Circulatory Changes Research Articles

Pathomorphological studies on renal disorders in sheep

Small ruminants are a potential source of meat, milk, fibre, hide and manure for rural landless, small and marginal farmers and hence provide a dependable source of income to 40 per cent of rural population below the poverty line in India. Numerous factors are responsible for economic losses in the sheep industry. Among them, problems related to health are of utmost importance. Major sources of etiologies/affections are from pathogenic organisms, nutrition, xenobiotics or toxins whose effects are varied, which may be localized or generalized, cumulative or chronic, acute, sporadic or outbreaks, etc. Kidney is one of the most intriguing and challenging organ to a pathologist, with regards to the altered structure and disturbed function. A total of 110 sheep mortalities were necropsied and of which 102 kidneys showed abnormalities, eight kidneys were macroscopically and microscopically showed normal. Based on gross and histopathological features, renal disorders were recognized as circulatory changes, degenerative and necrotic changes, inflammatory and other changes. Frequently encountered circulatory changes were congestion (67.65%) and haemorrhage (18.63%). Degenerative and necrotic changes included cell swelling (29.41%), hydropic degeneration (16.67%), fatty changes (0.95%), hyaline degeneration (1.96%) and coagulative necrosis (19.61%). Inflammatory conditions were glomerulonephritis (1.96%), diffuse interstitial nephritis (0.98%), focal interstitial nephritis (4.90%), multifocal interstitial nephritis (2.94%) and abscess (0.95%). Other changes included polycystic kidney (0.98%).

Chapter 28 - Hemodynamics in acute stroke: Cerebral and cardiac complications

Hemodynamics is the study of blood flow, where parameters have been defined to quantify blood flow and the relationship with systemic circulatory changes. Understanding these perfusion parameters, the relationship between different blood flow variables and the implications for ischemic injury are outlined in the ensuing discussion. This chapter focuses on the hemodynamic changes that occur in ischemic stroke, and their contribution to ischemic stroke pathophysiology. We discuss the interaction between cardiovascular response and hemodynamic changes in stroke. Studying hemodynamic changes has a key role in stroke prevention, therapeutic implications and prognostic importance in acute ischemic stroke: preexisting hemodynamic and autoregulatory impairments predict the occurrence of stroke. Hemodynamic failure predisposes to the formation of thromboemboli and accelerates infarction due to impairing compensatory mechanisms. In ischemic stroke involving occlusion of a large vessel, persistent collateral circulation leads to preservation of ischemic penumbra and therefore justifying endovascular thrombectomy. Following thrombectomy, impaired autoregulation may lead to reperfusion injury and hemorrhage.

Segmental Volume and Circulatory Changes that Occur in Humans and Rhesus Monkeys During 4 Hour, -6 Degree Head Down Tilt.

Nonhuman primates are often used to investigate physiologic processes that occur in man during aerospace/cardiovascular orthostatic research. Few studies have compared nonhuman primates and man under identical test conditions to assess the degree of similarity between the two species. Impedance plethysmography was used to measure calf, thigh, pelvic, thoracic, upper arm, and lower arm volume changes in eight rhesus (Macacca Mulatta) monkeys and twelve human subjects during four hour exposures to −6 degree head down tilt (HDT).

Non-Invasive Hemodynamic Monitoring in TAVI-Patients Reveals More Pronounced Early in-Hospital Circulatory Recovery for Low-Gradient Aortic Stenosis

