Functional outcome in dogs undergoing hemilaminectomy for thoracolumbar disc extrusion but without nociception > 96 h: A prospective study.

This prospective study investigated the functional recovery of surgically treated dogs with thoracolumbar intervertebral disc extrusion (IVDE) without deep pain perception (DPP) for > 96 h. Dogs (n = 36) with paraplegia secondary to thoracolumbar intervertebral disc extrusion with loss of deep pain perception ranging from 4 to 60 days were enrolled. All dogs underwent hemilaminectomy and fenestration of the affected intervertebral disc and postoperative follow-up was provided for a maximum of 180 days. Recovery of motor function was satisfactory (based on the owner's assessment) in 22 dogs, 61.1% (47.2% with DPP, and 13.9% without DPP) and unsatisfactory in 38.9% of cases (n = 14). Postoperative physiotherapy, preoperative anti-inflammatory drugs, and age had no effect on recovery. In this study, the longer the time taken to regain pain perception, the longer the recovery time. The median time to recovery was 30 days. A total of 47.2% of dogs with paraplegia and absence of DPP secondary to thoracolumbar IVDE lasting > 96 h, recovered functional ambulation after decompressive surgery.

Composite Coatings of Chitosan and Silver Nanoparticles Obtained by Galvanic Deposition for Orthopedic Implants.

In this work, composite coatings of chitosan and silver nanoparticles were presented as an antibacterial coating for orthopedic implants. Coatings were deposited on AISI 304L using the galvanic deposition method. In galvanic deposition, the difference of the electrochemical redox potential between two metals (the substrate and a sacrificial anode) has the pivotal role in the process. In the coupling of these two metals a spontaneous redox reaction occurs and thus no external power supply is necessary. Using this process, a uniform deposition on the exposed area and a good adherence of the composite coating on the metallic substrate were achieved. Physical-chemical characterizations were carried out to evaluate morphology, chemical composition, and the presence of silver nanoparticles. These characterizations have shown the deposition of coatings with homogenous and porous surface structures with silver nanoparticles incorporated and distributed into the polymeric matrix. Corrosion tests were also carried out in a simulated body fluid at 37 °C in order to simulate the same physiological conditions. Corrosion potential and corrosion current density were obtained from the polarization curves by Tafel extrapolation. The results show an improvement in protection against corrosion phenomena compared to bare AISI 304L. Furthermore, the ability of the coating to release the Ag+ was evaluated in the simulated body fluid at 37 °C and it was found that the release mechanism switches from anomalous to diffusion controlled after 3 h.

Change in opioid and analgesic use for headaches after aneurysmal subarachnoid hemorrhage over time.

BACKGROUND: Severe headache, a hallmark of aneurysmal subarachnoid hemorrhage (aSAH), affects up to 90% of patients during hospitalization. Opioids remain the guideline recommended mainstay of acute therapy despite their significant side effects and potential for tolerance and addiction. We evaluated time trends in opioid prescriptions, hypothesizing a decline with increasing recognition of the opioid crisis. METHODS: We performed a retrospective review of patients with aSAH admitted to a single tertiary care center between 2012 and 2019 and included patients with Hunt-Hess-Grade≤3 who were able to verbalize pain scores. Collected variables included mean and maximum daily headache scores, aneurysm treatment modality, and daily analgesic medication doses. RESULTS: Of 340 patients with aSAH, 114 (86 from 2012-2016 and 28 from 2017-2019) were included. Of the included patients, 86/114 (75.4%) were female. Patients in the 2012-2016 had a median age of 55 compared to 63 in the 2017-2019 group (P=0.02). Otherwise, there was no significant difference in demographic data including time in hospital, treatment option utilized, or aneurysm characteristics. Maximal daily headache score ranged from 6 to 8 for 2012-2016 and 5 to 8 for 2017-2019 cohorts. Average oral morphine equivalents (in mg) administered during hospitalization were similar between groups (2012-2016: 251±345 95% CI [178,323]; 2017-2019: 207±237 95% CI [119,295]; P=0.319). When prescribed, doses of opioids provided at discharge were less in the more recent group (2012-2016: 84.4±78.9 95% CI [57.5, 111]; 2017-2019: 38.1±20.2 95% CI [33.7, 42.5]; P=0.004) CONCLUSION: Despite recognition of important drawbacks of opioid use for headache control, and efforts to reduce opioid use during hospitalization, we found that utilization during hospitalization for SAH did not decrease over time. Maximal headache scores remained similar in the studied time periods, indicative of insufficient pain relief. This points out a pressing need to further investigate alternative opioid and narcotic sparing strategies for patients with SAH.

