ABSTRACT
OBJECTIVE: To study the correction of a 'myelomeningocele-like' defect in fetal rabbits. METHODS: Twelve pregnant rabbits had a spinal defect surgically created in 40 of their fetuses at 23 days of gestation. Immediate repair was performed in 30 fetuses (group I), and 10 remained uncorrected (group II). After 30 days, the fetuses were harvested and the anatomopathological aspects where compared using Fisher's exact test. RESULTS: Three different techniques to apply a cellulose graft were used for correction in 8 (technique A), 7 (technique B), and 15 animals (technique C), but only one (technique C) was successful. The survival rate at 30 days was 66.7% (10/15) in group I and 80% (8/10) in group II. A 'myelomeningocele-like' defect was present in all fetuses in group II, while in group I the defect was successfully repaired in 80% of the surviving fetuses (p < 0.01). CONCLUSION: The surgically created spinal defect was successfully repaired, and also the fetal rabbit could be established as a model for the study of intrauterine correction of a myelomeningocele-like defect.
Subject(s)
Fetoscopy/methods , Meningomyelocele/surgery , Animals , Biocompatible Materials , Cellulose , Disease Models, Animal , Female , Meningomyelocele/pathology , Pregnancy , RabbitsABSTRACT
OBJECTIVE: To evaluate the fetal survival rate using a modified technique to surgically create a 'myelomeningocele-like' defect in a rabbit model. METHODS: Six white New Zealand rabbits had a spinal defect created in their fetuses at 23 days of gestation. At 30 days of gestation, the fetuses were harvested for anatomo-pathologic evaluation. RESULTS: The defect was created in 19 fetuses and an attempt to correct it was made in 15 cases (group I), and 4 fetuses where left without correction (group II). At 30 days, a 'myelomeningocele-like' defect was present in all surviving fetuses. The total survival rate was 73.68% (14/19); 11 fetus survived in group I and 3 in group II. CONCLUSION: The technical modifications, including fetal positioning and exposure of its back prior to the incision of the lamina, associated with a different technique for myometrium closure, offer an alternative and probably safer method to surgically create a spinal defect in the fetal rabbit.
Subject(s)
Disease Models, Animal , Fetal Diseases/physiopathology , Fetus/surgery , Meningomyelocele/physiopathology , Rabbits , Animals , Female , Fetal Diseases/pathology , Fetal Diseases/surgery , Meningomyelocele/pathology , Meningomyelocele/surgery , Pilot Projects , Pregnancy , Surgical Procedures, OperativeABSTRACT
Five patients who had permanent pacemaker and infective endocarditis were analyzed. Diagnose was confirmed by a positive blood cultures in all patients and 2 of them had identifiable vegetation in the echocardiogram too. The etiologic agent was Staphylococcus aureus in 3, Staphylococcus epidermidis in 1 and Staphylococcus viridans in 1. Three patients were treated with antibiotics alone: one had no clinical conditions to be operated, one died before surgery and one had good response to antimicrobial therapy alone. Two patients were submitted to antibiotic therapy and surgical removal of the pacemaker system, without complications. It was concluded that the surgical removal of the pacemaker system, as soon as possible, is the choice's therapy
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Endocarditis, Bacterial/microbiology , Staphylococcal Infections/microbiology , Streptococcal Infections/microbiology , Staphylococcus aureus , Staphylococcus epidermidis , Streptococcus , Echocardiography , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/therapyABSTRACT
Two patients with chronic valvular heart disease and myocardial infarction were assisted at our hospital. Both of them were febrile and only one had petechiae associated with signs of valvular involvement led to suspicion of infective endocarditis. Although blood cultures were negative, echocardiographic, surgical and anatomopathologic findings were compatible with infective endocarditis. They required cardiac surgery during the acute phase of the infection because they presented progressive hemodynamic deterioration and no satisfactory response to antimicrobial regimen too. One patient died at late follow-up (two weeks after the hospital discharge) and the other survived, but with signs of cardiac failure (class II of NYHA) one year after the procedure
