RESUMO
Interferon-γ (IFN-γ) is a proinflammatory cytokine that activates glial cells. IFN-γ is increased in the plasma and brain of Parkinson's disease patients, suggesting its potential role in the disease. We investigated whether the IFN-γ deficiency could interfere with nigrostriatal degeneration induced by the neurotoxin 6-hydroxydopamine, L-DOPA-induced dyskinesia, and the neuroinflammatory features as astrogliosis, microgliosis, and induced nitric oxide synthase (iNOS) immunoreactivity induced by L-DOPA treatment. Wild type (WT) and IFN-γ knockout (IFN-γ/KO) mice received unilateral striatal microinjections of 6-hydroxydopamine. Animals were sacrificed 1, 3, 7, and 21 days after lesions. Additional group of WT and IFN-γ/KO parkinsonian mice, after 3 weeks of neurotoxin injection, received L-DOPA (intraperitoneally, for 21 days) resulting in dyskinetic-like behavior. Tyrosine hydroxylase immunostaining indicated the starting of dopaminergic lesion since the first day past toxin administration, progressively increased until the third day when it stabilized. There was no difference in the lesion and L-DOPA-induced dyskinesia intensity between WT and IFN-γ/KO mice. Remarkably, IFN-γ/KO mice treated with L-DOPA presented in the lesioned striatum an increase of iNOS and glial fibrilary acid protein (GFAP) density, compared with the WT group. Morphological analysis revealed the rise of astrocytes and microglia reactivity in IFN-γ/KO mice exibiting dyskinesia. In conclusion, IFN-γ/KO mice presented an intensification of the inflammatory reaction accompanying L-DOPA treatment and suggest that iNOS and GFAP increase, and the activation of astrocytes and microglia induced afterward L-DOPA treatment was IFN-γ independent events. Intriguingly, IFN-γ absence did not affect the degeneration of dopaminergic neurons or LID development.
Assuntos
Antiparkinsonianos/toxicidade , Discinesia Induzida por Medicamentos/metabolismo , Mediadores da Inflamação/metabolismo , Interferon gama/deficiência , Levodopa/toxicidade , Transtornos Parkinsonianos/metabolismo , Animais , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Corpo Estriado/patologia , Discinesia Induzida por Medicamentos/genética , Discinesia Induzida por Medicamentos/patologia , Interferon gama/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Oxidopamina/toxicidade , Transtornos Parkinsonianos/genética , Transtornos Parkinsonianos/patologiaRESUMO
PURPOSE: The purpose of this work is to report mid- to long-term clinical results, recurrence rates and instability following surgery to repair anterior dislocation of the shoulder by the remplissage technique. METHODS: This was a retrospective case series at a single center with patients with anterior shoulder instability that received surgery using the remplissage technique. Rowe questionnaire, instability complaints, recurrence episodes and return to sport were analyzed. RESULTS: Of all patients screened, 21 (92.3%) were enrolled and only 2 patients were lost to follow-up. The mean age of the patients at the time of surgery was 27.8y.o., and the mean number of dislocations before surgery was 3.2 episodes. The follow-up average was 83.8 months (range 28-126). No case of postoperative infection was observed. Two patients (9.5%) had recurrent shoulder instability and required reintervention after 18 and 48 months. The average final Rowe score was 92.9 (range 75-100). All patients that played sports before surgery returned to the sport, and 73.7% of them returned to the same activity level. CONCLUSION: The remplissage technique applied to repair anterior shoulder dislocation with humeral bone loss presents good results regarding clinical scores, shoulder stability and acceptable rates of return to sports, even in a mid- to long-term follow-up. LEVEL OF EVIDENCE: IV.
Assuntos
Lesões de Bankart , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Artroscopia , Seguimentos , Humanos , Instabilidade Articular/cirurgia , Recidiva , Estudos Retrospectivos , Ombro , Luxação do Ombro/diagnóstico por imagem , Luxação do Ombro/cirurgiaRESUMO
Nutrition and physical training have important roles in the accumulation and maintenance of bone mass. The aim of this study was to evaluate, in ovariectomized rats (OVX), the effects of treadmill training (T) with high-fat diet (F) on weight gain and bone tissue properties with eight groups (n = 10) for 12 weeks: OVX SC (OVX, sedentary lifestyle, diet control); OVX SF; OVX TC; OVX TF; SH SC (SHAM, sedentary lifestyle, diet control); SH SF; SH TC; and SH TF. Weekly weight gain and final body composition were assessed. After euthanasia, tibiae were analyzed. The trained animals had higher body weight (P = 0.001), bone mineral density (P < 0.001), and trabecular bone (P < 0.001). The animals with a high-fat diet showed higher global fat (P < 0.001), percentage of global fat (P < 0.001) and deformation at impact (P = 0.031) and reduced tibial bone mineral content (P = 0.036). Physical training improves bone microarchitecture, without presenting an increase in impact resistance, and a high-fat diet increases body fat and impairs bone mineralization.
