A considerable interest in autologous tissue breast reconstructions has developed recently, especially since Food and Drug Administration (FDA) experts have raised the polemic on silicone implants. Although such enthusiasm for the transverse rectus abdominis musculocutaneous (TRAM) flap is justified in what concerns the final cosmetic result of the reconstructed breast, the risk of abdominal sequelae should be explained to the patient. Abdominal scarring, parietal weakness, strength loss, and back pain have been recorded in a series of pedicled TRAM flap reconstructions performed at the Institut Gustave-Roussy before 1991. Cosmetic results of the abdomen were tested by three independent judges on the photographs taken of 132 patients. The global appearance of the abdomen was rated as "natural" in 70 percent of the patients. The umbilical scar was unacceptable in 25 percent and very good or not visible in 21 percent. The lower abdominal scar was rated as "not acceptable" in 35 percent. Abdominal strength was tested among the 38 patients who underwent both preoperative and postoperative muscular testing, of whom 18 had single-pedicled and 20 had bipedicled TRAM flap reconstructions. In the first group, the physiotherapist observed an impairment of function of the upper portion of the rectus abdominis and of the oblique muscle in almost 50 percent. In the second group, the same muscles were more severely impaired (in 60 percent), as well as the function of the lower portion of the rectus (in 15 percent). The percentage of patients complaining of "light back pain" in the 6-month postoperative period was 55 percent in the single-pedicle group and 30 percent in the double-pedicle group. However, 20 percent of the bipedicled patients complained of "severe" back pain, while there was none in the single-pedicled group. In conclusion, abdominal sequelae after TRAM flap breast reconstruction should not be underestimated and constitute one of the drawbacks of the technique when it is compared with reconstruction with a prosthesis.

Background: Obstructive urinary tract disease in horses is a rare and low prevalence pathology in the species, but potentially severe. It is an emergency condition that presents variable clinical signs and depends on the anatomical location of the obstruction. The bladder calculus are the most common followed by the urethra and less commonly seen are the kidney or ureteral. The main crystalloid component of uroliths in horses is calcium carbonate. The higher prevalence of urolithiasis in male horses is justified by some anatomical differences between genders. The urethra of males is narrower and longer than that of females. The tissue injury is the most important factor for the development of uroliths in horses. Desquamation of epithelial cells, presence of leukocyte and necrotic cell debris are relevant contributors to crystal growth. Urinary stasis favors nucleation by increasing the chance of contact between crystalloid material and urinary epithelium. Once crystal growth has begun, the urine alkalinity of the equines favors the crystallization and further deposition of other components, especially calcium carbonate. Typical clinical signs of urolithiasis include tenesmus, dysuria, strangury and polaquiuria. Hematuria is often present, mainly observed after exercise and at the end of urination. In addition signs of colic are quite frequent in the acute bladder and urethral urolithiasis due to bladder distension. Upper urinary tract surgery may be technically challenging due to limited structural exposure, especially in adult horses The prognosis for horses with urolithiasis depends on the location of the urolith and the degree of renal injury that occurred.Case: This report aims to describe a rare case of obstructive urolithiasis in a 8-year-old castrated male horse with 24 h evolution. The horse was expressing signs of abdominal pain and during the transretal examination through palpation, it was possible to notice great distension and turgidity of the bladder, in addition to a high pain sensitivity to the palpation of the kidneys. Was perform urethral catheterization, but it was unproductive. The diagnosis was made through perineal ultrasonography and treated surgically by perineal urethrotomy. The animal presented an excellent evolution after being discharged after 10 days of hospitalization and did not present any complication or recurrence of the disease after one year of the procedure.Discussion: Urolithiasis in horses has a prognosis dependent on the location of the urolith and the degree of renal damage. Cases of obstructive urolithiasis in horses are rare and require prompt and appropriate intervention. Therefore, a rapid and accurate diagnosis is directly related to the success of the treatment. In the present case, the animal had characteristic clinical signs of an acute abdomen. Transrectal palpation, for evaluation of the intestinal portions, was important to diagnose an excessively distended urinary vesicle with no intestinal changes. Transcutaneous ultrasonography of the perineum allowed visualization of the calculus, and then a case of perineal urolithiasis was diagnosed. The choice for perineal urethrotomy was performed because of the ease of palpation of the calculus through the skin below the anus and because it is a non-invasive technique. The urethra was sutured to guide the cicatricial process and the urethral catheter was maintained, reducing the risks of occlusion of the urethral lumen.

It has been emphasized in the human medical literature, that when using a neuromuscular blocking agent, it is of vital importance the monitoring of the neuromuscular block and that these agents should never be used without it. The purpose of this study was to evaluate the use of the neuromuscular transmission monitor TOF-Guard in horses. Twelve horses were randomly assigned whether to receive pancuronium or atracurium as the neuromuscular blocking agent. All horses were pre-medicated with romifidine, anaesthesia induced with diazepam and ketamine and maintenance with halothane. Abolition of spontaneous ventilation was accomplished by the administration of atracurium or pancuronium. The time from injection of the muscle relaxant agent to the onset of maximum block (T1=0), recovery of T1 to 25% and the recovery of TOF ratio to 0.7 were recorded, as was the time for recovery of T1 from 25 to 75%. It was concluded that it is very important the neuromuscular transmission monitoring during the use of a nondepolarizing neuromuscular blocking agent, since it provides a safer anaesthetic and surgical procedure with the use of adequate dosages and due to the impossibility of a superficialization of the neuromuscular blockade during a surgical procedure. The TOF-Guard showed to be a good option for neuromuscular monitoring in horses.

INTRODUÇÃOToracoscopia é um método que permite a visibilização da cavidade torácica através de endoscópio rígido ou flexível. Está indicada quando outros exames de auxílio diagnóstico das afecções da cavidade pleural, como ultra-sonografia, radiografia e biópsia percutânea, não foram efetivos, uma vez que a toracoscopia, por ser técnica invasiva,

RESUMO Os efeitos da acepromazina, detomidina e romifidina em eqüinos foram comparados