Cardioprotective solutions exposure for 1 hour in hypoxia and low temperatures affects vascular reactivity differently

Abstract Introduction: Heart preservation benefits cardiac performance after operations decreasing morbidity but the contribution of the vascular reactivity has been neglected. Objective: We evaluated whether cardioprotective solutions, Krebs-Henseleit (KH), Bretschneider-HTK (BHTK), St. Thomas No. 1 (STH-1), and Celsior (CEL), affect vascular reactivity. Methods: Aortic rings from Wistar rats were used in two protocols. First, the rings were exposed to BHTK, STH-1 or CEL for 1 hour of hypoxia at 37 °C. Second, the rings were exposed to 10 °C or 20 °C for 1 hour under hypoxia. After treatment, the rings were immersed in KH at 37 °C, endothelial integrity was tested and concentration-response curves to phenylephrine were performed. Results: In the first protocol, the solutions did not damage the endothelium; CEL and BHTK reduced KCl-induced contractions but not STH-1; only CEL and BHTK reduced vascular reactivity; there was a positive correlation between Rmax and KCl concentration. At 20 °C, 1 hour under hypoxia, the solutions produced similar KCl-induced contractions without endothelial damage. CEL, BHTK and STH-1 decreased vascular reactivity. At 10 °C, STH-1 increased reactivity but CEL and BHTK decreased. After 1 hour under hypoxia in CEL or BHTK solutions, reactivity was similar at different temperatures. At 20 °C, endothelial damage after exposure to STH-1 produced more vasoconstriction than CEL and BHTK. However, at 10 °C, endothelial damage after CEL and BHTK exposure elicited more vasoconstriction while STH-1 showed a small vasoconstrictor response, suggesting endothelial damage. Conclusion: STH-1 decreased reactivity at 20 °C and increased at 10 °C. CEL promoted greater endothelial modulation at 10 °C than at 20 °C, while STH-1 promoted higher modulation at 20 °C than at 10 °C. Vascular tone was reduced by CEL and BHTK exposure, also depending on the KCl concentration.

Cardioprotective Solutions Exposure For 1 Hour in Hypoxia and Low Temperatures Affects Vascular Reactivity Differently.

INTRODUCTION: Heart preservation benefits cardiac performance after operations decreasing morbidity but the contribution of the vascular reactivity has been neglected. METHODS: We evaluated whether cardioprotective solutions, Krebs-Henseleit (KH), Bretschneider-HTK (BHTK), St. Thomas No. 1 (STH-1), and Celsior (CEL), affect vascular reactivity. Methods: Aortic rings from Wistar rats were used in two protocols. First, the rings were exposed to BHTK, STH-1 or CEL for 1 hour of hypoxia at 37 °C. Second, the rings were exposed to 10 °C or 20 °C for 1 hour under hypoxia. After treatment, the rings were immersed in KH at 37 °C, endothelial integrity was tested and concentration- response curves to phenylephrine were performed. RESULTS: In the first protocol, the solutions did not damage the endothelium; CEL and BHTK reduced KCl-induced contractions but not STH- 1; only CEL and BHTK reduced vascular reactivity; there was a positive correlation between Rmax and KCl concentration. At 20 °C, 1 hour under hypoxia, the solutions produced similar KCl-induced contractions without endothelial damage. CEL, BHTK and STH-1 decreased vascular reactivity. At 10 °C, STH-1 increased reactivity but CEL and BHTK decreased. After 1 hour under hypoxia in CEL or BHTK solutions, reactivity was similar at different temperatures. At 20 °C, endothelial damage after exposure to STH-1 produced more vasoconstriction than CEL and BHTK. However, at 10 °C, endothelial damage after CEL and BHTK exposure elicited more vasoconstriction while STH-1 showed a small vasoconstrictor response, suggesting endothelial damage. CONCLUSION: STH-1 decreased reactivity at 20 °C and increased at 10 °C. CEL promoted greater endothelial modulation at 10 °C than at 20 °C, while STH-1 promoted higher modulation at 20 °C than at 10 °C. Vascular tone was reduced by CEL and BHTK exposure, also depending on the KCl concentration.

Correction: Testosterone deficiency reduces the effects of late cardiac remodeling after acute myocardial infarction in rats.

[This corrects the article DOI: 10.1371/journal.pone.0213351.].

Testosterone deficiency reduces the effects of late cardiac remodeling after acute myocardial infarction in rats.

