Evaluation of three therapeutic alternatives for the early treatment of ovine pregnancy toxaemia.

BACKGROUND: Ovine pregnancy toxaemia is a common metabolic disorder of ewes due to increased foetal energy requirements in late pregnancy. This pathology is a metabolic condition characterized by hypoglycaemia and hyperketonaemia resulting in the inability of the animal to maintain an adequate energy balance. The response to treatment is effective, if it is started in the early stages of the disease, when irreversible neurological injuries have not yet been established. The aim was to evaluate three therapeutic alternatives to effectively reverse the disease process in its early stages. For this, thirty adult Corriedale ewes, pregnant with a single lamb, were randomly separated in three groups of ten animals each, at day 130 of gestation. From that day onwards, ewes were locked up for forage fasting until glycaemia reached clinical values defining sub-clinical pregnancy toxaemia (1.59 ± 0.24 mmol/L). After fasting, ewes grazed and received a treatment for 4 days: 50 ml i.v. infusions of hypertonic glucose and 20 UI insulin/ewe/day s.c. or 100 ml/sheep/12 h of glycerol together with propylene glycol oral solution or fed with pasture supplemented with two daily intakes 300 g/sheep of cracked corn. Glycaemia and ß-hydroxybutyrate were determined in all the animals from the beginning of fasting until the completion of the treatment. RESULTS: Fasting caused a decline in blood glucose in the 3 groups. This decline continued until fasting was withdrawn and treatment began. Thereafter blood glucose increased in all three groups, although in the group supplemented with glycerol and propylene glycol it started to increase significantly after 12 h. The values of ß-hydroxybutyrate decreased in the 3 groups at the start of treatment, and this decline was more pronounced earlier on and in the group supplemented with glycerol and propylene glycol. We found no significant differences between all experimental groups. No animal showed clinical signs of pregnancy toxaemia throughout the research. CONCLUSIONS: The three treatments administered to sheep affected by sub-clinical pregnancy toxaemia were able to restore normal concentration of glucose and ß-hydroxybutyrate in blood, although per os administration of 100 ml/sheep/12 h of glycerol with propylene glycol, was the most successful treatment, normalizing the aforementioned biochemical parameters in a shorter time.

Enfermedad cerebrovascular: su relación con cardiovasculopatías y nefropatías en 134 necropsias clínicas / Cerebrovascular disease: its relationship with cardiovascular and renal pathology in 134 clinical autopsies

Objetivo. Establecer la interrelación existente entre las cardiopatías y las nefropatías crónicas (NC), y la patología cerebrovascular en necropsias clínicas realizadas en adultos. Materiales y métodos. Se revisaron los protocolos de 861 necropsias clínicas realizadas entre 1990 y 2000; se seleccionaron 134 necropsias con diagnóstico de enfermedad cerebrovascular (ECV) y se analizaron los aspectos neuropatológicos de la ECV, los hallazgos patológicos renales y cardíacos y la causa de la muerte. Resultados. La ECV representó el 15,5 por ciento de las necropsias practicadas. La ECV isquémica constituyó el 56,7 por ciento de los casos y la hemorrágica el 43,3 por ciento. Las causas incluyeron: hipertensión arterial -HTA- (33 por ciento), aterosclerosis (19 por ciento), émbolos y malformaciones vasculares (13 por ciento cada uno, respectivamente), coagulopatías (8 por ciento), angitis (4 por ciento), tumores (1 por ciento) y de origen desconocido (11 por ciento). Los tipos de ECV isquémica fueron aterosclerótico (34,2 por ciento), lacunar (32,8 por ciento), embólico (14,4 por ciento), de origen desconocido (17,1 por ciento) y secundaria a angitis (1,3 por ciento). La ECV hemorrágica se presentó como hematoma intraparenquimatoso (50 por ciento), hemorragia subaracnoidea (28 por ciento), hemorragias petequiales (19 por ciento) e intraventricular (3 por ciento). La ECV isquémica se asoció con cardiopatía hipertensiva en el 86,5 por ciento de los casos, y con nefroesclerosis en el 51,3 por ciento; en la ECV hemorrágica, estas asociaciones fueron del 86,2 y el 29,3 por ciento, respectivamente. Los fenómenos de herniación fueron la causa de la muerte en el 2,6 por ciento de los pacientes con ECV isquémica y en el 74,1 por ciento de los pacientes con ECV hemorrágica. Conclusiones. La ECV se relacionó con una elevada frecuencia de patologías intercurrentes, principalmente cardiopatía hipertensiva, aterosclerosis, nefroesclerosis y NC, que eventualmente interactúan entre sí y que se reconocen como factores predisponentes y/o concomitantes al evento cerebrovascular (AU)

