Long term follow-up of shunted idiopathic normal pressure hydrocephalus patients: a single center experience.

Idiopathic normal pressure hydrocephalus (iNPH) is a condition characterized by gait disturbance, dementia and/or urinary incontinence and enlarged ventricular system due to disturbance of cerebrospinal fluid (CSF). This study aims to describe the long-term experience with patients with iNPH submitted to ventriculoperitoneal shunt (VPS) with the programmable valve STRATA® (Medtronic). We prospectively selected a cohort of patients with a diagnosis of iNPH from January 2010 to April 2013 in a Brazilian tertiary hospital. All patients underwent clinical evaluation, which consists of the Mini-Mental State Examination and Time Up and Go tests and the application of Japanese Scale for Idiopathic Normal Pressure Hydrocephalus in three stages: prior to the TT, 3 h after the TT and 72 h after the TT. Fifty patients were submitted to VPS and followed. There were 32 men and 18 women. Mean age was 77.1 with standard deviation of 10.9. Follow-up time ranged from 96 to 120 months, with mean of 106 months. After 1 year of follow-up, 42 (83%) patients presented with clinical improvement, decreasing to 62% of patients at mid-term follow-up and 38% of patients at late follow-up. Complications occurred in 18% of subjects, needing reoperation in 16%. Our results show relevant clinical impact of shunting in iNPH patients, decreasing over time. Complications should not be underestimated, reaching up to 18% and demanding reoperation in 16% of cases. Thus, although much has been improved with current shunt technology, it is still important to consider the drawbacks of treatment.

Psychiatric symptoms are frequent in idiopathic intracranial hypertension patients.

Idiopathic intracranial hypertension (IIH) is a rare disease with an incidence rate of 0.5-2.0/100,000/year. Characteristic symptoms are headache and several degrees of visual impairment. Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In this study, we evaluated IIH subjects to determine the association with psychiatric symptoms. We evaluated thirty consecutive patients with IIH submitted to neurosurgery from January 2017 to January 2020 in two Brazilian tertiary hospitals. They underwent clinical evaluation, obtaining medical history, comorbidities, body mass index (BMI-kg/m2), and applying Neuropsychiatric Inventory Questionnaire (NPI-Q). There were 28 females and 2 males. Ages ranged from 18 to 66 years old, with mean age of 37.97 ± 12.78. Twenty-five (83%) presented comorbidities, being obese and having arterial hypertension the most frequent. Body mass index ranged from 25 to 35 kg/m2 and mean value was 31 ± 3.42. After application of Neuropsychiatric Interview, 26 of 30 presented psychiatric symptoms (86%). Depression-anxiety syndromes were reported in 25 patients (83%). Nighttime disturbances were reported by 14 subjects (46%). Appetite and eating disorders were described by 23 (76%). Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In our sample, twenty-six out of 30 (86%) reported psychiatric symptoms. We highlight the high prevalence of psychiatric symptoms among IIH patients and the need of managing these patients with a multidisciplinary team, including psychiatrists.

BIO-NAIL: a bacterial cellulose dressing as a new alternative to preserve the nail bed after avulsion.

Avulsion of the nail plate is the most accomplished surgical procedure among the nail apparatus surgeries. Since it is not possible to use the removed nail to cover the nail bed, some materials have been suggested, however, they are generally not available for use and often at a high cost. To evaluate the use of Bacterial Cellulose (BC) dressing as a biological nail (Bio-Nail) after partial or total avulsion of the nail plate. Twenty-six candidates for nail avulsion, were randomized into two groups: Control, using Vaseline with gauze (11 patients) and Experimental group, BC group, using the Bio-Nail (15 patients). The patients were followed up during the 180-day period. The distribution of the patients in the groups was homogeneous for both sociodemographic and clinical data. The occurrence of infection (1 case in the control group) was not statistically relevant. The BC group had lower pain intensity (p = 0.011) with earlier temporal resolution when compared to the control group (p = 0.003). The BC group presented earlier reepithelization (p = 0.022) and better quantitative (p = 0.021) and qualitative conditions (p = 0.011) for the exudate. Regarding satisfaction, all the patients were satisfied. Good preservation of the nail plate area was observed in the BC group at the end of the 180-day period (p = 0.024). Average time of BC dressing permanence was 16.4 ± 7.1 days. BC showed to be appropriate as a dressing after partial or total avulsion of the nail plate. BC is a Bio-Nail promising for nail bed healing.

