Combinación de técnicas quirúrgicas en la hernia gigante de Amyand irreductible

Las hernias gigantes de Amyand son hernias inguinales excepcionales por extenderse por debajo de la mitad del muslo en posición de pie y contener al apéndice cecal. Presentamos un paciente portador de una hernia gigante de Amyand irreductible, al cual se le realiza una reparación quirúrgicas, mediante una combinada de técnicas para su resolución. El tratamiento de las hernias inguinales gigantes es todo un desafío, debido a la distorsión anatomía existente, y por la pérdida de derecho a domicilio de los órganos que puede llegar a ocasionar. Consideramos que la combinación de las técnicas de Bassini y Lichtennstein asociado a las maniobras de Ombrédanne y de Camay es una estrategia adecuada para reparar exitosamente las hernias inguinales gigantes grado I. La apendicectomía en la hernia de Amyand tipo I es una alternativa de tratamiento cuando existe riesgo de apendicitis aguda.

Giant Amyand hernias are exceptional inguinal hernias because they extend below the middle of the thigh in the standing position and contain the cecal appendix. We present a patient with an irreducible giant Amyand hernia, who underwent surgical repair, using a combination of techniques for its resolution. The treatment of giant inguinal hernias is quite a challenge, due to the existing anatomical distortion, and the loss of the right to domicile of the organs that it can cause. We consider that the combination of the Bassini and Lichtenstein techniques associated with the Ombrédanne and Camay maneuvers is an appropriate strategy to successfully repair grade I giant inguinal hernias. Appendectomy in Amyand type I hernia is a treatment alternative when a risk of acute appendicitis exists.

Cecal dilatation in cattle ingesting Megathyrsus maximus (syn. Panicum maximum) cv. Mombaça and cv. Tanzânia.

Nine outbreaks of cecal dilatation are reported in cattle in rotationally-grazed pastures of Megathyrsus maximus during the rainy season with one day grazing and rest intervals of 23-28 days. Clinical signs, observed 6-24 h after entering the pasture, were inappetence, long periods in sternal recumbency, rough hair coat, arched back, tenesmus with difficult defecation, dry stools, reduced ruminal movements, intestinal tympany with right abdominal distention, and decreased milk production. The animals recovered 8-12 h after their removal from the pastures. All pastures were fertilized at 80-120 kg/ha of urea/year. In six farms, in addition to urea, chicken litter (CL) was also added. Water-soluble carbohydrates (WSC), non-fiber carbohydrates (NCF) and starch concentrations in the pastures causing tympany were higher (P < 0.05) than in control pastures. To demonstrate the relationship of the disease with fertilization of the pastures, a pasture of M. maximus was divided into five blocks of 16 m2 and each block subdivided into four plots each, totaling 20 plots. One plot of each block was randomly chosen for 1 of 4 different treatments: 1. fertilized with 8 t/ha of CL; 2. fertilized with 16 t/ha of CL; 3. fertilized with 180 kg/ha urea; 4. control without fertilization. In general, plots fertilized with urea or with CL had higher NFC and starch concentrations (p < 0,05) than the control plots. In another experiment a pasture of M. maximus was divided into 23 paddocks and rotationally grazed. Ten paddocks were fertilized with 180 kg/ha of urea and five fertilized with 8 t/ha of CL. The concentration of NFC and starch were significantly higher (p < 0.05) in the pastures fertilized with urea and with urea plus CL. These results suggest that cecal dilatation may be caused by the high concentrations of NFC and starch in the pastures fertilized with urea and/or poultry litter.

Potential of piperine for neuroprotection in sepsis-associated encephalopathy.

AIMS: Sepsis-associated encephalopathy (SAE) is a common complication that increases mortality and leads to long-term cognitive impairment in sepsis survivors. However, no specific or effective therapy has been identified for this complication. Piperine is an alkaloid known for its anti-inflammatory, antioxidant, and neuroprotective properties, which are important characteristics for treatment of SAE. The objective of this study was to evaluate the neuroprotective effect of piperine on SAE in C57BL/6 mice that underwent cecum ligation and perforation surgery (CLP). MAIN METHODS: C57BL/6 male mice were randomly assigned to groups that underwent SHAM surgery or CLP. Mice in the CLP group were treated with piperine at doses of 20 or 40 mg/kg for short- (5 days) or long-term (10 days) periods after CLP. KEY FINDINGS: Our results revealed that untreated septic animals exhibited increased concentrations of IL-6, TNF, VEGF, MMP-9, TBARS, and NLRP3, and decreased levels of BDNF, sulfhydryl groups, and catalase in the short term. Additionally, the levels of carbonylated proteins and degenerated neuronal cells were increased at both time points. Furthermore, short-term and visuospatial memories were impaired. Piperine treatment reduced MMP-9 activity in the short term and decreased the levels of carbonylated proteins and degenerated neuronal cells in the long term. It also lowered IL-6 and TBARS levels at both time points evaluated. Moreover, piperine increased short-term catalase and long-term BDNF factor levels and improved memory at both time points. SIGNIFICANCE: In conclusion, our data demonstrate that piperine exerts a neuroprotective effect on SAE in animals that have undergone CLP.

