Dermátomos humanos C5 e C6: estudo clínico, eletromiográfico, de imagem e cirúrgico

There is substantial controversy in literature about human dermatomes. In this work, C5 and C6 superior limb dermatomes were studied. The method consisted of comparing clinical signs and symptoms with conduction studies, electromyographical data, neurosurgical findings, and imaging findings obtained by computerized tomography (CT) or magnetic resonance imaging (MRI), for each patient. Data analysis from superior members in 18 patients suggests that C5 is located in the lateral aspect of the shoulder and arm, and C6 in the lateral aspect of the forearm and 1st, 2nd, and 3rd fingers. To our knowledge this is the first time that C5 and C6 human dermatomes have been studied by all the following methods together: clinical, electromyographical, CT and MR imaging, and surgical findings.Há controvérsias na literatura sobre os dermátomos humanos. Neste estudo os dermátomos do membro superior C5 e C6 foram analisados. O método consistiu em comparar os sinais e sintomas com achados eletromiográficos, de imagem e achados cirúrgicos. Análise dos dados do membro superior de 18 pacientes sugere que o dermátomo C5 esteja localizado na região lateral do ombro e braço, e o dermátomo C6 na região lateral do antebraço e 1º, 2º e 3º dedos da mão. Este é o primeiro estudo em que os dermátomos C5 e C6 foram avaliados pelos dados clínicos, eletromiográficos, de imagem e achados cirúrgicos.26226

Anesthesia in Patient with Lead Poisoning: Case Report

SummaryBackground and objectivesLead poisoning, also Saturnism, results from chronic lead poisoning, common after occupational exposure. Projectiles retained in the body may result in increased levels of plasma lead with numerous clinical implications, particularly neurological. We report a case of a symptomatic patient, undiagnosed, whose diagnosis was made during the preanesthesia evaluation.Case reportThe patient was attended at our hospital to remove a bullet lodged in his left knee 14 years ago, presenting with polyneuropathy without investigation. During the preanesthetic visit, saturnism was hypothesized and confirmed by high plasma lead levels (129μg.dL-1). Surgery was performed under general anesthesia before starting lead chelation. During anesthesia, the patient developed apnea, without chest-wall rigidity after administration of fentanyl (50μg).ConclusionLead poisoning interferes with the function of various organs and systems, alters oxidative metabolism and intracellular signaling mechanisms. Neurological involvement, with reduced neural conduction, deserves special attention from anesthesiologists

Evaluation of the effects of low intensity laser in proliferation of dental pulp stem cells/ Avaliação dos efeitos do laser de baixa intensidade na proliferação de células-tronco de polpa dentária

Objective: In this study, the effects of the low intensity laser were evaluated in the proliferation of human dental pulp stem cells (DPSCs). Design: These cells were irradiated every 12 hours for 72 hours or at 0 and 48 hours only, with a Red-InGaAlP laser (660nm, 30mW and 0.5 or 1J/cm2) for 16 or 33 seconds and their proliferation was assessed by the MTT assay. In addition, the Trypan Blue assay was used to analyze the viability of DPSCs in the best parameter recorded by MTT. Results: It was observed that the lowest dose of the laser (0.5J/cm2) in applications at 0 and 48 hours obtained the higher proliferation rates then all the other groups. Finally, through the Trypan Blue assay, we observed that the viability of the stem cells was not affected by the low intensity laser (0.5J/cm2). Conclusions: Our data corroborate with other data from the literature and therefore suggest that the low intensity laser can be used in order to improve cell proliferation. However, further studies should be carried out in order to evaluate if these parameters can be used in other cell lines

Trochlear Nerve Palsy Associated with Claude Bernard-Horner Syndrome after Brainstem Stroke

The association of unilateral trochlear nerve palsy with Claude Bernard-Horner syndrome represents a rare clinical condition. We present the case of a patient with this unusual presentation. The investigation performed implicated cerebrovascular disease as the underlying cause of the condition in this patient

TOXICIDADE DE AGENTES CLAREADORES SOBRE STREPTOCOCCUS MUTANS

Embora os agentes de clareamento dental venham sendo utilizados extensivamente, efeitos biológicos adversos sobre estruturas do organismo e bactérias têm sido reportados. Objetivo deste estudo foi avaliar a toxicidade in vitro de agentes clareadores [peróxido de carbamida 16% (PC) e peróxido de hidrogênio 35% (PH)] sobre Streptococcus mutans crescido em fase planctônica e biofilme em dois tempos de exposição continuada. Os resultados foram submetidos aos testes Kruskal-Wallis e U de Mann-Whitney (p<0,05). Os grupos PH, PC, e seus excipientes demonstraram efeito bactericida para as células em fase planctônicas, nos dois tempos. PC e PH apresentaram efeito bactericida em biofilme.. Os tratamentos com excipientes apresentaram redução tempo-dependente na viabilidade de células crescidas em biofilme para todos os períodos de tempo. Os agentes clareadores e seus excipientes apresentaram toxicidade para Streptococcus mutans crescido em fase planctônica e em biofilme, nos dois tempos investigados.  

