Comparison of the efficacy of transforaminal and interlaminar radicular block techniques for treating lumbar disk hernia

AbstractObjectiveTo compare the interlaminar and transforaminal block techniques with regard to the state of pain and presence or absence of complications.MethodThis was a randomized double-blind prospective study of descriptive and comparative nature, on 40 patients of both sexes who presented lumbar sciatic pain due to central-lateral or foraminal disk hernias. The patients had failed to respond to 20 physiotherapy sessions, but did not present instability, as diagnosed in dynamic radiographic examinations. The type of block to be used was determined by means of a draw: transforaminal (group 1; 20 patients) or interlaminar (group 2; 20 patients).ResultsForty patients were evaluated (17 males), with a mean age of 49 years. There was a significant improvement in the state of pain in all patients who underwent radicular block using both techniques, although the transforaminal technique presented better results than the interlaminar technique.ConclusionBoth techniques were effective for pain relief and presented low complication rates, but the transforaminal technique was more effective than the interlaminar technique

Avaliação da Qualidade de Vida Em pacientes Submetidos A Tratamento Cirúrgico Para Escoliose Idiopática Do Adolescente, De Acordo Com A Última Vértebra Instrumentada

Objective: Evaluate the influence of the last instrumented vertebra on the quality of life of patients undergoing surgical treatment for adolescent idiopathic scoliosis. Methods: This is a retrospective and cross-sectional study, with level 4 of evidence. For this evaluation, the SRS-22r questionnaire was applied. The variables sex, age at the date of surgery, number of instrumented vertebrae and last instrumented vertebrae were correlated with the domains of the SRS-22r questionnaire. Results: 39 patients were evaluated, 33 (84.6%) of whom were female, with a mean age of 14.5 years at the date of surgery. All patients were introduced to arthrodesis posteriorly and instrumented with pedicle screws. The last instrumented vertebrae were D12, L1, L3 and L4. The average number of instrumented vertebrae was 11.9. There was no statistical significance in the correlation between the variables gender and the last instrumented vertebra with quality of life. The correlation between the variable number of instrumented vertebrae and the function / activity domain, as well as the correlation between the variable age at the date of surgery and the satisfaction with the treatment domain, presented statistical significance. Conclusion: The last instrumented level does not seem to interfere with quality of life, although patients with less instrumented levels had better scores in the function / activity domain.Objetivo: Avaliar a influência da última vértebra instrumentada na qualidade de vida de pacientes submetidos a tratamento cirúrgico para escoliose idiopática do adolescente. Métodos: Trata-se de um estudo retrospectivo e transversal do tipo série de casos, com nível IV de evidência. Para essa avaliação, aplicou-se o questionário SRS-22r. Foram correlacionadas as variáveis sexo, idade na data da cirurgia, número de vértebras instrumentadas e última vértebra instrumentada com os domínios do questionário SRS-22r. Resultados: Foram avaliados 39 pacientes, sendo 33 (84,6%) do sexo feminino, com idade média de 14,5 anos na data da cirurgia. Todos foram submetidos à artrodese por via posterior e instrumentação com parafusos pediculares. As últimas vértebras instrumentadas foram D12, L1, L3 e L4. Não houve significância estatística na correlação entre as variáveis sexo e última vértebra instrumentada com a qualidade de vida. A correlação entre a variável número de vértebras instrumentadas e o domínio função/atividade, assim como a correlação entre a variável idade na data da cirurgia e o domínio satisfação com o tratamento apresentaram significância estatística. Conclusão: O último nível instrumentado não parece interferir na qualidade de vida, embora pacientes com menos níveis instrumentados tenham apresentado melhor pontuação no domínio função/atividade

Ensaio clínico randomizado prospectivo comparando a ablação por radiofrequência e a retirada completa de veia safena em pacientes com doença venosa crônica leve à moderada com seguimento de 3 anos

Objective: To compare the use of the radiofrequency thermoablation of the saphenous vein with the ligation technique, and complete removal of the saphenous vein, from the saphenofemoral junction to the ankle. Methods: A total of 49 patients with chronic venous disease in the Comprehensive Classification System for Chronic Venous Disorders (CEAP) classes 2 to 4 for clinical signs, etiology, anatomic distribution and pathophysiology, were assessed at baseline, after 4 weeks, and after 1 year. The parameters assessed were complications, period of absence from activities, Venous Clinical Severity Score (VCSS) and quality of life scores according to Aberdeen Varicose Veins Questionnaire (AVVQ). They were re-examined 1 and 3 years after treatment to evaluate recurrence rates. Results: The success rate per limb (p=0.540), VCSS (p=0.636), AVVQ (p=0.163), and clinical complications were similar in the two treatment groups. Nevertheless, the radiofrequency thermoablation group had significant shorter length of hospital stay (0.69±0.47) and absence from activities (8.62±4.53), p<000.1. Conclusion: Patients submitted to radiofrequency thermoablation had an occlusion rate, clinical recurrence and improvement in quality of life comparable to removal of the saphenous vein. However, these patients spent less time hospitalized and away from their daily activities during recovering

Nitrogen efficiency in marandupalisadegrass pastures under increasing nitrogen levels

