Caracterización del nivel ético profesional de estudiantes y docentes de la carrera de medicina veterinaria de la Universidad Santo Tomás, sede Puerto Montt, Chile / Characterization of the professional ethical level of students and teachers of the veterinary medicine career at the Santo Tomás University, Puerto Montt headquarters, Chile

RESUMEN El objetivo principal de este estudio fue caracterizar el nivel ético en estudiantes y docentes de la carrera de medicina veterinaria de la Universidad Santo Tomás, sede de Puerto Montt, Chile. Para esto, se aplicó una encuesta dilemática a 3 grupos de estudio conformados por estudiantes de primer y quinto año, además de docentes que imparten asignaturas de formación profesional de la sede Puerto Montt. La creación de la encuesta fue por medio de la contratación de especificaciones éticas de la carrera con los diles de juicio moral en Kohlberg. De los resultados obtenidos se pudo concluir que las especificaciones de la carrera de medicina veterinaria solo contemplan el 20% de 59 artículos estudiados del Código de Ética profesional. Además, es posible decir que los estudiantes de primero y quinto año, y los docentes no conocen a cabalidad los artículos del Código de Ética según la clasificación de la teoría de Kohlberg.

ABSTRACT The main objective of this study was to characterize the ethical level in students and teachers of the veterinary medicine career of the Santo Tomás University, Puerto Montt headquarters, Chile. For this a dilemmatic survey was applied to 3 study groups, made up of students from the first and fifth years, in addition to teachers who teach professional training subjects at the Puerto Montt campus. The survey was created by contracting ethical specifications of the career with the moral judgment diles in Kohlberg. From the results obtained, it was possible to conclude that the specifications of the veterinary medicine career only contemplate 20% of the 59 articles studied of the professional code of ethics. In addition, it was possible to say that the first and fifth year students, and teachers do not fully know the articles of the code of ethics according to the classification of Kohlberg's theory.

Circulating endothelial cells are increased in chronic myeloid leukemia blast crisis

We measured circulating endothelial precursor cells (EPCs), activated circulating endothelial cells (aCECs), and mature circulating endothelial cells (mCECs) using four-color multiparametric flow cytometry in the peripheral blood of 84 chronic myeloid leukemia (CML) patients and 65 healthy controls; and vascular endothelial growth factor (VEGF) by quantitative real-time PCR in 50 CML patients and 32 healthy controls. Because of an increase in mCECs, the median percentage of CECs in CML blast crisis (0.0146%) was significantly higher than in healthy subjects (0.0059%, P<0.01) and in the accelerated phase (0.0059%, P=0.01). There were no significant differences in the percentages of CECs in chronic- or active-phase patients and healthy subjects (P>0.05). In addition, VEGF gene expression was significantly higher in all phases of CML: 0.245 in blast crisis, 0.320 in the active phase, and 0.330 in chronic phase patients than it was in healthy subjects (0.145). In conclusion, CML in blast crisis had increased levels of CECs and VEGF gene expression, which may serve as markers of disease progression and may become targets for the management of CML.

Epilepsy-induced electrocardiographic alterations following cardiac ischemia and reperfusion in rats

The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. In addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode.

Hábitos alimentarios y condición física en estudiantes de pedagogía en educación física / Eating habits and physical condition of physical education students

Objective: To determinate dietary habits and physical condition of physical activity students from the Autonomous University of Chile, Temuco, relating these to their fitness level. Methods: An observational cross-sectional study was conducted among 239 students (76.5 % males). Assessment included a food questionnaire, anthropometric measurements and physical condition. Results: In a sample of 239 students, 35.6% of them were overweight or obese as well as having unhealthy dietary habits independent of the academic year at university. Only 4.7 % of the students used the national recommendations for fruit intake and only 30% ate breakfast daily. In men weight, waist circumference and BMI were negatively associated with the Nvette Course test (R = -0.203, R= -0.249 and R= -0.196, p<0.01 respectively). Conclusion: Physical activity education students have poor dietary habits throughout the university academic years while their fitness decreases irregularly as studies progress. This is a major concern since they will become healthy life style role models for their future students.

