Comparison of four different protocols using levobupivacaine for spinal anaesthesia in red-footed tortoises (Chelonoidis carbonarius).

Background: The popularity of tortoises kept in captivity is increasing and has caused concern regarding the necessity to establish safe and straightforward anaesthesia for those reptiles. Aim: This study aimed to compare four protocols using levobupivacaine in spinal anaesthesia for the blockade of the caudal neuraxis of red-footed tortoises (Chelonoidis carbonarius). Methods: Twenty-four tortoises were randomly assigned into four groups: G1, levobupivacaine 0.75% (1.15 mg kg-1); G2, levobupivacaine 0.37% (1.15 mg kg-1); G3, levobupivacaine 0.75% (2.3 mg kg-1); and G4, levobupivacaine 0.75% (0.1 ml 5 cm-1 of straight carapace length). Tortoises were evaluated for respiratory rate, muscle relaxation, response to hindlimb or tail pinch, and cloacal reflex. Results: A 1.15 mg kg-1 dose of levobupivacaine 0.37% appears adequate for shorter procedures, whereas a 1.15 mg kg-1 dose of levobupivacaine 0.75% should be appropriate for longer procedures in red-footed tortoises. Conclusion: Our results are the first to show the effects of levobupivacaine on spinal anaesthesia in reptiles. Weight-based doses presented more intense and more homogeneous effects than carapace length-based doses in red-footed tortoises. Spinal anaesthesia of red-footed tortoises was safe and effective with any of the weight-based protocols.

An acidless microwave-assisted wet digestion of biological samples as a greener alternative: applications from COVID-19 monitoring to plant nanobiotechnology.

Sample preparation in an analytical sequence increases the number of errors, is highly time-consuming, and involves the manipulation of hazardous reagents. Therefore, when an improvement in an analytical method is required, the sample preparation step needs to be optimised or redesigned. Moreover, this step can involve significant toxic reagents and a high volume of waste. In that regard, this study proposes a new procedure based on microwave-assisted wet digestion combining two green strategies: a miniaturised system (with a few microlitres of volume) and the only use of hydrogen peroxide. Three biological samples (human serum, urine, and plant in vitro material) were chosen due to their high potential for disease monitoring, toxicological studies, and biotechnology applications. Several trace elements (Ca, Cd, Co, Cu, Fe, Mg, Mn, Mo, Ni, Se, and Zn) were determined by inductively coupled plasma optical emission spectroscopy and inductively coupled plasma mass spectrometry. For human serum and urine, a certified reference material was used to check for accuracy; the recovery ranged from 72% (Cd, ICP-MS) to 105% (Mg, ICP OES) for serum, while for urine, they varied from 82% (Ni, ICP-MS) to 122% (Zn, ICP-MS). For the soybean callus sample (in vitro plant material), a comparison between the proposed method and the acid digestion method was conducted to evaluate the accuracy, and the results agreed. The detection limits were 0.001-60 µg L-1 (lowest for Cd), thus demonstrating a suitable sensitivity. Moreover, the decomposition efficiency was demonstrated by determining the residual carbon, and a low amount was found in the final product digested (below 0.8% w v-1). A green metric approach was calculated for the proposed method, and according to AGREEprep software, it was found to be around 0.4. Finally, the method was applied to urine samples collected in patients with COVID-19 and soybean callus cultivated with silver nanoparticles. This sample preparation method is a new acidless and miniaturised alternative for elemental analysis involving biological samples.

Reliability of radioguided occult lesion localization in reoperation of loco-regional persistent/recurrent differentiated thyroid cancer: Retrospective cohort study.

OBJECTIVES: We aimed to determine the radioguided occult lesion localization (ROLL) reliability in the reoperation of patients with differentiated thyroid cancer (DTC) and persistent or recurrent non-palpable loco-regional disease who underwent surgery at the Instituto Nacional de Cancerología between 2012 and 2021. DESIGN: Observational retrospective cohort study. PARTICIPANTS: We included data from patients with DTC that underwent resection with ROLL. MAIN OUTCOME MEASURES: Reliability analysed as percentage of patients with complete resection of tumour lesion using ROLL, disease-free survival, second loco-regional relapse, adequate resectability and complications. RESULTS: Two hundred and four cases were obtained. Pathological examination revealed papillary thyroid carcinoma in 202 patients, and follicular thyroid carcinoma in 2. Reliability was 96.57% in patients who underwent ROLL. When wide resection was performed-at surgeon's discretion-the reliability increased to 97.5%. CONCLUSIONS: The high reliability obtained suggests that ROLL was effective to localize non-palpable relapsing lesions. To our knowledge, this is the largest sample size published on this topic to date.

Paralytic Shellfish Toxins in the Gastropod Concholepas concholepas: Variability, Toxin Profiles and Mechanisms for Toxicity Reduction.