Testosterone is associated with an increased risk of coronary heart disease. This study evaluated cardiac remodeling 60 days after myocardial infarction (MI) in rats with testosterone deficiency. One week after castration, the animals underwent myocardial infarction. Rats were divided into four groups: orchidectomized (OCT); orchidectomized and infarcted (OCT+MI), MI and control (Sham). The myocyte cross-sectional area and the papillary muscle contractility were evaluated 8 weeks after MI. The coronary bed was perfused with Biodur E20 resin to evaluate the neovascularization after MI. Data were expressed as mean ± SEM followed by ANOVA. Castration reduced myocyte hypertrophy when compared to Sham and myocardial infarction alone as well as preserved the contraction force and activation time after myocardial infarction. After beta-adrenergic stimulation, activation and relaxation kinetics were less impaired in the OCT+MI group than in the MI group. Contraction force was preserved in the OCT+MI group after beta-adrenergic stimulation. Multiple scanning electronic microscope images were obtained to characterize changes in the coronary arteries. Capillary density index was increased in the MI and OCT+MI groups compared with control. The MI and OCT+MI groups were characterized by irregular vessel arrangements with distorted shape, abrupt changes in vessel direction, as well as abrupt changes in diameter after bifurcations when compared to Sham and OCT. The results indicated that testosterone deficiency attenuates adverse cardiac remodeling after MI. Novel findings in this study were that testosterone deficiency in rats, induced by castration, changes the later remodeling after MI, when compared with non castrated rats. The absence of this androgenous hormone seems to be benefic against pathological hypertrophy.

Treatment with high dose of atorvastatin reduces vascular injury in diabetic rats.

BACKGROUND: Previous reports showed conflicting results regarding the treatment effects of statin on Diabetes mellitus (DM). We investigated how treatment with high dose of atorvastatin affects the impaired vascular function in diabetic rats. METHODS: Atorvastatin (80mg/kg/day, oral gavage, 4 weeks) or its vehicle was administered to male control or streptozotocin (STZ)-induced diabetic rats. Aortic segments were used to investigate the vascular reactivity, protein expression of cyclooxygenase-2 (COX-2) and nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) 1 (NOX1) and superoxide anions levels. RESULTS: Atorvastatin treatment did not affect glycemia levels. In diabetic rats, the vascular reactivity to phenylephrine increased compared with controls and the atorvastatin treatment reduced this response. Removal of the endothelium increased the response to phenylephrine in control rats, but not in the diabetic group. Atorvastatin increased the endothelial modulation in diabetic rats. L-NAME (100µM) increased the reactivity in all groups, but this effect was greater in atorvastatin-treated diabetic rats. Indomethacin (10µM) and NS398 (1µM) decreased the contractile response in diabetic rats and atorvastatin reversed these effects, without changing COX-2 expression. Apocynin (30µM) decreased the phenylephrine response in diabetic rats, which also showed increased NOX1 and superoxide anions; these effects were prevented by atorvastatin treatment. CONCLUSIONS: The results suggest that treatment with high dose of atorvastatin, independent of glycemia, improves endothelial function in aortas from diabetic rats by reducing the constrictor prostanoids derived from COX-2 and by reducing the oxidative stress by NADPH oxidase, as well as a possible increasing of nitric oxide participation.

Densidade mineral óssea estimada pelo Osteorisk em pacientes com escoliose idiopática do adolescente / Bone mineral density estimated by osteorisk in patients with adolescent idiopathic scoliosis

OBJETIVO: Considera-se a prevalência de osteoporose em portadores de Escoliose Idiopática do Adolescente (EIA) maior do que na população adolescente em geral.Uma alternativa à radiologia para caracterização da densidade mineral óssea pode ser através de índices correlativos, como o Osteorisk, de fácil acesso e baixo custo, que auxilia o médico na solicitação da Densitometria Óssea. Por considerarmos que a osteoporose pode interferir na evolução e no tratamento da EIA fomos motivados a realizar este estudo. Nosso objetivo foi avaliar subjetivamente a densidade mineral óssea através do índice Osteorisk em pacientes portadores de EIA. MÉTODOS: Foram avaliados pacientes saudáveis, (grupo controle, n=30) e pacientes com EIA (n=30), dos quais obtivemos idade, peso e altura, sendo estabelecido o Osteorisk. Feito teste t de Student não-pareado, com p< 0,05 significante. RESULTADOS: O valor médio do Osteorisk encontrado para os pacientes com EIA foi de 6,38 ± 2,2 enquanto que no grupo controle foi de 8,27 ± 2,14, o que representa baixo risco para o desenvolvimento de osteoporose em ambos os grupos. Quando comparadas estas médias entre os grupos, foi observado menor Osteorisk no grupo EIA. CONCLUSÃO: Nosso trabalho demonstrou existir baixo risco para o desenvolvimento de osteoporose nos pacientes com EIA. Nível de Evidência I, Estudo prospectivo.