Copper nanowire array as highly selective electrochemical sensor of nitrate ions in water.

Contamination of water with nitrate ions is a significant problem that affects many areas of the world. For this reason, European legislation has set the maximum permissible concentration of nitrates in drinking water at 44 mg/L. Thus, it is clear that a continuous monitoring of nitrate ions is of high technological interest but it must be rapid, easy to perform and directly performable in situ. In this work we have developed a nanostructured sensor based on array of copper nanowires obtained with the simple method of galvanic deposition. The nanostructured sensors have a very short response time with a detection limit less than 10 µM. Different interfering species were tested finding a negligible effect except for the chloride ions. However, this problem has been solved by removing chloride ions from the water through a simple precipitation of chloride compounds with low solubility. Nanostructured sensors were also used to analyze real water samples (rain, river and drinking water). In the case of drinking water, we have measured a concentration of nitrate ions very close to the that measured by conventional laboratory techniques.

Proposta de sequenciamento das projeções mielográficas na identificação de compressão da medula espinhal em cães com doença do disco intervertebral cervical / [Sequential proposal in the myelographic views for detection of spinal cord compression in dogs with cervical intervertebral disc disease]

O objetivo deste trabalho foi verificar em quais projeções foi possível identificar compressão da medula espinhal em cães com doença do disco intervertebral (DDIV) cervical e propor um sequenciamento das projeções a ser realizado no exame mielográfico dessa região. Foram avaliadas quatro projeções mielográficas (lateral, ventrodorsal e oblíquas esquerda e direita) de 41 pacientes diagnosticados com DDIV cervical. Em 40 pacientes (97,5%), foi possível identificar compressão da medula espinhal na projeção lateral; em 22 (53,6%), nas oblíquas; e em 11 (26,8%), na ventrodorsal (P<0,05). Havia lateralização da compressão em 22 (53,6%) pacientes; 100% delas (n=22) foram detectadas pelas projeções oblíquas e 50% (n=11) pela ventrodorsal. Em 10 (24,4%) cães, foi observado mais que um local de compressão, tendo as projeções ventrodorsal e oblíquas auxiliado na definição do local de compressão em 50% e 70%, respectivamente. Pode-se concluir que todas as projeções mielográficas estudadas permitem identificar compressão na medula espinhal em cães com DDIV cervical, sendo a incidência lateral a que mais a revelou, seguida das oblíquas e da ventrodorsal, estabelecendo-se, assim, uma proposta de sequenciamento das projeções mielográficas a serem realizadas para essa região.(AU)

The aim of this study was to verify in which of the myelographic views it was possible to identify spinal cord compression in dogs with cervical intervertebral disc disease (IVDD), and to establish a sequence in which myelographic views should be obtained for this region. Four myelographic views (lateral, ventrodorsal, left oblique and right oblique) of 41 patients diagnosed with cervical IVDD were evaluated. In 40 patients (97.5%) it was possible to identify spinal cord compression by lateral view, 22 (53.6%) by the oblique view, and 11 (26.8%) by the ventrodorsal view (P< 0.05). There were lateralized compressions in 22 (53.6%) patients, detected by all oblique views (100%) and by 11 (50%) of the ventrodorsal views. In 10 (24.4%) dogs, more than one compression site was observed, where the ventrodorsal view helped to decide the site in 50% of the cases and oblique in 70%. It can be concluded that all the tested myelographic views allow the identification of spinal cord compressions in dogs with cervical IVDD, the lateral view being the most relevant, followed by the oblique and ventrodorsal view, therefore establishing a sequence of myelographic views should be obtained for this region.(AU)