Harmful algal blooms of toxin-producing microalgae are recurrent in southern Chile. Paralytic shellfish poisoning (PSP) outbreaks pose the main threat to public health and the fishing industry in the Patagonian fjords. This study aims to increase understanding of the individual and spatial variability of PSP toxicity in the foot of Concholepas concholepas, Chile's most valuable commercial benthic invertebrate species, extracted from the Guaitecas Archipelago in Chilean Patagonia. The objective is to determine the effect of pigment removal and freezing during the detoxification process. A total of 150 specimens (≥90 mm length) were collected from this area. The live specimens were transferred to a processing plant, where they were measured and gutted, the foot was divided into two equal parts, and pigment was manually removed from one of these parts. The PSP toxicity of each foot (edible tissue) was determined by mouse bioassay (MBA) and high-performance liquid chromatography with fluorescence detection and postcolumn oxidation (HPLC-FLD PCOX). The individual toxicity per loco, as the species is known locally, varied from <30 to 146 µg STX diHCL eq 100 g−1 (CV = 43.83%) and from 5.96 to 216.3 µg STX diHCL eq 100 g−1 (CV = 34.63%), using MBA and HPLC, respectively. A generalized linear model showed a negative relation between individual weight and toxicity. The toxicological profile showed a dominance of STX (>95%), neoSTX and GTX2. The removal of pigment produced a reduction in PSP toxicity of up to 90% and could represent a good detoxification tool moving forward. The freezing process in the muscle with pigment did not produce a clear pattern. There is a significant reduction (p < 0.05) of PSP toxicity via PCOX but not MBA. Furthermore, the study discusses possible management and commercialization implications of the findings regarding small-scale fisheries.

Trombolisis dirigida por catéter en paciente con oclusión arterial periférica aguda / Catheter-directed thrombolysis in patients with acute peripheral arterial occlusion

Introducción: Las oclusiones arteriales periféricas agudas de menos de 14 días y de causa embólica y trombótica están asociadas a una alta morbimortalidad. La trombólisis dirigida por catéter representa en la actualidad una modalidad de tratamiento efectivo para la oclusión de vasos distales infrageniculares, que históricamente ha tenido malos resultados mediante embolectomía convencional, debido a la oclusión preexistente de vasos colaterales y al daño mecánico al endotelio, que conlleva esta técnica tradicional. Se decidió presentar este caso por ser la primera vez que se practica esta modalidad de tratamiento en Cuba. Objetivo: Exponer los resultados obtenidos con la aplicación de la trombolisis fibrinolitica mediante catéter en un paciente afectado por trombosis arterial periférica aguda. Presentación del caso: Paciente masculino de 57 años de edad con diagnóstico de trombosis arterial aguda de la arteria poplítea del miembro inferior izquierdo, con más de 24 horas de evolución de la isquemia y del compromiso de la viabilidad de la extremidad. Se utilizó el tratamiento fibrinolítico, mediante infusión de 250 000 unidades de Heberkinasa® en tres horas y se logró la mejoría del nivel de amputación. Conclusiones: El tratamiento fibrinolítico con Heberkinasa® fue útil en el paciente tratado porque redujo el nivel de amputación en el paciente, que presentó isquemia irreversible y criterio inicial de amputación supracondílea alto, en la extremidad comprometida(AU)

Introduction: Acute peripheral arterial occlusions of less than 14 days and of embolic and thrombotic cause are associated with a high morbidity and mortality. Catheter-directed thrombolysis currently represents an effective treatment modality for the occlusion of infragenicular distal vessels, which has historically had poor results by conventional embolectomy, due to the pre-existing occlusion of collateral vessels and the mechanical damage to the endothelium, which this traditional technique entails. It was decided to present this case because it is the first time that this modality of treatment is practiced in Cuba. Objective: Present the results obtained with the application of fibrinolytic thrombolysis by catheter in a patient affected by acute peripheral arterial thrombosis. Case presentation: A 57-year-old male patient diagnosed with acute arterial thrombosis of the popliteal artery of the left lower limb, with more than 24 hours of evolution of ischemia and compromised viability of the limb. Fibrinolytic treatment was used, by infusion of 250,000 units of Heberkinase® in three hours and the improvement of the amputation level was achieved. Conclusions: Fibrinolytic treatment with Heberkinase® was useful in the treated patient because it reduced the level of amputation in the patient, who presented irreversible ischemia and initial criteria of high supracondylar amputation in the compromised limb(AU)

Cardiorespiratory and hemogasometric effects of epidural ketamine and its associations with morphine and xylazine in sheep / Efeitos cardiorrespiratórios e hemogasométricos da cetamina e suas associações com morfina e xilazina por via epidural em ovinos

