9 results on '"Dábila Araújo Sônego"'
Search Results
2. Infusão contínua de duas doses de fentanil associadas à lidocaína e cetamina em fêmeas caninas anestesiadas com sevoflurano e submetidas à ovariohisterectomia eletiva
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Luciana Dambrósio Guimarães, Samuel Monzem, Dábila Araújo Sônego, Andresa de Cássia Martini, Lianna Ghisi Gomes, Paulo Roberto Spiller, and Daiana Cristina Winter
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Mean blood pressure ,Lidocaine ,business.industry ,Anesthesia ,Anesthetic ,medicine ,Ketamine ,Propofol ,business ,Loading dose ,Sevoflurane ,medicine.drug ,Fentanyl - Abstract
O objetivo deste trabalho foi avaliar os efeitos cardiorrespiratórios de duas doses de fentanil associadas à lidocaína e cetamina em fêmeas caninas anestesiadas com sevoflurano e submetidas à ovariohisterectomia eletiva. Foram utilizados 18 animais distribuídos aleatoriamente em dois grupos. Os animais do grupo A (GA) receberam pela via intravenosa um bolus de fentanil de 0,0018 mg/kg e os do grupo B (GB) 0,0036 mg/kg, ambos associados a lidocaína 3 mg/kg e cetamina 0,6 mg/kg. Imediatamente após o bolus realizou-se a indução com propofol seguido do início da infusão contínua (IC) de fentanil na dose de 0,0018 mg/kg/h para o GA e 0,0036 mg/kg/h para GB, ambos associados a 3 e 0,6 mg/kg/h de lidocaína e cetamina. A anestesia foi mantida com sevoflurano diluído em oxigênio 100% a 1,5V% através de vaporizador calibrado que foi ajustado para a manutenção do plano anestésico cirúrgico. Os animais foram posicionados em decúbito dorsal e permaneceram sob ventilação espontânea. Foram avaliados os valores basais (T0), após indução (T1) e 5 (T5), 20 (T20) e 35 (T35) minutos de IC dos seguintes parâmetros: frequência cardíaca (FC), frequência respiratória (f), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM), saturação de oxigênio na hemoglobina (SatO2), pressão parcial de dióxido de carbônico (EtCO2) e o sevoflurano expirado (EtSevo). A analise estatística foi realizada através da análise de variância seguida do teste de Scott-knott. As diferenças foram consideradas significativas quando P < 0,05. A FC reduziu após 20 minutos de IC e a f, PAS, PAD e PAM diminuíram após indução anestésica. Tais diferenças não foram relevantes clinicamente e os valores se mantiveram dentro do limite fisiológico. Pode-se concluir que as duas doses de infusão contínua de fentanil produziram estabilidade cardiovascular e respiratória, além de permitirem a diminuição do requerimento de sevoflurano para a realização da ovariohisterectomia eletiva.
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- 2019
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3. Long-term bisphosphonate treatment coupled with ovariectomy in mice provokes deleterious effects on femoral neck fracture pattern and modifies tibial shape
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Rafael Yague Ballester, Dábila Araújo Sônego, Andrew A. Pitsillides, Behzad Javaheri, R. L. Souza, Blandine Poulet, and Samuel Monzem
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0301 basic medicine ,medicine.medical_treatment ,Dentistry ,030209 endocrinology & metabolism ,bone strength ,Biomechanical properties ,03 medical and health sciences ,0302 clinical medicine ,Bone strength ,lcsh:Orthopedic surgery ,Bone quality ,medicine ,Femoral neck ,Bone geometry ,Hip ,business.industry ,bone geometry ,General Engineering ,Bisphosphonate ,bone quality ,lcsh:RD701-811 ,030104 developmental biology ,medicine.anatomical_structure ,Ibandronate ,Fracture (geology) ,business ,Bisphosphonate treatment - Abstract
Aims The processes linking long-term bisphosphonate treatment to atypical fracture remain elusive. To establish a means of exploring this link, we have examined how long-term bisphosphonate treatment with prior ovariectomy modifies femur fracture behaviour and tibia mass and shape in murine bones. Methods Three groups (seven per group) of 12-week-old mice were: 1) ovariectomized and 20 weeks thereafter treated weekly for 24 weeks with 100 μm/kg subcutaneous ibandronate (OVX+IBN); 2) ovariectomized (OVX); or 3) sham-operated (SHAM). Quantitative fracture analysis generated biomechanical properties for the femoral neck. Tibiae were microCT scanned and trabecular (proximal metaphysis) and cortical parameters along almost its whole length measured. Results Fracture analyses revealed that OVX+IBN significantly reduced yield displacement (vs SHAM/OVX) and resilience, and increased stiffness (vs SHAM). OVX+IBN elevated tibial trabecular parameters and also increased cortical cross-sectional area and second moment of area around minor axis, and diminished ellipticity proximally. Conclusion These data indicate that combined ovariectomy and bisphosphonate generates cortical changes linked with greater bone brittleness and modified fracture characteristics, which may provide a basis in mice for interrogating the mechanisms and genetics of atypical fracture aetiology. Cite this article: Bone Joint Open 2020;1-9:512–519.
