Pluronic® F127 Hydrogel Containing Silver Nanoparticles in Skin Burn Regeneration: An Experimental Approach from Fundamental to Translational Research.

Presently, skin burns are considered one of the main public health problems and lack therapeutic options. In recent years, silver nanoparticles (AgNPs) have been widely studied, playing an increasingly important role in wound healing due to their antibacterial activity. This work is focused on the production and characterization of AgNPs loaded in a Pluronic® F127 hydrogel, as well as assessing its antimicrobial and wound-healing potential. Pluronic® F127 has been extensively explored for therapeutic applications mainly due to its appealing properties. The developed AgNPs had an average size of 48.04 ± 14.87 nm (when prepared by method C) and a negative surface charge. Macroscopically, the AgNPs solution presented a translucent yellow coloration with a characteristic absorption peak at 407 nm. Microscopically, the AgNPs presented a multiform morphology with small sizes (~50 nm). Skin permeation studies revealed that no AgNPs permeated the skin after 24 h. AgNPs further demonstrated antimicrobial activity against different bacterial species predominant in burns. A chemical burn model was developed to perform preliminary in vivo assays and the results showed that the performance of the developed AgNPs loaded in hydrogel, with smaller silver dose, was comparable with a commercial silver cream using higher doses. In conclusion, hydrogel-loaded AgNPs is potentially an important resource in the treatment of skin burns due to their proven efficacy by topical administration.

Effects of Reflective Labyrinth Walking Assessed Using a Questionnaire.

Background: Meditation as it is currently known is an ancient practice, which can be traced back to Asian traditions. With the proper technique, a state of physical relaxation and respiratory balance can be reached naturally and spontaneously. This paper considers meditative labyrinth walking to be a unique expression of Dr. Lauren Artress' work, who studied and applied the image of the labyrinth on the floor of the Chartres Cathedral in France. Methods: This study used a qualitative approach. It is a cross-sectional non-randomized study, conducted at an institute for psychotherapies with a sample of 30 participants. Results: 99% of the group reported feeling emotional distress caused by the feeling of a longer walk on the way out, 21% reported feeling the same while walking the path, and 41% at the beginning. The remaining participants felt lost in time and space. Conclusions: This study showed that the practice of labyrinth walking is a physical, emotional, and sensory experience. On the clinical level, correlating this experience to the planning of care seems to be particularly relevant.

Neurology at Escola Paulista de Medicina (1933-1995). From Fausto Guerner to José Geraldo Camargo Lima.

Escola Paulista de Medicina (EPM) was founded in 1933 and the first Professor of Neurology was Fausto Guerner, who could not effectively assume the teaching activities due to his premature death in 1938. Professor Guerner had had his neurological training at Paris. Professor Longo was his successor. Longo was one of the founders of Arquivos de Neuro-Psiquiatria the foremost journal of neurosciences in Latin American. Longo died in 1967 and Professor Paulo Pupo succeeded him. Pupo introduced electroencephalography in Brazil. After his death in 1970, Professor Dante Giorgi succeeded him until 1974. Professor José Geraldo Camargo Lima took over the position after Giorgi's death. He created the Neurological Emergency unit, initiated the Post-Graduation in Neurology and divided the Discipline in specialized units. During the 1980's and until his retirement in 1995, EPM had become one of most important centers of Brazil training neurologists and researchers in neurological sciences.

Neurology at Escola Paulista de Medicina (1933-1995). From Fausto Guerner to José Geraldo Camargo Lima / Neurologia na Escola Paulista de Medicina (1933-1995). De Fausto Guerner a José Geraldo Camargo Lima.