Background: Little is known about differences and changes in hemodynamic in patients with Low-gradient (LG) and Non-Low-Gradient (NLG-) Aortic valve Stenosis (AS). Our current observation reveals such specific changes using the non-invasive NICaS® electrical bio-impedance monitoring system. Aim: Primary goal was to illustrate possible differences in subgroups of LG-AS and NLG-AS patients and to discriminate post-procedural adaptive mechanisms for the two subgroups. Methods and findings: In 99 unselected patients subjected to TAVI, NICaS® measurements were performed at baseline, 6 to 8 hours after TAVI and before discharge. 46 patients had a mean pressure gradient <40 mmHg corresponding to a LG-AS. Primary endpoint was defined as the change in cardiac index between the LG-AS and NLG-AS group at discharge. Cardiac index increased in both groups as compared with baseline [from 2.52 ± 0.75 to 3.45 ± 1.15 L/min/m2 (P=0.00014) in LG-AS and form 2.70 ± 0.97 to 3.08 ± 0.94 L/min/m2 (P=0.0198) in NLG-AS]. Increase in cardiac index was more pronounced in LG-AS with a difference between the groups of 0.52 ± 0.32 L/min/m2 (P=0.041) at discharge. Additionally, LG-AS patients showed higher increase in stroke volume index, cardiac power index, and Granov-Goor index and decrease of total peripheral resistance and total peripheral resistance index as secondary parameters. One limitation of our study is the observational design in a small cohort of patients. Therefore, larger trials are warranted to confirm our findings and to show whether there is prognostic relevance for long term outcomes of the different subgroups. Conclusion: NICaS® monitoring represents an accurate non-invasive bedsidetool to discriminate adaptive circulatory changes in subgroups of aortic stenosis patients subjected to TAVI. Hemodynamic parameters recovered more effectively in LG-AS patients after procedure. Whether a measurement-guided approach might be used for tailored peri-procedural management and could have long-term prognostic influence for AS subgroups remains to be elucidated.

Gas embolism and massive blunt force trauma to sea turtles entrained in hopper dredges in North and South Carolina, USA.

Decompression sickness (DCS) has been described mainly in loggerhead turtles Caretta caretta bycaught in trawls and gillnets. Here we present cases of gas emboli (GE) in 8 green turtles Chelonia mydas and 2 Kemp's ridleys Lepidochelys kempii entrained in hopper dredges that were working at 8.8-15.2 m depths during shipping channel maintenance or beach renourishment activities. Turtle weights ranged from 2.2 to 6.7 kg. All were found alive with blunt force injuries from passage through the dredge and were taken to rehabilitation facilities. Four green turtles died or were euthanized within 24 h. Six turtles survived. Radiographic or ultrasonographic evidence of GE was detected in 4 turtles, including 3 mortalities. Computed tomography (CT) revealed perirenal and cervical GE in 4 turtles, including 1 mortality. No GE were detected in 2 of the survivors. Upon necropsy, GE were found in mesenteric vessels, the right atrium, and kidneys. Histopathology confirmed that tissues were in a good state of preservation without evidence of bacterial overgrowth or putrefactive gas formation. Death likely resulted primarily from massive tissue trauma from the dredge, but moderate GE could have led to DCS and complicated recovery. The surviving turtles weighed less than those that did not survive. Besides hypothesized stress/exercise-induced circulatory changes of blood through the lungs and pressure reduction of forced surfacing from depth, drastic pressure change within the dredge pipes before and after the pump could contribute to GE. Hopper dredge entrainment is an additional cause of GE and potential DCS in sea turtles.

Finding Out The Neurological Consequences Of Covid-19

Introduction: Since the first official case of COVID-19 in China in December 2019, researchers have been trying to uncover the mechanism of action of the severe acute respiratory syndrome Coronavirus 2 (Sars-CoV-2), which attacks several organs in addition to the lungs and causes circulatory changes that can lead to death not only from lung failure but also due to commitment of other organs.

