DSpace Collection:
http://hdl.handle.net/10174/160
2024-03-04T09:31:13ZRECONSTRUÇÃO PALPEBRAL BEM-SUCEDIDA E REPARO INFRAORBITAL USANDO UMA TÉCNICA DE RETALHO DE MUSTARDÉ EM UM CÃO
http://hdl.handle.net/10174/34629
Title: RECONSTRUÇÃO PALPEBRAL BEM-SUCEDIDA E REPARO INFRAORBITAL USANDO UMA TÉCNICA DE RETALHO DE MUSTARDÉ EM UM CÃO
Authors: Guimarães, Tarcísio; Cardoso, Karla; Botelho, Filomena; Alexandre, Nuno; Pacheco, Magda; Olivério, Pedro; Faim, Susana; Figueira, Ana Catarina
Abstract: Introdução
A complexidade das alterações palpebrais exige do cirurgião amplo conhecimento anatómico
e domínio de várias técnicas cirúrgicas para o tratamento bem-sucedido1,2. A técnica de Mustardé é
usada na medicina humana para reconstruir defeitos que envolvem muita ou toda a pálpebra inferior e
região infraorbital3. Tecnicamente, consiste num grande retalho de avanço da rotação da pele da
bochecha, realizado em um único tempo cirúrgico4.
Objectivos
O presente trabalho tem como objetivo descrever a reconstrução de grande defeito palpebral e
infraorbital em um cão, em um único momento cirúrgico. Utilizando técnicas cirúrgicas combinadas,
incluindo retalho modificado com enxerto de cartilagem autóloga (Mustardé Flap). Para o
conhecimento dos autores, este é o primeiro relato do uso do Mustardé Flap em cães.
Metodologia
Um cão, sem raça definida, cinco anos, apresentando alterações da região ocular e facial direita
e histórico de cirurgia pregressa. Ao exame físico observou -se região palpebral do olho direito com
ausência/cicatricial de margem inferior e superior, ausência de tecido cutâneo na região infraorbitária.
Devido à grande falha tecidual incluindo margem palpebral e musculatura orbicular, indicou
reconstruir os defeitos da pálpebra inferior e região infraorbitária empregando a técnica de Mustardé,
e pálpebra superior com técnica de ressecção em cunha. Reconstrução região inferior: realizou-se
incisão musculo-cutânea lateral ao olho direito, estendendo para região temporal até antes da orelha,
depois inferiormente a articulação temporomandibular, formando um grande retalho. Um fragmento
de tamanho adequado da cartilagem da orelha foi retirado e utilizada para sustentação e fixados entre
a conjuntiva residual e o flap cutâneo. Tecidos da periferia do defeito foram cuidadosamente
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revitalizados e o grande retalho recobriu toda a extensão do defeito sem tensão. A fixação medial foi
realizada no periósteo orbital medial, com sutura 3-0 não absorvível. O canto lateral foi suturado (4-0
absorvíveis) ao periósteo para fixação e formação da pálpebra inferior. A união do espaço subcutâneo
e intradérmica realizada com fio absorvível(5-0) e sutura cutânea, com fio não absorvível(4-0).
Reconstrução região superior: Realizou a ressecção em cunha de espessura total, na região de maior
alongamento (euribléfaro). Pela incisão temporal ocorreu a divulsão subcutânea da região frontal e
parietal, deslizando frontalmente o tecido cutâneo e aplicadas suturas trans-cutâneas fixadas a
musculatura. Aplicação sutura captonada e proteção do flap de terceira pálpebra foram realizadas
adicionalmente visando a não retração cicatricial. No pós-operatório o animal foi mantido em ambiente
hospitalar.
Resultados
O estabelecimento de boa altura vertical do retalho foi importante e auxiliou alcançar uma boa
posição anatômica do ângulo do canto lateral do olho. O emprego da cartilagem auricular forneceu
adequadamente rigidez estrutural, mimetizando uma placa tarsal. Não foram observadas complicações
do retalho cutâneo, do enxerto de cartilagem ou de tecidos vizinhos. O resultado estético obtido foi
satisfatório e devido à ausência da musculatura orbicular a oclusão palpebral não estava presente.
