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The classic 1966 description of locked-in syndrome was performed by Plum and Posner. Here, we revisit the world's first case report of this condition, which was presented in 1875 by Camille Darolles, an intern supervised by François Damaschino, at a monthly meeting of the Société Anatomique de Paris chaired by Jean-Martin Charcot. We also review the fascination of classic writers with this syndrome, including Alexandre Dumas, a genius of literature and known admirer of the medical sciences who, in the book "The Count of Monte Cristo" published in 1846, described a character with this condition.
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Síndrome de Enclaustramiento , Medicina , Neurología , Humanos , CogniciónRESUMEN
The role of telomerase reverse transcriptase has been widely investigated in the contexts of ageing and age-related diseases. Interestingly, decreased telomerase activities (and accelerated telomere shortening) have also been reported in patients with emotion-related disorders, opening the possibility for subjective appraisal of stressful stimuli playing a key role in stress-driven telomere shortening. In fact, patients showing a pessimistic judgement bias have shorter telomeres. However, in humans the evidence for this is correlational and the causal directionality between pessimism and telomere shortening has not been established experimentally yet. We have developed and validated a judgement bias experimental paradigm to measure subjective evaluations of ambiguous stimuli in zebrafish. This behavioural assay allows classification of individuals in an optimistic-pessimistic dimension (i.e. from individuals that consistently evaluate ambiguous stimuli as negative to others that perceive them as positive). Using this behavioural paradigm we found that telomerase-deficient zebrafish (tert-/-) were more pessimistic in response to ambiguous stimuli than wild-type zebrafish. The fact that individuals with constitutive shorter telomeres have pessimistic behaviours demonstrates for the first time in a vertebrate model a genetic basis of judgement bias.
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Pesimismo , Telomerasa , Animales , Telomerasa/genética , Telomerasa/metabolismo , Telómero/genética , Acortamiento del Telómero , Pez Cebra/genéticaRESUMEN
This is a cross-sectional analysis of data obtained in the baseline of the Longitudinal Study on the Lifestyle and Health of University Students (n 685) carried out in a public Brazilian university. Food intake was assessed using a 24-h dietary recall. Dietary patterns (DP) for breakfast, lunch and dinner were identified using principal component analysis. Generalised linear models were used to analyse the variables associated with each DP. Three DP were extracted for each meal: breakfast: 'White bread and butter/margarine', 'Coffee and tea' and 'Sausages, whole wheat bread and cheese'; lunch: 'Traditional', 'Western' and 'Vegetarian' and dinner: 'Beans, rice and processed juice', 'White bread and butter/margarine' and 'White meat, eggs and natural juice'. Students who had meals at the campus showed greater adherence to the 'White bread and butter/margarine' (exp (ßadj) = 1·15, 95 % CI 1·11, 1·19) and 'Coffee and tea' (exp (ßadj) = 1·06, 95 % CI 1·02, 1·10) breakfast patterns; 'Western' lunch pattern (exp (ßadj) = 1·04, 95 % CI 1·01, 1·08) and to the 'Beans, rice and processed juice' dinner pattern (exp (ßadj) = 1·10, 95 % CI 1·06, 1·14). Having meals at the campus was associated with lower adherence to the 'Sausages, whole wheat bread and cheese' breakfast pattern (exp (ßadj) = 0·93, 95 % CI 0·89, 0·97), 'Traditional' lunch pattern (exp (ßadj) = 0·96, 95 % CI 0·93, 0·99) and to the 'White bread and butter/margarine' (exp (ßadj) = 0·96, 95 % CI 0·93, 0·99) and 'White meat, eggs and natural juice' (exp (ßadj) = 0·96, 95 % CI 0·93, 0·99) dinner pattern. The food environment at campus may influence students' DP. Recognising meal eating patterns is important to support healthy eating promotion strategies on campus. Adjustments in the University Canteen menu could contribute to healthier eating choices among students.