This study aimed to evaluate the cardiorespiratory and hemogasometric effects of epidural ketamine and its associations with morphine and xylazine in ewes submitted to transcervical cervix transposition with a hegar dilator. Ten Santa Inês breed ewes were studied in a cross over model study where three epidural protocols (GK = ketamine 2.0 mg kg-1; GKM = ketamine 2.0 mg kg-1 + morphine 0.1 mg kg-1; GKX = ketamine 2.0 mg kg-1 + xylazine 0.05 mg kg-1) were compared among each other and with a control treatment (GS= saline 1 mL/7.5 kg). The assessed variables were heart rate, respiratory frequency, ear temperature, non-invasive blood pressure and hemogasometric analysis. All parameters were assessed at baseline and then ewes were sedated with an association of acepromazine (0.1 mg kg -1) and diazepam (0.2 mg kg -1). Ten minutes after sedation all parameters were reassessed and afterwards the epidural injections were performed. Hemogasometry was repeated at 15 and 30 minutes after epidural and the other parameters assessed at 05, 15, 30, 45 and 60 minutes after epidural. GKX showed a slight respiratory depression with lower levels of PO2 and a compensatory increase in respiratory frequency. GKM presented the lower temperature mean. All protocols showed few cardiorespiratory effects when compared with control. Epidural with 2.0 mg kg-1 ketamine isolated was considered the best opti

Este estudo teve como objetivo avaliar os efeitos cardiorrespiratórios e hemogasométricos da cetamina peridural e suas associações com morfina e xilazina em ovelhas submetidas à manipulação uterina por via transcervical. Foram estudadas dez ovelhas da raça Santa Inês. Três protocolos epidurais foram avaliados: (GK = cetamina 2,0 mg kg−1, GKM = cetamina 2,0 mg kg−1 + morfina 0,1 mg kg−1, GKX = cetamina 2,0 mg kg−1 + xilazina 0,05 mg kg−1). Os três protocolos foram comparados entre si e com um tratamento controle (GS = solução salina 1 mL/7,5kg). As variáveis avaliadas foram frequência cardíaca, frequência respiratória, temperatura auricular, pressão arterial não-invasiva além da análise hemogasométrica. Todos os parâmetros foram avaliados no momento basal e em seguida as ovelhas foram sedadas com associação de acepromazina (0,1 mg kg−1) e diazepam (0,2 mg kg−1). Dez minutos após a sedação, todos os parâmetros foram novamente avaliados e foram realizadas as injeções peridurais. A hemogasometria foi repetida aos 15 e 30 minutos após a peridural e os outros parâmetros avaliados aos 05, 15, 30, 45, e 60 minutos após a peridural. O GKX mostrou sinais de hipoxemia com menores níveis de pO2 e um aumento compensatório na frequência respiratória. O GKM apresentou a média de temperatura mais baixa. Todos os protocolos apresentaram poucos efeitos cardiorrespiratórios em relação ao controle. O protocolo epidural com 2,0 mg kg−1 de cetamina foi considerado a melhor opção para procedimentos curtos como manipulações obstétricas em ovinos devido à estabilidade cardiorrespiratória quando comparado com os protocolos que utilizaram associações.

Cardiorespiratory and hemogasometric effects of epidural ketamine and its associations with morphine and xylazine in sheep / Efeitos cardiorrespiratórios e hemogasométricos da cetamina e suas associações com morfina e xilazina por via epidural em ovinos

This study aimed to evaluate the cardiorespiratory and hemogasometric effects of epidural ketamine and its associations with morphine and xylazine in ewes submitted to transcervical cervix transposition with a hegar dilator. Ten Santa Inês breed ewes were studied in a cross over model study where three epidural protocols (GK = ketamine 2.0 mg kg-1; GKM = ketamine 2.0 mg kg-1 + morphine 0.1 mg kg-1; GKX = ketamine 2.0 mg kg-1 + xylazine 0.05 mg kg-1) were compared among each other and with a control treatment (GS= saline 1 mL/7.5 kg). The assessed variables were heart rate, respiratory frequency, ear temperature, non-invasive blood pressure and hemogasometric analysis. All parameters were assessed at baseline and then ewes were sedated with an association of acepromazine (0.1 mg kg -1) and diazepam (0.2 mg kg -1). Ten minutes after sedation all parameters were reassessed and afterwards the epidural injections were performed. Hemogasometry was repeated at 15 and 30 minutes after epidural and the other parameters assessed at 05, 15, 30, 45 and 60 minutes after epidural. GKX showed a slight respiratory depression with lower levels of PO2 and a compensatory increase in respiratory frequency. GKM presented the lower temperature mean. All protocols showed few cardiorespiratory effects when compared with control. Epidural with 2.0 mg kg-1 ketamine isolated was considered the best opti

Este estudo teve como objetivo avaliar os efeitos cardiorrespiratórios e hemogasométricos da cetamina peridural e suas associações com morfina e xilazina em ovelhas submetidas à manipulação uterina por via transcervical. Foram estudadas dez ovelhas da raça Santa Inês. Três protocolos epidurais foram avaliados: (GK = cetamina 2,0 mg kg−1, GKM = cetamina 2,0 mg kg−1 + morfina 0,1 mg kg−1, GKX = cetamina 2,0 mg kg−1 + xilazina 0,05 mg kg−1). Os três protocolos foram comparados entre si e com um tratamento controle (GS = solução salina 1 mL/7,5kg). As variáveis avaliadas foram frequência cardíaca, frequência respiratória, temperatura auricular, pressão arterial não-invasiva além da análise hemogasométrica. Todos os parâmetros foram avaliados no momento basal e em seguida as ovelhas foram sedadas com associação de acepromazina (0,1 mg kg−1) e diazepam (0,2 mg kg−1). Dez minutos após a sedação, todos os parâmetros foram novamente avaliados e foram realizadas as injeções peridurais. A hemogasometria foi repetida aos 15 e 30 minutos após a peridural e os outros parâmetros avaliados aos 05, 15, 30, 45, e 60 minutos após a peridural. O GKX mostrou sinais de hipoxemia com menores níveis de pO2 e um aumento compensatório na frequência respiratória. O GKM apresentou a média de temperatura mais baixa. Todos os protocolos apresentaram poucos efeitos cardiorrespiratórios em relação ao controle. O protocolo epidural com 2,0 mg kg−1 de cetamina foi considerado a melhor opção para procedimentos curtos como manipulações obstétricas em ovinos devido à estabilidade cardiorrespiratória quando comparado com os protocolos que utilizaram associações.(AU)

