Release of silicone oil and the off-label use of syringes in ophthalmology.

BACKGROUND/AIMS: To assess silicone oil (SO) release by different brands of syringes used for intravitreal injection under different handling conditions. METHODS: Eight syringes were analysed: from the USA, Terumo 0.5 mL, Becton-Dickinson (BD) Tuberculin 1 mL, BD Luer-lok 1 mL, BD Ultra-Fine 0.3 mL and Exel Insulin 0.3 mL; from Germany, Braun Omnifix-F 1 mL and Braun Injekt-F 1 mL and from Spain, BD Plastipak 1 mL. The impact of air, priming the plunger, agitation by flicking and fluid temperature on SO release were assessed by light microscopy. Fourier transform infrared spectroscopy (FTIR) was performed to identify the molecular compound in each syringe. RESULTS: Five hundred and sixty syringes were analysed. Terumo 0.5 mL and BD Ultra-Fine 0.3 mL released more SO than all others. BD Luer-lok 1 mL, BD Plastipak and Braun Omnifix-F 1 mL released little SO; BD Tuberculin 1 mL, Exel 0.3 mL and Braun Injekt-F 1 mL released the least SO. Priming the syringe and different temperatures did not significantly affect SO release. Agitation by flicking caused a significantly higher proportion of samples to have SO droplets and an increased number of oil droplets. Air had an additive effect on the release of oil in the agitation groups. FTIR identified polysiloxane in all syringes but Injekt-F. CONCLUSION: Syringes commonly used for intravitreal injections frequently release SO droplets, especially when agitated by flicking. To avoid unnecessary ocular risks, syringes should not be agitated before intravitreal injection. It is desirable that syringes be manufactured specifically for ophthalmic use.

Interaction of demographic factors with the results of the surgery for degenerative disease of the cervical spine: a retrospective evaluation.

OBJECTIVE: Degenerative disease of the cervical spine is a frequent source of intermittent neck pain, where the predominant symptom is axial neck pain. The indications for surgical treatment are reserved for the cases where the conservative treatment has not relieved the symptoms or the patient presents progressive neurological impairment. The objective of this study was to evaluate the prognostic factors involved in patients submitted to surgical treatment of the cervical spine. METHODS: The study analyzed data from patients submitted to cervical spine surgery between July 2011 and November 2015 (n = 58). The evaluated data included smoking habits, hypertension, diabetes, overweight, surgical technique, and number of levels of fusion. The primary outcome was defined as pain and the secondary outcomes were quality of life and disability. RESULTS: A statistically significant difference was found between baseline and the 12-month post-operative results regarding pain in favor of non-hypertensive patients (p = 0.009) and discectomy plus instrumentation (p = 0.004). There was also significant difference between the results of neck disability in favor of non-hypertensive patients (p = 0.028) and patients with body mass index lower than 25 kg/m2 (p = 0.005). There was no significant interaction between any analyzed data and the quality of life score results. CONCLUSIONS: Non-hypertensive patients, those with body mass index lower than 25 kg/m2, and those submitted to discectomy combined with arthrodesis of the cervical spine are the most benefited by cervical degenerative disease surgery.

OBJETIVO: A doença degenerativa da coluna cervical é uma fonte frequente de dor cervical intermitente, na qual os sintomas predominantes são dor axial cervical. As indicações para cirurgia são reservadas para os casos de falha do tratamento conservador ou com sintomas neurológicos progressivos. O objetivo deste estudo foi avaliar os fatores prognósticos dos pacientes submetidos ao tratamento cirúrgico da coluna cervical. MÉTODOS: O estudo avaliou os pacientes submetidos à cirurgia da coluna cervical entre julho de 2011 e novembro de 2015 (n = 58). As variáveis de comparação avaliadas foram tabagismo, hipertensão, diabete, sobrepeso, técnica cirúrgica aplicada e número de níveis de artrodese. O desfecho primário foi definido como dor e os desfechos secundários foram qualidade de vida e disfunção. RESULTADOS: Encontramos diferença estatisticamente significativa entre os escores de dor de base e aos 12 meses após a cirurgia, favorável aos pacientes sem hipertensão arterial sistêmica (p = 0,009) e aos submetidos à discectomia com instrumentação (p = 0,004). Também houve diferença estatisticamente significativa na avaliação da disfunção da coluna cervical: o resultado foi mais favorável para os pacientes sem diagnóstico prévio de hipertensão (p = 0,028) e para os pacientes com IMC menor do que 25 kg/m2 (p = 0,005). Não se observou evidência de interação significativa entre os dados avaliados e os resultados do questionário de qualidade de vida. CONCLUSÕES: Os pacientes não hipertensos, com índice de massa corpórea menor do que 25 kg/cm2 e submetidos à artrodese combinada à discectomia, são os mais beneficiados com o procedimento cirúrgico da doença degenerativa da coluna cervical.