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Dieta , Conducta Alimentaria , Comidas , Brasil , Pan , Mantequilla , Café , Estudios Transversales , Huevos , Jugos de Frutas y Vegetales , Humanos , Estudios Longitudinales , Margarina , Carne , Estudiantes , Té , UniversidadesRESUMEN
Triazoles are well-known organic corrosion inhibitors of copper. 1H-1,2,3-Triazole and 1,2,4-triazole, two very simple molecules with the only difference being the positions of the nitrogen atoms in the triazole ring, were studied in this work as corrosion inhibitors of copper in 50 mM NaCl solution using a set of electrochemical and analytical techniques. The results of electrochemical tests indicate that 1H-1,2,3-triazole exhibited superior inhibitor properties but could not suppress anodic copper dissolution at moderate anodic potentials (>+300 mV SCE), while 1,2,4-triazole, although it exhibited higher anodic currents, suppressed anodic copper dissolution at very anodic potentials. Density functional theory calculations were also performed to interpret the measured data and trends observed in the electrochemical studies. The computational studies considered either the inhibitors isolated in the gaseous phase or adsorbed onto Cu(111) surface models. From the calculations, the mechanisms of the inhibitive effects of both triazoles were established and plausible mechanisms of formation of the protective films on the Cu surface were proposed. The results of this study hold positive implications for research in the areas of catalysis, and copper content control in water purification systems.
RESUMEN
AIMS: The objective of this work was to assess the antibacterial effect of 2-mercaptobenzothiazole (MBT), used as model-biocide, immobilized in a layered double hydroxide (LDH) structure, under different conditions of pH and salinity, envisaging possible applications of the system in active antifouling and anticorrosion coatings. METHODS AND RESULTS: Biological effects of MBT immobilized in LDH were assessed by monitoring bacterial bioluminescence of cell suspensions of either Allivibrio fischeri or a recombinant strain of Escherichia coli, as a proxy for bacterial activity. Salinity (1, 2 and 3% NaCl) and pH (4, 5, 6 and 7) of the suspension media were experimentally manipulated and biocide release tests were performed in parallel. The release profiles obtained by UV-visible spectrophotometry indicated a fast release of biocide from MBT@LDH, slightly enhanced in 3% NaCl and under alkaline conditions. However, biological effects were more pronounced at 1% NaCl and at neutral pH. CONCLUSIONS: The release and toxic effect of MBT immobilized in LDH is dependent on the concentration of solutes in the suspension medium. SIGNIFICANCE AND IMPACT OF THE STUDY: The results confirm LDH as a biologically compatible material with potential to be used for biocide delivery.
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Antibacterianos/farmacología , Benzotiazoles/farmacología , Hidróxidos/química , Antibacterianos/química , Benzotiazoles/química , Composición de Medicamentos , Escherichia coli/efectos de los fármacos , Concentración de Iones de Hidrógeno , Cinética , Nanoestructuras/químicaRESUMEN
Our aim was to compare the responses of physical treatment with or without manual lymphatic drainage (MLD) in lymphedema after breast cancer treatment in a Brazilian population. This was a controlled clinical trial with lymphedema secondary to breast cancer treatment patients that were randomized into either: Group 1 consisting of MLD, skin care, bandaging and remedial exercises; or Group 2 using skin care, bandaging and remedial exercises. Sixty-six patients were randomized and 9 were excluded during the first phase, resulting in a total of 57 patients eligible for analyzes with 28 in Group 1 and 29 in Group 2. The first phase of treatment had an average duration of 24 days (+/- 12.38) and final volume excess average (VE) between limbs was 494.51 ml, corresponding to 29.18% of the initial volume. Volume reduction was highly significant, independent of the intervention (p < 0.001), and both treatments led to an average of percentage volume excess reduction (PVER) of 15.02%. Patients with incomplete range of motion and lymphatic-related fibrotic tissues showed a statistically significant reduction in the percentage of volume excess (p = 0.010; p = 0.009). The presence of arm paresthesia was associated with the lowest therapeutic response (p = 0.024). Both treatment groups demonstrated absolute and relative reductions of excess limb volume, and the addition of MLD did not significantly increase the therapeutic response in women with lymphedema after breast cancer.
