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PURPOSE: Drain placement in retromuscular ventral hernia repair is controversial. Although it may reduce seroma formation, there is a concern regarding an increase in infectious complications. We aimed to perform a meta-analysis on retromuscular drain placement in retromuscular ventral hernia repair. METHODS: We performed a literature search of Cochrane, Scopus and PubMed databases to identify studies comparing drain placement and the absence of drain in patients undergoing retromuscular ventral hernia repair. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics. RESULTS: 3808 studies were screened and 48 were thoroughly reviewed. Four studies comprising 1724 patients were included in the analysis. We found that drain placement was significantly associated with a decrease in seroma (OR 0.34; 95% CI 0.12-0.96; P = 0.04; I2 = 78%). Moreover, no differences were noted in surgical site infection, hematoma, surgical site occurrences or surgical site occurrences requiring procedural intervention. CONCLUSIONS: Based on the analysis of short-term outcomes, retromuscular drain placement after retromuscular ventral hernia repair significantly reduces seroma and does not increase infectious complications. Further prospective randomized studies are necessary to confirm our findings, evaluate the optimal duration of drain placement, and report longer-term outcomes.

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A 2-year-old English bulldog presented history of recurrent lower urinary tract disease, refractory to treatment. The Complete Blood Count revealed lymphopenia, hyperproteinemia, and hyperglobulinemia, while urinalysis indicated leukocyturia and bacteriuria. On the abdominal ultrasound, the bladder had a focal wall thickening in its cranial portion, as well as irregular echogenicity and internal margins. A bladder surgical biopsy was performed, indicating the presence of follicular cystitis. Clinical signs disappeared after treatment with a combination of amoxicillin and clavulanic acid, NSAIDs, supplementation with cranberry extract associated with cat's claw (Uncaria tomentosa). Clinical follow-up 12 months after surgery showed remission at all clinical signs. Follicular cystitis in dogs was reported only once worldwide, this case report is the first in Brazil; thus, it may be considered in the differential diagnosis for patients with refractory and recurrent lower urinary tract disease.

Um Bulldog Inglês de 2 anos apresentou história clínica de doença recorrente do trato urinário inferior, refratária ao tratamento. O hemograma revelou uma discreta linfopenia, hiperproteinemia e hiperglobulinemia. Já a urinálise apontou leucocitúria e bacteriúria. Na ultrassonografia, a bexiga apresentava espessamento focal da parede da bexiga em porção cranial, ecogênica e margens internas irregulares. A biópsia cirúrgica da bexiga foi compatível com cistite folicular. Os sinais clínicos desapareceram após o tratamento com uma combinação de amoxicilina - ácido clavulânico, AINEs, suplementação alimentar de extrato de cranberry associado a unha de gato (fitoterápico da planta Uncaria tomentosa). O acompanhamento, 12 meses após a cirurgia, confirmou que o cão estava livre de sinais clínicos. A cistite folicular foi relatada apenas em 1 cão no mundo, sendo esse considerado o primeiro relato no Brasil. Essa enfermidade deve ser considerada um diferencial para pacientes com doença refratária do trato urinário inferior de longa data.

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The toxicity of diphenyl ditelluride (PhTe)2 is associated with its ability to oxidize sulfhydryl groups from biological molecules. Therefore, we evaluated possible molecular mechanisms of toxicity induced by this organochalcogen in Escherichia coli (E. coli) by evaluating oxidative damage markers, relative expression of genes associated with the cellular redox state in bacteria, such as katG, sodA, sodB, soxS, and oxyR, as well as the activity of enzymes responsible for cellular redox balance. After exposure of (PhTe)2 (6, 12, and 24 µg/mL), there was a decrease in non-protein thiols (NPSH) levels, an increase in protein carbonylation and lipid peroxidation in E. coli. Intra- and extracellular reactive species (RS) was increased at concentrations of 6, 12, and 24 µg/mL. The superoxide dismutase (SOD) activity was increased at the three concentrations tested, while catalase (CAT) activity was higher at 12 and 24 µg/mL. The soxS gene showed lower expression at the three concentrations tested, while the oxyR gene was supressed at 24 µg/mL. The katG antioxidant response gene showed lower expression, and sodA and sodB were positively activated, except for sodB at 6 µg/mL. Our findings demonstrate that exposure to (PhTe)2 induced RS formation, NPSH depletion and changes in transcriptional factors regulation, characterizing it as a multi-target compound, causing disruption in cellular oxidative state, as well as molecular mechanisms associated in E. coli.

