ABSTRACT
Resumo A organização e o processo de trabalho são espaços privilegiados para reconhecer as forças que levam ao sofrimento psíquico. Este artigo pretende analisar as percepções de médicos(as) da atenção primária à saúde, que atuam no Programa Mais Médicos, sobre as relações entre sofrimento psíquico e processo de trabalho, no contexto da pandemia do coronavirus. Esta pesquisa foi realizada por meio de um estudo de caso, utilizando métodos e técnicas qualitativas para a coleta, descrição e análise dos dados. Foi selecionada uma amostra intencional em conformidade com a técnica de saturação teórica. A coleta de informações foi realizada com ajuda de entrevistas semiestruturadas, seguindo um roteiro construído para atender aos objetivos desta pesquisa. A análise do discurso dos entrevistados articulou categorias de análise extraidas de cinco eixos temáticos que têm pontos de articulação entre si, com consensos e contradições que dão sentido às visões e posições dos atores no campo da saúde. Os resultados evidenciaram a pandemia como catástrofe sanitária e traumática, redimensionando o processo de trabalho e contribuindo para a sobrecarga, conflitos, medo, sentimento de desamparo e sofrimento psíquico. Inúmeras carências, problemas de infraestrutura, burocracia, interferências políticas, descompasso entre a formação e a prática também contribuiram para esse sofrimento.
Abstract Work organization and process are privileged spaces to recognize the forces that lead to psychological suffering. This study aims to analyze the perceptions of physicians of primary health care, who work in the More Doctors Program, on the relation between psychological suffering and work process during the COVID-19 pandemic. This research was conducted with a case study using qualitative data collection, description, and analysis. An intentional sample was selected in accordance with the theoretical saturation technique. Information was collected by semi-structured interviews, following a script built to meet the objectives of this research. The analysis of interviewees' discourse articulated categories of analysis drawn from five thematic axes with points of articulation between them, consensuses and contradictions that give meaning to the visions and positions of the actors in health. Results evinced the pandemic as a health and traumatic catastrophe, resizing the work process and contributing to overload, conflicts, fear, feelings of helplessness, and psychological suffering. Numerous shortcomings, infrastructure problems, bureaucracy, political interference, mismatch between training and practice also contributed to this suffering.
ABSTRACT
INTRODUCTION: The current context of multiprofessional approach in health is based on quality of care and patient safety, with the key contribution of the dentist in the hospital team to improve the health of hospitalized patients. OBJECTIVE: To characterize the systemic and buccal profile of patients treated in a medical clinic of a University Hospital from the Brazilian Public Health System, aiming to provide information for guiding dental care in the multidisciplinary attendance in the hospital setting. METHODS: Retrospective observational study carried out on 104 clinical records with data collection about general characteristics, systemic alterations, habits, oral situation and dental treatments of hospitalized patients attended by the dentist. RESULTS: There was a high frequency of hypertensive patients (36.5%) and with cardiac problems (33.6%). A significant association between diabetes (60%) and hypertension (50%) in the age group from 60 to 75 years of age was observed. For most patients, the frequency of oral hygiene was less than three times a day (54.3%), without flossing (85.7%). Biofilm (73.3%), dental calculus (70.5%), prosthesis use (25.7%), with poor hygiene (14.3%) and prosthetic stomatitis (8.6%) were recorded. Among the treatments performed by dentist, basic periodontal therapy (71.4%) and exodontia (39%) were noteworthy. CONCLUSION: The high frequency of biofilm presence, dental calculus, prosthesis with poor hygiene and basic periodontal therapy performed during the hospitalization denote the need for dental care with preventive activities.