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Neoplasias de la Mama/cirugía , Linfedema/terapia , Modalidades de Fisioterapia , Adulto , Anciano , Brazo , Vendajes , Drenaje , Femenino , Humanos , Linfedema/etiología , Linfedema/patología , Persona de Mediana Edad , Satisfacción del Paciente , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
The present paper reports on the development of new sensing active coating on the basis of nanocontainers containing pH-indicating agent. The coating is able to detect active corrosion processes on different metallic substrates. The corrosion detection functionality based on the local colour change in active cathodic zones results from the interaction of hydroxide ions with phenolphthalein encapsulated in mesoporous nanocontainers which function as sensing nanoreactors. The mesoporous silica nanocontainers are synthesized and loaded with pH indicator phenolphthalein in a one-stage process. The resulting system is mesoporous, which together with bulkiness of the indicator molecules limits their leaching. At the same time, penetration of water molecules and ions inside the container is still possible, allowing encapsulated phenolphthalein to be sensitive to the pH in the surrounding environment and outperforming systems when an indicator is directly dispersed in the coating layer.The performed tests demonstrate the pH sensitivity of the developed nanocontainers being dispersed in aqueous solutions. The corrosion sensing functionality of the protective coatings with nanocontainers are proven for aluminium- and magnesium-based metallic substrates. As a result, the developed nanocontainers show high potential to be used in a new generation of active protective coatings with corrosion-sensing coatings.
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Nanoestructuras/química , Dióxido de Silicio/química , Corrosión , Fenolftaleína/química , Porosidad , Protones , Propiedades de SuperficieRESUMEN
The aim of the present study was to investigate the effect of acute third ventricle injections of two different 5-HT(4) receptor antagonists, GR 113808 and SB 204070, on water intake in different situations. Injections of 80 nmol/rat of both GR 113808 and SB 204070 were unable to modify water intake in normohydrated rats. Pretreatment with GR 113808 (40 and 80 nmol/rat) and SB 204070 (80 and 160 nmol/rat) blunted water intake after third ventricle injections of angiotensin II (9.6 pmol/rat) compared to saline-pretreated controls. Pretreatment with 80 nmol/rat of both antagonists potentiated drinking induced by third ventricle injections of carbachol (11.0 nmol/rat) compared to saline-pretreated control. In all doses employed, none of the compounds was able to modify water intake in dehydrated rats. A separate control test using one-bottle taste aversion paradigm indicated that the reduction in water intake observed in some of the present experiments could not be attributed to a drug-induced malaise. It is suggested that central 5-HT(4) receptors exert a dualistic role on the control of water intake potentiating angiotensin II-induced drinking and inhibiting thirst induced by central cholinergic activation
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Conducta de Ingestión de Líquido/fisiología , Receptores de Serotonina/fisiología , Animales , Dioxanos/administración & dosificación , Ingestión de Líquidos/efectos de los fármacos , Ingestión de Líquidos/fisiología , Conducta de Ingestión de Líquido/efectos de los fármacos , Indoles/administración & dosificación , Inyecciones Intraventriculares , Masculino , Piperidinas/administración & dosificación , Ratas , Ratas Wistar , Receptores de Serotonina 5-HT4 , Antagonistas de la Serotonina/administración & dosificación , Sulfonamidas/administración & dosificación , Sed/efectos de los fármacos , Sed/fisiología , Privación de Agua/fisiologíaRESUMEN
Prosthesis loosening is a major problem associated with the use of poly(methyl methacrylate) (PMMA) bone cement that may be related to a peri-implant vacuolisation commonly observed at bone-cement interface. Methyl methacrylate (MMA) monomer may be one of the cement components partly responsible for the mentioned vacuolisation due to a cytotoxic effect associated to this compound. Alcoholism has been related to bone necrosis in predisposed individuals. Furthermore, ethanol has been shown to clean material with adherent cement debris during cleaning procedure in laboratory. Consequently, we have decided to study whether ethanol will also be related to an increased liberation of MMA from the polymer matrix. 'In vitro' release studies using PMMA plates were conducted to access the role of ethanol on the liberation of the monomer. Contact angle measurements and surface tension estimation were also carried out in order to find a possible effect of ethanol on surface cement properties. Results suggest that ethanol, even in small quantities, enhances the leaching of the monomer from the polymer matrix, but does not considerably change the wettability properties of the cement surface.