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BACKGROUND: Uncontrolled occupational exposure to silica is still frequent in Brazil, with several recent records in the state of Minas Gerais. However, few national studies have addressed silica-related diseases other than silicosis. AIMS: To describe the occurrence of the main non-malignant silica-related diseases: silicosis, tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and autoimmune diseases in a specialized outpatient clinic. METHODS: Case series study of 1525 patients exposed to silica, seen between 1984 and 2021, with descriptive findings of clinical and occupational data from the first medical evaluation. RESULTS: Medians of age and exposure time were 47 and 15 years, respectively, and 97% of patients were male. The prevalence of silicosis was 44%, of which 27% had large opacities. The main occupational sectors were underground gold mining (28%), precious and semi-precious stone work (20%), and artisanal mining (9%). Spirometries were abnormal in 55%, with obstructive disorder being the most common finding. COPD (25%), active TB or sequelae (12%), and connective tissue diseases (6%) were diagnosed in patients with and without silicosis. CONCLUSIONS: The percentage of silicosis appears to be alarming, even considering the biases of selective referrals. The patients were relatively young and already had a functional impact, caused not only by silicosis but by one or more silica-related diseases. COPD, TB, and connective tissue diseases proved to be frequent, leading to the need for specifics protocols to investigate them in individuals exposed to silica. By adopting strategies to combat silicosis, the prevention of other silica-related diseases is concomitantly promoted.

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The present report describes a case of conjoined twins of the cephalo-thoraco-omphalopagus deradelphous type in cats. A feline female was transferred to our veterinary hospital as an emergency for dystocic labor. The stillborn was subjected to radiographic evaluation, and a single skull and two complete distinct vertebral columns were found. Anatomopathological examination revealed that the twins presented the head, chest, and umbilicus as the main points of union and were classified as the cephalo-thoraco-omphalopagus type. In addition, the twins had unique and well-developed faces, which allowed them to be classified as deradelphous. This malformation is rare in domestic animals, and to the best of our knowledge, this type has not been reported in felines. Further studies are warranted on this embryonic alteration, primarily because its etiology remains unknown.(AU)

O presente relato descreve um caso de gêmeos siameses do tipo cefalotoraconfalopago deradelfo em gatos. Uma fêmea felina foi atendida na emergência do hospital veterinário em trabalho de parto distócico. Os natimortos foram encaminhados para avaliação radiográfica e constatou-se que apresentavam um único crânio e duas colunas vertebrais completas e distintas. O exame anatomopatológico evidenciou que os gêmeos possuíam cabeça, tórax e umbigo como principais pontos de união, sendo classificados como cefalotoraconfalopago. Além disso, os gêmeos apresentaram face única e bem desenvolvida, o que permitiu classificá-los como deradelfos. Esse tipo de malformação é raro em animais domésticos, e não foi encontrado nenhum trabalho em felino com a mesma classificação do presente relato. Há necessidade de mais estudos sobre essa alteração embrionária, pois a etiologia do processo ainda não foi esclarecida.(AU)

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Tacrolimus (TAC), a calcineurin inhibitor, and everolimus (EVL), an mTOR inhibitor, have been used as immunosuppressive (ISS) drugs in post-kidney transplantation therapy. The objective of this study was to compare the efficacy of EVL vs TAC in the ISS maintenance triple therapy. Ninety-seven kidney transplant patients, who received triple maintenance therapy with TAC, mycophenolate mofetil (MMF), and methyl prednisone (PRED), were evaluated. After four months of post-kidney transplant therapy, 30 patients enrolled in a randomized controlled clinical trial, in which 16 patients received TAC+MMF+PRED (cohort 1), and 14 patients switched to EVL+MMF+PRED (cohort 2). The patients were followed-up for 36 months. Two patients from cohort 1 lost their grafts after one year due to non-adherence. Two patients from cohort 2 had intolerance to mTOR inhibitors and were switched back to TAC from EVL. One case (6.25%) in cohort 1 and three cases (21.43%) in cohort 2 of acute T-cell-mediated rejection was observed. Antibody-mediated acute rejection (ABMAR) was observed in four patients (25.0%) in cohort 1, and antibody-mediated chronic rejection (ABMCR) was observed in two patients (12.50%). One patient from cohort 2 lost the graft after 15 months due to polyomavirus infection. The graft survival rate was 87.50% in cohort 1 and 92.86% in cohort 2. This clinical trial showed that the EVL+MMF+PRED triple maintenance therapy was efficacious compared with TAC during 32 months of follow-up. However, further studies are needed to confirm the efficacy of this regimen for long-term graft survival.

