Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta

Purpose  

The purpose of this study was to describe the preliminary results of prophylactic temporary balloon occlusion of the internal iliac arteries for bleeding control in patients with placenta accreta during cesarean hysterectomy.     

Re‐evaluating the electro‐vectorcardiographic criteria for left bundle branch block

The criteria for left bundle branch block have gained growing interest in the last few years. In this overview, we discuss diagnostic and prognostic aspects of different criteria. It was already shown that stricter criteria, including longer QRS duration and slurring/notching of the QRS, better identify responders to cardiac resynchronization therapy. We also include aspects of ST/T concordance and discordance and vectorcardiography, which could further improve in the fine‐tuning of the left bundle branch criteria.     

The relation between maternal breast feeding and non-nutritive sucking habits

This study sought to identify the type and duration of breastfeeding received by children and establish the association with non-nutritive suction habits. A retrospective, transversal study was conducted using a questionnaire given to 330 mothers or persons responsible for 3 to 6-year-old children registered in kindergartens in Ara?atuba, State of S?o Paulo, after obtaining their free and informed consent. It was revealed that 86.4% of mothers breastfed their children. With respect to duration, only 33.4% of these mothers breastfed exclusively after 6 months. The average time of exclusive breastfeeding received by children was 3.84 months and complementary breastfeeding was 11.68 months. Of this total, 53.3% reported that their infants manifested non-nutritive suction habits and of these children, 70.45% were not exclusively breastfed for the first 6 months, there being a significant association between both (p<=0.05). Pacifier use was the most frequent habit (44.4%), showing a statistically significant association with breastfeeding time (p<0.0001). It was concluded that breastfeeding was practiced, albeit for a lesser duration than considered indispensable for the baby's development, there being an association between duration and type of breastfeeding and non-nutritive suction habits.     

Use of pyrosequencing and denaturing gradient gel electrophoresis to examine the effects of probiotics and essential oil blends on digestive microflora in broilers under mixed Eimeria infection

A protective digestive microflora helps prevent and reduce broiler infection and colonization by enteropathogens. In the current experiment, broilers fed diets supplemented with probiotics and essential oil (EO) blends were infected with a standard mixed Eimeria spp. to determine effects of performance enhancers on ileal and cecal microbial communities (MCs). Eight treatment groups included four controls (uninfected-unmedicated [UU], unmedicated-infected, the antibiotic BMD plus the ionophore Coban as positive control, and the ionophore as negative control), and four treatments (probiotics BC-30 and Calsporin; and EO, Crina Poultry Plus, and Crina PoultryAF). Day-old broilers were raised to 14 days in floor pens on used litter and then were moved to Petersime batteries and inoculated at 15 days with mixed Eimeria spp. Ileal and cecal samples were collected at 14 days and 7 days postinfection. Digesta DNA was subjected to pyrosequencing for sequencing of individual cecal bacteria and denaturing gradient gel electrophoresis (DGGE) for determination of changes in ileal and cecal MC according to percentage similarity coefficient (%SC). Pyrosequencing is very sensitive detecting shifts in individual bacterial sequences, whereas DGGE is able to detect gross shifts in entire MC. These combined techniques offer versatility toward identifying feed additive and mild Eimeria infection modulation of broiler MC. Pyrosequencing detected 147 bacterial species sequences. Additionally, pyrosequencing revealed the presence of relatively low levels of the potential human enteropathogens Campylobacter sp. and four Shigella spp. as well as the potential poultry pathogen Clostridiun perfringens. Pre- and postinfection changes in ileal (56%SC) and cecal (78.5%SC) DGGE profiles resulted from the coccidia infection and with increased broiler age. Probiotics and EO changed MC from those seen in UU ilea and ceca. Results potentially reflect the performance enhancement above expectations in comparison to broilers not given the probiotics or the specific EO blends as feed supplements.     

Endovascular transluminal stent grafting

Iliac vessels are prone to injury during lumbar spine surgery due to their proximity to the lumbar spine. Arterio‐venous fistula formation during lumbar spine surgery is an uncommon complication and can present as an asymptomatic incidental finding to rapidly deteriorating hemodynamics leading to cardiopulmonary collapse. We have reported three patients who had symptomatic iliac arterio‐venous fistula detected soon after lumbar spine surgery. All these patients were successfully treated by endovascular transluminal stent grafting. © 2013 Wiley Periodicals, Inc.     

Prednisone as initial treatment of analgesic-induced daily headache

The majority of the patients who seek medical care in tertiary headache centres present with transformed migraine, and convert to daily headache, as a result of excessive intake of symptomatic medications (SM). This study aimed to analyse the possibility of using a short course of oral prednisone for detoxifying patients with chronic daily headache due to medication overuse in an out-patient setting. Four hundred patients with headache occurring more than 28 days per month for longer than 6 months were studied (mean baseline frequency of 0.96). Symptomatic medications were stopped suddenly and prednisone was initiated in tapering doses during 6 days, followed by the introduction of preventive treatment. Withdrawal symptoms and the frequency, intensity and duration of the headache, as well as the consumption of rescue medications, were analysed during the first 16 and 30 days of withdrawal. Eighty-five percent of the patients experienced a reduction in headache frequency and no patients presented severe attacks during the first 6 days. With regard to the following 10 days, 46% of the patients experienced at least 2 days without headache and 58% less intense attacks. Most of the patients noticed attacks with longer duration. After the 30-day period there was a significant decrease in headache frequency (mean 0.83, P<0.001), and no patients returned to overuse of SM. This study demonstrates that it is possible to detoxify patients suffering from rebound headaches, using oral prednisone during the first days of withdrawal, in an out-patient setting.