Local and systemic inflammatory lipid profiling in a rat model of osteoarthritis with metabolic dysregulation.

OBJECTIVE: Bioactive oxidised lipids (oxylipins) are important signalling mediators, capable of modulating the inflammatory state of the joint and anticipated to be of importance in joint homeostasis and status of osteoarthritis. The aim of this study was to quantify oxylipin levels in plasma and synovial fluid from rats with experimentally induced osteoarthritis to investigate the potential role of oxylipins as a marker in the disease process of early osteoarthritis. DESIGN: Forty rats were randomly allocated to a standard or high-fat diet group. After 12 weeks, local cartilage damage was induced in one knee joint in 14 rats of each diet group. The remaining 6 rats per group served as controls. At week 24, samples were collected. Oxylipin levels were quantified by liquid chromatography-mass spectrometry. RESULTS: Overall, 31 lipid-derived inflammatory mediators were detected in fasted plasma and synovial fluid. Principal component analysis identified four distinct clusters associated with histopathological changes. Diet induced differences were evident for 13 individual plasma oxylipins, as well as 5,6-EET in synovial fluid. Surgical-model induced differences were evident for three oxylipins in synovial fluid (15-HETE, 8,9-DHET and 17R-ResolvinD1) with a different response in lipid concentrations for synovial fluid and plasma. CONCLUSIONS: We demonstrate the quantification of oxidised lipids in rat plasma and synovial fluid in a model of early experimental osteoarthritis. Oxylipins in the synovial fluid that were altered as consequence of the surgically induced osteoarthritis were not represented in the plasma. Our findings suggest differential roles of the oxylipins in the local versus peripheral compartment.

Chemical profiling of two congeneric sea mat corals along the Brazilian coast: adaptive and functional patterns.

Metabolomic profiles were explored to understand environmental and taxonomic influences on the metabolism of two congeneric zoanthids, Palythoa caribaeorum and P. variabilis, collected across distinct geographical ranges. Integrated mass spectrometry data suggested the major influence of geographical location on chemical divergence when compared to species differentiation.

A velocidade de infusão da solução poli-iônica intravenosa contendo 84mEq/L de lactato determina a intensidade do efeito alcalinizante em equinos / The intravenous polyionic solution with 84mEq/L of lactate infusion rate determines the intensity of the alkalizing effect in horses

O objetivo deste trabalho foi verificar os efeitos da solução poli-iônica intravenosa contendo 84mEq/L de lactato (L84) sobre os equilíbrios hidroeletrolítico e ácido-base de equinos, quando administrada de forma rápida ou lenta. Cinco equinos sadios adultos receberam a infusão contínua intravenosa da L84, em volume correspondente a 10% do peso corporal, em duas ocasiões: a) infusão rápida (16,66mL/kg/h) durante seis horas; b) infusão lenta (8,33mL/kg/h) durante 12 horas. Amostras de sangue venoso foram colhidas ao início da infusão (hora zero) e três, seis, nove, 12 e 24 horas após, e amostras de urina nas horas zero, seis, 12 e 24. Determinaram-se pH (sanguíneo e urinário), pCO2, HCO3 -, BE, PPT, lactato L, Na+, K+, Cl-, AG, SID, Atot, VVP, densidade urinária e excreções fracionadas urinárias de lactato L, Na+, K+ e Cl-. A L84 provoca efeito alcalinizante iatrogênico de menor magnitude quando administrada de forma lenta, porque os mecanismos renais, atuantes durante o período de infusão, promovem a correção gradativa do desequilíbrio. Pode-se concluir que a infusão de forma lenta da solução L84 em equinos é recomendável nos casos em que se suspeite de acidose metabólica e não seja possível quantificar o grau do desequilíbrio.(AU)

The aim of this study was to investigate the effects of an intravenous polyionic solution containing 84mEq/L of lactate (L84) on the hydroelectrolyte and acid-base balances when administered quickly or slowly in horses. Five healthy adult horses received the L84 solution, in a volume corresponding to 10% of BW, by continuous intravenous infusion, in two instants: a) rapid infusion (16.66mL/kg/h) during 6 hours; b) slow infusion (8.33mL/kg/h) during 12 hours. Venous blood samples were taken at the beginning of the infusion (hour 0) and 3, 6, 9, 12, and 24 hours after. Urine samples were taken at 0, 6, 12, and 24h. pH (blood and urine), pCO2, HCO3-, BE, TPP, L-lactate, Na+, K+, Cl-, AG, SID, Atot, PVV, urine specific gravity, and L-lactate, Na+, K+, and Cl- renal fractional clearance were determined. The L84 solution causes lower magnitude alkalizing effect when administered slowly, due to the gradual correction of the iatrogenic imbalance by the kidneys during the infusion period. The L84 solution infused at a low rate in horses could be recommended in cases where metabolic acidosis is suspected and it is not possible to quantify the imbalance degree.(AU)