Objetivo: Determinar los hábitos alimentarios y condición física de los estudiantes de pedagogía en educación física de la Universidad Autónoma de Chile, sede Temuco y relacionarlos con el nivel de condición física. Sujetos y métodos: Estudio transversal observacional, se evaluaron 239 estudiantes de educación física, de los cuales 76,5% eran hombres, aplicándoles una encuesta alimentaria, antropometría y evaluación de la condición física. Resultados: El 35,6% de los estudiantes presentaba sobrepeso/obesidad, además tenían malos hábitos alimentarios independientes del año de ingreso. Sólo 4,7% consumía las recomendaciones de frutas y 30% tomaba desayuno todos los días. En hombres el peso, la circunferencia de la cintura e IMC correlacionan negativamente con la prueba de Course navette (R=-0,203; R=-0,249; R=-0,196, p<0,01 respectivamente). Conclusión: Los estudiantes universitarios presentan malos hábitos alimentarios durante toda la carrera universitaria, mientras que su condición física disminuye de manera irregular a medida que avanzan los estudios, situación preocupante ya que ellos se transformaran en modelos de estilos de vida saludable especialmente a nivel escolar.

Cáncer tiroideo papilar: reporte de 4 casos familiares / Papillary thyroid cancer: case reports of four family cases

Introducción: El cáncer papilar del tiroides (CPT) es la neoplasia endocrina más frecuente, siendo el 80% de los casos de la variedad papilar; sólo el 10 por ciento se manifiesta antes de los 21 años y tiene una incidencia estimada en este grupo de 0,54:100.000. Su comportamiento en la edad pediátrica se caracteriza por el diagnóstico en una etapa más avanzada de la enfermedad pero con buena respuesta terapéutica y muy baja mortalidad. Objetivo: Presentar 4 casos familiares de CPT, discutir las características particulares y la importancia del diagnóstico precoz en pacientes. Casos clínicos: Se presentan 4 familias con sujetos portadores de un carcinoma papilar familiar de Tiroides, en todas ellas el caso pediátrico se presentó con posterioridad a un caso de un adulto familiar directo, por lo que su búsqueda fue más precoz, y a pesar de un tratamiento oportuno ya tenían enfermedad avanzada al diagnóstico. Los casos pediátricos corresponden a 3 mujeres y 1 varón de edades promedio de 12 años 6 meses al momento del diagnóstico. Discusión: La variedad familiar del carcinoma papilar de tiroides (2 o más familiares de primer grado afectados), representa el 5 por ciento de los cánceres papilares. Se transmite a través de herencia autosómica dominante con penetrancia incompleta y expresividad variable. Se manifiesta a menor edad que el esporádico, es más agresivo con mayor invasión local (32 por ciento), recurrencia (20-50 por ciento) y metástasis linfática (57 por ciento), y se asocia a enfermedades tiroídeas benignas. Con frecuencia es multifocal. Conclusión: El cáncer familiar papilar de tiroides es una patología con peor pronóstico que la variedad esporádica por lo que se requiere una alto índice de sospecha en las familias afectadas para un diagnóstico y tratamiento precoz.

Introduction: Papillary thyroid cancer (PTC) is the most common endocrine malignancy, representing 80 percent of all thyroid cancers; only 10 percent of cases are manifested before age 21 and have an estimated incidence of 0.54 cases per 100,000 people. In children it is diagnosed at a more advanced stage of the disease but with good therapeutic response and very low mortality. Objective: To present four family cases with PTC, discuss the particular characteristics and the importance of early diagnosis. Case reports: 4 families with members affected by family papillary thyroid carcinoma are presented, all pediatric cases were manifested after a direct member adult case was diagnosed, therefore pediatric patients were early detected, but despite a timely treatment, the disease was advanced at the time of diagnosis. The pediatric cases are 3 females and 1 male with an average age of 12 ½ years old at diagnosis. Discussion: The family variety of papillary thyroid carcinoma (2 or more direct members affected), represents 5 percent of papillary cancers. It is transmitted through autosomal dominant inheritance with incomplete penetrance and variable expressivity. It occurs at a younger age than the sporadic type, and it is more aggressive with greater local invasion (32 percent), recurrence (20-50 percent) and lymphatic metastases (57 percent), and it is associated with benign thyroid diseases and often, it is multifocal. Conclusion: The family papillary thyroid cancer is a disease with worse prognosis than the sporadic variety; therefore, a high index of suspicion is required in affected families for early diagnosis and treatment.