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Resinas Acrílicas/química , Cementos para Huesos/química , Etanol/química , Algoritmos , Tampones (Química) , Semivida , Modelos Teóricos , Fosfatos/química , Polimetil Metacrilato/química , Solubilidad , Solventes , Tensión Superficial , Factores de TiempoRESUMEN
Poly(methyl methacrylate) (PMMA) is used to fill the gap between the prosthesis and the surrounding bone in cemented arthroplasties. Biocompatibility problems related to bone cement application limit the clinical success of these cemented arthroplasties. Being the cement surface in close connection with the living bone, it is reasonable to assume that surface properties such as, surface composition and surface energy, will play a role in the biomaterial performance. X-ray photoelectron spectroscopy (XPS) analysis and surface energy studies were carried out during 4 months, in order to assess a possible correlation between aging time and surface changes. The aging of PMMA, in a biological model fluid, strongly influences the composition and wettability of the cement surface. These changes may be explained through the hydrolysis of PMMA ester groups and the subsequent hydrogen bonding. Although our study does not exactly reproduce the in vivo environment surrounding a prosthesis, it suggests that the changes in the composition and wettability of the surface may modulate the host response towards the implant, thus contributing to its loosening.
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Cementos para Huesos/química , Polimetil Metacrilato/química , Tecnología Farmacéutica/métodos , Propiedades de SuperficieRESUMEN
Renal vascular escape is a physiological phenomenon of adaptation that occurs in vascular smooth muscle. It has been described in many preparations subjected to electrical stimulation or treated with vasoactive agents, such as noreprinephrine, angiotensin and vasopressin. We have recently demonstrated that a naturally occurring ginkgolide (BN 52021), which is a PAF antagonist, was able to block norepinephrine-induced escape in perfused rabbit kidney. In the present work other PAF antagonists, such as the ginkgolides BN 52022 and BN 52024, and the synthetic compounds 48740 RP and WEB 2086, were tested. Their effects on renal vascular escape, perfusion pressure and tachyphylaxis were evaluated. They all were shown to block the escape. Among the ginkgolides, BN 52024 is generally recognized as one of the weaker PAF antagonists. However, in spite of this, BN 52024 was able to significantly and simultaneously block renal vascular escape and tachyphylaxis in perfused rabbit kidney infused with norepinephrine.
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Azepinas/farmacología , Diterpenos , Riñón/fisiología , Lactonas/farmacología , Factor de Activación Plaquetaria/antagonistas & inhibidores , Piridinas/farmacología , Circulación Renal/efectos de los fármacos , Taquifilaxis , Tiazoles/farmacología , Triazoles/farmacología , Animales , Femenino , Gangliósidos/farmacología , Ginkgólidos , Técnicas In Vitro , Riñón/efectos de los fármacos , Cinética , Masculino , Perfusión , Conejos , Factores de TiempoRESUMEN
Immune complexes (IC) were isolated from sera of six chronic schistosomiasis patients in order to study the regulatory mechanisms of granulomatous hypersensitivity to Schistosoma mansoni egg antigens in vitro. Purified blood mononuclear cells (PBMC) from patients (N = 14) with active schistosome infection when treated with a pool of isolated IC were able to inhibit granulomatous hypersensitivity as determined in an in vitro model of granuloma formation. The suppressive effect of IC on granuloma index varied from 33% to 73%. Analysis of the in vitro proliferation of PBMC from individuals infected with S. mansoni on blastogenesis assay (N = 7) showed that isolated IC were able to induce a suppression degree on cell proliferation from 31% to 93%. Significant inhibition of the in vitro granuloma reaction continued to be present after treatment of PBMC with supernatant from IC treated chronic patient cells. These results demonstrate that circulating IC may down-regulate granulomatous hypersensitivity to S. mansoni eggs in patients with chronic intestinal schistosomiasis.
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Complejo Antígeno-Anticuerpo/inmunología , Granuloma/inmunología , Esquistosomiasis mansoni/inmunología , Western Blotting , Enfermedad Crónica , Electroforesis en Gel de Poliacrilamida , Humanos , Técnicas In VitroRESUMEN
Although multinucleated giant cells have been described for many years in association with different chronic inflammatory responses, their participation in immunoregulatory mechanisms within the schistosome egg granulomas remains to be clarified. In this study we determined if soluble egg antigen (SEA) or adult worm antigen preparations (SWAP) from S. mansoni induce giant cell formation in vitro and their relationship with the intensity of granulomatous reactivity. Antigenic stimulation of peripheral blood mononuclear cells (PBMC) from patients (N = 9) with active schistosomiasis infection increased giant cell formation per field after the 12th day in culture when treated with S. mansoni SEA conjugated to polyacrylamide beads (PB-SEA) (17 +/- 1.2) and SWAP (PB-SWAP) (18.5 +/- 1.5). The increase in the number of giant cells was statistically significant when compared to the control polyacrylamide beads (PB) (9 +/- 1.1) and purified protein derivative conjugated to beads (PB-PPD) (11.6 +/- 1.7). We also observed a correlation between an increase in the number of giant cells and a decrease in in vitro granuloma index (GI) to PB-SEA (GI decreased from 4.3 +/- 0.2 on the 6th day to 3.2 +/- 0.2 on the 12th day) and PB-SWAP (GI decreased from 4.8 +/- 0.3 on the 6th day to 3.5 +/- 0.05 on the 12th day). These data suggest that giant cell formation may be one of the immunoregulatory mechanisms involved in the down-regulation of the granuloma reaction against S. mansoni eggs.
