RESUMO
INTRODUCTION: Hallux valgus is a high frequency disorder, affecting the first ray. Operative correction techniques have grown popularity lately. One of them is the Reverdin-Isham technique (first metatarsal medial incomplete osteotomy). Recently, a protection and osteotomy cutting guide has been developed: the BARU system. OBJECTIVE: To test the usefulness of the BARU system as a protective factor for soft structures adjacent to the surgical site and guidance for osteotomy. MATERIAL AND METHODS: Experimental cadaveric study. Six cadaveric feet (two fresh-frozen and four in formaldehyde solution), unapproached. Feet were numbered and intervened with RI technique, three of them with BARU system and three without it. Afterwards, dissection by two dissectors who did not know whether the BARU system had been used or not, establishing a single-blinded model. 13 structures were evaluated in each foot. Data was recovered into Microsoft Office Excel and processed with SPSS. 2 test (significative if p value < 0.05) and relative risk were calculated. RESULTS: Approach using BARU system was satisfactory, with usual-size operation-ports. BARU system colocation was simple and radiological control showed adequate spatial location. The device contributed as reference for cutting direction and depth. 65 out of the 78 searched structures were found (83.3%). Six injuries were found among the assessed structures: plantar medial nerve (one injury), plantar medial artery (one injury), flexor brevis muscle (three injuries), abductor muscle (one injury). Five of these injuries occurred in non-utilizing BARU system feet. CONCLUSION: Promising results in terms of protection of nearby structures, cutting guide, and ease of intervention. Avoids X-rays exposure. Not significant statistical calculations, the sample should be enlarged.
INTRODUCCIÓN: El hallux valgus es una patología con alta prevalencia en la población. Técnicas de corrección quirúrgica han crecido en popularidad últimamente. Una de ellas es la de Reverdin-Isham (RI: osteotomía incompleta medial en primer metatarsiano), se desarrolló un dispositivo de protección y guía de corte para dicho procedimiento: el sistema BARU. OBJETIVO: Probar la utilidad del sistema BARU como factor protector de estructuras blandas adyacentes al sitio de abordaje y guía para osteotomía. MATERIAL Y MÉTODOS: Estudio cadavérico; seis pies (dos frescos y cuatro formolados) sin abordajes previos. Tres con el sistema BARU y tres sin éste. Posteriormente disección por dos disectores con enmascaramiento simple ciego. Se evaluaron 13 estructuras en cada pie. Los datos fueron recabados con Microsoft Office Excel y procesados en SPSS. Se realizó test de 2 (valor p < 0.05 significativo) y se calculó el riesgo relativo. RESULTADOS: El sistema BARU fue satisfactorio. Su colocación fue sencilla y el control radiológico mostró adecuada ubicación espacial. Ayudó como referencia para la dirección y profundidad del corte. Se encontraron 65 de las 78 estructuras buscadas (83.3%). En las estructuras evaluadas hubo seis lesiones: nervio plantar medial (uno dañado), arteria plantar medial (uno dañado), músculo flexor corto (tres dañados), músculo abductor (uno dañado). Cinco de estas lesiones ocurrieron en pies donde no se utilizó el sistema BARU. CONCLUSIÓN: Resultados prometedores en cuanto a protección de estructuras cercanas, guía de corte y facilidad para la intervención. Cálculos estadísticos no significativos, la muestra debería ampliarse.
Assuntos
Hallux Valgus , Ossos do Metatarso , Cadáver , Hallux Valgus/cirurgia , Humanos , Osteotomia , Resultado do TratamentoRESUMO
Resumen: Introducción: El hallux valgus es una patología con alta prevalencia en la población. Técnicas de corrección quirúrgica han crecido en popularidad últimamente. Una de ellas es la de Reverdin-Isham (RI: osteotomía incompleta medial en primer metatarsiano), se desarrolló un dispositivo de protección y guía de corte para dicho procedimiento: el sistema BARU. Objetivo: Probar la utilidad del sistema BARU como factor protector de estructuras blandas adyacentes al sitio de abordaje y guía para osteotomía. Material y métodos: Estudio cadavérico; seis pies (dos frescos y cuatro formolados) sin abordajes previos. Tres con el sistema BARU y tres sin éste. Posteriormente disección por dos disectores con enmascaramiento simple ciego. Se evaluaron 13 estructuras en cada pie. Los datos fueron recabados con Microsoft Office Excel y procesados en SPSS. Se realizó test de χ2 (valor p < 0.05 significativo) y se calculó el riesgo relativo. Resultados: El sistema BARU fue satisfactorio. Su colocación fue sencilla y el control radiológico mostró adecuada ubicación espacial. Ayudó como referencia para la dirección y profundidad del corte. Se encontraron 65 de las 78 estructuras buscadas (83.3%). En las estructuras evaluadas hubo seis lesiones: nervio plantar medial (uno dañado), arteria plantar medial (uno dañado), músculo flexor corto (tres dañados), músculo abductor (uno dañado). Cinco de estas lesiones ocurrieron en pies donde no se utilizó el sistema BARU. Conclusión: Resultados prometedores en cuanto a protección de estructuras cercanas, guía de corte y facilidad para la intervención. Cálculos estadísticos no significativos, la muestra debería ampliarse.