Escola Paulista de Medicina (EPM) was founded in 1933 and the first Professor of Neurology was Fausto Guerner, who could not effectively assume the teaching activities due to his premature death in 1938. Professor Guerner had had his neurological training at Paris. Professor Longo was his successor. Longo was one of the founders of Arquivos de Neuro-Psiquiatria the foremost journal of neurosciences in Latin American. Longo died in 1967 and Professor Paulo Pupo succeeded him. Pupo introduced electroencephalography in Brazil. After his death in 1970, Professor Dante Giorgi succeeded him until 1974. Professor José Geraldo Camargo Lima took over the position after Giorgi’s death. He created the Neurological Emergency unit, initiated the Post-Graduation in Neurology and divided the Discipline in specialized units. During the 1980’s and until his retirement in 1995, EPM had become one of most important centers of Brazil training neurologists and researchers in neurological sciences.

A Escola Paulista de Medicina foi fundada em 1933 e o primeiro Professor de Neurologia foi Fausto Guerner, que morreu prematuramente em 1938, antes do início das aulas. O Professor Paulino Longo foi o seu sucessor. Longo, juntamente com outros, fundou os Arquivos de Neuro-Psiquiatria e a Academia Brasileira de Neurologia. Professor Paulo Pupo, seu sucessor, introduziu a eletroencefalografia no Brasil. O Professor José Geraldo Camargo Lima tornou-se chefe da Neurologia em 1974. Criou o Pronto-Socorro de Neurologia, iniciou a Pós-Graduação e dividiu a disciplina em setores especializadas. A partir dos anos 1980, a Neurologia da EPM tornou-se um dos centros acadêmicos mais importantes do Brasil.

Proteínas totais no LCR antes e após radioterapia / CSF protein contents before and after radiotherapy

Com o uso da radioterapia e quimioterapia intratecal associados, passou-se a observar alterações do sistema nervoso central que denotaram lesões neuronais ou vasculares...

Reversão de urgência da anticoagulação / Urgent reversal of anticoagulation

Com o envelhecimento da população e as consequentes comorbidades associadas, o uso de anticoagulantes tem se tornado cada vez mais prevalente. Os anestesiologistas devem estar preparados para o manejo do sangramento e dos riscos associados a esses medicamentos. Esta revisão tem o intuito de nortear a reversão de urgência da anticoagulação e estabelecer as opções disponíveis para este fim.

The use of anticoagulants has become increasingly prevalent with the aging of the populations and the consequent comorbidities associated with it. Anesthesiologists should be prepared for the management of bleeding and the risks associated with these medications. This review is intended to guide the urgent reversion of anticoagulation and establish options available for this purpose.

The role of nitric oxide in muscle fibers with oxidative phosphorylation defects.

NO has been pointed as an important player in the control of mitochondrial respiration, especially because of its inhibitory effect on cytochrome c oxidase (COX). However, all the events involved in this control are still not completely elucidated. We demonstrate compartmentalized abnormalities on nitric oxide synthase (NOS) activity on muscle biopsies of patients with mitochondrial diseases. NOS activity was reduced in the sarcoplasmic compartment in COX deficient fibers, whereas increased activity was found in the sarcolemma of fibers with mitochondrial proliferation. We observed increased expression of neuronal NOS (nNOS) in patients and a correlation between nNOS expression and mitochondrial content. Treatment of skeletal muscle culture with an NO donor induced an increase in mitochondrial content. Our results indicate specific roles of NO in compensatory mechanisms of muscle fibers with mitochondrial deficiency and suggest the participation of nNOS in the signaling process of mitochondrial proliferation in human skeletal muscle.

Personality features in a sample of psychophysiological insomnia patients.

UNLABELLED: The personality is the way people express themselves inside the environment they live. Sleep, quality or quantity, is a way of this physical and psychological expression of well being. Psychological factors, associated with psychophysiological insomnia (PPI) suggest an exaggerated perception of the difficulties to fall asleep. Worries, anxiety and the fear of not sleeping produce a bad sleep quality or sleep misperception. This study aims to identify personality features associated with PPI throughout Rorschach test (RT). METHOD: We studied 32 patients with PPI (22 women), between 29 and 75 years old. We excluded patients with other sleeping or psychiatric disorders. We analysed the data from PPI patients submitted to the RT and we compared our results with the standard data. RESULTS: We noticed a significant increase in global answers and a significant decrease in detailed answers; a trend of a low number of answers; great number of shape and animal answers, especially for women. CONCLUSION: The features of the PPI patient's personality were daily problems insecure and the incapability to avoid or remove them from their thought, making bedtime a time for worries to appear again and motivate insomnia.

