Maytenus ilicifolia Extract Increases Oxygen Uptake without Changes in Neuromuscular Fatigue Development during a High-Intensity Interval Exercise.

OBJECTIVE: We investigated the effects of acute ingestion of Maytenus ilicifolia extract on metabolic and cardiopulmonary responses during a high-intensity interval exercise (HIIE), and its consequence on neuromuscular fatigue. METHODS: Ten healthy men underwent a HIIE (4 x 4 min, 3 min recovery) one hour after ingesting 400 mg of Maytenus ilicifolia extract (MIE) or placebo. Oxygen uptake (V̇O2), dioxide carbon production (V̇CO2), ventilation (V̇E) and heart rate (HR) were measured throughout the HIIE. Maximal voluntary contraction (MVC), voluntary activation (VA), and evoked 1, 10 and 100 Hz force twitch were measured before supplementation (baseline), and before (pre-HIIE) and after the HIIE (post-HIIE). RESULTS: The V̇O2, V̇E, V̇E/V̇O2 ratio and HR increased progressively throughout the HIIE under both conditions (p < 0.05). MIE increased HR, however, at bouts 1 and 2 and mean V̇O2 during HIIE. The mean respiratory exchange ratio during recovery was also reduced with MIE (p < 0.05). MVC and evoked force at 1, 10 and 100 Hz declined similarly after HIIE, regardless of the condition (MIE: -18 ± 17%, -50 ± 15%, -61 ± 13% and -34 ± 10% vs. placebo: -19 ± 15%, -48 ± 16%, -58 ± 12 and -29 ± 11%, respectively, p < 0.05). There was no effect of exercise or MIE on VA (p > 0.05). CONCLUSION: MIE increases heart rate in the first bouts and mean oxygen uptake during HIIE without changes in neuromuscular fatigue development.

Anterior sagittal approach without splitting the rectal wall.

INTRODUCTION: The anterior sagittal transrectal approach (ASTRA) has already become popular to treat lesions in the proximal urethra such as trauma, duplicity and stenosis, prostatic utricle, urethral-vaginal fistulas and urogenital sinus anomalies. It provides much better exposure than the traditional perineal approach. Morbidity caused by this technique could be potentially decreased if the anterior sagittal access were to be made without sectioning the rectum. We report our initial experience using anterior approach without rectal sectioning for the treatment of three different types of pelvic disorders. PRESENTATION OF CASE: Anterior sagittal access without sectioning the rectal wall was carried out in three different clinical cases - a vaginoplasty in a female patient with congenital adrenal hyperplasia; to treat paradoxical urinary incontinence in a patient with proximal hypospadias (46XY karyotype) and another one with gonadal dysgenesis (46XO/XY karyotype). DISCUSSION: Several surgical techniques have been reported to repair congenital or acquired lesions in the posterior urethra with high morbidity and no guarantees of adequate and safe surgical exposition. ASTRA provides an excellent exposure, splitting only the anterior rectal wall. In this study, the anterior sagittal approach was applied without splitting the rectal wall to repair different posterior urethral anomalies, providing excellent exposure without compromising the fecal continence mechanism. CONCLUSION: The anterior sagittal approach without splitting the rectum is a feasible procedure which provides excellent exposure to the posterior urethra in most cases and leads to less morbidity as it avoids the splitting and suturing of the rectum anterior wall.

Apple-peel intestinal atresia: enteroplasty for intestinal lengthening and primary anastomosis.

Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis.

Unusual case of epigastric heteropagus twinning.

Asymmetrical conjoined twins or heteropagus twins are extremely rare. They are characterized by an incomplete component (parasite) that is normally smaller and dependent on the host (autosite). In cases of an epigastric heteropagus twin, the insertion occurs in the epigastrium. There are few reports of epigastric heteropagus twinning in the English-language literature. The authors report an extremely rare case of epigastric heteropagus twinning in which the parasite presented with head, thorax, and a rudimentary heart.

Crossed testicular ectopia

Introduçao: A ectopia testicular cruzada (ETC) e uma anomalia rara, caracterizada pela descida de um testiculo no canal inguinal do lado oposto. Apresentamos um caso de ectopia cruzada do testiculo direito, tratado por transposicao extraperitoneal da gonada e orquipexia direita. Conclusao: Os conhecimentos embriologicos e os achados cirurgicos sugerem que a ETC seja uma consequencia comum de varios fatores etiologicos, sobretudo fatores mecanicos, e pode causar persistencia do ducto de Muller. Apos extensa revisao da literatura, sugerimos uma classificacao da ETC em 3 tipos: 1- associada somente a hernia inguinal; II- associada a remanescentes mullerianos; III- associada a outras anomalias, sem remanescentes mullerianos. O tratamento inclui orquipexia trans-septal ou transposicao trans-abdominal do testiculo, pesquisa de remanescentes mullerianos e outras anomalias, e seguimento pos-operatorio a longo prazo, devido a resci de malignizacao.

Evisceraçäo do intestino delgado através de perfuraçäo de prolapso retal em uma criança / Evisceration of the small intestine through the rectal prolapse perforation in children

The rectal prolapse is very common in children under 3 years old. Rectal mucosae herniated in to the anal canal. The ethiologic causes are diarrhea, intestinal parasitosis, obstipation and desnutrition. The effort during the defecation, prolonged diarrhea and obstipation are important contribucting factors. The treatment in the majority of cases is medical treating factors like desnutrition, diarrheia and parasitosis. The authors report a case of a 3-month-old child with chronic diarrhea, severe desnutrition and recurrent rectal prolapse with perforation hole. This is a rare complication and considerations are made regarding the management of the case

Estudo comparativo entre as anastomoses íleo-cólica término-terminal e término-latéral em cäes / Comparative study between end to end and end to side ileocolic anastomosis, in dogs

Realizou-se um estudo comparativo entre as anastomoses íleo-cólicas término-terminal (10 cäes) e término-terminal-lateral (10 cäes). Avaliou a evoluçäo clínica pós-operatória, verificou a integridade das suturas e sua resistência tensil e realizou o estudo microscópico de todos os espécimes. Os resultados obtidos näo mostraram diferenças significantes entre os dois procedimentos operatórios

Abscesso de supra-renal na infância / Adrenal abscess in childhood

Apresenta-se um caso de abscesso de supra-renal na infância como consequência provável de infecçäo de hematoma da glândula adrenal. O abscesso de supra-renal é uma raridade na infância e seu diagnóstico diferencial inclui as massas retroperitoneais: rim multicístico, hidronefrose, nefroblastoma (tumor de Wilms). Somente 14 casos foram encontrados na literatura. Este é o 15§ e foi tratado cirurgicamente conservando-se o rim do lado afetado com bom resultado. Embora a cuidadosa avaliaçäo da história, achados físicos e dados laboratoriais possam sugerir um processo inflamatório, o diagnóstico depende fundamentalmente da exploraçäo cirúrgica e estudo anátomo-patológico