[Psychological factors in the context of perioperative knee and joint pain: the role of treatment expectations in pain evolvement]. / Psychologische Faktoren im Kontext perioperativer Knie- und Gelenkschmerzen: die Rolle der Behandlungserwartungen für den Schmerzverlauf.

Chronic knee and joint pain, like all chronic pain, is a complex multidimensional event that involves somatic, psychological and social factors. Patients with knee and other joint pain experience limited mobility in their daily lives, in their professional and personal activities, and in their leisure physical exercise activities. Pain increasingly prevents them from achieving their goals. Psychological factors not only interact with neurobiological and immunological processes of pain, they play an important role in the development and maintenance of pain. Within that, expectations concerning the course of the disease and its treatment play a significant role. Study designs involving a placebo knee surgery show the high influence of these variables. The patients receiving the verum surgery do not report-as expected-less pain or better functioning than those receiving a placebo surgery. This significant influence of psychological factors may be clinically relevant. A positive patient-staff relationship-characterized by trust, warmth and empathy-is essential in order to achieve optimal therapeutic efficacy of a treatment. Every surgeon, pain physician, pain psychologist or pain physiotherapist is responsible for establishing a trusting interpersonal relationship between themselves and their patients.

Enlargement of GAD-immunopositive terminals in the lateral vestibular nucleus (LVN) of weaver mutant mice.

Reorganization of cerebellar circuitry due to specific cell loss in Weaver mutants causes physiological and morphological alterations in the terminal domains of the GABAergic cerebellar corticovestibular projections. In this study sizes of anti-GAD immunopositive terminals in the dorsal part of the lateral vestibular nucleus (dLVN) of normal mice and Weaver mutants were quantified morphometrically. In anti-GAD-immunoreacted material terminal sizes in the dLVN of Weaver exceed significantly those of coprocessed wildtypes. This suggests that the cerebellar disturbances in Weaver predispose the normal synaptic remodelling observed in wildtypes towards the formation of enlarged terminals.

Correction of iron interface in the spectrophotometric flow injection catalytic determination of molybdenum in plants.

Iron interference in the spectrophotometric catalytic determination of molybdenum based on the iodide-hydrogen peroxide reaction can be corrected by using sulphosalicylic acid as masking and color-forming reagent. The catalytic influence of iron ions is circumvented to the extent of about 90% and correction of any remaining iron ions is possible by monitoring the colored iron(III)-salicylate complex at 490 nm. In this way, iron is also determined. With the proposed system, molybdenum can be determined in plant and food digests within the 0-100 mug Mo 1(-1) range in the presence of up to 25 mg Fe 1(-1), at a sampling rate of about 50 determinations h(-1). The relative standard deviation of 10 consecutive measurements was estimated as < 2%. Results for samples were comparable with those obtained by graphite furnace atomic absorption spectrometry. In addition, recoveries within the range 94-100% were calculated.

Determination of ytterbium in animal faeces by tungsten coil electrothermal atomic absorption spectrometry.

A method for ytterbium determination in animal faeces by tungsten coil electrothermal atomic absorption spectrometry (TCAAS) was developed. Faeces were dry-ashed in a muffle furnace, the ashes were treated with hydrochloric acid, and 10 mul of sample solution were delivered into 150-W tungsten coil atomizer. A matrix-matching procedure employing a 66-s heating program proved to be efficient for obtaining accurate results. Characteristic mass and detection limit were 7.1 pg and 0.35 mug g(-1) Yb, respectively. The tungsten coil atomizer lifetime exceeded 300 firings with digested solutions and R.S.D. of measurements was 1.9% after ten consecutive injections of 10.0 mug l(-1) Yb. Accuracy of the proposed method was assessed by employing a graphite furnace atomic absorption spectrometric procedure. Application of the paired t-test did not reveal any significant difference for ytterbium contents determined by both methods at 95% confidence level. It was demonstrated that the proposed procedure can successfully be used for evaluation of kinetic passage rate of feed through digestive tract of animals.

Sulphate preconcentration by anion exchange resin in flow injection and its turbidimetric determination in water.

A preconcentration procedure was established for sulphate determination in rain waters at the mg/l level, employing a small column packed with the AG1-X8 (200-400 mesh) anionic resin inserted into a flow injection system. Sulphate determination was performed by using the turbidimetric method based on reaction with barium. For concentrations within 0.10 and 2.0 MgSO(2-)(4)/l, a throughput of 50 determinations/hr was achieved, and the relative standard deviation of results was better than 2%.

