Treatment of Elephantiasis with Physiological Retraction of the Skin to Clinical Standards of Normality.

Stage III lymphedema, also known as elephantiasis, is the most advanced stage and involves the occurrence of large deformities. This article reports the case of a 30-year-old woman with bilateral stage III lymphedema who weighed 109 kg. The largest circumference measurements below the knee were 97 cm on the right leg and 76 cm on the left leg. Intensive treatment was performed, involving 8 hour per day of mechanical lymphatic therapy with the RAGodoy® device, which performs passive plantar flexion and extension, 15 min of cervical lymphatic therapy per day, and the use of non-elastic laced compression stockings. Treatment resulted in a considerable loss of edema as well as the occurrence of folds of excess skin, which were resolved by continuing treatment in a slower, non-intensive manner. Folds of excess skin are common during the treatment of large lymphedemas until reaching standards of normality or near normality but can be resolved with further clinical treatment.

Biochemical metal accumulation effects and metalloprotein metal detoxification in environmentally exposed tropical Perna perna mussels.

Marine bivalves have been widely applied as environmental contamination bioindicators, although studies concerning tropical species are less available compared to temperate climate species. Assessments regarding Perna perna mytilid mussels, in particular, are scarce, even though this is an extremely important species in economic terms in tropical countries, such as Brazil. To this end, Perna perna mytilids were sampled from two tropical bays in Southeastern Brazil, one anthropogenically impacted and one previously considered a reference site for metal contamination. Gill metallothionein (MT), reduced glutathione (GSH), carboxylesterase (CarbE) and lipid peroxidation (LPO) were determined by UV-vis spectrophotometry, and metal and metalloid contents were determined by inductively coupled plasma mass spectrometry (ICP-MS). Metalloprotein metal detoxification routes in heat-stable cellular gill fractions were assessed by size exclusion high performance chromatography (SEC-HPLC) coupled to an ICP-MS. Several associations between metals and oxidative stress endpoints were observed at all four sampling sites through a Principal Component Analysis. As, Cd, Ni and Se contents, in particular, seem to directly affect CarbE activity. MT is implicated in playing a dual role in both metal detoxification and radical oxygen species scavenging. Differential SEC-HPLC-ICP-MS metal-binding profiles, and, thus, detoxification mechanisms, were observed, with probable As-, Cu- and Ni-GSH complexation and binding to low molecular weight proteins. Perna perna mussels were proven adequate tropical bioindicators, and further monitoring efforts are recommended, due to lack of data regarding biochemical metal effects in tropical species. Integrated assessments, as performed herein demonstrate, are invaluable in evaluating contaminated aquatic environments, resulting in more accurate ecological risk assessments.

One-year mortality rates after minor and major amputations of the lower limbs.

Introduction: Critical limb ischemia is the most severe form of peripheral arterial disease. The anatomic and clinical severity of the disease is often heterogeneous and the choice of treatment is affected by different clinical and patient-related factors. The aim of the present study was to evaluate the mortality rate in a period of 1 year following minor and major amputations and compare the rates with that related to major amputation of lower limbs in 2005. Material and methods: A cross-sectional study evaluated minor and major amputations of the lower limbs at the School Hospital affiliated with the São Jose do Rio Preto School of Medicine in the period from July 2018 to July 2019. It was conducted using the charts of 233 patients who had undergone minor and major amputations of the lower limbs. Results: The 1-year mortality rate was analyzed among 108 patients submitted to minor amputations and the mortality rate of 80 patients submitted to major amputations in 2019 was compared to that among 50 patients submitted to major amputations in 2005. Conclusions: Significant 1-year mortality rates were found following minor and major amputations, with a higher rate among patients submitted to the latter procedure. Moreover, there has been no reduction in the mortality rate among patients submitted to major amputation in the past 15 years.

Evaluation of the bioaccumulation kinetics of toxic metals in fish (A. brasiliensis) and its application on monitoring of coastal ecosystems.

