Condenações por síndrome ascítica em frangos abatidos sob inspeção federal entre 2002 e 2006 no Estado do Rio Grande do Sul, Brasil / Ascitic condemnations in broilers slaughtered under Federal Inspection between 2002 and 2006 in Rio Grande do Sul, Brazil

A ocorrência de condenação total de carcaças de frangos devido à síndrome ascítica (SA) em matadouros sob inspeção federal, no Estado do Rio Grande do Sul, alcançou a soma de 1.605.439 unidades no período compreendido entre 2002 e 2006, chegando a 8,19 por cento do total de condenações do período, sem aproveitamento parcial, conforme dados obtidos junto ao Ministério da Agricultura Pecuária e Abastecimento (MAPA). Este trabalho teve como objetivos discutir e apresentar as causas e formas de controle da SA, bem como avaliar a evolução da ocorrência deste transtorno metabólico, uma vez que, em 2002, a síndrome ascítica representou 6,4 por cento do total de condenações, crescendo gradativamente até 2006, quando a ascite representou, até o mês de novembro, 9,6 por cento das condenações de carcaça total. A regressão linear apresentou uma forte correlação (0.92), demonstrando que os casos de condenações por ascite estão aumentando gradualmente. Os prejuízos advindos destas condenações, durante o período avaliado, geram valores na ordem de R$ 3,6 milhões, o equivalente a US$1,7 milhões. Esses dados demonstram a importância de maior controle e do monitoramento da enfermidade para o setor avícola.

The occurrence of broiler carcass condemnation due to ascitic syndrome (AS) in slaughterhouses under federal inspection in Rio Grande do Sul reached the sum of 1.605.439 units between 2002 and 2006, coming to 8.19 percent of total condemnations. There was no partial advantage during this period according to Brazilian agriculture authorities (MAPA). This research aimed to discuss and introduce causes and ways to control AS and evaluate the occurrence of this metabolic disease. In 2002 the AS was responsible for 6.4 percent of total commendation, growing gradually until 2006, where ascitic represented, until November, 9.6 percent of total carcass commendation. The linear regression showed a strong correlation (0.92), demonstrating that commendations due to ascites are growing gradually. During this period the damage caused by these commendations resulted in R$ 3.6 million losses (equivalent to US$ 1.7 millions). These results demonstrate the importance of more effectiveness control of this disease for the poultry industry.

Ascitis en la práctica ambulatoria / Ascites in the ambulatory practice

El diagnóstico de la ascitis y de su causa se basa en datos de la historia clínica, del examen físico y del análisis del líquido peritoneal extraído por paracentesis. En general son innecesarios otras pruebas diagnósticas para encontrar la causa que origina el síndrome ascítico. Si el gradiente albúmino/albúmina es mayor a 1,1 pero los signos y síntomas no son concluyentes de enfermedad hepática, un valor elevado de proteínas en el líquido peritoneal ayuda a diferenciar una obstrucción al flujo hepático como la que ocurre en la insuficiencia cardíaca, la pericarditis y el síndrome de Budd Chiari ya que el nivel de proteínas es inferior a 2,5 gr/dl en la cirrosis y superior a dicha cifra en los trastornos hepáticos congestivos. En una pequeña cantidad de pacientes la evaluación clínica, las pruebas de función hepática y el análisis del líquido ascítico no proporcionan un diagnostico definitivo. En estos casos la laparoscopia ayuda al permitir una visualización directa de la cavidad peritoneal y la toma de muestra para biopsia hepática y/o peritoneal.

Clinical profile of dengue hemorrhagic fever cases in Mexico

OBJETIVO: El dengue hemorrágico en México es una enfermedad emergente desde 1994. La circulación de los cuatro serotipos incrementa el riesgo de epidemias de dengue hemorrágico. MATERIAL Y MÉTODOS: Se reportan los datos clínicos y epidemiológicos de los casos de dengue hemorrágico confirmados y notificados por el IMSS de 1995 a 2003. Se analizaron las características clínicas y epidemiológicas entre grupos. Para el control y la evaluación final de las variables se utilizó un modelo multivariado. RESULTADOS: Los casos fueron asignados en dos grupos: 438 con dengue clásico, que incluye 109 casos con manifestaciones hemorrágicas sin trombocitopenia, y 977 casos de dengue hemorrágico con 79 defunciones. Los factores de riesgo asociados a las defunciones fueron: hematemesis (RR 2.6; IC 95 por ciento 1.4-4.6) y melena (RR 2.2; IC 95 por ciento 1.2-3.7). CONCLUSIONES: El cuadro clínico descrito para la población del Instituto Mexicano del Seguro Social permite identificar factores pronósticos que ayuden al clínico a prevenir y manejar adecuadamente los casos severos de dengue hemorrágico.

Prevalence of bacterascites

This is a Hospital based prospective study carried out in Medical Unit-I, Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi from June, 1993 to May, 1994, to find the prevalence of bacterascites in cirrhotic patients with ascites. 65 cirrhotic patients with ascites were selected. Aspiration of ascitic fluid of all patients was done. The fluid was sent for analysis, culture and sensitivity. The main laboratory indicators were polymorph count/mm3 and culture positive ascitic fluid. Patients with bacterascites were followed for 12 weeks. Prevalence of bacterascites was 8%. Twenty% patients of bacterascites developed spontaneous bacterial peritonitis [SBP] during 12 weeks follow up. Bacterascites does not require aggressive treatment. It usually resolves spontaneously

Role of intraperitoneal drains on subhepatic collection following routine uncomplicated cholecystectomy.

The effect of intraperitoneal drains on the incidence and significance of subhepatic fluid collection following elective cholecystectomy was prospectively evaluated by ultrasound scanning in 200 patients. Subhepatic area was drained in 100 patients by using corrugated and vacuum drains while no drains were used in 100 patients. Subhepatic collection was detected in 12 patients (12%) in the drainage group and only 4 patients (4%) in the non-drainage group. The difference is statistically significant (p < 0.05). Two patients (2%) in the drainage group required re-exploration. Overall morbidity (30%) was higher in the drainage group than non-drainage group (18%). It is concluded that routine use of drains following elective cholecystectomy should be abandoned and they should be used only when indicated.

Ascitis. Fisiopatología y tratamiento

Cirrhosis of the liver is the main cause of ascitis. Recent studies have shown in compensated cirrhotics a 40 percent chance to develop ascitis after five years of follow up. The presence of ascitis is usually associated with advanced liver disease, and higher mortality than patients with compensated cirrhosis. Many theories have been proposed to explain ascitis formation being the most important the presence of portal hypertension and sodium retention. Extravascular fluid accumulation depends directly of a balance between hydrostatic and colloid-osmotic pressure (Starling law). Hepatic sinusoids differ from splanchnic ones in regard to the presence of fenestrae, that allows albumin and other substances to flow freely from the sinusoid to the extravascular space. For these reasons the sinusoids lacks colloid-osmotic pressure, and the hydrostatic pressure regulates the flow of fluids passing through them. In cirrhosis, diffuse fibrosis and nodule formation cause functional obstruction to the hepatic blood flow, and a secondary increase in the sinusoidal pressure, that leads to exit of fluids from the sinusoids to the hepatic lymphatics and the thoracic duct. When the amount of fluid that leaves the sinusoids exceeds the capacity of the thoracic duct, fluids accumulate in the abdominal cvity (ascitis). A new theory about ascitis formation states that the first event is a diffuse peripheral arterial vasodilation that cause ineffective plasma volume that triggers the production of humoral factors directed to retain sodium in the kidney...