancy-associated glycoprotein (PAG)-1 and -2, and prolactin patterns produced during gestation in N caninum-infected beef/dairy cows. We analyzed 74 pregnancies in nonaborting cows carrying a single fetus established in 26 lactating HF cows bred with Holstein bulls (H-H), 13 HF cows bred with Limousin bulls (H-L), 12 HF cows used as recipients of transferred in vivo-produced frozen-thawed Rubia Gallega (beef breed; RG) embryos (H-RG-ET), and 23 RG suckling cows bred with RG bulls (RG-RG). Of the cows, 29 (39%) were seropositive for N caninum. Blood samples for hormone and placental protein determinations were collected on Days 30, 60, 90, 120, 150, and 180 of gestation. Procedures of repeated measures analysis of variance throughout gestation revealed higher PAG-1 levels in the H-L and H-RG-ET groups compared with H-H and RG-RG. Higher prolactin levels were detected in RG-RG than in the remaining groups. N caninum seropositivity and fetal genotype had a significant effect on PAG-2 concentrations, such that highest levels of PAG-2 occurred in RG-RG seropositive cows and lowest in H-H seropositive cows, whereas Neospora-seropositive cows showed lower P4 concentrations than their seronegative partners. In conclusion, chronic N caninum infection modifies endocrine patterns of PAG-2 and P4 during pregnancy, whereas PAG-1 and prolactin concentrations are affected by breed and fetal genotype, irrespective of Neospora infection status.


Assuntos
Bovinos/genética , Bovinos/fisiologia , Coccidiose/veterinária , Neospora , Complicações Parasitárias na Gravidez/veterinária , Animais , Ácido Aspártico Endopeptidases/sangue , Coccidiose/sangue , Cruzamentos Genéticos , Feminino , Genótipo , Masculino , Gravidez , Complicações Parasitárias na Gravidez/sangue , Proteínas da Gravidez/sangue , Progesterona/sangue , Prolactina/sangue
2.
Theriogenology ; 76(8): 1380-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21872319

RESUMO

The aim of the present study was to evaluate the effect of restraint stress, which is commonly practised in the field, on plasma concentrations of cortisol, progesterone (P4) and bovine pregnancy-associated glycoprotein-1 (boPAG-1) in pregnant heifers between Days 30 to 40 of gestation. Twelve Holstein-Friesian heifers between Days 30 (Day 0 of experiment) and 40 (Day 10 of experiment) of pregnancy in a Hungarian dairy farm were used in the present study. The heifers were exposed to an acute stressor consisting of immobilisation (restraint stress) in a crush for 2 h (Group 1, n = 6) on Day 2 (Hour 48) and for 2 × 2 h (Group 2, n = 6) on Days 2 and 3 (Hour 72) of the experiment. Transrectal ultrasonography (7.5 MHz linear-array rectal transducer) was performed daily from Day 0 to Day 10 of the experiment to detect embryonic heartbeat or the fate of the conceptus. Blood samples were withdrawn before each ultrasonographic examination. Additional blood samples were withdrawn by 1 and 2 h (at Hours 49 and 50 in Groups 1 and 2 and Hours 73 and 74 in Group 2) of the onset of applying the stressor. Plasma cortisol, P4 and boPAG-1 concentrations were measured by radioimmunoassay. Acute restraint stress significantly (P < 0.001) increased the plasma cortisol level in pregnant heifers at 1 h of the exposure to the stressor at Days 2 (48 h) and 3 (72 h) of the experiment. On the other hand, the restraint stress did not affect the concentration of P4 and boPAG-1 concentrations in both groups. In conclusion, restraint stress for 2 h during early pregnancy in heifers increased blood cortisol, but it did not affect the concentrations of P4 and boPAG-1 between Days 30 to 40 of gestation.