This study proposes a pro-active approach for evaluations of methylmercury (MeHg), total mercury (THg), arsenic (As), cadmium (Cd) and lead (Pb) in situ bioaccumulation in fish (Atherinella brasiliensis) muscles, using specimens from the external sector of Guanabara Bay as a study case. This approach included an hierarchical sequence: analysis of the pollutants concentrations and their comparison to safety criteria; correlations between specimens concentrations vs length (as a proxy of exposure time); projections of concentrations in key lengths (sexual maturation, asymptotic, length limits for fishing and median of fish population) through polynomial regressions, dose-response analysis (Probit), decreasing curves and incorporation rates (using only three length intervals). The incorporation rates were ascending for MeHg and THg (continued bioaccumulation) and descending for As, Pb and Cd (possible biological dilution). The projections were satisfactory, evidencing their use for an improvement on the risks monitoring of fishing and fish consumption by humans in coastal environments.

Erysipelas as an aggravating factor for impaired lymphatics in saphenectomy patients.

BACKGROUND: The aim of this study was to evaluate lymphoscintigraphic changes in patients who developed erysipelas after saphenous vein stripping. METHODS: Lymphoscintigraphic changes related to erysipelas were evaluated in a retrospective, cross-sectional and quantitative study of 21 saphenectomy patients. Patients with infections, those weighing over 120 kg, with chronic arterial disease or heart failure were excluded from the study. A control group was formed of 21 patients submitted to saphenectomies matched by age and gender but with no history of erysipelas. All patients underwent lymphoscintigraphy of both legs. The Fisher's Exact and χ2 tests were used for statistical analysis with an alpha error of 5% being considered acceptable. RESULTS: Associations of dermal reflux and popliteal lymph nodes with erysipelas were observed in operated patients compared to non-operated patients (P value= 0.002 and 0.03, respectively). Semiquantitative analysis showed a variation in the Kleinhans transport indexes of 0.15 to 20.5 for the entire sample. Group I showed a mean semiquantitative index of 2.42 (0.3 to 14.5), group II of 3.15 (0.225 to 15.125) and group III of 10.2 (0.15 to 38.25). The comparison of semiquantitative indexes of the groups by χ2 analysis showed that there was a statistically significant difference between the first two groups (I and II) and group III (P value <0.05). CONCLUSIONS: Erysipelas is a synergistic mechanism of injury of the lymphatic system in patients submitted to saphenectomies.

Selenium Levels in the Whole Blood of Children and Teenagers from Two Riparian Communities at the Madeira River Basin in the Western Brazilian Amazon.

Selenium (Se) is an essential micronutrient that exerts multiple functions in the organism, and both its deficiency and excess can cause health impairments. Thus, it is important to monitor its levels in the population, especially in vulnerable groups, such as children from the Brazilian Amazon region, where there is a lack of information in this regard. The aim of this research was to study Se levels in the whole blood of children and teenagers (5-16 years old) from two riparian communities at the Madeira River (Cuniã RESEX and Belmont). Se level variations related to the communities' location, seasonality, diet, and body mass index (BMI) were assessed. Blood samples were collected in both communities for Se determinations, using ICP-MS and hemogram analyses, during May and September of 2011. Food frequency questionnaires were applied to assess consumption rates of specific food items. Non-parametric tests and linear multiple regressions were applied in the data analyses. Median Se levels were significantly higher during May (Cuniã RESEX 149 µg L-1; Belmont 85 µg L-1) compared to September (Cuniã RESEX 79 µg L-1; Belmont 53 µg L-1). No significant differences were found between the communities regarding BMI measurements and anemia prevalence. However, Se blood levels were significantly higher at the Cuniã RESEX compared to Belmont. In addition, the former showed higher fish and Brazil nut intakes, which may be the main Se sources for this community. These results contribute to a better understanding of Se reference levels for children and teenagers of Western Amazon riparian communities.