INTRODUÇÃO: O contexto atual de abordagem multiprofissional em saúde fundamenta-se na qualidade do atendimento e segurança ao paciente, com contribuição importante do cirurgião-dentista na equipe hospitalar para melhoria de saúde dos hospitalizados. OBJETIVO: Caracterizar o perfil sistêmico e bucal de pacientes atendidos em clínica médica de um Hospital Universitário do Sistema de Saúde Pública do Brasil, visando fornecer subsídios no direcionamento da assistência odontológica ao atendimento multidisciplinar em âmbito hospitalar. MÉTODOS: Foi realizado estudo observacional retrospectivo em 104 fichas clínicas com coleta de dados sobre características gerais, alterações sistêmicas, hábitos, situação bucal e tratamentos odontológicos de pacientes internados, atendidos pelo odontólogo. RESULTADOS: Verificou-se alta frequência de pacientes hipertensos (36,5%) e com problemas cardíacos (33,6%). Observou-se associação significativa de diabetes (60%) e hipertensão (50%) na faixa etária de 60 a 75 anos de idade. Para a maioria dos pacientes, a higiene bucal foi realizada menos que três vezes ao dia (54,3%), sem uso de fio dental (85,7%). Biofilme (73,3%), cálculo dental (70,5%), uso de próteses (25,7%), com higiene deficiente (14,3%), e estomatite protética (8,6%) foram registradas. Dentre os tratamentos realizados, destacam-se a terapia básica periodontal (71,4%) e exodontias (39%). CONCLUSÃO: A alta frequência de presença de biofilme, cálculo dental, próteses com higiene deficiente e a terapia básica periodontal executada durante o período de internação denotam a necessidade de atuação odontológica com atividades preventivas.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Health Profile , Oral Health , Comprehensive Dental Care , Hospitalization , Hospitals, UniversityABSTRACT
The embryology of anorectal malformation (ARM) is a controversial issue. The study in humans is difficult due to the scarcity of fetuses with this anomaly. Therefore, ARM animal models, naturally obtained or induced by drugs, have been employed to understand physiopathology and possible treatments. Pigs, rabbits, rats, and mice have been employed as animal models. Additionally, many drugs have been used with this purpose: Etretinate, Ethylenethiourea, and Adriamycin. The animal more frequently used is the rat because of good reproducibility, low cost, and easy handling. Pig is a good model, but it is expensive, and difficult to handling and lodging. Concerning the drugs, Adriamycin promotes a more severe ARM compared with Ethylenethiourea. The models of ARM are of value in the understanding of the embryologic development. Nowadays, researches are aimed at identifying the molecular mechanism of this process, providing the basis for the application of tissue engineering in future experiments with ARM.
Subject(s)
Anorectal Malformations , Disease Models, Animal , Translational Research, Biomedical/methods , Animals , Anorectal Malformations/etiology , Anorectal Malformations/physiopathology , Anorectal Malformations/therapy , HumansABSTRACT
A Paracoccidioidomicose é uma infecção micótica sistêmica, que envolve primariamente os pulmões, podendo se estender para outros sítios, inclusive a boca. Relata-se um caso clínico de Paracoccidioidomicose, destacando a importância da Odontologia Hospitalar no seu diagnóstico. Paciente, 56 anos, masculino, fumante e etilista por 40 anos. Apresentava área ulcerada localizada em gengiva inserida entre os dentes 44 e 45. Foi realizada biópsia incisional de lesão bucal, detectando-se a presença do fungo Paracoccidioides brasilienses no exame histopatológico. A terapêutica médica foi direcionada para a PCM com itraconazol 100 mg (2x/dia) por dois anos. No exame clínico de proservação, verificou-se cicatrização completa da região. A interação do Cirurgião-Dentista com profissionais das diferentes áreas médicas em âmbito hospitalar é importante para o cuidado integral do paciente hospitalizado
Paracoccidioidomycosis is a systemic fungal infection, primarily involving the lungs and may extend to other sites, including the mouth. We report case of paracoccidioidomycosis, highlighting the importance of Hospital Dentistry for their diagnosis. Patient, 56, male, smoking and drinking for forty years. There was an ulcerated area located in attached gingiva between teeth 44 and 45. Incisional biopsy of oral lesion was performed by detecting the presence of Paracoccidioides brasiliensis fungus in the histopathological examination. Medical therapy was directed to the PCM with itraconazole 100mg (2x/day) for two years. On examination of follow up, there was complete healing of the region. The interaction of dentist with professionals from diï¬erent medical areas is important to the wholly care of hospitalized patient
Subject(s)
Paracoccidioidomycosis , Biopsy , Diagnosis, OralABSTRACT
Accidental ingestion of magnetic foreign bodies has become more common due to increased availability of objects and toys with magnetic elements. The majority of them traverse the gastrointestinal system spontaneously without complication. However, ingestion of multiple magnets may require surgical resolution. The case of an 18-month girl who developed an intestinal fistula after ingestion of two magnets is reported.