Особливості плацентарних структур у жінок з передчасними пологами

The objective: study of histochemical, morpho-functional features of placentas in premterm birth at different gestational ages. Materials and methods. We examined 172 pregnant women, who were hospitalized and gave birth in the Perinatal Center of Kyiv during 2016–2018 years at 24–33 weeks of gestation. The control group included 40 women with a physiological course of singleton pregnancy at 38–41 weeks of gestation. Patients of the experimental group were divided into three subgroups: the first consisted of 46 pregnant women at 22–27 weeks of gestation, the second one – of 44 pregnant women at 28–33 weeks, the third one – of 42 pregnant women at 34–37 weeks. Clinical and statistical analysis of exchange cards of pregnant women (form 113/y) and birth histories (form 096/0) of mothers of all groups was performed. For morphofunctional assessment of placenta in the study histological (staining with hematoxylin-eosin after Van-Gizon) and immunohistochemical (indirect streptavidin-peroxidase – for detection of progesterone receptor’s expression level) methods were used. Results. No significant age difference was found between the study groups. More than 66.5% of patients had a second pregnancy. Obstetric and gynecological history of women are burdened in most cases by the following conditions: previous premature birth, miscarriage, inflammatory diseases, extragenital pathology (diseases of the urinary and endocrine systems). When analyzing the results of histological examination of the placenta in patients whose pregnancies resulted in childbirth at 22–27 weeks, inflammatory changes in the placenta were found in 84.8%, and in women in labor at 28–33 weeks – only 56.8%. At 34–37 weeks of gestation, the percentage of inflammatory changes in placental structures do not have a significant difference with the control group (30.9% and 27.5%, respectively; p≤0.05). With gestational age increase the percentage of involutive-dystrophic changes in the placenta decreases, the number of circulatory disorders increases, and accelerated chorionic maturation is observed. Analysis of the data of monoclonal antibodies’ to progesterone receptors expression in the structures of the placenta depending on gestational age revealed the greatest expression in decidual membranes (55%) in very early preterm birth, which had a significant difference with the control group (14%), (p&lt;0.05) . In women of group II, the level of expression of progesterone receptors was reduced (30%), but had no significant difference with group III of the studied placentas (26%), (p&gt;0.05). Immunohistochemical examination of the progesterone receptors (PR) shows a reaction in the epithelium and stem cells of the stroma, intermediate and terminal villi; in amniotic membranes and extravillous cytotrophoblast; in the vascular endothelium. Conclusion. In very early preterm birth, inflammatory changes and significant expression activity of progesterone receptors predominate in placental structures. During childbirth at 33–37 weeks of gestation the most common disorders are maturation of the villous chorion, combined with circulatory and involutive-dystrophic changes. Keywords: preterm labor, placenta, histological changes, immunohistochemistry, progesterone receptors.

Methane Exhalation Can Monitor the Microcirculatory Changes of the Intestinal Mucosa in a Large Animal Model of Hemorrhage and Fluid Resuscitation.

Background: Internal hemorrhage is a medical emergency, which requires immediate causal therapy, but the recognition may be difficult. The reactive changes of the mesenteric circulation may be part of the earliest hemodynamic responses to bleeding. Methane is present in the luminal atmosphere; thus, we hypothesized that it can track the intestinal circulatory changes, induced by hemorrhage, non-invasively. Our goal was to validate and compare the sensitivity of this method with an established technique using sublingual microcirculatory monitoring in a large animal model of controlled, graded hemorrhage and the early phase of following fluid resuscitation.Materials and Methods: The experiments were performed on anesthetized, ventilated Vietnamese minipigs (approval number: V/148/2013; n = 6). The animals were gradually bled seven times consecutively of 5% of their estimated blood volume (BV) each, followed by gradual fluid resuscitation with colloid (hydroxyethyl starch; 5% of the estimated BV/dose) until 80 mmHg mean arterial pressure was achieved. After each step, macrohemodynamic parameters were recorded, and exhaled methane level was monitored continuously with a custom-built photoacoustic laser-spectroscopy unit. The microcirculation of the sublingual area, ileal serosa, and mucosa was examined by intravital videomicroscopy (Cytocam-IDF, Braedius).Results: Mesenteric perfusion was significantly reduced by a 5% blood loss, whereas microperfusion in the oral cavity deteriorated after a 25% loss. A statistically significant correlation was found between exhaled methane levels, superior mesenteric artery flow (r = 0.93), or microcirculatory changes in the ileal serosa (ρ = 0.78) and mucosa (r = 0.77). After resuscitation, the ileal mucosal microcirculation increased rapidly [De Backer score (DBS): 2.36 ± 0.42 vs. 8.6 ± 2.1 mm−1], whereas serosal perfusion changed gradually and with a lower amplitude (DBS: 2.51 ± 0.48 vs. 5.73 ± 0.75). Sublingual perfusion correlated with mucosal (r = 0.74) and serosal (r = 0.66) mesenteric microperfusion during the hemorrhage phase but not during the resuscitation phase.Conclusion: Detection of exhaled methane levels is of diagnostic significance during experimental hemorrhage as it indicates blood loss earlier than sublingual microcirculatory changes and in the early phase of fluid resuscitation, the exhaled methane values change in association with the mesenteric perfusion and the microcirculation of the ileum.