Impacto de diferentes soluções eletrolíticas orais sobre a glicemia e os equilíbrios hídrico, eletrolítico e ácido-base de bezerros neonatos sadios / Effects of different oral electrolyte solutions on the glycemia and water, electrolyte, and acid-base balances of healthy neonatal calves

Este trabalho objetivou estudar os efeitos de quatro soluções eletrolíticas orais (SEO) comerciais, de uma SEO não comercial (SEO UEL) e da solução de ringer com lactato (SRL), sobre a glicemia e os equilíbrios hídrico, eletrolítico e ácido-base de bezerros neonatos sadios. Utilizaram-se seis bezerros, os quais receberam todas as seis SEO, uma por vez, e cada tratamento foi realizado no período de um dia. Amostras de sangue venoso foram coletadas, em diferentes momentos do dia de tratamento, para a determinação da proteína plasmática total, glicemia e hemogasometria. Valores de SID3 e variação do volume plasmático foram calculados. A análise de variância de medidas repetidas foi empregada para comparação entre os momentos e as soluções. As SEO não provocaram alterações de magnitude alta ou prolongadas nos equilíbrios hídrico, eletrolítico e ácido-base dos bezerros. Pode-se concluir que todas as SEO, à exceção da SEO A, originaram expansão da volemia. As SEO B e C originaram efeito alcalinizante, enquanto a D afetou a glicemia, e a SRL aumentou a cloremia. A SEO UEL não produziu nenhum efeito marcante além da expansão do volume plasmático.(AU)

This work aimed to study the effects of four commercially available oral electrolyte solutions (OES), of a non-commercial OES (OES UEL), and of the lactated Ringer's solution (LRS) administered orally, on the glycemia and water, electrolyte, and acid base balance of healthy neonatal calves. Six calves were used, all of them received the six OES, one at a time, and each treatment was performed within one day. Venous blood samples were taken, in different moments in the treatment day, for determination of total plasma protein, glycemia and blood gas analysis. Values of SID3 and plasma volume variation were calculated. Repeated measures ANOVA was used for comparison between moments and solutions. The OES studied did not induced changes of high or prolonged magnitude in the water, electrolyte, and acid base balances of the calvesIn conclusion, all OES, with the exception to OES A, led to expansion of the plasma volume. The OES B and C had an alkalizing effect while D affected glycemia and LRS increased chloremia. The OES UEL did not produce any marked effect, besides the expansion of plasma volume.(AU)

Qualidade microbiologica da carne de frango irradiada em embalagem convencional e a vácuo / Microbiological evaluation of chicken breast meat irradiated in conventional and vacuum package

Foram avaliados os efeitos da radiação gama nas doses de 1,5 e 3,0kGy, em peitos de frango embalados em embalagem convencional e a vácuo. As amostras embaladas foram submetidas à irradiação e estocadas sob refrigeração (4ºC) por 30 dias. A radiação mostrou-se eficiente na redução de mesófilos aeróbios estritos e facultativos viáveis, coliformes totais e termotolerantes, com destaque para Salmonella spp. Os bolores e leveduras mostraram-se bastante resistentes à radiação. Os resultados sugerem que a dose de 3,0kGy pode ser utilizada no controle da microbiota do peito de frango armazenado sob refrigeração, sendo uma alternativa para o aumento da vida de prateleira por até 10 dias, ao garantir a segurança do consumidor pela eliminação de possíveis patógenos.

The effects of gamma radiation doses of 1.5 and 3.0kGy on chicken breasts packed under conventional or vacuum atmosphere were evaluated. The packed samples were subjected to irradiation and stored under refrigeration (4ºC) for 30 days. The radiation was efficient in reducing strict and facultative aerobic mesophiles, total and fecal coliforms, and mainly Salmonella spp. The molds and yeasts were very resistant to radiation. The results suggest that gamma radiation at 3.0kGy can be used to control the microbiota in chicken breast stored under refrigeration, as an alternative to extend the shelf-life for more than ten days and ensure the food safety by eliminating potential pathogens.

Simulation of endoscopic third ventriculostomy in fresh cadaveric specimens.