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- 2020
4. Urethral catheterization after pharmacological induction for semen collection in dog
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Antonio Henrique Kuczmarski, Heitor José Bento, Regina Celia Rodrigues da Paz, Gabriella Accardi Iglesias, Marisol Alves de Barros, Dábila Araújo Sônego, Tathiana Ferguson Motheo, and Luiz Felipe Souza de Lima
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Male ,medicine.medical_specialty ,Ejaculation ,Urology ,Pilot Projects ,Urine ,Semen collection ,Specimen Handling ,03 medical and health sciences ,Semen quality ,0302 clinical medicine ,Dogs ,Food Animals ,Semen ,medicine ,Animals ,Ketamine ,Dexmedetomidine ,Small Animals ,Sperm plasma membrane ,030219 obstetrics & reproductive medicine ,Sperm Count ,Equine ,business.industry ,0402 animal and dairy science ,04 agricultural and veterinary sciences ,Medetomidine ,040201 dairy & animal science ,Sperm ,Semen Analysis ,Animal Science and Zoology ,business ,Urinary Catheterization ,medicine.drug - Abstract
The α-adrenergic agents are known to influence erection and ejaculation, and ejaculatory reflex is a primarily α-adrenergically mediated event. This paper aims to describe the urethral catheterization technique after pharmacological induction for semen collection in domestic dogs. For dose determination, semen collection was performed using increasing doses of dexmedetomidine (5 μg/kg, n = 2; 10 μg/kg, n = 2 and 15 μg/kg, n = 2) associated to 3 mg/kg ketamine in six animals. Once the dose was established, additional semen collection using association of 15 μg/kg dexmedetomidine and 3 mg/kg ketamine was carried out in eight dogs. After the procedure, sperm volume (0.092 ± 0.03 mL), total motility (58.33 ± 8.7%), vigor (1.89 ± 0.309), sperm concentration (1186.67 ± 304.667 × 106 sperm/mL), sperm plasma membrane integrity (83.22 ± 4.82%), acrosomal integrity (73 ± 6.187%) and normal sperm morphology (53.22 ± 5.6%) were assessed. Thus, this study demonstrates that urethral catheterization after pharmacological ejaculation using dexmedetomidine-ketamine association can be performed in dogs and it may be possible to obtain good semen quality, despite urine contamination.