Modalidades fisioterapêuticas na reabilitação de cães com doença do disco intervertebral toracolombar submetidos à cirurgia descompressiva: 30 casos (2008-2016) / Physiotherapeutic modalities in the rehabilitation of dogs with thoracolumbar intervertebral disc disease that underwent to decompressive surgery: 30 cases (2008-2016)

Este estudo retrospectivo teve como objetivo demonstrar as modalidades fisioterapêuticas empregadas no tratamento de cães com doença do disco intervertebral (DDIV) toracolombar após descompressão cirúrgica da medula espinhal, bem como relatar os fatores que determinaram as alterações das modalidades. Foram incluídos 30 cães que apresentavam sinais neurológicos desde paraparesia ambulatória a paraplegia com dor profunda na primeira sessão de fisioterapia. As modalidades utilizadas nos protocolos de todos os pacientes foram a crioterapia, massagem, alongamento passivo, movimentação passiva articular, estímulo do reflexo flexor e estimulação elétrica neuromuscular. A inclusão ou exclusão de exercícios terapêuticos, como a tipoia corporal, a plataforma proprioceptiva circular, a natação, a hidroesteira, os obstáculos e a caminhada em colchão, foi de acordo com a evolução clínica e a adaptação de cada paciente. Oitenta por cento (80%) dos cães alteraram o grau de disfunção neurológica antes de iniciar a fisioterapia e 93% retornaram à habilidade de caminhar (paraparesia ambulatória) ao final da fisioterapia. O número de sessões e o tempo de recuperação foram maiores quanto pior foi o grau de lesão do paciente.(AU)

This retrospective study aimed to demonstrate the physiotherapeutic modalities used in the treatment of dogs with thoracolumbar intervertebral disc disease (IVDD) after surgical spinal cord decompression and to report elements that determined the modalities changes. Thirty dogs with deep pain perception were selected in the first physiotherapy session, presenting a range of clinical signs from ambulatory paraparesis to paraplegia. The modalities used in the protocols of all patients were cryotherapy, massage, passive stretching, passive range of motion, flexor reflex stimulation and neuromuscular electrical stimulation. The inclusion or exclusion of the therapeutic exercises how body sling (walking sling), circular proprioceptive platform, swimming, underwater treadmill, cavaletti rails and foam mattress walking were according to the clinical evolution and acceptance of each patient. Eighty percent (80%) of the dogs manifested improvement in their neurological dysfunction degree before starting physical therapy and 93% were able to walk again (ambulatory paraparesis) at the end of physiotherapy. The number of sessions and recovery times were higher in patients with higher neurological dysfunction degrees.(AU)

Extrusão de disco intervertebral caudal (coccígea) em um Basset Hound: primeiro relato de caso / First report of caudal intervertebral disk extrusion in a Basset Hound

Relata-se o primeiro caso no Brasil de doença do disco intervertebral (Hansen tipo I) entre as vértebras caudais (coccígeas) em uma cadela Basset Hound com seis anos de idade, castrada, pesando 16kg e com histórico de dor durante defecação e manipulação da região pélvica associada à inabilidade de mover, elevar ou abanar a cauda. Na radiografia simples, observou-se opacidade do forame intervertebral entre a quarta e a quinta vértebra caudal. O animal foi submetido à laminectomia dorsal modificada, seguida de fenestração do disco intervertebral afetado. Decorridos 15 dias da cirurgia, a paciente não demonstrava sinais de dor ao defecar e realizava movimentos de abano de cauda, mas ainda com desconforto na palpação e sem elevação da cauda acima da coluna vertebral, o que foi resolvido após 30 dias do procedimento cirúrgico. A relevância do caso está na inclusão, mesmo que rara, da doença do disco intervertebral caudal no diagnóstico diferencial em cães com dor durante a defecação e manipulação da cauda, sendo o exame radiográfico uma ferramenta auxiliar importante para o diagnóstico definitivo e o plano terapêutico.(AU)