Assuntos
Ácido Aspártico Endopeptidases/sangue , Bovinos/sangue , Hidrocortisona/sangue , Proteínas da Gravidez/sangue , Progesterona/sangue , Restrição Física/veterinária , Estresse Fisiológico/fisiologia , Animais , Ácido Aspártico Endopeptidases/genética , Ácido Aspártico Endopeptidases/metabolismo , Bovinos/fisiologia , Feminino , Gravidez , Proteínas da Gravidez/genética , Proteínas da Gravidez/metabolismo , Fatores de Tempo
3.
Theriogenology ; 76(3): 512-21, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21529913

RESUMO

Embryo reduction may prevent the negative effects of twinning in dairy cattle; however, the technique may carry an additional risk of pregnancy loss. The aim of this study was to evaluate the effect on pregnancy maintenance of embryo reduction by manual amnion rupture in unilateral and bilateral twin pregnant cows. A secondary objective was to examine the dynamics of endocrine factors following the treatment. On Day 35-41 of gestation 55 cows bearing two live twin embryos (28 bilateral, 27 unilateral) were randomly assigned to a twin reduction group (n = 27; cows fitted with a progesterone releasing intra-vaginal device for 21 days after manual amnion rupture) or control group (n = 28; untreated cows). Pregnancy loss before Day 90 was recorded in nine control and eleven twin reduction cows (32.1% vs 40.7%, respectively, p = 0.508). Logistic regression models indicated that laterality was the only variable significantly affecting pregnancy loss. The pregnancy loss risk was 8.7 times higher for unilateral than for bilateral twin pregnancies (59.3% vs 14.3%, respectively, P < 0.001) yet was similar in the unilateral control and unilateral twin reduction cows (62.3% vs 53.8%, respectively, P = 0.581). In contrast, four of 14 cows with bilateral twin pregnancies undergoing twin reduction lost their pregnancies while no losses were recorded in control cows with bilateral pregnancies (P = 0.049). A rise in plasma progesterone concentration was detected on the day following treatment in the twin reduction group and concentrations remained high within the first week of treatment. Plasma pregnancy-associated glycoprotein-1 (PAG-1) concentrations fell between Day 35-41 and Day 42-48, regardless of treatment. Our findings indicate that embryo reduction by manual amnion rupture did not carry an additional risk of pregnancy loss for unilateral twin pregnancies, whereas it increased the risk of pregnancy failure in bilateral twin pregnancies. However, benefits of preventing cows from delivering twins might also be considered when assessing the success of embryo reduction in bilateral twin pregnancies.


Assuntos
Bovinos , Redução de Gravidez Multifetal/veterinária , Aborto Animal/etiologia , Animais , Ácido Aspártico Endopeptidases/sangue , Feminino , Glicoproteínas/sangue , Gravidez , Resultado da Gravidez , Proteínas da Gravidez/sangue , Redução de Gravidez Multifetal/efeitos adversos , Redução de Gravidez Multifetal/métodos , Gravidez Múltipla , Progesterona/sangue , Medição de Risco
4.
Theriogenology ; 74(2): 212-20, 2010 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-20416940

RESUMO

Q fever is a zoonotic infection caused by Coxiella burnetii that is endemic worldwide. Domestic ruminants are a source of infection for humans. Given the suggestion that the bacterium recrudesces during pregnancy in cattle, this study was designed to determine whether C. burnetii infection affects hormonal patterns, such as progesterone, cortisol, pregnancy associated glycoproteins (PAG), and prolactin during gestation in lactating cows. Possible interactions with Neospora caninum were also explored. The study was performed on 58 gestating non-aborting cows. Blood samples for hormone determinations were collected on Days 40, 90, 120, 150, 180, and 210 of gestation. For antibody determinations, blood was collected at day 40 postinsemination and postpartum. By GLM repeated measures analysis of variance, we established the effects of production and reproductive variables as well as Coxiella and Neospora seropositivity related to changes on cortisol, PAG, progesterone, and prolactin levels. Coxiella antibody levels were significantly related to cortisol, PAG, and plasma progesterone concentrations, whereas Neospora seropositivity was linked to plasma progesterone concentrations. The interaction between Coxiella and Neospora seropositivity was correlated with cortisol and plasma progesterone levels, whereas the interaction seropositivity against C. burnetii-plasma cortisol concentration was related to plasma PAG levels. Finally, an effect of lactation number only was observed on plasma prolactin. Our findings suggest that both the N. caninum and C. burnetii infection or the presence of both modify endocrine patterns throughout gestation. Cows seropositive to both, Neospora and Coxiella, showed higher plasma progesterone levels than the remaining animals examined. Seropositivity to C. burnetii was associated with placental damage and diminishing PAG levels throughout the second half of gestation, along with increased plasma cortisol levels on Day 180 of gestation.