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calfs forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...(AU)

SEOM clinical guidelines in advanced and recurrent breast cancer (2018).

Although the metastasic breast cancer is still an incurable disease, recent advances have increased significantly the time to progression and the overall survival. However, too much information has been produced in the last 2 years, so a well-based guideline is a valuable document in treatment decision making. The SEOM guidelines are intended to make evidence-based recommendations on how to manage patients with advanced and recurrent breast cancer to achieve the best patient outcomes based on a rational use of the currently available therapies. To assign a level of certainty and a grade of recommendation the United States Preventive Services Task Force guidelines methodology was selected as reference.

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calf’s forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...

Paradigma Biomédico X Psicossocial: Onde são Ancoradas as Representações Sociais Acerca do Sofrimento Psíquico? / Paradigma Biomédico X Psicosocial: ¿Dónde están Ancladas las Representaciones Sociales Acerca del Sufrimiento Psíquico? / Psychosocial X Biomedical Paradigm: Where is the Social Representation Anchored in Psychic Suffering?

Resumo Este estudo tem como objetivo conhecer as representações sociais de profissionais da saúde mental, universitários da área da saúde e estudantes do ensino médio acerca do louco e do doente mental, relacionando-as aos paradigmas de atenção à saúde mental. A amostra dessa pesquisa foi formada por 150 participantes, sendo 50 de cada grupo social. Para a coleta de dados, foi usada a TALP (Técnica de Associação Livre de Palavras), com os estímulos louco e doente mental. Os dados foram analisados no programa Tri-Deux-Mots, por meio da Análise Fatorial de Correspondência. Os estudantes do ensino médio e os universitários apresentaram representações do louco e do doente mental ancoradas no paradigma biomédico, o qual enfatiza a medicalização e a hospitalização na assistência à saúde mental; já os profissionais apresentaram representações ancoradas no paradigma psicossocial, o qual norteia as ideias da Reforma Psiquiátrica. Percebe-se que apesar de a assistência em saúde mental no Brasil ser pautada nos preceitos da reforma, ainda há na sociedade uma visão negativa do doente mental/louco ancorada no paradigma biomédico, a qual reforça a exclusão e manutenção do estigma social frente a esses sujeitos.

Resumen El objetivo fue conocer las representaciones sociales de profesionales de salud mental, estudiantes de la salud y de enseñanza secundaria sobre locos y enfermos mentales, relacionándose los paradigmas de la atención a la salud mental. Muestra formada por 150 participantes, 50 de cada grupo social. Para recolección de datos, se utilizó la Técnica de Asociación Libre de Palabras, con estímulos locos y enfermos mentales. Datos analizados en el software Tri-Deux-Mots, a través del análisis factorial de correspondencia. Los estudiantes de enseñanza secundaria y los universitarios presentaron representaciones de loco y enfermo mental ancladas en el paradigma biomédico, que hace hincapié a la medicalización y hospitalización en la atención de salud mental; ya los profesionales presentaron representaciones ancladas en el paradigma psicosocial, que guía las ideas de la Reforma Psiquiátrica. Se percibió que a pesar de la atención en salud mental en Brasil se basada en los preceptos de la Reforma, todavía hay en la sociedad visión negativa de enfermos mentales/loco anclada en el paradigma biomédico, lo que refuerza la exclusión y el mantenimiento del estigma social delante de estos sujetos.

Abstract This study aims to determine the social representation of mental health professionals, university students from the health area, and secondary school students with regard to the crazy person and the mentally ill person, regarding the paradigms of mental health care. The study sample was composed of 150 participants, with 50 in each social group. For data collection, the free word association technique (TALP) was used, with the prompts "crazy person" and "mentally ill person". The data were analyzed using the Tri-Deux-Mots software,through correspondence factor analysis. The secondary school students and university students presented representations of the crazy person and the mentally ill person anchored in the biomedical paradigm, which emphasizes medicalization and hospitalization with regard to mental health care. The professionals, on the other hand, presented representations anchored in the psychosocial paradigm, which guides the ideas of the Psychiatric Reform. It is recognized that although mental health care in Brazil is based on the principles of the Reform, there is still a negative view of the mentally ill person/crazy person on the part of society anchored in the biomedical paradigm, which reinforces the exclusion and maintenance of the social stigma that these individuals face.

