Transrectal endoscopy with three different techniques of rectal suture associate: NOTES survival study with liver biopsy in a swine model / Endoscopia transretal para biópsia hepática associada com três diferentes técnicas de sutura retal: estudo da NOTES em modelo experimental suíno

A cirurgia endoscópica por orifícios naturais (NOTES) representa um novo conceito de cirurgia, caracterizada por ausência de incisões abdominais. Os acessos mais comumente usados são o transvaginal e o transgástrico. Entretanto, as rotas transcolônica e transretal representam alternativas promissoras. O presente estudo objetiva avaliar três diferentes técnicas de sutura retal em três suínos submetidos a NOTES transretal para biópsia hepática, avaliando-se concomitantemente as repercussões clínicas e hematológicas. Sob anestesia geral, foi realizada uma incisão transversal no reto para a passagem do endoscópio até a cavidade abdominal em todos os animais para a realização da biópsia hepática. Cada animal recebeu um tipo de sutura retal: sutura em dois planos; reforço com tela de polipropileno ou reforço com membrana de pericárdio bovino. A NOTES transretal em modelo experimental suíno não apresentou implicações clínicas e hematológicas importantes, o que demonstra um acesso alternativo para biópsia hepática. Nenhum animal apresentou sinais de peritonite, aderências ou deiscência de pontos. O uso de reforço com pericárdio bovino para a sutura retal apresenta um atraso na cicatrização quando comparado com a sutura convencional ou com o uso de tela de polipropileno.(AU)

Fibropapillomatosis in green turtles Chelonia mydas in Brazil: characteristics of tumors and virus.

Fibropapillomatosis (FP) is a benign neoplasia that affects physiological functions of sea turtles and may lead to death. High prevalence of FP in sea turtle populations has prompted several research groups to study the disease and the associated herpesvirus, chelonid herpesvirus 5 (ChHV5). The present study detected and quantified ChHV5 in 153 fibropapilloma samples collected from green turtles Chelonia mydas on the Brazilian coast between 2009 and 2010 to characterize the relationship between viral load and tumor characteristics. Of the tumor samples collected, 73 and 87% were positive for ChHV5 in conventional PCR and real-time PCR, respectively, and viral loads ranged between 1 and 118.62 copies cell⁻¹. Thirty-three percent of turtles were mildly, 28% were moderately and 39% were severely affected with FP. Skin samples were used as negative control. High viral loads correlated positively with increasing FP severity in turtles sampled on the Brazilian coast and with samples from turtles found dead in the states of São Paulo and Bahia. Six viral variants were detected in tumor samples, 4 of which were similar to the Atlantic phylogenetic group. Two variants were similar to the western Atlantic/eastern Caribbean phylogenetic group. Co-infection in turtles with more than one variant was observed in the states of São Paulo and Bahia.

Daytime sleepiness in Parkinson's disease: perception, influence of drugs, and mood disorder.

Parkinson's disease (PD) is associated with sleep complaints as excessive daytime sleepiness (EDS) and several factors have been implicated in the genesis of these complaints. Objective. To correlate the subjective perception of EDS with variables as the severity of the motor symptoms, medications, and the presence of depressive symptoms. Materials and Methods. A cross-sectional study, using specific scales as Epworth sleepiness scale (ESS), Beck depression inventory (iBeck) and Hoehn and Yahr (HY), in 42 patients with PD. Results. The patients had a mean age of 61.2 ± 11.3 years and mean disease duration of 4.96 ± 3.3 years. The mean ESS was 7.5 ± 4.7 and 28.6% of patients reached a score of abnormally high value (>10). There was no association with gender, disease duration, and dopamine agonists. Patients with EDS used larger amounts of levodopa (366.7 ± 228.0 versus 460.4 ± 332.25 mg, P = 0.038), but those who had an iBeck >20 reached lower values of ESS than the others (5.9 ± 4.1 versus 9.3 ± 4.8, P = 0.03). Conclusions. EDS was common in PD patients, being related to levodopa intake. Presence of depressed mood may influence the final results of self-assessment scales for sleep disorders.

Cistolitectomia e ressecção de cisto renal por laparoscopia em uma cadela com aderências intraperitoneais: relato de caso / Cystolithectomy and renal cyst resection by laparoscopic surgery in a female dog with intraperitoneal adhesions: case report

No presente relato descreve-se a remoção de urólitos vesicais, bem como o tratamento de um cisto renal por cirurgia laparoscópica em um cão com aderências intraperitoneais. Para o acesso foram utilizados três portais, dois de 10mm e um de 5mm, dispostos na linha média ventral e nas paredes abdominal direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical em duas camadas. O cisto renal direito foi drenado e sua cápsula extirpada. Ocorreu a perda temporária de um urólito na cavidade abdominal e sua posterior recuperação pela cirurgia laparoscópica. O paciente não apresentou recidiva da doença pelo período mínimo de 14 meses. A cirurgia laparoscópica mostrou-se eficaz na terapêutica de ambas as patologias, sem a necessidade de alteração do posicionamento dos portais.

This study reports the laparoscopic treatment of urolithys and renal cist in a dog with adherences after laparotomy. Three portals (two with 10mm and one with 5mm) were used in the middle ventral line or lateral flanks. The calculi were removed, and two intracorporeal sutures were made in the vesicle tissue. The right cystic tissue was drained and its capsule was extirpated. One calculus was lost in the peritoneal cavity, but later recovered by laparoscopy. The patient did not show urinary vesicle disease during at least 14 months. The laparoscopic cistotomy appears to be adequate to remove urolithys and to treat renal cystic disease in dogs.

Specific treatment of hepatosplenic schistosomiasis can increase T-lymphocyte reactivity.

It has been recognized that Schistosoma mansoni infection causes depression of T-cell responsiveness. In this study we have evaluated whether immunodepression associated to schistosomiasis could be reverted by specific treatment. T-cell immune response was assessed by means of intradermal tests using recall antigens in a group of 22 patients with hepatosplenic schistosomiasis, one year after treatment with oxamniquine and compared with a group of untreated hepatosplenic patients. Only 27% of treated patients presented complete anergy to all tested antigens, in marked contrast to 80% unresponsiveness showed by hepatosplenic patients without treatment. Although most of the treated individuals showed some response to the tested antigens, in some individuals this unresponsiveness still persisted after treatment. Anergy was not found in any normal individual of the control group. It was concluded that Schistosoma mansoni infected patients may recover their normal immune responsiveness after the elimination of the worm by treatment.

[Frequency of neutralizing antibodies to the vesiculovirus Piry, in blood donors of Uberaba, Minas Gerais, Brazil]. / Freqüência de anticorpos neutralizantes contra o vesiculovirus Piry, em doadores de sangue de Uberaba, Minas Gerais, Brasil.

Thirteen (8.0%) of 162 blood donors from Uberaba-Minas Gerais State showed neutralizing antibodies to the vesiculovirus Piry. The previous residence in rural area (p less than 0.0001) and in the cities of the São Paulo State (p less than 0.05) were statistically more frequent in the Piry seropositive group.