Techniques of left atrial appendage tomography for planning intervention treatment of atrial fibrillation

Due to intracardiac circulatory changes atrial fibrillation creates conditions for thrombus formation in the left atrial appendage (LAA). The presence of thrombus in LAA is poor prognostic factor of subsequent cardiovascular events. It is the source of up to 64% of ischemic stroke cases, and concomitant anticoagulant therapy leads to a high frequency of hemorrhagic conversion. For patient with symptomatic and drug-refractory arrhythmia is recommended surgical rhythm correction or electrical cardioversion. There is a high risk of cardioembolic stroke during the intervention, so it is necessary to exclude LAA thrombosis at pre-operation stage. The main method of LAA visualization is transesophageal echocardiography, but today computed tomography and, less, magnetic resonance tomography become important. The purpose of this review is to analyze the possibilities of each visualisation technique and their role in the diagnostic algorithm when examining patients before catheter ablation of atrial fibrillation sources.

REDUCED SYSTEMIC AND CEREBRAL AND INCREASED PULMONARY BLOOD FLOW FROM LATE FETAL TO PREOPERATIVE NEONATAL LIFE IN HYPOPLASTIC LEFT HEART SYNDROME

Fetuses with hypoplastic left heart syndrome (HLHS) have cerebral blood flow patterns suggestive of brain sparing. They may become unstable following birth secondary to pulmonary over-circulation, pathophysiology which may also impair cerebral blood flow. The impact of the perinatal circulatory changes on peripheral, including cerebral, blood flow has not to date been well examined in HLHS.

Recommendations for the treatment of severe coronavirus disease 2019 based on critical care ultrasound

Severe patients with coronaviras disease 2019 (COVID-19) are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects: (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancement, stress cardiomyopathy, diffuse cardiac depression and other multiple abnormalities; (3) Critical ultrasonography helps with initiating early treatment in the suspect patient, screening confirmed patients after intensive care unit admission, early assessment of sudden critical events, rapid grading assessment and treatment based on it; (4) Critical ultrasonography helps to quickly screen for the etiology of respiratory failure in patients with COVID-19, make oxygen therapeutic strategy, guide the implementation of lung protective ventilation, graded management and precise off-ventilator; (5) Critical ultrasonography is helpful for assessing the circulatory status of patients with COVID-19, finding chronic cardiopulmonary diseases and guiding extracorporeal membrane oxygenation management; (6) Critical ultrasonography contributes to the management of organs besides based on cardiopulmonary oxygen transport; (7) Critical ultrasonography can help to improve the success of operation; (8) Critical ultrasonography can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19. In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19 patients therapy.

