Ascending renal infection following experimental candiduria by Candida tropicalis in immunocompromised mice.

The present study evaluated renal infection resulting from the implantation of C. tropicalis in the bladder of immunosuppressed mice. Yeasts were implanted in two manners: planktonic and via preformed biofilm on a small catheter fragment (SCF). Renal histopathology and cultures was performed 72 and 144 h after cystotomy was carried out in mice from three groups: group I contained non-contaminated mice implanted with a sterile SCF; group II mice received a sterile SCF plus a yeast suspension containing 1 × 107 yeasts/mL in a planktonic form; group III mice were implanted with a SCF containing preformed C. tropicalis biofilm. Viable yeasts were found in the kidneys of mice from both groups II and III. However, after 72 h the planktonic cells (group II) invaded more quickly than the sessile cells (group III). Over a longer period (144 h), group III exhibited a more invasive infection (50% of the animals presented renal infection and the renal fungal load was 3.2 log10 CFU/g tissue) than in group II, where yeasts were not found. C. tropicalis introduced into the bladder in two ways (in planktonic or biofilm form) were able to reach the kidney and establish a renal fungal infection, causing interstitial disorders. The data of the present study therefore support the hypothesis of an ascending pathway for renal infections by C. tropicalis. Furthermore, the biofilm resulted in a greater and progressive risk of renal infection, attributed to the slow detachment of the yeasts.

Effects of dexmedetomidine combined with commonly administered opioids on clinical variables in dogs.

OBJECTIVE To evaluate cardiopulmonary, sedative, and antinociceptive effects of dexmedetomidine combined with commonly administered opioids in dogs. ANIMALS 8 healthy Beagles. PROCEDURES Dogs were sedated by IM administration of each of 7 treatments. Treatments comprised dexmedetomidine (0.01 mg/kg; Dex) and the same dose of dexmedetomidine plus butorphanol (0.15 mg/kg; Dex-But), meperidine (5 mg/kg; Dex-Mep), methadone (0.5 mg/kg; Dex-Meth), morphine (0.5 mg/kg; Dex-Mor), nalbuphine (0.5 mg/kg; Dex-Nal), or tramadol (5 mg/kg; Dex-Tram). Cardiorespiratory and arterial blood gas variables and sedative and antinociceptive scores were measured before drug injection (time 0; baseline) and at 15-minute intervals for 120 minutes. RESULTS Heart rate was reduced at all time points after injection of Dex-But, Dex-Mep, Dex-Meth, and Dex-Mor treatments. There was a significant reduction of mean arterial blood pressure for Dex-But, Dex-Mep, and Dex-Mor treatments at all time points, compared with baseline. There was a significant decrease in respiratory rate, compared with the baseline value, for Dex, Dex-But, Dex-Meth, and Dex-Tram treatments from 15 to 120 minutes. A significant decrease in arterial blood pH was detected from baseline to 120 minutes for all treatments, with differences among Dex, Dex-Mep, and Dex-Mor. Reduction in Pao2 was greater for the Dex-Mep treatment than for the other treatments. The highest sedation scores were detected for Dex-Mep and Dex-Meth treatments. Antinociceptive effects were superior for Dex-But, Dex-Meth, Dex-Mor, and Dex-Nal treatments. CONCLUSIONS AND CLINICAL RELEVANCE Drug combinations caused similar cardiorespiratory changes, with greater sedative effects for Dex-Mep and Dex-Meth and superior antinociceptive effects for Dex-But, Dex-Meth, Dex-Mor, and Dex-Nal.

Mechanical flexural ex vivo study of osteotomized swine femurs stabilized with two types of polyamide 12 rods / Estudo mecânico de flexão, ex-vivo, de fêmures suínos osteotomizados, estabilizados com dois tipos de haste de poliamida 12

ABSTRACT: Long bone fractures are commonly in surgery routine and several bone imobilization techniques are currently available. Technological progress has enabled to use low cost materials in surgical procedures. Thus, the aim of this study was to evaluate the applicability of polyamide 12 rods, solid and hollow in swine femurs, comparing them through flexion strength. This study had as second aim to fix the locking errors, commom place in interlocking nails, once polyamide 12 allows perforation in any direction by orthopaedic screw. Six groups were used: G1 - eight whole swine femurs; G2 - eight whole swine femurs with drilled medullary canal; G3 - two solid polyamide 12 rods; G4 - two hollow polyamide 12 rods; G5 - eight osteotomized drilled swine femurs with a solid polyamide 12 rod implanted in the medullary canal and locked by four 316L stainless steel screws; and G6 - similar to G5 but using hollow rods instead of solid ones. No significant differences were observed for the modulus of rupture between solid and hollow rods, demonstrating that both rods had similar performances. These results led to the speculation that the addition of other polymers to the hollow rods could increase their strength and thus the bone-implant system. Furthermore, the comparison between G1, G5 and G6 could be analyzed using the finite element method in future. New polymeric materials may be developed based on the data from this study, strengthening the bone-implant system and making possible screws to be placed in any direction, nullifying the detrimental forces on the fracture site.