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Antígenos Helmínticos/inmunología , Células Gigantes/inmunología , Schistosoma mansoni/inmunología , Animales , Células Gigantes/patología , Granuloma/inmunología , Humanos , Leucocitos Mononucleares/inmunología , Óvulo/inmunología , Esquistosomiasis mansoni/inmunologíaRESUMEN
We have demonstrated that central administration of zinc in minute amounts induces a significant antidipsogenic action in dehydrated rats as well as in rats under central cholinergic and angiotensinergic stimulation. Here we show that acute third ventricle injections of zinc also block water intake induced by central ss-adrenergic stimulation in Wistar rats (190-250 g). Central inhibition of opioid pathways by naloxone reverses the zinc-induced antidipsogenic effect in dehydrated rats. After 120 min, rats receiving third ventricle injections of isoproterenol (160 nmol/rat) exhibited a significant increase in water intake (5.78 +/- 0.54 ml/100 g body weight) compared to saline-treated controls (0.15 +/- 0.07 ml/100 g body weight). Pretreatment with zinc (3.0, 30.0 and 300.0 pmol/rat, 45 min before isoproterenol injection) blocked water intake in a dose-dependent way. At the highest dose employed a complete blockade was demonstrable (0.54 +/- 0.2 ml/100 g body weight). After 120 min, control (NaAc-treated) dehydrated rats, as expected, exhibited a high water intake (7.36 +/- 0.39 ml/100 g body weight). Central administration of zinc blocked this response (2.5 +/- 0.77 ml/100 g body weight). Naloxone pretreatment (82.5 nmol/rat, 30 min before zinc administration) reverted the water intake to the high levels observed in zinc-free dehydrated animals (7.04 +/- 0.56 ml/100 g body weight). These data indicate that zinc is able to block water intake induced by central ss-adrenergic stimulation and that zinc-induced blockade of water intake in dehydrated rats may be, at least in part, due to stimulation of central opioid peptides.
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Agonistas Adrenérgicos beta/administración & dosificación , Ingestión de Líquidos/efectos de los fármacos , Isoproterenol/administración & dosificación , Naloxona/administración & dosificación , Antagonistas de Narcóticos/administración & dosificación , Zinc/administración & dosificación , Agonistas Adrenérgicos beta/farmacología , Animales , Deshidratación/fisiopatología , Relación Dosis-Respuesta a Droga , Inyecciones Intraventriculares , Isoproterenol/farmacología , Masculino , Naloxona/farmacología , Antagonistas de Narcóticos/farmacología , Péptidos Opioides/efectos de los fármacos , Ratas , Ratas Wistar , Receptores Adrenérgicos beta/efectos de los fármacos , Sed/efectos de los fármacos , Factores de Tiempo , Zinc/farmacologíaRESUMEN
We have demonstrated that acute third ventricle injections of lead acetate (PbAc) exert a powerful antidipsogenic effect and induce a significant increase in renal sodium excretion. In the present study we confirm the antidipsogenic effect of lead and demonstrate that central administration of this metal, in minute amounts, significantly reduces salt intake both during dehydration and after central angiotensinergic stimulation. Adult male Wistar rats had the third ventricle cannulated seven days before the experiments. During this period they had free access to distilled water and hypertonic saline solution (1.5%). After a 24-h period of fluid deprivation, experimental animals received third ventricle injections of PbAc (0.3, N = 8 and 3.0 nmol/rat, N = 14) while controls received sodium acetate (NaAc; 3.0 nmol/rat, N = 10). Rats treated with PbAc at the highest dose showed a significant reduction (P<0.05) both in water and hypertonic saline intake when compared to controls. When the effect of lead administration on angiotensin II-induced water and salt intake was studied, normohydrated animals received third ventricle injections of angiotensin II (9.6 nmol/rat) after pretreatment with 3.0 nmol/rat of PbAc (experimental group, N = 10) or NaAc (controls, N = 8). The group pretreated with PbAc presented a significant reduction (P<0.05) in both water and salt intake compared to controls. Thus, this study confirms the antidipsogenic effect of central lead injections and demonstrates that the presence of lead in the brain exerts a significant inhibition of sodium appetite.