Differential metallothionein, reduced glutathione and metal levels in Perna perna mussels in two environmentally impacted tropical bays in southeastern Brazil.

Mussel farming is an important economic activity in Brazil, and these organisms are consumed by the majority of the population in most coastal zones in the country. However, despite the increasing pollution of aquatic ecosystems in Brazil, little is known about the biochemical activity in mussels in response to metal exposure. In this context, the aim of the present study was to investigate metal and metalloid exposure effects in Perna perna mussels, by determining metal levels, the induction of metallothionein (MT) synthesis, and oxidative stress, in the form of reduced glutathione (GSH) in 3 contaminated areas from the Guanabara Bay in comparison to a reference site, Ilha Grande Bay, both in summer and winter. Metal and metalloid concentrations were also compared to Brazilian and international guidelines, to verify potential health risks to human consumers. Mussels from all sampling sites were shown to be improper for human consumption due to metal contamination, including Ilha Grande Bay, which has previously been considered a reference site. Several statistically significant correlations and seasonal differences were observed between MT, GSH and metals and metalloids in both analyzed tissues. A Discriminant Canonical Analysis indicated that the digestive gland is a better bioindicator for environmental contamination by metals and metalloids in this species and offers further proof that MT variations observed are due to metal exposure and not oxidative stress, since GSH influence for both muscle tissue and the digestive glands was non-significant in this analysis. These results show that P. perna mussels are an adequate sentinel species for metal contamination with significant effects on oxidative stress and metal exposure biomarkers. To the best of our knowledge, this is the first study to report metals, metalloids, MT and GSH levels in the muscle tissue of this species.

Viable biobanking of primary head and neck squamous cell carcinoma.

OBJECTIVES/HYPOTHESIS: To determine the feasibility of viable storage of head and neck squamous cell carcinoma (HNSCC) for regrowth of cells in culture. STUDY DESIGN: Laboratory-based translational study. METHODS: Methods for intermediate-term frozen storage of viable HNSCC were explored using small pieces of primary tumor and dissociated HNSCC cells after short-term culture. Viable cells after freezing were confirmed by adherence to tissue culture plates, cell morphology, and increased cell or colony density. Two cultures were immunostained for cytokeratin to confirm epithelial origin of viable cultured cells after freezing. RESULTS: Six primary HNSCCs (two oral cavity, three larynx, one oropharynx) and two HNSCCs that had been passaged through a xenograft (two oral cavity) were dissociated to single cells and grown in short-term cell culture for 0 to 12 passages. After short-term culture, cells were frozen for up to 8 months, thawed, and replated. Frozen cells derived from all tumors (six primary and two xenografts) were successfully replated with cultures lasting >7 days with seven of eight tumors presenting increased colony or cell density over 1 week of growth after freezing. In total, 15 of 15 tested samples derived from six primary and two xenografted HNSCCs were viable after freezing. CONCLUSIONS: In the current study, we show that biopreservation of primary or xenografted HNSCC using short-term cell culture is feasible. Initial short-term cell culture was required for successful storage and viability of frozen cells. These proof-of-principle studies, if more widely implemented, could improve preclinical testing of new therapies for HNSCC.

Bacterial pattern in chronic sinusitis and cystic fibrosis.