OBJECTIVE: The prevalence of osteoporosis in patients with Adolescent Idiopathic Scoliosis (AIS) is believed to be higher than in the general adolescent population. An alternative to radiology for the characterization of bone mineral density may be through correlative indexes like the Osteorisk index, which is easy to access and low in cost, and which helps the doctor in the request for Bone Densitometry. Our belief that osteoporosis can affect the evolution and treatment of AIS was what motivated us to conduct this study. Our objective was to subjectively evaluate bone mineral density by the Osteorisk index in patients with AIS. METHODS: Healthy patients (control group, n=30) and patients with AIS (n = 30) were evaluated, documenting age, weight and height, and establishing the Osteorisk. The unpaired Student t test was performed, with a level of significance of p <0.05. RESULTS: The mean Osteorisk found for the patients with AIS was 6.38 ± 2.2 while in the control group, it was 8.27 ± 2.14, which represents a low risk of developing osteoporosis in both groups. Comparing these means between the groups, a lower Osteorisk was observed in the AIS group. CONCLUSION: Our study showed that there is low risk of developing osteoporosis in patients with AIS. Level of Evidence I, prospective study.

Fratura toracolombar do tipo explosão: o que o radiologista deve conhecer / Thoracolumbar burst fracture: what the radiologist should know

As fraturas vertebrais do tipo explosão são definidas como fraturas nas quais ocorre comprometimento da coluna anterior, média e posterior da vértebra. O tratamento destas fraturas vertebrais persiste indefinido, gerando questionamentos quanto à melhor forma de intervenção destes pacientes. Devido a estas dúvidas, os métodos de imagem apresentam papel fundamental na propedêutica pré-operatória. No entanto, diversas análises e mensurações são realizadas pelos cirurgiões de coluna sem padronização e consenso antes de se decidir sobre a melhor abordagem destes casos. Nesta revisão temos como objetivo padronizar e descrever as principais técnicas e achados radiológicos, com base nos principais critérios de instabilidade utilizados pelos cirurgiões na avaliação da fratura toracolombar tipo explosão, sendo eles, a medida da perda da altura da parede anterior da vértebra fraturada, a porcentagem de fragmento intracanal e o grau de abertura da distância interespinhosa e interpedicular. Acreditamos que, ao padronizar as principais mensurações realizadas para avaliação das fraturas toracolombares do tipo explosão por meio dos métodos radiológicos, estaremos fornecendo informações necessárias para a melhor interpretação dos resultados dos exames e, consequentemente, para uma tomada de decisão mais adequada acerca do tratamento.

Thoracolumbar burst fractures are defined as those fractures involving compromise of the anterior, middle and posterior vertebral columns. The treatment for such vertebral fractures still remains undefined, raising questions about the best form of intervention in these cases. Because of these doubts, imaging methods play a key role in the preoperative workup. However, several tests and measurements are performed by spine surgeons before deciding on the best approach to be adopted, with no standardization and neither consensus. The present review was aimed at standardizing and describing the main techniques and radiological findings on the basis of instability criteria adopted by surgeons in the assessment of thoracolumbar burst fractures, namely extent of height loss of the anterior wall of the fractured vertebra, level of spinal canal compromise by bone fragments and degree of widening of interspinous and interpedicular distance. It is the authors' opinion that the standardization of the main measurements in the evaluation of thoracolumbar burst fractures by radiological methods will provide the information required for a better interpretation of tests results and consequently aiding in the decision making about the most appropriate treatment.

Bone mineral density estimated by osteorisk in patients with adolescent idiopathic scoliosis.

OBJECTIVE: The prevalence of osteoporosis in patients with Adolescent Idiopathic Scoliosis (AIS) is believed to be higher than in the general adolescent population. An alternative to radiology for the characterization of bone mineral density may be through correlative indexes like the Osteorisk index, which is easy to access and low in cost, and which helps the doctor in the request for Bone Densitometry. Our belief that osteoporosis can affect the evolution and treatment of AIS was what motivated us to conduct this study. Our objective was to subjectively evaluate bone mineral density by the Osteorisk index in patients with AIS. METHODS: Healthy patients (control group, n=30) and patients with AIS (n = 30) were evaluated, documenting age, weight and height, and establishing the Osteorisk. The unpaired Student t test was performed, with a level of significance of p <0.05. RESULTS: The mean Osteorisk found for the patients with AIS was 6.38 ± 2.2 while in the control group, it was 8.27 ± 2.14, which represents a low risk of developing osteoporosis in both groups. Comparing these means between the groups, a lower Osteorisk was observed in the AIS group. CONCLUSION: Our study showed that there is low risk of developing osteoporosis in patients with AIS. Level of Evidence I, Prospective study.