Subject(s)
Foreign Bodies/complications , Intestinal Fistula/etiology , Intestinal Perforation/etiology , Magnetics , Play and Playthings/injuries , Female , Humans , InfantABSTRACT
Accidental ingestion of magnetic foreign bodies has become more common due to increased availability of objects and toys with magnetic elements. The majority of them traverse the gastrointestinal system spontaneously without complication. However, ingestion of multiple magnets may require surgical resolution. The case of an 18-month girl who developed an intestinal fistula after ingestion of two magnets is reported.
A ingestão acidental de corpo estranho magnético tem sido mais observada, devido à disponibilidade cada vez maior de brinquedos e objetos com imãs. A maioria deles é eliminada pelo trato digestivo espontaneamente. Porém, a ingestão de duas ou mais peças podem desencadear situações de resolução cirúrgica. Relatamos aqui o caso de uma menina de 18 meses que desenvolveu fístula intestinal após a ingestão de 2 peças imantadas.
Subject(s)
Humans , Child , Child , Foreign Bodies , Intestinal Fistula/ethnology , Play and Playthings/injuries , MagneticsABSTRACT
The authors report a case of a 13-year old child who was submitted to a laparoscopic appendectomy and developed, during the postoperative period, an intestinal obstruction caused by small bowel volvulus in the absence of a congenital malrotation.
Subject(s)
Appendectomy , Ileal Diseases/etiology , Intestinal Volvulus/etiology , Laparoscopy , Postoperative Complications/etiology , Adolescent , Anesthetics/adverse effects , Appendectomy/adverse effects , Appendicitis/complications , Appendicitis/surgery , Humans , Ileal Diseases/diagnosis , Ileal Diseases/surgery , Ileum/blood supply , Ileum/pathology , Intestinal Volvulus/surgery , Ischemia/diagnosis , Ischemia/etiology , Ischemia/surgery , Laparoscopy/adverse effects , Male , Necrosis , Pneumoperitoneum, Artificial/adverse effects , Postoperative Complications/diagnosis , Postoperative Complications/surgeryABSTRACT
The authors report a case of a 13-year old child who was submitted to a laparoscopic appendectomy and developed, during the postoperative period, an intestinal obstruction caused by small bowel volvulus in the absence of a congenital malrotation.
Relato do caso de uma criança de 13 anos de idade submetida à apendicectomia laparoscópica e que, no pós-operatório, desenvolveu quadro de obstrução intestinal, decorrente de um volvo de intestino delgado, na ausência de má rotação intestinal.