AGROTÓXICOS: PRESENÇA DIÁRIA NOS ALIMENTOS CONSUMIDOS

Aspectos relevantes de agrotóxicos são destacados neste trabalho, tais como histórico, riscos, toxicidades, legislação, os benefícios e os prejuízos causados pelo uso de agrotóxicos. Atualmente, resíduos de agrotóxicos causam danos irreversíveis ao meio ambiente, ser humano e animais. Apesar de todos os benefícios registrados, há preocupação mundial com o uso indiscriminado dos “venenos agrícolas” e os resíduos deixados por eles. Há, ainda, um crescente questionamento acerca do estabelecimento de uma dose diária, supostamente, segura para ingestão de agrotóxicos

Endotoxinas em instrumentais cirúrgicos de artroplastia do quadril

OBJETIVO Investigar las endotoxinas en instrumentales quirúrgicos esterilizados empleados en artroplastias de la cadera. MÉTODO Estudio exploratorio, descriptivo, desarrollado en un hospital público de enseñanza. Fueron seleccionados seis tipos de instrumentales, a saber: raspa de acetábulo, raspa femoral, sacacorchos (para extraer la cabeza femoral), gubia quirúrgica, fresa femoral y cabeza femoral de prueba. La selección se hizo desde el análisis de la dificultad para la retirada de residuos de sangre y hueso durante la limpieza. La muestra estuvo constituida de 60 instrumentales quirúrgicos, que fueron puestos a prueba para endotoxinas en tres momentos diferentes. Se utilizó el método de gelificación (Gel-clot) Lisado de Amebocitos de Limulus (LAL) Endosafe(tm). RESULTADO Hubo formación de gel consistente con análisis positivo en ocho instrumentos, lo que corresponde a el 13,3%, siendo cuatro raspas femorales y cuatro fresas femorales. CONCLUSIÓN Fueron detectadas endotoxinas en cantidad ≥0,125 UE/mL en el 13,3% de los instrumentos probados.OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method) was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.OBJETIVO Investigar endotoxinas em instrumentais cirúrgicos esterilizados empregados em artroplastias do quadril. MÉTODO Estudo exploratório, descritivo, desenvolvido em um hospital público de ensino. Foram selecionados seis tipos de instrumentais, a saber: raspa acetabular, raspa femural, saca-cabeça de fêmur, formão box, fresa de fêmur e cabeça de prova de fêmur. A seleção foi feita a partir da análise da dificuldade para a remoção de resíduos de sangue e osso durante a limpeza. A amostra foi constituída por 60 instrumentais cirúrgicos, que foram testados para endotoxinas em três momentos distintos. Foi utilizado o método de gel-clot pelo Limulus Amebócito Lisado (LAL) Endosafe(tm). RESULTADO Houve formação de gel consistente com análise positiva em oito instrumentais, o que corresponde a 13,3%, sendo quatro raspas de fêmur e quatro fresas de fêmur. CONCLUSÃO Foram detectadas endotoxinas em quantidade ≥0,125 UE/mL em 13,3% dos instrumentais testados

Avaliação eletroneuromiográfica em gatos normais e submetidos ao hiperparatireoidismo secundário nutricional