Atomization of Al in a tungsten coil electrothermal atomic absorption spectrophotometer.

Electrothermal atomic absorption spectrophotometry of Al in a tungsten coil atomizer was evaluated and applied for its determination in hemodialysis fluid. The system was mounted on a Varian Spectra AA-40 spectrophotometer with continuum background correction and all measurements, in peak height absorbance, were done at 309.3 nm. The purge gas was a mixture of 90% Ar plus 10% H(2). Observation height, gas flow, drying, pyrolysis and atomization steps were optimized. The heating program was carried out by employing a heating cycle in four steps: dry, pyrolysis, atomization and clean. The determination of Al in hemodialysis solutions was performed by using a matrix-matching procedure. Al in hemodialysis solutions was determined by TCA and by electrothermal atomization with a graphite tube atomizer. There is no differences between results obtained by both methods at a confidence level of 95%. The characteristic mass of Al by using the TCA was 39 pg and the detection limit was 2.0 mug l(-1).

[Evaluation of tibial torsion--comparison of clinical methods and computed tomography]. / Bestimmung der Tibiatorsion--Vergleich von klinischen Winkelmessungen zur Computertomographie.

PURPOSE: To determine variability between clinical goniometric methods and computed tomography (CT) in measuring posttraumatic malrotation of the tibia. MATERIALS AND METHODS: In a prospective study, absolute tibial torsion of both legs after unilateral fracture of the tibia as well as the difference between both legs (intra-individual torsional difference) was postoperatively determined with two goniometric and two CT methods in 40 patients (female : male = 16 : 24, mean age = 46 +/- 34 years). RESULTS: The mean difference between goniometric and CT methods in determining intra-individual torsional difference was not significant. Nevertheless, variance of values was higher in goniometric measurement (up to +/- 11 degree), with the measurements of torsional difference showing two times greater standard deviation in interobserver variability of goniometric methods as compared to CT. CONCLUSION: Goniometric methods do not significantly differ from the CT methods for determination of intraindividual torsional difference. The higher variance of interobserver values limits accuracy of goniometric methods. Therefore, goniometric determination of tibial torsion can only be considered an estimate but not a precise measurement.

Mercury fluxes in a natural forested Amazonian catchment (Serra do Navio, Amapá State, Brazil).

Mercury (Hg total) fluxes were calculated for rainwater, throughfall and stream water in a small catchment located in the northeastern region of the Brazilian Amazon (Serra do Navio, Amapá State), whose upper part is covered by a natural rainforest and lower part was altered due to deforestation and activities related to manganese mining. The catchment area is 200 km from the nearest gold mining (garimpo). Minimum and maximum Hg concentrations were measured monthly from October 1996 to September 1997 and were 3.5-23.4 ng l(-1) for rainwater, 16.5-82.7 ng l(-1) for throughfall (March-August 1997) and 1.2-6.1 and 4.2-18.8 ng l(-1) for stream water, in natural and disturbed areas, respectively. In the natural area, the inputs were 18.2 microg m 2 year(-1) in rainwater and 72 microg m(-2) year(-1) in throughfall. This enrichment was attributed to dry deposition. The stream output of 2.9 microg m(-2) year(-1) indicates that Hg is being recycled within the forest as other chemical species or is being retained by the soil system, as confirmed by the cumulative Hg burden in the 0-10 cm surface layer, which was 36480 microg m(-2). When the disturbed area of the catchment was included, the stream output was 9.3 microg m(-2), clearly indicating the impact of the deforestation of the lower part of the basin on the release of mercury. The Hg burden in the disturbed area was 7560 microg m(-2) for the 0-10 cm surface layer.

[Incisional hernias after laparoscopic interventions]. / Narbenhernien nach laparoskopischen Eingriffen.

The importance of the complication incisional hernia after laparoscopic surgery was determined by analyzing our own cases and extensive review of the literature. The data recorded give its incidence as 1 in 550 cases. The most frequent event was intestinal incarceration with a high portion of Richter's hernias. To avoid postlaparoscopic hernias the important step is suturing the fascia when the trocar diameter exceeds 5 mm. When external suturing of the fascia is impossible, the laparoscopic technique using the Reverdin needle is a sufficient procedure for fascial closure after minimally invasive surgery.

[Laparoscopic implantation of Oreopoulos-Zellermann catheters for peritoneal dialysis]. / Laparoskopische Anlage von Oreopoulos-Zellermann-Kathetern zur Peritonealdialyse.

