Efeito da massagem e do kinesio taping na dismenorreia primária / Effect of massage and kinesio taping on primary dysmenorrhea

Introdução: A dismenorreia é caracterizada por dores na região lombar e abdominal inferior e está associada ao ciclo menstrual sendo frequente em jovens mulheres e afetando suas atividades de vida diária e a qualidade de sono. Objetivo: Verificar o efeito da massagem do tecido conjuntivo (MTC) e do Kinesio Taping na dismenorreia primária nas variáveis dor, influência da dor nas atividades de vida diária e qualidade do sono. Métodos: Participaram do estudo 63 mulheres entre 18-26 anos e que referiam dor igual ou superior a 5 na Escala Visual Analógica (EVA). Destas, apenas 21 participaram efetivamente do estudo, e foram divididas em 3 grupos: Grupo Controle (7) que não recebeu intervenção, Grupo MTC (6) tratado com massagem terapêutica e grupo Kinesio Taping (8) que recebeu aplicação do recurso em baixo ventre e lombar. Para avaliação foi utilizada a EVA para dor; questionário para influência da dor nas AVDs, e as Escalas Visuais Análogas do Sono para qualidade de sono. Resultados: Os grupos que receberam intervenção apresentaram melhora significativa da dor em relação ao grupo controle em todos os momentos avaliados (p < 0,05) e melhora da influência da dor nas AVDs em todos os dias do ciclo quando comparado o mês controle e o mês da intervenção (p < 0,05). A avaliação do sono não demonstrou diferença estatística entre o mês controle e tratamento, mas na análise entre grupos, o Kinesio Taping demonstrou-se superior (p = 0,03). Conclusão: Houve redução do quadro álgico nos grupos que receberam intervenção, e o Kinesio Taping demonstrou-se mais efetivo na melhora da qualidade do sono.

K+ontrol rapidly and efficiently reduces potassium in donor blood during ex vivo circulation.

BACKGROUND: Patients with kidney failure are at risk for lethal complications from hyperkalemia. Resuscitation, medications, and hemodialysis are used to mitigate increased potassium (K+) levels in circulating blood; however, these approaches may not always be readily available or effective, especially in a resource limited environment. We tested a sorbent cartridge (KC, K+ontrol CytoSorbents Medical Inc., Monmouth Junction, New Jersey) which contains a resin adsorber for K+. The objective of this study was to test the utility of KC in an ex vivo circulation system. We hypothesized that KC reduces K+ levels in extracorporeal circulation of donor swine whole blood infused with KCl. METHODS: A six-hour circulation study was carried out using KC, a NxStage (NxStage Medical, Inc., Lawrence, MA) membrane, blood bag containing heparinized whole blood with KCl infusion, 3/16-inch ID tubing, a peristaltic pump, and flow sensors. The NxStage permeate line was connected back to the main circuit in the Control group (n = 6), creating a recirculation loop. For KC group (n = 6), KC was added to the recirculation loop, and a continuous infusion of KCl at 10 mEq/hour was administered for two hours. Blood samples were acquired at baseline and every hour for 6 h. RESULTS: In the control group, K+ levels remained at ∼9 mmol/L; 9.1 ± 0.4 mmol/L at 6 h. In the KC group, significant decreases in K+ at hour 1 (4.3 ± 0.3 mmol/L) and were sustained for the experiment duration equilibrating at 4.6 ± 0.4 mmol/L after 6 h (p = 0.042). Main loop blood flow was maintained under 400 mL/min; recirculation loop flow varied between 60 and 70 mL/min in the control group and 45-55 mL/min in the KC group. Decreases in recirculation loop flow in KC group required 7% increase of pump RPM. CONCLUSIONS: During ex-vivo extracorporeal circulation using donor swine blood, KC removed approximately 50% of K+, normalizing circulating levels.