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Angiotensinas/farmacología , Apetito/efectos de los fármacos , Ingestión de Líquidos/efectos de los fármacos , Compuestos Organometálicos/administración & dosificación , Sodio en la Dieta/administración & dosificación , Animales , Líquidos Corporales/efectos de los fármacos , Inyecciones Intraventriculares , Masculino , Compuestos Organometálicos/farmacología , Ratas , Ratas WistarRESUMEN
OBJECTIVE: To analyze the relation between characteristics of symptom-limited treadmill exercise stress test, after acute myocardial infarction (MI) and coronariographic results (number of diseased vessels). Both tests were performed before hospital discharge. DESIGN: Retrospective study with comparative analysis between variable defined groups. POPULATION AND SETTING: From 232 patients interned in the department of Cardiology of Hospital de Santa Marta with a first acute MI, a population of 112 patients submitted to exercise stress test and coronary angiography before discharge were selected (aged 29 to 69 years). METHODS: Symptom-limited treadmill exercise stress tests were performed according to Bruce protocol, with no heart-rate limitation. The following parameters were analyzed: Stress test duration (DUR); Double product variation (varDP); Metabolic equivalent units (METS); Maximal heart rate (FCmax); Percentage of the maximal reached heart rate (% FCmax); Incidence of ST segment depression (InfST); Maximal ST segment depression (Max-InfST); Onset minute of ST segment depression (MinInfST); Heart rate at the onset of ST segment depression (FCInfST); Double product at the onset of ST segment depression (DPInfST); Recovery minute of ST segment depression (MinRInfST); Onset minute of angina (MinAng); Heart rate at the onset of angina (FCAng); Double product at the onset of angina (DPAng). RESULTS: Statistical significant differences were obtained between coronariographic groups concerning the following parameters: DUR: 1-vessel/3-vessel P = 0.02; VarDP: 1-vessel/3-vessel p = 0.008, 2-vessel/3-vessel p = 0.004; METS: 1-vessel/3-vessel p = 0.01. No differences were seen between anterior and inferior myocardial infarctions regarding all the stress test parameters. However in patients with anterior MI significant differences were obtained concerning the following variables: VarDP: 1-vessel/2-vessel p = 0.02; InfraST: 1-vessel/2-vessel p = 0.006, 1-vessel/3-vessel p = 0.03; MaxInfST: 1-vessel/2-vessel p = 0.01, 1-vessel/3-vessel p = 0.0006; Angina: 1-vessel/2-vessel p = 0.0005, 1-vessel/3-vessel p = .001. In inferior myocardial infarctions only the stress duration differed between 1-vessel and 3-vessel groups (p = 0.003). CONCLUSIONS: Symptom-limited treadmill exercise stress tests, safely performed in our institution, were an important method for post MI evaluation and allowed the diagnosis of a great number of patients with residual ischemia. Statistical significant differences were found in ergometric parameters, between coronariographic groups (defined by the number of diseased vessels), emphasising the importance of stress tolerance analysis.