For the insertion of CAPD-catheters the laparoscopic implantation technique and the use of Oreopoulos-Zellermann catheters have been shown to be advantageous if compared with the open technique using Tenckhoff catheters. The implantation procedure shown here makes it possible to place the Oreopoulos-Zellermann catheter laparoscopically, combining different advantages. The procedure is quick, efficient and not stressful for the patients. After 4700 days of catheter-use in the patients positive results are seen with regard to permanently good inlet and outlet flows, low incidences of catheter exit site infections and leakages of the catheter tunnel.

[Spiral trocar--a new trocar concept]. / Der Spiraltrokar--ein neues Trokarkonzept.

INTRODUCTION: We would like to introduce a new trocar technique for minimal invasive surgery. The new trocar is a spiral whose coil becomes ever increasingly stronger towards the centre. Because of this, there is a smooth transition between spiral, screw and rod. The outer diameter remains the same. The spiral-trocar is screwed through the abdominal wall like a corkscrew. Because of this, the primary channel of puncture runs spirally. Furthermore, the channel is dilated and centralised so that the trocar's rod together with its sleeve can be pushed through the abdominal wall. This trocar design demonstrates the following advantages: The trocar can be screwed through the abdominal wall in a controlled manner without having to apply axial pressure. This prevents any unintentional perforation of organs. Because different layers of the tissue are penetrated at different places, they overlap, thus sealing one another after removal of the sleeve. The puncture channel was minimal, thus leaving very little risk of trocar site hernia. METHODS: The spiral-trocar was examined and compared with other types of trocars in vivo and vitro. RESULTS: During these tests, the spiral-trocar demonstrated a high level of safety and good usability. DISCUSSION: The spiral-trocar is an easily cleanable, reusable product without a mechanical sealing device and can be used together with most sleeves. This makes it very cost effective.

[Blunt trocar with modified tip for open laparoscopy]. / Wechselstab mit modifizierter Spitze für die offene Laparoskopie.

A blunt trocar for open laparoscopy is presented. Its modified design leads to better visual control of the trocar tip during insertion. Thus the risk of misplacement of the trocar is reduced.

Avaliação diagnóstica na síndrome disfunção cognitiva canina / Diagnostic Evaluation of Canine Cognitive Dysfunction Syndrome

O objetivo do presente estudo foi avaliar o questionário observacional e os testes de reatividade como forma de triagem e diagnóstico da disfunção cognitiva em cães idosos. Foram estudados 10 cães acima de sete anos, que apresentavam queixas comportamentais. Foi utilizado questionário que abordava questões comportamentais, como desorientação, atividade, interação socioambiental, alterações no padrão do sono e casa-sujidade. As respostas foram convertidas em pontuações, cujo somatório classificou o cão com disfunção cognitiva canina (DCC), ou borderline (BL), ou sem alterações comportamentais (SAC). Logo depois, foram realizados, em todos os cães, os seguintes testes cognitivos: open field, curiosidade, interação com humano e com espelho. Pela avaliação do questionário, foi determinado que dois cães tinham DCC, três eram BL, cinco eram SAC. Os cães classificados com DCC tinham idade superior aos demais e apresentaram alterações em todos os testes de reatividade, enquanto os cães BL apresentaram alterações em dois testes de reatividade e os SAC não apresentaram alterações. Conclui-se que, com o aumento da expectativa de vida canina, o questionário observacional foi um instrumento de triagem para a identificação dos cães classificados com DCC, BL e SAC, e os testes de reatividade como um método inovador para identificar o verdadeiro estado cognitivo dos pacientes idosos.(AU)

The objective was to evaluate the observational questionnaire and the reactivity tests as a way of screening and diagnosis of cognitive dysfunction in elderly dogs. Ten dogs over seven years of age, with behavioral complaints, were studied. A questionnaire was used that addressed behavioral issues such as disorientation, activity, socioenvironmental interaction, changes in sleep pattern, and house-dirtiness. Responses were converted into scores, which summed the dog with canine cognitive dysfunction (DCC), or Borderline (BL) or without behavioral changes (SAC). Soon after, the following cognitive tests were performed on all dogs: open field, curiosity, interaction with human and with mirror. Through questionnaire evaluation, two dogs had CHD, three were BL, and five were SAC. The dogs classified with DCC were older than the others and presented alterations in all reactivity tests, while the BL dogs presented changes in two reactivity tests and CAD showed no alterations. With the increase in canine life expectancy, the observational questionnaire was a screening instrument for the identification of dogs classified with DCC, BL and SAC and the reactivity tests as an innovative method to identify the true cognitive status of the dogs elderly patients.(AU)