Transmitted-light plethysmography detects changes in human pulpal blood flow elicited by innocuous tooth cooling and foot heating

ObjectivesThe present study aimed firstly, to investigate whether pulpal circulatory changes elicited by innocuous tooth cooling and foot heating can be monitored with transmitted-light plethysmography (TLP), which detects pulpal blood volume changes, and secondly, to assess the effect of autonomic nervous control on TLP values. DesignThirty sound permanent maxillary incisors in 30 healthy volunteers (age: 25–35 years) were examined. The photodiode and 525-nm light-emitting diode of a prototype TLP system (J. Morita) were fixed onto the palatal and labial side, respectively, of each tooth with a custom-made acrylic cap. The subjects were stimulated for 10 min by cold (0 °C) water application to the experimental tooth or 30 min by foot heating with a footbath (43 °C). TLP and finger plethysmography were simultaneously recorded before (baseline), during and after stimulation. TLP values and autonomic nerve activity were statistically analyzed using a repeated measures one-way ANOVA followed by Tukey post-hoc test and partial correlation analysis. ResultsTLP values decreased significantly after both innocuous stimuli (P < 0.05), and returned to their baseline levels shortly after the removal of the stimuli. There was no significant serial correlation between the autonomic nervous activity and TLP values (P > 0.05). ConclusionTLP was able to monitor the pulpal circulatory changes evoked by innocuous stimuli. Systemic autonomic nervous control mechanisms were not associated with the pulpal circulatory changes, suggesting the involvement of other mechanisms, such as somatosensory-sympathetic nervous control.

Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature.

Acute viral respiratory infections are the main infectious disease in the world. In 2020, a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), coronavirus disease 2019 (COVID-19), became a global pandemic. The immune response to the virus depends on factors such as genetics, age and physical state, and its main input receptor is the angiotensin-converting enzyme 2. The practice of physical exercises acts as a modulator of the immune system. During and after physical exercise, pro- and anti-inflammatory cytokines are released, lymphocyte circulation increases, as well as cell recruitment. Such practice has an effect on the lower incidence, intensity of symptoms and mortality in viral infections observed in people who practice physical activity regularly, and its correct execution must be considered to avoid damage. The initial response is given mainly by type I interferons (IFN-I), which drive the action macrophages and lymphocytes, followed by lymphocyte action. A suppression of the IFN-I response has been noted in COVID-19. Severe conditions have been associated with storms of pro-inflammatory cytokines and lymphopenia, as well as circulatory changes and virus dispersion to other organs. The practice of physical activities strengthens the immune system, suggesting a benefit in the response to viral communicable diseases. Thus, regular practice of adequate intensity is suggested as an auxiliary tool in strengthening and preparing the immune system for COVID-19. Further studies are needed to associate physical exercise with SARS-CoV-2 infection.

Circulating pregnancy hormone relaxin as a first trimester biomarker for preeclampsia.

Preeclampsia, a multi-system hypertensive disorder, is associated with perturbations in the maternal cardiovascular system during early pregnancy. The corpus luteal hormone relaxin, a potent vasodilator, may contribute to physiological circulatory changes especially in early gestation when circulating levels are highest. This study investigated whether first trimester circulating relaxin may be a suitable biomarker for the early prediction of preeclampsia. Relaxin was initially measured in first-trimester samples of women who developed late-onset preeclamptic (LO-PE; delivery≥34weeks; n=33) and uncomplicated pregnancies (n=25) in Pittsburgh, USA. Subsequently, to expand the group numbers, relaxin was measured in women who developed LO-PE (n=95), early-onset preeclamptic (EO-PE; delivery<34weeks; n=57), and uncomplicated pregnancies (n=469) in Utrecht, the Netherlands. In the Pittsburgh subjects, low relaxin levels (lowest centile: <p10) showed an adjusted odds ratio (OR) of 5.29 (95%CI 1.10-25.5) for LO-PE. In the Utrecht population, low relaxin levels (<p10) demonstrated adjusted ORs of 1.45 (95%CI 0.54-3.90) and 2.03 (95%CI 1.06-3.88) for EO-PE and LO-PE respectively, the latter increasing to an adjusted OR of 3.18 (95%CI 1.41-7.20) when newborn weight was<10%. Serum relaxin concentrations slightly improved the detection rate of a previously derived prediction model for LO-PE from 42.5% to 45.1% at a fixed 10% false-positive rate. Relaxin shows little improvement in the performance of first trimester prediction models, which does not support its clinical implementation as a biomarker. Although this study was only correlational, the results point to a possible pathophysiologic role for low relaxin levels in pregnancies that later develop LO-PE.