We report here the first case in Brazil of an intervertebral disc disease (Hansen type I) between the caudal vertebrae (coccygeal) in a six-year-old Basset Hound dog, castrated, weighing 16 kg and history of pain during defecation and manipulation of the pelvic region, associated with the inability to move, raise and shake its tail. In the radiography survey, an opacity of the intervertebral foramen between the fourth and fifth caudal vertebra was observed. The animal underwent a modified dorsal laminectomy followed by fenestration of the affected intervertebral disc. After 15 days following surgery, the patient showed no signs of pain when defecating and was able to perform the tail wag movements, but with discomfort on palpation and could not rise the tail high up the spine, which was resolved after 30 days of surgery. The relevance of this report is the inclusion, even if rare, of the caudal intervertebral disc disease in the differential diagnosis in dogs with pain during defecation and handling of the tail, and the radiographic survey is an important auxiliary tool for definitive diagnosis and treatment plan for this disease.(AU)

Sonda uretral flexível como método alternativo para aferição invasiva da pressão intracraniana em trauma cranioencefálico induzido em coelhos / Flexible urethral catheter as alternative method to invasive measurement of intracranial pressure in induced head trauma in rabbits

O objetivo deste estudo foi utilizar a sonda uretral flexível como método alternativo para aferição da pressão intracraniana em coelhos com trauma cranioencefálico induzido pelo cateter de Fogarty 4 Fr (balão epidural) e comparar os dados obtidos com o método convencional de cateter de ventriculostomia. Foram utilizados 12 coelhos, machos, adultos, distribuídos aleatoriamente em dois grupos, denominados de G1: mensuração da PIC com cateter de ventriculostomia (n=6) e G2: mensuração com sonda uretral (n=6). Foram realizadas duas craniotomias na região parietal direita e esquerda para a implantação do cateter de ventriculostomia ou sonda uretral flexível e o balão epidural, respectivamente. A PAM, a PPC, a FC, a FR e a TR foram mensurados antes e após a craniotomia. A PIC foi avaliada após a craniotomia e a cada 10 minutos depois do preenchimento do balonete com 0,3mL de NaCl 0,9%, durante 40 minutos, e com 0,6mL, pelo mesmo período de tempo, totalizando 80 minutos. A PIC aumentou em ambos os grupos, sendo menores os valores registrados com a sonda uretral flexível. Foi possível reproduzir o aumento da PIC com o modelo experimental de TCE utilizando o cateter de Fogarty 4 Fr na região epidural e, embora haja a necessidade de outros estudos, a sonda uretral flexível demonstra ser um método alternativo de mensuração da PIC em coelhos com trauma cranioencefálico.(AU)

The aim of this study was to evaluate the use of flexible urethral catheter as an alternative method for measuring intracranial pressure in rabbits with head trauma induced by 4 F Fogarty catheter (epidural balloon) and compare the data obtained with the conventional method of ventriculostomy catheter. In this study, New Zealand rabbits were randomly distributed into two groups, G1: measuring the ICP with ventriculostomy catheter (n=6) and G2: measuring the ICP with urethral catheter (n=6). Two craniotomies were performed in the right and left parietal region for the implantation of a ventriculostomy catheter and/or flexible urethral catheter and epidural 4 Fr Fogarty arterial embolectomy catheter, respectively. MAP, CPP, HR, RF and RT values were measured before and after of the craniotomy. The ICP value was measured after craniotomy, every five minutes during 40 minutes after the balloon was inflated with 0.3 ml with NaCl and further 40 minutes after the balloon was inflated with 0.6 ml. The ICP value increased in both groups; however, the ICP values were lower in the flexible urethral catheter. The flexible urethral catheter can be used as an alternative method to measure ICP values in rabbits with head injury.(AU)

Heating produced by therapeutic ultrasound in the presence of a metal plate in the femur of canine cadavers / Aquecimento gerado pelo ultrassom terapêutico em presença de placa óssea metálica no fêmur de cadáveres caninos