Enucleation of Odontogenic Cyst with Bone Graft / Enucleación de Quiste Odontogénico con Injerto Óseo

ABSTRACT: Periapical cyst originates from an inflammatory reaction in the body that occurs due to a long-term endodontic aggression. It is more prevalent in caucasian male, during the third decade of life, in the anterior portion of the maxilla. They are commonly radiographic findings, due to their asymptomatic aspect. This study reports a Periapical Cyst in the portion corresponding to teeth 21, 22 and 23, which was treated by enucleation of the cyst, apicoectomy and retrograde root filling with Mineral trioxide aggregate (M.T.A) of teeth 21 and 22, filling of the cyst cavity with xenogeneic bone graft GenOx and a collagen membrane Gen-Derm. Observations after three months show good and rapid bone regeneration, periodontal and periapical health of the teeth involved.

RESUMEN: El quiste periapical se origina de una reacción inflamatoria que ocurre debido a una agresión endodóntica a largo plazo. Es más frecuente en el varón caucásico, durante la tercera década de la vida, en la porción anterior del maxilar. Son comúnmente hallazgos radiográficos, debido a su aspecto asintomático. En este estudio informamos acerca de un quiste periapical, en la porción correspondiente a los dientes 21, 22 y 23, que se trató mediante enucleación, apicectomía y relleno de raíz retrógrada con agregado de trióxido mineral (MTA) de los dientes 21 y 22, relleno de la cavidad del quiste con injerto óseo xenogénico Gen-Ox y una membrana de colágeno GenDerm. Las observaciones después de tres meses mostraron una buena y rápida regeneración ósea, con conservación de la salud periodontal y periapical de los dientes involucrados.

Tracing synaptic connectivity onto embryonic stem cell-derived neurons.

Transsynaptic circuit tracing using genetically modified rabies virus (RV) is an emerging technology for identifying synaptic connections between neurons. Complementing this methodology, it is now possible to assay the basic molecular and cellular properties of neuronal lineages derived from embryonic stem cells (ESCs) in vitro, and these properties are under intense investigation toward devising cell replacement therapies. Here, we report the generation of a novel mouse ESC (mESC) line that harbors the genetic elements to allow RV-mediated transsynaptic circuit tracing in ESC-derived neurons and their synaptic networks. To facilitate transsynaptic tracing, we have engineered a new reporter allele by introducing cDNA encoding tdTomato, the Rabies-G glycoprotein, and the avian TVA receptor into the ROSA26 locus by gene targeting. We demonstrate high-efficiency differentiation of these novel mESCs into functional neurons, show their capacity to synaptically connect with primary neuronal cultures as evidenced by immunohistochemistry and electrophysiological recordings, and show their ability to act as source cells for presynaptic tracing of neuronal networks in vitro and in vivo. Together, our data highlight the potential for using genetically engineered stem cells to investigate fundamental mechanisms of synapse and circuit formation with unambiguous identification of presynaptic inputs onto neuronal populations of interest.

Laparoscopic single port surgery in children using Triport: our early experience.

Laparoscopy has become the gold standard technique for appendectomy and cholecystectomy. With the emergence of newer laparoscopic instruments which are roticulating and provide 7 degrees of freedom it is now possible to perform these operations through a single umbilical incision rather than the standard 3-4 incisions and thus lead to more desirable cosmetic results and less postoperative pain. The newer reticulating telescopes provide excellent exposure of the operating field and allow the operations to proceed routinely. Recently, ports [Triports (Olympus surgery)/SILS ports] especially designed for single incision laparoscopic surgery (SILS) have been developed. We herein describe our experience with laparoscopic single port appendectomies and cholecystectomies in children using the Triport. This is a retrospective cohort study of children who underwent single incision laparoscopic surgery between May 2009 and August 2010 at Texas Children's Hospital and Ben Taub General Hospital in Houston Texas by a single surgeon. Charts were reviewed for demographics, type of procedure, operative time, early or late complications, outcome and cosmetic results. Fifty-four patients underwent SILS. A total of 50 appendectomies (early or perforated) and 4 cholecystectomies were performed using this new minimally invasive approach. The average operative time for SILS/LESS appendectomy was 54 min with a range between 25 and 205 min, while operative time for SILS cholecystectomy was 156 min with a range of 75-196 min. Only small percentage (4%) of appendectomies (mostly complicated) were converted to standard laparoscopy, but none were converted to open procedure. All patients were followed up in the clinic after 3-4 weeks. No complications were noted and all patients had excellent cosmetic results. Parents were extremely satisfied with the cosmetic results. SILS/LESS is a safe, minimally invasive approach for appendectomy and cholecystectomy in children. This new approach is performed in an acceptable operative time with good outcomes and great cosmetic result.