Ressecção de cisto e abscesso renais por laparoscopia em um cão / Resection of renal cyst and abscess by laparoscopy in a dog

Cistos renais podem formar-se em qualquer parte do néfron e dos ductos coletores. Alguns são hereditários, originando-se durante a organogênese, e outros se desenvolvem no tecido renal normal, depois que os rins estão completamente formados. No presente relato, descreve-se a ressecção de cisto e abscesso renais, por cirurgia laparoscópica em um cão. Para o acesso, foram utilizados três portais, dois de 10mm de diâmetro e um de 5mm, dispostos na parede abdominal lateral direita e, num segundo momento, na parede abdominal lateral esquerda. Conclui-se, portanto, que a técnica laparoscópica com três portais permite a realização de ressecção de cisto e abscesso renais em cães, sem a ocorrência de recidivas em curto prazo.

Renal cysts can be formed anywhere in the nephron and collecting duct system. Some are hereditary, originated during organogenesis, and others could have origin in the normal kidney tissue, after the kidney's development. This report describes the resection of renal cysts and abscesses by laparoscopic surgery in a dog. In order to access the cavity, three portals were used; two with 10mm and another with 5mm diameter, in the right lateral abdominal wall, and in another moment, in the left lateral abdominal wall. It is concluded that the laparoscopic technique with three portals allows the resection of renal cysts and abscesses in dogs, without the occurrence of relapses in the short postoperative time.

Biotipos periodontales, un resumen actualizado / Periodontal biotypes, an updated review

El interés por los biotipos periodontales se ha acrecentado en el último tiempo, por lo cual en los años recientes el estudio de las dimensiones de los diferentes tejidos periodontales se ha desarrollado desde un punto de vista epidemiológico, estético y terapéutico en varias áreas de la odontología, especialmente en periodoncia. Esta revisión bibliográfica tiene por objetivo mostrar las últimas evidencias relacionadas con esta temática.

Delirium postoperatorio: una ventana hacia una mejoría de la calidad y seguridad en la atención de pacientes quirúrgicos / Postoperative delirium: a window to quality improvement and safety in the care of surgical patients

Postoperative delirium or acute confusional state is a common complication among older subjects. Many factors influence its appearance, such as preexistent problems of the patient, medication use, pain, the perioperative anesthetic management and the intensity of the inflammatory reaction to surgical trauma. Its consequences are a longer hospital stay, higher risk of complications and a long term derangement of functional status and cognitive performance. The management of delirium is multifactorial, including the avoidance of precipitating factors, the maintenance of an adequate environment and the conscious use of neuroleptics. The prevention of delirium should be a priority that will improve health care standards.

El delirium postoperatorio constituye una complicación frecuente y relevante de los pacientes quirúrgicos, en particular en los adultos mayores Su génesis es multifactorial participando características preexistentes del paciente, y gatillantes como medicamentos, dolor, el enfrentamiento anestésico peri operatorio y la intensidad de la respuesta inflamatoria asociada al trauma quirúrgico, entre otros. La aparición de delirium postoperatorio se asocia a desenlaces adversos, como una mayor estadía hospitalaria, mayor riesgo de complicaciones, y a una reducción en la funcionalidad y el estado cognitivo en la evolución alejada. Estrategias de prevención no farmacológicas multimodales, han documentado una reducción significativa en la incidencia de delirium. La terapia del delirium, debe enfocarse en la búsqueda y manejo de factores precipitantes, en favorecer un adecuado entorno no farmacológico, y en el uso apropiado de neurolépticos. El adecuado reconocimiento de esta entidad, y la implementación de estrategias de prevención no farmacológicas constituyen actualmente un estándar que promueve una atención de calidad y segura a los pacientes quirúrgicos.

Malestar psicofisiológico en profesionales de la salud pública de la Región Metropolitana / Psychophysiological distress among health care professionals working in Chilean public hospitals

Background: The public health reform in Chile resulted in changes in working conditions and organization of health centers. Aim: To examine the presence of psychophysiological symptoms in professionals of public hospitals in the Metropolitan Region and their association with current working conditions. Material and Methods: A questionnaire of quality of working life was applied to a sample of 80 physicians and 110 nurses. The questionnaire considers scales and open questions. Results: Nurses had a higher level of discomfort than physicians (p < 0.01) and had significantly higher scores for emotional distress, physical fatigue, digestive disorders, headache, insomnia, back pain and muscle tension (p < 0.01). There were statistically significant negative correlations between psychophysiological distress and working conditions (r = -0.418), social climate (r = -0.395), satisfaction with the organization (r = -0.337) and psychosocial well-being (r = -0.267). A regression model showed that 21 percent of the variance in psychophysiological distress was explained by working conditions, psychosocial well-being and adaptation to the organization. Conclusions: There is a relationship between the high prevalence of psychophysiological symptoms and bad working conditions of public health professionals.