Stevia as a natural additive on gut health and cecal microbiota in broilers.

Stevia mash (SM), leaves of Stevia rebaudiana Bertoni plant, is an additive used in poultry that enhances growth and health. Objective: to determine the effect of 1 % SM on productive parameters, gut health, and the cecal microbiome in broilers between the first 15 and 21 days old. One hundred sixty male, 1-day-old broilers (48.5 ± 2.5 g) were divided into Control (C) without SM and Treated (T) with 1 % SM on diet, during 15/21 days. Each subgroup had eight broilers/five repetitions/treatment. At day 15 or 21, all broilers were dissected, Fabricius Bursa and Gut removed and processed for histomorphometry, followed by Villi Height/Crypt Deep (VH/CD) ratio. Conversion Index (CI) was determined. The V3-V4 region of 16S rRNA gene was amplified from DNA obtained from pooled cecal contents and sequenced on Illumina Miseq PE 2 × 250 platform. Sequence processing and taxonomic assignments were performed using the SHAMAN pipeline. Both T groups have better VH/CD Ratios than C groups (p ≤ 0.05). In guts, increased plasmatic and goblet cells number and thicker mucus layer were found in T15 and T21. All groups received SM showed early immunological maturity in Fabricius Bursa. IC was similar between all treatments. Faecalibacterium, Ruminococcus torques group, and Bacteroides were the major genera modulated by SM addition. At 15 and 21 days old, SM exerts a impact on diversity and evenness of the cecal microbiome.  Conclusion: SM (1 %) produced early immunologic maturity on Fabricius Bursa, increased intestinal functionality, and modified the microbiota, increasing beneficial microbial genera and microbial diversity.

Laparoscopic cecectomy for diseases of the appendix and cecum

Introduction: The cecum is the first part of the large bowel. Cecectomy is a sufficient treatment for some patients, avoiding overtreatment by ileocolic resection. Purpose:The goal of this study was to review a surgeon's experience with laparoscopic cecectomy and provide a technical video demonstration of this uncommon operation. Methods: A retrospective chart review was conducted of all consecutive patients treated with laparoscopic cecectomy over a 16-year period. All operations were performed using a 3-trocar technique. The cecum was transected with 1 to 2 firings of a 60 millimeters linear stapler, preserving the ileocecal valve and ascending colon. Results: 19 patients were identified including 12 females (63.2%). Median age was 42 years (range 16-84). Indication for surgery included appendiceal pathology in 12 patients (63.2%) and cecal abnormality in 7 (38.9%). There was no conversion to open surgery. Median intraoperative blood loss was 25 ml (range 0-150 ml) and no patient received a blood transfusion. No intraoperative or postoperative complication was noted. The median length stay was 1 day (range 0-6). Readmission rate was 0%. Final appendiceal histopathology revealed acute/chronic appendicitis in 5 patients, mucinous cystadenoma in 4 patients. Cecal histopathology revealed adenoma in 4 patients. Median follow-up was 16 months (range 4-53). Conclusions: Laparoscopic cecectomy is a sufficient treatment for some patients with benign conditions of the appendix and cecum. It carries minimal morbidity. It should be considered as an alternative to segmental bowel resection in a select group of patients. (AU)

Feeding laying hens with lactobacilli improves internal egg quality and animal health.

Feeding animals with lactobacilli strains is a biotechnological strategy to improve production, food quality, and animal health. Thus, this study aimed to select new lactic acid bacteria (LAB) able to improve laying hens health and egg production. Forty Bovans White layers (two days old) were randomly divided into four experimental groups that receive an oral gavage with saline solution (control group) or with one of the three lactobacilli selected (KEG3, TBB10, and KMG127) by their antagonistic activity against the foodborne pathogen Bacillus cereus GGD_EGG01. 16 S rRNA sequencing identified KEG3 as Lentilactobacillus sp., and TBB10 and KMG127 as Lactiplantibacillus sp. The data showed that feeding birds with LAB increased weight uniformity and improved the internal quality of the eggs (high yolk index and Haugh unit) compared with the control group (p < 0.05). Beta-diversity analysis showed that LAB supplementation modifies the cecal microbiota of laying hens. The prokaryotic families Bacteroidaceae, Ruminococcaceae, Rikenellaceae, and Lactobacillaceae were most important to the total dissimilarity of the cecal microbial community (calculated by SIMPER test). At end of in vivo experiments, it was possible to conclude that the feed of laying hens with Lentilactobacillus sp. TBB10 and Lentilactobacillus sp. KEG3 can be an important biotechnological tool for improving food quality and animal health.