Subject(s)
Humans , Male , Adolescent , Appendectomy , Ileal Diseases/etiology , Intestinal Volvulus/etiology , Laparoscopy , Postoperative Complications/etiology , Anesthetics/adverse effects , Appendectomy/adverse effects , Appendicitis/complications , Appendicitis/surgery , Ileal Diseases/diagnosis , Ileal Diseases/surgery , Ileum/blood supply , Ileum/pathology , Intestinal Volvulus/surgery , Ischemia/diagnosis , Ischemia/etiology , Ischemia/surgery , Laparoscopy/adverse effects , Necrosis , Pneumoperitoneum, Artificial/adverse effects , Postoperative Complications/diagnosis , Postoperative Complications/surgeryABSTRACT
OBJECTIVE: To assess the incidence of necrotizing pneumonia (NP) in children submitted to thoracoscopy, comparing patients with and without NP in terms of the presentation and clinical evolution. METHODS: A retrospective study of children with pleural empyema submitted to thoracoscopy. Thoracoscopy was performed in patients not previously submitted to thoracic drainage and in whom there was evidence of loculated effusion or pneumothorax, as well as in those previously submitted to thoracic drainage and in whom there was persistent pneumothorax or fever with purulent discharge. On the basis of the thoracoscopy findings, patients were distributed into two groups: those with NP (NP group) and those without (no-NP group). RESULTS: The study sample comprised 52 patients. Of the 24 patients with NP, 19 (79%) had undergone thoracic drainage prior to thoracoscopy, 11 (46%) presented with pneumothorax, and 16 (67%) developed bronchopleural fistula. In the NP group, the median drainage time and the median length of hospital stay were 18 and 19 days, respectively. Of the 28 patients without NP, 10 (36%) had undergone thoracic drainage prior to thoracoscopy, 9 (32%) presented pneumothorax, and 5 (18%) developed bronchopleural fistula. In the no-NP group, the median drainage time and the median length of hospital stay were 6 and 10 days, respectively. CONCLUSIONS: Pneumothorax should raise the suspicion of NP. Early thoracoscopy can be a valuable treatment option for NP in children because it hastens recovery in comparison with the medical treatment alone and avoids extensive late thoracotomy lung resections.
Subject(s)
Empyema, Pleural/surgery , Pneumonia, Staphylococcal , Thoracoscopy , Child, Preschool , Epidemiologic Methods , Female , Humans , Length of Stay/statistics & numerical data , Male , Pneumonia, Staphylococcal/epidemiology , Pneumonia, Staphylococcal/pathology , Pneumonia, Staphylococcal/therapy , Pneumothorax/pathology , Time FactorsABSTRACT
OBJETIVO: Analisar a incidência de pneumonia necrosante (PN) em crianças submetidas a toracoscopia e comparar pacientes com e sem PN em relação às diferentes apresentações e evolução clínica. MÉTODOS: Estudo retrospectivo de crianças portadoras de empiema e submetidas a toracoscopia. A toracoscopia foi realizada em pacientes não submetidos a drenagem torácica prévia e evidência de derrame septado ou pneumotórax, assim como naqueles submetidos previamente a drenagem torácica e pneumotórax persistente ou febre e secreção purulenta. Baseado na presença de PN durante a toracoscopia, os pacientes foram divididos em dois grupos: com PN e sem PN. RESULTADOS: Participaram do estudo 52 pacientes. Dos 24 pacientes com PN, 19 (79 por cento) foram submetidos a drenagem torácica anterior à toracoscopia, 11 (46 por cento) apresentaram pneumotórax, e 16 (67 por cento) evoluíram com fístula broncopleural. Neste grupo, as medianas do tempo de drenagem e de hospitalização foram, respectivamente, 18 e 19 dias. Dos 28 pacientes sem PN, 10 (36 por cento) foram submetidos a drenagem torácica anterior à toracoscopia, 9 (32 por cento) apresentaram pneumotórax, e 5 (18 por cento) evoluíram com fístula broncopleural. Neste grupo, as medianas do tempo médio de drenagem e de hospitalização foram, respectivamente, 6 e 10 dias. CONCLUSÕES: A PN deve ser suspeitada na presença de pneumotórax. A toracoscopia precoce pode ser uma opção terapêutica de grande valor na PN da infância, pois acelera a recuperação quando comparada ao tratamento médico isolado e evita ressecções pulmonares extensas da toracotomia tardia.