OBJECTIVE: To assess the association between pathogenic bacteria found in bronchoalveolar lavages and paranasal cavity cultures in patients with cystic fibrosis (CF) who underwent endonasal endoscopic sinus surgery. The authors hypothesized that the pathogenic bacterial pattern of the upper airway would be associated with that of the lower airway. STUDY DESIGN: Prospective case series with planned data collection. SETTING: Tertiary referral center. SUBJECTS AND METHODS: A group of 16 patients with diagnosis of CF who underwent endonasal endoscopic sinus surgery from July 2001 to August 2009 participated in the study. Culture samples were obtained from bronchoalveolar lavages and paranasal cavities. A Fisher exact test was performed to examine the significance of the association between upper airway and lower airway cultures. RESULTS: The most frequent microorganisms in cultures of para-nasal cavities and bronchoalveolar lavages were Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus viridans. Statistical analysis revealed a significant association between upper airway cultures (paranasal cavities) and lower airway cavities (bronchoalveolar lavages) for the 2 most frequent microorganisms, P. aeruginosa and S. aureus (P = .007 and P = .030, respectively). CONCLUSION: The authors confirmed their initial hypothesis that a significant association between bronchoalveolar lavages and sinus cultures was established, once more confirming the idea of a unified airway. They found chronic rhinosinusitis with polyps to be a common clinical presentation in patients with CF. Further studies are required to indicate the role of antibiotics and the pathogenesis of the microorganisms as a manifestation of clinical severity.

Uranium determination using atomic spectrometric techniques: an overview.

This review focuses on the determination of uranium using spectroanalytical techniques that are aimed at total determination such as flame atomic absorption spectrometry (FAAS), electrothermal atomic absorption spectrometry (ETAAS), inductively coupled plasma optical emission spectrometry (ICP-OES); and inductively coupled plasma mass spectrometry (ICP-MS) that also enables the determination of uranium isotopes. The advantages and shortcomings related to interferences, precision, accuracy, sample type and equipment employed in the analysis are taken into account, as well as the complexity and costs (i.e., acquisition, operation and maintenance) associated with each of the techniques. Strategies to improve their performance that employ separation and/or preconcentration steps are considered, with an emphasis given to solid-phase extraction because of its advantages compared to other preconcentration procedures.

Simultaneous speciation of arsenic (As(III), MMA, DMA, and As(V)) and selenium (Se(IV), Se(VI), and SeCN-) in petroleum refinery aqueous streams.

High-performance liquid chromatography (HPLC) coupled to an ICP-MS with an octapole reaction system (ORS) has been used to carry out quantitative speciation of selenium (Se) and arsenic (As) in the stream waters of a refining process. The argon dimers interfering with the (78)Se and (80)Se isotopes were suppressed by pressurizing the octapole chamber with 3.1 mL min(-1) H(2) and 0.5 mL min(-1) He. Four arsenic species arsenite--As(III), arsenate (As(V)), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA)--and three inorganic Se species--selenite Se(IV), selenate Se(VI), and selenocyanate (SeCN(-))--were separated in a single run by ion chromatography (IC) using gradient elution with 100 mmol L(-1) NH(4)NO(3), pH 8.5, adjusted by addition of NH(3), as eluent. Repeatabilities of peak position and of peak area evaluation were better than 1% and about 3%, respectively. Detection limits (as 3sigma of the baseline noise) were 81, 56, and 75 ng L(-1) for Se(IV), Se(VI), and SeCN(-), respectively, and 22, 19, 25, and 16 ng L(-1) for As(III), As(V), MMA, and DMA, respectively. Calibration curve R (2) values ranged between 0.996 and 0.999 for the arsenic and selenium species. Column recovery for ion chromatography was calculated to be 97 +/- 6% for combined arsenic species and 98 +/- 3% for combined selenium species. Because certified reference materials for As and Se speciation studies are still not commercially available, in order to check accuracy and precision the method was applied to certified reference materials, BCR 714, BCR 1714, and BCR 715 and to two different refinery samples--inlet and outlet wastewater. The method was successfully used to study the quantitative speciation of selenium and arsenic in petroleum refinery wastewaters.

[Evaluation of the extent of movement of the shoulder after breast cancer treatment]. / Avaliação da amplitude de movimento de ombro após tratamento de cancro da mama.