RESUMO: Fraturas em ossos longos são comumente encontradas na rotina cirúrgica e várias técnicas de imobilização óssea estão disponíveis. Com o avanço tecnológico, tornou-se viável utilizar materiais de baixo custo nos procedimentos, portanto esse estudo objetivou avaliar a aplicabilidade de hastes de poliamida 12, sólidas e vazadas, implantadas em fêmures suínos, comparando-as segundo as forças de flexão e aos erros de bloqueio, corriqueiros nesse implante, uma vez que a poliamida 12 permite sua perfuração em qualquer direção por meio de parafusos ortopédicos. Seis grupos foram usados: G1 - oito fêmures suínos íntegros; G2 - oito fêmures suínos, fresados intramedularmente; G3 - duas hastes maciças de poliamida 12; G4 - duas hastes vazadas de poliamida 12; G5 - oito fêmures suínos osteotomizados e fresados, com haste de poliamida 12 maciça implantada no canal medular e bloqueada com quatro parafusos de aço inoxidável 316L e G6 - diferente de G5 apenas por utilizar hastes vazadas. Não foram observadas diferenças significativas no módulo de ruptura entre hastes sólidas e vazadas, demonstrando que ambas apresentaram o mesmo desempenho. Estes resultados levaram à especulação de que adicionar outros polímeros às hastes vazadas aumentaria sua força e, portanto, do sistema osso-implante. Além disso, a comparação entre G1, G5 e G6 poderia no futuro ser analisada utilizando o método dos elementos finitos. Novos polímeros podem ser desenvolvidos baseando-se nos dados deste estudo, reforçando o sistema osso-implante e também possibilitando o uso de perfurações para o bloqueio no transoperatório em qualquer direção, anulando as forças deletérias atuantes no sítio de fratura.

Sedative and cardiopulmonary effects of xylazine alone or in combination with methadone, morphine or tramadol in sheep.

OBJECTIVE: To evaluate the cardiopulmonary and sedative effects of xylazine alone or in combination with methadone, morphine or tramadol in sheep. STUDY DESIGN: Experimental, prospective, crossover, randomized, blinded study. ANIMALS: Six Santa Inês breed sheep (females) aged 12 ± 8 months and weighing 39.5 ± 7.4 kg. METHODS: Sheep were sedated with each of four treatments in a randomized, crossover design, with a minimum washout period of 7 days between treatments. Treatments were: X [xylazine (0.1 mg kg(-1))]; XM [xylazine (0.1 mg kg(-1)) and methadone (0.5 mg kg(-1))]; XMO [xylazine (0.1 mg kg(-1)) and morphine (0.5 mg kg(-1))], and XT [xylazine (0.1 mg kg(-1)) and tramadol (5 mg kg(-1))]. Each drug combination was mixed in the syringe and injected intravenously. Sedation, heart rate (HR), mean arterial blood pressure (MAP), rectal temperature (RT°C), respiratory rate (fR), arterial blood gases and electrolytes were measured before drug administration (T0) and then at 15 minute intervals for 120 minutes (T15-T120). RESULTS: Heart rate significantly decreased in all treatments compared with T0. PaCO2 values in XM and XMO were higher at all time points compared with T0. In treatments X and XM, pH, bicarbonate (HCO3-) and base excess were increased at all time points compared with T0. PaO2 was significantly decreased at T15-T75 in XM, at all time points in XMO, and at T15 and T30 in XT. Sedation at T15 and T30 in XM and XMO was greater than in the other treatments. CONCLUSIONS AND CLINICAL RELEVANCE: The combinations of methadone, morphine or tramadol with xylazine resulted in cardiopulmonary changes similar to those induced by xylazine alone in sheep. The combinations provided better sedation, principally at 15 minutes and 30 minutes following administration.

Cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone or in combination with methadone, morphine or tramadol in dogs.