Estudo descritivo sobre o primeiro mutirão no Brasil de cirurgias eletivas para tratamento de escoliose / Estudio descriptivo sobre el primer esfuerzo conjunto en la cirugía electiva de Brasil para el tratamiento de la escoliosis / Descriptive study about the first collective effort of elective surgeries for scoliosis treatment in Brazil

OBJETIVO: Descrever os resultados estatísticos do primeiro mutirão de cirurgias eletivas realizado no Brasil, não somente com o intuito de divulgar a iniciativa, mas, sobretudo, para que o conhecimento dessas ações possa incentivar outros estados e também outros mutirões no Espírito Santo. MÉTODO: Estudo descritivo observacional transversal, em que foram avaliados pessoas oriundas da Grande Vitória e do interior do estado do Espírito Santo com deformidades ou sintomas álgicos na região dorsal de origem osteomuscular, classificando-as de acordo com a idade, sexo e patologia, e quando diagnosticado escoliose, se possível classifica-la segundo King, Lenke, Winter et al. e Lounstein e Akbarnia, indicando-se tratamento. RESULTADOS: Foram avaliados 169 pacientes, sendo 48 homens e 121 mulheres, com média de idade de 39,7 anos e 41,1 anos, respectivamente. Foi encontrado 25,4% de pacientes com doenças ortopédicas em geral, 36,1% de doenças específicas da coluna vertebral exceto escoliose e 38,5% de escoliose. Dos pacientes com escoliose, 81,5% eram idiopática do adolescente, com maioria classificada por King como tipo II e por Lenke como tipo I. Dentre outras etiologias da escoliose, a congênita mais comum foi a hemivertebra associada a barra contralateral quando classificado por Winter et al. e das neuromusculares o tipo 2B da classificação de Louenstein e Akbarnia. CONCLUSÃO: Nossos dados epidemiológicos corroboram com a literatura atual. Conseguimos alcançar um numero satisfatório de pacientes com doenças da coluna vertebral, determinar um tratamento e acompanhamento e, ainda, divulgar e orientar a população sobre tais doenças.

OBJECTIVE: Describe the statistical results of the first campaign for elective surgeries performed in Brazil, not only in order to make the initiative public, but more importantly, so that the knowledge of these actions will encourage other States and also other collaborative efforts in Espírito Santo. METHODS: Descriptive cross-sectional observational study, which evaluated people from Grande Vitória and from the State of Espirito Santo with deformities or dorsal pain of musculoskeletal origin, classifying them according to age, sex and pathology, and when the diagnosis was scoliosis, if possible classified according to King, Lenke, Winter et al. and Lounstein and Akbarnia, and then indicating the treatment. RESULTS: We studied 169 patients, 48 men and 121 women with mean age of 39.7 years and 41.1 years, respectively. Of the total patients, 25.4% had orthopedic diseases general 36.1% had specific diseases of the spine, except scoliosis, and 38.5% had scoliosis. Scoliosis was of adolescent idiopathic type in 81.5% of patients, the majority being classified as type II by King and Lenke as type I.Among other causes, the most common congenital scoliosis was associated contralateral hemivertebra when ranked by Winter et al. and the neuromuscular type 2B was the most common when ranked by Louenstein Akbarnia. CONCLUSION: Our data corroborate the epidemiological literature. We have achieved a satisfactory number of patients with spinal diseases, determined a treatment and follow-up plan, and also divulged these diseases, providing guidance to the people about them.

