RESUMO -A articulação acetábulo-femoral é a mais acometida pela luxação traumática em cães e gatos, representando 50% de todas as luxações. Apesar da literatura médica veterinária descrever inúmeras técnicas para a redução da luxação, são freqüentes as recidivas pós-operatórias e as complicações como fibrose restritiva pós-ostectomia do colo femoral. Considerando-se o elevado número de cães com luxações acetábulo-femorais e as complicações pós-cirúrgicas em potencial, este experimento visa estabilizar a articulação acetábulo-femoral com a utilização de membrana biológica. Na primeira etapa do experimento, 10 cães sem raça definida, com peso médio de 10 kg foram submetidos à artrotomia e ressecção do ligamento redondo, iatrogenizando-se assim a luxação acetábulo-femoral direita. Quinze dias após procedeu-se a artroplastia, reconstituindo-se o ligamento redondo com um segmento de pericárdio bovino conservado em glicerina 98%. Para estabilizar a articulação foram feitos dois orifícios, na posição de 10 e 1 horas, comunicando a epífise, colo e cabeça femorais ao acetábulo. Na seqüência dois segmentos de pericárdio medindo 10cm de comprimento por 1cm de largura foram inseridos nos trajetos, sendo que suas extremidades foram fixadas às fáscias musculares e periósteo através de suturas interrompidas simples com fio de polipropileno n º 2-0. No período pós-operatório além da administração de analgésicos, antibióticos e dos cuidados com a ferida cirúrgica, o membro pélvico direito foi imobilizado com bandagem de Ehmer durante 14 dias. Após a remoção da bandagem constatou-se atrofia por desuso temporária, pois o paciente deambulava normalmente após 2 semanas de fisioterapia. Nos exames radiográficos realizados nos 15º e 45º dias não observou-se luxação acetábulo-femoral, podendo-se concluir que a artroplastia com membrana biológica é uma técnica que pode ser indicada para reduzir luxação acetábulo-femoral, em cães.Palavras chaves: artroplastia acetábulo-femoral; luxação coxofemoral; cão.ABSTRACT -The coxofemoral is the more affected articulation by traumatic luxation in dogs and cats, representing about 50% of all the luxations cases in these species. In spite of de veterinary medical literature describe countless of techniques for the reduction of luxatio, are very frequent postoperative recurrence and complications as restrictive fibrosis after ostectomy of the femur head.Considering the high number of dogs with coxofemoral luxations and the potential post-surgical complications, this experiment aims to use a technique able to stabilize the coxofemural articulation with the use of biological membrane. In the first stage of the experiment, 10 dogs without defined race, with a medium weight of 10 kg were submitted to incision at the right joint followed by resection of the round ligament, promoting, this way, an acetabulo-femoral luxation. Fifteen days after, arthroplasty was performed by the reconstitution of the round ligament with a segment of bovine pericardium preserved in glycerin 98%. In order stabilize the articul...

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Aim:The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units.Method: An online survey was circulated amongst European Society of Coloproctology members in 2019-2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 ('rarely') to 4 ('always'). Respondents were also asked to recall whether practice had changed since 2017.Subgroup analyses based on hospital characteristics were conducted.Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they 'most often' or 'always' adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from 'rarely' to 'always' in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017.Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.

Objective To determine if the intrapartum use of a 5% glucose-containing intravenous solution decreases the chance of a cesarean delivery for women presenting in active labor. Methods This was a multi-center, prospective, single (patient) blind, randomized study design implemented at 4 obstetric residency programs in Pennsylvania. Singleton, term, consenting women presenting in active spontaneous labor with a cervical dilation of <6cm were randomized to lactated Ringer's with or without 5% glucose (LR versus D5LR) as their maintenance intravenous fluid. The primary outcome was the cesarean birth rate. Secondary outcomes included labor characteristics, as well as maternal or neonatal complications. Results There were 309 women analyzed. Demographic variables and admitting cervical dilation were similar among study groups. There was no significant difference in the cesarean delivery rate for the D5LR group (23/153 or 15.0%) versus the LR arm (18/156 or 11.5%), [RR (95%CI) of 1.32 (0.75, 2.35), P=0.34]. There were no differences in augmentation rates or intrapartum complications. Conclusions The use of intravenous fluid containing 5% dextrose does not lower the chance of cesarean delivery for women admitted in active labor.

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