Nonsecretory intestinocystoplasty: postoperative outcomes of 25 years

ABSTRACT Objective The objective of bladder augmentation (BA) is to create a low-pressure reservoir with adequate capacity. Despite its benefits, the use of intestinal patches in bladder enlargement provides a high risk of developing complications and BA with demucosalised bowel represents a potential alternative. Therefore, this study evaluated urological parameters and long-term clinical follow-up of patients submitted to non-secretory BA in a single center with 25 years of experience. Materials and Methods Patients treated with BA underwent urological evaluation, which included history, physical examination and urodynamic study. The main urodynamic parameters (bladder capacity and bladder compliance) were assessed in the pre and postoperative moments, and compared by the Wilcoxon Signed Rank test. The main long-term complications were described. Results 269 patients (mean age 14±13 years, 47% male) underwent BA with the use of demucolised intestinal segments. Among the patients in the sample, 187 (69.52%) had neurogenic bladder, 68 (25.28%) had bladder exstrophy, nine had tuberculosis (3.34%), four had a posterior urethral valve (1.49%) and one with hypospadia (0.37%). After the surgical procedure, a significant increment in both urodynamic parameters was found, with a 222% increase in bladder capacity and 604% in bladder compliance (p <0.001 in both analyzes). Mean follow-up time ranged from 2 to 358 months, with a median of 72 months (IQR 74-247). Among all patients, 5 presented spontaneous perforation. Conclusion The study showed statistically significant increase in both compliance and bladder capacity after non-secretory BA, with a low rate of severe complications.

Ocorrência do vírus da leucemia felina em Felis cattus em Belo Horizonte / Occurrence of feline leukemia virus in Felis cattus in Belo Horizonte

Blood samples from 1,072 domestic cats of nine administrative regions of Belo Horizonte, MG, were collected and tested using PCR nested for the occurrence of feline leukemia virus (FeLV). Overall occurrence was 47.5 percent (507/1072) being North (68.1 percent) and East (54.4 percent) the most prevalent areas. Epidemiological data showed that FeLV infection was very common among examined cats and breed neither gender nor were predisposing factors for FeLV. The results suggest that the agglomeration of a large number of cats in the same environment can be an important factor for the increase in the rate of transmission of this retrovirus among domestic cats in the studied city.

Ambientes virtuais, escrita e clínica fonoaudiológica / Virtual environments, writing and clinical speech therapy

O uso da escrita em ambientes virtuais, sobretudo na Web, tem sido objeto de reflexão e de polêmica, pois afeta convenções e o uso tradicional da mesma. Na literatura fonoaudiológica informática e internet, geralmente, são utilizadas como subsídios terapêuticos modernos e eficazes. Entretanto, áreas afins já fazem uso do meio digital tanto para capacitação e aprimoramento profissional, como para mediação com o outro: aluno, paciente, familiares.O objetivo desta pesquisa exploratória, realizada por meio de revisão bibliográfica e vinhetas clínicas, é discutir a efetividade do emprego da escrita virtual como dispositivo terapêutico fonoaudiológico. Aspectos éticos da relação terapeuta-paciente e o uso de novas formas da linguagem escrita no dia-a-dia de nossos pacientes são alguns dos pontos que merecem a atenção, discussão e reflexão por parte dos fonoaudiólogos na clínica contemporânea.

The use of writing in virtual environments, particularly the Web, has been a subject of discussion and controversy, since it affects conventions and the its traditional use. In Speech therapy literature, computer science and the internet are generally used as modern and effective therapeutic assistance. However, similar areas are already making use of digital media for both training and professional improvement, and for mediation with others: students, patients, family members.The aim of this exploratory research, developed through bibliographic research and clinical memories, is to discuss the effectiveness of the use of writing in virtual environments as a speech therapeutic device. Ethical aspects of the therapist-patient relationship, the clinical demands of each case, and the proliferation of new forms of writing in our patients' everyday lives are just some of several aspects that deserve attention, discussion and reflection by Speech Therapy professionals in contemporary clinical practice

El uso de la escritura en ambientes virtuales, sobretodo en la Web, es objeto de discusión y controversia, porque afecta convenciones y su uso tradicional. En la literatura fonoaudiológica, informática y Internet son, generalmente utilizados como subsídios terapéuticos modernos e eficaces. Sin embargo, áreas afines ya se utilizan del medio digital tanto para la capacitación como para la mediación con el otro: alumno, paciente, familiares.El objetivo de esta investigación exploratoria desarrollada por médio de revisión bibliográfica y viñetas clínicas, es discutir la eficacia de la utilización de la escritura virtual como dispositivo terapéutico fonoaudiológico. Aspectos éticos de la relación terapeuta-paciente y el uso diário de formas del lenguaje escrito por nuestros pacientes, son algunos de los puntos que merecen la atención, discusión y reflexión por parte de los fonoaudiólogos en la clínica contemporánea.

Prevalência das doenças periodontais no Brasil: parte II: 1993-2003 / Prevalence of periodontal diseases in Brazil: part II: 1993-2003

Em 1993, através de uma revisão da literatura dos levantamentos epidemiológicos até então realizados evidenciou que 86,7% do total de indivíduos examinados apresentavam atividade de doença periodontal. O propósito deste artigo foi avaliar a prevalência de doença periodontal através de uma revisão crítica da literatura odontológica referente a diversos estudos epidemiológicos independentes realizados e publicados no Brasil entre 1993 e 2003. Diferenças na metodologia empregada não permitiram muitas comparações entre os dados coletados. Entretanto, concluiu-se que a prevalência geral de doença periodontal encontrada foi de 92,92%. Esta revisão também revelou uma carência de dados sobre a epidemiologia das doenças periodontais em todas as regiões geográficas brasileiras. Todos os levantamentos epidemiológicos estudados apontam a placa dental como único agente etiológico das doenças gengivais e periodontais.