Conclusão
Reconstruções palpebrais são procedimentos complexos, devido características peculiares
anatômicas e fisiológicas. Um repertorio cirúrgico amplo é exigido para intervenções palpebrais,
visando alcançar resultados terapêuticos otimizados. Grande defeito palpebral foi reparado de forma
eficiente, empregando uma técnica inédita para espécie.
Bibliografia
1Teixeira, V., Ramos, L., Serra, D., Vieira, R., & Figueiredo, A. (2013). Métodos reconstrutivos da pálpebra
inferior–Aplicação na prática dermatológica. Rev SPDV, 71(2), 159-69.
2Esson, D. (2001). A modification of the Mustardé technique for the surgical repair of a large feline eyelid
coloboma. Veterinary ophthalmology, 4(2), 159-160.
3Lo Torto, F., Losco, L., Bernardini, N., Greco, M., Scuderi, G., & Ribuffo, D. (2017). Surgical treatment with
locoregional flaps for the eyelid: a review. BioMed research international, 2017.
4Ibáñez-Flores, N., Bruzual-Lezama, C., Castellar-Cerpa, J. J., & Fernández-Montalvo, L. (2019). Lower eyelid
reconstruction with pericranium graft and Mustarde flap. Archivos de la Sociedad Española de Oftalmología.2020-02-04T00:00:00ZIN VITRO PHOTODYNAMIC THERAPY ON OCULAR MELANOMA CELLS
http://hdl.handle.net/10174/34579
Title: IN VITRO PHOTODYNAMIC THERAPY ON OCULAR MELANOMA CELLS
Authors: Guimarães, Tarcísio Guerra; Carvalho, Gabriela; Mamede, Fabrício Vilela; Cardoso, Karla Menezes; Marto, Carlos Miguel; Piñeiro, Marta; Pinho e Melo, Teresa; Alexandre, Nuno; Botelho, Maria Filomena; Laranjo, Mafalda
Abstract: Purpose. To evaluate the effect of newly developed Ring-fused chlorins on cell proliferation of ocular melanoma. Methods. Human cell line MP-41 and a canine primary culture were subjected to the photosensitizers at concentrations between 0,5-1000 nM for 24 hours. The cells were irradiated with 10J (ƛ>570nm). Control groups included: untreated cells and cells submitted only to the administration vehicle (dimethylsulfoxide). The cytotoxicity (MTT) assessment was performed 24 hours after photodynamic therapy (PDT). Results. The dihydroxymethyl ring-fused chlorin (PS1) was the most active, with an IC50 value of 95.1 nM. The dihydroxymethyl-Pt(II) ring-fused chlorin (PS3) also showed promising photodynamic activity with an IC50 value of 114.8nM in MP-41 cells. These chlorins also showed highly satisfactory results in canine cells, with IC50 of 0.6nM for the PS1 and 2.2 nM for PS3. The dicarboxylic acid ring-fused chlorin (PS2) and dicarboxylic acid Pt(II) ring-fused chlorin (PS4) were less efficient in both ocular melanoma cells. PDT had a direct effect on ocular melanoma cell metabolic activity. High activity was obtained at very low concentrations. Conclusion. Satisfactory outcomes were achieved using new photosensitizers, particularly PS1 and PS3. The photosensitizers used are promising, particularly PS1 and PS3. This approach might become an option in treating eye melanoma in medicine and veterinary medicine. Supported by FCT, Portugal, SFRH/BD/139319/2018, SFRH/BD/116794/2016, UID/NEU/04539/2019, UIDB/04539/2020, UIDP/04539/2020 and POCI-01-0145-FEDER-007440. None.2022-10-26T23:00:00ZLIPOSSARCOMA IN GUINEA PIG: A CASE REPORT
http://hdl.handle.net/10174/34577
Title: LIPOSSARCOMA IN GUINEA PIG: A CASE REPORT
Authors: Guimarães, Tarcísio; Cardoso, Karla; Moraes, Joana; Moraes, Carlos; Botelho, Filomena; Laranjo, Mafalda; Alexandre, Nuno
Abstract: Introduction
Liposarcomas are malignant tumors of adipocytic differentiation1
, of rare incidence,
affecting animals and humans2
. According to the clinical and pathological characteristics
of liposarcoma, it can be classified into well-differentiated, undifferentiated, myxoid and
pleomorphic3
. Surgical excision is recommended, but recurrence4
and metastasis may
occur1
.
