Background: The incidental discovery of an adrenal mass raises the problem of distinguishing the frequent benign masses from the infrequent malignant ones that require surgery. At present, univocal guidelines to approach this problem are not available. The aim of the present study was to perform a multicentric retrospective analysis of adrenal masses incidentally discovered (adrenal incidentalomas). Patients and Methods: Hospital records of adrenal incidentalomas diagnosed over a 15-year period in 29 surgical and medical centers in Italy were scrutinized. Collected cases were 1,013, and 887 were analyzed. Results: The majority of patients were in the 5th and 6th decade and females were predominantly affected. The frequency of adrenocortical cancer was 12% among operated patients (316 cases). The tumor diameter was highly correlated with the risk of malignancy, as well as the CT characteristics such as density, shape and margins. The frequency of pheochromocytoma was 10% among operated patients. Conclusions: The occurrence of incidentally discovered adrenocortical carcinomas and pheochromocytomas is not rare. Evaluation of the mass size and CT characteristics are simple and effective methods to differentiate malignant lesions. Biochemical screening for pheochromocytoma is mandatory before surgery.

Pharmacopuncture, the injection of subclinical doses of drugs into acupoints reduces drug undesirable side effects, residues in animal consumption products and treatment costs in large animals. Acepromazine (Acp) produces several undesirable effects, such as hypotension. Previous studies with the injection of 1/10 of Acp dose in dog acupoints showed its advantage for sedation, minimizing undesirable effects. Eight horses were randomly submitted to four different treatment protocols according to a Latin Square double-blind design: (i) 0.1 ml kg−1 of saline subcutaneously injected at the cervical region, (ii) 0.1 mg kg−1 of Acp injected subcutaneously at the cervical region, (iii) 0.01 ml kg−1 of saline injected into GV1 acupoint (aquapuncture) and (iv) 0.01 mg kg−1 of Acp injected into GV1 acupoint (pharmacopuncture). Heart rate, respiratory rate, head height and degree of sedation were measured before and at 30, 60 and 90 min after treatments. Signs of sedation were observed in all treated groups at 30 min and only in 1/10Acp-GV1 at 60 min after the treatments. Only the group treated with 0.1 mg kg−1 of Acp s.c. had significantly lower values of head height at 30 min. Respiratory rate tended to reduce in all groups but was significantly lower only in horses treated with 0.1 mg kg−1 of Acp s.c. Heart rate remained unchanged in all groups. Acp-pharmacopuncture on GV1 in horses produced a mild sedation when compared with the conventional dose of Acp. More investigations are necessary to determine the optimal dosage of Acp-pharmacopuncture for sedation in horses.

O objetivo deste estudo foi analisar a eficácia e os métodos de acupuntura utilizados no tratamento dedoenças neurológicas em cães, bem como discutir a abordagem holística dos padrões de doençasencontrados nestes pacientes. Foram estudados 43 casos de doenças neurológicas em cães. A cadasessão semanal e a cada melhora clínica ou observação diferente feita pelo proprietário do paciente, oneurologista veterinário fazia uma reavaliação neurológica. O tratamento foi considerado eficaz quandoos pacientes foram capazes de recuperar seu controle neuromuscular ou a capacidade normal dedeambulação. Todos os pacientes foram submetidos a exames complementares e somente animaiscom diagnósticos conclusivos foram incluídos nesta investigação. As doenças neurológicas maisencontradas foram hérnia de disco, espondilose e trauma medular, sendo que alguns pacientesapresentaram mais de uma afecção simultaneamente. Noventa e três por cento dos animais melhorarame sete por cento não apresentaram resposta significativa após o tratamento com acupuntura. Estesúltimos foram acometidos por doenças como síndrome da cauda equina, “síndrome de cambaleios ouoscilações” e hérnia de disco com ausência de dor profunda. A acupuntura com agulha simples foi atécnica mais utilizada para os tratamentos, com cerca de 46% de prevalência. O número de sessõessemanais de acupuntura variou de 6±4 até 25±22. Conclui-se que o estímulo de acupontos utilizandodiferentes métodos foi eficiente no tratamento dos padrões ocidentais das doenças neurológicas dosanimais estudados nesta investigação e que um bom diagnóstico diferencial ocidental e oriental é necessáriopara o sucesso no tratamento de doenças neuromusculares.

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