Sildenafil prevents the increase of extravascular lung water and pulmonary hypertension after meconium aspiration in newborn piglets

Meconium aspiration syndrome causes respiratory failure after birth and in vivo monitoring of pulmonary edema is difficult. The objective of the present study was to assess hemodynamic changes and edema measured by transcardiopulmonary thermodilution in low weight newborn piglets. Additionally, the effect of early administration of sildenafil (2 mg/kg vo, 30 min after meconium aspiration) on this critical parameter was determined in the meconium aspiration syndrome model. Thirty-eight mechanically ventilated anesthetized male piglets (Sus scrofa domestica) aged 12 to 72 h (1660 ± 192 g) received diluted fresh human meconium in the airway in order to evoke pulmonary hypertension (PHT). Extravascular lung water was measured in vivo with a PiCCO monitor and ex vivo by the gravimetric method, resulting in an overestimate of 3.5 ± 2.3 mL compared to the first measurement. A significant PHT of 15 Torr above basal pressure was observed, similar to that of severely affected humans, leading to an increase in ventilatory support. The vascular permeability index increased 57 percent, suggesting altered alveolocapillary membrane permeability. Histology revealed tissue vessel congestion and nonspecific chemical pneumonitis. A group of animals received sildenafil, which prevented the development of PHT and lung edema, as evaluated by in vivo monitoring. In summary, the transcardiopulmonary thermodilution method is a reliable tool for monitoring critical newborn changes, offering the opportunity to experimentally explore putative therapeutics in vivo. Sildenafil could be employed to prevent PHT and edema if used in the first stages of development of the disease.

Absceso tiroideo con fístula del seno piriforme: tres casos clínicos / Thyroid abscess with pyriform sinus fistulae: 3 clinical cases

Thyroid abscess is an infrequent, potentially life-threatening condition. It accounts for 0,1 to 0,7 percent of thyroid pathology, usually occurring in patients with preexisting disease of the gland or more commonly, associated to local anatomical defects, such pyriform sinus fistulae. Three cases of thyroid abscess in children are presented, in which no bacterial etiology was confirmed. Intravenous antibiotics were used, cefotaxime, cloxacillin or clindamicin. Recurrence was confirmed in 2 of them, and a pyriform sinus fistulae was demostrated by esophagogram.

El absceso tiroideo es un cuadro infrecuente y una emergencia endocrina potencialmente fatal. Representa el 0,1 a 0,7 por ciento de las patologías tiroideas. Habitualmente se produce en pacientes con patología preexistente de la glándula o más frecuentemente, asociado a defectos anatómicos locales, como una fístula del seno piriforme. Presentamos 3 casos de abscesos tiroideos en escolares. Recibieron tratamiento antibiótico endovenoso de amplio espectro, a pesar de lo cual dos de ellos recidivaron precozmente. En dos de ellos se demostró una fístula del seno piriforme con esofagograma que se manejó quirúrgicamente.

Medición de cambios cuantitativos de la microbiota subgingival posterior a la remoción de placa bacteriana supragingival / Measurement of quantitative changes of the microbiota subgingival after to removal of bacterial plaque supragingival

Uno de los campos de interés en el estudio de la microbiología periodontal para muchos investigadores ha sido identificar si es posible que los microorganismos responsables del origen y progresión de la enfermedad periodontal que habitan sobre el margen gingival (supragingival) y bajo este (subgingival) tengan una relación directa que permita mantener interacciones influyentes en el crecimiento y desarrollo de las diferentes especies bacterianas que habitan en los tejidos periodontales. Por lo tanto, al remover los microorganismos que se ubican supragingivalmente sería posible encontrar cambios en el medio subgingival al no existir un intercambio entre los ambientes aerobios (supragingival) y anaerobios (subgingival) una vez desorganizada la placa bacteriana supragingival. Para demostrar esta relación se seleccionaron 7 individuos con diagnóstico de periodontitis crónica moderada y severa a los cuales se les realizó un destartraje supragingival de boca completa para lograr desorganizar la placa bacteriana supragingival. A su vez se tomaron muestras microbiológicas de los sacos periodontales más profundos de cada cuadrante de estos individuos, siendo la primera muestra tomada previo al destartraje supragingival considerada como muestra basal (día 0), luego se tomaron a las 24 horas, a los 7 y 21 días de removida la placa bacteriana supragingival. De los resultados del presente estudio pudimos concluir que al desorganizar el biofilm supragingival se observa una disminución en la cantidad total de microorganismos subgingivales, así como también disminuye de manera considerable la proporción de Porphyoromona gingivalis presente en el medio subgingival. Lo cual permitiría establecer la existencia de una relación directa y dependiente entre los microorganismos que habitan el medio supragingival y subgingival.

