No abstract

PURPOSE: To assess comparatively the inflammatory response that follows CO2 or Ringer's lactate joint capsular distension of horses submitted to experimental arthroscopy METHODS: Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention in one joint and fluid distention in the contralateral joint. Synovial fluid was evaluated at 0, six, 12, 24 and 48 hours post-operative. RESULTS: The use of CO2 for arthroscopy causes an acute and mild synovitis alike to the liquid capsular distension, showing similar synovial fluid increase of leukocytes, TP, and TNF-α. Although synovial fluid PGE2 content was higher in joints submitted to CO2 distension, lower levels of hemoglobin and leukocytes oxidative burst after surgery indicates that CO2 arthroscopy decreased intra-articular bleeding and activation of infiltrating leukocytes. CONCLUSIONS: The use of CO2 for arthroscopic examination causes acute and mild synovitis that is similar to the effects caused by the liquid capsular distension. CO2 also seems to decrease intra-articular bleeding and activation of leukocytes.

Summary:  A case of localized cutaneous verrucous sporotrichosis of 26 years duration was studied in São Paulo (Brazil). Clinical aspects and therapeutic measures are discussed. Zusammenfassung:  Es wird über einen Fall von lokalisierter, verruköser Sporotrichose der Haut von 26 Jahren Dauer in São Paulo (Brasilien) berichtet. Klinische Aspekte und Therapiemaßnahmen werden diskutiert.

Autorizo a reprodução parcial ou total desta obra, para fins acadêmicos, desde que citada a fonte. Intra-articular disorders are the leading cause of human and equine athlete's functional incapacity. The development of arthroscopy as a minimal invasive intraarticular surgery was one of the greatest medical advances in sports medicine. The defining characteristic of diagnostic or surgical arthroscopy is featured by minimal tissue damage and broad inspection of internal structures inside the joint associated with low morbidity and complications. Although liquid distension is widely used for arthroscopy, gas distension using carbon dioxide (CO 2 ) has already been described and has pointed out a larger number of advantages of this technique in several studies. The inflammatory response to liquid capsular distension was studied in horses and described as minimal, transient and frequently overwhelmed by its benefits to treatment. However none of these effects had been investigated employing CO 2 during arthroscopic examination. Therefore, the aim of this study was to asses comparatively the inflammatory damage followed by CO 2 joint capsular distension to that of Ringer's lactate solution distension. Nine healthy adult horses of various breeds, genders and ages were used. Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention (group GD) in one joint and fluid distention (group LD) in the contralateral joint, both for 30 minutes. Synovial membrane specimens were collected before, at the end of the procedure and after 48 DADOS INTERNACIONAIS DE CATALOGAÇÃO-NA-PUBLICAÇÃO(hours. Arthrocentesis were aseptically performed at 0, 6, 12, 24 and 48 hours after arthroscopy in order to assess the degree of inflammation within the joint. Synovial fluid was collected for cytological examination and determination of total protein, hemoglobin, TNF-α and PGE 2 contents and evaluation of synovial fluid cell oxidative burst. The synovial membrane was examined histologically and also imunostained for COX-2 and E-selectin. Either distension protocol caused an increase in total white blood cells, total protein, hemoglobin, TNF-α, PGE 2 and also in neutrophil and macrophage oxidative burst. In general terms, those parameters analyzed in the synovial fluid demonstrated minimal differences between groups with only a few isolate significant differences. Histological evaluation of synovial membrane shows a rapid, but mild inflammatory response in both groups. Imunostaining for COX-2 was similar between DG and DL, but showed a weak correlation to the degree of synovitis demonstrated by other parameters. Contrarily, the imunostaining for E-selectin revealed that this molecule is a good biomarker for early inflammatory changes in the synovial membrane. The use of carbon dioxide for capsular joint distension during arthroscopic examination causes an acute and mild synovitis that promotes inflammatory changes in the synovial fluid and membrane that are similar to the effects caused by the liquid capsular distensio...

