Utilização de plasma rico em plaquetas de coelhos com poucos leucócitos e hemácias para a consolidação de ossos / Use of plasma rich in platelets of rabbits with few leukocytes and erythrocytes to consolidate bones

Objetivou-se utilizar o plasma rico em plaquetas, obtido por técnica capaz de produzir um produto autólogo, com reduzido número de leucócitos e hemácias, e avaliar, por meio de radiografias, a capacidade de cicatrização de uma falha óssea induzida no rádio de coelhos. Foram coletados 10,5mL de sangue por via intracardíaca, o qual foi distribuído em três tubos de hemossedimentação contendo citrato de sódio. Os tubos contendo as amostras foram submetidos a uma centrifugação a 2.000rpm (670,8G) por 20 minutos, e da coluna de sedimentação foram aspirados de cada tubo 1.000µL de plasma para a redução do volume sobrenadante. Aspirou-se o plasma acima do anel de leucócitos e transferiu-se para outro tubo para centrifugação a 2.000rpm por 10 minutos. O conteúdo plaquetário no fundo do tubo foi ressuspendido e homogeneizado a 1.000µL do plasma sobrenadante para formar o PRP líquido. Uma falha de 1,0cm foi realizada no rádio esquerdo de cada coelho. O tempo de consolidação foi observado por meio de exame radiográfico aos 45 e 90 dias de pós-operatório (PO). As imagens foram comparadas entre o grupo controle (G1) e o grupo que recebeu o implante de PRP por via transdérmica (G2). A evolução da cicatrização foi verificada com auxílio do programa Adobe Photoshop CC e em uma escala de cinza que representa o contraste. No G2 foi verificada média de 63% de contraste aos 45 dias de PO e de 65% aos 90 dias de PO. No G2, aos 45 dias de PO, a média encontrada foi de 42,7%, e aos 90 dias de PO, 31,25%, indicando que houve evolução do processo de reparação óssea em comparação ao grupo que não recebeu o implante de PRP. O método de obtenção de plasma rico em plaqueta autólogo de coelhos reduziu o número de leucócitos e hemácias e recuperou o número de plaquetas, sendo este maior ou igual aos valores fisiológicos para a espécie. O PRP obtido foi capaz de acelerar o processo de consolidação óssea em coelhos.

The aim of this study was to use the platelet-rich plasma obtained by a technique capable of producing an autologous product, with a reduced number of white blood cells and red blood cells and assessed by radiographs, the healing ability of a bone defect induced in the radio rabbits. 10.5mL of blood was collected via intracardiac blood sedimentation and distributed into three tubes containing sodium citrate. The tubes containing the samples were subjected to centrifugation at 2,000 rpm (670.8G) for 20 minutes and the sediment column were aspirated from each plasma tube1,000μL to reduce the supernatant volume. The plasma was aspirated from above the leukocytes ring and transferred to another tube for centrifugation at 2,000 rpm for 10 minutes. The platelet content in the tube bottom was resuspended and homogenized to 1,000μL plasma supernatant PRP to form the liquid. A1.0 cm failure was performed on the left radio of each rabbit. The healing time was observed by means of radiographic examination at 45 and 90 days after surgery. The images were compared between the control group (G1) and the group receiving PRP implant transdermally (G2). The healing progress was assessed with the help of Adobe Photoshop program and a gray scale that represents the contrast. G2 had an average of 63% contrast at 45 days PO and 65% at 90 days PO. In G2, at 45 days PO the average was 42.7% and at 90 days PO 31.25% indicating that there was an increase in bone repair process compared to the group that did not receive the PRP implant. The method of obtaining an autologous platelet rich plasma of rabbits reduced the number of leukocytes and erythrocytes and platelets recovered which is greater than or equal to the physiological range for the species. The obtained PRP was able to accelerate the process of bone healing in rabbits.

Side of pupillary mydriasis predicts the cognitive prognosis in patients with severe traumatic brain injury.

BACKGROUND: Pupils' abnormalities are associated to bad prognosis in traumatic brain injury. We investigated the association between the side of pupil mydriasis and the long-term cognitive performance of patients with severe traumatic brain injury (TBI). METHODS: We analyzed the cognitive performance of patients admitted at the intensive care unit with isochoric pupils (IP, n = 28), left mydriasis (LM, n = 10), right mydriasis (RM, n = 9) evaluated in mean 2.5 years after the severe TBI and controls (n = 26) matched for age, sex and education level. RESULTS: Patients and controls had similar scores in the four WAIS-III investigated subtests. In comparison with controls, LM patients had lower scores in Letters and Category Fluency and IP patients in Category Fluency. Among the 10 evaluated memory tests, LM patients had lower scores than controls in eight, RM patients in two and IP in three memory tests. IP and RM were 3.5 to nine times more associated to significant impairment (cognitive scores under the percentile 10 of controls) in six of 16 investigated cognitive tests. LM was six to 15 times more associated to significant impairment in 10 of 16 cognitive tests. The association among the pupil abnormalities and cognitive performances remained significant after the multiple linear regression analysis controlling for age, gender, admission coma Glasgow scale and serum glucose, presence of associated trauma, and cranial computed tomography abnormalities. CONCLUSION: Side of admission pupil abnormalities may be a useful variable to improve prognostic models for long-term cognitive performance in severe TBI patients.