The present study aimed to assess the heat generated by a therapeutic ultrasound (TUS) in a metal bone plate and adjacent structures after fixation to the femur of canine cadavers. Ten pairs of hind limbs were used, and they were equally distributed between groups that were subjected to 1- and 3-MHz frequencies, with each frequency testing 1- and 2-W/cm² intensities. The right hind limb was defined as the control group (absence of the metal plate), and the left hind limb was the test group (presence of the metal plate). Therefore, the control groups (CG) were denominated CGI, using TUS with 1-MHz frequency and 1-W/cm² intensity; CGII, using 1-MHz frequency and 2-W/cm² intensity; CGIII, using 3-MHz frequency and 1-W/cm² intensity; and CGIV, using 3-MHz frequency and 2-W/cm² intensity. For each control group, its respective test group (TG) was denominated TGI, TGII, TGIII and TGIV. The TUS was applied to the lateral aspect of the thigh using the continuous mode and a 3.5-cm² transducer in a 6.25-cm² area for 2 minutes. Sensors were coupled to digital thermometers that measured the temperature in different sites before (t0) and after (t1) of the TUS application. The temperatures in t1 were higher in all tested groups. The intramuscular temperature was significantly higher (P<0.05) in the groups used to test the 3-MHz frequency in the presence of the metal plate. The therapeutic ultrasound in the continuous mode using frequencies of 1 and 3 MHz and intensities of 1 and 2 W/cm2 for 2 minutes caused heating of the metal plate and adjacent structures after fixation to the femur of canine cadavers...

O objetivo deste estudo foi avaliar o aquecimento gerado pelo ultrassom terapêutico (UST) na placa óssea metálica e estruturas adjacentes após a fixação no fêmur de cadáveres caninos. Foram utilizados dez pares de membros pélvicos, distribuídos igualmente entre os grupos que utilizaram as frequências de 1 e 3 MHz. Cada frequência testou as intensidades de 1 e 2 W/cm², sendo que o membro pélvico direito foi definido grupo controle (ausência da placa óssea metálica) e o membro pélvico esquerdo o grupo teste (presença da placa óssea metálica). Portanto, os grupos controles foram denominados GCI, com UST na frequência de 1 MHz e intensidade de 1 W/cm²; GCII, com 1 MHz e 2 W/cm²; GCIII, com frequência de 3 MHz e intensidade de 1 W/cm²; e GCIV, com 3 MHz e 2 W/cm². Para cada grupo controle, seu respectivo grupo teste foi denominado GTI, GTII, GTIII e GTIV. O UST foi aplicado na face lateral da coxa, utilizando o modo contínuo, transdutor de 3,5cm², em uma área de 6,25cm², durante dois minutos. Foram utilizados sensores acoplados a termômetros digitais que mediram a temperatura em diferentes locais antes (t0) e após (t1) a aplicação do UST. Pode-se verificar que as temperaturas em t1 foram maiores em todos os grupos testados. Os grupos que testaram a frequência de 3 MHz demonstraram que a temperatura intramuscular foi significativamente maior (P<0,05) na presença da placa óssea metálica. O ultrassom terapêutico no modo contínuo de 1 e 3 MHz e intensidades de 1 e 2 W/cm2 durante dois minutos promove o aquecimento da placa óssea metálica e estruturas adjacentes após a fixação no fêmur de cadáveres caninos...

Metabolic and hormonal consequences of two different meals after a moderate intensity exercise bout in obese prepubertal children.