Chia (Salvia hispanica L.) flour modulates the intestinal microbiota in Wistar rats fed a high-fat and high-fructose diet.

A diet rich in sugar and fat can promote metabolic disorders development, especially in the intestine. Chia flour (Salvia hispanica. L) is a source of dietary fiber, alpha-linolenic fatty acid (ALA), bioactive peptides, and phenolics, promoting health benefits. This study aimed to analyze chia flour's effect on gut microbiota modulation and intestinal health in adult male Wistar rats fed a high-fat and high-fructose (HFHF) diet. Male Wistar rats (n = 10/group) were fed the diets standard (AIN-93M) or HFHF (31% saturated fat and 20% fructose) in the first phase to induce metabolic disorders. In the second phase, the rats were fed AIN-93M, HFHF, or HFHF plus 14.7% chia flour (HFHF + CF) for 10 weeks. The consumption of chia flour increased the ALA (3.24 ± 0.24) intake and significantly improved immunoglobulin A (IgA) levels (1126.00 ± 145.90), goblet cells number (24.57 ± 2.76), crypt thickness (34.37 ± 5.86), crypt depth (215.30 ± 23.19), the longitudinal muscle layer (48.11 ± 5.04), cecum weight (4.39 ± 0.71), Shannon index (p < 0.05), and significantly increased the production of acetic (20.56 ± 4.10) and butyric acids (5.96 ± 1.50), Monoglobus sp., Lachnospiraceae sp., and Prevotellaceae sp. abundance. Furthermore, chia significantly reduced the cecal pH content (7.54 ± 1.17), body mass index (0.62 ± 0.03) and weight (411.00 ± 28.58), and Simpson index (p < 0.05). Therefore, chia intake improved intestinal health parameters and functionality in rats with metabolic disorders, which demonstrates to be an effective strategy for gut microbiota modulation.

Research Note: Preliminary assessment of the impact of dietary yeast products on egg production and cecal microbial profiles of laying hens.

The objective of the current study was to conduct an initial comparison of commercial yeast products in layer hen diets on egg production parameters and the corresponding impact on the cecal microbiota. A short-term feeding study was conducted with 35 laying hens receiving either a control, or 1 of 4 different yeast fermentation products, Immunowall, Hilyses (both from ICC, São Paulo, Brazil), Citristim (ADM, Decatur, IL), and Maxi-Gen Plus (CBS Bio Platforms, Calgary, Canada) with 7 hens per treatment from 40 to 46 wk of age. At the end of the trial, hens were euthanized, the ceca removed and prepared for denatured gradient gel electrophoresis (DGGE) microbial compositional analyses. Although initial shell weight and shell thickness were similar among the treatment groups, hens fed Hilyses had lower shell weight and thickness at the end of the experiment. The most predominant DGGE bands with the strongest intensity were identified as Lactobacillus species and excised double bands were identified as Bacillus, Clostridium, or Lachnospiraceae. In this short-term feeding trial, the commercial yeast products tested had little effect on egg production and shell quality, and only moderately impacted the composition of mature layer hen cecal microbiota.

Invaginación Apendicular en preescolar: Reporte de un caso y revisión de la literatura / Appendicular invagination in a pre-school child; a case-report and literature review

La invaginación intestinal sucede cuando un segmento del intestino se introduce en otro. La presentación apendicular es menos común, afectando principalmente a lactantes. Frecuentemente, se comprueba durante el intraoperatorio. El tratamiento es la desinvaginación, seguido de la exéresis del apéndice. De no lograrse, se prefiere la resección amplia o una hemicolectomía derecha. Se presenta en caso de una niña de 4 años que acudió por dolor abdominal, hiporexia, vómitos y sensación de alza térmica; la ecografía mostró conglomeración de asas intestinales e imagen redondeada. En cirugía se encontró invaginación apendicular que compromete el ciego, se resecó la masa hasta el inicio del colon ascendente. Se realizó una ileostomía sin fístula mucosa; el estudio anatomo-patológico informó necrosis del apéndice cecal. Tres meses después se restituyó el tránsito intestinal. La Intususcepción apendicular tiene síntomas inespecíficos. En Perú, puede llegar a ser mortal. Una historia clínica detallada con evaluación minuciosa ofrece un acertado diagnóstico y un tratamiento oportuno.