Personality features ina sample of psychophysiological insomnia patients

The personality is the way people express themselves inside the environment they live. Sleep, quality or quantity, is a way of this physical and psychological expression of well being. Psychological factors, associated with psychophysiological insomnia (PPI) suggest an exaggerated perception of the difficulties to fall asleep. Worries, anxiety and the fear of not sleeping produce a bad sleep quality or sleep misperception. This study aims to identify personality features associated with PPI throughout Rorschach test (RT). METHOD: We studied 32 patients with PPI (22 women), between 29 and 75 years old. We excluded patients with other sleeping or psychiatric disorders. We analysed the data from PPI patients submitted to the RT and we compared our results with the standard data. RESULTS: We noticed a significant increase in global answers and a significant decrease in detailed answers; a trend of a low number of answers; great number of shape and animal answers, especially for women. CONCLUSION: The features of the PPI patient's personality were daily problems insecure and the incapability to avoid or remove them from their thought, making bedtime a time for worries to appear again and motivate insomnia

The diagnosis of delirium in 80 emergency unit patients

We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included. The patients were subdivided into four etiologic groups: vascular, associated with the use of alcohol; infectious-parasitic; miscellaneous. The results showed a rate of correct diagnosis ranging from 65 to 80 percent with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for intial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.

Cerebrospinal fluid syndromes in patients with acute consciousness compromise

We reviewed the laboratory cards of 200 analysis of cerebrospinal fluid (CSF) performed to evaluate acute alterations of consciousness in adult patients attended in a neurological emergency room. 61 percent were men; the mean age was 46 years. The most common clinical data were infective and neurologic. The CSF was abnormal in 149 (74.5 percent) patients and the most common syndromes were: compressive (21 percent), hemorrhagic (11.5 percent), "viral"(8.5 percent), septic (7.5 percent), moderate hyperglycorrachia (6.5 percent), hidroelectrolytic disturbances (5.5 percent). There were some statistically significant correlations between CSF syndromes and clinical data: septic syndrome and fever and meningeal signs, hemorrhagic syndrome and headache and meningeal signs, CSF hydroelectrolytic disturbance syndrome and seizure, severe hyperproteinorrchia and headache, fever, meningeal signs and vomiting, moderate hyperproteinorrachia and age over 65 and male sex. We classified the abnormal results in two groups: 1 - sufficient for an immediate clinical decision; 2 - nonspecific. The former group was found in 27.5 percent of the patients and in 36.9 percent of the abnormal CSF results. In patients attending to neurologic emergency rooms with acute alterations of consciousness, the ecamination of the CSF frequently could contribute to an etiologic diagnosis. It must be performed after a rigorous clinical evaluation of the patient.

Hemorragia subaracnóidea com tomografia de crânio sem sinais de sangramento / Subarachnoidal hemorrhage with cranial tomography without bleeding signals

Foram observados 23 casos de pacientes com suspeita clínica de hemorragia subaracnoídea (HSA), com tomografia de crânio (CT) sem sinais de sangramento, com diagnóstico definitivo realizado por exame de líquido cefalorraquidiano (LCR). Desses, 20 casos foram submetidos a angiografia cerebral. Estabeleceu-se a classificaçäo clínica de Hunt & Hess. Os principais achados neste estudo foram: 1) um terço dos pacientes apresentou intervalo de tempo entre o ictus e a realizaçäo da CT e do LCR entre 24 e 48 horas, período de maior sensibilidade da CT; 2) dos pacientes estudados com angiografia cerebral, 55 por cento tiveram o diagnóstico de aneurisma com predomínio no território de carótida e cerebral anterior; 3) o grau clínico dominante foi Hunt & Hess I e II. Todos os achados encontrados demonstraram a necessidade da realizaçäo de LCR em suspeita de HSA sem sinais de sangramento na CT.

