Summary Therapeutics are often administered to donkeys based on dosage and intervals recommended for horses because very few drugs have donkey‐specific label indications. Yet differences between donkeys and horses in drug distribution, metabolism and elimination have been noted for most therapeutic agents studied. These differences can be partially explained by the donkey's unique physiology. Since their ancestors evolved in a desert environment, the modern donkey exhibits qualities that allow them to tolerate dehydration better than the horse and recover more quickly from its effects. Fluid balance and body water compartment partitioning differ from the horse and may have implications regarding drug distribution. Since donkeys are preferential browsers, differences in diet may have influenced evolutionary differences in metabolic disposition of drugs. It is important to acknowledge these differences when designing dose regimes for donkeys based on horse protocols in order to avoid either lack of efficacy or toxicity.
Background: Thymomas are epithelial neoplasms of the thymus, although lymphocyte infiltration is common. Histological features are not sufficient to define its biological behaviour, which is dependent of clinical criteria of invasiveness and resectability. Myasthenia gravis may happen as a paraneoplastic syndrome in up to 47% of canine thymomas. Thisarticle aims at reporting a case of thymoma associated with myasthenia gravis in a dog, emphasizing the morphological, phenotypical and therapeutical aspects.Case: A 7-year-old, male Labrador, was presented with a history of acute dyspnea and exercise intolerance. The physical examination revealed a “red-brick” mucousa, tachycardia and cardiac and pulmonar hypofonese. Chest radiographs revealed an area of increased radiopacity in the cranial mediastinum without a plane of separation to the heart. The eccodopplercardiogram exam identified a poorly delimited mass adjacent to the base of the heart, measuring 9.5x6.8cm. Computed tomographydemonstrated it as an expansive neoformation (9.5x6.5x7.8cm). Mass was removed through intercostal thoracotomy and the removed tissue was submitted to histopathology with a diagnosis compatible with type AB thymoma (mixed). Immunohistochemistry was positive for AE1/AE3 citokeratin in 90% of epithelial cells, confirming tumour origin. Tumour infiltrating lymphocytes were positive for CD79a (70%) and CD3 (20%). The proliferation index (Ki-67 imunolabeling) was 60%. About 45 days after surgery the patient was presented with generalized muscle weakness and regurgitation, with confirmed megaesophagus on chest X-ray. Treatment with pyridostigmine was initiated because of suspected myasthenia gravis, and complete remission of the neurological signs occurred within a month. A chemotherapeutic protocol with carboplatin wasthen instituted. After four sessions, a new thoracic radiograph revealed tumour recurrence in the cranial mediastinum. Therefore, metronomic chemotherapy was started sequentially with oral chlorambucil and firocoxib. Patient remained well for nine months when regurgitation and muscle weakness re-initiated, even with pyridostigmine treatment. New chestX-ray demonstrated increased tumour mass and the owner decided for euthanasia, resulting in a survival time of 368 days.Discussion: The prognosis of the thymoma depends on the histological type, clinical staging and presence of paraneoplastic syndromes. Due to the heterogeneity of the cases, there are not enough studies available to compare the animals submitted to different therapeutic modalities. In humans, when possible, and in the absence of metastases, complete surgical resection is the standard treatment followed by chemotherapy and/or adjuvant radiotherapy. In dogs, surgical resection of thymomasshould be considered, despite the invasiveness detected in imaging studies. The presence of paraneoplastic syndromes, such as myasthenia gravis, are commonly associated with worse prognosis, however, as evidenced in this case, pyridostigmine was useful in maintaining the neuromuscular function and patient´s quality of life, along with surgery and adjuvant chemotherapy, which probably contributed to the increase of the expectation of life. Further studies are necessary to evaluate the efficacy of adjuvant chemotherapy in maximum tolerated and metronomic dosage, for thymic neoplasms in dogs.Keywords: thymus, neoplasia, paraneoplastic syndrome, carboplatin, cyclophosphamide.
Trata-se de uma pesquisa quantitativa descritiva realizada em uma maternidade escola do Município de Natal, Rio Grande do Norte e teve como objetivo caracterizar a assistência obstétrica à parturiente através dos indicadores tipo de parto, presença do acompanhante durante o trabalho de parto, presença do acompanhante na sala de parto, amamentação em sala de parto, encaminhamento ao alojamento conjunto, acolhimento, privacidade e estrutura física. A amostra constou de 351 mulheres em 12 horas pós-parto e a pesquisa foi aprovada e respeitou preceitos éticos. Como resultado verificou-se que a maioria das parturientes era jovem, entre 20 e 30 anos (56%), predominância de partos cesarianos (65%) e ausência de acompanhantes em sala de parto (76%). Conclui-se que é necessária atender à legislação específica, oferecendo atenção integral à saúde da mulher, privacidade, conforto, acolhimento, escuta ativa e resolutiva.
Pyometra is a common disease in intact female dogs and can cause glomerulopathy and tubular injury. This study aimed to evaluate kidney injury in female dogs with pyometra, as well as progression of the injury during treatment and the markers of this condition. This study analyzed 20 intact female dogs with both clinical and sonographic diagnosis of pyometra. Dogs were treated with intravenous fluids and antibiotics, and an ovariohysterectomy was performed. The following parameters were assessed at eight separate time points: blood pressure; serum creatinine, phosphorus, and urea levels; urinalysis and urinary biochemical parameters [urinary gamma-glutamyl transferase (uGGT) and urinary protein-to-creatinine ratio (UPCR)]; glomerular filtration rate (GFR); and urine output. All dogs showed some degree of kidney injury at the time of pyometra diagnosis. This was transient in most animals, resolving with treatment of the pyometra. Measurement of uGGT and UPCR identified renal parenchymal injury, helping to determine the prognosis of the animals analyzed in the present study.
Objective: to identify the degree of satisfaction of puerperal women regarding the Quality of Care (QOC) in Rooming-in (RI) of a public maternity. Method: descriptive quantitative research with 351 women who answered a structured interview that obeyed legal procedures for research involving human beings. Data analysis was performed by means of the Likert scale. The study was approved by Ethics Research Committee of the Federal University of Rio Grande do Norte, under the Protocol No. 034/11-P and certificate presentation to Ethics Assessment nº. 0043.0.051.000-11. Results: there was satisfaction with the care, multidisciplinary team, guidelines, visiting hours and dissatisfaction for the indicators: physical structure, privacy, comfort and ventilation. Conclusion: it is concluded that most users are satisfied with the health services although there were complaints with the ambiance. The opinion of the mothers is important and reflects the actions that have been developed in the health sector, directing to a planning that offers quality, once that the RI is characterized as a hospital system and should provide cozy space with comfort, privacy, infrastructure to have adequate assistance
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