OBJETIVO: Describir los resultados estadísticos de la primera campaña de cirugías electivas realizada en Brasil, no solo con el fin de difundir la iniciativa, sino, sobre todo, para que el conocimiento de esas acciones pueda alentar a otros Estados y también a otros esfuerzos conjuntos en el Estado de Espírito Santo. MÉTODOS: Estudio descriptivo transversal, observacional, que evaluó a las personas de los alrededores de la ciudad de Vitória y del interior del Estado de Espírito Santo con deformidades o síntomas de dolor, en la región dorsal, de origen osteomuscular, clasificando a esas personas de acuerdo a la edad, el sexo y la patología, y cuando se diagnosticó la escoliosis, se fue posible, se la clasificó según King, Lenke, Winter et al. y Lounstein y Akbarnia, y se indicó el tratamiento. RESULTADOS: Se evaluó un total de 169 pacientes, 48 hombres y 121 mujeres, edad promedio de 39,7 años y 41,1 años, respectivamente. Del total de pacientes evaluados, 25,4% tenían enfermedades ortopédicas en general, 36,1% enfermedades específicas de la columna vertebral excepto escoliosis, y 38,5% escoliosis. De los pacientes con escoliosis, 81,5% fueron de idiopática del adolescente, con la mayoría clasificados por King como de tipo II y por Lenke como de tipo I. Entre otras etiologías de la escoliosis, la congénita más común fue la hemivértebra asociada a barra contralateral cuando se clasifica por Winter et al y, de las neuromusculares, el tipo 2B de la clasificación de Louenstein y Akbarnia. CONCLUSIÓN: Nuestros datos epidemiológicos corroboran la literatura actual. Logramos conseguir un número satisfactorio de pacientes con enfermedades de la columna vertebral, determinar un tratamiento y seguimiento, así como divulgar y orientar a la población sobre tales enfermedades.

Comparação do Índice de Torg obtido por meio de radiografia e ressonância magnética nos pacientes com mielopatia cervical espondilótica / Comparación del Índice de Torg, obtenido por medio de radiografía y resonancia, en los pacientes con mielopatía espondilótica cervical / Comparison of the Torg Index obtained by radiography and magnetic resonance in patients with spondylotic cervical myelopathy

OBJETIVO: A Mielopatia Cervical Espondilótica (MCE) é uma disfunção da medula espinhal relacionada à degeneração típica do envelhecimento. No estudo de imagem podemos obter a medida do Índice de Torg, para estimar a estenose cervical. Objetivamos, assim, medir o Índice de Torg através de radiografia e ressonância magnética (RM), possibilitando verificar possíveis discrepâncias entre os métodos de medida. MÉTODOS: Realizada mensuração do Índice de Torg na radiografia e na RM da coluna cervical, sendo obtido através da relação entre a superfície posterior do corpo vertebral e o ponto mais próximo à linha laminar correspondente, dividido pelo diâmetro sagital do corpo vertebral. RESULTADOS: Participaram 29 pacientes, sendo 10 mulheres e 19 homens, com médias de idade 48,1 ± 11 anos, de peso 68,7 ± 5 Kg e de altura 1,68 ± 0,6 m. Houve diferença significativa entre o Índice de Torg calculado através de radiografia e RM, sendo menores os índices observados na RM (radiografia: 0,73 ± 0,17 vs. RM: 0,48 ± 0,14, p< 0,05). No entanto, ambas as aferições traduzem o mesmo resultado: estenose cervical absoluta (Índice de Torg < 0,8). CONCLUSÕES: Nossos resultados corroboram relatos de outros autores que acreditam que o Índice de Torg medido através da radiografia, como preconizado, minimiza a real estenose do canal cervical. Sugerimos em nosso estudo que a RM permite melhor estimativa do grau de estenose do canal, muito embora nossos resultados em relação ao grau de estenose cervical tenham sido semelhantes estatisticamente.

OBJECTIVE: Cervical spondylotic myelopathy (SCM) is a dysfunction related to spinal cord degeneration typical of aging. In the imaging studies can achieve a measure of the Torg index to estimate cervical stenosis. We aim therefore to measure the Torg index in X-rays and Magnetic Resonance (MR), to investigate possible discrepancies between the methods of measurement. METHODS: The Torg Index was measured on radiographs and MR of the cervical spine, obtained by determining the relationship between the posterior surface of the vertebral body and the nearest point to the corresponding laminar line, divided by the sagittal diameter of vertebral body. RESULTS: A total 29 patients has participated, 10 women and 19 men, with mean age of 48.1 ± 11 years, weight 68.7 ± 5kg and height 1.68 ± 0.6m. There were significant differences between the Torg Index calculated by radiography and MR, and lower rates observed on MR (radiography: 0.73 ± 0.17 vs. RM: 0.48 ± 0.14, p <0.05). However, both measurements reflect the same result: absolute cervical stenosis (Torg index < 0.8). CONCLUSIONS: Our results confirm reports by other authors who believe that the Torg Index measured by radiography, as recommended, minimizes the actual cervical canal stenosis. Our study suggests that MRI allows better estimate of the degree of stenosis, although our results regarding the degree of cervical stenosis were statistically similar.