Bone marrow adipose cells - cellular interactions and changes with obesity.

The bone marrow is a spatially restricted niche, housing cells of the hematopoietic and mesenchymal lineages in various hierarchical commitment states. Although highly localized, cells within this niche are also subject to regulation by environmental and/or circulatory changes through extensive vascularization. Bone marrow adipocytes, derived from mesenchymal stem cells and once known as marrow space fillers, are a heterogeneous population. These cells reside in distinct niches within the bone marrow and interact with proximal cells, such as hematopoietic precursors and lineage-committed cells. In this diverse cellular milieu, bone marrow adipocytes influence commitment decisions and cellular lineage selection by interacting with stem and progenitor cells. In addition, bone marrow adipocytes respond to environmental changes, such as obesity, by undergoing hypertrophy, hyperplasia or adoption of characteristics resembling those of peripheral brown, beige or white adipocytes. Here, we review recent findings and concepts on the influence of bone marrow adipocytes on hematopoietic and other cellular lineages within this niche. We discuss how changes in local, systemic, cellular and secreted signals impact on mesenchymal stem cell expansion, differentiation and lineage commitment. Furthermore, we highlight that bone marrow adipocytes may be intermediaries conveying environmental cues to influence hematopoietic cellular survival, proliferation and preferential differentiation.

Immune and Apoptosis Mechanisms Regulating Placental Development and Vascularization in Preeclampsia

Preeclampsia is the most severe type of hypertensive disorder of pregnancy, affecting one in 10 pregnancies worldwide and increasing significantly maternal and neonatal morbidity and mortality. Women developing preeclampsia display an array of symptoms encompassing uncontrolled hypertension and proteinuria, with neurological symptoms including seizures at the end of pregnancy. The main causes of preeclampsia are still unknown. However, abnormal placentation and placenta vascularization seem to be common features in preeclampsia, also leading to fetal growth restriction mainly due to reduced placental blood flow and chronic hypoxia. An over activation of maternal immunity cells against the trophoblasts, the main cells forming the placenta, has been recently shown as an important mechanism triggering trophoblast apoptosis and death. This response will further disrupt the remodeling of maternal uterine arteries, in a first stage, and the formation of new placental vessels in a later stage. A consequent chronic hypoxia stress will further contribute to increase placental stress and exacerbate systemic circulatory changes in the mother. The molecular mechanisms driving these processes of apoptosis and anti-angiogenesis are also not well-understood. In this review, we group main evidences suggesting potential targets and molecules that should be better investigated in preeclampsia. This knowledge will contribute to improve therapies targeting a better placenta formation, having a positive impact on maternal disease prevention and on fetal development.

The “missing glaciations” of the Middle Pleistocene

AbstractGlobal glaciations have varied in size and magnitude since the Early–Middle Pleistocene transition (~773 ka), despite the apparent regular and high-amplitude 100 ka pacing of glacial–interglacial cycles recorded in marine isotope records. The evidence on land indicates that patterns of glaciation varied dramatically between different glacial–interglacial cycles. For example, Marine Isotope Stages (MIS) 8, 10, and 14 are all noticeably absent from many terrestrial glacial records in North America and Europe. However, globally, the patterns are more complicated, with major glaciations recorded in MIS 8 in Asia and in parts of the Southern Hemisphere, such as Patagonia, for example. This spatial variability in glaciation between glacial–interglacial cycles is likely to be driven by ice volume changes in the West Antarctic Ice Sheet and associated interhemispheric connections through ocean–atmosphere circulatory changes. The weak global glacial imprint in some glacial–interglacial cycles is related to the pattern of global ice buildup. This is caused by feedback mechanisms within glacial systems themselves that partly result from long-term orbital changes driven by eccentricity.