One of the fields of interest in the study of the microbiology periodontal for many investigators has been to identify if it is possible that the microorganisms responsible for the origin and progression of the disease periodontal that live on the margin gingival (supragingival) and under this (subgingival) they have a direct relation that allows to support influential interactions in the growth and development of the different bacterial species that they live in the tissue periodontal.Therefore having removed the microorganisms that are located supragingivalmente would be possible to find changes in the way subgingival when an exchange not to exist between the aerobic environments (supragingival) and anaerobic (subgingival) once disorganized the bacterial plate supragingival. To demonstrate this relation 7 individuals selected with diagnosis of periodontitis chronicle moderate and severe to which they there was realized a destartraje supragingival of complete mouth to achieve supragingival to disorganize the bacterial plate. In turn microbiological samples of the sacks took periodontales deeper of every quadrant of these individuals, being the first taken sample before the destartraje supragingival considered as sample basal (the 0th), then they took at to 1, 7 and 21 days of removed the bacterial plate supragingival anaerobios (subgingival) once disorganized the bacterial plate supragingival Of the results of the present study we could conclude that on having disorganized the biofilm supragingival a decrease is observed in the total quantity of microorganisms subgingivales, as well as also it diminishes in a considerable way the proportion of present Porphyoromona gingivalis in the way subgingival. Which would lead to thinking that there exists a direct and dependent relation between the microorganisms that live the way supragingival and subgingival.

Técnica modificada de injerto de tejido conectivo interposicionado y sobrepuesto en implantología y rehabilitación oral: reporte de dos casos clínicos / Description of two clinical cases showing surgical possibilities of correction or ridges reconstruction, using connective yissue graft and gingival sculping

Se describen dos reportes de casos clínicos mostrando posibilidades quirúrgicas de corrección o reconstrucción para rebordes usando tejido conectivo y posterior modelado gingival.

Description of two clinical cases showing surgical possibilities of correction or ridges reconstruction, using connective tissue graft and gingival sculping.

Radiologia do intestino delgado de cães por meio da técnica de duplo-contraste / Small bowel double-contrast study in dogs

Radiographic exams still the main form to evaluate small bowel in all its extension, and when surveyprojections are not diagnostic, barium series are used although its sensibility can be imitated by filledoverlapped loops, difficulting detailed mucosa visualization. The objective of this study was to adjust anexam technique with intestinal double-contrast, based on techniques used in the human medicine, whichresulted satisfactorily in the demonstration of the mucosal surface in the 30 dogs submitted to the exam.The double-contrast in the lumen was achieved by a combination of a positive contrast medium,recovering the mucosal surface, and a negative filling the lumen. Ambient air and carboximethylcelullosewere the negative contrast medium tested and both were radiographicaly similar.

Hipertiroidismo en niños y adolescentes / Hyperthyroidism in children and adolescents

Background: Hyperthyroidism (HT) prevalence is 0.1/100,000 children and 1/100,000 adolescents and Graves Disease is the most frequent etiology. Objective: To evaluate the clinical presentation, etiology and treatment in hyperthyroid children. Method: Retrospective review of clinical charts of children under 15 years-old, between June 2004 and August 2005. Hyperthyroidism diagnosis was performed with suppressed TSH and increased thyroid hormones levels. Etiological study was done by TRAb, ATPO, ATG, thyroid echotomography and I131 capture. Results: 26 patients were evaluated; 84.6 percent females and age at diagnosis was 9.8 +/- 3,5 years-old (range: 3,8 - 14,5). Goiter was the most frequent clinical sign (96,2 percent), tachicardy and swelling. Etiology: Graves Disease (73 percent),Hashitoxicosis (15,3 percent) and unknown etiology (11,5 percent). Treatment: 88,4 percent began with anti-thyroid drugs (DAT): 78 percent PTU and 22 percent Tiamazol. 62.5 percent became euthyroid after 6 months and 79.1 percent after 12 months. 31.5 percent of GD presented hypothyroidism at 6.3 +/- 4 months of DAT, requiring LT4 substitution. I131 was applied to 4 children (16.6 percent); 3 due to hepatic compromise pre or post PTU use and 1 girl for missing treatment, developing a thyrotoxic torment. Thyroidectomy was done in 2 patients (8.3 percent), both with GD; 1 for giant goiter without DAT response at 19 months and 1 for persistant hyperthyroidism after 25 months of DAT. 92 percent received (3-blockers (Propanolol) for adrenergic symptoms for 5 +/- 4 months. Conclusions: Goiter was the most frequent pediatric HT symptom and Graves disease the main etiology. DAT treatment control HT in 76.9 percent patients and no adverse reactions with I131 were observed. These resUIts promote DAT treatment as first line in HT management, prefering Tiamazol for its better adherence and less adverse reactions. Radioiodide therapy and thyroidectomy are alternatives if treatment fails...

