Pulmonary capacity of patients with total traumatic injury of the brachial plexus submitted to neurotization with the phrenic nerve: a case series.

Total traumatic injury often requires surgical intervention such as neurotization using the phrenic nerve with the aim to recover the elbow function. However, its repercussions on the respiratory kinematics are unknown. Objective: To  valuate the ribcage volume in tricompartments division, kinematics of Duty Cycle, and shortening velocity of the respiratory muscles after nerve phrenic transfer. Methods: Five participants (4 male), aged 18 to 40 years old (32±2), diagnosed with total brachial plexus injury and with nerve phrenic transfer. The optoelectronic plethysmography (OEP) was the instrument to evaluate volume in quiet breathing (QB), inspiratory capacity (IC) and vital capacity (VC) of the rib cage in its tricompartments division (pulmonary rib cage, abdominal rib cage and abdomen rib cage) and in each hemithorax, as well as the shortening velocity of the respiratory muscles, and respiratory rate. Assessments occurred 30 days prior and 30 days after surgery. Results: There was a decrease in the total compartmental distribution in QB with statistical difference only in the abdominal compartment (p 0.05). Four patients showed a reduction in the shortening speed of the left diaphragm muscle. It was not possible to perform a group analysis of respiratory kinematics and volumes in CV, IC due to the variation found in each patient analyzed. Conclusion: There was a reduction in volume in the rib cage as well as a change in the speed of shortening of the respiratory muscles after the transfer of the phrenic nerve one month after surgery

Lippia origanoides essential oil possesses anticonvulsant effect in pentylenetetrazol-induced seizures in rats: a behavioral, electroencephalographic, and electromyographic study

Epilepsy is a neuronal disorder characterized by abnormal excitability of the brain, leading to seizures. Only around 66% of the epileptic patients respond adequately to treatment with existing conventional anticonvulsants, making it necessary to investigate new antiepileptic drugs. The growing research into natural products and their pharmacological properties has become increasingly promising, particularly in the study of essential oils, which are already widely used in popular culture for treating various diseases. The present study evaluated the anticonvulsant effects of Lippia origanoides essential oil (LOEO) (100 mg/kg i. p.) compared to diazepam (DZP) (5 mg/kg i. p.), and the combined administration of these two substances to control convulsions induced by pentylenetetrazol (PTZ) (60 mg/kg i. p.). This evaluation was carried out using 108 male Wistar rats, which were divided into two experiments. Experiment 1–Behavioral assessment: The animals were divided into 4 groups (n = 9): (I) saline solution + PTZ, (II) DZP + PTZ, (III) LOEO + PTZ, (IV) LOEO + DZP + PTZ. The convulsive behavior was induced 30 min after the administration of the tested anticonvulsant drugs, and the observation period lasted 30 min. Experiment 2- Electrocorticographic evaluation: The animals were divided into 8 groups (n = 9): (I) saline solution; (II) LOEO; (III) DZP; (IV) LOEO + DZP; (V) saline + PTZ, (VI) DZP + PTZ (VII) LOEO + PTZ, (VIII) LOEO + DZP + PTZ. PTZ was administered 30 min after LOEO and DZP treatments and electrocorticographic activity was assessed for 15 min. For the control groups, electromyographic recordings were performed in the 10th intercostal space to assess respiratory rate. The results demonstrated that Lippia origanoides essential oil increased the latency time for the appearance of isolated clonic seizures without loss of the postural reflex. The animals had a more intense decrease in respiratory rate when combined with LOEO + DZP. EEG recordings showed a reduction in firing amplitude in the LOEO-treated groups. The combining treatment with diazepam resulted in increased anticonvulsant effects. Therefore, treatment with Lippia origanoides essential oil was effective in controlling seizures, and its combination with diazepam may represent a future option for the treatment of difficult-to-control seizures

Comparação da saúde mental dos acadêmicos de medicina do primeiro e quarto ano de uma instituição de ensino superior no Rio de Janeiro / Comparison of the mental health of medical schools in the first and fourth year of a higher education institution in Rio de Janeiro