Physiological and Pathological Alterations in the Mammary Gland of Holstein Cows during Transition Period

Background: Physiological and immunological adaptations occurred in peripartum period may be responsible for susceptibility to intramammary infections during colostrogenesis. Increase in blood flow and hormones cause physiological edema by accumulation of lymphatic fluid in interstitial space. Specific composition of mammary secretion increases the susceptibility to mastitis. So, the study of physical, cellular and microbiological changes in the mammary gland in this period are fundamental for understanding, diagnosing and adopting prophylactic measures for bovine mastitis. This study aimed to characterize physiological and pathological changes that occur in the mammary gland during transition period.Materials, Methods &amp; Results: Thirteen cows, in second to fourth lactation were followed from 3 weeks pre-calving to 3 weeks post-calving. Cows were submitted weekly to physical examination of mammary gland, strip cup test, California Mastitis Test (CMT), Microscopic Somatic Cell Count (MSCC), and bacteriological examination of mammary secretion. Mammary quarters were divided into two groups: BAC-: samples that did not present bacteriological growth throughout transition period; BAC+: samples that presented bacteriological growth in at least two isolates of the same bacterial genus. Regarding physical examination of mammary gland, the parameters localized or generalized alteration in volume, asymmetry, reddish color, reduced skin elasticity, increased temperature, and swollen consistency presented higher frequencies in the BAC- group. On the other hand, infection in mammary quarters of cows from BAC+ group promoted a decrease in frequencies of increased volume, decreased elasticity, and elevated temperature in the mammary gland, in addition to a higher positivity to CMT and higher cellularity. Overall rate of intramammary infection was 25.82%, with non-aureus Staphylococci (NAS) being the predominant agent (69.2%). Maximum peak of bacterial isolates occurred immediately after calving (33.3%). Differences were observed between groups (P = 0.021) for CMT, showing a higher frequency of positive tests in BAC+ group (36.5%) compared to BAC- group (18%). MSCC varied between weeks (P = 0.001), groups (P = 0.001), and between the interaction of the two variables (P = 0.019). Highest median value of MSCC was observed at calving (1.5 × 106 cells/mL), being different (P = 0.001) from the +1, +2, and +3 weeks and the lowest median value of MSCC (0.08×106 cells/mL) was observed in +3 compared to previous weeks (P &lt; 0.05).Discussion: NAS was predominantly isolated in mammary secretions of cows during peripartum, it is commonly found in the skin and canal of the teat and are associated with subclinical mastitis. Peak of mammary infection was observed on calving, probably by the cortisol peak resulting in a stress leucogram and decrease in the functional activity of immune cells. Changes observed in the physical examination of mammary gland of cows from BAC- group are compatible with physiological edema caused by circulatory changes that occurs with the proximity of calving, increasing blood flow necessary for production of colostrum. Alterations in the mammary quarters of cows from BAC+ group may be associated with functional loss of mammary parenchyma or persistent infectious process, characterizing clinical findings of pathological changes during transition period. Mammary quarters of the BAC+ group presented higher percentages of positive reactions to CMT in weeks +1 and +2, and higher MSCC values and are associated with infection of the mammary gland.