SUMMARY Intestinal invagination occurs when an intestinal segment is introduced into another segment. The appendicular presentation is less common and affects predominantly infants. The diagnosis is corroborated during the surgical intervention which consists of de-invagination followed by surgical removal of the appendix, if the latter is not possible then a wide resection or right hemicolectomy is indicated. We present the case of a 4-year-old girl who attended with a history of abdominal pain, anorexia, vomiting and fever; an abdominal ultrasound showed intestinal agglomeration and a rounded mass. The surgical findings included appendicular invagination that affected the cecum, the lesion was resected until the ascending colon. An ileostomy was performed, the anatomopathological findings indicated necrosis of the appendix. Three months later the normal intestinal transit was restored. Appendicular intussusception has non-specific symptoms and could be mortal in Peru. A detailed clinical history may help in diagnosing and offering proper treatment.

Manejo de la Diverticulitis Apendicular: una patología poco común

La diverticulitis apendicular es una enfermedad poco frecuente, con una incidencia aproximada de 1%. Se define por la presencia de divertículos verdaderos o falsos en la pared del apéndice cecal. Durante la fase aguda posee una clínica indistinguible a la apendicitis, sin embargo en ocasiones presenta características clínicas particulares que la distinguen de la apendicitis aguda, tales como la presencia de dolor abdominal insidioso o intermitente y/o ausencia de sintomatología gastrointestinal (náuseas, vómitos o anorexia). En la diverticulitis apendicular las técnicas imagenológicas son de utilidad limitada al otorgar información inespecífica, por lo que el diagnóstico tiende a realizarse mediante el estudio anatomopatológico del apéndice posterior a una intervención quirúrgica en paciente con cuadro clínico compatible con apendicitis aguda. El tratamiento de elección corresponde a la apendicectomía, lo que permite evitar complicaciones futuras como por ejemplo perforación apendicular, neoplasias, entre otros. Se obtuvieron los datos de fuentes como Pubmed y Scielo. Específicamente la búsqueda de artículos originales y de revisiones sistemáticas, preferentemente menores a 15 años de publicación en revistas científicas de alto índice de impacto, con las palabras "diverticulitis apendicular", "diverticulosis" y "complicaciones diverticulares".

Appendiceal diverticulitis is a rare disease with an incidence of approximately 1%. It is defined by the presence of true or false diverticula in the wall of the cecal appendix. During the acute phase, it has symptoms that are indistinguishable from appendicitis, however, it sometimes presents particular clinical characteristics that distinguish it from acute appendicitis, such as the presence of insidious or intermittent abdominal pain and/or the absence of gastrointestinal symptoms (nausea, vomiting, or anorexia). In appendiceal diverticulitis, imaging techniques are of limited utility as they provide non-specific information, so the diagnosis tends to be made through the pathology study of the treatment after surgery in a patient with a clinical picture compatible with acute appendicitis. The treatment of choice corresponds to appendectomy, which allows avoiding future complications such as appendiceal perforation, neoplasms, among others. Data were obtained from sources such as Pubmed and Scielo, specifically searching for original articles and systematic reviews with the words "apendicular diverticulitis", "diverticulosis" and "diverticular complications". The criteria used were articles mainly under 5 years of publication in high-impact scientific journals.

Vólvulo de ciego desde dos variantes de tratamiento / Cecal Volvulus from two Treatment Variants

Introducción: El vólvulo de ciego es infrecuente en Occidente y representa solo el 1 por ciento de los casos de oclusión intestinal en el adulto. Los pacientes con esta entidad presentan habitualmente un cuadro clínico de dolor abdominal intermitente, vómitos, ausencia de expulsión de gases y heces por el recto. Objetivo: Describir dos alternativas de tratamiento ante el vólvulo de ciego. Presentación de caso: Se presentan dos casos de pacientes masculinos, ambos de la tercera edad que presentan cuadro clínico sugestivo de oclusión intestinal mecánica de intestino grueso por vólvulo de ciego. Se realizó laparotomía explorada con los diagnósticos antes referidos y se encontró vólvulo del ciego. Luego se aplicaron técnicas quirúrgicas distintas para cada caso según el estado individual de cada uno de ellos. Conclusiones: Fue factible la aplicación de técnicas quirúrgicas diferentes, tras valorar el estado individual de los pacientes, pues ambos presentaron una evolución favorable(AU)