Response to Loco-Regional Therapy Predicts Outcomes After Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma.

INTRODUCTION AND AIM: Combined hepatocellular-cholangiocarcinoma (HCC-CCA) is a rare liver malignancy distinct from either hepatocellular carcinoma (HCC) or cholangiocarcinoma. Liver transplantation (LT) is not recommended for HCC-CCA because of suboptimal outcomes. Non-invasive diagnosis of HCC-CCA is extremely challenging; thus, some HCC-CCAs are presumed as HCC on imaging and listed for LT with the correct diagnosis ultimately made on explant pathology. We compared HCC-CCA with HCC to determine the utility of response to pre-transplant loco-regional therapy (LRT) in predicting outcomes for HCC-CCA after LT as a potential means of identifying appropriate HCC-CCA patients for LT. MATERIAL AND METHODS: Retrospective review of 19 patients with pathologically confirmed HCC-CCA were individually matched to 38 HCC patients (1:2) based on age, sex, and Milan criteria at listing was performed. The modified response evaluation criteria in solid tumors was used to categorize patients as responders or non-responders to pre-transplant LRT based on imaging performed before and after LRT. Overall survival (OS) and recurrence-free survival (RFS) were examined. RESULTS: OS at 3 years post-transplant was 74% for HCC-CCA and 87% for HCC. RFS at 3 years was 74% for HCC-CCA, and 87% for HCC. Among responders to LRT, the 3-year OS was 92% for HCC-CCA and 88% for HCC; among non-responders, 3-year OS was 43% for HCC-CCA and 83% for HCC. Higher 3-year OS was observed among HCC-CCA responders (77%) compared with HCC-CCA non-responders (23%). CONCLUSIONS: OS was similarly high among.

Avaliação do bloqueio bilateral do tronco do nervo pudendo em gatos com obstrução uretral / Assessment of the bilateral block of the trunk of the pudendal nerve in cats with urethral obstruction

Background: Clinical care of cats with urethral obstruction is a common routine in feline clinical medicine and the re-establishment of urinary flow is essential for long-lasting correction of the pathophysiological alterations presented. For this chemical restraint is usually employed, that together with the alteration, increases the anesthetic risk of these patients. Improvement in anesthetic techniques, especially the loco-regional, may contribute to reducing the anesthetic risk of these patients and facilitate maneuvers to clear the obstruction. Thus the objective of the present study was to describe and assess the bilateral block technique of the pudendal nerve in 16 cats with urethral obstruction.Materials, Methods & Results: Sixteen male crossbred cats were used, with partial or total urethral obstruction, attended at the Veterinary Hospital of the Federal University of Campina Grande, PB, Brazil. The anesthetic block of the pudendal nerve trunk was carried out by placing the local anesthetic close to the ventral foramen of the second sacral vertebra, using a 13 x 0.45 mm needle attached to a 1 mL syringe. To assess the effectiveness of the bilateral block, the analgesia promoted was assessed using the substitute (“Reaction to Palpating the Surgical Wound” of subscale 1 (pain expression) of the “Compound Multi-dimensional Scale to Assess Post Operational Pain in Cats”. This assessment was made before the bilateral block (M0) and 10 min afterwards (M1) and the scores ranged from 0 to 3. In addition, a segmental assessment of the urethra was made, where, by passing a probe the sensitivity was assessed of the urethral ostium, penile and pelvic urethra and the relaxing of the external urethral sphincter. This assessment was made at M1 and classified as present or absent.[...](AU)

Avaliação do bloqueio bilateral do tronco do nervo pudendo em gatos com obstrução uretral / Assessment of the bilateral block of the trunk of the pudendal nerve in cats with urethral obstruction

Background: Clinical care of cats with urethral obstruction is a common routine in feline clinical medicine and the re-establishment of urinary flow is essential for long-lasting correction of the pathophysiological alterations presented. For this chemical restraint is usually employed, that together with the alteration, increases the anesthetic risk of these patients. Improvement in anesthetic techniques, especially the loco-regional, may contribute to reducing the anesthetic risk of these patients and facilitate maneuvers to clear the obstruction. Thus the objective of the present study was to describe and assess the bilateral block technique of the pudendal nerve in 16 cats with urethral obstruction.Materials, Methods & Results: Sixteen male crossbred cats were used, with partial or total urethral obstruction, attended at the Veterinary Hospital of the Federal University of Campina Grande, PB, Brazil. The anesthetic block of the pudendal nerve trunk was carried out by placing the local anesthetic close to the ventral foramen of the second sacral vertebra, using a 13 x 0.45 mm needle attached to a 1 mL syringe. To assess the effectiveness of the bilateral block, the analgesia promoted was assessed using the substitute (“Reaction to Palpating the Surgical Wound” of subscale 1 (pain expression) of the “Compound Multi-dimensional Scale to Assess Post Operational Pain in Cats”. This assessment was made before the bilateral block (M0) and 10 min afterwards (M1) and the scores ranged from 0 to 3. In addition, a segmental assessment of the urethra was made, where, by passing a probe the sensitivity was assessed of the urethral ostium, penile and pelvic urethra and the relaxing of the external urethral sphincter. This assessment was made at M1 and classified as present or absent.[...]