BACKGROUND/OBJECTIVES: To investigate the relationship between postprandial nutrient balance, satiety and hormone changes induced by two different meals taken after a moderate intensity exercise bout. SUBJECTS/METHODS: Ten prepubertal obese children participated in the study. The experiment was designed as a cross-over study for repeated measures. Each test period lasted five consecutive hours during which the children were under medical supervision. The effects of two isocaloric meals were compared after a moderate intensity exercise (4 multiples of resting metabolic rate, 30 min, cycling): a low-fat/high-carbohydrate meal (meal A) and a high-fat/low-carbohydrate meal (meal B). Pre and postprandial (3 h) substrate oxidation, biochemical parameters, gastrointestinal hormone concentrations and appetite were measured. RESULTS: The main results were: (i) higher fat balance (5.1±5.0 vs -5.0±6.6 g, P=0.001) and lower carbohydrate balance after meal B than A (-9.7±13.3 vs 11.3±18.3 g, P<0.01); (ii) higher energy balance after meal B than after meal A (5.9±21.5 vs -13.9±20.2 kcal, P<0.05); (iii) higher plasma triglyceride concentrations (area under the curve) after meal B than after meal A (2962.5±2095.8 mg*180 min/dl vs -169.5±1633.7 mg*180 min/dl, P<0.01); (iv) higher serum glucagon-like peptide-1 concentrations after meal B than after meal A (1101.5±873.0 pmol*180 min/l vs 478.8±638.3 pmol*180 min/l, P<0.05). CONCLUSIONS: After a bout of moderate intensity exercise, a meal with a high-fat/low-carbohydrate ratio had a less favorable metabolic impact than an isoenergetic, isoproteic low-fat/high-carbohydrate meal.

Citizen, interrupted: the 2011 English riots from a psychosocial perspective.

Aims. This is a contribution to the debate over the 2011 English riots from a psychosocial perspective. Methods. We compare the impulsive and 'mindless' behaviour of rioters with the impulsive, violent and contradictory behaviour of people affected by severe personality disorders. Results. We propose that the lack of a sense of social identity and of mentalization skills is a common feature of the two conditions - the lack of social identity, leading to frustration and anger, coupled with a lack of mentalization, leading to the impulsive and violent expression. Furthermore, we highlight the confusing impact that the social marginalization and consumerism can have on young generations from lower classes in cities from the Western world. Conclusions. By building a parallel with the therapeutic intervention offered to severe personality disorders, we speculate on how the community, by modifying its communication's style and actively intervene in deprived socio-economic contexts, could inspire more confidence, trust and sense of belonging in its marginalized members.

Temperatura de polimerização da resina acrílica odontológica na medula espinhal de ratos Wistar / Polymerization temperature of dental acrylic resin in the spinal cord of rats

Objetivou-se investigar se a temperatura de polimerização da resina acrílica odontológica ocasiona sinais neurológicos e alteração histológica na medula espinhal de ratos. Foram utilizados 48 ratos, Wistar, distribuídos em dois grupos denominados GI ou cimento ósseo (controle positivo) e GII ou resina acrílica odontológica. Cada grupo foi redistribuído em seis subgrupos, de acordo com a quantidade do composto, o tempo de pós-operatório e o local de aferição da temperatura. O cimento ósseo ou a resina acrílica odontológica foram moldados e colocados sobre as lâminas ósseas dorsais e os processos espinhosos das vértebras L1 e L2. A temperatura de polimerização do composto foi aferida a cada 10 segundos. A temperatura máxima de polimerização e a diferença entre a temperatura externa e a interna ao canal vertebral foram maiores nos subgrupos que receberam 10 gramas. Não foi observada alteração neurológica em nenhum dos animais deste estudo. Na análise histológica, foi observada reação inflamatória de intensidade variável na meninge e no parênquima medular. Pode-se concluir que a temperatura de polimerização da resina acrílica odontológica nas quantidades de um e 10 gramas provoca alterações histológicas na meninge e no parênquima medular, sem ocasionar sinais neurológicos em ratos.

The purpose of this study was to evaluate if the polymerization temperature of the dental acrylic leads to neurological signs and histological changes in the rat spinal cord. Forty eight rats were distributed in two groups: GI or bone cement (positive control) and GII or dental acrylic resin. Each group was redistributed in six subgroups according to compound quantity, postoperative period and location of temperature measurement. The bone cement or dental acrylic resin were molded and positioned on the bony lamina and the dorsal spinous processes of vertebrae L1 and L2. The polimerization temperature was measured every 10 seconds. The polymerization maximum temperature and the temperature difference between internal and external spinal canals were superior in subgroups that received 10 grams. There were no neurological deficits in any animal of this study. The histological analysis showed intensity variation of inflammatory reaction in the meninges and spinal cord parenchyma. The results demonstrate that the polymerization temperature of dental acrylic resin in quantity of 1 or 10 grams causes histological changes in the spinal cord parenchyma and meninges, without neurological deficits in rats.