O primeiro ano da Faculdade de Medicina é marcado por uma euforia de ter conseguido passar numa seleção competitiva pelos jovens, na idealização de um sonho de criança ou de uma expectativa familiar. O quarto ano diferencia pelo peso da responsabilidade uma vez que estão indo para o internato. É percebido que durante o período de formação, os estudantes de Medicina enfrentam a dualidade entre a realização pessoal, por iniciarem a formação médica, frustração por viverem, ao mesmo tempo, um período desafiador, bastante relacionado a transtornos como estresse, ansiedade e depressão. A questão que buscou-se responder foi sobre a que vulnerabilidades estão sujeitos os ingressantes na formação médica? Neste sentido, esta pesquisa teve como objetivo comparar a saúde mental dos alunos no primeiro ano da faculdade com os alunos do quarto ano, quando já estão ingressando no internato. Materiais e métodos: A pesquisa investigou a ocorrência de transtornos mentais em alunos de Medicina, dentre os quais foram comparados alunos do primeiro (primeiro e segundo períodos) e quarto (sétimo e oitavo períodos) anos da faculdade. Foi realizado um estudo transversal, cujo método para análise de investigação foi um questionário composto por 34 questões, aplicado através de um formulário online. Para isso, os participantes concordaram com o Termo de Consentimento Livre e Esclarecido (TCLE) antecedendo as respostas do questionário. Resultados e Discussão: Os resultados evidenciaram indícios de transtornos mentais tanto em alunos do primeiro ano (podendo ser causados por grandes expectativas, ansiedade, ruptura entre o modelo do Ensino Médio e Ensino Superior), quanto em alunos do quarto ano (ocasionados pela proximidade da saída da graduação e início de vivência em ambiente profissional, ter que lidar com o paciente mais diretamente). Conclusão: Vê-se que o apoio psicológico ao estudante de Medicina é imprescindível para a manutenção de qualidade de vida e bem estar, visto que os desafios e dificuldades enfrentados são inúmeros e a relação entre transtornos mentais e a graduação de Medicina são comprovados através de pesquisas. Os pesquisadores assumem o viés construído nos resultados uma vez que este estudo é mais indicado para ser de coorte longitudinal, mas os resultados não foram tão diferentes dos encontrados na literatura científica

Genotoxicidade humana e fármacos antidepressivos: avaliação da duloxetina em culturas de linfócitos

Antidepressants are widely used for the symptomatic treatment of depressive disorder. Numerous current research on depression has contributed to the advancement of drug therapy and the emergence of new antidepressant drugs. Current guidelines for genotoxicity testing of new drugs suggests the important utility of assays that detect DNA damage, or tests to evaluate the induction of DNA breakage. However, the small number of data on the genotoxicity of drugs causes the number of drugs that can actually be used safely is reduced. Therefore, it is of utmost importance genotoxicology studies on the evaluation of drugs, especially drugs used for a long period of time such as antidepressants. Duloxetine is a new antidepressant belonging to the class of selective serotonin reuptake inhibitors of serotonin and norepinephrine (SNRIs), used in the symptomatic treatment of depression. Despite the existence of studies showing that some antidepressant drugs are genotoxic, there is to date no study on the possible genotoxicity of duloxetine in human cells. Thus, this study aims to explore the possible genotoxic potential of duloxetine in vitro in primary cultures of human lymphocytes through the techniques of detection of chromosomal aberrations and micronuclei. Primary cultures of blood lymphocytes of healthy volunteers were exposed to different concentrations of duloxetine (10-150 ng/ml) and cyclophosphamide (6 μg/ml) as a positive control. Structural chromosomal aberrations, mitotic index, nuclear division index, index binucleation, number of cells with one, two, three and four micronuclei and the number of cells with nucleoplasmáticas bridges were evaluated. All cultures incubated with indices of duloxetine were significantly lower than those of the control groups, indicating a degree of cytotoxicity of the drug. However, only concentrations of 100 and 150 ng/ml caused a significant increase in the presence of chromosomal aberrations and micronuclei. Whereas these concentrations are close to the upper limit of the therapeutic range of the drug used in humans, our results call already on the need to deepen their understanding of human genotoxicity of duloxetine.Fármacos antidepressivos são largamente utilizados no tratamento sintomático do transtorno depressivo. Inúmeras pesquisas atuais sobre a depressão vêm contribuindo para o avanço da terapia farmacológica e para o surgimento de novos fármacos antidepressivos. Diretrizes atuais para testes de genotoxicidade de novos medicamentos sugerem a importante utilidade de ensaios que detectem danos ao DNA, ou seja, testes para avaliar a indução de quebras no DNA. Entretanto, o número escasso de dados sobre a genotoxicidade de fármacos faz com que seja reduzido o número de fármacos que realmente podem ser usados em segurança. Portanto, é de extrema importância estudos sobre a avaliação genotoxicológica de fármacos, principalmente, drogas utilizadas por um longo período de tempo como é o caso dos antidepressivos. A duloxetina é um antidepressivo novo, pertencente à classe dos inibidores seletivos da recaptação de serotonina e noradrenalina (ISRSN), utilizada no tratamento sintomático da depressão. Apesar da existência de trabalhos demonstrando que alguns fármacos antidepressivos são genotóxicos, não existe até hoje nenhum estudo sobre a possível genotoxicidade da duloxetina em células de origem humana. Assim, o presente estudo tem como objetivo explorar o possível potencial genotóxico in vitro da duloxetina em culturas primárias de linfócitos humanos através das técnicas de detecção de aberrações cromossômicas e micronúcleos. Culturas primárias de linfócitos sanguíneos de voluntários sadios foram expostas a diferentes concentrações de duloxetina (10-150 ng/ml) e ciclofosfamida (6 μg/ml) como controle positivo. Aberrações cromossômicas estruturais, índice mitótico, índice de divisão nuclear, índice de binucleação, número de células com um, dois, três e quatro micronúcleos e o número de células com pontes nucleoplasmáticas foram avaliadas. Todos os índices das culturas incubadas com duloxetina foram significativamente menores que aqueles dos grupos controles, indicando um certo grau de citotoxicidade da droga. Entretanto, só as concentrações de 100 e 150 ng/ml provocaram o aumento significativo da presença de aberrações cromossômicas e micronúcleos. Considerando que essas concentrações ficam perto do limite superior da faixa terapêutica da droga usada em humanos, nossos resultados alertam já sobre a necessidade de aprofundar no conhecimento da genotoxicidade humana da duloxetina