Dermatological changes associated to obesity: a literature review

INTRODUCTION: Obesity is a chronic disease that is increasing in prevalence worldwide, and is amajor contributor to health problems in most countries. This comorbidity increases the risk or isassociated with more than 30 medical problems, including dermatological conditions. OBJECTIVE:To discuss the main dermatological changes related to obesity, in order to provide the clinician with anoverview on the subject. METHODOLOGY: This is a systematic literature review study, in which thesearch was performed using the PubMed platform. DISCUSSION: Several changes in the skin andattachments have been linked to obesity, xerosis and changes in trans epidermal water loss; changes incollagen structure and wound healing; in the sebaceous glands and in the production of sebum and inthe sweat glands. In addition to circulatory and lymphatic changes; obesity seems to be the main causeof microvascular dysfunction, contributing to the development of microangiopathy. CONCLUSION:Cutaneous manifestations also deserve due attention, as, on many occasions, it can manifest the firstsign of a metabolic disorder.

Hysteropexy in the Treatment of Total Uterine Prolapse in a Brazilian Molosser Bitch

Background: Uterine prolapse is an obstetric emergency because the exposed tissue can present edema, devitalization or even gangrene, depending on the evolution time and on the severity of circulatory changes. Haemorrhage due to the rupture of ovarian or uterine vessels can evolve rapidly to hypovolemic shock. More rarely, secondary thromboembolism to the uterine strangulation can be developed, complication that can also lead to death. This study reports the case of a Brazilian Molosser bitch treated by reducing total uterine prolapse, complemented with hysteropexy, in order to prevent recurrence and maintain its reproductive ability. Case: A 5-year-old Brazilian Molosser bitch was attended presenting double firm and tubular mass protruding through the vulva. The patient gave birth to five live pups, the last two of which needed to be pulled. Two days after parturition, she had abdominal contraction when a mass protruded from the vagina. A total uterine prolapse was diagnosed, since both uterine horns were found exposed and inverted, with exposition of the endometrium and the areas of placental implantation, together with the body of the uterus. The tissue was apparently edematous and lightly parched, with the presence of strange bodies, but without signals of circulatory complications or lacerations that could turn a possible reduction and maintenance of the uterus unfeasible. Due to interest of the tutor in preserving the reproductive ability, an internal reduction via ventral medial celiotomy and the fixation of the uterus in the lateral abdominal wall (hysteropexy) was chosen in order to diminish the possibility of relapse in future parturition.Discussion: The definitive treatment of the uterine prolapse can be realized through ovariohysterectomy when the exposed uterine tissue is highly compromised or there is vessel rupture or no reproductive purpose for the female. The amputation of everted tissue through the vulva is also an option, but the risk of intracavitary bleeding during tissue resection must be considered when the uterine and ovarian artery and vein escape to the interior of the abdomen without according hemostasis. In cases which there are no complications of the prolapsed tissue and is desired to maintain the reproductive ability of the female, the internal reduction with hysteropexy is recommended. As the etiology of the uterine prolapse is a condition bound to several factors, in between them multiple pregnancies, relaxation of the uterine ligaments and genetic factors, conditions which can be associated to the cause of the prolapse in the mentioned patient, the hysteropexy was preferred as a complementary technique to uterine preservation and prevention of the prolapse relapse in a possible new parturition. In this case, the reduction of prolapse followed by hysteropexy was preferred, because the female dog was apparently well, without signs of complication of the prolapsed tissue and with satisfactory preoperative evaluation. Adding these to the request of the tutor in maintaining the reproductive ability of the female, since the procedure would not pose as a life risk to it. The absence of severe lacerations and circulatory complications in the prolapsed uterus of the bitch under study and the non-detection of toxemia and septicemia corroborated to the reduction and preservation of the uterus. Even though the uterine prolapse is a rare disease, it is necessary to improve surgical techniques that enable the conservation of the female dog in reproduction. In situations of viability of the prolapsed tissue, the technique of hysteropexy in abdominal wall showed itself effective, concluding that hysteropexy is feasible and efficient as a complementary procedure to the reduction of uterine prolapse, having contributed to avoid relapse and maintaining the reproductive of the subject related in this article.