Treatment of breast cancer generally involves quadrantectomy and mastectomy followed by radiotherapy and chemotherapy depending on indication. The object of the present study was to verify the extent of movement of the shoulder after breast cancer treatment and the influence of the type of surgery (quadrantectomy and mastectomy). A total of 90 women submitted to surgery for breast cancer in the Region of Catanduva, Brazil and a control group of 20 women without surgical compromise were evaluated. The extents of bilateral flexion and abduction movements of the shoulders were assessed by goniometry. The non-matched student t-test and Fisher exact test were utilized for statistical analysis with an alpha error of up to 5% being considered acceptable. Differences of 20 degrees or more in the extent of movement of the shoulders of women submitted to surgery were seen in 47.7% of the cases for flexion and in 56.6% for abduction. The compromise to the movement of the shoulder in the control group was less than 20 degrees in 9 (45%) of the women. On comparing the incidence of alterations in the movements of the arms of women submitted to surgery with the control group, a significant difference was identified for both limbs (p-value < 0.01). The articular mobility of both arms of patients submitted to treatment for breast cancer can be affected.

Força de preensão palmar em portadoras de linfedema secundário ao tratamento para câncer de mama / Hand grip force in patients with lymphedema post breast cancer therapy

Introdução. A abordagem terapêutica do linfedema secundário ao tratamento do câncer de mama propõe-sea prevenir limitações de movimento da cintura escapular, alterações posturais, fibrose e aderência cicatricial, com o objetivo primordial de melhorar a qualidade de vida de tais pacientes. Nesse contexto, este estudo procurou identificar alterações de força muscular no segmento distal do membro superior linfedematoso, nointuito de, possivelmente, incrementar o processo de reabilitação a partir do favorecimento à ação das bombas musculares do antebraço no retorno venolinfático, e tendo em vista o tratamento para o câncer de mama não ser considerado fator causal de modificações na estrutura osteomuscular analisada. Método. Participaram do grupo de estudo (GE) 16 mulheres com linfedema unilateral, que tiveram o membro linfedematoso comparado com o membro contralateral sadio, e ambos comparados a um grupo controle (GC)de 25 mulheres sadias. A força de preensão palmar foi mensurada pelo dinamômetro Sammons Preston®, tendo sido realizadas três medições em cada membro, alternadamente, e anotado o maior valor de cada um. Para análise estatística foram utilizados o teste t pareado e o teste t não pareado, com p d” 0,05. Resultados. Os resultados apontaram uma diferença significativa na força de preensão palmar entre o membro acometido e o membro contralateral em portadoras de linfedema (p = 0,0002), mas não identificou diferenças entre as forças de preensão do membro dominante e não dominante em mulheres sem a linfopatia (p = 0,1177). A comparação do membro linfedematoso com os membros do grupo controle também apresentou diferença estatisticamente significante, tendo sido o valor de p = 0,0026 em relação ao membro dominante, e p = 0,0226 quando comparado ao membro não dominante, enquanto que o membro sadio das portadoras de linfedema não teve diferença estatística em relação às mulheres sadias. Conclusão. Os dados obtidos apontam uma redução da força de preensão palmar...

Introduction: The therapeutic approach toward lymphedema secondary to breast cancer management suggests preventing restrictions of shoulder girdle motion, postural changes, fibrosis, and scar tissue adherence primarily aiming at improving the patients’ quality of life. In this context, the present study sought to identify the changes of muscle strength in the distal segment of the lymphedematous lower limb, in order to possibly develop the rehabilitation process from promoting the action of the forearm muscle pump in the venous-lymphatic return, and keeping in mind that the breast cancer management is not considered to be acausative factor of changes in the analyzed musculoskeletal structure. Method: The study group (SG) included 16 women with unilateral lymphedema who were compared to their non affected arm and also to a control group (CG) comprised of 25 healthy women. The hand grip force was measured by a hand dynamometer(Sammons Preston™, Bolingbrook, IL). The measurements were performed 3 times in each limb, alternately, and then the highest value of which one of them was chosen. The data were assessed using a paired and anunpaired Student’s t-tests. We considered p d” .05 as statistically significant. Results: The results showed a significant difference in hand grip forces between the affected limb and the limb on the opposite side inpatients with lymphedema post-mastectomy (p = 0.0002). However, this study did not identify significant differences between the hand grip forces in both dominant and non-dominant limb in healthy women (p =0.1177). When the lymphoedematous limb was compared with the limbs of the control group it was observed a statistically significant difference in relation to both dominant and non-dominant member (p = 0.0026 and0.0226, respectively). However, there was no statistically difference between the non affected limb of patients with lymphedema when compared to the control group of healthy women...