OBJECTIVE: To assess the incidence of necrotizing pneumonia (NP) in children submitted to thoracoscopy, comparing patients with and without NP in terms of the presentation and clinical evolution. METHODS: A retrospective study of children with pleural empyema submitted to thoracoscopy. Thoracoscopy was performed in patients not previously submitted to thoracic drainage and in whom there was evidence of loculated effusion or pneumothorax, as well as in those previously submitted to thoracic drainage and in whom there was persistent pneumothorax or fever with purulent discharge. On the basis of the thoracoscopy findings, patients were distributed into two groups: those with NP (NP group) and those without (no-NP group). RESULTS: The study sample comprised 52 patients. Of the 24 patients with NP, 19 (79 percent) had undergone thoracic drainage prior to thoracoscopy, 11 (46 percent) presented with pneumothorax, and 16 (67 percent) developed bronchopleural fistula. In the NP group, the median drainage time and the median length of hospital stay were 18 and 19 days, respectively. Of the 28 patients without NP, 10 (36 percent) had undergone thoracic drainage prior to thoracoscopy, 9 (32 percent) presented pneumothorax, and 5 (18 percent) developed bronchopleural fistula. In the no-NP group, the median drainage time and the median length of hospital stay were 6 and 10 days, respectively. CONCLUSIONS: Pneumothorax should raise the suspicion of NP. Early thoracoscopy can be a valuable treatment option for NP in children because it hastens recovery in comparison with the medical treatment alone and avoids extensive late thoracotomy lung resections.
Subject(s)
Child, Preschool , Female , Humans , Male , Empyema, Pleural/surgery , Pneumonia, Staphylococcal , Thoracoscopy , Epidemiologic Methods , Length of Stay/statistics & numerical data , Pneumonia, Staphylococcal/epidemiology , Pneumonia, Staphylococcal/pathology , Pneumonia, Staphylococcal/therapy , Pneumothorax/pathology , Time FactorsABSTRACT
OBJECTIVE: The aim of the study was to determine which was the optimal side for the conduit to be placed (right or left colon) for antegrade continence enema implantation. MATERIALS AND METHODS: Between July 1999 and March 2006, 31 patients underwent the construction of a catheterizable conduit using the Malone principle (MACE) In 22 cases the conduit was re-implanted in the right colon and in 9 cases in the left colon. There were 20 male patients and 11 female patients, with a mean age of 10.23 years. The follow-up period varied from 3 from 83 months (average 25 months). Right and left implantation of the conduit in the colon were compared with regards to the presence of complications, volume of the solution utilized, frequency of colonic lavage, time needed for performing the enema, and degree of satisfaction. RESULTS: One patient with the conduit in the right colon, using the appendix, lost the mechanism after two month follow-up. Thirty patients remain clean and are all capable of performing self-catheterization. No statistically significant differences were found between the groups regarding the variables studied: complications (p = 1.000), solution volume (p = 0.996), time required (p = 0.790) and patient's rating (p = 0.670). The lavage frequency required for patients with the conduit in the right colon may be lower. CONCLUSION: The MACE principle was considered effective for treating fecal retention and leaks, independent of the implantation site. The success of this surgery appears to be directly related to the patient's motivation and not to the technique utilized.
Subject(s)
Colon/surgery , Enema/methods , Fecal Incontinence/surgery , Adolescent , Child , Child, Preschool , Constipation/surgery , Enema/adverse effects , Female , Follow-Up Studies , Humans , Male , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the results of thoracoscopy for the treatment of pleural empyema in pediatric patients. METHODS: A retrospective study of 117 patients who underwent mediastinoscopy or video-assisted thoracoscopy for pleural empyema treatment. General anesthesia and single-lumen oral intubation were used. Surgery was indicated when there was pleural effusion and no clinical and radiological response to clinical treatment (antibiotics, physiotherapy and thoracocentesis) or severe sepsis, together with loculated pleural effusion (confirmed through ultrasound or computed tomography of the chest). RESULTS: Between February of 1983 and July of 2006, 117 thoracoscopies were performed in patients ranging in age from 5 months to 17 years (mean, 4 years). Mean time for thoracic drainage was 9 days (range, 2-33 days), and mean period of hospitalization was 16.4 days (range, 4 to 49 days). One patient (0.8%) died after surgery, and persistent fistula was observed in 33 patients (28%). In 7 cases (6%), open thoracotomy with pulmonary decortication was performed due to the disposition of the empyema. CONCLUSIONS: Management of pleural empyema in this age bracket is still controversial, and surgical indication is often delayed, particularly when there are multiple loculations or severe sepsis. Early thoracoscopy yields a better clinical outcome for pediatric patients with pleural empyema, with apparent decreased morbidity and mortality, earlier chest tube removal, earlier hospital discharge and improved response to antibiotic therapy.