Avaliação de novas práticas de compostagem em pequena escala com aproveitamento energético / Evaluation of new composting practices in small-scale with energy recovery

RESUMO: Foram avaliados neste estudo novos sistemas de compostagem de mínimo impacto ambiental para o tratamento in loco de resíduos orgânicos. Dois tipos de composteiras e quatro formas de manejo foram testados. Focaram-se ainda duas composições de resíduos sólidos orgânicos com relação ao aproveitamento energético por aquecimento de água. Os resíduos mantiveram temperaturas termofílicas por mais de 20 dias, apresentaram produção desprezível de metano e não geraram chorume em condições de aeração passiva. Como aspectos de maior influência, podem ser considerados: a suspensão das composteiras sobre pallets, a composição dos resíduos, as condições de contorno das composteiras e o manejo adotado. No teste de recuperação energética, temperaturas de até 51ºC foram alcançadas após 24 horas de circulação de água no sistema, sugerindo que o processo pode ser uma fonte potencial de economia de energia. O modelo de compostagem proposto é ambientalmente adequado, porque minimiza emissões e geração de lixiviado se comparado a aterros sanitários e plantas de compostagem industrial, sendo indicado para cozinhas industriais, condomínios, shopping centers e outros geradores em pequena e média escalas.

ABSTRACT: This study comprehends the research of new composting systems for the organic solid waste treatment with low environmental impact. Two types of composting, four types of management and its economic feasibility were tested, as well as two compositions of organic solid waste focused at energy recovery by heating water. The composting maintained the thermophilic process for more than 20 days, showed a non-significant CH4 emission, maintained aerobic conditions by passive aeration, without leachate generation. The aspects with increase influence were: suspension of composters on pallets, waste composition, condition of composters, and adopted management. The test of energetic recovery showed that the water reached temperatures up to 51ºC after 24 hours of recirculation, demonstrating that this process can be a potential energy source. The proposed composting model is environmental feasible, because it minimizes gas emission and leachate generation compared to the landfill or industrial composting plants. Therefore, it is suggested to be used in industrial kitchens, condos, shopping malls, and other small and medium generators.

Intraoperative analgesic effects of intratesticular lidocaine in a dog undergoing elective orchiectomy: case report

A 1-year-old male Cocker Spaniel, weighing 10.5 kg, was referred for elective orchiectomy. An intratesticular injection of lidocaine was performed as a part of multimodal anesthetic protocol that also included: acepromazine, meloxicam, tramadol and ketamine. During the intraoperative period the cardiorespiratory parameters (heart rate, respiratory rate, and mean arterial blood pressure), the intraoperative anesthetic (ketamine) and analgesic (fentanyl) consumption, and the presence of autonomous nociceptive responses were evaluated. Increases of baseline cardiorespiratory parameters above 10% or the presence of autonomous nociceptive responses would be considered as indicative of insufficient analgesic coverage, for which 1 µg/kg IV of fentanyl would be employed. The evaluated cardiorespiratory variables were stable, and no autonomous nociceptive responses were observed. For this reason no additional ketamine boluses nor rescue analgesics were administered. It is suggested that intratesticular lidocaine, as a part of the multimodal analgesic protocol employed, contributed to improve the analgesic coverage during orchiectomy in this dog.

Um cão da raça Cocker Spaniel de um ano de idade e 10,5kg de peso foi encaminhado para orquiectomia eletiva. Foi realizada a administração de Lidocaína intratesticular como parte de um protocolo de anestesia multimodal que também incluía Acepromazina, Meloxicam, Tramadol e Ketamina. Durante o período intraoperatório foram avaliados os parâmetros cardiorrespiratórios (frequência cardíaca, frequência respiratória e pressão arterial média), o consumo intraoperatório de anestésicos (ketamina) e analgésicos (fentanil), e a presença de respostas nociceptivas autónomas. Incrementos nos valores basais dos parâmetros cardiorrespiratórios superiores a 10% ou a presença de respostas nociceptivas autónomas foram consideradas como indicativo de cobertura analgésica insuficiente, para o qual seria usado 1 µg/kg IV. As variáveis cardiorrespiratórias avaliadas se mantiveram estáveis e não se observaram respostas nociceptivas autónomas. Por essa razão não se administrou quantidades adicionais de ketamina nem analgesia de resgate. Sugere-se que a lidocaína intratesticular, como parte do protocolo de anestesia multimodal empregado, contribuiu para melhorar a cobertura analgésica durante a orquiectomia nesse cão.