Assuntos
Composição Corporal , Densidade Óssea , Osso Esponjoso/patologia , Osso Cortical/patologia , Dieta Hiperlipídica , Condicionamento Físico Animal , Tíbia/patologia , Aumento de Peso , Tecido Adiposo , Animais , Feminino , Ovariectomia , Ratos , Ratos WistarRESUMO
Despite the deleterious effects, immobilization, is still often used in the treatment of musculoskeletal disorders, even with the occurrence of muscular atrophy, its reversal is a major challenge to rehabilitation. The aim of this study was evaluate the tropism of rats soleus muscle submitted to remobilization with static stretching, preceded by ultrasound, thermal and non thermal. We used 28 rats divided into four groups: G1‑immobilized and remobilized with static stretching, G2-remobilized with stretching preceded by ultrasound 1.0 W.cm²; G3 ultrasound at 0.5 W.cm² , G4 ultrasound with 0.2 W.cm². All animals were immobilized in plantarflexion, producing shortening of the right soleus muscle for 15 days. For the groups subjected to remobilization with ultrasound doses were used according to the group, for 3 minutes, for 10 days with an interval of 2 days after the 5th treatment. After treatment with ultrasound (or not for the G1), the animals were subjected to 3 sets of 30 seconds, with 30 seconds interval between them, of static stretching of the soleus. The soleus were dissected, weighed and processed for preparation of histological slides in cross section, and evaluated the smallest diameter of 100 fibers per muscle. There was significant reduction in weight between left and right muscles in all groups, for diameters G3 showed no difference. Conclusion: stretching with or without ultrasound, was unable to reverse the deleterious effects of immobilization on muscle weight, but in the mean dose there was protective effect on the diameter of the fibers.
Assuntos
Animais , Masculino , Ratos , Exercícios de Alongamento Muscular , Atrofia Muscular , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Músculo Esquelético , Dissecação , Desenvolvimento Muscular , Ratos Wistar , Tropismo , Terapia por Ultrassom/veterináriaRESUMO
The objective of this study was to describe the results and complications of a prospectively designed high-dose-rate (HDR) brachytherapy schedule for early-stage cancer of the cervix, at 14 Gy/h to point A, based on the linear-quadratic model and our clinical experience. We used a combination of brachytherapy and external beam pelvic and parametrial irradiation in 88 consecutively seen patients with stage IB1-IIB treated by irradiation alone (1995-1998). The modeled HDR schedule consisted of three insertions on three treatment days separated by 10 days, with six 7 Gy planned brachytherapy fractions to point A, at 14 Gy/h, two on each treatment day with an interfraction interval of 6 h, plus an 18 Gy external whole-pelvic dose followed by additional parametrial irradiation. The calculated biologically effective dose (BED) was 92 Gy10 for tumor and 110 Gy3 for the rectum, equivalent to 77 and 66 Gy in 2 Gy fractions, respectively. The median overall treatment time was 41 days. The actuarial 4-year central recurrence-free rate, pelvic control, and disease-free survival rate were 97%, 93%, and 88% for stages IB-IIA and 79%, 75%, and 75% for stage IIB. The actuarial 4-year late complication rate for grades 2-3 was 4.7% (scale 0-3). We conclude that preliminary results of this HDR brachytherapy schedule for early-stage disease at a median follow-up of 52 months are as effective as the previously used low dose rate (LDR) at 0.44 Gy/h at point A. They are also as effective as medium-dose-rate schedules (MDR) at 1.6-1.5 Gy/h at this institution and do not require a further increase in fractionation of intracavitary treatments or in the whole-pelvic external beam irradiation dose common to standard HDR schedules. In addition, more patients per machine can be treated per day compared with MDR. Longer follow-up is required for a complete assessment of late complications.