Abstract: Introduction: Hallux valgus is a high frequency disorder, affecting the first ray. Operative correction techniques have grown popularity lately. One of them is the Reverdin-Isham technique (first metatarsal medial incomplete osteotomy). Recently, a protection and osteotomy cutting guide has been developed: the BARU system. Objective: To test the usefulness of the BARU system as a protective factor for soft structures adjacent to the surgical site and guidance for osteotomy. Material and methods: Experimental cadaveric study. Six cadaveric feet (two fresh-frozen and four in formaldehyde solution), unapproached. Feet were numbered and intervened with RI technique, three of them with BARU system and three without it. Afterwards, dissection by two dissectors who did not know whether the BARU system had been used or not, establishing a single-blinded model. 13 structures were evaluated in each foot. Data was recovered into Microsoft Office Excel and processed with SPSS. χ2 test (significative if p value < 0.05) and relative risk were calculated. Results: Approach using BARU system was satisfactory, with usual-size operation-ports. BARU system colocation was simple and radiological control showed adequate spatial location. The device contributed as reference for cutting direction and depth. 65 out of the 78 searched structures were found (83.3%). Six injuries were found among the assessed structures: plantar medial nerve (one injury), plantar medial artery (one injury), flexor brevis muscle (three injuries), abductor muscle (one injury). Five of these injuries occurred in non-utilizing BARU system feet. Conclusion: Promising results in terms of protection of nearby structures, cutting guide, and ease of intervention. Avoids X-rays exposure. Not significant statistical calculations, the sample should be enlarged.
RESUMO
La enfermedad o síndrome de moyamoya es una rara afección que provoca una oclusión de las carótidas intracraneales y determina una red vascular colateral anormal en la base del cráneo y que, por su aspecto arteriográfico, hace ya más de 50 años un grupo de neurocirujanos japoneses denominaron moyamoya, y de la cual persisten muchas interrogantes sin resolver. Se realizó un estudio descriptivo y longitudinal de 19 niños con síndrome o enfermedad de moyamoya. La edad promedio de inicio fue de seis años. Del total de niños incluidos, doce debutaron en forma aguda con infarto cerebral; dos pacientes (con antecedentes de epilepsia y retraso) lo hicieron, uno con infarto y otro con hemorragia cerebral, otros dos con epilepsia y retraso, uno con trastorno del lenguaje, siendo en los dos restantes un hallazgo casual. Entretanto doce pacientes se consideraron idiopáticos (portadores de enfermedad de moyamoya) y siete asociados a enfermedades sistémicas (síndrome de moyamoya). El diagnóstico inicial se confirmó por angiorresonancia en diez casos y por arteriografía convencional en nueve. El seguimiento promedio fue de cinco años, once evidenciaron progresión clínica y ocho estabilidad, con un seguimiento promedio de siete y dos años respectivamente. Todos mostraron progresión angiográfica. En siete niños se realizaron diez cirugías de revascularización sin complicaciones y con buenos resultados clínicos y angiográficos. Dos niños fallecieron (uno por hemorragia cerebral y otro por un infarto expansivo) y catorce presentaron secuelas leves a moderadas. Resulta importante identificar los niños que se pueden beneficiar con la cirugía de revascularización, una de las pocas opciones terapéuticas para evitar la progresión y complicaciones de esta grave enfermedad.