El hipertiroidismo (HT) tiene una prevalencia de 0,1/100 000 en niños y 1/100 000 en adolescentes, siendo la enfermedad de Graves (EG) la etiología más frecuente. Objetivo: Revisar presentación clínica, etiología y manejo de niños con HT. Método: Estudio retrospectivo de fichas clínicas de niños con HT menores de 15 años, evaluados entre Junio/04 y Agosto/05. El diagnóstico de HT se hizo con TSH suprimida y hormonas tiroideas elevadas. El estudio etiológico se realizó en base a anticuerpos TRAb, ATPO, ATG; Ecotomograña tiroidea, y captación de I131. Resultados: Se evaluaron 26 pacientes; 84,6 por ciento fueron mujeres. Edad promedio al diagnóstico fue 9,8 +/- 3,5 años (rango 3,8 a 14,5). La presentación clínica más frecuente fue bocio (96,2 por ciento), seguidos por taquicardia y sudoración. Etiología: Enfermedad de Graves 73 por ciento, Hashitoxicosis 15,3 por ciento y etiología no precisada 11,5 por ciento. Manejo: 88,4 por ciento inician con drogas antitiroideas (DAT); 78 por ciento PTU y 22 por ciento con Tiamazol. 62,5 por ciento se hizo eutiroideo a los 6 meses y 79,1 por ciento a los 12 meses. El 31,5 por ciento de EG presentó hipotiroidismo a los 6,3 +/- 4 meses de uso de DAT, requiriendo sustitución con LT4. El I131 fue indicado a 4 niños (16,6 por ciento): en 3 casos por compromiso hepático importante pre o post uso de PTU y 1 niña por abandono de tratamiento y reingreso con tormenta tiroidea. Tiroidectomía: se indicó a 2 pacientes (8,3 por ciento), ambos con EG; uno por bocio gigante, sin respuesta a DAT después de 19 meses de uso y el otro por persistir hipertiroideo después de 25 meses de uso de DAT. El 92 por ciento recibió (3 bloqueador (propanolol) para manejo de los síntomas adrenérgicos, (5 +/- 4 meses). Discusión y conclusiones: El bocio es el síntoma principal en pediatría. La etiología más frecuente es la Enf de Graves. Las DAT permitieron controlar el HT en 76,9 por ciento de los pacientes, no observamos complicaciones con el uso de I131...

Densidade mineral óssea em cadelas submetidas à ovarioisterectomia com e sem reposição estrogênica oral / Mineral density in bones of ovariohysterectomized bitches, with or without oral estrogen replacement / Mineral density in bones of ovariohysterectomized bitches, with or without oral estrogen replacement

Estudaram-se os efeitos da ovarioisterectomia na densidade mineral óssea de cadelas e da reposição de estrógenos após a cirurgia. Foram utilizadas 12 cadelas, sem raça definida, entre dois e seis anos de idade e pesos entre 5 e 15kg. Os animais, submetidos à ovarioisterectomia, foram separados em dois grupos de seis. Um grupo serviu como controle, e o outro recebeu estrógenos naturais conjugados na dose de 0,01mg/kg via oral a cada 48 horas, durante 12 meses. No dia da cirurgia e após 12 meses, foram feitas radiografias com vistas à densitometria óptica em imagem radiográfica. A ovarioisterectomia diminuiu a densidade óssea, e a reposição estrogênica, na dose utilizada, foi capaz de preservá-la.