Avaliação da amplitude articular do joelho: correlação entre as medidas realizadas com o goniômetro universal e no dinamômetro isocinético / Knee joint range-of-motion evaluation: correlation between measurements achieved using a universal goniometer and an isokinetic dynamometer

CONTEXTUALIZAÇÃO: O instrumento mais utilizado pelos terapeutas para mensuração da amplitude de movimento (ADM) articular é o goniômetro universal. No entanto, há carência de estudos que analisem a confiabilidade das medidas da ADM do joelho realizadas no dinamômetro isocinético. OBJETIVO: O objetivo deste estudo foi analisar a correlação entre as medidas de ADM na articulação do joelho, realizadas com o goniômetro universal e no dinamômetro isocinético. MÉTODO: Foram avaliados 38 voluntários saudáveis (27 mulheres, 11 homens), com idade de 36 ± 11 anos, com limitação mínima de 20° na ADM de extensão do joelho. No membro dominante de cada sujeito foram realizadas três mensurações da ADM do joelho com o goniômetro e três mensurações no dinamômetro. RESULTADOS: Os resultados deste estudo mostraram que há alto grau de correlação entre as medidas da ADM do joelho obtidas com o goniômetro universal e no dinamômetro isocinético (Coeficiente de Correlação de Pearson = 0,90). CONCLUSÃO: Com os procedimentos realizados, tanto o goniômetro universal como o dinamômetro isocinético podem ser utilizados para avaliação da ADM do joelho, pois ambos apresentam mensurações confiáveis.

The cost of an action potential.

Neuronal modules, or 'cell-assemblies', comprising millions of mutually interconnected cells have been postulated to form the basis of many functions of the brain, such as mood, sleep, hunger, vigilance, and more. Depending on the extent of the module, neurocommunication in cell-assemblies might exceed metabolic resources. A medium-size (10000 neurons) module would require at least 10 J per l of brain, based on a calculated cost of an isolated action potential (AP) of 10(11)-10(12) molecules of ATP per cm(2) of cell membrane, with an absolute minimum of 10(6) ATP at a node of Ranvier. The figure matches the cost of depolarizing the unmyelinated axon of the large monopolar cell in the blowfly retina. A circuit model of the cell membrane, based on abrupt changes of Na(+) and K(+) conductances, is used to emulate the AP and to assess the resulting ionic unbalance. The cost of an AP is equated to the metabolic energy necessary to fuel ATP-based pumps that restore intracellular K(+). The high metabolic demand of a cell-assembly suggests that less expensive means of neurocommunication may be involved, such as non-synaptic diffusion neurotransmission (NDN), which would comply with a proposed law of conservation of space and energy in the brain.

Antibiotic prophylaxis in orthognathic surgery: a 1-day versus 5-day regimen.

PURPOSE: The effect on infection rates of 1-day and 5-day administration of prophylactic antibiotics in orthognathic surgical procedures was compared. PATIENTS AND METHODS: A prospective, randomized, double-blind clinical trial using placebo was conducted. Thirty patients were distributed equally between two groups. Each group received penicillin G, two million units intravenously, immediately preoperatively, and one million units intravenously every 3 hours intraoperatively and once postoperatively 3 hours after the last intraoperative dose. Group 1 then received penicillin G, one million units intravenously, every 6 hours for eight doses, followed by penicillin V suspension 300 mg orally every 6 hours for eight doses. Group 2 received placebo in a similar dosing schedule. The wounds were inspected on a regular schedule and evaluated for infection according to criteria established by the Centers for Disease Control. RESULTS: One of 15 patients in group 1 (6.7%) and 9 of 15 patients (60%) in group 2 became infected. The overall infection rate was 33.3%. There was a statistically significant difference in rates of infection between the two groups (P < .01). CONCLUSION: Antibiotic prophylaxis for orthognathic surgical procedures should continue beyond the immediate postoperative period. Five days of antibiotic administration appears to provide adequate coverage.