Subject(s)
Empyema, Pleural/surgery , Thoracoscopy/methods , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Length of Stay , Male , Treatment OutcomeABSTRACT
OBJETIVO: Apresentar resultados obtidos com a toracoscopia no tratamento do empiema pleural em pacientes pediátricos. MÉTODOS: Foram avaliados 117 empiemas pleurais, utilizando-se o mediastinoscópio ou a videotoracoscopia, com anestesia geral e sonda de intubação simples. As indicações para a intervenção cirúrgica foram: derrame pleural com ausência de resposta clínica e radiológica ao tratamento clínico (antibióticos, fisioterapia e toracocentese) ou sepse grave, e derrame pleural loculado (documentado por ultrassonografia ou tomografia computadorizada do tórax). RESULTADOS: De fevereiro de 1983 a julho de 2006, 117 toracoscopias foram realizadas em pacientes com idade entre 5 meses e 17 anos (média, 4 anos). O tempo médio de permanência do dreno torácico foi de 9 dias (2 a 33), e o tempo de internação hospitalar foi de 16,44 dias (4 a 49). Houve apenas um óbito (0,8 por cento), e 33 pacientes (28 por cento) tiveram como complicação fístula aérea prolongada. Em 7 pacientes (6 por cento), houve necessidade de conversão para toracotomia com decorticação pulmonar em decorrência da organização do empiema. CONCLUSÕES: Não existe consenso para o tratamento do empiema pleural nesta faixa etária. A terapêutica cirúrgica é geralmente requisitada tardiamente no curso da doença, particularmente quando já existem múltiplas loculações ou quadro séptico grave. A toracoscopia indicada mais precocemente no tratamento do empiema pleural em pacientes pediátricos proporcionou uma melhor resposta à terapêutica clínica, aparentemente reduzindo o índice de morbi-mortalidade, o tempo de permanência do dreno torácico, o tempo de internação hospitalar e o tempo de antibioticoterapia.
OBJECTIVE: To evaluate the results of thoracoscopy for the treatment of pleural empyema in pediatric patients. METHODS: A retrospective study of 117 patients who underwent mediastinoscopy or video-assisted thoracoscopy for pleural empyema treatment. General anesthesia and single-lumen oral intubation were used. Surgery was indicated when there was pleural effusion and no clinical and radiological response to clinical treatment (antibiotics, physiotherapy and thoracocentesis) or severe sepsis, together with loculated pleural effusion (confirmed through ultrasound or computed tomography of the chest). RESULTS: Between February of 1983 and July of 2006, 117 thoracoscopies were performed in patients ranging in age from 5 months to 17 years (mean, 4 years). Mean time for thoracic drainage was 9 days (range, 2-33 days), and mean period of hospitalization was 16.4 days (range, 4 to 49 days). One patient (0.8 percent) died after surgery, and persistent fistula was observed in 33 patients (28 percent). In 7 cases (6 percent), open thoracotomy with pulmonary decortication was performed due to the disposition of the empyema. CONCLUSIONS: Management of pleural empyema in this age bracket is still controversial, and surgical indication is often delayed, particularly when there are multiple loculations or severe sepsis. Early thoracoscopy yields a better clinical outcome for pediatric patients with pleural empyema, with apparent decreased morbidity and mortality, earlier chest tube removal, earlier hospital discharge and improved response to antibiotic therapy.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Empyema, Pleural/surgery , Thoracoscopy/methods , Length of Stay , Treatment OutcomeABSTRACT
OBJECTIVE: The aim of the study was to determine which was the optimal side for the conduit to be placed (right or left colon) for antegrade continence enema implantation. MATERIALS AND METHODS: Between July 1999 and March 2006, 31 patients underwent the construction of a catheterizable conduit using the Malone principle (MACE) In 22 cases the conduit was re-implanted in the right colon and in 9 cases in the left colon. There were 20 male patients and 11 female patients, with a mean age of 10.23 years. The follow-up period varied from 3 from 83 months (average 25 months). Right and left implantation of the conduit in the colon were compared with regards to the presence of complications, volume of the solution utilized, frequency of colonic lavage, time needed for performing the enema, and degree of satisfaction. RESULTS: One patient with the conduit in the right colon, using the appendix, lost the mechanism after two month follow-up. Thirty patients remain clean and are all capable of performing self-catheterization. No statistically significant differences were found between the groups regarding the variables studied: complications (p = 1.000), solution volume (p = 0.996), time required (p = 0.790) and patient's rating (p = 0.670). The lavage frequency required for patients with the conduit in the right colon may be lower. CONCLUSION: The MACE principle was considered effective for treating fecal retention and leaks, independent of the implantation site. The success of this surgery appears to be directly related to the patient's motivation and not to the technique utilized.