OBJETIVO: La Mielopatía Cervical Espondilótica (MCE) es un trastorno relacionado con la degeneración de la médula espinal, típica del envejecimiento. En el estudio de imagen se puede obtener la medida del Índice de Torg para estimar la estenosis cervical. Nuestro objetivo es, por tanto, medir el índice de Torg mediante rayos-X y resonancia magnética (RM), posibilitando verificar posibles discrepancias entre los métodos de medición. MÉTODOS: Se realiza la medición del Índice de Torg en la radiografía y en la resonancia magnética de la columna cervical, siendo obtenido mediante la determinación de la relación entre la superficie posterior del cuerpo vertebral y el punto más cercano a la línea de la lámina correspondiente, dividido por el diámetro sagital del cuerpo vertebral. RESULTADOS: Participó un total de pacientes 29, siendo 10 mujeres y 19 hombres, edad promedio de 48,1 ± 11 años, peso 68,7 ± 5 Kg y altura de 1,68 ± 0,6 m. No hubo diferencias significativas entre el Índice de Torg calculado por la radiografía y el de la resonancia magnética, siendo menores los índices observados en la RM (radiografía: 0,73 ± 0,17 vs RM: 0,48 ± 0,14, p <0,05). Sin embargo, ambas mediciones reflejan el mismo resultado: estenosis cervical absoluta (Índice de Torg <0,8). CONCLUSIONES: Nuestros resultados confirman los informes de otros autores quienes creen que el Índice de Torg medido por radiografía, como se recomienda, minimiza la estenosis real del canal cervical. En nuestro estudio se sugiere que la RM permite hacer una mejor estimativa del grado de estenosis del canal, aunque nuestros resultados, sobre el grado de estenosis cervical, fueron estadísticamente similares.

Avaliação da lordose da coluna cervical nos pacientes com escoliose do tipo Lenke I submetidos ao tratamento cirúrgico / Evaluation of cervical behavior in patients with scoliosis Lenke who underwent surgery / Evaluación de la lordosis de la columna cervical en los pacientes con escoliosis del tipo Lenke I sometidos al tratamiento quirúrgico

OBJETIVO: Avaliar a angulação da lordose cervical nos pacientes portadores de Escoliose Idiopática do Adolescente (EIA) do tipo Lenke I, no período pré- e pós-operatório. MÉTODO: Estudo prospectivo e descritivo em que foram avaliados pacientes com EIA, sendo documentadas medidas antropométricas. Foram avaliadas as angulações das radiografias (posição ortostática) em perfil cervical de C3 a C7 no período pré- e pós-operatório, estabelecendo como normal a lordose cervical entre 10 e 30 graus. RESULTADOS: Participaram 26 pacientes com EIA, sendo a maioria do sexo feminino (73 por cento), com média de idade de 14,3 anos. Observamos que no período pré-operatório 80,9 por cento dos pacientes apresentavam angulação cervical não fisiológica, sendo que 42,3 por cento dos pacientes apresentavam diminuição da lordose cervical (<10°) e 38,6 por cento, inversão desta angulação (<0°). No pós-operatório, todos os pacientes apresentaram melhora da angulação cervical em relação aos níveis fisiológicos, sendo que 69,3 por cento dos pacientes obtiveram a angulação normal desejada da coluna cervical e nenhum dos pacientes manteve inversão da lordose cervical. CONCLUSÕES: A correção cirúrgica da escoliose cursou com melhoria secundária da angulação da lordose cervical.

OBJECTIVE: This study was to evaluate the angle of cervical lordosis in patients with Adolescent Idiopathic Scoliosis (AIS) ranked in Lenke I pre- and postoperatively. METHODS: Prospective and descriptive study, which evaluated patients with AIS and documented anthropometric measures. We assessed the angulations of the radiographs (orthostatic position) in cervical profile of C3 to C7 in the pre- and post-operative setting as the normal cervical lordosis between 10 and 30 degrees. RESULTS: A total of 26 patients with AIS, the majority being female (73 percent) with mean age of 14.3 years. We noted that in the pre-operative 42.3 percent of patients had reduced cervical lordosis (<10°) and 38.6 percent, reversal of this angle (<0°). Postoperatively, all patients had improvement in cervical angle in relation to physiological levels, with 69,3 percent of patients achieving the desired normal angle and no cervical spine of patients maintained reversal of cervical lordosis. CONCLUSIONS: Surgical correction of scoliosis has led to the secondary improvement of angulation of the cervical lordosis,.