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Angiografía Coronaria , Infarto del Miocardio/fisiopatología , Adulto , Anciano , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagenRESUMEN
OBJECTIVE: To report one case of a rare heart disease (Isolated Hypoplasia of the Right Ventricle) and discuss the methodology used to propose surgery with goal. Good follow up results. DESIGN: To report a case. SETTING: One patient studied in the Cardiology Department of the Santa Marta Hospital, Lisbon, and submitted to surgery in the Cardiothoracic Surgery Department of the same Hospital. PATIENT: A 22 years old woman, who had cyanosis since birth, normal cardiac auscultatory findings, pulmonary oligohemia in the chest Roentgenogram and right atrial strain on the Electrocardiogram. INTERVENTIONS: She had an echocardiogram (M1 Mode and 2D) and catheterised, with pressure and oximetry measurements. During the latter procedure, the atrial septal defect was occluded for 20 minutes with a Fogarty catheter and pressure and oximetries were reevaluated. She was later operated. MEASUREMENTS AND RESULTS: The Echocardiogram showed right ventricular hypoplasia, with a normally inserted tricuspid valve and a dilated right atrium. The hemodynamic study confirmed the presence of an atrial septal defect with right to left shunt, normal pulmonary artery pressure, no gradients and giant "a" wave in the right auriculogram. The right ventriculography showed right ventricular inflow hypoplasia. The occlusion of the atrial septal defect with the balloon catheter decreased the peripheral insaturation, without a significant increase in the right ventricular pressure. With this information, surgery was proposed (closure of the atrial septal defect), with good results (4 years of follow-up). CONCLUSION: The interruption of the shunt with a balloon allows us to see if the right ventricle can handle properly the volume load. With this information surgery can be suggested. It may be rather simple as in this case.
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Cardiopatías Congénitas/fisiopatología , Adulto , Femenino , Estudios de Seguimiento , Ventrículos Cardíacos/anomalías , HumanosRESUMEN
Neuropathic pain occurs when there is a lesion or a dysfunction of the nervous system. Humans and veterinary patients may develop neuropathic pain, but in veterinary it is not often reported probably because of its mistaken diagnosis. A canine patient was admitted to the Veterinary Hospital of UNESP-Jaboticabal-SP, Brazil with a nodule on the left thoracic limb. The nodule was surgically removed, and histopathological analysis demonstrated the tumor was a soft tissue sarcoma (STS) and the margins were not clean. Based on the patient's health condition and the lack of suitable equipment, the next procedure was limb amputation. The patient received analgesic medication in the post-surgery period; nevertheless, clinical signs of neuropathic pain were present, such as compulsive licking and other behavioral disorders. Medications were administered for forty days, but clinical signs ceased only when replaced with a tryciclic antidepressant drug, Amitriptyline. Therapeutic management of the patient in this report can be considered effective, since five years after the end of the treatment there was no recurrence or presence of metastasis.(AU)
A dor neuropática ocorre quando há uma lesão ou disfunção do sistema nervoso. Tanto pacientes humanos quanto veterinários podem desenvolver a dor neuropática, mas na medicina veterinária ela é pouco relatada provavelmente por não ser corretamente diagnosticada. Um paciente canino foi atendido no Hospital Veterinário da Unesp-Jaboticabal, SP, Brasil, com um nódulo em membro torácico esquerdo. O nódulo foi removido cirurgicamente, e o exame histopatológico evidenciou a presença de sarcoma de tecidos moles (STM) e de margens comprometidas. Baseando-se nas condições de saúde do paciente e na ausência de equipamentos adequados, o próximo procedimento foi a amputação do membro. No pós-cirúrgico, o animal recebeu medicações analgésicas, todavia, mesmo assim, apresentava sinais de dor neuropática, como lambedura compulsiva e outros distúrbios comportamentais. O tratamento para dor aguda se estendeu por 40 dias; no entanto, os sinais clínicos cessaram apenas quando os analgésicos comuns foram substituídos por um medicamento antidepressivo tricíclico, a amitriptilina. O manejo terapêutico do paciente do presente relato pode ser considerado satisfatório, uma vez que, após cinco anos do término do tratamento, não houve recidiva nem presença de metástase.(AU)
