Pesticide changes odds of interactions between native and invasive ants

BACKGROUND: A variety of facial nerve grading scales have been developed over the years with the intended goals of objectively documenting facial nerve function,tracking recovery, and facilitating communication between practitioners. Numerous scales have been proposed; however, all are subject to limitation because of varying degrees of subjectivity, reliability, or longitudinal applicability. At present, such scales remain the only widely accessible modalities for facial functional assessment. The authors' objective was to ascertain which scales(s) best accomplish the goals of objective assessment. METHODS: A systematic review of the English language literature was performed to identify facial nerve grading instruments. Each system was evaluated against the following criteria: convenience of clinical use, regional scoring, static and dynamic measures, features secondary to facial palsy (e.g., synkinesis), reproducibility with low interobserver and intraobserver variability, and sensitivity to changes over time and/or following interventions. Results : From 666 articles, 19 facial nerve grading scales were identified. Only the Sunnybrook Facial Grading Scale satisfied all criteria. The Facial Nerve Grading Scale 2.0 (or revised House-Brackmann Scale) fulfilled all criteria except intraobserver reliability, which has not been assessed. CONCLUSIONS: Facial nerve grading scales intend to provide objectivity and uniformity of reporting to otherwise subjective analysis. The Facial Nerve Grading Scale 2.0 requires further evaluation for intraobserver reliability. The Sunnybrook Facial Grading Scale has been robustly evaluated with respect to the criteria prescribed in this article. Although sophisticated technology-based methodologies are being developed for potential clinical application,the authors recommend widespread adoption of the Sunnybrook Facial Grading Scale as the current standard in reporting outcomes of facial nerve disorders

Eletrocirurgia: sistemas mono e bipolar em cirurgia videolaparoscópica

O conhecimento das leis físicas e dos mecanismos de funcionamento da eletrocirurgia são de grande importância para o cirurgião. Lesões por eletrocirurgia em laparoscopia têm sido observadas, e estão associadas ao uso do eletrodo monopolar, com freqüência de 1 a 2 lesões a cada 1000 procedimentos.Com relação ao desenvolvimento de lesão, existem vários fatores que influenciam: densidade da corrente; o tipo de onda e de coagulação usadas, com suas respectivas voltagens; as condições de isolamento dos dispositivos; a ocorrência do fenômeno de capacitância; e os riscos oferecidos pelo uso em pacientes com marcapasso. No sistema bipolar, a densidade de corrente encontrada ao redor de seus eletrodos é bem menor, levando a menos lesões e, ainda, elimina vários dos outros mecanismos lesivos, como a placa de retorno e os citados acima. Vários estudos demonstram, em colecistectomias, apendicectomias, polipectomias e outros, que o índice de complicações com o eletrodo bipolar é significativamente menor.<br>the knowledge of the physical laws and of the mechanisms of functioning of electrosurgery are of great importance for the surgeon. Lesions caused by electrosurgery in laparoscopic procedures have been observed, and are associated with the use of monopolar electrode, with the frequency of 1 to 2 lesions in every 1000 procedures. Concerning the development of the lesions, several factors are involved; current density, the waveform and the type of coagulation used, with its respective voltages; the insulation condition of the devices; the occurrence of the phenomenon of capacitance and the risks involved with the use in patients with pacemakers. In bipolar electrosurgery, the current density produced around the electrodes is much lower, causing less tissue damage and, still, eliminating several of the other mechanims of injury, such as the dispersive electrode and those quoted above. Several studies reveal that the incidence of complications with the use of bipolar electrodes in cholecystectomies, appendicectomies, polypectomies and other procedures is significantly lower