OBJETIVO: Evaluar el ángulo de la lordosis cervical en pacientes con Escoliosis Idiopática del Adolescente (EIA), clasificados en Lenke I en el pre y posoperatorio. MÉTODOS: Estudio prospectivo y descriptivo, en el que se evaluó a pacientes con EIA y se documentaron mediciones antropométricas. Se evaluó la angulación de las radiografías (posición ortostásica) de perfil de columna cervical de C3 a C7, en el entorno de pre y posoperatorias, estableciéndose como normal la lordosis cervical entre 10 y 30 grados. RESULTADOS: Un total de 26 pacientes fue evaluado, en su mayoría mujeres (73 por ciento) con edad promedio de 14,3 años. Observamos que, en el período preoperatorio, 80,9 por ciento de los pacientes presentaban angulación cervical no fisiológica, siendo que 42,3 por ciento de los pacientes habían reducido la lordosis cervical (<10 °) y 38,6 por ciento la inversión de este ángulo (<0 °). Después de la operación, todos los pacientes tuvieron una mejoría en el ángulo de la columna cervical en relación con los niveles fisiológicos, con 69,3 por ciento de los pacientes que alcanzaron el ángulo normal deseado de la columna cervical y ninguno de los pacientes mostró una reversión de la lordosis cervical. CONCLUSIONES: La corrección quirúrgica de la escoliosis produjo una mejora secundaria de la angulación de la lordosis cervical.

Soybean oil increases SERCA2a expression and left ventricular contractility in rats without change in arterial blood pressure.

BACKGROUND: Our aim was to evaluate the effects of soybean oil treatment for 15 days on arterial and ventricular pressure, myocardial mechanics and proteins involved in calcium handling. METHODS: Wistar rats were divided in two groups receiving 100 microL of soybean oil (SB) or saline (CT) i.m. for 15 days. Ventricular performance was analyzed in male 12-weeks old Wistar rats by measuring left ventricle diastolic and systolic pressure in isolated perfused hearts according to the Langendorff technique. Protein expression was measured by Western blot analysis. RESULTS: Systolic and diastolic arterial pressures did not differ between CT and SB rats. However, heart rate was reduced in the SB group. In the perfused hearts, left ventricular isovolumetric systolic pressure was higher in the SB hearts. The inotropic response to extracellular Ca2+ and isoproterenol was higher in the soybean-treated animals than in the control group. Myosin ATPase and Na(+)-K(+)ATPase activities, the expression of sarcoplasmic reticulum calcium pump (SERCA2a) and sodium calcium exchanger (NCX) were increased in the SB group. Although the phosfolamban (PLB) expression did not change, its phosphorylation at Ser16 was reduced while the SERCA2a/PLB ratio was increased. CONCLUSIONS: In summary, soybean treatment for 15 days in rats increases the left ventricular performance without affecting arterial blood pressure. These changes might be associated with an increase in the myosin ATPase activity and SERCA2a expression.

Auxílio da tomografia computadorizada no planejamento pré-operatório de pacientes portadores de escoliose idiopática do adolescente / Computed tomography aid in preoperative planning of patients with adolescent idiopathic scoliosis / Auxilio de la tomografía computarizada en el plan preoperatorio de pacientes portadores de escoliosis idiopática del adolescente

A escoliose idiopática do adolescente (EIA) é uma doença diagnosticada no início da puberdade. Ela apresenta etiologia indefinida e caracteriza-se pelo desvio lateral da coluna vertebral maior que 10º, associado à rotação do corpo vertebral. O uso de instrumentação de terceira geração produziu um melhor resultado na correção da curva do que as técnicas anteriores. Porém, ainda existem dificuldades técnicas no momento da passagem e da escolha dos parafusos pediculares, devido à angulação e ao diâmetro dos pedículos vertebrais. Apesar de apresentar vantagens, essa técnica não é isenta de riscos e complicações, necessitando de uma maior curva de aprendizado pelo médico-cirurgião, bem como de um adequado planejamento pré-operatório. Até o momento, não há na literatura relato sobre a utilização da tomografia computadorizada no auxílio do planejamento cirúrgico de pacientes com escoliose. Diante do exposto, objetivamos, no presente estudo, descrever uma técnica de planejamento pré-operatório, com o auxílio da tomografia computadorizada para a fixação da coluna em pacientes com escoliose idiopática do adolescente, especificando a angulação e o diâmetro dos pedículos vertebrais, o que poderá auxiliar o médico-cirurgião no momento da fixação.

