Objective To evaluate the cardiopulmonary and sedative effects of xylazine alone or in combination with methadone, morphine or tramadol in sheep. Study design Experimental, prospective, crossover, randomized, blinded study. Animals Six Santa Inês breed sheep (females) aged 12 ± 8 months and weighing 39.5 ± 7.4 kg. Methods Sheep were sedated with each of four treatments in a randomized, crossover design, with a minimum washout period of 7 days between treatments. Treatments were: X [xylazine (0.1 mg kg−1)]; XM [xylazine (0.1 mg kg−1) and methadone (0.5 mg kg−1)]; XMO [xylazine (0.1 mg kg−1) and morphine (0.5 mg kg−1)], and XT [xylazine (0.1 mg kg−1) and tramadol (5 mg kg−1)]. Each drug combination was mixed in the syringe and injected intravenously. Sedation, heart rate (HR), mean arterial blood pressure (MAP), rectal temperature (RT°C), respiratory rate (fR), arterial blood gases and electrolytes were measured before drug administration (T0) and then at 15 minute intervals for 120 minutes (T15–T120). Results Heart rate significantly decreased in all treatments compared with T0. PaCO2 values in XM and XMO were higher at all time points compared with T0. In treatments X and XM, pH, bicarbonate (HCO3−) and base excess were increased at all time points compared with T0. PaO2 was significantly decreased at T15–T75 in XM, at all time points in XMO, and at T15 and T30 in XT. Sedation at T15 and T30 in XM and XMO was greater than in the other treatments. Conclusions and clinical relevance The combinations of methadone, morphine or tramadol with xylazine resulted in cardiopulmonary changes similar to those induced by xylazine alone in sheep. The combinations provided better sedation, principally at 15 minutes and 30 minutes following administration.

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Esta pesquisa objetivou investigar a existência e a acessibilidade ao prontuário eletrônico na atenção primária à saúde. Trata-se de estudo quantitativo, descritivo e exploratório, realizado em Montes Claros - Minas Gerais, Brasil. Os dados foram coletados entre nos meses de outubro de 2010 ea março de 2011. A análise foi realizada por meio do Statistical Package for The Social Science PASW® 17.0. Foram entrevistados médicos, enfermeiros e cirurgiõães-dentistas de Equipes de Saúde da Família (ESF). Este trabalho foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual de Montes Claros, parecer consubstanciado nº 2011/2010. Os resultados demonstraram a inexistência do prontuário eletrônico.

The sedative and selected cardiopulmonary effects of acepromazine alone or in combination with methadone, morphine, or tramadol were compared in sheep. Six ewes were randomly assigned to treatments: A (0.05 mg/kg acepromazine), AM (A plus 0.5 mg/kg methadone), AMO (A plus 0.5 mg/kg morphine), and AT (A plus 5 mg/kg tramadol). Parameters were assessed before sedative drug administration (baseline) and every 15 minutes thereafter, for two hours. Treatments A and AM were associated with increases in sedation score for 60 minutes and treatments AMO and AT for 30 minutes; however, there were no significant differences between treatments. There was a decrease in mean arterial pressure compared to baseline values in treatment A at 15, 45, 60, and 90 minutes, in treatment AM at 15 minutes, and in treatment AT from 45 to 120 minutes. Arterial blood carbon dioxide pressure increased at all time points in all treatments. Arterial oxygen pressure decreased in treatment AMO at 15, 30, and 120 minutes and in treatment AT at 15–45, 105, and 120 minutes, compared to baseline. Acepromazine alone causes a level of sedation similar to that observed when it is coadministered with opioids methadone, morphine, and tramadol. These combinations did not cause clinical cardiopulmonary changes.

Systemic sclerosis (SSc) is an autoimmune systemic disease characterized by small vessel involvement that leads to tissue ischemia and fibroblast stimulation resulting in accumulation of collagen (fibrosis) in the skin and internal organs. Lipomembranous panniculitis is a peculiar type of fat necrosis and has been reported with clinical conditions, commonly with peripheral vascular diseases. We describe a case of a 43-year-old woman with SSc manifestations, who presented with black scaly skin plaques, associated with thickening of the subcutaneous fat tissue, on the lateral surface of her thighs, her calves, gluteal area and lower abdomen. Biopsy revealed lipomembranous panniculitis. Lipomembranous changes have been seen in connective tissue disorders such as lupus profundus, morphea, systemic sclerosis and panniculitis associated with dermatomyositis, but rarely in thighs, calves, gluteal area and lower abdomen.