OBJECTIVE: The purpose of this research is to describe and analyze the endoscopic anatomy of cerebral ventricles, especially of the lateral ventricle and third ventricle. METHODS: 47 brains of adult human cadavers were studied at the Death Check Unit (DCU) of São Paulo. Age, sex, day and approximate time of death, day and time of study, cause of death, outcome of puncture and number of attempts were recorded. A rigid neuroendoscope was utilized. The approach to the ventricular system was via the pre-coronal point on the right side. RESULTS: The number of individuals studied was 47, of which 22 (47%) were women and 25 (53%) were men. Age ranged from 20 to 95 years. The minimum time lag between the death and the study was 8 h and the maximum time was 29 h. Of the cadavers studied, three presented alterations in the central nervous system as the cause of death. Successful puncture was obtained in 42 (89%) being 72% in the first attempt. In the analysis performed by Fisher's exact test with a 5% level of significance, an association between the number of attempts (2) and the cause of cerebral death was found (p=0.018). CONCLUSIONS: The visualization of neural structures without bleeding, the possibility of training techniques such as third ventriculostomy, the development of new techniques and to help sctructure new concepts about anatomic landmarks have by far overcome the difficulties.

Influence of organic matter on the uptake of cadmium, zinc, copper and iron by sorghum plants.

This article describes an experiment, carried out under controlled environment conditions, to investigate the effects of a fulvic acid fraction of soil organic matter on growth, cadmium (Cd) uptake and redistribution by sorghum. In addition the uptake of copper (Cu), zinc (Zn) and iron (Fe) was also determined. Sorghum was grown in nutrient solutions with 0, 0.1, 1 and 10 mg Cd dm(-3), in the absence and presence of organic matter (32 mg C dm(-3)), for various periods up to 20 days. A decrease in sorghum biomass due to Cd toxicity was observed at 10 mg Cd dm(-3), but for concentrations of 0.1 and 1 mg Cd dm(-3) the biomass was increased compared with control, without visual toxicity symptoms. The presence of organic matter (OM) further increased biomass production. Cadmium was mainly retained in sorghum roots, as usually found in tolerant plants, but Cd accumulation in sorghum was greater than in other Gramineae, or even more tolerant plants such as lettuce. The presence of OM decreased the bioavailability of Cd that was partially retained in solution by the OM ligands. However, OM promoted the translocation of Cd to shoots, an effect that may pose a risk to public health because plant-animal transfer of Cd could be enhanced. The presence of OM decreased the uptake of Cu, Zn and Fe. The presence (vs. absence) of 0.1 mg Cd dm(-3) enhanced the uptake of Fe, both in the absence and presence of OM.

Cycloartane triterpenes from Euphorbia tuckeyana.

Investigation of the acetone extract of the whole plant of Euphorbia tuckeyana afforded a new cycloartane-type triterpene named as cyclotucanol. Its structure was established as cycloartane-24-methylene-3beta,25-diol (1). The known cycloartane triterpenes cycloeucalenol (2), 3beta-hydroxycycloart-25-en-24-one (3), cycloart-25-ene-3beta,24-diol (4), 25,26,27-trisnor-3beta-hydroxycycloartan-24-al (5) and cycloart-23-ene-3beta,25-diol (6) were also isolated and identified.

[Main variations of the extrahepatic biliary system and their application to the so-called "split-liver" transplantation technique]. / Principais variações do sistema biliar extra-hepático e sua aplicação na técnica de transplante de fígado chamada "split-liver".

Sixty fresh adult livers were obtained from cadavers together with celiac trunk, head of the pancreas and superior mesenteric artery. We have found a single right hepatic duct in 13(21.6%) of the cases and a multiple right hepatic duct in 47(78.3%). A single left hepatic duct was found in 3(5%) of the cases and a multiple left hepatic duct in 57(95%). A median hepatic duct was found in 18(30%) of the cases, out of this 2(3.3%) was multiple median hepatic duct.

[Effect of electromagnetic fields on osteogenesis: an experimental study on rats]. / Efeito do campo magnético na osteogênese: estudo experimental em ratos.

The authors studied experimentally the electromagnetic pulsing field effects in an experimental model in rats, for evaluation of the velocity of consolidation of tibial and fibular fractures. The animals were followed for a period of three weeks under continuous stimulation and there were done radiological evaluation weekly and histological study at the end of the study. There were no histological, clinical or radiological differences between the group of rats submitted to electromagnetic pulsing fields and the control group.