Epidemiological Profile of Surgically-Treated Peripheral-Nerve Diseases

Objective To outline the epidemiological profile of surgical patients treated at the peripheral-nerve outpatient clinic of a public hospital in the state of Pernambuco, Brazil, from 2008 (the year this service was implemented in the hospital ) to 2016. Material and Methods A cross-sectional study with data collection from the medical records. A descriptive analysis was performed with the qualitative variables presented as relative and absolute frequencies, and the quantitative variables, as means and standard deviations. The studied variables were gender, age, diagnosis, and surgical techniques. Results In total, 506 medical records were analyzed. Of these, 269 were of male patients (53%), and 238 were of female patients (46%). The age of the sample ranged from 5 to 84 years (41 ± 14 years). The most prevalent diagnoses were: carpal tunnel syndrome (38.9%) followed by traumatic brachial plexus injury (33.2%). The first diagnosis was more frequent among women, while the second, among men. This collaborates with the predominant findings of upper-limb lesions (91%), in which men accounted for 52,75% (244) and women, for 47,25% (217). Conclusion The present study provided relevant information regarding the reality of peripheral-nerve surgeries performed at a public hospital in the state of Pernambuco, Brazil. Public health issues increasingly require the continuity of public policies and government incentive

Life quality, depression and anxiety symptoms in chronic post-traumatic headache after mild brain injury

ABSTRACT Post-traumatic headache (PTH) is the most common symptom found in the post-traumatic syndrome, whose onset occurs within seven days of the trauma. The condition is characterized as acute when it persists for up to 3 months. PTH beyond this period is considered chronic. Objectives: The objective of this study was to determine the clinical features of chronic post-traumatic headache (cPTH) and its association with depression, anxiety and quality of life. Methods: A total of 73 female subjects were evaluated. Patients were divided into three groups: (a) group without headache, CONTROL, n=25; (b) cPTH group, n=19; and (c) MIGRAINE, n=29, with all subjects in the 11-84 year age group. Symptoms of anxiety and depression were evaluated by the Beck inventories of anxiety and depression, and quality of life assessed by the Lipp and Rocha quality of life inventory. Qualitative variables were analyzed using the Chi-square or Fisher's exact tests and expressed as percentages whereas quantitative variables were analyzed by ANOVA, Mann-Whitney or Kruskal-Wallis tests with data expressed as mean±standard deviation, p<0.05. Results: Subjects with cPTH presented with headache manifesting similar features to those found in migraine. The cPTH group was associated with similar levels of anxiety and depression to the migraine group and higher than the CONTROL (p<0.001). Quality of life of individuals with cPTH was similar to that of subjects with migraine and lower than CONTROL subjects (p<0.05). Conclusions: cPTH presents similar clinical characteristics to migraine. Subjects with cPTH had high levels of anxiety and depression symptoms and reduced quality of life