Assuntos
Doenças dos Bovinos/imunologia , Coccidiose/veterinária , Coxiella burnetii/imunologia , Neospora/imunologia , Complicações Infecciosas na Gravidez/veterinária , Complicações Parasitárias na Gravidez/veterinária , Febre Q/veterinária , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antiprotozoários/sangue , Bovinos , Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/parasitologia , Coccidiose/complicações , Coccidiose/imunologia , Sistema Endócrino/microbiologia , Sistema Endócrino/parasitologia , Feminino , Hidrocortisona/sangue , Lactação/imunologia , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Complicações Infecciosas na Gravidez/imunologia , Complicações Parasitárias na Gravidez/etiologia , Complicações Parasitárias na Gravidez/imunologia , Proteínas da Gravidez/sangue , Progesterona/sangue , Prolactina/sangue , Febre Q/complicações , Febre Q/imunologia , Estudos Soroepidemiológicos
5.
Theriogenology ; 71(6): 920-9, 2009 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-19100610

RESUMO

In order to explore pregnancy patterns in high producing dairy cows treated with GnRH or progesterone at pregnancy diagnosis (Days 28-34), two consecutive experiments were designed. In Experiment 1, cows bearing a single embryo were randomly assigned to a PRID (n=40; cows fitted with a progesterone releasing intra-vaginal device for 28 days), GnRH (n=40; cows receiving GnRH) or Control (n=26; untreated cows) group. PRID treatment led to a rise in plasma progesterone concentrations in the 7 days following the onset of treatment compared to the other two groups. In Experiment 2, in which we also examined twin pregnancies, animals were randomly assigned to PRID (n=312) or GnRH (n=294) treatment groups. Treatments were the same as described for Experiment 1. Logistic regression procedures revealed that in cows with a single corpus luteum, the probability of pregnancy loss between the first (Days 28-34) and second (Days 65-62) pregnancy diagnosis decreased by a factor of 0.51 in the PRID group compared to the GnRH group. However, in cows with two or more corpora lutea, PRID treatment increased the likelihood of pregnancy loss by a factor of three, compared to GnRH treatment. In cows carrying twins, the conceptus reduction rate was higher (P=0.02) for the GnRH (36%) than for the PRID (16.4%) group. Formation of a new corpus luteum was recorded in 17.7% of cows in the GnRH group. Our results indicate that compared to GnRH treatment, progesterone treatment given at pregnancy diagnosis in high producing dairy cows, reduced by a factor of 0.51 and increased by a factor of 3 the probability of pregnancy loss in cows with a single or with two or more corpora lutea, respectively, and reduced the conceptus reduction rate in cows carrying twins. The practical implications of our findings are that in herds with a high incidence of early fetal loss of a non-infectious nature, treatment at the time of pregnancy diagnosis with PRID in cows with one corpus luteum and with GnRH in cows with two or more corpora lutea should offer considerable benefits.


Assuntos
Bovinos/fisiologia , Hormônio Liberador de Gonadotropina/administração & dosagem , Progesterona/administração & dosagem , Aborto Animal/epidemiologia , Animais , Corpo Lúteo/fisiologia , Feminino , Lactação , Modelos Logísticos , Gravidez , Progesterona/sangue , Gêmeos
6.
Domest Anim Endocrinol ; 36(2): 57-66, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19036554

