Systemic acupuncture in patients with faecal incontinence.

CONTEXT: Faecal incontinence is defined as the involuntary loss of intestinal contents (whether faeces or gas). Although it is not frequently reported, it does cause physical and psychological distress. Traditional Chinese medicine believes that the healthy human body is originally in a state of balanced energy (Qi) between Yin and Yang, and all disorders that occur in the body are explained by disruptions in this energy balance. Acupuncture is a valuable therapy and is used as a therapeutic approach for the treatment of pelvic floor dysfunction. Data regarding faecal incontinence and acupuncture is scarce. This research describes the efficacy of using acupuncture in patients with faecal incontinence. PATIENTS AND METHODS: Eighteen adults (2 men and 16 women) underwent acupuncture therapy with traditional acupuncture needles for 10 weeks. Before and after treatment, all patients completed a Fecal Incontinence Quality of Life (FIQL) survey and the incontinence intensity was assessed using a visual analogue scale. RESULTS: After 10 sessions of acupuncture, all patients reported an improvement, and the vast majority of patients showed statistically significant improvements in both tests. CONCLUSION: Therefore, evidence now shows that acupuncture can improve the quality of life of patients undergoing faecal incontinence treatment.

Sonographic assessment of vessel invasion by cervical masses in dogs / Avaliação ultrassonográfica da invasão vascular por massas cervicais em cães

Tumor invasion of the vessels displays both therapeutic and prognostic implications and represents a challenge for head and neck surgeons. Although previous research has shown that ultrasound can detect such invasions, accurate sonographic parameters to do so have not yet been established. We sought to determine sonographic criteria which are able to characterize these invasions. A high-resolution transducer was used to perform ultrasound examinations of 15 patients selected from a group with inconclusive radiography and computed tomography diagnosis. We found that encasement of the vessel, tumor immobility or fixation in the vessel wall, and narrowing and/or deformity of the lumen were the best criteria. Indeed, when loss of hyperechoic interface of the vessel wall was used as a single criterion it generated false positive results. This study shows that a combination of parameters can be used to provide the best sensitivity and specificity values to produce conclusive diagnosis of vessel invasion by tumors in the cervical region.

Determinaram-se critérios ultrassonográficos capazes de caracterizar a invasão vascular por tumores em cães. Utilizaram-se transdutores de alta resolução para os exames ultrassonográficos realizados em 15 pacientes, selecionados de um grupo submetido previamente à radiografia e tomografia computadorizada, com resultados inconclusivos. Os melhores critérios encontrados foram: encarceramento do vaso, imobilidade do tumor ou aderência na parede vascular e estreitamento ou deformidade luminal. A perda de definição da interface hiperecoica da parede vascular quando foi usada como critério isolado produziu resultados falso positivos. O estudo demonstrou que uma combinação de parâmetros pode ser usada para aumentar a sensibilidade e especificidade diagnóstica, produzindo diagnósticos mais conclusivos e precisos pra definir a invasão vascular por tumores na região cervical ventral.

Phenotypic characterization of Microsporum canis isolated from cats and dogs.

To characterize strains of Microsporum canis that infect dogs and cats in São Paulo city, 30 isolates of this dermatophyte were tested for their ability to assimilate carbon and nitrogen sources, for proteinase and phospholipase secretion, for susceptibility to yeast killer toxins, and for susceptibility to the antifungals fluconazole, ketoconazole, itraconazole, 5-fluorocytosine and amphotericin B, in E test. All samples assimilated the nitrogen sources asparagine, ammonium sulphate, urea and sodium nitrate, as well as the carbon sources inulin, mannitol, trehalose, meso-erythritol, maltose, mannose, sorbitol, cellobiose, fructose and dextrin. Not all the samples assimilated adonitol, galactose, arabinose, rhamnose, raffinose, melibiose, ribose and sucrose, and none of them was capable of growing with dulcitol, lactose, or xylose as the only carbon source. Proteinase and phospholipase secretion was observed for most isolates. In the test of yeast killer toxin, 10 types could be identified, with four types exclusively observed in isolates from dogs and two types exclusively observed in isolates from cats. In the E test, all isolates were found to be resistant to the fluconazole and 5-fluorocytosine, while they were variably sensitive to amphotericin B, ketoconazole and itraconazole. When the data were submitted to the qualitative analysis in the matrix distance program FITOPAC, the similarity of the isolates could be assessed.

Production of extracellular enzymes by Microsporum canis and their role in its virulence.

Microsporum canis is the most prevalent dermatophyte of domestic animals. Several enzymes produced by dermatophytes, particularly keratinases, are considered to play a role in the virulence of this fungus. To investigate the possible relationship between the clinical status of M. canis infection and enzymatic activity of isolates, we studied the relationship between keratinase, elastase, lipase and DNase levels produced in vitro by different isolates and virulence as expressed in a guinea pig model. Samples isolated from symptomatic dogs and cats showed a statistically significantly (P < 0.05) higher keratinase activity than samples isolated from asymptomatic animals. Experimental infection of guinea pigs showed that a strain with high in vitro keratinase activity induced acute infection, which resolved clinically and mycologically faster than the infection induced by a strain with low keratinase activity. This suggested a strong correlation between high keratinase activity and the development of symptoms. The same correlation was not observed for other enzymes tested.