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Colon/surgery , Enema/methods , Fecal Incontinence/surgery , Constipation/surgery , Enema/adverse effects , Follow-Up Studies , Treatment OutcomeABSTRACT
PURPOSE: To study the ganglion cells (GC) in the terminal bowel of rats with ethylenethiourea (ETU) induced anorectal malformations (ARM). METHODS: The animals were divided into three groups: Group A - normal fetuses from pregnant rats that were not administered ETU; Group B - fetuses without ARM born from pregnant rats that were administered ETU and Group C - fetuses with ARM born from pregnant rats that received ETU. ETU was administered on the 11th day of pregnancy at the dose of 125 mg/kg body weight by gastric gavage. The rats had cesarean section on the 21st day of gestation. The fetuses terminal bowel tissue was analyzed by immunohistochemistry to demonstrate ganglion cells. RESULTS: Statistically significant differences were found between groups A, B and C regarding ganglion cell densities. Group A had the highest cell density, followed by Group B and the lowest density was found in Group C. CONCLUSION: Ganglion cell densities are decreased in the terminal bowel of rats with ARM.
OBJETIVO: Estudar as células ganglionares (CG) no intestino terminal de ratos portadores de anomalia anorretal (AAR) induzida pela etilenotiouréia (ETU). MÉTODOS: Os animais foram distribuídos em três grupos: Grupo A - fetos normais, obtidos de ratas grávidas às quais não foi administrada ETU; Grupo B - fetos não portadores de AAR obtidos de ratas grávidas às quais foi administrada ETU e Grupo C - fetos portadores de AAR obtidos de ratas grávidas às quais foi administrada ETU. A ETU foi administrada no décimo primeiro dia de gestação na dose de 125 mg/Kg, por gavagem. As ratas foram submetidas à laparotomia e histerotomia para retirada dos fetos no vigésimo primeiro dia de gestação. O intestino terminal dos fetos foi retirado e analisado por imunohistoquímica para pesquisa de CG. RESULTADOS: Foram encontradas diferenças estatisticamente significantes entre os grupos A, B e C quanto à densidade de CG. O grupo A apresentou a maior densidade, seguida pelo grupo B, e a menor densidade foi encontrada no Grupo C. CONCLUSÃO: Existe uma menor densidade de CG no intestino terminal de ratos portadores de AAR.
Subject(s)
Animals , Female , Pregnancy , Rats , Anal Canal/abnormalities , Enteric Nervous System/drug effects , Ganglia/cytology , Rectum/abnormalities , Anal Canal/innervation , Anal Canal/pathology , Cell Count , Disease Models, Animal , Ethylenethiourea , Enteric Nervous System/pathology , Immunohistochemistry , Rats, Wistar , Rectum/innervation , Rectum/pathology , /analysisABSTRACT
PURPOSE: To evaluate an experimental model for anorectal anomalies and their principal associated malformations induced by ethylene thiourea (ETU). METHODS: Rat fetuses were utilized, divided into two groups: experimental group - fetuses from rats that received ETU on the 11th day of gestation at the dose of 125 mg/kg, diluted in distilled water to 1 percent concentration (12.5 ml/kg); and control group - fetuses from rats that received distilled water alone, at a volume of 12.5 ml/kg. On the 21st day of gestation, the animals were sacrificed by hypoxia in a carbon dioxide chamber, followed by laparotomy to remove the fetuses. These were initially examined externally to determine the sex and whether anorectal anomalies and malformations of the vertebral column and tail were present. Then, with the aid of microscopy, the fetuses underwent exploratory laparotomy to characterize the type of anorectal anomaly and investigate urological malformations. RESULTS: None of the fetuses in the control group presented anorectal anomaly, vertebral column malformation or urological structural alterations. In the experimental group, 71 percent presented anorectal anomaly, 80 percent presented vertebral column alterations and 35 percent presented urological alterations. CONCLUSION: The model described was shown to be easy to implement and presented results that allow its use in studying anorectal anomalies and associated malformations.