Maternal exposure to fluoxetine during gestation and lactation affects the DNA methylation programming of rat's offspring: modulation by folic acid supplementation.

Fluoxetine is an antidepressant that has been largely used for treatment of depression in pregnancy. In the present study we evaluated the effects of the exposure to fluoxetine during gestation and lactation on DNA methylation of rat brain regions. Female Wistar rats were treated with 5mg/kg of fluoxetine during pregnancy and lactation. In order to assess the effects of fluoxetine in the context of maternal folic acid supplementation we performed an additional combined treatment composed by folic acid (8 mg/kg/day) and fluoxetine (5 mg/kg/day). On the postnatal day 22, male rats were euthanized and hippocampus, cortex, hypothalamus, and periaqueductal gray area were removed. Global DNA methylation was quantified using a high-throughput ELISA-based method. Neurofunctional changes were addressed using validated behavioral tests: hot plate, elevated plus maze and open field. A decrease in the global DNA methylation profile of hippocampus was associated to the exposure to fluoxetine, whereas an increase in methylation was observed in cortex. The combined treatment induced an increase in the methylation of hippocampus indicating the potential of folic acid to modulate this epigenetic alteration. Increase in the latency to the thermal nociceptive response was observed in animals exposed to fluoxetine whereas this effect was abolished in animals from the combined treatment. In summary we demonstrated that exposure to fluoxetine during gestation and lactation affect the DNA methylation of brain and the nociceptive response of rats. Furthermore our data reveal the potential of folic acid to modulate epigenetic and functional changes induced by early exposure to fluoxetine.

Avaliação do equilíbrio estático de crianças e adolescentes com síndrome de Down / Static balance assessment among children and adolescents with Down syndrome

OBJETIVOS: Avaliar o equilíbrio estático de crianças e adolescentes com Síndrome de Down (SD) pela Biofotogrametria Computadorizada e verificar a influência da visão nesta situação. MÉTODOS: Participaram 11 crianças e adolescentes com SD e 14 crianças e adolescentes de ambos os gêneros, neurologicamente normais que compuseram o grupo controle. Durante as filmagens, os participantes se mantiveram na posição ortostática com os braços posicionados ao lado do corpo e com os pés paralelos sobre uma superfície plana. As crianças de ambos os grupos foram filmadas na vista anterior (plano frontal) e na vista de perfil direito (plano sagital) nas condições com visão e sem visão. Nas filmagens na condição de olhos fechados, foram utilizados óculos de natação totalmente vedados, com a finalidade do participante não ter nenhuma informação visual. O instrumento utilizado foi a Biofotogrametria Computadorizada, que serviu como referência angular para verificar as oscilações do corpo em equilíbrio estático. RESULTADOS:As crianças e adolescentes com SD oscilaram mais (p<0,05) que as do grupo controle e, quando a informação visual foi manipulada, as oscilações ântero-posterior e latero-lateral mostraram a existência de diferenças significativas no equilíbrio nas crianças e adolescentes com SD quando comparadas com as crianças do grupo controle (p<0,01). CONCLUSÃO:O presente estudo mostrou que as crianças e adolescentes com SD oscilaram mais que as crianças do grupo controle com e sem a informação visual nos planos ântero-posterior e latero-lateral.

OBJECTIVES: To evaluate static balance and the influence of visual information among children and adolescents with Down Syndrome (DS) by means of computerized biophotogrammetry. METHODS: Eleven children and adolescents with DS took part in the study and 14 neurologically normal children and adolescents comprised the control group (both genders). During filming, the subjects remained in the orthostatic position with arms to the side of the body and feet parallel on a flat surface. Both groups were filmed in anterior view (frontal plane) and right lateral view (sagittal plane) with and without the eyes covered. While being filmed with eyes covered, the subjects wore fully blacked-out swimming goggles to eliminate all visual information. The instrument used was computerized biophotogrammetry, which served as an angular reference for verifying body sway in static stance. RESULTS:The subjects with DS swayed more (p<0.05) than the control group. When the visual information was eliminated, the anterior-posterior and lateral sway showed significant differences in the balance of the subjects with DS, compared with the subjects of the control group (p<0.01). CONCLUSION: The present study showed that children and adolescents with DS swayed more than the children in the control group with and without visual information and in both the anterior-posterior and lateral planes.