RESUMO

The aim of the present study was to investigate possible relationships between plasma concentrations of prolactin and the following factors throughout gestation in lactating dairy cows: photoperiod, season, milk production, Neospora caninum-seropositivity, twin pregnancy, and plasma concentrations of pregnancy associated glycoproteins-1 (PAG-1), progesterone and cortisol. Pregnancy was diagnosed by trans-rectal ultrasonography on Day 40 post-insemination and by palpation per rectum on Days 90, 120, 150, 180 and 210 or until abortion in aborting cows. Blood samples were collected from each animal immediately before each pregnancy diagnosis. The study population was comprised of 73 non-aborting (54 Neospora-seropositive cows) and 20 aborting cows (all Neospora-seropositive) cows. In non-aborting cows, GLM repeated measures of analysis of variance revealed that lactation number and days in milk had no effect on plasma prolactin concentrations throughout gestation, whereas high plasma prolactin concentrations were significantly associated with high plasma levels of cortisol and PAG-1, with Neospora-seropositivity, positive photoperiod (increasing day length), twin pregnancy, and with low plasma progesterone concentrations. An interaction among plasma prolactin, plasma cortisol and milk production was observed in that plasma prolactin concentrations differed significantly throughout gestation and were highest in high-producing cows with high cortisol levels. In Neospora-seropositive non-aborting versus aborting cows, mean prolactin concentrations failed to differ on Days 40, 90, 120, 150 and 180 of pregnancy, whereas prolactin values were significantly lower (P=0.03) in aborting animals on Day 210 of pregnancy. Our results indicate that a positive photoperiod and Neospora-infection lead to increased plasma prolactin concentrations throughout gestation. Reduced prolactin concentrations detected in Neospora-seropositive aborting cows compared to non-aborting animals suggests a protective effect of prolactin in N. caninum infection.


Assuntos
Doenças dos Bovinos/sangue , Coccidiose/veterinária , Neospora/imunologia , Complicações Parasitárias na Gravidez/veterinária , Prenhez/sangue , Prolactina/sangue , Animais , Ácido Aspártico Endopeptidases/sangue , Bovinos , Doenças dos Bovinos/parasitologia , Coccidiose/sangue , Coccidiose/parasitologia , Feminino , Hidrocortisona/sangue , Lactação , Leite/metabolismo , Fotoperíodo , Gravidez , Complicações Parasitárias na Gravidez/sangue , Proteínas da Gravidez/sangue , Progesterona/sangue , Estações do Ano
7.
Reprod Domest Anim ; 44(4): 672-6, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18694426

RESUMO

This study analyses anomalous cases of gestation ending in pregnancy loss during the early foetal period and their effect on progesterone and plasma pregnancy-associated glycoprotein-1 (PAG-1) concentrations. Data derived from a large-scale ultrasound pregnancy diagnosis programme in high producing dairy cows. Over a 3-year period (2004-2007), a very low incidence (0.5%: 15 of 3094) of anomalous pregnancies was recorded. The results revealed that the following anomalies were detected on days 35-41 of gestation in cows carrying singletons with one single corpus luteum: embryo death in eight cows (0.3%); and embryo in the uterine horn contralateral to the corpus luteum in seven cows (0.2%). All these animals suffered pregnancy loss during the early foetal period. In cows carrying dead embryos, no signs of conceptus degeneration were observed on pregnancy diagnosis. Amnion size (approximately 25 mm diameter) and uterine horn fluid contents were estimated to be similar to those of the normal pregnant cows in this period. In the contralateral gestations, live embryos were observed in all ultrasound checks before pregnancy loss. Uterine fluid contents increased in the two cows in which gestation continued for more than a week. In the cases of embryo death but not in those of contralateral gestation, a drop in PAG-1 levels was noted prior to pregnancy loss. Two cows carrying dead embryos increased with time allantoic fluid contents. The PAG-1 values increased with time in one cow bearing a dead embryo (from 2.31 to 6.79 ng/ml) and in two of the contralateral gestations (from 1.66 to 2.33 ng/ml and from 0.39 to 6.79 ng/ml, respectively). Results of this study indicate that the foetal membranes continue to undergo some activity following embryo death, and that contralateral pregnancy may determine failure of the gestation process.