Radiocarbon dating of archaeological samples (sambaqui) using CO(2) absorption and liquid scintillation spectrometry of low background radiation.

Sambaqui means, in the Tupi language, a hill of shells. The sambaquis are archaeological sites with remains of pre-historical Brazilian occupation. Since the sambaqui sites in the Rio de Janeiro state region are older than 10,000 years, the applicability of CO(2) absorption on Carbo-sorb and (14)C determination by counting on a low background liquid scintillation counter was tested. In the present work, sambaqui shells were treated with H(3)PO(4) in a closed vessel in order to generate CO(2). The produced CO(2) was absorbed on Carbo-sorb. On saturation about 0.6g of carbon, as CO(2), was mixed with commercial liquid scintillation cocktail (Permafluor), and the (14)C activity determined by counting on a low background counter, Packard Tricarb 3170 TR/SL, for a period of 1000 mins to enable detection of a radiocarbon age of 22,400 BP. But only samples with ages up to 3500 BP were submitted to the method because the samples had been collected in the municipality of Guapimirim, in archaeological sambaqui-type sites belonging to this age range. The same samples were sent to the (14)C Laboratory of the Centro de Energia Nuclear na Agricultura (CENA/USP) where similar results were obtained.

Freqüência da mutação 844ins68 do gene da cistationina beta-sintetase em pacientes com trombose venosa profunda / Frequency of the 844ins68 mutation on the cystathionine beta-synthetase gene in deep venous thrombosis patients

A hiper-homocisteinemia, resultante da deficiência na conversão da homocisteína em cistationina, constitui em fator de risco isolado para doenças vasculares. A mutação 844ins68 do gene da cistationina beta-sintetase é um fator adicional de risco para a trombose venosa profunda. O objetivo deste estudo foi avaliar a freqüência da mutação 844ins68 do gene da cistationina beta-sintetase em pacientes com trombose venosa profunda. Foram avaliados em estudo caso-controle 95 pacientes com trombose venosa profunda, a presença da mutação 844ins68 no éxon 8 do gene da cistationina beta-sintetase. Como critério de inclusão foi adotada a presença de trombose venosa profunda confirmada pelo dúplex ou flebografia. O grupo controle constituiu-se de 95 doadores de sangue, sem história familiar prévia de trombose venosa, com sexo, grupo étnico e idades pareados aos do grupo de estudo. Foram coletados 5 mL de sangue venoso com o uso de anticoagulante EDTA de cada participante. O DNA foi extraído dos leucócitos pelo método DTAB e CTAB. A detecção da mutação do gene foi realizada por amplificação de um segmento gênico por PCR, com iniciadores que flanqueiam a região de inserção e com revelação em gel de agarose a 2 por cento, corado com brometo de etídio, sob luz UV. O fragmento correspondente ao alelo normal contém 184 pares de base e o correspondente ao alelo mutante, 252 pares de base. O teste exato de Fisher foi utilizado na análise dos resultados. A condição heterozigota para a mutação foi encontrada em 14,73 por cento dos pacientes e em 3,1 por cento dos indivíduos do grupo controle (p = 0,009). A freqüência do alelo mutante mostrou diferença significativa (p = 0,01), sendo 0,074 para os pacientes versus 0,016 para o grupo controle. Não foram encontrados casos de homozigose.