Objectives
The objective of this study was to report case of a Guinea pig submitted to surgical
excision of a spontaneous liposarcoma.
Methodology
A male Guinea pig (Cavia porcellus), 4 years old, was treated due to the presence
of a large cutaneous nodule, rapidly growing in the abdominal region. The semiological
evaluation showed a subcutaneous neoformation of 7 cm in diameter in the middle
abdominal region (left flank), firm in consistency, and non painfull on palpation. No other
noteworthy alterations in physiological parameters and complementary exams were
detected. The cytological findings on fine-needle aspiration puncture were compatible with
fatty tissue. Exeresis of the neoformation was advised and the animal was referred for
surgical procedure.
Pre-anesthesia sedation was performed with the combination of ketamine
hydrochloride(10mg/kg) and butorphanol(0,5mg/kg) via intramuscularly, and anesthetic
induction and maintenance was performed by inhalation using a mask), with isoflurane in
100% oxygen. Local anesthesia was performed at the incision line with 2% lidocaine,
administered subcutaneously with a 26G needle. In a continuous act, the surgical resection
of the neoformation occurred, presenting multilobulated aspect with yellowish-white color
and soft consistency. Surgical incision was closed with continuous suture with absorbable
thread(subcutaneous) and simple interrupted suture with non absorbable thread(skin).
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Postoperative analgesia consisted of administration of meloxicam(0,1mg/kg, SC) for 2
days, tramadol hydrochloride(2,0 mg/kg, SC) for 3 days and antibiotherapy with
enrofloxacin(5,0mg/kg, SC) for 7 days.
Results
The results of the histopathological examination revealed neoplasia composed of
fusiform mesenchymal cell bundles with multiple dilated spaces of fat, with
histopathological diagnosis of well differentiated Liposarcoma. After hospital treatment,
the animal showed excellent recovery, being discharged at after 7 days. It was referred for
further evaluation with the veterinary oncologist, reporting no complications during eight
months of follow-up.
Conclusion
Guinea pigs are popular as pets, being a species that can be affected by spontaneous
cutaneous and subcutaneous neoplasias. Taking in account the clinical evaluation of the
animal, surgical resection of the neoplasia was recommended. Although uncommon,
liposarcoma should be considered an anatomopathological differential diagnosis of
neoplasms that affect this species.
References
[1] Lee, A. T. J., Thway, K., Huang, P. H., & Jones, R. L. (2018). Clinical and Molecular Spectrum of
Liposarcoma. Journal of clinical oncology: official journal of the American Society of Clinical
Oncology, 36(2), 151-159.
[2] Quinton, J. F., Ollivier, F., & Dally, C. (2013). A case of well‐differentiated palpebral liposarcoma in a
Guinea pig (Cavia porcellus). Veterinary ophthalmology, 16, 155-159.
[3] Sahoo, A., Dwibedi, B., Das, J., Behera, M., & Behera, L. (2017). Spontaneous Liposarcoma in a Guinea
Pig (Cavia porcellus) and its Surgical Management. International Journal of Livestock Research, 1.
[4] Hoffman, A., Lazar, A. J., Pollock, R. E., & Lev, D. (2011). New frontiers in the treatment of
liposarcoma, a therapeutically resistant malignant cohort. Drug Resistance Updates, 14(1), 52-66.2020-02-20T00:00:00ZSURGICAL RESOLUTION AFTER MULTIMODAL TREATMENT IN A DOG WITH GRANULOMATOUS NODULAR EPISCLERITIS
http://hdl.handle.net/10174/34576
Title: SURGICAL RESOLUTION AFTER MULTIMODAL TREATMENT IN A DOG WITH GRANULOMATOUS NODULAR EPISCLERITIS
Authors: Guimarães, Tarcísio; Cardoso, Karla; Botelho, Filomena; Laranjo, Mafalda; Rozin, A.; Tralhão, Pedro; Alexandre, Nuno
Abstract: Introduction
Granulomatous nodular episcleritis(GNE) is a mixed lymphocytic and granulomatous nodular
inflammation of the conjunctiva or adjacent sclera4, rarely described in dogs. Defined as an idiopathic
conjunctiva and scleral primary disease, is presumed to be an immune-mediated disorder; although
may also be derived from secondary disease1.Clinically characterized by an elevated, non-painful,
single or multiple nodular formations, is common in the temporal limbus and may also affect the
conjunctiva, episclera and cornea2. In spite of highly suggestive clinical appearance, histopatological
analysis is necessary to confirm the diagnosis4. Medical therapy consistis of topically and systemically
administrations of corticosteroids and immunomodulators3. Beta-irradiation,cryotherapy and surgical
removal may also be used4.