Introduction: Cecal volvulus is uncommon in the West and represents only 1 percent of cases of intestinal occlusion in adults. Patients with this entity usually present a clinical picture of intermittent abdominal pain, vomiting, as well as absence of gas and stool expulsion through the rectum. Objective: To describe two treatment alternatives for cecal volvulus. Case presentation: The cases are presented of two cases of male patients, both elderly, with clinical symptoms suggestive of mechanical intestinal occlusion of the large intestine caused by cecal volvulus. Exploratory laparotomy was performed with the aforementioned diagnoses and cecal volvulus was found. Then different surgical techniques were applied for each case according to the individual condition of each case. Conclusions: It was feasible to apply different surgical techniques after assessing the individual condition of the patients, since both presented a favorable evolution(AU)

Metagenomics analysis of the morphological aspects and bacterial composition of broiler feces.

In this descriptive study, we used metagenomics to analyze the relationship between the morphological aspects of chicken feces and its respective bacterial compositions. The microbiota composition was determined by sequencing the V4 region of the 16S rRNA genes collected from fresh broiler feces at 19 d old. In total, 48 samples were collected and divided into 8 groups of 6 samples each. The morphological changes studied were feed passage (FP) and reddish mucus (RM). Each was classified into 3 levels of intensity: 1 (slight), 2 (moderate), or 3 (intense). Thus, the 8 groups studied were feed passage (FP-1; FP-2; FP-3), reddish mucus (RM-1; RM-2; RM-3), normal ileal feces (NIF), and cecal discharge (CD). The alpha diversity (Shannon's index) revealed that the CD group showed greater diversity, and was significantly different from FP-2, FP-3, and RM-1. The beta diversity showed that the CD group samples were more homogeneous than the ileal feces groups. The relative abundance analysis revealed that Firmicutes and Proteobacteria were the most abundant phyla in the ileal feces groups. In CD, Firmicutes and Bacteroidetes were the most abundant. The relative abundance at the genus level revealed 136 different bacterial genera. In the ileal feces groups, the two most abundant genera were Lactobacillus and Escherichia/Shigella, except in the FP-1 and RM-2 groups, which had the opposite order. Unlike the others, the CD group had a higher abundance of Bacteroides and Faecalibacterium. When comparing the NIF group with the others, significant changes were found in the fecal microbiota, with nine genera for the FP groups, 19 for the RM groups, and 61 when compared to CD. The results of the present study suggest that evaluation of fecal morphology is a fundamental task that makes it possible to act quickly and assertively, as the morphological aspects of the feces may be related to the composition and structure of fecal microbiota.

Diverticulitis cecal. A propósito de un caso / Cecal Diverticulitis. A Case Report

La diverticulosis cecal es una entidad poco común, representando el 3,6% de los casos de enfermedad diverticular y su complicación más frecuente es la diverticulitis. Caso clínico : Presentamos el caso de un paciente de 79 años quien consultó por presentar dolor en fosa ilíaca derecha, náuseas y escalofríos; laboratorio leucocitos 16900uL (neutrófilos 79%), proteína C reactiva 4,51mg/l. Se realiza laparoscopia evidenciando tumor de ciego de 2 x 3cm de coloración violácea con signos de inflamación pericecal, se realizó hemicolectomía derecha. El informe histopatológico informó divertículo verdadero isquémico de ciego. Conclusión : La diverticulitis cecal es una patología poco frecuente que puede presentarse como un abdomen agudo, por lo que se debe mantener un alto índice de sospecha en pacientes mayores de 40 años de edad. El abordaje laparoscópico es un método seguro y eficaz para el diagnóstico y tratamiento de estos pacientes(AU)

Cecal diverticulosis is an uncommon condition, representing 3.6% of diverticular disease cases, with its most common complication being diverticulitis. Case report: We present the case of a 79-year-old patient who consulted for right iliac fossa pain, nausea, and chills; laboratory findings showing a white blood cell count of 16,900/µL (neutrophils 79%) and C-reactive protein of 4.51 mg/L. Laparoscopy revealed a 2 x 3 cm purple-colored cecal tumor with signs of pericecal inflammation, right hemicolectomy was performed. Histopathological analysis confirmed a true ischemic cecal diverticulum. Conclusion: Cecal diverticulitis is an infrequent condition that can mimic an acute abdomen, necessitating a high index of suspicion, especially in patients over 40 years of age. Laparoscopic approach proves to be a safe and effective method for diagnosis and treatment in these patients(AU)

Complicated acute appendicitis with compromised appendiceal base: A review of surgical strategies.