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- 2019
5. Parasitism by Dioctophyma renale in a Dog: Clinical and Surgical Aspects
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Dábila Araújo Sônego, Matias Bassinello Stocco, Nathalie Moro Bassil Dower, Andresa de Cássia Martini, Fábio Dumit Pizzinatto, Nathalia Freschi, and Roberto Lopes de Souza
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Kidney ,Pathology ,medicine.medical_specialty ,Creatinine ,Urinalysis ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Physical examination ,General Medicine ,Abdominal cavity ,Asymptomatic ,Nephrectomy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.anatomical_structure ,chemistry ,Abdominal ultrasonography ,medicine ,030212 general & internal medicine ,medicine.symptom ,business - Abstract
Background : Dioctophimosis is a parasitic disease caused by Dioctophyma renale , more commonly known as "giant Kidney worm," and can be found in other organs or free in the abdominal cavity, which is related to the patient's eating habits. Most of the animals affected are asymptomatic. The diagnosis is made through ultrasonography, finding eggs of the parasite in the urine, or necropsy. The treatment of choice is nephrectomy of the affected kidney. We aimed to report the accidental diagnosis of parasitism by D. renale in an 8-year-old dog, which was surgically treated by nephrectomy of the right kidney after evident destruction of the renal parenchyma on ultrasonography. Case : An 8-year-old Boxer female dog underwent a physical examination and showed a mass in the region of the left caudal thoracic breast, bilateral alopecia on flanks, and purulent ocular secretions. Laboratory tests of complete blood count (CBC) and serum biochemical profile, X-ray examination, and ultrasonography were requested. Anemia was observed on the erythrogram, and enzymes (creatinine, urea, alanine aminotransferase [ALT], and albumin) were within normal limits. There were no abnormalities on X-ray examination, and abdominal ultrasonography showed slight splenomegaly, enlarged left kidney, reduced corticomedullary region, measuring approximately 7.63 cm longitudinally. In the right kidney, loss of the renal parenchyma, measuring approximately 5.49 cm in diameter and the presence of a cylindrical and rounded structure, typical of D. renale infection. After this, a urinalysis was suggested, which revealed the presence of the helminthic eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected kidney as treatment. The kidney showed destruction of the renal parenchyma. A single parasite was removed, measuring approximately 46 cm in length. The patient was successfully treated and was hospitalized for 4 days for observation and evaluation of function of the contralateral kidney. Discussion : The parasitic infection of the animal was due to the ingestion of fish contaminated by the aquatic anelid Lumbriculus variegatus , and the reported patient had access to home-cooked food and ingested water near the farm. D. renale is the largest nematode capable of parasitizing the kidney, reaching up to 100 cm in length, and was 46 cm long in the present case. Usually, when there is unilateral involvement, the vast majority of parasitized animals do not present clinical signs or show nonspecific signs such as hematuria and apathy, or as observed in the present case, the patient is asymptomatic. The diagnosis often occurs through ultrasonography and urine tests, which are considered essential to diagnose the parasite, but the diagnosis is often made on necropsy. Due to its proximity to the duodenum, the parasite is usually found in the right kidney, and it may be found in other organs as well. In the present case, the parasite was found in the right kidney of the patient. Usually, hypertrophy of the contralateral kidney (7.86 cm in this case) is observed on ultrasonography, which is a compensatory mechanism for the lack of normal function of the affected kidney of the affected kidney. The case occurred in the state of Mato Grosso, where there are no records of parasitism by D. renale in domestic dogs, compared with other states. Since the parasite usually affects the kidney, the treatment of choice is nephrectomy, especially if the other kidney can compensate for the absence of the other kidney, a technique that proved to be effective with excellent prognosis in the patient described.
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- 2019
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6. Evaluation of Postoperative Analgesia of DexmedetomidineAlone or Associated to Morphineas Premedicants in Bitches Undergoing Ovariosalpingohisterectomy
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Tais Aroma Fernandes da Costa, Alexandre Pinto Ribeiro, Dábila Araújo Sônego, Fabíola Niederauer Flôres, Giulia Maria Dilda Campos, Wellington Monteiro da Anunciação Filho, Luciana Dambrósio Guimarães, and Lívia Caroline de Mascarenhas