Multidimensional electrocutaneous stimulation.

Probing the subjective response to a five-parameter electrocutaneous stimulus has revealed a noisy perceptual space. A method for reducing the noise is hypothesized and experimentally tested by comparing the intensity discrimination thresholds along and off the energy gradient. Preliminary results show a reduction of the threshold of up to 60% when stimulating along the gradient. The method is exploited to implement an optimal intensity control in an electrotactile vision-substitution device.

[Prevalence of simple sporadic goiter in relation to other non-neoplastic thyroid pathologies in an internal medicine department]. / Prevalenza del gozzo semplice sporadico in rapporto ad altre patologie tiroidee non neoplastiche in una divisione di medicina interna.

BACKGROUND AND AIM: Thyroid pathologies, in particular goiter, are commonly found in everyday clinical practice in hospitalised patients. METHODS: The authors carried out a prospective type survey lasting 80 months in a mountain community with about 30,000 inhabitants with uniform socio-demographical characteristics. A total of 8,034 subjects (4,131 males and 3,903 females) were included in the study who were hospitalised in an Internal Medicine Department. All patients underwent screening using standard diagnostic criteria. RESULTS: Thyroid pathology was identified and classified into its various forms. There was a net prevalence of goiter which, owing to the unique features identified by the study, was defined as the sporadic form. The study demonstrated a marked prevalence in females, the familial pattern, the homogeneity of distribution throughout the area, the progression of disease with age and its evolution into immersed forms, the prevalence in both sexes in adults, the frequent use of surgery and its inherent problems, the inadequacy of treatment. CONCLUSIONS: The authors affirm that this pathology is regularly underestimated because it is not adequately identified, treated and monitored. They suggest a clinical and methodological approach based on a correct nosological definition, adequate diagnostic and prognostic stratification, an appropriate therapeutic protocol and clinical controls performed over time.

An alternative to continuous subcutaneous infusion of desferrioxamine in thalassaemic patients.

Sixteen patients with thalassaemia major were treated with subcutaneous desferrioxamine (DF) 50 mg/kg/d, 5 consecutive days a week, for 8 weeks. Every other week the total dose was administered by 12 h infusion pump or by rapid injection of the same dose (25 x 2 mg/kg) twice a day. The two methods of DF administration produced no significant differences in urinary iron excretion. No significant changes in serum ferritin levels were observed at the end of the study. Compared with continuous infusion, rapid injection is equally efficacious, does not induce serious side-effects, is better accepted by the patients, and can improve their compliance to the iron-chelating therapy.

Brain cell microenvironment effects on neuron excitability and basal metabolism.

In a model of neurons in a brain cell assembly, changes in volume of the extracellular space affect neuronal excitability and basal metabolism. A widely applicable coefficient of excitability with respect to a variation of the volume fraction has been determined. Calculations suggest that chloride increases membrane stability by indirectly promoting an acceleration of the metabolic pumping rate as a response to a diminished extracellular volume fraction. Volume fraction changes induced by cell swelling in a compact and highly tortuous microenvironment may play a role in epilepsy and, following brain damage, in cell death and recovery.

Nerve length and volume in synaptic vs diffusion neurotransmission: a model.

Non-synaptic diffusion neurotransmission (NDN) may be an important factor in brain space and energy conservation, especially within cell assemblies and for mass sustained functions. We have illustrated the extreme cases of total synaptic and total ND neurotransmission for the purpose of noting the differences between the two. For these modeling studies, in which we assume assemblies of 1000 to 100 000 cells supplied by at least one fiber and a single synapse from each of the other cells, each cell assembly would have approximately 200 m to 8000 km of nerve fibers more than when innervated by diffusion. For coeruleo-cortical synaptic innervation, linking each to a common origin (the locus coeruelus), the fiber lengths are 38 cm (1000 cells) to 170 m (100,000 cells). It is likely , however, that neuronal arrays include both 'wireless' (NDN) as well as synaptic intercellular communication systems.