The aim of this study was to evaluate the motor nerve conduction velocity, neuromuscular transmission, and electromyography at rest in healthy cats (group I) and in cats submitted to the nutritional secondary hyperparathyroidism (group II). Ten mongrel cats, six males and four females, aged between 4 and 5 months and average body weight of 1.67 kg were used to establish normal pattern (group I). Ten mongrel cats, five males and five females, initial age between 2 and 3 months, old and initial body weight of 820 grams were used in group II. After 10 days of adaptation period, the group II animals were fed with raw heart beef for 60 days to induce the nutritional secondary hyperparathyroidism. It was possible to conclude that the motor nerve conduction velocity, and electromyographic findings of insertional and spontaneous activities of cats with nutritional secondary hyperparathyroidism showed similar pattern to healthy cats at the same age. Using repetitive stimulation at 3Hz it was observed global tendency to decrement of the compound muscle action potentials, and using repetitive stimulation at 10Hz a tendency to decrement or increment occurred; though, the variations were at normal limit.O trabalho teve por objetivos estudar a condução nervosa motora e a transmissão neuromuscular e eletromiografia de repouso em gatos normais (grupo I), submetidos a hiperparatireoidismo secundário nutricional (grupo II). Para estudo normativo (grupo I), foram utilizados 10 gatos, aparentemente saudáveis, sem raça definida, sendo seis machos e quatro fêmeas, com idades entre 4 e 5 meses e peso médio de 1,67kg. No grupo II, empregaram-se 10 gatos, sem raça definida, sendo cinco machos e cinco fêmeas, com idade aproximada inicial entre 2 e 3 meses e peso inicial médio de 820 gramas. Após um período de adaptação de 10 dias, foram alimentados por 60 dias com coração bovino moído e cru, visando a indução de hiperparatireoidismo secundário nutricional. Foi possível concluir que latência, amplitude e velocidade de condução nervosa motora e os achados eletromiográficos das atividades insercional e espontânea de gatos com hiperparatireoisdismo secundário nutricional, apresentaram um padrão similar aos de gatos normais da mesma idade. Para estimulações repetitivas a 3Hz, observou-se tendência global a decremento dos potenciais de ação musculares compostos e a 10 Hz houve tendência de incremento ou decremento; entretanto, tais variações apresentaram-se dentro dos limites de normalidade

Cholinergic Signaling Exerts Protective Effects in Models of Sympathetic Hyperactivity-Induced Cardiac Dysfunction

Cholinergic control of the heart is exerted by two distinct branches; the autonomic component represented by the parasympathetic nervous system, and the recently described non-neuronal cardiomyocyte cholinergic machinery. Previous evidence has shown that reduced cholinergic function leads to deleterious effects on the myocardium. Yet, whether conditions of increased cholinergic signaling can offset the pathological remodeling induced by sympathetic hyperactivity, and its consequences for these two cholinergic axes are unknown. Here, we investigated two models of sympathetic hyperactivity: i) the chronic beta-adrenergic receptor stimulation evoked by isoproterenol (ISO), and ii) the alpha(2A)/alpha(2C)-drenergic receptor knockout (KO) mice that lack pre-synaptic adrenergic receptors. In both models, cholinergic signaling was increased by administration of the cholinesterase inhibitor, pyridostigmine. First, we observed that isoproterenol produces an autonomic imbalance characterized by increased sympathetic and reduced parasympathetic tone. Under this condition transcripts for cholinergic proteins were upregulated in ventricular myocytes, indicating that non-neuronal cholinergic machinery is activated during adrenergic overdrive. Pyridostigmine treatment prevented the effects of ISO on autonomic function and on the ventricular cholinergic machinery, and inhibited cardiac remodeling. alpha(2A)/alpha(2C)-KO mice presented reduced ventricular contraction when compared to wild-type mice, and this dysfunction was also reversed by cholinesterase inhibition. Thus, the cardiac parasympathetic system and non-neuronal cardiomyocyte cholinergic machinery are modulated in opposite directions under conditions of increased sympathetic drive or ACh availability. Moreover, our data support the idea that pyridostigmine by restoring ACh availability is beneficial in heart disease

30-Month randomised clinical trial to evaluate the clinical performance of a nanofill and a nanohybrid composite

Objective To evaluate the clinical performance of a nanofill and a nanohybrid composite in restorations in occlusal cavities of posterior teeth in a randomised trial over 30 months. Methods Forty-one adolescents participated in the study. The teeth were restored with a nanofill (Filtek Z350, 3M ESPE), a nanohybrid (Esthet-X, Dentsply); Filtek Z250 (3M ESPE) was used as a control. After 30 months, the restorations were evaluated in accordance with the US Public Health Service (USPHS) modified criteria. The McNemar and Friedman tests were used for statistical analysis, at a level of significance of 5%. Results There were significant differences in the roughness of Filtek Z250 (p = 0.008) and Filtek Z350 (p < 0.001) when the four time periods (baseline, 6 months, 12 months and 30 months) were compared. There were significant differences in the marginal adaptation of Filtek Z250 (p = 0.001), Filtek Z350 (p < 0.001) and Esthet-X (p = 0.011). Except for one of each composite restoration, all the modifications ranged from Alpha to Bravo. There were significant differences in the surface roughness (p = 0.005) when the three composites were compared after 30 months. Conclusions The materials investigated showed acceptable clinical performance after 30 months. Long-term re-evaluations are necessary for a more detailed analysis of these composites (CEP: #1252)