Aspectos clínicos e laboratoriais da mastite induzida por inoculação intramamária de Staphylococcus aureus em vacas e búfalas / Clinical and laboratory aspects of mastitis induced by intramammary inoculation of Staphylococcus aureus in cows and buffaloes

Vários aspectos relacionados à mastite bubalina precisam ser esclarecidos. Muitas condutas são adaptadas a essa espécie pelo conhecimento adquirido com a espécie bovina. Com este experimento, objetivou-se evidenciar particularidades da mastite em búfalas e vacas que tiveram uma glândula inoculada com 1,0 x 103 UFC de S. aureus. Os animais foram monitorados por cultura bacteriana do leite, California Mastitis Test (CMT), e escores para avaliação da severidade da mastite. Foram utilizados os seguintes critérios: temperatura retal, apetite, produção de leite (resposta sistêmica à inflamação), contagem de células somáticas (CCS), aparência/consistência da glândula e aparência da secreção láctea (resposta localizada à inflamação). Todos os animais desenvolveram mastite clínica superaguda. A bactéria foi recuperada de todas as glândulas desafiadas, sem diferença significativa no percentual de isolamento entre as espécies até o 11º dia pós-inoculação, porém com diferença (P<0,001) no 30º dia pós-inoculação. A CCS pelo método eletrônico e o CMT detectaram nas búfalas resposta mais intensa logo após a inoculação e diminuição mais rápida da contagem ao final do experimento, quando se comparou essa espécie com as vacas. Ambos os testes demonstraram correlação com a cultura bacteriana. Na avaliação da severidade da mastite, as médias do escore total, do escore da resposta local e do escore da resposta sistêmica foram mais elevadas na espécie bovina (P<0,05). Ao longo do período de observação, verificou-se uma capacidade superior das búfalas em recuperar o status sanitário adequado, chegando, ao final do experimento, com os parâmetros avaliados mais próximos dos fisiológicos...

Several aspects related to bubaline mastits need to be clarified. Many conducts are adapted to this species by the knowledge adquired with the bovine species. This experiment aimed to evidence particularities of mastits in buffaloes and cows submitted to one-gland inoculation with 1.0 x 103 CFU of S. aureus. The animals were monitored through bacterial culturing milk, California Mastitis Test (CMT) and scores to assess the severity of mastitis. The following criteria were used: rectal temperature, appetite, milk production (systemic response to inflammation), somatic cell count (SCC), appearance/consistency of the gland and appearance of the milk secretion (localized response to inflammation). All animals developed hyperacute clinical mastitis. The bacteria was recovered from all challenged glands, with no significant difference in the percentage of isolation between the species until day 11 after inoculation, but with a difference (p<0.001) on day 30 post inoculation. The SCC with the electronic method and CMT, detected in buffaloes a more intense response right after the inoculation and a faster decrease of counting by the end of the experiment, when compared to cows. In both tests correlation with the bacterial culture was detected. In assessing the severity of mastitis, the averages of total score, of the score of local response and the systemic response score were higher in the bovine species (P<0.05). Throughout the observation period, there was a higher capacity of buffaloes in reaching the appropriate sanitary status, coming to the end of the experiment with the parameters closer to the physiological...

Study of environmental burden of lead in children using teeth as bioindicator.

The south region of Sao Paulo city hosts the Guarapiranga dam, responsible for water supply to 25% of the city population. Their surroundings have been subject to intense and irregular occupation by people from very low socioeconomics classes. Measurements undertaken on sediment and particulate materials in the dam revealed concentrations of lead, copper, zinc and cadmium above internationally accepted limits. Epidemiological and toxicological studies undertaken by the World Health Organization in individuals exhibiting lead concentrations in blood, near or below the maximum recommended (10 microg dl(-1)), surprisingly revealed that toxic effects are more intense in individuals belonging to low socioeconomics classes. Motivated by these facts, we aimed at the investigation of chronic incorporation of lead, as well as the use of our BIOKINETICS code, which is based on an accepted ICRP biokinetics model for lead, in order to extrapolate the results from teeth to other organs. The focus of our data taking was children from poor families, living in a small, restrict and allegedly contaminated area in São Paulo city. Thus, a total of 74 human teeth were collected. The average concentration of lead in teeth of children 5 to 10 years old was determined by means of a high-resolution inductively coupled plasma mass spectrometer (ICP-MS). For standardization of the measurements, an animal bone certified material (H-Animal Bone), from the International Atomic Energy Agency, was analyzed. The amount of lead in children living in the surroundings of the dam, was approximately 40% higher than those from the control region, and the average lead concentration was equal to 1.3 microg g(-1) approximately. Grouping the results in terms of gender, tooth type and condition, it was concluded that a carious molar of boys is a much more efficient contamination pathway for lead, resulting in concentrations 70% higher than in the control region. We also inferred the average concentrations of lead in other organs of these children, by making use of our BIOKINETIC code.