In 1993 a review of epidemiological surveys of the prevalence of periodontal diseases in Brazil has shown that 86.7% of the total of examined individuals had evidence of marginal gingivitis or periodontal damage. The aim of this paper was to evaluate the prevalence of periodontal disease through a critical review of the dental literature of several independent epidemiologic studies that have been conducted during the last 10 years in Brazil (1993-2003). Differences in epidemiological methodology and clinical differential diagnosis made comparative evaluation of surveys data difficult and subjective. However, it can be concluded that the general prevalence rate of periodontal diseases was 92.92%. This review also revealed a lack of data on the epidemiology of periodontal disease in all Brazilian geographic regions. All the epidemiological data reviewed pointed to dental plaque as the primary aetiological agent in gingivitis and periodontitis.

Use of the monti principle for constructing a continent gastrostomy

OBJECTIVE: To research technical alternatives for permanent gastrostomy that minimizes the drawbacks and complications reported by several authors. MATERIALS AND METHODS: An experimental model was developed where the material was divided into 2 groups: the study group (SG) composed of 12 half-breed dogs where the proposed technique was applied, and the control group (CG) composed of 10 animals where a gastrostomy as proposed by Webster in 1974 was applied. On the 90th postoperative day, both groups underwent tests for assessing competence concerning leakage. These were performed under general anesthesia and following sacrifice. RESULTS: In the SG, under anesthesia only one animal had leakage through the gastrostomy. Following sacrifice, leakage was observed in 2 animals. In the CG, under anesthesia, 2 animals had leakage and, following sacrifice, only 1 animal did not present leakage. On histopathological analysis of the SG, gastric mucosa was evidenced around the jejunal tubes, with normal features, moderate inflammatory mononuclear infiltrate in jejunal tubes and only slight infiltrate around the gastrostomy stoma. In the CG, ulceration was constant around the external stoma of the gastrostomy tubes. In the corium, the inflammatory infiltrate was less intense than in the SG. The SG proved to be more efficacious than the CG concerning leakage, and this efficacy is attributed to the submucous valvular system. CONCLUSION: The featured technique showed competence concerning leakage, allowing its clinical applicability as an alternative for permanent gastrostomy.

Total bladder replacement with de-epithelialized ileum: experimental study in dogs

OBJECTIVE: To assess the value of the silicone modeler in preventing graft retraction in dogs undergoing bladder replacement with de-epithelialized ileum. MATERIALS AND METHODS: Twelve female dogs underwent total cystectomy and bladder replacement by neobladder made of demucosalized ileal segment, comparing the group with modeler (group I) and the group without modeler (group II). Cystometry data, graft epithelization and radiological assessment (cystography and excretory urography) were analyzed. RESULTS: Neobladder capacity, at 2 months, ranged from 50 to 250 mL (mean 191 mL) and from 5 to 60 mL (mean 22 mL) and at 6 months, from 60 to 270 mL (mean 202.5 mL) and from 5 to 75 mL (mean- 30.5 mL), respectively in groups I and II, with a statistically significant difference between groups. After 30 days, postoperatively the presence of transitional epithelium was observed in all fragments obtained by biopsy. CONCLUSION: The use of the intravesical silicone modeler prevented the retraction of the neobladder of de-epithelialized ileum.

Atividade antinociceptiva do extrato etanólico do fruto de Solanum acanthodes Hook.f. em camundongos

Solallum acanthodes. popularmente conhecido como "jurubeba", foi estudada com o objetivo de avaliar suas propriedades antinocicept i vas nos modelos de nociccpção induzida pela I'ormalina e glutamato. Para isto foi utilizado o extrato elanólico dos frutos (EES) da planta. Os resultados apresentaram altos níveis de significância, demonstrando o potencial analgésico de S. acanthodes.

Solanum acanthodes, popularly known as "jurubcba", was studied with the objective to evaluatc its antinocíccptivc propcrties In lhe models aI' fonnalin-induced nociceptive and glutamate. For this lhe cthanolic extract of lhe fruits (E.ES) of the plant was used. The results had prescnlcd high lcvcls 01' significance, demonstrating lhe analgesic potcntial of S. acanthodes.

Evolução clínica de pacientes submetidos à ventriculectomia esquerda parcial / Outcome of Patients Submitted to Partial left Ventriculectomy

OBJECTIVE: To assess the efficacy of partial left ventriculectomy as a treatment for patients with end-stage heart failure. METHODS: From February to June 1995, 7 patients with end-stage heart failure underwent partial left ventriculectomy. Subsequently, patients underwent clinical evaluation every 2 months, and 2-dimensional echocardiography at the 6th and 12th months after cardiac surgery. All patients were given digitalis and diuretics at conventional doses, and captopril or enalapril at maximal tolerated doses. RESULTS: Two (28) patients died; 1 from cardiac arrhythmia associated with gastrointestinal hemorrhage, and the other suddenly. One (14) patient developed an embolic cerebrovascular accident. Four (57) patients were hospitalized for congestive heart failure; all of them had either decreased the daily dose of captopril or enalapril or discontinued the drugs by themselves. Twelve months after ventriculectomy, left ventricular ejection fraction values were greater and left ventricular diastolic dimension and functional class values lower than those found before cardiac operation. CONCLUSION: Beneficial effects of partial left ventriculectomy are observed one year after the surgical procedure. This technique, therefore, can be useful for the treatment of patients with end-stage heart failure.