Moyamoya's disease or syndrome is a rare illness wich causes symptoms of cerebral ischemia due to intracranial arteries' stenosis, with secondary abnormal vasculature networks at the base of the brain. Since the first description of moyamoya disease done by a group of Japanese neurosurgeons more than 50 years ago, this rare illness is still considered an intriguing disease. The clinical features, treatment, imaging findings and outcomes of a series of not Asian children with Moyamoya disease are described in this study. A total of 19 six year old patients were analyzed. The initial presentation in 12 patients was infarctions, 2 with epilepsy and mental retardation, another 2 who had personal history of epilepsy and mental retardation developed symptoms of ischemic stroke (one of them), and hemorrhagic stroke the other one; 1experienced language problems, while in the last two the diagnosis was casual. On the other hand, 12 patientes were considered idiopathic cases (moyamoya's disease) and 7 were related to systemic illnes (moyamoya's syndrome). Initial diagnosis was achieved by magnetic resonance angiography in 10 cases, and conventional angiography in 9. All patients were followed up for a mean period of 5 years. While 11 patients experienced clinical worsening of symptoms, 6 asymptomatic. However, all of them showed angiographic progression. Seven patients underwent bypass surgery with no further complications, 2 passed away and 14 remained with moderate handicaps. A number of surgical procedures have been developed for revascularization, improving the outcome of some of these patients by preventing ischemic and hemorrhagic stroke. Due to the fact that moyamoya disease is not a silent disorder and its progress cause complications, surgical revascularization should always be considered in the management of these patients.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Doença de Moyamoya/cirurgia , Doença de Moyamoya/complicações , Doença de Moyamoya/diagnóstico , Revascularização CerebralRESUMO
The hydroalcoholic extract of Equisetum arvense (HAE) tested at the doses of 200 and 400 mg/kg showed a significant activity on the open-field, enhanced the number of falls in the rota-rod reducing the time of permanence in the bar and increased the sleeping time (46% and 74%) in the barbiturate-induced sleeping time. In the pentylenetetrazole-seizure, it increased the first convulsion latency, diminished the severity of convulsions, reduced the percentage of animals which developed convulsion (50% and 25%) and protected animals from death. On the contrary, in the elevated plus maze, the doses 50, 100 and 150 mg/kg did not affect the evaluated parameters. Thus, HAE presented anticonvulsant and sedative effects. Phytochemical analysis detected the presence of tannins, saponins, sterols and flavonoids.
Assuntos
Anticonvulsivantes/farmacologia , Equisetum , Hipnóticos e Sedativos/farmacologia , Aprendizagem em Labirinto/efeitos dos fármacos , Fitoterapia , Extratos Vegetais/farmacologia , Convulsões/prevenção & controle , Sono/efeitos dos fármacos , Animais , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pentilenotetrazol , Extratos Vegetais/administração & dosagem , Extratos Vegetais/uso terapêutico , Caules de Planta , Ratos , Ratos Wistar , Convulsões/induzido quimicamenteRESUMO
Venlafaxine, an atypical antidepressant drug, has been used to treat several neurological disorders, presenting excellent efficacy and tolerability. Clinical seizures after venlafaxine treatment have occasionally been reported when the drug was used at very high doses or in combination with other medications. The aim of the present study was to investigate the convulsant effects of venlafaxine in rats under controlled laboratory conditions. Adult male Wistar rats (8 per group) receiving venlafaxine or saline at the doses of 25-150 mg/kg were subjected 30 min later to injections of pentylenetetrazole at the dose of 60 mg/kg. The animals receiving 75, 100 and 150 mg/kg venlafaxine presented increased severity of convulsion when compared to controls (P = 0.02, P = 0.04, and P = 0.0004, respectively). Indeed, an increased percentage of death was observed in these groups (50, 38, and 88%, respectively) when compared to the percentage of death in the controls (0%). The group receiving 150 mg/kg showed an reduction in death latency (999 +/- 146 s) compared to controls (1800 +/- 0 s; cut-off time). Indeed, in this group, all animals developed seizures prior to pentylenetetrazole administration. Surprisingly, the groups receiving venlafaxine at the doses of 25 and 50 mg/kg showed a tendency towards an increase in the latency to the first convulsion. These findings suggest that venlafaxine at doses of 25 and 50 mg/kg has some tendency to an anticonvulsant effect in the rat, whereas doses of 75, 100 and 150 mg/kg presented clear proconvulsant effects in rats submitted to the pentylenetetrazole injection. These findings are the first report in the literature concerning the role of venlafaxine in seizure genesis in the rat under controlled conditions.
