Ropivacaína isolada ou associada à metadona ou à morfina, pela via epidural, em cadelas submetidas à ovário-histerectomia / Ropivacaine sole or associated to methadone or morphine, by epidural route, in bitches undergoing ovariohysterectomy

Objetivou-se avaliar os efeitos fisiológicos, sedativos e analgésicos da administração peridural de ropivacaína isolada ou associada à morfina ou à metadona. Para tal, 24 cadelas submetidas à ovário-histerectomia receberam acepromazina, e a anestesia foi induzida e mantida com propofol e isoflurano (FiO2 = 1,0), respectivamente. De acordo com o protocolo peridural, formaram-se três grupos de igual número: GR (ropivacaína - 2,0mg/kg); GRMETA (ropivacaína - 2,0mg/kg e metadona - 0,3mg/kg) e GRMORF (ropivacaína - 2,0mg/kg e morfina - 0,1mg/kg). Registraram-se os parâmetros fisiológicos intraoperatórios e os graus de sedação e analgesia pós-operatórios. No GR constataram-se maiores médias de pressões arteriais 30 minutos após a anestesia epidural em relação ao GRMETA (sistólica e média) e ao final do procedimento cirúrgico comparativamente ao GRMORF (sistólica, diastólica e média). Não foram observadas diferenças significativas entre os grupos relativamente à analgesia e ao grau de sedação pós-operatórios. A administração epidural de ropivacaína é segura e eficaz e proporciona boa analgesia, independentemente da sua associação com morfina ou metadona.(AU)

The aim of this study was to evaluate the physiological, sedative and analgesic effects of epidural administration of ropivacaine sole or associated to morphine or methadone. Twenty-four bitches were submitted to ovariohysterectomy and received acepromazine and after, propofol and isoflurane (FiO 2 = 1.0) for anesthesia induction and maintenance, respectively. Based on established epidural protocol (L7-S1), three groups were formed: GR (ropivacaine - 2.0mg/kg); GRMETA (ropivacaine - 2.0mg/kg and methadone - 0.3mg/kg) and GRMORF (ropivacaine - 2.0mg/kg and morphine - 0.1mg/kg). Intraoperative physiological parameters and degrees of postoperative sedation and analgesia were recorded. In the GR, the means of arterial pressures, 30 minutes after epidural anesthesia, were higher compared with GRMETA (systolic and mean) and, at the end of the clinical procedure, compared to GRMORF (systolic, diastolic and mean). Differences between groups were not observed for postoperative analgesia and degree of sedation. Epidural administration of ropivacaine is safe and effective and provides good analgesia regardless of its association with morphine or methadone.(AU)

Possible benefit of consolidation therapy with high-dose cytarabine on overall survival of adults with non-promyelocytic acute myeloid leukemia

In adults with non-promyelocytic acute myeloid leukemia (AML), high-dose cytarabine consolidation therapy has been shown to influence survival in selected patients, although the appropriate doses and schemes have not been defined. We evaluated survival after calculating the actual dose of cytarabine that patients received for consolidation therapy and divided them into 3 groups according to dose. We conducted a single-center, retrospective study involving 311 non-promyelocytic AML patients with a median age of 36 years (16-79 years) who received curative treatment between 1978 and 2007. The 131 patients who received cytarabine consolidation were assigned to study groups by their cytarabine dose protocol. Group 1 (n=69) received <1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles. The remaining patients received high-dose cytarabine (≥1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles). The actual dose received during the entire consolidation period in these patients was calculated, allowing us to divide these patients into 2 additional groups. Group 2 (n=27) received an intermediate-high-dose (<27 g/m2), and group 3 (n=35) received a very-high-dose (≥27 g/m2). Among the 311 patients receiving curative treatment, the 5-year survival rate was 20.2% (63 patients). The cytarabine consolidation dose was an independent determinant of survival in multivariate analysis; age, karyotype, induction protocol, French-American-British classification, and de novo leukemia were not. Comparisons showed that the risk of death was higher in the intermediate-high-dose group 2 (hazard ratio [HR]=4.51; 95% confidence interval [CI]: 1.81-11.21) and the low-dose group 1 (HR=4.43; 95% CI: 1.97-9.96) than in the very-high-dose group 3, with no significant difference between those two groups. Our findings indicated that very-high-dose cytarabine during consolidation in adults with non-promyelocytic AML may improve survival.

Spawning season, recruitment and early life distribution of Anchoa tricolor (Spix and Agassiz, 1829) in a tropical bay in southeastern Brazil / Período de reprodução, recrutamento e distribuição de jovens de Anchoa tricolor (Spix and Agassiz, 1829) em uma baía tropical do sudeste do Brasil

The pattern of the use of the Sepetiba Bay, a semi-closed 450 km² area in southeastern Brazil, by Anchoa tricolor was investigated to assess spawning period, recruitment and to detect spatial-temporal patterns of this major fishery resource. Fishes were sampled by seine nets, from spring, 1998 to winter, 1999 and by beach seine, from spring, 1998 to winter, 2000. Reproductive season, measured in terms of GSI, gonad development and appearance of recruits, indicate that reproduction occurs from August to March, when they reach the best condition. Recruitment peaks in winter/spring at sandy beaches where they stay until late summer, moving toward deeper bay areas during autumn. After that, they join adults and perform movements between the bay and the adjacent continental shelf to reproduce.

O padrão de uso da Baía de Sepetiba, uma área semifechada no Sudeste do Brasil, por Anchoa tricolor foi estudado visando determinar o período reprodutivo, recrutamento e detectar padrões de distribuição espacial e temporal. As amostras foram realizadas por rede de cerco, entre a primavera de 1998 e o inverno de 1999, e por arrasto de praia, da primavera de 1998 ao inverno de 2000. O período reprodutivo, estimado com base no índice gonadossomático, desenvolvimento gonadal e aparecimento de recrutas, ocorre de agosto a março, quando é atingida a melhor condição dos adultos. O recrutamento ocorre principalmente no inverno/primavera nas praias arenosas onde eles permanecem até fins do verão, movendo-se para áreas mais fundas da baia durante o outono. Depois disto eles se juntam aos adultos e fazem movimentos entre a baia e a plataforma costeira adjacente para reproduzir.

Curso: Tópicos de Medicina Interna: Hemorragia digestiva alta não-varicosa: avaliação da gravidade e conduta terapêutica / Course: Internal Medicine topics: Nonvariceal upper gastrointestinal bleeding: Gravity evaluation and therapeutical approach

A hemorragia digestiva alta (HDA) continua sendo uma das principais causas de atendimento hospitalar emergencial