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040301 veterinary sciences ,business.industry ,Sedation ,Analgesic ,04 agricultural and veterinary sciences ,General Medicine ,Pain scale ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Preanesthetic Medication ,Anesthesia ,Anesthetic ,medicine ,Morphine ,Dexmedetomidine ,medicine.symptom ,business ,Propofol ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background : Elective ovariossalpingohysterectomy is a common surgery that causes mild to moderate pain. Aiming at the treatment of pain in these patients, analgesia should be balanced from pre-anesthetic, transoperative and postoperative medication, with α-2-agonists and opioids being commonly used, especially dexmedetomidine that has sedation, relaxation muscle and analgesia. The aim of the present study was to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and associated with morphine when used in the preanesthetic medication of bitches submitted to elective ovarian oysterectomy using the modified Glasgow pain scale and the Melbourne pain scale. Materials,Methods & Results : Twenty bitches were used in this study, all of them submitted to ovarian oysterectomy, and were clinically healthy according to laboratory and clinical exams. During the experiment, bitches were randomly distributed into two groups, which received preanesthetic medication (MPA) with 5μg/kg dexmedetomidine alone (GD) or associated with 0.3 mg/kg morphine (GDM) intramuscularly (IM). In both groups, anesthetic induction with dose-effect propofol was performed and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the weight of the animal and maintained on spontaneous ventilation. After stabilization of the patient the surgery was started, which lasted 45 min. The bitches were evaluated by the Modified Glasgow Scale (GSM), the Melbourne Scale (MS) and the Dobbins Sedation Scale (DS), previously administered MPA (T0) and the others performed in 1h (T1), 2h (T2), 4h (T3), 8h (T4), 12h (T5) and 24h (T6) after extubation. If the GSM score was greater than the value of 3.3 an analgesic rescue of 0.5 mg/kg of morphine intramuscularly would be administered. An increase in the scoring of pain scales in both groups can be observed from the T1, with significant difference only of the T1 in relation to the T0 in the GSM of the GDM. Two rescues were performed in T1 of GD and three rescues in T1 and a rescue in T3 of GDM. There was no significant difference between the groups in relation to this variable, as a result of P = 0.62. Discussion : Based on the results of this study, dexmedetomidinedoes not have adequate analgesic effect for use in preemptive analgesia of bitches submitted to elective OSH due to the high number of analgesic rescues. A small increase in GSM and MS scores from T1 can be expected compared to values prior to the surgical procedure since there was no nociceptive stimulation. This increase was only significant in T1 of GDM, moment of greatest rescue number (n = 3). The absence of significant difference between the groups proves that the analgesic effect of dexmedetomidine was not potentiated by the association with morphine at the dose and route used in this experiment. Although morphine is widely used and proven to be effective for the surgical procedure of ovariossalpingohysterectomy, both when used alone and in combination with other drugs, this fact has not been proven in the present study. This fact may have occurred due to the low dose of dexmedetomidine used or due to its short duration. Therefore, dexmedetomidine at the dose used as preanesthetic medication did not produce an adequate analgesic effect in the postoperative period of bitches submitted to elective ovariossalpingohysterectomy. The effects of the same were not potentiated by the association with morphine, at the dose used. Not being recommended for postoperative analgesic control of electiveovariossalpingohysterectomy in bitches. However, further studies are needed to better evaluate the analgesic effect of this α-2-agonist.
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- 2019
7. Porphyromonas gingivalis in the Oral Cavity of English Bulldog Newborn Puppies
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Fábio Dumit Pizzinatto, Dábila Araújo Sônego, Paulo Roberto Spiller, Murilo de Souza Mendes da Costa, Luciano Nakazato, Andresa de Cássia Martini, Lianna Ghisi Gomes, Roberto Lopes de Souza, Letícia Camara Pitchenin, and Emanuelle Denise de Brito Almeida
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Periodontitis ,biology ,business.industry ,Tooth eruption ,Dentistry ,General Medicine ,periodontal disease ,dental eruption ,tooth brushing ,medicine.disease ,biology.organism_classification ,Oral hygiene ,Tooth brushing ,medicine.anatomical_structure ,Puppy ,biology.animal ,medicine ,Deciduous teeth ,Gingival sulcus ,business ,Porphyromonas gingivalis - Abstract