Assuntos
Doenças dos Bovinos , Perda do Embrião/veterinária , Morte Fetal/veterinária , Lactação , Aborto Animal/epidemiologia , Animais , Bovinos , Doenças dos Bovinos/sangue , Doenças dos Bovinos/epidemiologia , Perda do Embrião/sangue , Perda do Embrião/epidemiologia , Feminino , Morte Fetal/sangue , Morte Fetal/epidemiologia , Idade Gestacional , Glicoproteínas/sangue , Gravidez , Proteínas da Gravidez/sangue , Progesterona/sangue
8.
Reprod Domest Anim ; 44(4): 600-5, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18992084

RESUMO

This study was designed to establish the factors, if any, which could affect plasma pregnancy-associated glycoprotein-1 (PAG-1) expression in a study population of 87 pregnant, high-producing dairy cows. The factors examined were: semen providing breed (Holstein-Friesian vs Limousin), outcome of gestation (male vs female newborn, and singleton vs twin pregnancies), lactation number, milk production at pregnancy diagnosis, plasma progesterone concentration, season of gestation (warm period, March-November vs cool period, December-February), and day of gestation (40, 90, 120, 150, 180 and 210). Pregnancy was diagnosed by transrectal ultrasound on day 40 post-insemination and by palpation per rectum on days 90, 120, 150, 180 and 210. Blood samples were collected from each animal immediately before each pregnancy diagnosis. The relative contributions of the different factors on PAG-1 concentrations were evaluated by GLM repeated measures analysis of variance. No significant effects of the herd, foetal sex, milk production, lactation number and plasma progesterone concentrations were observed. In contrast, twin pregnancy, the use of Limousin semen and conception during the cool period were correlated with significantly increased plasma PAG-1 concentrations throughout gestation. Our data indicate that both cow well-being during early placental development, determined in our conditions by reduced heat stress when conception occurred in the cool season, and crossbreed pregnancies lead to improved PAG-1 production throughout the gestation period.


Assuntos
Ácido Aspártico Endopeptidases/sangue , Bovinos/sangue , Proteínas da Gravidez/sangue , Animais , Cruzamento , Feminino , Idade Gestacional , Glicoproteínas/sangue , Temperatura Alta , Hibridização Genética , Lactação , Masculino , Gravidez , Progesterona/sangue , Estações do Ano , Sêmen , Razão de Masculinidade
9.
Theriogenology ; 69(4): 426-32, 2008 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-18045673

RESUMO

The aim of the present study was to determine whether certain animal- or management related factors could affect plasma progesterone concentrations on Day 42 of gestation in high producing dairy cows. Factors affecting early fetal loss were also analyzed. The study population was comprised of 199 pregnant cows classified as having high (> or =9 ng/ml) or low (<9 ng/ml) plasma progesterone concentrations. Through logistic regression procedures it was determined that, based on the odds ratio, cows with two or more corpora lutea were three times more likely to have high progesterone concentrations than cows with a single corpus luteum. Low producing cows during the warm season were 2.86 times more likely to have high progesterone concentrations than the remaining cows. Primiparous cows with high concentrations (>4 ng/ml) of pregnancy associated glycoprotein-1 (PAG-1) were 2.73 times more likely to have high progesterone concentrations than the remaining cows. Of the 199 pregnancies, 25 (12.6%) suffered early fetal loss: 22/136 (16.2%) during the warm season and 3/63 (4.8%) during the cool season, all in cows without additional corpora lutea. Based upon the odds ratio, cows without an additional corpus luteum were 3.67 times more likely to suffer fetal loss during the warm season than during the cool season. Our results indicate that milk production, the presence of two or more corpora lutea and plasma PAG-1 concentrations can affect plasma progesterone concentrations at the onset of the fetal period. The presence of an additional corpus luteum strongly diminished the risk of early fetal loss during the warm period.


Assuntos
Bovinos/sangue , Idade Gestacional , Lactação/fisiologia , Progesterona/sangue , Aborto Animal/epidemiologia , Animais , Ácido Aspártico Endopeptidases/sangue , Corpo Lúteo/fisiologia , Feminino , Modelos Logísticos , Gravidez , Proteínas da Gravidez/sangue , Estações do Ano
10.
Domest Anim Endocrinol ; 32(1): 29-42, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16423500