Proteínas totais no LCR antes e após radioterapia / Csf protein contents before and after radiotherapy

Com o uso da radioterapia e quimioterapia intratecal associados, passou-se a observar alteraçöes do sistema nervoso central que denotaram lesöes neuronais e vasculares. A atribuiçäo da causalidade dessas alteraçöes a um dos dois fatores terapêuticos passou a ser estudada. Quanto ao papel da radioterapia, há trabalhos experimentais e clínicos que apontam para a possibilidade de ser um fator lesivo. E cogitada a possibilidade da radioterapia lesar a barreira hematencefálica, permitindo com isso a entrada de amethopterin no sistema nervoso. Como as dosagens de irradiaçäo usadas experimentalmente säo bem amiores que as terapêuticas, a analogia feita com o tratamento profilático de pacientes leucêmicos näo parece bastante clara. O propósito desse trabalho é estudar a taxa de proteínas totais no líquido cefalorraquino de pacientes com leucemia aguda, sem comprometimento do sistema nervoso, submetidos a radioterapia, como parametro de avaliaçäo de pertubaçäo da barreira hematencefálica. Para esse estudo foram selecionados 18 pacientes com leucemia aguda, sendo 16 com leucemia linfóide aguda, 2 com leucemia mielóide aguda e que näo tinham sinais ou sintomas clínicos de comprometimento neurológico, nem células blásticas no LCR. As amostras de LCR para este estduo foram colhidas até 8 dias antes do início da radioterapia e de 1 semana até 6 meses após o término dessa mesma sequência radioterápica. A dosagem da taxa de proteínas totais foi feita pelo método de Denis & Ayer. Em conclusäo, pelo método de avaliaçäo empregado, näo se pode evidenciar alteraçäo de permeabilidade da barreira hematencefálica, decorrente de irradiaçäo do sistema nervoso central para profilaxia da neuroleucemia.

Metotrexato intratecal em carcinomatose do sistema nervoso: apresentaçäo de caso / Intrathecal methotrexate in carcinomatosis of nervous system: case report

É apresentado caso de paciente com metástase de adenocarcinoma no sistema nervoso, que com tratamento intratecal com metotrexato teve regressäo total dos sintomas neurológicos e normalizaçäo do líquido cefalorraquidiano

O líquido cefalorraquiano inicial nas meningencefalites por Cryptococcus neoformans / Initial cerebrospinal fluid in meningoencephalitis due to Cryptococcus neoformans

A criptococose, conhecida desde 1905, é doença grave, causada pelo Cryptococcus neoformans. Nesta entidade o estudo do líquido cefalorraquino é muito importante visto que o sistema nervoso está envolvido em 81% dos casos5.O propósito do presente trabalho é o evidenciar as alteraçöes do líquido cefalorraquiano inicial nas meningencefalites criptocócicas e demonstrar a importância de exame minucioso do líquido cefalorraquiano para o diagnóstico precoce desta doença. O material é constituido por 46 observaçöes de pacientes com diagnóstico de meningencefalite criptocócia. O quadro inflamatório crônico, caracterizado por pleocitose predominantemente linfocitária, hiperproteinorraquia e glicose diminuida foi observado em 54% das amostras de líquido cefalorraquiano. Em 69% dos casos o líquido cefalorraquiano mostrava hipertensäo. A glicose estava diminuida em 61% dos pacientes e a taxa de cloretos em 16%. Eosinófilos em baixa percentagem foram observados em 48% dos casos. O criptococo foi identificado no líquido cefalorraquiano de 98% dos pacientes; é salientada a importância da pesquisa a fresco do fungo pelo método da tinta da China, sempre que uma amostra de líquido cefalorraquiano revelar pleocitose. Esta é uma conduta básica para o diagnóstico precoce da criptococose do sistema nervoso