Effects on bone density of ovariohysterectomy and post-operative estrogen replacement were studied in bitches. Twelve mixed-breed bitches, ranging from 2 to 6 years of age and weighing between 5 and 15kg were submitted to ovariohysterectomy and separated in two groups of six, after a period of adaptation of 60 days. Bitches from the first group were an un-innoculated control; whereas treated bitches received 0.01mg/kg per os of natural estrogen every 48 hours for 12 months. Radiographs were taken on the day of surgery and 12 months later. Variation in bone density was quantified by optic densitometry in radiographic images. Ovariohysterectomy decreased bone density, whereas estrogen replacement moderated the effect.

Pesquiza precoz de nefropatía diabética en niños y adolescentes portadores de diabetes mellitus tipo 1 / Early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus

Introducción: La nefropatía diabética se iniciaría precozmente, luego del debut de DM-1 y se han descrito factores de riesgo asociados a su progresión como años de evolución, mal control metabólico, pubertad e hipertensión arterial. Objetivo: Evaluar parámetros de compromiso renal precoz en pacientes con DM-1 y asociarlos con los factores de riesgo mencionados. Método: Se estudiaron prospectivamente pacientes con DM-1, con microalbuminura y creatininuria aislada matinal (índice microalbuminuria/creatininuria ACR), creatinina plasmática, clearance de creatinina, ecografía renal, hemoglobina glicosilada A1c (HbA1c) actual y promedio de años anteriores, microalbuminurias previas, edad al debut, años de evolución, estadío puberal y presión arterial. Resultados: Se evaluaron 44 DM-1 20 varones, edad promedio 11,68 ± 3,01 años, y 3,8 ± 2,84 años de evolución. Al analizar el control metabólico mediante HbA1c, el promedio fue de 9,1 ± 1,9 por ciento. La hiperfiltración se observó en 7 pacientes (15,9 por ciento) y nefromegalia en 25 por ciento de los pacientes que se les realizó ecografía renal. Ocho pacientes (18,2 por ciento) tuvieron ACR elevado y los prepúberes que presentan ACR elevado (25 por ciento) tienen su debut a menor edad. No existió correlación entre las variables control metabólico, hiperfiltración y nefromegalia con las demás variables estudiadas. Conclusiones: La microalbuminuria determinada por ACR está presente en el 18,2 por ciento de los pacientes, siendo más frecuente en los prepúberes y la menor edad al debut sería un factor de riesgo para desarrollarla.

Fisometra em cadela (Canis familiaris Linnaeus, 1758) - relato de caso / Physometra in a bitch (Canis familiaris Linnaeus, 1758) - case report / Fisometra en una perra (canis familiaris linnaeus, 1758) ­ relato de caso

Fisometra é a dilatação do útero por formação de gás de origem putrefativa. É observada em cadelas que têm partos distócicos, e em muitos casos vem acompanhada de morte e maceração fetal. Desenvolve-se como aumento de volume abdominal, que geralmente é notado pelo proprietário, e pode ou não ser acompanhada por secreção vaginal oriunda de vaginite. O tratamento é cirúrgico e deve ser instituído com urgência, pois pode desencadear choque por obstrução na grande circulação ou choque endotóxico. Este artigo relata o caso de uma cadela da raça Cocker Spaniel, com idade de três anos, que apresentou aumento de volume abdominal, pequena quantidade de secreção vaginal mucopurulenta, vômito e histórico de estro há 30 dias. O exame físico evidenciou dor à palpação abdominal e som timpânico à percussão abdominal. As mucosas estavam róseo-pálidas e o tempo de reperfusão capilar maior que dois segundos. Radiografias simples em dupla posição da região abdominal revelaram uma grande quantidade de gás localizado de forma segmentar por toda a cavidade abdominal. Realizou-se laparotomia exploratória, que revelou útero segmentado por gás (fisometra). A cérvix se encontrava fechada e o corno uterino direito apresentava duas adesões omentais focais. O corno uterino esquerdo se encontrava espessado em sua porção cranial, mas não era preenchido por gás, e os ovários eram normais. Realizou-se então ovariosalpingohisterectomia. Constatou-se que as duas adesões omentais eram respostas à ruptura parcial de camadas musaculares uterinas, e que a fisometra fora causada por produção de gás provinda de decomposição e maceração fetal. A paciente demonstrou melhora significativa e recebeu alta no dia seguinte à cirurgia, recuperando-se plenamente.