ABSTRACT: The use of nitrogen (N) in pastoral ecosystems leads to increased productivity, as it allows the plant to elongate its leaves and, therefore, grazing herbivores harvest the green leaves. However, there are very volatile N sources, which can be replaced by ammonium nitrate, which is less volatile and less dependent on the application in rainy days. The treatments are compound of Marandu palisade grass pastures managed under continuous stocking at a canopy height of 25 cm, with different levels of N fertilizer: 0, 75, and 150 kg ha-1year-1, as ammonium nitrate (32% of N), with four replicates (pastures) in a completely randomized design. Nitrogen uptake (54.9, 96.5, 113.8 kg N ha-1) and N nutrition index (0.67, 0.98, 1.15) were different between N level, respectively, 0, 75 and 150 kg ha-1 year-1. The N recovery (58.3, 40.9 %) differed between 75 and 150 kg ha-1 year-1, respectively. The dose of 75 kg N kg ha-1 year-1 results in better N utilization, while the dose of 150 kg N ha-1 year-1 enables greater stocking rate; therefore, requiring less grazing area

Stoichiometric gene-to-reaction associations enhance model-driven analysis performance: Metabolic response to chronic exposure to Aldrin in prostate cancer

[Background] Genome-scale metabolic models (GSMM) integrating transcriptomics have been widely used to study cancer metabolism. This integration is achieved through logical rules that describe the association between genes, proteins, and reactions (GPRs). However, current gene-to-reaction formulation lacks the stoichiometry describing the transcript copies necessary to generate an active catalytic unit, which limits our understanding of how genes modulate metabolism. The present work introduces a new state-of-the-art GPR formulation that considers the stoichiometry of the transcripts (S-GPR). As case of concept, this novel gene-to-reaction formulation was applied to investigate the metabolic effects of the chronic exposure to Aldrin, an endocrine disruptor, on DU145 prostate cancer cells. To this aim we integrated the transcriptomic data from Aldrin-exposed and non-exposed DU145 cells through S-GPR or GPR into a human GSMM by applying different constraint-based-methods.[Results] Our study revealed a significant improvement of metabolite consumption/production predictions when S-GPRs are implemented. Furthermore, our computational analysis unveiled important alterations in carnitine shuttle and prostaglandine biosynthesis in Aldrin-exposed DU145 cells that is supported by bibliographic evidences of enhanced malignant phenotype.[Conclusions] The method developed in this work enables a more accurate integration of gene expression data into model-driven methods. Thus, the presented approach is conceptually new and paves the way for more in-depth studies of aberrant cancer metabolism and other diseases with strong metabolic component with important environmental and clinical implications.The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP/2007–2013) / ERC Grant Agreement n. 320737 and from the Novo Nordisk Foundation (NNF10CC1016517 and NNF14OC0009473). MC is funded by ICREA Academia programme-2015 (Icrea Fundation), AGAUR-Generalitat de Catalunya (2017SGR-1033), MINECO European Commission FEDER funds (SAF2017-89673-R) and Instituto de Salud Carlos III (CIBEREHD CB17/04/00023).Peer reviewe

Leis penais especiais comentadas

- Divulgação dos SUMÁRIOS das obras recentemente incorporadas ao acervo da Biblioteca Ministro Oscar Saraiva do STJ. Em respeito à Lei de Direitos Autorais, não disponibilizamos a obra na íntegra.- Localização na estante: 343.232(81)(094) Coment. L532pe- Coordenado por: Rogério Sanches Cunha, Ronaldo Batista Pinto e Renee do Ó Souza

Caracterização dos carcinomas mamários de fenótipo triplo negativo em um laboratório privado da cidade de Goiânia, Goiás

A neoplasia de mama é o tipo de câncer mais frequente entre as mulheres, com uma estimativa de cerca de 66 mil novos casos para cada ano entre 2020-2022. A incidência deste carcinoma, por si só, justifica a necessidade de estudos aprofundados acerca desta temática. Trata-se de um estudo descritivo transversal, que é um estudo utilizado para traçar perfil epidemiológico da doença em questão, podendo-se levantar dados em um ponto no tempo pré-definido. Foram avaliados 6.379 casos de carcinoma mamário invasor, dos quais 817 foram classificados com fenótipo triplo negativo (TN). O ano de 2020 apresentou o maior número de casos TN. A idade das pacientes variou de 23 a 95 anos, com uma média de 51,8 anos. Nesta pesquisa, apenas 12,8% dos casos de carcinoma mamário invasor foram classificados como Triplo-negativo. Este padrão se repete em estudos internacionais, confirmando que este subtipo é ligeiramente mais raro do que os outros. Pesquisas apontaram que apenas 16% das mulheres que tiveram diagnóstico de neoplasia mamária dentre os anos de 2006-2011 no país receberam a classificação Triplo-negativa. Entre os anos de 2015 e 2021, observamos um aumento de cerca de 73% de diagnósticos de carcinoma triplo negativos no laboratório INGOH. Os casos de câncer de mama são caracterizados pelo tipo Ductal não especial, com predomínio do grau 3, mais prevalentes na mama esquerda e provenientes de Core Biopsy e de pacientes com idade acima de 50 anos