OBJECTIVE: To evaluate the cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone or in combination with methadone, morphine or tramadol in dogs. STUDY DESIGN: Experimental, blinded, randomized, crossover study. ANIMALS: Six mixed breed dogs (two males and four females) weighing 10 ± 4 kg. METHODS: The animals were randomly divided into four treatments: D (10 µg kg(-1) of dexmedetomidine), DM (dexmedetomidine 10 µg kg(-1) and methadone 0.5 mg kg(-1)); DMO (dexmedetomidine 10 µg kg(-1) and morphine 0.5 mg kg(-1)), and DT (dexmedetomidine 10 µg kg(-1) and tramadol 2 mg kg(-1)). The combinations were administered intramuscularly in all treatments. The variables evaluated were heart rate (HR), respiratory rate (f(R)), rectal temperature (RT), systolic arterial pressure (SAP), sedation scale and pedal withdrawal reflex. These variables were measured at T0 (immediately before the administration of the protocol) and every 15 minutes thereafter until T105. RESULTS: A decrease in HR and f(R) occurred in all the treatments compared with T0, but no significant difference was observed between the treatments. The RT decreased from T45 onward in all the treatments. The SAP did not show a difference between the treatments, but in the DT treatment, the SAP was lower at T30 and T45 compared with T0. The D treatment had lower scores of sedation at T15 to T75 compared with the other treatments, and the DMO and DM treatments showed higher scores at T60 and T75 compared with DT. CONCLUSIONS AND CLINICAL RELEVANCE: The treatments with morphine and methadone added to the dexmedetomidine showed higher sedation scores than the control treatment and the treatment with tramadol added to the dexmedetomidine showed no relevant differences in any of the variables evaluated in the study.

Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization at admission to ICU and the relation to outcome.

OBJECTIVE: To evaluate the changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization in the ICU and their relation to outcome. DESIGN: Prospective observational study. SETTING: ICU of a veterinary university medical center. ANIMALS: Thirty dogs with severe sepsis or septic shock caused by pyometra who underwent surgery and were admitted to the ICU. MEASUREMENTS AND MAIN RESULTS: Severe sepsis was defined as the presence of sepsis and sepsis-induced dysfunction of one or more organs. Septic shock was defined as the presence of severe sepsis plus hypotension not reversed with fluid resuscitation. After the presumptive diagnosis of sepsis secondary to pyometra, blood samples were collected and clinical findings were recorded. Volume resuscitation with 0.9% saline solution and antimicrobial therapy were initiated. Following abdominal ultrasonography and confirmation of increased uterine volume, dogs underwent corrective surgery. After surgery, the animals were admitted to the ICU, where resuscitation was guided by the clinical parameters, central venous oxygen saturation (ScvO(2)), lactate, and base deficit. Between survivors and nonsurvivors it was observed that the ScvO(2), lactate, and base deficit on ICU admission were each related independently to death (P = 0.001, P = 0.030, and P < 0.001, respectively). ScvO(2) and base deficit were found to be the best discriminators between survivors and nonsurvivors as assessed via receiver operator characteristic curve analysis. CONCLUSION: Our study suggests that ScvO(2) and base deficit are useful in predicting the prognosis of dogs with severe sepsis and septic shock; animals with a higher ScvO(2) and lower base deficit at admission to the ICU have a lower probability of death.

Bispectral monitoring in dogs subjected to ovariohysterectomy and anesthetized with halothane, isoflurane or sevoflurane.

OBJECTIVE: To assess the effect of halothane (H), isoflurane (I) or sevoflurane (S) on the bispectral index (BIS), and the effect of the addition of meperidine in dogs subjected to ovariohysterectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical trial. ANIMALS: Forty-eight female mixed-breed dogs, with weights varying from 10 to 25 kg. METHODS: All dogs were premedicated with acepromazine (A) (0.1 mg kg(-1) IM) or A and meperidine (M) (3 mg kg(-1) IM) and they were divided into six groups of eight animals (AH, AMH, AI, AMI, AS, and AMS). Fifteen minutes after premedication they were anesthetized with propofol (5 mg kg(-1) IV) and then orotracheally intubated. Anesthesia was maintained with halothane, isoflurane or sevoflurane, respectively. The BIS, variables were recorded at 15 minutes after administering pre-anesthetic medication (T0); 10 minutes of anesthesia maintenance (T1); right ovarian pedicle ligation (T2); muscle suturing (T3); skin suture (T4) and 10 minutes after terminating the inhalant anesthetic (T5), respectively. RESULTS: BIS values were decreased at all times when compared to the baseline values in all groups (p<0.05). In the comparative assessment between groups, the values obtained at T0 and T1 were similar for all groups. At T2, the values in AMH were lower than those obtained in AI, AMI and AS (p<0.05). At the same time significantly higher values were found for AI when compared to AMS (p<0.01). There was a correlation between the bispectral index and the expired anesthetic fraction in all groups. CONCLUSIONS AND CLINICAL RELEVANCE: Within groups given the same inhalant anesthetic the bispectral index was a good indicator for the degree of hypnosis in dogs, indicating a good correlation with the amount of anesthetic and the nociceptive stimulation. BIS was a less reliable indicator of relative anesthetic depth when comparing equipotent end-tidal concentrations between the three inhalants.