The adolescent idiopathic scoliosis is a diagnosed disease in the beginning of puberty, with unknown etiology, characterized by lateral deviation of the spine (above 10º), which is related to vertebral rotation. The form of surgical treatment by spinal fixation with pedicle screws showed better results when compared to other fastening systems, but there are still technical difficulties at the time of passage and the choice of pedicle screws because of vertebral pedicles angle and diameter. Despite its advantages, this technique presents risks and complications, requiring a greater learning curve for the surgeon, as well as an adequate preoperative planning. So far, there is no literature report about the use of computed tomography as an aid to surgical planning of patients with scoliosis. In this light, the present study aims to describe a preoperative planning technique with the aid of computed tomography for spinal fixation in patients with Adolescent Idiopathic Scoliosis, specifying the angle and diameter of the vertebral pedicles, which may help the surgeon in the fixation.

La escoliosis idiopática en el adolescente (EIA) es una enfermedad diagnosticada en el inicio de la pubertad. Esta presenta una etiología indefinida y es caracterizada por el desvío lateral de la columna vertebral por encima de los diez grados asociados a la rotación del cuerpo vertebral. El uso de instrumentación de tercera generación produjo un mejor resultado en la corrección de la curva comparado con las técnicas anteriores. Sin embargo, existen dificultades técnicas en el momento del paso y de escoger los tornillos pediculares debido a la angulación y al diámetro de los pedículos vertebrales. A pesar de presentar ventajas, esta técnica no está libre de riesgos y complicaciones, necesitando de una mayor curva de aprendizaje por el médico cirujano, así como también de un adecuado plan preoperatorio. Hasta el momento, no hay en la literatura un relato sobre la utilización de la tomografía computarizada en el auxilio quirúrgico de los pacientes con escoliosis. Según lo expuesto, proponemos, en el presente estudio, describir una técnica para el plan preoperatorio con el auxilio de la tomografía computarizada para la fijación de la columna en pacientes con escoliosis idiopática del adolescente, especificando la angulación y el diámetro de los pedículos vertebrales, lo que podrá auxiliar al médico cirujano en el momento de la fijación.

PARSONAGE-TURNER SYNDROME: CASE REPORT OF A HIV-SEROPOSITIVE PATIENT.

Parsonage-Turner Syndrome is a rare disease that affects the musculature of the scapular girdle, leading to muscle atrophy and large motor deficit. The etiology is uncertain, but it is believed that infectious and autoimmune factors are involved. The diagnosis is made by exclusion, and the main differential diagnoses are cervical disc hernias, rotator cuff injuries and rheumatic diseases. During diagnostic investigations, we perform laboratory tests, radiographs and MRI on the shoulders and cervical spine, with emphasis on electroneuromyography to help in making a definitive diagnosis. This case report is presented because it shows a disease that is rarely associated with HIV seropositivity and the importance of early diagnosis for better treatment of these patients.

Síndrome de parsonage-turner: relato de caso em paciente HIV soropositivo / Parsonage-turner syndrome: case report of a HIV seropositive patient

A síndrome de Parsonage-Turner é uma doença rara que acomete a musculatura da cintura escapular levando à hipotrofia muscular e grande déficit motor. A etiologia é indeterminada; acredita-se que existam fatores infecciosos e autoimunes envolvidos. O diagnóstico é de exceção, e os principais diagnósticos diferenciais são hérnias discais cervicais, lesões do manguito rotador e doenças reumáticas. Na investigação diagnóstica realizamos exames laboratoriais, radiografias e ressonância magnética dos ombros e da coluna cervical com destaque para a eletroneuromiografia auxiliando no diagnóstico definitivo. Por se tratar de uma doença raramente associada à soropositividade do vírus HIV e pela importância do diagnóstico precoce para o melhor tratamento destes pacientes é que relatamos este caso.

The Parsonage-Turner Syndrome is a rare disease that affects the muscles of the scapular girdle, leading to muscular atrophy and a large motor deficit. The etiology is unknown, but it is believed that infectious and autoimmune factors are involved. The diagnosis is made by exclusion, and the main differential diagnoses are cervical disc hernias, rotator cuff injuries and rheumatic diseases. During diagnostic research, we conducted laboratory tests, radiographs and MRI of the shoulder and cervical spine, with particular reference to electroneuromyography to help generate a definitive diagnosis. This case report is presented because it shows a disease that is rarely associated with HIV seropositivity and the importance of early diagnosis for better treatment of these patients.