Objective. To establish the relationship between cardiopathy and chronic nephropathy, and cerebral vascular pathology in clinical necropsies performed in adult patients. Materials and methods. The protocols of 861 clinical autopsies done during the lapse 1990-2000 were reviewed, of these, 134 cases with diagnosis of cerebrovascular disease (CVD) were selected. Analyzed features included: neuropathological study of CVD, renal and cardiovascular pathology, and cause of death. Results. CVD represented 15,5% of all autopsies done during the study period. Ischemic CVD constituted 56.7% of the cases, whereas cases of hemorrhagic CVD accounted for 43.3% of the total. Causes included arterial hypertension (33%), atherosclerosis (19%), emboli and vascular malformations (13% each, respectively), coagulopathies (8%), angeiitis (4%), tumors (1%), and unknown origin (11%). Ischemic CVD was caused by atherosclerosis in 34.2% of the cases, lacunar infarcts in 32.8%, of embolic cause in 14.4% of the cases, angeiitis in 1.3%, and of unknown origin in 17.1% of the cases. Hemorrhagic CVD presented as intraparenchymal hematoma in 50% of the cases, as sub-arachnoid hemorrhage in 28%, as disseminated petechial hemorrhages in 19%, and intraventricular in 3% of the cases. Ischemic CVD was associated with hypertensive cardiopathy in 86.5% of the cases, and with nephrosclerosis in 51.3%, whereas hemorrhagic CVD was seen associated with the same pathological entities in 86.2% and 29.3% of the cases, respectively. Cerebral herniation was the cause of death in 2.6% of the patients with ischemic CVD, and in 74.1% of the patients with hemorrhagic CVD. Conclusions. CVD was associated with a high frequency of intercurrent pathological processes, namely hypertensive cardiopathy, atherosclerosis, nephroscleroisis, and other chronic nephropathies, that eventually interact, and constitute well known predisposing and/or concomitant factors to the cerebrovascular event (AU)

Lesiones ocupantes de espacio no neoplásicas que simulan tumores del sistema nervioso central / Non-neoplastic space-occupying lesions mimicking central nervous system tumors

Objetivo. Establecer la frecuencia y naturaleza de las lesiones ocupantes de espacio del sistema nervioso central (SNC) que simulan crecimientos de estirpe neoplásica. Pacientes y métodos. Se revisaron las historias clínicas, los estudios por imágenes y los exámenes neuropatológicos correspondientes a aquellos pacientes con diagnóstico preoperatorio de enfermedad neoplásica del SNC, cuyo diagnóstico definitivo resultó lesión expansiva de naturaleza no tumoral, intervenidos en diferentes hospitales de Maracaibo, Venezuela, desde el 1 de enero de 1996 al 31 de julio de 2002. Resultados. Los 33 casos de lesiones expansivas no tumorales que simularon neoplasias constituyeron el 8 por ciento del total de las 408 lesiones del SNC intervenidas durante el lapso del estudio. Aproximadamente dos terceras partes de los casos (63,36 por ciento) correspondieron a procesos infecciosos de diversa etiología y malformaciones vasculares. El tercio restante agrupó afecciones misceláneas de diversa naturaleza. Conclusiones. Aun cuando no es frecuente que los procesos no tumorales del SNC mimeticen lesiones expansivas de naturaleza neoplásica, en ocasiones los rasgos clínicos y de imagen de ambos grupos de entidades son particularmente similares (AU)

Objective. To establish the frequency and nature of space-occupying lesions of the central nervous system (CNS) that mimic neoplastic growths. Patients and methods. We reviewed the clinical records, imaging and neuropathological studies of patients operated in different hospitals of Maracaibo, Venezuela during the period January 1 1996-July 31 2002. These patients had a pre-operative diagnosis of CNS tumor, and their definitive diagnosis was non-neoplastic disease. Results. The 33 cases of expansive, non-neoplastic growths represented 8% of 408 CNS lesions diagnosed during the study period. Approximately two thirds of the cases (63,36%) consisted of either inflammatory or vascular lesions, whereas the rest of the cases grouped miscellaneous conditions. Conclusions. Even though it is not frequent that non-neoplastic lesions of the CNS mimic expansive growths of neoplastic nature, on occasions the clinical and neuroimaging features of both groups of entities are remarkably similar (AU)

Las Unidades de orientación estudiantil: una nueva experiencia en los centros de docencia médica

Se analizan las experiencias obtenidas en la atención a los estudiantes que acudieron a la Unidad de Orientación Estudiantil en el curso 1988-1989, así como el funcionamiento integral de la unidad. Se realiza un análisis de las vías a través de los cuales los estudiantes acuden a la unidad y sus principales motivos, además de las diferentes técnicas psicólogicas y psicopedagógicas que se utilizan en la orientación y tratamiento de los educandos. Se ha podido constatar que con un trabajo organizado y sistemático las Unidades de Orientación Estudiantil se convierten en un elemento poderoso que ayuda a la retención escolar y a la elevación de la calidad en las actividades docentes, por otra parte, expone la importancia de la labor educativa y preventiva que deben jugar los profesores en la detección precoz de los estudiantes con dificultades y que no recaiga solamente en los profesores guías como único eslabón. (AU)