Avaliação clínica e bioquímica de cães submetidos a dois métodos de hidroterapia / Clinical and biochemical evaluation of dogs submitted to two methods of hydrotherapy

Avaliou-se a resposta dos parâmetros fisiológicos de frequência cardíaca (FC) e respiratória (FR), temperatura retal (TR) e a atividade sérica das enzimas creatina quinase (CK) e lactato desidrogenase (LDH) em cães adultos hígidos, machos e fêmeas, sob duas modalidades de hidroterapia. Dez cães foram distribuídos em dois grupos de cinco animais, denominados de grupo I (caminhada em esteira aquática) e grupo II (natação) e submetidos a duas sessões por semana com duração inicial de 10 minutos, acrescida de cinco minutos por sessão até 30 minutos, durante nove semanas. As avaliações foram realizadas antes, imediatamente depois e quatro horas após o exercício em todas as sessões para as variáveis de FC, FR e TR e nos dias um, sete, 28 e 60 para CK e LDH. Não houve diferença (P>0,05) quando comparados os valores médios dos parâmetros fisiológicos de frequência cardíaca e respiratória e de temperatura retal. Os níveis de CK e LDH não se elevaram após a hidroterapia nos diferentes tempos e dias avaliados. Dessa forma, foi possível concluir que as sessões de natação e de caminhada em esteira aquática não causaram alterações nos parâmetros fisiológicos de frequência cardíaca e respiratória, temperatura retal e nos níveis sanguíneos de creatina quinase (CK) e lactato desidrogenase (LDH) no protocolo proposto.(AU)

The physiological parameters of heart rate (HR), respiratory rate (RR), rectal temperature (TR), and serum activity of creatine kinase (CK) and lactate dehydrogenase (LDH) enzymes were determined in healthy dogs, male and female, under two hydrotherapy modalities. Ten dogs were distributed in two groups of five animals, named Group I (underwater treadmill walk) and Group II (swimming), submitted to two sessions per week with initial duration of 10 minutes, plus 5 minutes per session up to 30 minutes, during 9 weeks. The evaluations were performed before, immediately after and 4 hours after exercise in all sessions for the HR, RR and TR variables and on days one, seven, 28 and 60 for CK and LDH. There was no difference (P> 0.05) when comparing the mean values of physiological parameters of heart and respiratory rate and rectal temperature. CK and LDH levels did not rise after hydrotherapy at different times and days evaluated. So, it was possible to conclude that swimming sessions and underwater treadmill walking did not cause alterations in the physiological parameters of heart and respiratory rate, rectal temperature, and the blood levels of creatine kinase (CK) and lactate dehydrogenase (LDH) in the proposed protocol.(AU)

Combined cataract surgery and vitrectomy for recurrent retinal detachment.

PURPOSE: To report our experience with combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in the management of recurrent retinal detachment (RD) and visually significant cataract. METHODS: Retrospective chart review of patients with cataract and recurrent RD who underwent combined cataract extraction, posterior chamber intraocular lens implantation, and pars plana vitrectomy between January 1991 and September 1998 at the Bascom Palmer Eye Institute. Sixteen eyes were included. All eyes had visually significant cataract and had undergone primary repair of the RD with encircling scleral buckle; eight eyes also had undergone pars plana vitrectomy during the primary repair. The technique of cataract extraction included phacoemulsification (10 eyes), extracapsular cataract extraction (5 eyes), and pars plana lensectomy (1 eye). All eyes underwent pars plana vitrectomy, membrane peeling, fluid-air exchange, endolaser treatment, and placement of a retinal tamponade. Perfluoropropane (C3F8) gas was used in 14 eyes, and silicone oil was placed in two eyes. RESULTS: The postoperative follow-up interval ranged from 4 to 64 months (mean, 16 months). Preoperative visual acuity ranged from 20/60 to hand motions and was better than 20/200 in 3 (19%) eyes. Postoperatively, 9 (56%) eyes improved to better than 20/200. Anatomic success was achieved after the initial reoperation in 13 (81 %) eyes. With further surgery, the overall success rate was 94%. CONCLUSIONS: Combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in selected patients with cataract and recurrent RD was successful in improving visual acuity and achieving retinal reattachment in most of these reoperated patients.

