Therapeutic Management of Hypothenar Hammer Syndrome Causing Ulnar Nerve Entrapment

Introduction. The hypothenar hammer syndrome is a rare traumatic vascular disease of the hand. Method and Materials. We report the case of a 43-years-old man with a painful tumefaction of the left hypothenar region. The ulnar artery appeared thrombosed clinically and radiologically. The patient underwent surgery to resolve the ulnar nerve compression and revascularise the artery. Results. The symptoms disappeared immediately after surgery. The arterial flow was reestablished. Postoperatively on day 20, a new thrombosis of the ulnar artery occurred. Conclusion. Hypothenar hammer syndrome is caused by repetitive trauma to the heel of the hand. The alterations of the vessel due to its chronic inflammation caused an acute compression of the ulnar nerve at the Guyon's canal and, in our case, do not allow a permanent revascularisation of the ulnar artery

A criminalidade aliada a tecnologia: uma abordagem acerca dos meios insuficientes para prevenção e repressão no ciberespaço

É evidente que a criminalidade venha se tornando descomunal no Brasil. Do mesmo modo ou ainda pior, é a criminalidade no ciberespaço. Desta feita, a criminalidade ganhou um nupérrimo modo de se camuflar, o que já não é novidade usar a internet para a prática de meios ilícitos e danosos por muitos criminosos hoje em dia. Um grande aliado para o imenso número de cibercrimes é a tecnologia, que não para de avançar e inovar, dentre essas novidades e avanços, encontra-se a internet – rede mundial de comunicabilidade entre dispositivos eletrônicos e pessoas. O presente artigo foi desenvolvido tendo como base pesquisas bibliográficas, consultas em sites jurídicos e legislações vigentes no ordenamento jurídico brasileiro. Além disso, versa apresentar as dificuldades encontradas no trabalho investigativo na tentativa de reduzir a limites mais estritos a cibercriminalidade evidenciando a realidade do tema no Brasil e finalmente patenteando as formas de resolução e os meios adequados para prevenção e repressão

Characterization of the cork oak transcriptome dynamics during acorn development

Background: Cork oak (Quercus suber L.) has a natural distribution across western Mediterranean regions and is a keystone forest tree species in these ecosystems. The fruiting phase is especially critical for its regeneration but the molecular mechanisms underlying the biochemical and physiological changes during cork oak acorn development are poorly understood. In this study, the transcriptome of the cork oak acorn, including the seed, was characterized in five stages of development, from early development to acorn maturation, to identify the dominant processes in each stage and reveal transcripts with important functions in gene expression regulation and response to water. Results: A total of 80,357 expressed sequence tags (ESTs) were de novo assembled from RNA-Seq libraries representative of the several acorn developmental stages. Approximately 7.6 % of the total number of transcripts present in Q. suber transcriptome was identified as acorn specific. The analysis of expression profiles during development returned 2,285 differentially expressed (DE) transcripts, which were clustered into six groups. The stage of development corresponding to the mature acorn exhibited an expression profile markedly different from other stages. Approximately 22 % of the DE transcripts putatively code for transcription factors (TF) or transcriptional regulators, and were found almost equally distributed among the several expression profile clusters, highlighting their major roles in controlling the whole developmental process. On the other hand, carbohydrate metabolism, the biological pathway most represented during acorn development, was especially prevalent in mid to late stages as evidenced by enrichment analysis. We further show that genes related to response to water, water deprivation and transport were mostly represented during the early (S2) and the last stage (S8) of acorn development, when tolerance to water desiccation is possibly critical for acorn viability. Conclusions: To our knowledge this work represents the first report of acorn development transcriptomics in oaks. The obtained results provide novel insights into the developmental biology of cork oak acorns, highlighting transcripts putatively involved in the regulation of the gene expression program and in specific processes likely essential for adaptation. It is expected that this knowledge can be transferred to other oak species of great ecological value.Fundação para a Ciência e a Tecnologi

Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

<p>Abstract</p> <p>Background</p> <p>One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study.</p> <p>Methods/Design</p> <p>The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome.</p> <p>Discussion</p> <p>The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia.</p> <p>Trial Registration</p> <p><b>Clincaltrials.gov Identifier</b>: NCT00395915</p

Linfangioma della regione glutea

Il linfangioma è un raro tumore vascolare benigno di origine linfatica. Si tratta di una patologia congenita nella maggior parte dei casi ma può verificarsi a qualunque età. Le localizzazioni più frequenti sono quelle cranio-facciali sebbene ogni distretto corporeo possa essere coinvolto, frequentemente è asintomatico e l’unico segno evidente è la presenza di una massa. Il linfangioma è considerato una malformazione benigna dei vasi linfatici trattabile chirurgicamente, tuttavia il danno alle strutture limitrofe, la resezione incompleta determinata dall’invasione degli organi adiacenti, l’elevata probabilità di recidiva hanno incoraggiato la ricerca di trattamenti alternativi. La Scleroterapia, metodica il cui razionale è l’iniezione di un agente sclerosante per ottenere l’ obliterazione dei vasi linfatici, viene usata sempre con maggiore frequenza. Numerosi agenti vengono utilizzati per ottenere la sclerosi percutanea dei linfangiomi come il destrosio al 50%, la bleomicina, l’OK-432, la doxociclina, l’etanolo (Ethibloc), la soluzione alcolica di Zein. In questo studio riportiamo il caso di un linfangioma localizzato in regione glutea trattato combinando scleroterapia e chirurgi

Surgical Correction of Gynecomastia in Thin Patients

Gynecomastia refers to a benign enlargement of the male breast. This article describes the authors' method of using power-assisted liposuction and gland removal through a subareolar incision for thin patients. Power-assisted liposuction is performed for removal of fatty breast tissue in the chest area to allow skin retraction. The subareolar incision is used to remove glandular tissue from a male subject considered to be within a normal weight range but who has bilateral grade 1 or 2 gynecomastia. Gynecomastia correction was successfully performed for all the patients. The average volume of aspirated fat breast was 100-200 ml on each side. Each breast had 5-80 g of breast tissue removed. At the 3-month, 6-month, and 1-year follow-up assessments, all the treated patients were satisfied with their aesthetic results. Liposuction has the advantages of reducing the fat tissue where necessary to allow skin retraction and of reducing the traces left by surgery. The combination of surgical excision and power-assisted lipoplasty also is a valid choice for the treatment of thin patients

Lavagem de dinheiro e crime organizado : diálogos entre Brasil e Portugal

- 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: 343.72(81+469) R696

Short-Scar Surgical Approach for the Treatment of Glomus Tumor of the Digit

Background: A glomus tumor is a biologically benign neoplasm. The traditional surgical approach to treat this tumor boasts the lowest recurrence rates but may cause nail deformities. Objective: A short-scar surgical approach was applied, with the aim of preserving the aesthetics of the nail. Methods: Between January 1999 and January 2009, 25 patients who underwent surgery for a glomus tumor were included in the study. All patients underwent radical resection with three different surgical approaches based on the location of the tumor. Results: All patients who were operated on had complete regression of pain immediately after surgery and at postsurgery follow-ups. Conclusion: The treatment of glomus tumors consists of surgical excision, which is successful if properly executed. Excision of sensitive afferent nervous fibers is a prerequisite to achieve regression of pain. A short-scar surgical approach ensures complete eradication of the tumor and preservation of nail aesthetics

Erratum to: Co2/Erbium:YAG/Dye Laser Combination: An Effective and Successful Treatment for Angiofibromas in Tuberous Sclerosis.

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