<b><br>Introduction:</b> Acute appendicitis is one of the most frequent emergencies in hospitals around the world; it requires early surgical treatment in complicated cases. One of the challenges that the surgeon faces during appendectomy is when the base of the appendix is compromised by either a perforation or gangrene. To show the surgical strategies that have been reported, as well as the complications associated with a compromised appendicular base in a complicated acute appendicitis.</br> <b><br>Methods:</b> A bibliographic search was carried out in the databases of Pubmed, Embase, Web of Science, and Google Scholar. The search expression ("appendiceal stump closure" OR "Closure of the appendiceal stump" OR "Management of appendiceal stump") was used to search for articles. The inclusion criteria were observational studies (case reports, case series, or cross-sectional, case-control, or cohort studies).</br> <b><br>Discussion:</b> Different techniques have been reported for the treatment of a compromised appendicular base. Among the most used are primary closure, partial resection of the cecum, cecostomy tube, ileocecectomy, and right hemicolectomy. The most frequent complications are surgical site infection, intra-abdominal abscess, postoperative ileus, intestinal obstruction, and others.</br> <b><br>Conclusions:</b> The appendicular base, compromised by necrosis or perforation, requires adequate treatment in order to prevent dehiscence of the appendicular stump sutures and fecal peritonitis. A number of surgical options have been reported.</br>.

Clinical and epidemiological findings of cecal disorders in horses in the state of Paraíba / Achados clínicos e epidemiológicos dos distúrbios cecais em cavalos no estado da Paraíba

This was a retrospective case study of colic syndrome of cecal origin in 159 horses treated at a reference Veterinary Center between June 2015 and July 2021. The data studied were breed, age, sex, clinical examinations of the initial emergency care, treatment protocols (clinical and/or surgical) and resolution (hospital discharge, euthanasia or death). It was observed that 7.55% (n = 12) of the cases corresponded to colic syndrome of cecal origin, where 75% (n = 9) had heart rate within the physiological range for the species, as well as 50% (n = 6) for capillary refill time values, 33.33% (n = 4) for pink mucosa, 41.67% (n = 5) for rectal temperature, and 16.67% (n = 2) on abdominal auscultation. In 58.34% (n = 7) of patients, pain could be controlled with analgesics, with recurrence in 41.67% (n = 5). All treated cases were cecal impaction, where 58.33% (n = 7) ruptured the cecum. In 75% (n = 9) of the cases, surgical treatment was performed. Regarding the general resolution of cases, 41.67% (n = 5) of the animals were discharged. Therefore, it is concluded that despite the increase in the diagnosis of colic of cecal origin, this disease is still rare (7.55%) and has a high potential for death since there are few clinical alterations, making its early diagnosis difficult.(AU)

Este foi um estudo retrospectivo dos casos de síndrome cólica de origem cecal em 159 cavalos atendidos em um Centro Veterinário de referência entre junho de 2015 e julho de 2021. Os dados estudados foram raça, idade, sexo, exames clínicos do atendimento inicial de emergência, protocolos de tratamento (clínico e/ou cirúrgica) e resolução (alta hospitalar, eutanásia ou óbito). Observou-se que 7,55% (n = 12) dos casos correspondiam à síndrome cólica de origem cecal, onde 75% (n = 9) apresentavam frequência cardíaca dentro da faixa fisiológica para a espécie, assim como 50% (n = 6) para valores de tempo de enchimento capilar, 33,33% (n = 4) para mucosa rosada, 41,67% (n = 5) para temperatura retal e 16,67% (n = 2) para ausculta abdominal. Em 58,34% (n = 7) dos pacientes, a dor pôde ser controlada com analgésicos, com recidiva em 41,67% (n = 5). Todos os casos tratados foram de impactação cecal, onde 58,33% (n = 7) romperam o ceco. Em 75% (n = 9) dos casos, o tratamento cirúrgico foi realizado. Em relação à resolução geral dos casos, 41,67% (n = 5) dos animais tiveram alta. Portanto, conclui-se que apesar do aumento do diagnóstico de cólica de origem cecal, esta enfermidade ainda é rara (7,55%) e apresenta um alto potencial de óbito visto que há poucas alterações clínicas dificultando seu diagnóstico precoce.(AU)

Effect of Dietary Level of Beet Pulp, with or without Molasses, on Health Status, Growth Performance, and Carcass and Digestive Tract Traits of Rabbits.