OBJETIVO: Avaliar o modelo experimental de AAR, induzido pela Etilenotiouréia (ETU), quanto à ocorrência de anomalia anorretal e das principais malformações associadas. MÉTODOS: Foram utilizados fetos de ratos distribuídos em 2 grupos: Grupo experimental - Fetos provenientes de ratas que receberam ETU no décimo primeiro dia de gestação na dose de 125 mg/Kg, diluída em água destilada na concentração de 1 por cento (12,5 ml/Kg) e Grupo controle - Fetos de ratas que receberam somente água destilada num volume de 12,5 ml/Kg. No 21° dia de gestação, os animais foram submetidos à eutanásia por hipóxia em câmara de gás carbônico e laparotomia para retirada dos fetos. Os fetos foram, inicialmente, examinados externamente para determinação do sexo, presença de AAR, de malformações de coluna vertebral e da cauda. A seguir, com o auxílio de microscopia, os fetos foram submetidos a laparotomia exploradora para caracterização do tipo de AAR e investigação de malformações urológicas. RESULTADOS: Nenhum dos fetos do grupo controle apresentou AAR, malformações de coluna vertebral e alterações urológicas estruturais. No grupo experimental, 71 por cento apresentaram anomalia anorretal, 80 por cento apresentaram alterações de coluna vertebral e 35 por cento apresentaram alterações urológicas. CONCLUSÃO: O modelo descrito se mostrou de fácil execução e apresentou resultados que permite o seu emprego no estudo das anomalias anorretais e das malformações associadas.
Subject(s)
Animals , Female , Male , Pregnancy , Rats , Abnormalities, Drug-Induced , Anus, Imperforate/chemically induced , Disease Models, Animal , Ethylenethiourea , Teratogens , Anal Canal/abnormalities , Anal Canal/embryology , Fetus/drug effects , Rats, Wistar , Rectum/abnormalities , Rectum/embryology , Spinal Cord/abnormalities , Spinal Cord/embryology , Urinary Tract/abnormalitiesABSTRACT
PURPOSE: To evaluate an experimental model for anorectal anomalies and their principal associated malformations induced by ethylene thiourea (ETU). METHODS: Rat fetuses were utilized, divided into two groups: experimental group - fetuses from rats that received ETU on the 11th day of gestation at the dose of 125 mg/kg, diluted in distilled water to 1% concentration (12.5 ml/kg); and control group - fetuses from rats that received distilled water alone, at a volume of 12.5 ml/kg. On the 21st day of gestation, the animals were sacrificed by hypoxia in a carbon dioxide chamber, followed by laparotomy to remove the fetuses. These were initially examined externally to determine the sex and whether anorectal anomalies and malformations of the vertebral column and tail were present. Then, with the aid of microscopy, the fetuses underwent exploratory laparotomy to characterize the type of anorectal anomaly and investigate urological malformations. RESULTS: None of the fetuses in the control group presented anorectal anomaly, vertebral column malformation or urological structural alterations. In the experimental group, 71% presented anorectal anomaly, 80% presented vertebral column alterations and 35% presented urological alterations. CONCLUSION: The model described was shown to be easy to implement and presented results that allow its use in studying anorectal anomalies and associated malformations.