Trombose de veia cava em adolescente com deficiência de proteínas "C" e "S" / Vena cava thrombosis in a teenager with protein

Relata-se o caso de um adolescente com 14 anos de idade, do sexo masculino, que apresentava diagnóstico de deficiência de proteína C e S e desnvolveu trombose de veia cava após treino de capoeira. Enfatiza-se os achados clínicos e dados relevantes de literatura e alerta-se para os cuidados preventivos

Tratamento do linfedema em portador de deficiência mental / Lymphoedema treatment in a mentally disabled patient

Relata-se o caso de um paciente de 28 anos de idade com linfedema de membros inferiores e deficiência mental. O linfedema surgiu por volta dos sete anos de idade, porém, nunca foi realizado tratamento específico. O envolvimento de uma equipe interdisciplinar, na qual o psicólogo deu suporte para os membros da equipe em relação aos aspectos psicológicos, facilitou o tratamento. O resultado foi a melhora clínica, redução perimétrica e volumétrica com adesão do paciente ao tratamento. A atuação de uma equipe interdisciplinar deve ser encorajada no tratamento do linfedema em pacientes com deficiência mental, podendo ser facilitadora na sua abordagem.

Aminaftona no tratamento da epistaxe / Amnaphtone in the treatment of nosebleed

Nasal haemorrhage or nosebleed, is the most common of haemorrhages due to the intense vasculization of the nose, the fragility of the nasal mucous membrane and its vulnerability to traumas and irritant agents. The aim of this study is to report on a reduction of episodes of nosebleed in two patients with the use of amnophtone. A 34-year-old male patient and a 44- year-old female patient presented with histories of two or more nosebleeds per week, despite treatment during the acute phase. They both sought medical assistance for other vascular complaints, which were suggestive of vascular insufficiency as, during the physical examination petechia lesions in the lower limbs were detected. They were treated with 75 mg of amnaphtone three times daily. One week after, at the follow-up, they reported an improvement of the vascular symptoms, however, more markedly was the significant improvement in relation to the nosebleeds which were frequent but had not been reported in the first consultation. In conclusion, amnaphtone demonstrated to be efficient in the prevention of recurrence of nosebleed in these patients

Oxigenação extracorpórea por membrana e alterações hematológicas em estudo experimental / Extra-corporeal membrane oxygenation and hematological alterations in an experimental study

A oxigenação extracorpórea por membrana é uma técnica de suporte cardiopulmonar prolongado, com finalidade de auxiliar o pulmão e/ou o coração, quando os mesmos entram em falência não responsiva aos tratamentos convencionais não invasivos. O objetivo do presente estudo foi avaliar as alterações hematimétricas durante 12 horas de ECMO em estudo animal. Foram estudados 11 ovinos, da raça Santa Inês, sendo seis machos e cinco fêmeas, com peso entre 5,4 e 15kg (12,2 ± 3,1kg). Nos cinco primeiros animais, o prime do circuito extracorpóreo foi feito com solução de Ringer com lactato de sódio (Ringer-Lactato Glicolabor - Ribeirão Preto - SP) e solução de gelatina a 3,5 por cento (Hisocel - Campinas - SP), na proporção de 2:1, no total de 750ml. No sexto animal foi diminuído o volume do prime para 450ml, sendo 250ml de solução de Ringer com lactato de sódio e 200ml de solução de gelatina a 3,5 por cento. Nos cinco últimos experimentos (casos 7 a 11), empregou-se 250ml de sangue fresco total anticoagulado com citrato de sódio e 200ml de Ringer com lactato de sódio. Os exames realizados foram: hematócrito, hemoglobina, leucócitos, plaquetas, albumina e globulina. No estudo estatístico foram empregados os testes de Mann-Whitney e Análise da Variância e, no caso deste último demonstrar variação significativa (p<0,05), aplicou-se o teste de Tukey. Foi detectada redução em todos elementos analisados e com diferença estatística entre o grupo 1 e 2 no hematócrito e leucócitos. A oferta excessiva de volume desencadeou alterações hematimétricas em estudo experimental utilizando a ECMO em carneiro.