Treatment strategies and visual acuity outcomes in chronic postoperative Propionibacterium acnes endophthalmitis.

PURPOSE: To report the treatment strategies and visual acuity outcomes of chronic postoperative endophthalmitis caused by Propionibacterium acnes. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: All patients presenting 8 or more weeks after cataract surgery with intraocular inflammation caused by culture-proven P. acnes infection and treated at two institutions from 1974 through 1996 were included. METHODS: Patients underwent three different initial treatment strategies. The study did not have a defined treatment protocol, but all patients received intraocular antibiotics. Patients were not randomly assigned to the various treatment strategies. MAIN OUTCOME MEASURES: Final visual acuity and effectiveness of various treatment procedures either as initial or follow-up therapy were assessed. RESULTS: Using the 3 initial strategies, 36 patients were treated: (1) intraocular antibiotic injection alone (IOAB; n = 12); (2) pars plana vitrectomy and IOAB injection (PPV; n = 10); and (3) PPV with subtotal capsulectomy and IOAB injection (PPV-PC; n = 14). The number of patients with recurrent or persistent inflammation after one of the three initial treatment strategies were as follows: (1) IOAB alone, 12 (100%); (2) PPV, 5 (50%); and (3) PPV-PC, 2 (14%). None of the patients that underwent subsequent PPV, total capsular bag removal, IOAB injection, and either intraocular lens (IOL) exchange or removal had persistent or recurrent intraocular inflammation. Overall, final visual acuity was 20/40 or better in 18 patients (50%), and a total of 28 patients (78%) retained 20/400 or better vision. The mean follow-up after the last treatment was 2.9 years. CONCLUSIONS: In this series of chronic P. acnes endophthalmitis, initial treatment with IOAB injection alone or vitrectomy without capsulectomy was associated with high rates of recurrent or persistent intraocular inflammation. Pars plana vitrectomy, partial capsulectomy, and IOAB injection without IOL exchange was usually successful on long-term follow-up. In patients with recurrent intraocular inflammation, pars plana vitrectomy, total capsular bag removal, IOAB injection, and IOL exchange or removal was a uniformly successful strategy. In contrast to other types of postoperative endophthalmitis, IOL exchange can be considered in these patients after total capsular bag removal.

Combined lensectomy, vitrectomy and scleral fixation of intraocular lens implant after closed-globe injury.

PURPOSE: To describe our experience in the surgical management of cataracts in patients with complications of closed-globe injury using pars plana lensectomy (PPL), pars plana vitrectomy (PPV), and scleral fixation of posterior chamber intraocular lens (PCIOL). METHODS: We retrospectively reviewed charts of all patients with closed-globe injury who underwent PPL, PPV and scleral fixation of PCIOL at our institution between January 1991 and July 1997. We identified 28 eyes; because of less than 2 weeks follow-up, 4 eyes were excluded from the current study. All eyes had lens subluxation/dislocation and visually significant cataract. Additional indications for surgery included secondary glaucoma (10 eyes), vitreous hemorrhage (3 eyes) and retinal detachment (1 eye). RESULTS: The postoperative follow-up interval ranged from 6 to 61 months (mean 18.5 months). Preoperative visual acuity (VA) ranged from 20/60 to hand motion and was 20/100 or better in 6 eyes (25%). Postoperatively, 19 eyes (79%) improved to 20/100 or better. Five eyes had subsequent surgery for the following indications: retinal detachment (2 eyes), poorly controlled glaucoma (2 eyes), and epiretinal membrane formation (1 eye). CONCLUSIONS: In patients undergoing PPL, PPV and scleral fixation of PCIOL for cataract after a closed-globe injury, a substantial visual improvement occurred in a majority of the involved eyes.