RESUMO

This study was designed to establish possible factors affecting plasma pregnancy-associated glycoprotein (PAG) concentrations during early pregnancy in high producing dairy cows with live fetuses. Blood samples were obtained on days 35, 42, 49, 56 and 63 of gestation from 80 lactating cows in two herds carrying live fetuses. Radioimmunoassay systems were used to determine PAG (RIA-497 and RIA-706) and progesterone concentrations. We evaluated the effects on PAG concentrations of herd, lactation number, sire of fetus, day of gestation, fetus number, plasma progesterone and milk production at each time point established, along with possible paired interactions. Mean milk production per cow approached 41kg during the study period. PAG concentrations were not affected by herd, lactation number or plasma progesterone concentration. Significant positive effects on PAG concentrations were shown by the gestation day, and the interaction between day of gestation and twin pregnancy. Significant differences between bulls and a significant negative correlation between milk production and PAG values on day 63 of pregnancy were also detected. Proportions of blood samples showing undetectable PAG levels and false negative diagnoses throughout the study period were significantly higher (P<0.001) using the RIA-497 system (2.5% and 5.3%, respectively) compared to RIA-706 (0% and 0.8%, respectively). Our findings suggest that PAG concentrations during the early fetal period are related to the day of gestation, milk production, number of fetuses and sire of fetus in high producing dairy cows. Under our working conditions, the RIA-706 method was better at detecting plasma PAG molecules than the RIA-497 system.


Assuntos
Ácido Aspártico Endopeptidases/sangue , Bovinos/sangue , Lactação/sangue , Leite/metabolismo , Proteínas da Gravidez/sangue , Prenhez/sangue , Animais , Bovinos/fisiologia , Feminino , Feto , Masculino , Gravidez , Progesterona/sangue , Análise de Regressão
11.
Pediatr Surg Int ; 19(1-2): 4-8, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12721712

RESUMO

Surgery for Hirschsprung's disease is associated with high rate of morbidity, in the form of either constipation or incontinence or a combination of the two. This study investigates the mechanisms responsible for incontinence and/or constipation following the pull-through operation for Hirschsprung's disease. There were 19 children (15 boys and 4 girls), who at the time of study; 16 had undergone Duhamel, 1 Rehbein, and 2 Soave operation. We classified patients according to their symptoms into 3 groups: Group A was incontinent of faeces; Group B was constipated and incontinent of faeces, and Group C was constipated only. The median age at referral was 6 years, and the median period after operation was 5 years. All patients were investigated by intestinal transit study, endoanal sonography and anorectal manometry. Group A had normal or rapid transit study, as opposed to Groups B and C, who had delayed-transit study. On endoanal sonography, all children had an intact internal and an external anal sphincter, below the level of pull-through operation. The anorectal manometry showed a significantly lower resting anal pressure in the incontinent Group A as compared to the constipated children with or without incontinence in Group B or C (38 mmHg versus 57 or 66 mmHg respectively). The rectal pressure was also significantly higher in children in Group A as compared to those in Group B or C (71 mmHg versus 42 or 36 mmHg). The ratio of rectal/anal pressure was higher in incontinent children in Group A, as compared to constipated children in Group B or C. Therefore, constipation can be caused by high anal resting pressure and a weak rectal peristalsis, while faecal incontinence can be secondary to poor compliance and elevated rectal pressure in the presence of normal or low anal sphincter resting pressure. Aperients are the mainstay of treatment of constipation, however, children with incontinence are more difficult to treat. We did not attempt to define the pattern of nerve plexus because of poor results of revision operation for residual hypoganglionic segment and intestinal neuronal dysplasia. Treatment of these children can become more rational, if furnished with detailed functional studies. We advocate investigation of the anorectal function at an early stage in symptomatic children after surgery for Hirschsprung's disease, and less invasive treatment should be considered before embarking on major surgery.


Assuntos
Constipação Intestinal/epidemiologia , Incontinência Fecal/epidemiologia , Doença de Hirschsprung/cirurgia , Complicações Pós-Operatórias/epidemiologia , Criança , Constipação Intestinal/fisiopatologia , Incontinência Fecal/fisiopatologia , Feminino , Doença de Hirschsprung/fisiopatologia , Humanos , Masculino , Manometria , Complicações Pós-Operatórias/fisiopatologia , Pressão , Reto/fisiopatologia , Estatísticas não Paramétricas , Resultado do Tratamento
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