Arthroscopic rotator cuff repair using a single or double row technique: A meta-analysis of randomized clinical trial. / Reparación artroscópica del manguito rotador mediante una técnica de hilera simple o doble hilera: un metaanálisis de los ensayos clínicos aleatorizados.

PURPOSE: To compare the double row technique versus the single row technique for arthroscopic rotator cuff repair, in order to assess whether there are clinical differences. METHODS: Systematic review of randomized clinical trials comparing the clinical results of the double-row technique versus the single-row technique in arthroscopic rotator cuff repair. Demographic, clinical, and surgical variables were analyzed, including functional scores, tendon healing rate, and re-tear rate. RESULTS: Thirteen randomized clinical trials were selected. 437 patients in the single row group (50.7%) and 424 patients in the double row group (49.3%) were analyzed. No significant differences were found between the two groups in terms of age (P=.84), sex (P=.23) and loss to follow-up (P=.52). Significant differences were found for the better results of the double row technique at the UCLA level (P=.01). No significant differences were found on the Constant-Murley scale (P=.87) or on the ASES scale (P=.56). Similarly, there was a higher healing rate (P=.006) and less risk of rotator cuff re-tears with the double row technique (P=.006). CONCLUSIONS: In rotator cuff repair, the double row technique was found to be superior to the single row technique in terms of better UCLA score, better tendon healing rate, and lower re-tear rate. No clinically significant differences were found on the Constant-Murley scale or on the ASES scale.

Measurements of magnetic field fluctuations in TJ-II plasmas with new in-vessel helical arrays of magnetic coils.

This paper describes two new helical arrays of magnetic coils recently installed inside the TJ-II vacuum vessel. Their main objective is the precise measurement of the spatial periodicity of the magnetohydrodynamic perturbations usually found in the TJ-II plasmas. Given the high probability of coil failures due to the harsh plasma environment and in view of the extremely difficult access to the TJ-II vessel interior for maintenance, the coil system has been divided in two quasi-identical helical arrays. Both arrays consist of 32 triaxial sensors measuring orthogonal components of the local magnetic field along an ideal helical path whose trajectory runs close to the plasma edge. A description of the main characteristics of coils and arrays as well as their nominal positioning along an ideal helical path, inside the vessel, is given. A precise experimental determination of the real spatial orientation of the coils is performed by comparing the signals measured in current ramp-up and ramp-down experiments with calculations based on a filamentary model for the TJ-II magnetic coils. After this fine calibration procedure, it is possible to analyze the dependence of the amplitude of the measured magnetic field and its fluctuations as a function of the coil distance to the last closed flux surface. The study of the phase evolution of the parallel and perpendicular oscillatory components is also enabled. Finally, two examples of mode number determination are shown. One corresponds to a low frequency mode appearing in pure electron cyclotron resonance heating plasma, and the other one shows several modes observed during combined injection of both co and counter neutral beams and identified as shear Alfvén waves.

Integrated data analysis at TJ-II: the density profile.

An integrated data analysis system based on Bayesian inference has been developed for the TJ-II stellarator. It reconstructs the electron density profile at a single time point, using data from interferometry, reflectometry, Thomson scattering, and the Helium beam, while providing a detailed error analysis. In this work, we present a novel analysis of the ambiguity inherent in profile reconstruction from reflectometry and show how the integrated data analysis approach elegantly resolves it. Several examples of the application of the technique are provided, in both low-density discharges with and without electrode biasing, and in high-density discharges with an (L-H) confinement transition.

Observation of confined current ribbon in JET plasmas.

We report the identification of a localized current structure inside the JET plasma. It is a field-aligned closed helical ribbon, carrying current in the same direction as the background current profile (cocurrent), rotating toroidally with the ion velocity (corotating). It appears to be located at a flat spot in the plasma pressure profile, at the top of the pedestal. The structure appears spontaneously in low density, high rotation plasmas, and can last up to 1.4 s, a time comparable to a local resistive time. It considerably delays the appearance of the first edge localized mode.

[Multicenter open study with docetaxel. Treatment of patients with locally advanced or metastatic breast carcinoma]. / Estudo aberto multicêntrico com docetaxel. Tratamento de doentes com carcinoma da mama localmente avançado ou metastático.

The efficacy and safety of docetaxel were evaluated in an open, multicentric, non comparative study involving 24 patients with locally advanced or metastatic breast cancer, eligible for second line or subsequent anticancer chemotherapy; the results confirm a global response around 50%, suggesting some advantages when compared to the usual treatments in this set of patients; the median duration of response, the median time to progression and the median time of survival were respectively, 309, 219 and 345 days; the main iatrogenic event was haematological, mainly in the white and red blood cells.

Developmental changes of hypothalamic, pituitary and striatal tachykinins in response to testosterone: influence of prenatal melatonin.