Interaction of demographic factors with the results of the surgery for degenerative disease of the cervical spine: a retrospective evaluation / Interação dos dados demográficos com os resultados da cirurgia da doença degenerativa da coluna cervical: uma avaliação retrospectiva

ABSTRACT Objective: Degenerative disease of the cervical spine is a frequent source of intermittent neck pain, where the predominant symptom is axial neck pain. The indications for surgical treatment are reserved for the cases where the conservative treatment has not relieved the symptoms or the patient presents progressive neurological impairment. The objective of this study was to evaluate the prognostic factors involved in patients submitted to surgical treatment of the cervical spine, Methods: The study analyzed data from patients submitted to cervical spine surgery between July 2011 and November 2015 (n= 58). The evaluated data included smoking habits, hypertension, diabetes, overweight, surgical technique, and number of levels of fusion. The primary outcome was defined as pain and the secondary outcomes were quality of life and disability., Results: A statistically significant difference was found between baseline and the 12-month post-operative results regarding pain in favor of non-hypertensive patients (p= 0.009) and discectomy plus instrumentation (, p= 0.004). There was also significant difference between the results of neck disability in favor of non-hypertensive patients (p= 0.028) and patients with body mass index lower than 25, kg/m2 (p= 0.005). There was no significant interaction between any analyzed data and the quality of life score results. Conclusions: Non-hypertensive patients, those with body mass index lower than 25 kg/m2, and those submitted to discectomy combined with arthrodesis of the cervical spine are the most benefited by cervical degenerative disease surgery.

RESUMO Objetivo: A doença degenerativa da coluna cervical é uma fonte frequente de dor cervical intermitente, na qual os sintomas predominantes são dor axial cervical. As indicações para cirurgia são reservadas para os casos de falha do tratamento conservador ou com sintomas neurológicos progressivos. O objetivo deste estudo foi avaliar os fatores prognósticos dos pacientes submetidos ao tratamento cirúrgico da coluna cervical. Métodos: O estudo avaliou os pacientes submetidos à cirurgia da coluna cervical entre julho de 2011 e novembro de 2015 (n = 58). As variáveis de comparação avaliadas foram tabagismo, hipertensão, diabete, sobrepeso, técnica cirúrgica aplicada e número de níveis de artrodese. O desfecho primário foi definido como dor e os desfechos secundários foram qualidade de vida e disfunção. Resultados: Encontramos diferença estatisticamente significativa entre os escores de dor de base e aos 12 meses após a cirurgia, favorável aos pacientes sem hipertensão arterial sistêmica (p = 0,009) e aos submetidos à discectomia com instrumentação (p = 0,004). Também houve diferença estatisticamente significativa na avaliação da disfunção da coluna cervical: o resultado foi mais favorável para os pacientes sem diagnóstico prévio de hipertensão (p = 0,028) e para os pacientes com IMC menor do que 25 kg/m2(p = 0,005). Não se observou evidência de interação significativa entre os dados avaliados e os resultados do questionário de qualidade de vida. Conclusões: Os pacientes não hipertensos, com índice de massa corpórea menor do que 25 kg/cm2e submetidos à artrodese combinada à discectomia, são os mais beneficiados com o procedimento cirúrgico da doença degenerativa da coluna cervical.

Association between CD62 ligand on naïve and memory T cells and history of cow's milk hypersensitivity in atopic patients.

BACKGROUND: Both IgE and non-IgE cell-mediated reactions can contribute to the immunopathogenesis of food hypersensitivity. OBJECTIVE: To study L-selectin expression in naïve (CD45RA+) and memory (CD45RO+) T cells in atopic patients with a history of cow's milk allergy and CD69 expression. METHODS: We evaluated 12 children with a history of cow's milk allergy. All 12 children underwent clinical history, examination, in vivo skin prick testing to inhalants and milk allergen, and in vitro radioallergosorbent testing for milk and total serum IgE levels. L-selectin levels on naive and memory T cells from patients and controls were analyzed by flow cytometry with fluorochrome-conjugated monoclonal antibodies after 4 hours or 7 days of incubation with medium alone, 1 microg/mL of pokeweed mitogen, or 50 microg/mL of casein. RESULTS: The percentage of CD45RA+ 62L+ cells with casein was 56% +/- 11% vs 38% +/- 7.7% in healthy controls (P < .009). The percentage of CD45RO- 62L+ cells was 22% +/- 7.1% vs 39% +/- 7.6% in healthy controls (P < .001), whereas the expression of CD62L+ in CD45RA+ and CD45RO+ cells decreased 149% +/- 33% vs 540% +/- 36% for healthy controls (P < .001) and 89% -+/- 16% vs 402% +/- 103% for healthy controls (P < .001), respectively. CONCLUSIONS: The results of the present study demonstrate the presence of CD62 ligand on naive and memory T cells, which might serve as a predictive marker for atopic dermatitis withother overlapping atopic disorders, such as asthma and allergic rhinitis.

Vagotomia gástrica proximal; esquematização técnica e resultados, contribuição para o seu estudo / Proximal gastric vagotomy; layout technique and results, their contribution to the study

O presente trabalho tem por finalidade apresentar uma esquematização técnica que possibilite a fácil e eficiente execução da VGP. É praticamente universal a opinião de que os resultados da presente operação estão, mais do que nunca dependentes, de uma correta execução cirúrgica...Além da esquematização técnica, apresentamos os dados relativos a 312 pacientes, observados no período de 1974 a 1991 e internados no Hospital Penitenciário do Rio de Janeiro, que confirmam plenamente os postulados de grande eficácia do método terapêutico.

Tumores desmóides / Desmoid tumors

Säo apresentados cinco casos de tumores desmóides de parede abdominal anterior cuja correçäo foi feita com tela de marlex após ressecçäo com ampla margem de segurança. Todos os casos foram confirmados pela patologia