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Animales , Perros , Miembro Fantasma/tratamiento farmacológico , Sarcoma/veterinaria , Amitriptilina/uso terapéutico , Amputación Quirúrgica/veterinaria , Analgesia/veterinaria , Conducta Animal , Extremidad Superior/patologíaRESUMEN
This study aims to report the technique of partial cystectomy and bilateral ureteral reimplantation for resection of transitional cell carcinoma (TCC) in the trigone region of the bladder and the long-term follow-up in a Bernesse Mountain dog. The proposed surgical technique was considered viable and a potential treatment option for TCC in bladder trigone, with benefits regarding the prevention of urinary tract obstruction due to neoplastic growth and local removal of the primary tumor, which may limit or delay the spread of the disease even without adjuvant chemotherapy. The main disadvantages related to the described technique are ureteral stricture, intermittent cystitis and local relapse. However, the results are acceptable considering the long-term survival of 610 days in the case described.(AU)
Esse estudo tem como objetivo relatar a técnica de cistectomia parcial e reimplantação uretral bilateral para ressecção de carcinoma de células de transição em região trigonal de bexiga e seguimento clínico de cão da raça Bernesse Mountain. A técnica cirúrgica proposta foi considerada viável e opção potencial de tratamento com benefícios na prevenção de obstrução de trato uretral devido a crescimento neoplásico e remoção local de tumor primário que pode limitar ou retardar a disseminação da doença mesmo sem quimioterapia adjuvante. A principal desvantagem relatada em relação à técnica descrita são constrição uretral, cistite intermitente, e relapso local. No entanto, os resultados são aceitáveis levando em consideração a sobrevida a longo prazo de 610 no caso descrito.(AU)
Asunto(s)
Animales , Perros , Carcinoma/veterinaria , Cistectomía/clasificación , Cistectomía/normasRESUMEN
The aim of this study was to evaluate of the efficacy of PRP employment associated with surgical sponges to improve the integration of the graft in the recipient bed. It was held at the Veterinary Hospital UNESP, Campus of Jaboticabal - SP, a study of 64 rabbits, divided into eight groups with eight animals. The groups were divided in control with saline solution 0,9%, control with PRP both without the sponge, surgical sponge with PRP, surgical sponge without PRP, and were used mesh and layer grafts in the respective groups. The data were submitted to statistical analysis (paired t-test, Kruskal-Wallis test, with subsequent use of the multiple comparison tests of Dunn, analysis of variance (F) test, Tukey test, P< 0.05). Edema and exudate with 3 and 3 and 7 days (P= 0,03 e P= 0,0049); coloring on the 14th day (P= 0,0001); cosmetic appearance on the 7th and 14th day (P= 0,0026 and P= 0,0001); mononuclear cells (P= 0,01) and polymorphonuclear (P= 0,01); fibroblast proliferation (P= 0,01); collagenous (P= 0,05); hemorrhage (P-007); necrosis and re-epithelialization (P= 0,2928 and P= 0,1). We concluded that the use of Platelet Rich Plasma Gel on skin grafts associated with a sponge as a compressive dressing promote the skin graft survival without a previous granulation tissue.(AU)
O objetivo deste estudo foi avaliar a eficácia do PRP associado com esponjas cirúrgicas na integração do enxerto ao leito receptor. Realizou-se, no Hospital Veterinário da Unesp, Jaboticabal, SP, um estudo com 64 coelhos, separados em oito grupos, com oito animais. Os grupos foram: Gprpc (PRP, sem esponja cirúrgica, enxerto camada), Gprpce (PRP, esponja cirúrgica, enxerto camada), Gcc (solução fisiológica 0,9%, sem esponja cirúrgica, enxerto camada), Gcce (solução fisiológica 0,9%, esponjas cirúrgicas, enxerto camada), Gprpm (PRP, sem esponja cirúrgica, enxerto malha), Gprpme (PRP, esponja cirúrgica, enxerto malha), Gcm (solução fisiológica 0,9%, sem esponja cirúrgica, enxerto malha) e Gcce (solução fisiológica 0,9%, esponjas cirúrgicas, malha). Os dados foram analisados pelo teste t emparelhado, Kruskal-Wallis, análise de variância, e teste de Tukey (P<0,05). Edema e exsudato presente com três e sete dias (P=0,03 e P=0,0049); coloração cianótica no 14º dia (P=0,0001); aspecto cosmético bom no sétimo e no 14º dia (P=0,00026 e P=0,0001); presença de células mononucleares (P=0,01) e polimorfonucleares (P=0,01); proliferação de fibroblastos discreta (P=0,01); colagenização intensa (P=0,05); hemorragia discreta (P=0,007); ausência de diferença significativa em necrose e reepitelização (P=0,2928 e P=0,1). Conclui-se que o emprego do PRP gel em enxertos cutâneos associando esponjas cirúrgicas como curativo compressivo favorece sua integração ao leito receptor sem a presença prévia de tecido de granulação.(AU)