To evaluate the effect of dietary level of beet pulp, with or without molasses, on growth performance, a total of 470 28-day-old rabbits were used (614 ± 6 g). Animals were randomly allocated into five dietary treatment groups: Control, without beet pulp; BP20, and BP40 with 20 and 40% of beet pulp without molasses, respectively; and BPM20 and BPM40, with 20 and 40% of beet pulp with molasses, respectively. Daily feed intake (DFI) and average daily gain (ADG) were controlled at 28, 49, and 59 days of age. Carcass and digestive tract traits were also determined at 59 days of age. Mortality and morbidity were controlled daily. Mortality during the growing period was higher in BPM than in BP groups (+9.2%; p < 0.05). The higher the inclusion of beet pulp, the lower the DFI and ADG of animals (5.5 and 4.6% for every 20% inclusion, respectively; p < 0.001), as well as the dressing out percentage, the liver proportion, and the dissectible fat percentage of their carcasses. However, the best feed efficiency during the last 10 days was obtained with the BPM40 group. The higher the inclusion of beet pulp, the higher the weight of the empty gastrointestinal tract and cecum (+2.4 and +3.0 percentage points for every 20% inclusion, respectively; p < 0.001). In fact, a higher inclusion of beet pulp decreased the pH and dry matter and decreased the total volatile fatty acids content of cecum richer in acetic acid but poorer in propionic, isobutiric, isovaleric, and valeric acids. Stomach weight was lower, and the capric acid content in the cecum was higher in the BPM than in the BP group. The inclusion of beet pulp in the feed reduced the growth performance and carcass yield of growing rabbits, and an even higher incidence of digestive disorders was observed when beet pulp included molasses.

[Ceccum leiomyoma: an unusual cause of intestinal occlusion in adults] / Leiomioma de ciego: una causa inusual de oclusión intestinal en adultos.

Introduction: Cecal leiomyoma is a very rare benign tumor of the colon, constituted by a proliferative process of smooth muscle that originates from the muscularis propria or the muscularis of the cecum mucosa. These are often asymptomatic tumors that are found incidentally during screening studies or in the context of some other pathology. In cases with clinical expression, it commonly presents as chronic abdominal pain or a palpable abdominal mass. Infrequently it manifests as complications such as intestinal perforation, intestinal bleeding, or intestinal obstruction that require surgical treatment. Method: We present the case of a 25-year-old woman who came to the Central Guard service of the institution for abdominal colic pain of 48 hours of evolution associated with vomiting and abdominal distention. The videolaparoscopic surgical approach was decided in which an abdominal mass was identified at the level of the ileoceccal valve. Conventional right hemicolectomy with proximal loop ileostomy was performed with good postoperative evolution. Histopathological examination of the resected specimen revealed a benign ceccum leiomyoma. Results: The patient resolved her acute abdominal symptoms without complications and was discharged on the 5° postoperative day. Conclusion: The scarcity of studies and bibliography related to this infrequent pathology denotes the need to elaborate new studies of greater scope that offer answers to the questions and controversial aspects that still persist in relation to the clinical, diagnostic and therapeutic management of benign cecal tumors of mesenchymal lineage.

Introducción: El leiomioma cecal es un tumor benigno del colon, muy raro, constituido por un proceso proliferativo de músculo liso que se origina a partir de la muscularis propia o la muscularis de la mucosa del ciego. Con frecuencia se trata de tumores asintomáticos que se encuentran de forma incidental durante los estudios de detección o en el contexto de alguna otra patología. En los casos con expresión clínica, comúnmente se presentan con dolor abdominal crónico o masa abdominal palpable. Infrecuentemente debutan con complicaciones como perforación intestinal, sangrado intestinal u obstrucción intestinal que requieren tratamiento quirúrgico.Método: Presentamos el caso de una mujer de 25 años que acude al servicio de Guardia Central de la institución por dolor cólico abdominal de 48 horas de evolución asociado con vómitos y distensión abdominal Se decidió el abordaje quirúrgico videolaparoscópico en el que se identifico una masa abdominal a nivel de la válvula ileoceccal. Se realizó hemicolectomía derecha convencional con Ileostomía en asa proximal con buena evolución post operatoria. El examen histopatológico de la pieza resecada reveló un leiomioma benigno de ciego. Resultados: La paciente resolvió su cuadro abdominal agudo sin complicaciones y fue dada de alta al 5° día post-operatorio. Conclusión: La escasez de estudios y bibliografía relacionados con esta infrecuente patología denota la necesidad de elaborar nuevos estudios de mayor alcance que ofrezcan respuestas a los interrogantes y aspectos controvertidos que aún persisten en relación al manejo clínico, diagnóstico y terapéutico de los tumores cecales benignos de estirpe mesenquimal.

Efficacy and safety in the use of intraperitoneal hyperthermia chemotherapy and peritoneal cytoreductive surgery for pseudomyxoma peritonei from appendiceal neoplasm: A systematic review.