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Tacrolimus (TAC), a calcineurin inhibitor, and everolimus (EVL), an mTOR inhibitor, have been used as immunosuppressive (ISS) drugs in post-kidney transplantation therapy. The objective of this study was to compare the efficacy of EVL vs TAC in the ISS maintenance triple therapy. Ninety-seven kidney transplant patients, who received triple maintenance therapy with TAC, mycophenolate mofetil (MMF), and methyl prednisone (PRED), were evaluated. After four months of post-kidney transplant therapy, 30 patients enrolled in a randomized controlled clinical trial, in which 16 patients received TAC+MMF+PRED (cohort 1), and 14 patients switched to EVL+MMF+PRED (cohort 2). The patients were followed-up for 36 months. Two patients from cohort 1 lost their grafts after one year due to non-adherence. Two patients from cohort 2 had intolerance to mTOR inhibitors and were switched back to TAC from EVL. One case (6.25%) in cohort 1 and three cases (21.43%) in cohort 2 of acute T-cell-mediated rejection was observed. Antibody-mediated acute rejection (ABMAR) was observed in four patients (25.0%) in cohort 1, and antibody-mediated chronic rejection (ABMCR) was observed in two patients (12.50%). One patient from cohort 2 lost the graft after 15 months due to polyomavirus infection. The graft survival rate was 87.50% in cohort 1 and 92.86% in cohort 2. This clinical trial showed that the EVL+MMF+PRED triple maintenance therapy was efficacious compared with TAC during 32 months of follow-up. However, further studies are needed to confirm the efficacy of this regimen for long-term graft survival.

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The present report aimed to describe the main characteristics of the parotid salivary mucocele in an adult male rabbit, which presented with a painless fluctuating mass with fluid content. Owing to the need for repeated fluid drainage, surgical excision was the chosen mode of treatment. Preoperative evaluation included radiography and blood analysis. The patient underwent surgical excision of the affected gland. Inhalation anesthesia was maintained by means of isoflurane and the cardio-respiratory parameters were monitored throughout the surgery. A bipolar electrocautery was used to assist in the incision and polyglactin 910 and nylon were the suture materials used in the wound closure technique. Post-operative medications included analgesics, anti-inflammatory agents and antibiotics. Histopathology of the excised glandular tissue revealed a mixed inflammatory infiltrate, fibroblasts, hemorrhage and hyperemia. The observations in this case suggest that surgical excision of the affected gland is the treatment of choice for the management of mucocele in companion rabbits, which has already been identified for other animals. Periodic acid-reactive Schiff staining confirmed the diagnosis of salivary mucocele. The complementary investigations helped to rule out the differential diagnosis and indicated a favorable prognosis, in view of the fact that the case was successfully resolved without complications or recurrence.(AU)

O presente relato teve como objetivo descrever as principais características da mucocele salivar parotídea em um coelho macho adulto, que apresentou uma massa flutuante indolor e com um conteúdo líquido em seu interior. Devido à necessidade de repetidas punções deste fluido, optou-se pela excisão cirúrgica como forma de tratamento. A avaliação pré-operatória incluiu radiografias e análises sanguíneas. O paciente foi submetido ao tratamento cirúrgico com excisão da glândula afetada. A anestesia inalatória foi mantida com isoflurano e os parâmetros cardio-respiratórios foram monitorados durante a cirurgia. Um eletrocautério bipolar foi utilizado para auxiliar na incisão e os fios poliglactina 910 e nylon foram utilizados na técnica de sutura. As medicações pós-operatórias incluíram agentes analgésicos, anti-inflamatórios e antibióticos. A histopatologia do tecido glandular removido revelou infiltrado inflamatório misto, fibroblastos, hemorragia e hiperemia. As observações neste caso sugerem que a remoção cirúrgica da glândula afetada seja o tratamento de escolha no manejo da mucocele em coelhos de companhia, o que já vem sendo identificado para outros animais. A coloração do ácido periódico reativo de Schiff confirmou o diagnóstico da mucocele salivar. Os exames complementares ajudaram a excluir as doenças que fazem parte do diagnóstico diferencial e indicaram um prognóstico favorável, tendo em vista o fato que este caso foi resolvido com sucesso, sem complicações ou recorrência.(AU)

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