Background: Periodontal disease (PD) is the most common disease of the oral cavity in cats and dogs, and it affects up to 80% of these animals. PD begins with the accumulation of bacteria on the surface of the teeth, and it poses a risk for the health of pets. Research on PD in dogs has focused on the identification and characterization of bacterial communities present in the oral cavity. Porphyromonas gingivalis is highly prevalent in the oral cavity. Therefore, the aim of this study was to detect P. gingivalis before and after dental eruption in 15 English bulldog newborn puppies, hoping to contribute to early guidance of oral hygiene management and prevent future PD.Materials, Methods & Results: Fifteen English bulldog newborn puppies were used in this study. Two groups (G1 and G2) were formed with eight and seven puppies, respectively. Oral swab samples were taken from the maxillary incisor region of animals from G1 and G2 10 days after birth (T10). At this moment, the clinical evaluation of the oral cavity showed healthy gums with a thin, shiny, pinkish, and firm margin, without any odor or granular appearance, and with no tooth eruption. On postnatal day 25 (T25), a subgingival sample was collected with a Gracey curette from the maxillary incisors; the oral cavity examination revealed healthy gums and presence of gingival sulcus. Bilateral subgingival samples were also collected from the maxillary canines and fourth premolars of the dams at T10 and T25. All newborn puppies were fed maternal breast milk and supplementation exclusively with commercial milk for dogs in individual bottles. The dams were fed commercial dry food. The average weight of G1 and G2 at T10 was 625.87 ± 85.26 g and 543.50 ± 92.88 g, respectively, and 100% (15/15) of the animals were negative for PG as assessed by polymerase chain reaction (PCR) on oral swab samples. At T25, puppies from groups G1 and G2 weighed 1.465 ± 194 g and 1.206 ± 201 g, respectively, and 100% (15/15) of the puppies were positive for P. gingivalis as assessed by PCR on subgingival samples collected with a Gracey curette. The dams of the puppies in G1 and G2 were positive for PG at T10 and T25 as determined by PCR on subgingival samples.Discussion:An important finding of this study was that the dams of the puppies in G1 and G2 were positive for P. gingivalis at T10. Several species of bacteria that cause periodontal disease can be transmitted from humans to pets; therefore, transmission from dam to puppy would be possible, but was not observed in this study at T10, when 100% (15/15) of the animals were negative for P. gingivalis. Subgingival microbiota associated with periodontitis consists essentially of Porphyromonas spp., and the presence of gingival sulcus and dental eruption are determinant factors for the presence of P. gingivalis in the oral cavity. Nevertheless, the hygiene habits of dogs, with the dam licking the puppies after dental eruption, could have been a relevant factor for transmission and appearance of P. gingivalis in the subgingival sample in 100% (15/15) of the puppies at T25. The oral microbiota is closely related to many diseases, and resident pathogenic oral bacteria can be transferred by close contact. Certain species of bacteria present in the subgingival biofilm exhibit higher etiologic relevance during the onset and progression of periodontitis, and Porphyromonas spp. is among the most important of these species. It is important to keep in mind that age is a relevant factor to prevent periodontitis. Therefore, providing owners with instructions for thorough dental brushing of animals when they still have deciduous teeth can prevent the appearance of future PD.
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- 2017
8. Evaluation of Postoperative Residual Analgesia of Two Solutions Used for Local Anesthesia By Tumescence In Bitches who Underwent a Unilateral Mastectomy
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Dábila Araújo Sônego, Deborah Braga Pytlak, Luciana Dambrósio Guimarães, Alexandre Pinto Ribeiro, Marcos de Almeida Souza, Giulia Maria Dilda Campos, Ângela Renata Bólico do Amaral, Lianna Ghisi Gomes, F. N. Flôres, and Samuel Monzem
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Tumescence ,business.industry ,Ropivacaine ,Analgesic ,General Medicine ,Acepromazine ,Isoflurane ,Anesthesia ,Anesthetic ,medicine ,Local anesthesia ,Propofol ,business ,medicine.drug - Abstract