Assuntos
Antidepressivos de Segunda Geração/efeitos adversos , Cicloexanóis/efeitos adversos , Convulsões/induzido quimicamente , Animais , Antidepressivos de Segunda Geração/administração & dosagem , Convulsivantes , Cicloexanóis/administração & dosagem , Interações Medicamentosas , Masculino , Pentilenotetrazol , Ratos , Ratos Wistar , Cloridrato de VenlafaxinaRESUMO
Venlafaxine, an atypical antidepressant drug, has been used to treat several neurological disorders, presenting excellent efficacy and tolerability. Clinical seizures after venlafaxine treatment have occasionally been reported when the drug was used at very high doses or in combination with other medications. The aim of the present study was to investigate the convulsant effects of venlafaxine in rats under controlled laboratory conditions. Adult male Wistar rats (8 per group) receiving venlafaxine or saline at the doses of 25-150 mg/kg were subjected 30 min later to injections of pentylenetetrazole at the dose of 60 mg/kg. The animals receiving 75, 100 and 150 mg/kg venlafaxine presented increased severity of convulsion when compared to controls (P = 0.02, P = 0.04, and P = 0.0004, respectively). Indeed, an increased percentage of death was observed in these groups (50, 38, and 88 percent, respectively) when compared to the percentage of death in the controls (0 percent). The group receiving 150 mg/kg showed an reduction in death latency (999 + or - 146 s) compared to controls (1800 + or - 0 s; cut-off time). Indeed, in this group, all animals developed seizures prior to pentylenetetrazole administration. Surprisingly, the groups receiving venlafaxine at the doses of 25 and 50 mg/kg showed a tendency towards an increase in the latency to the first convulsion. These findings suggest that venlafaxine at doses of 25 and 50 mg/kg has some tendency to an anticonvulsant effect in the rat, whereas doses of 75, 100 and 150 mg/kg presented clear proconvulsant effects in rats submitted to the pentylenetetrazole injection. These findings are the first report in the literature concerning the role of venlafaxine in seizure genesis in the rat under controlled conditions
Assuntos
Animais , Masculino , Ratos , Antidepressivos de Segunda Geração , Convulsões , Antidepressivos de Segunda Geração , Interações Medicamentosas , Pentilenotetrazol , Ratos Wistar , Estatísticas não ParamétricasRESUMO
Se realizó un estudio comparativo doble ciego por un período de un mes, llevando a cabo un grupo de 105 soldados de la escuela de caballería de Usaquén en Santafé de Bogotá (Colombia). La muestra total se dividió en tres grupos aleatoriamente de 35 soldados cada uno de los cuales se le administró un gel a la azar; los geles eran placebo, Antiblac-B y Dentagel. Para escogencia de pacientes se tuvo en cuenta un índice gingival 1.5, y un índice de placa mayor de 25, que no fueran fumadores, ni bebedores crónicos de cafeina, que no presentaran restauraciones clase III, que no tuvieran compromisos sistémicos y que no estuvieran en tratamiento farmacológico. Durante un período de un mes se realizaron controles cada ocho días, y se tuvo en cuenta como parámetros de examen el índice de placa, agusias y pigmentaciones. Los resultados mostraron mayor eficacia para los geles con clorhexidina para el control de placa bacteriana y.
Assuntos
Clorexidina , Placa DentáriaAssuntos
Arenavirus do Novo Mundo , Febre Hemorrágica Americana/tratamento farmacológico , Controle de Infecções/métodos , Infecção Laboratorial/tratamento farmacológico , Ribavirina/uso terapêutico , Brasil , Busca de Comunicante , Febre Hemorrágica Americana/virologia , Humanos , Infecção Laboratorial/virologia , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes , Gestão da Segurança/métodos , Precauções UniversaisRESUMO
A multicentric, comparative, single-blind, randomized, prospective study was designed to evaluate the efficacy and safety of the transference from animal source insulins to rDNA human insulin in Latinamerican insulin-requiring diabetic patients. All the patients were on animal insulin for at least two months before inclusion. The patients were evaluated at the beginning, and at two and six weeks after inclusion. A total 198 patients completed the study and were considered evaluable: 94 were assigned to the animal insulin group, and 104 to the human insulin group. There were no statistically significant baseline differences between groups. The only statistically significant difference, detected at the end of the study, was a reduction in fasting blood glucose level in the human insulin group (animal insulin 212 +/- 95.3 initial vs 193 +/- 78.3 mg/dL final, p = 0.18; human insulin 198 +/- 86.8 vs 169 +/- 71.7, p = 0.025). There were no statistically significant initial-final changes in the rest of the parameters evaluated although a trend of reduction in glycohemoglobin levels was observed in both groups. There were more episodes of mild hipoglycemia in the human insulin group, and only one episode of severe unwarned hypoglycemia in the same group. We conclude that the transference of insulins in Latinamerican diabetic patients is effective and reasonably safe (with a dose adjustment when the change is made).