Un canino de raza Cocker Spaniel de 1 año de edad y 10.5 kg de peso fue referido para orquiectomía electiva. Se realizó la administración de lidocaína intratesticular como parte de un protocolo de anestesia multimodal que también incluyó acepromacina, meloxicam, tramadol y ketamina. Durante el periodo intraoperatorio fueron evaluados los parámetros cardiorespiratorios (frecuencia cardiaca, frecuencia respiratoria, y presión arterial media), el consumo intraoperatorio de anestésicos (ketamina) y analgésicos (fentanilo), y la presencia de respuestas nociceptivas autónomas. Incremetos en los valores basales de los parámetros cardiorespiratorios superiores al 10% o la presencia de respuestas nociceptivas autónomas fueron considerados como indicativo de cobertura analgésica insuficiente, para lo cual se emplearía 1 µg/kg IV. Las variables cardiorrespiratorias evaluadas se mantuvieron estables y no se observaron respuestas nociceptivas autónomas. Por esta razón no se administraron bolos adicionales de ketamina ni analgesia de rescate. Se sugiere que la lidocaína intratesticular, como parte de un protocolo de anestesia multimodal empleado, contribuyó a mejorar la cobertura analgesica durante la orquiectomía en este perro.

"Ninguém esquece uma coisa dessas": problematizações sobre parricídio e hospitais de custódia / " Nadie se olvida de una cosa": problematizaciones sobre parricidio y hospitales de custodia / "No one forgets a thing like that": problematizations about parricide and custody hospitals

O considerado inimputável é absolvido por não entender o caráter ilícito de seu ato, embora, por medida de segurança, seja internado compulsoriamente em um hospital de custódia e tratamento psiquiátrico (HCTP): uma instituição pertencente ao sistema penitenciário. Cria-se assim a ambígua figura dolouco infrator - ora criminoso, ora doente mental - que raramente vimos contemplada em discussões e ações nas áreas da saúde e do direito. Ainda menos acolhido será aquele que atentar contra a vida de seus genitores: o chamado parricida. A partir dos aportes teóricos de Michel Foucault, Giorgio Agamben e Jacques Derrida, este trabalho discute discursos e práticas que se debruçam tanto sobre a questão da loucura, da infração e do parricídio quanto sobre a instituição do HCTP como modalidade de contenção e encaminhamento para os inimputáveis; assim como serão apresentadas discussões a partir das falas de pessoas classificadas como loucas, infratoras, parricidas - internadas em um HCTP.

El considerado inimputable es absuelto por no entender el carácter ilícito de su acto, aunque, por razones de seguridad, sea obligatoriamente ingresado en un hospital de custodia y tratamiento psiquiátrico (HCTP), una institución perteneciente al sistema penitenciario. Por lo tanto, se crea la figura ambigua del delincuente loco - ya sea infractor, a veces enfermo mental - que rara vez se ve abordado en las discusiones y acciones en materia de salud y del derecho. Menos bien recibido todavía será el que ponga en peligro la vida de sus padres: el llamado parricida. A partir de los aportes teóricos de Michel Foucault, Giorgio Agamben y Jacques Derrida, este trabajo analiza los discursos y las prácticas que se centran tanto en el tema de la locura, de la infracción y del parricidio, como en la institución de HCTP como modo de contención y asignación de los imputables; así como los debates se presentarán a partir de los discursos de las personas clasificadas como locos, parricidas, infractores - admitidos en un HCTP.

The person considered as unimputable is acquitted for not understanding the illicit character of his act, although, for security reasons, he is compulsorily hospitalized at a custody and psychiatric treatment hospital (CPTH), which is an institution belonging to the penitentiary system. It is created then the ambiguous figure of the crazy offender, either criminal or mentally ill, who is rarely seen or addressed in discussions and actions in health and law areas. Even less accepted is going to be the person who endangers his parents' lives: the so-called parricide. Starting from theoretical contributions of Michel Foucault, Giorgio Agamben and Jacques Derrida, this study develops discourses and practices that focus on issues of insanity, offense and parricide, and also, about the establishment of the CPTH as containment and referral modality for unimputable people. Accordingly, there will be presented some discussions regarding what people classified as crazy, offenders and parricides who are hospitalized at the CPTH have to say.

"NINGUÉM ESQUECE UMA COISA DESSAS": PROBLEMATIZAÇÕES SOBRE PARRICÍDIO E HOSPITAIS DE CUSTÓDIA / "NADIE SE OLVIDA DE UNA TAL COSA": PROBLEMATIZACIONES SOBRE PARRICIDIO Y HOSPITALES DE CUSTODIA / "NO ONE FORGETS A THING LIKE THAT": PROBLEMATIZATIONS ABOUT PARRICIDE AND CUSTODY HOSPITALS

Resumo O considerado inimputável é absolvido por não entender o caráter ilícito de seu ato, embora, por medida de segurança, seja internado compulsoriamente em um hospital de custódia e tratamento psiquiátrico (HCTP): uma instituição pertencente ao sistema penitenciário. Cria-se assim a ambígua figura dolouco infrator - ora criminoso, ora doente mental - que raramente vimos contemplada em discussões e ações nas áreas da saúde e do direito. Ainda menos acolhido será aquele que atentar contra a vida de seus genitores: o chamado parricida. A partir dos aportes teóricos de Michel Foucault, Giorgio Agamben e Jacques Derrida, este trabalho discute discursos e práticas que se debruçam tanto sobre a questão da loucura, da infração e do parricídio quanto sobre a instituição do HCTP como modalidade de contenção e encaminhamento para os inimputáveis; assim como serão apresentadas discussões a partir das falas de pessoas classificadas como loucas, infratoras, parricidas - internadas em um HCTP.(AU)