Background: Breast tumors are common and require surgical treatment. A mastectomy causes edema, inflammation, and moderate to severe pain; therefore, analgesics should be used efficiently during the trans- and postoperative periods. Tumescence anesthesia has been studied in veterinary medicine; however, there is limited literature on the comparison of the constituents of the different solutions and the most suitable protocol. The objective of this study was to evaluate the residual postoperative analgesia of two solutions through the Melbourne, Modified Glasgow for dogs (EGM), and Visual Analogue (EVA) scales in bitches who underwent a unilateral mastectomy.Materials, Methods & Results: Twelve bitches, weighing between 5 and 15 kilograms and aged between 5 and 13 years old, were included in the study. To determine if the animals were medically fit to undergo the procedure, they were evaluated by clinical examination, laboratory testing (complete blood count, serum biochemistry [urea, creatinine and alanine aminotransferase/ALT], and imaging (thorax x-ray and abdominal ultrasonography). Patients were randomly divided into two groups. One group received a lidocaine-containing tumescent solution (GTL) that consisted of 210 mL of lactated Ringer's solution (at a temperature between 8 and 12°C), 40 mL of 2% lidocaine hydrochloride without vasoconstrictor, and 0.5 mL of adrenaline (1 mg/mL). The other group received ropivacaine (GTR) with 233.3 mL of lactated Ringer's solution (at the same temperature as the previous group’s), 16.7 mL of ropivacaine (7.5 mg/mL), and 0.5 mL of adrenaline (1 mg/mL). Both groups received a combination of acepromazine (0.04 mg/kg) and meperidine (2 mg/kg) as preanesthetic medication (MPA), followed by induction using propofol (to effect) and maintenance using isoflurane. The solutions were infused subcutaneously (SC) 5 min after stabilization of the anesthetic plane. For the mastectomy, the solutions were distributed throughout the mammary chain to be withdrawn, starting at the thoracic and abdominal regions and ending in the inguinal region. In the postoperative period, the animals were evaluated using three different scales (Melbourne, Glasgow modified for dogs [EGM], and Visual Analogue [EVA] scales), at six time points: one, two, four, eight, 12 and 24 h after extubation, or until the time of analgesic rescue when the animal presented with a score higher than 3.33 on the EGM scale. There were no statistical differences between the groups (P > 0.05) in any of the scales evaluated; however, most of the animals demonstrated analgesic rescue in the first hour of evaluation. GTR showed an additional rescue compared to GTL.Discussion: Analgesic rescue occurred in the first hour of the postoperative period. This differs from other studies that used morphine in MPA and observed higher analgesia. This occurred because meperidine, the drug used in the study, has a shorter duration and is a less potent analgesic than morphine. We opted for this opioid because of its minimal interaction with the drug used in MPA and to better identify the residual effect of the administered solution. In addition, it does not interact with the other drugs used in the anesthetic protocol. It is known that the tumescence technique prolongs the analgesic effect of MPA because of subcutaneous absorption of a portion of the injected solution adjacent to the area being operated on. However, this was not observed as 50% of the animals in each group were rescued during the first hour of the evaluation. From this study, it was concluded that the tumescent solutions used in the trans-operative period should not be expected to have analgesic effects during the postoperative period of mastectomies because of the short duration of action.
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- 2018
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9. Reprodução experimental da doença articular degenerativa, pelo método cirúrgico associado à terapia condroprotetora, em ratos
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Marcos de Almeida Souza, R. L. Souza, Gentil Ferreira Gonçalves, Marcos Marini Melo, A. Marques, Dábila Araújo Sônego, Pedro Brandini Néspoli, Rosana Zanatta, and Paulo Ricardo Mallmann
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medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,Osteoarthritis ,Pentosan polysulfate ,medicine.disease ,Surgery ,Cruciate ligament ,Lesion ,chemistry.chemical_compound ,medicine.anatomical_structure ,Pharmacotherapy ,chemistry ,medicine ,Betamethasone ,Chondroitin sulfate ,medicine.symptom ,General Agricultural and Biological Sciences ,education ,business ,medicine.drug - Abstract
Osteoarthritis (OA) is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies, one with pentosan polysulfate, one with betamethasone, and one with chondroitin sulfate/ glucosamine. In order to produce joint disease, the cranial cruciate ligament was surgically transected. Animals were kept and treated for eight days after surgery and were assessed via both radiographies and tomographies taken before surgery and eight weeks later. All animals were euthanized having both macroscopic and microscopic analysis performed to evaluate the disorder progression and therapeutic action. Macroscopic analysis showed lesion in the knees subjected to OA induction. The untreated animals presented major lesions whereas the treated ones presented mild to moderate lesions. In conclusion, pentosan polysulfate is recommendable for the treatment of iatrogenic joint lesions in rats since the other treatments showed no significant difference.
- Published
- 2013
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