Veno-occlusive penile dysfunction is not always caused by true organic alterations of the penile venous system. Sometimes this pathology is caused by a dysfunction of cavernous tissue like the vasospasm. The aim of this study was to evaluate correctly this last pathology in order to discover true veno-occlusive dysfunction of the penis. It allows a better therapeutic strategy of these pathologies to be obtained.

Smoke is one of the most important causes of vascular diseases; these pathologies are also the most important causes of death in industrialised countries. Smoke causes impotence because it provokes irreversible organic arterial and/or venous alterations. Sometimes however it seems that smoke is able to determine reversible functional alterations of the cavernous system. The aim of this study was to show the significance of smoke in the anamnesis of certain patients and the importance of giving up smoking for a definitive diagnosis and therapy of reversible or irreversible impotency.

Background Cystocele is connected to an ingravescent relaxation of uretrovesical support system. During surgical correction of this disease, a mesh has been introduced to strengthen weak tissue. The aim of the study was to compare different material aspects and various devices. Methods From June 2002 to December 2008, 80 patients underwent surgical correction for high-degree cystocele. None of the patients had stress-incontinence. All the patients were studied with cistography and urodynamic test. Three different kinds of mesh were employed, such as: Goretex (26 pt.), Prolene (27 pt.), Bovine Pericardium (27 pt.). During surgery the mesh have been modelled if necessary and fixed by detached sutures. Results By comparing the devices: in Goretex group there were excellent results about anatomical correction, in the follow-up too (6 months), good continence and an improving of quality of life; in Prolene group no post-surgery complication, 3 pts. referred urge incontinence resolved in about 3 months. After 6 months a subset of patients reported sensation of foreign vulvar body and moderate dyspareunia; in Bovine Pericardium group we had an intra-operatory difficulty, for its softness a high risk to tear the net itself. No post-surgery complications. No urinary symptoms. After 3 months 5 of the patients referred a sensation of foreign vulvar body and dyspareunia. After 6 months, 4 patients still have the same sensation. Conclusion We hypothesize that Goretex mesh is an excellent device for its operator manageability, good anatomical results, and good tolerability. Further investigation is warranted to determine the effect of each of these techniques.

Objetivo: Analisar as diferentes formas de diagnóstico e tratamento de cistos subcondrais em eqüinos. Fontes Consultadas: Foram pesquisadas as bases de dados DEDALUS, PUBMED e o acervo da Biblioteca da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, São Paulo, SP, pelo período retrospectivo de 18 anos. Síntese dos Dados: As lesões císticas subcondrais (LCS), juntamente da osteocondrite dissecante, são consideradas manifestações comuns da osteocondrose nos eqüinos. As LCS no côndilo mediai do fêmur são as mais freqüentemente encontradas, porém, podem ocorrer em múltiplos locais, incluindo: metacarpo, metatarso, rádio, escápula, úmero, tíbia, fêmur, carpo, tarso, falanges e sesamóides. normalmente acometem animais jovens, em crescimento, com idade variando de seis meses a dois anos, que apresentam claudicação após iniciarem treinamento. Estudos clínicos indicam que o diagnóstico das LCS é possível por exame radiográfico, exame ultra-sonográfico, cintilografia e a ressonância magnética. Adebridagem cirúrgica via artroscópica ou por artrotomia, o tratamento conservativo e o uso de corticoides intralesionais são citados como opções de tratamento. Conclusões: Embora existam modernas tecnologias - como a ressonância magnética e a cintilografia, capazes de realizar diagnósticos precoces dessas lesões -, o exame radiográfico ainda é a modalidade diagnóstica mais utilizada nesses casos, seguido pela ultrassonografia. Com base no que foi revisto sobre os resultados obtidos com tratamento cirúrgico e conservativo, podemos considerar que são candidatos à curetagem cirúrgica os animais com sintomatologia clínica relacionada à LCS, de preferência por artroscopia, uma vez que dificilmente esses animais retornarão à atividade atlética sem o tratamento cirúrgico.