Resumen El considerado inimputable es absuelto por no entender el carácter ilícito de su acto, aunque, por razones de seguridad, sea obligatoriamente ingresado en un hospital de custodia y tratamiento psiquiátrico (HCTP), una institución perteneciente al sistema penitenciario. Por lo tanto, se crea la figura ambigua del delincuente loco - ya sea infractor, a veces enfermo mental - que rara vez se ve abordado en las discusiones y acciones en materia de salud y del derecho. Menos bien recibido todavía será el que ponga en peligro la vida de sus padres: el llamado parricida. A partir de los aportes teóricos de Michel Foucault, Giorgio Agamben y Jacques Derrida, este trabajo analiza los discursos y las prácticas que se centran tanto en el tema de la locura, de la infracción y del parricidio, como en la institución de HCTP como modo de contención y asignación de los imputables; así como los debates se presentarán a partir de los discursos de las personas clasificadas como locos, parricidas, infractores - admitidos en un HCTP.(AU)

Abstract The person considered as unimputable is acquitted for not understanding the illicit character of his act, although, for security reasons, he is compulsorily hospitalized at a custody and psychiatric treatment hospital (CPTH), which is an institution belonging to the penitentiary system. It is created then the ambiguous figure of the crazy offender, either criminal or mentally ill, who is rarely seen or addressed in discussions and actions in health and law areas. Even less accepted is going to be the person who endangers his parents' lives: the so-called parricide. Starting from theoretical contributions of Michel Foucault, Giorgio Agamben and Jacques Derrida, this study develops discourses and practices that focus on issues of insanity, offense and parricide, and also, about the establishment of the CPTH as containment and referral modality for unimputable people. Accordingly, there will be presented some discussions regarding what people classified as crazy, offenders and parricides who are hospitalized at the CPTH have to say.(AU)

Avaliação da sobrevida livre de doença de pacientes com recidiva loco-regional de carcinoma epidermóide de cavidade bucal e orofaringe submetidos a tratamento de resgate / Assessment of disease-free survival in patients with loco-regional recurrence of squamous cell carcinoma of the oral cavity and oropharynx submitted to salvage treatment

OBJETIVO: A cirurgia de resgate é primeira opção terapêutica, principalmente nas lesões de estadio clínico inicial. O objetivo do estudo é avaliação da sobrevida livre de doença após resgate cirúrgico de tumores de cavidade bucal e orofaringe. MÉTODOS: Estudo retrospectivo de 276 pacientes tratados com cirurgia, sendo que 127 desenvolveram recidiva loco-regional. Noventa e sete pacientes eram de estadiamento clínico inicial e 178 de estadiamento clínico avançado. Vinte e cinco casos de lábio, 173 cavidade bucal e 78 de orofaringe. A radioterapia pós-operatória foi realizada em 121 pacientes com dose média de 60,8 Gy. RESULTADOS: Oitenta e nove pacientes foram submetidos a tratamento de resgate, sendo que 76 destes foram à cirurgia. As recidivas loco-regionais de cavidade bucal foram submetidas ao resgate cirúrgico em 65 por cento casos. A sobrevida livre de doença pós-cirurgia de resgate foi de 13 por cento nas recidivas até seis meses e 48 por cento nas recidivas após 12 meses de seguimento (p=0,0009). O tipo de resgate e o intervalo livre de doença foram fatores independentes de sobrevida na análise multivariada. CONCLUSÃO: A sobrevida livre de doença pós-resgate nos estadios clínicos iniciais (I e II) foi de 70 por cento.

OBJECTIVE: Salvage surgery is the first therapeutic option for recurrent tumors of the mouth and oropharynx, mainly in early stage tumors. This study intends to evaluate the disease free survival interval after salvage treatment for recurrent tumors of the mouth and oropharynx. METHODS: Retrospective analysis of 276 patients with squamous cell carcinoma of the mouth and oropharynx treated with surgery. One hundred and twenty seven patients developed loco-regional recurrence. Ninety-seven were staged as early tumors and 178 as advanced ones. The tumor site was the lip in 25 cases, oral cavity in 173 and oropharynx in 78. Postoperative radiotherapy was indicated in 121 cases with a mean dose of 60.8Gy. RESULTS: Eighty-nine patients underwent salvage treatment (surgery in 76 patients). Loco-regional recurrences were treated with salvage surgery in 65 percent of cases. Disease free survival after salvage surgery was 13 percent in cases with recurrences diagnosed up to 6 months and 48 percent in those who recurred after 12 months of follow-up (p=0.0009). Modality of salvage treatment and the disease free interval were independent variables of survival in the multivariate analysis. CONCLUSION: In cases clinically staged as I and II, the disease free survival in five years after salvage treatment was 70 percent.