Effect of caffeine and alcohol on the toxicity and metabolism of methacrylonitrile in male Sprague-Dawley rats.

This study reports the toxicity and metabolism of methacrylonitrile (MeAN) in normal male Sprague-Dawley rats and those pre-treated with caffeine, alcohol or both. Rats were divided into groups often. One group received an oral dose by gavage of 6 % MeAN solution in corn oil (equivalent to 0.5 LD50). Other three groups of rats were pre-treated with alcohol (2 ml of 50% solution in water), caffeine (1 ml of 2% solution in water) or both alcohol and caffeine 12 hr before receiving MeAN dose by gavage. The rats were observed for mortality, cholinomimetic and central nervous system (CNS) effects and urinary dysfunction for 6 hr. The concentrations of cyanide, thiocyanate and glutathione (GSH) were determined in blood, liver, kidney and brain. Alcohol and alcohol + caffeine pre-treatment caused significant increase in cholinomimetic, CNS and urinary dysfunction effects of MeAN and mortality. However, caffeine alone pre-treatment protected rats from these effects. In the rats treated with MeAN alone and those pre-treated with alcohol and alcohol + caffeine the GSH concentrations significantly decreased in liver, brain and kidney. In the rats pre-treated with caffeine alone the concentrations of GSH were not significantly different from controls. In the rats treated with MeAN alone and those pretreated with alcohol and alcohol + caffeine the cyanide and thiocyanate concentrations increased in the blood and other organs up to 2-4 folds whereas in rats pre-treated with caffeine alone the concentrations of cyanide and thiocyanate were not significantly different from controls. Western Blot experiment showed CYP2E1 induction in rats pretreated with alcohol and MeAN. These results suggest that caffeine inhibited and alcohol enhanced toxicity and metabolism of MeAN.

El modelo situacional en la interconsulta psiquiátrica / The situational model in the psychiatric interconsult

Por ser la interconsulta el quehacer fundamental de la Unidad de Psiquiatría del Hospital Miguel Pérez Carreño, dirigida a la atención del paciente hospitalizado, los autores presentan el siguiente trabajo destinado a investigar las características del abordaje de la interconsulta en dicho Hospital durante el período Enero-Diciembre de 1992, a partir de cuyos resultados proponen un modelo alternativo, el modelo situacional. Se basa la investigación en la realización de un estudio descriptivo-exploratorio a partir de un instrumento de recolección de la información (Hoja de Registro), a través de la cual se recabó lo siguiente: datos de identificación, motivo de consulta verbal y escrita, actitud del tratante ante el paciente, actitud del tratante ante la consulta, diagnóstico e intervención terapéutica. A los fines del análisis se categorizó la información en relación al motivo de consulta en tanto claro, confuso, contradictorio o discordante, en virtud de la receptividad o no del médico tratrante hacia la interconsulta y en cuanto a la posición del interconsultante de Psiquiatría atinente a la orientación de su intervención: hacia el paciente, el médico o la relación médico paciente. Se realizó así un diagnóstico transversal de lo ocurrido en la Interconsulta de Psiquiatría en el lapso señalado. Los resultados mostraron centramiento de la atención hacia la figura del paciente, dificultades en la relación médico tratante-interconsultante psiquiatra y visión parcial de la problemática planteada. Se discuten los resultados y se propone como modelo alternativo de intervención, el modelo situacional que permite ampliar la visualización del problema, estrechar las relaciones tratante-interconsultante, privilegiar el trabajo en equipo y que redunda en beneficio de una intervención terapéutica más pertinente y por tanto más eficaz