Objectives
This paper aims to describe the case of a dog with GNE, submitted to multimodal therapeutic
management, culminating in surgical resolution.
Methodology
A 10-year-old Brazilian Mastiff female dog, current on vaccinations and deworming, was
consulted, presenting right eye with evidence of a nodular formation of red coloring and epiphora. In
the ophthalmological examination, the right eye presented, moderate conjunctival hyperemia,
vascularization extending from the conjunctiva to an elevated red colored neoformation, of about 1
cm, located in the region of the temporal bulbar conjunctiva and protruding externally between the
eyelids. Lagophthalmia and secondary epiphora were also present. The Schirmer test showed
24mm/min and intraocular pressure a mean value of 16mmHg. Fundoscopy revealed no noticeable
changes. The fluorescein test was considered negative and the rose bengal test stained a discrete
corneal temporal band. The left eye was physiologically normal. Other diagnostic tests(Hematological
and biochemical profile) were unremarkable. A presumptive diagnosis of GNE was considered and a
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14 day medical therapy was instituted, based on a topical combination of dexamethasone, neomycin
and polymyxinB every 6 hours and cyclosporine1.0% every 12 hours. From 15-30 day post-diagnosis
topical dexamethasone associated to cyclosporine was maintained and oral therapy with prednisolone
2mg/kg/day was initiated. Between days 31-45 post-diagnosis, topical cyclosporine was maintained
and oral therapy with doxycycline 10mg/kg/day was initiated. On day 46, surgical excision was
performed, and from 46-56 days period, topically retinol acetate, methionine and chloramphenicol
every 6 hours was started; and doxycycline was maintained. After day 56 onwards, topically 0.2%
cyclosporine in continuous use was advised to owners and reassessments every 6 months was
scheduled.
Results
In the period of day 0-45, the conjunctival hyperemia and the vascularization of neoformation
was reduced. However, no size reduction of neoformation was observed, which kept protruding in
between the eyelids, causing lagophthalmia and epiphora. From day 46-56, surgical healing occurred
uneventfully. Histopathological examination revealed granulomatous and fibrous inflammatory
infiltrate, composed of a mixture of histiocytes, lymphocytes, plasma cells and fibroblasts. Schiff
periodic acid staining was negative for fungi. A definitive diagnosis of GNE was achieved and the
topical use of cyclosporine was maintained, with no relapse to this date.
Conclusion
The primary etiology of this condition is presumed to be immunomediated. The surgical
exeresis was effective when compared to immunosuppressive therapy(topical and systemic) employed
in this case for resolution of GNE. Pathological analysis is always recommended for definitive
diagnosis.
Bibliography
1. Hamzianpour, N., Heinrich, C., Jones, R. G., McElroy, P., Wilson, N., & Scurrell, E. (2019). Clinical
and pathological findings in three dogs with a corneocentric presentation of nodular granulomatous
episcleritis. Veterinary ophthalmology.
2. Barnes, L. D., Pearce, J. W., Berent, L. M., Fox, D. B., & Giuliano, E. A. (2010). Surgical
management of orbital nodular granulomatous episcleritis in a dog. Veterinary ophthalmology, 13(4),
251-258.
3. Sandmeyer, L. S., & Grahn, B. H. (2008). Diagnostic ophthalmology. The Canadian Veterinary
Journal, 49(9), 923.
4. Maggs, D., Miller, P., & Ofri, R. (2017). Slatter's Fundamentals of Veterinary Ophthalmology EBook.
Elsevier Health Sciences.2020-02-20T00:00:00Z