Substance P (SP) and neurokinin A (NKA), members of the family of mammalian tachykinins, are involved in the regulation of many physiological functions and are widely distributed in mammalian tissues. In this report, the effects of prenatal melatonin on the postnatal developmental pattern of NKA, and SP, and on testosterone secretion were investigated. Also, tachykinin response to the administration of testosterone propionate (TP) was studied. The brain areas studied were medio-basal-hypothalamus, pituitary gland and striatum. Male rat offspring of control or melatonin treated mother rats were studied at different ages of the sexual development: infantile, juvenile or prepubertal periods, and pubertal period. Both groups received exogenous TP (control-offspring+TP and MEL-offspring+TP), or the vehicle (control-offspring+placebo and MEL-offspring+placebo). Hypothalamic concentrations of all peptides studied in control-offspring+placebo remained at low levels until the juvenile period, days 30-31 of age. After this age, increasing concentrations of these peptides were found, with peak values at puberty, 40-41 days of age, then declining until adulthood. In the MEL-offspring+placebo a different pattern of development was observed; hypothalamic concentrations of NKA and SP from the infantile period until the end of juvenile period were significantly higher than in control-offspring+placebo. TP administration exerted a more marked influence on MEL-offspring than on control-offspring and prevented the elevation in tachykinin concentrations associated with prenatal melatonin treatment. TP administration to control-offspring resulted in significantly reduced (P < 0.05) tachykinin concentration only at 40-41 days of age, and increased (P < 0.01) during infantile period as compared to control-offspring+placebo. Pituitary NKA concentrations were lower than in the hypothalamus. In control-offspring+placebo pituitary NKA levels did not show significant changes throughout sexual development. A different developmental pattern was observed in MEL-offspring+placebo, with significantly increased (P < 0.05) pituitary NKA concentrations at 35-36 days of age than in control-offspring+placebo. TP administration to control-offspring influenced pituitary NKA levels at the end of the infantile and pubertal periods, showing at both stages significantly higher (P < 0.05) NKA levels as compared to control-offspring+placebo. NKA levels in MEL-offspring+TP were only affected at 21-22 days of age, showing significantly increased (P < 0.01) values as compared to MEL-offspring+placebo. Striatal tachykinin concentrations in control-offspring did not undergo important modifications throughout sexual development, but during the prepubertal period they started to increase. Maternal melatonin and TP injections produced short-lived alterations during the infantile period. The results showed that prenatal melatonin delayed the postnatal testosterone secretion pattern until the end of the pubertal period and postnatal peptide secretion in brain structures. Consequently, all functions depending of the affected areas will in turn, be affected.

Effect of pinealectomy and melatonin treatment during pregnancy on the sexual development of the female and male rat offspring.

Sexual development of female and male rat offspring of control, pinealectomized (PIN-X) or melatonin (MEL 250 micrograms/100 g body wt)-treated mother rats during pregnancy was studied. Newborns were studied at the following phases of sexual development: neonate (5 days old), infantile (15 days old), juvenile (25 and 30 days old) and pubertal phase (55 days). In female offspring, MEL treatment during pregnancy significantly increased plasma luteinizing hormone (LH) in 15- and 25-day-old rats; however, at the end of the prepubertal period (30 days) the concentration of plasma LH decreased significantly as compared to control rats. This hormonal pattern was different from that observed in offspring of control and PIN-X rats, which had low LH levels at 25 days of age and higher LH levels at 30 days of age. Follicle-stimulating hormone (FSH) did not vary significantly among the three groups. Plasma prolactin levels were affected by PIN-X of the mother, showing significantly higher levels in the 5-day-old offspring than in the controls; plasma prolactin levels were also affected by MEL treatment of the mother, producing hyperprolactinemia in the 30-day-old female offspring. In male offspring, sexual development in control male rats progressed rapidly with significantly increased LH and FSH levels at 25 and 30 days compared to those measured during the neonatal and infantile periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Ondansetron in the treatment of nausea and vomiting induced by chemotherapy. Portuguese Ondansetron Study Group.

One-hundred and forty-five chemotherapy patients receiving cisplatin- and non-cisplatin-containing regimens participated in an open evaluation of ondansetron, a 5-HT3 receptor antagonist, in the prophylaxis of acute and delayed nausea and vomiting. The study had two groups of patients, one receiving cisplatin-containing regimens (Group A) and the other, non-cisplatin-containing regimens (Group B). There were 51 patients recruited to Group A. Ondansetron was given to these patients at a dose of 8 mg intravenously 15 min before chemotherapy, followed by an intravenous infusion for 24 h (1 mg/h), or 8 mg intravenously 4 and 8 h after the start of cisplatin, followed by 8 mg orally three times/day for 5 days. Ninety-four patients were recruited to Group B: these patients received ondansetron at a dose of 8 mg intravenously immediately before chemotherapy or 8 mg orally 1-2 h prior to it, and 8 mg orally three times/day for 3-5 days. For acute emesis (first 24 h), complete control was achieved in 79.5% of Group A patients and in 78.1% of Group B. For delayed emesis (days 2-5), 79.7% of Group A patients and 84.6% of Group B were completely protected during the entire study period. Nausea was also well controlled with ondansetron; 83.2% (Group A) and 86.5% (Group B) reported only mild nausea or no nausea at all. Ondansetron was effective in the control of both cisplatin- and non-cisplatin-induced emesis and well tolerated without any serious drug-related adverse events.

[Effects of a calcium antagonist, verapamil, on mild-moderate essential arterial hypertension]. / Efectos de un antagonista del calcio, verapamil, sobre la hipertensión arterial esencial leve-moderada.

A close comparative study of the hypotensive effects of verapamil and chlorthalidone was carried out on 60 patients affected with mild essential hypertension showing systemic. I-II OMS affectation degree, during 9 weeks. Both, the calcium channel blockers and the diuretics produced statistically significant decreases in the arterial pressure, being more evident with verapamil. An adequate control of the hypertension was achieved with both drugs, the results produced with verapamil (from 2nd week) being more important and quicker. The biochemical control did give the best results with verapamil, however, because it did not modify the plasmatic levels of cholesterol, uric acid and potassium. We concluded that the calcium channel blocker must be included in the therapeutic arsenal against essential hypertension, verapamil being the first choice because of its efficacy, tolerance and minimal alterations o in the biochemical blood test.