Use of Liposomal Gentamicin for Treatment of 5 Foals with Experimentally Induced Rhodococcus equi Pneumonia.

BACKGROUND: Adverse effects of, and bacterial resistance to, macrolides used to treat Rhodococcus equi infections have prompted search for clinically effective alternative antimicrobials. Liposomal gentamicin (LG) is effective against R. equi in vitro and decreases tissue concentrations of R. equi in experimentally infected mice. Effectiveness of LG treatment of foals with R. equi pneumonia, however, has not been described. HYPOTHESIS: Liposomal gentamicin is safe and effective for treating foals with R. equi pneumonia. ANIMALS: Ten foals with experimentally induced R. equi pneumonia. METHODS: Pilot treatment trial. Foals with pneumonia induced by intrabronchial instillation of R. equi were randomly allocated to receive either clarithromycin combined with rifampin (CLR + RIF) PO or LG IV, and followed by daily physical examinations and weekly thoracic ultrasonography and serum creatinine concentration determinations until the resolution of clinical signs. Treatment success was defined as the resolution of clinical signs and ultrasonographically identified pulmonary abscesses. RESULTS: All 10 foals were successfully treated. Two of 5 foals treated with LG developed azotemia within 1 week; LG was discontinued and treatment switched to CLR + RIF for these foals. None of the CLR + RIF treated foals developed azotemia. CONCLUSIONS AND CLINICAL IMPORTANCE: Liposomal gentamicin IV can be effective for treatment of R. equi pneumonia, but nephrotoxicity indicates that an alternative dosing interval or route (such as nebulization) will be needed before LG is adequately safe for clinical use. Larger comparative trials will be needed to evaluate the relative efficacy of a safer LG dosage regimen.

Desenvolvimento de Maytenus ilicifolia e de seus polifenóis totais sob condição de sombreamento e poda / Shadowing and pruning on the development and polyphenol contents in Maytenus ilicifolia

Maytenus ilicifolia Mart. ex Reissek (Celastraceae), conhecida popularmente por espinheira-santa, é nativa e cultivada, principalmente, no sul do Brasil. Suas folhas apresentam triterpenos e substâncias polifenólicas (flavonóides e taninos) relacionadas ao efeito antiulcerogênico. O objetivo do trabalho foi avaliar a produção de massa seca, altura, ramificação, e o teor de polifenóis totais em plantas de M. ilicifolia que se desenvolveram sob duas condições de luminosidade, após dois tratamentos distintos de poda. O delineamento experimental foi em blocos cazualizados com plantas desenvolvidas sob sombra e a pleno sol, e com plantas manejadas por poda parcial e rasa, com quatro repetições. No tratamento de poda rasa a maior altura das plantas foi observada nas plantas cultivadas a sombra em comparação com as conduzidas a pleno sol. No tratamento de poda parcial o número de ramos terciários aumentou significativamente nas plantas conduzidas a pleno sol. As plantas cultivadas a pleno sol apresentaram diferença significativa na concentração de polifenóis totais em relação às plantas produzidas à sombra alcançando valores de 10,29 ± 0,20% (CV=1,94%) e 7,16 ± 0,09% (CV=1,30%) respectivamente.

The Maytenus ilicifolia Mart. ex Reissek (Celastraceae), traditionally known as "espinheira-santa" in Portuguese, is native and cultivated in South Brazil. Its leaves contain triterpenes and polyphenolic compounds (flavonoids and tannins), which are related to the antiulcerogenic effect. The aim of this work was to evaluate the dried biomass production (g), height (m), ramification, and also the total content in polyphenol compounds of the leaves from the M. ilicifolia specie, which were developed under two different light conditions after two different pruning treatments. The design of the experiment was randomized blocks with two levels of light (shadow or full sunlight) and two levels of prune (partial and drastic), with four replications. The height of the plants grown in the shadow was greater for the treatment of drastic pruning than in plants in full sunlight. The ramification increased significantly with drastic prune in full sunlight. The plants grown in full sunlight showed a significant higher content in total polyphenols than the plants grown in the shadow, 10.29±0.20% (RSD=1.94%) and 7.16±0.09% (RSD=1.30%) respectively.

Communication between organ donor families and recipients: a definitely controversial subject.

In transplant centers, few topics are more controversial than communication between organ donor families (ODF) and recipients (RE). The Organ Procurement Organizations and transplant centers have felt obliged to protect the confidentiality and interests of ODF and RE. However, some authors have reported favorable effects of contact between ODF and RE. This study sought to investigate the current situation of the communication between ODF and RE from the viewpoint of transplanted patients (n = 50) and waiting transplant patients (n = 50) at a Brazilian University Hospital, ODF (n = 10), physicians from transplant centers (n = 50), as well as the opinion of the general population of a Brazilian city (n = 100). This work was developed as a survey whose questions related to the issue of communication between ODF and RE. The results showed that the majority of transplanted patients (82%) and patients awaiting transplant (60%) wanted to meet ODF to express their gratitude for receiving the organ. Likewise, ODF (67%) wanted to have a meeting with recipients, which allowed them to confirm the benefit of their donation. The general population was also favorable (66%) to ODF and RE communication. In contrast, the physicians (74%) were opposed to the ODF and RE contact. They affirmed that direct contact could lead to serious emotional conflicts or attempts of material involvement. One believes that decisions concerning the contact between ODF and RE would have to be determined by the involved parties. The transplant team could analyze the requests case by case, but ODF and RE must have the right to make the final decision.

Avaliaçäo urodinâmica de pacientes chagásicos / Urodynamic assessement in patients with Chagas disease

No presente trabalho estudou-se a fisiologia urinária de pacientes com Doença de Chagas nas suas diversas formas. Grupo A (controle) com 21 indivíduos normais; Gupo B: 16 pacientes com sorologia positiva; Grupo C: com 16 pacientes com cardiopatia chagásica e Grupo D: 21 pacientes com esofagopatia e/ou megacolon chagásicos. Os resultados mostraram que näo houve diferenças significantes (p > 0,05) entre os 4 grupos estudados para os parâmetros: capacidade cistométrica, pressäo de micçäo e fluxo urinário. Entretanto, houve diferenças significantes (p < 0,05) para os parâmetros: pressäo abdominal, pressäo do detrusor, pressäo uretral e tempo de micçäo na análise comparativa entre o grupo D e o controle A. Esses achados sugerem que a Doença de Chagas, em sua forma digestiva, também pode comprometer o trato urinário baixo, alterando sua fisiologia.