Physometra is the dilation of the uterus by gas of putrefactive origin. It is observed in female dogs that have dystocic parturition, and in many cases follows fetal death and maceration. It develops as an increase of abdominal volume, generally noticed by the owner, and can or cannot be accompanied by vaginal discharge from vaginitis. The treatment is surgicaland it should be instituted with urgency, because it can trigger shock due to obstruction in the big circulation or endotoxic. This article reports the case of a three year-old female Cocker Spaniel dog that presented increase of abdominal volume, small amount of mucous-purulent vaginal discharge, vomit and history of estrus 30 days ago. Physical exam evidenced pain to abdominal palpation and tympanic sounds to abdominal percussion. Mucous membranes were pale and capillary reperfusion time was more than two seconds. Simple radiographs of the abdominal area in double position revealed a great amount of gas located in a segmental form in the whole abdominal cavity. An exploratory laparotomy revealed a segmented uterus distended by gas (physometra). The cervix was closed and the right uterine horn presented two focal omental adhesions. The left uterine horn was thickened in its cranial portion, but it was not fi lled by gas, and the ovaries were normal. An ovariohisterectomy was the performed. It was verifi ed that the two omental adhesions were caused by partial rupture of uterine muscle layers, and that the physometra had been caused by production of gas from fetal decomposition and maceration. The patient's clinical condition has signifi cant improving after surgery, evolving to complete recovering.

Fisometra es la dilatación del útero por gas de origen putrefactiva. Se observa en perras que tienen parto distócico, y en muchos casos acompaña muerte y maceración fetal. Se desarrolla como un aumento del volumen abdominal, generalmente notado por el dueño, y puede o no puede ser acompañada por secreción vaginal proveniente de vaginitis. El tratamiento es quirúrgico y debe instituirse con urgencia, porque puede activar choque, debido a obstrucción de la gran circulación o endotóxico. Este artículo relata el caso de una perra Cocker Spaniel con edad de tres años que presentó aumento de volumen abdominal, pequeña cantidad de secrecíon vaginal muco-purulenta, vómito y historia de estro hace 30 días. El examen físico evidenció dolor a la palpación abdominal y sonido timpánico a la percusión abdominal. Las membranas mucosas eran pálidas y el tiempo de reperfusión capilar era más grande que dos segundos. Radiografías simples de la área abdominal en doble posición revelaran gran cantidad de gas localizada de forma segmentar en toda la cavidad abdominal. Una laparotomía exploratoria reveló un útero segmentado y distendido por gas (fi sometra). La cerviz estaba cerrada y el cuerno uterino derecho presentaba dos adherencias omentales focales. El cuerno uterino izquierdo estaba espesado en su porción craneal, pero no estaba lleno de gas, y los ovarios eran normales. Una ovario-histerectomía fue realizada. Se verifi có que las dos adherencias omentales fueron causadas por ruptura parcial de capas musculares uterinas, y que la fi sometra había sido causada por producción de gas debida a descomposición y maceración fetal. La condición clínica de la paciente mejoró signifi cativamente después de la cirugía, hasta completa recuperación.

Immunoexpression of CD95 in chronic gastritis and gastric mucosa-associated lymphomas

CD95 (Fas/APO-1)-mediated apoptosis plays an important role in immunological regulation and is related to the pathogenesis of autoimmune diseases. Immunoexpression of CD95 has been reported to frequently occur in low grade non-Hodgkin lymphomas, especially of post-germinal center histogenesis, among which those originating in mucosa-associated lymphoid tissue (MALT lymphomas). However, there is no report comparing in situ immunoexpression of this marker in lymphomas and the hyperplastic lymphoid reaction (chronic gastritis) related to Helicobacter pylori infection. The purpose of the present research was to compare the intensity of lymphoid CD95 immunoexpression in 15 cases of H. pylori-related chronic gastritis and 15 gastric MALT lymphomas. CD95 (anti-CD95) was detected by an immunoperoxidase technique in paraffin sections using the catalyzed amplification system. Graduation of reaction intensity (percentage of CD95-positive cells) was semiquantitative, from 1+ to 4+. Nine cases of chronic gastritis were 4+, five 2+ and one 1+. Three lymphomas were 4+, three 3+, four 2+, four 1+, and one was negative. Although 14 of 15 lymphomas were positive for CD95, the intensity of the reaction was significantly weaker compared to that obtained with gastric tissue for patients with gastritis (P = 0.03). The difference in CD95 immunoexpression does not seem to be useful as an isolated criterion in the differential diagnosis between chronic gastritis and MALT lymphomas since there was overlapping of immunostaining patterns. However, it suggests the possibility of a pathogenetic role of this apoptosis-regulating protein in MALT lymphomas.