The objective of this systematic review is to provide efficacy and safety data in the application of Intra-Abdominal Hyperthermia Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS) in patients with Peritoneal Pseudomyxoma (PMP) of origin in the cecal appendix. The databases Medline and Central Cochrane were consulted. Patients with PMP of origin in the cecal appendix, classified as low grade, high or indeterminate, submitted to HIPEC and CRS. The results were meta-analyzed using the Comprehensive Metanalysis software. Twenty-six studies were selected to support this review. For low-grade PMP outcome, 60-month risk of mortality, Disease-Free Survival (DFS), and adverse events was 28.8% (95% CI 25.9 to 32), 43% (95% CI 36.4 and 49.8), and 46.7% (95% CI 40.7 to 52.8); for high-grade PMP, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 55.9% (95% CI 51.9 to 59.6), 20.1% (95% CI 15.5 to 25.7) and 30% (95% CI 25.2 to 35.3); PMP indeterminate degree, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 32.6% (95% CI 30.5 to 34.7), 61.8% (95% CI 58.8 to 64.7) and 32.9% (95% CI 30.5 to 35.4). The authors conclude that the HIPEC technique and cytoreductive surgery can be applied to selected cases of patients with PMP of peritoneal origin with satisfactory results.

Autonomic Disbalance During Systemic Inflammation is Associated with Oxidative Stress Changes in Sepsis Survivor Rats.

Sepsis affects 31.5 million people worldwide. It is characterized by an intense drop in blood pressure driving to cardiovascular morbidity and mortality. Modern supportive care has increased survival in patients; however, after experiencing sepsis, several complications are observed, which may be potentiated by new inflammatory events. Nevertheless, the interplay between sepsis survivors and a new immune challenge in cardiovascular regulation has not been previously defined. We hypothesized that cecal ligation and puncture (CLP) cause persistent cardiovascular dysfunctions in rats as well as changes in autonomic-induced cardiovascular responses to lipopolysaccharide (LPS). Male Wistar rats had mean arterial pressure (MAP) and heart rate (HR) recorded before and after LPS or saline administration to control or CLP survivor rats. CLP survivor rats had similar baseline MAP and HR when compared to control. LPS caused a drop in MAP accompanied by tachycardia in control, while CLP survivor rats had a noteworthy enhanced MAP and a blunted tachycardia. LPS-induced hemodynamic changes were related to an autonomic disbalance to the heart and resistance vessels that were expressed as an increased low- and high-frequency power of pulse interval in CLP survivors after saline and enhancement in the low-frequency power of systolic arterial pressure in control rats after LPS. LPS-induced plasma interferon γ, but not interleukin-10 surges, was blunted in CLP survivor rats. To further access whether or not LPS-induced autonomic disbalance in CLP survivor rats was associated with oxidative stress dysregulation, superoxide dismutase (SOD) activity and thiobarbituric acid reactive substances (TBARS) plasma levels changes were measured. LPS-induced oxidative stress was higher in CLP survivor rats. These findings indicate that key changes in hemodynamic regulation of CLP survivors rats take place in response to LPS that are associated with oxidative stress changes, i.e., reduced SOD activity and increased TBARS levels.

Efficacy and safety in the use of intraperitoneal hyperthermia chemotherapy and peritoneal cytoreductive surgery for pseudomyxoma peritonei from appendiceal neoplasm: A systematic review

Abstract The objective of this systematic review is to provide efficacy and safety data in the application of Intra-Abdominal Hyperthermia Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS) in patients with Peritoneal Pseudomyxoma (PMP) of origin in the cecal appendix. The databases Medline and Central Cochrane were consulted. Patients with PMP of origin in the cecal appendix, classified as low grade, high or indeterminate, submitted to HIPEC and CRS. The results were meta-analyzed using the Comprehensive Metanalysis software. Twenty-six studies were selected to support this review. For low-grade PMP outcome, 60-month risk of mortality, Disease-Free Survival (DFS), and adverse events was 28.8% (95% CI 25.9 to 32), 43% (95% CI 36.4 and 49.8), and 46.7% (95% CI 40.7 to 52.8); for high-grade PMP, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 55.9% (95% CI 51.9 to 59.6), 20.1% (95% CI 15.5 to 25.7) and 30% (95% CI 25.2 to 35.3); PMP indeterminate degree, 60-month risk of mortality, Disease-Free Survival (DFS) and adverse events was 32.6% (95% CI 30.5 to 34.7), 61.8% (95% CI 58.8 to 64.7) and 32.9% (95% CI 30.5 to 35.4). The authors conclude that the HIPEC technique and cytoreductive surgery can be applied to selected cases of patients with PMP of peritoneal origin with satisfactory results.