In-house television news: focus on employees boosts morale.

A medical center is using a monthly videotaped television news program to effectively inform its departments and personnel about one another, to provide them with special recognition, and to help nurture their esprit de corps. For these reasons, staff participation, especially by nonsupervisory personnel, both in producing and in appearing on the program is emphasized.

Emergence of insulin receptors on human lymphocytes during in vitro transformation.

Essentially no specific binding sites for insulin are detected in small lymphocytes freshly isolated from human blood. Insulin-binding sites appear on the lymphocyte surface during transformation in vitro with concanavalin A, and the number of these receptors increases sharply to reach a maximum between 24 and 46 hr after exposure to the mitogen. The appearance of de novo binding sites for insulin coincides with the increase in [(3)H]thymidine uptake into nuclear DNA and clearly precedes the appearance of enlarged, morphologically transformed cells. No changes in insulin-binding are detected in unstimulated control cultures. A maximum of about 350 molecules of insulin can bind per transformed lymphocyte, while less than six insulin molecules bind to an untransformed cell. Circulating human leukemic lymphoblasts bind about as much insulin as the lymphocytes transformed in vitro. Giant, polynucleated, transformed lymphocytes cultured in the presence of cytochalasin B bind about 10 times more insulin than transformed lymphocytes, which is in harmony with a 10-fold increase in cell-surface area in these cells. Specific binding of insulin is a saturable process in transformed lymphocytes but not in the untransformed cells. In transformed cells, [(125)I]-insulin is displaced by as little as 2 ng/ml of native insulin, while in untransformed cells no significant displacement is observed with native insulin. Digestion of transformed cells with phospholipase C (EC 3.1.4.3.) enhances the specific binding of [(125)I]insulin 3-fold, but no effect occurs with untransformed cells. These observations indicate a possible functional role of insulin and of adenylate cyclase in cell growth and division.

Laparoscopic implantation of Oreopoulos-Zellermann catheters for peritoneal dialysis.

For the implantation of continuous ambulatory peritoneal dialysis (CAPD) catheters, both the laparoscopic technique and the use of an Oreopoulos-Zellermann catheter have been suggested to be preferable to the open technique using Tenckhoff catheters. Building on advantages of known techniques, we here describe a procedure for the laparoscopic implantation of the Oreopoulos-Zellermann catheter. The procedure is quick, efficient and unstressful to the patient. After nearly 10,000 patient-days of catheter use, we find positive results with regard to permanently good inlet and outlet flows, low incidence of exit site infections and leaks from the catheter tunnel.

Lead determination in slurries of biological materials by ETAAS using a W-Rh permanent modifier.

A tungsten-rhodium coating on the integrated platform of a transversely heated graphite atomiser (THGA) was used as a permanent chemical modifier for the determination of lead in biological materials by slurry sampling in electrothermal atomic absorption spectrometry (ETAAS). Slurries were sonicated during 20 s before being delivered to the previously W-Rh treated platform. The number of particles of biological materials introduced into the atomiser for delivering 20 microL slurry aliquot ranged from 5,100 to 39,000. The permanent W-Rh modifier remained stable during approximately 300 analytical measurements when 20 microL of slurries containing up to 1.5% m/v were delivered into the atomiser. In addition, the permanent modifier increases the tube lifetime by approximately 100% when compared to untreated integrated platforms. Also, there is less decrease of sensitivity during the atomiser lifetime when compared with the conventional modifiers, resulting in a decreased need of re-calibration during routine analysis and consequently increasing the sample throughput. The atomiser lifetime was limited to the THGA wall durability, because the W-Rh treated platform was intact after more than 650 analytical firings in a medium containing up to 1.5% m/v slurry of biological material. The detection limit based on integrated absorbance was 20 ng g(-1) Pb for 1.50% m/v slurries. Results from the determination of lead in slurries of biological materials using the W-Rh permanent modifier were in agreement with those obtained with digested solutions using Pd + Mg(NO3)2.