HIGH VOLTAGE PULSED CURRENT STIMULATION OF THE SCIATIC NERVE IN RATS: ANALYSIS BY THE SFI

Objective: To analyze the efficiency of high voltage pulsed current (HVPC) with early application in three different sites, in the regeneration of the sciatic nerve in rats submitted to crush injury, the sciatic functional index (SFI) was used to assess the functional recovery. Methods: After crushing of the nerve, 57 animals were submitted to cathodal HVPC at frequency of 50Hz and voltage of 100V, 20 minutes per day, 5 days per week. The rats were divided into five groups: control group; ganglion group; ganglion + muscle group; muscle group; and sham group. The SFI was determined weekly for seven weeks, from the preoperative period to the 6th postoperative week. Results: Compared with the control group, the results showed a significantly better performance of group 2 for the first 3 weeks; group 3 showed significantly better performance in the third week; and group 4 showed a significantly negative performance during the 481 and 6th weeks. Conclusion: Early application of HVPC had a positive effect in the treatment of the spinal cord region and the sciatic nerve root ganglion with a dispersive electrode on the contralateral lumbar region or on the gastrocnemius. However, HVPC had a negative effect in the treatment with an active electrode on the gastrocnemius and a dispersive electrode on the contralateral thigh. Level of evidence II, Prospective comparative study.

Antiresorptive drugs (bisphosphonates), atypical fractures and rebound effect: new evidence of similitude

Background: Homeopathy is based on treatment by similitude ('like cures like') administering to sick individuals substances that cause similar symptoms in healthy individuals, employing the secondary and paradoxical action of the organism as therapeutic response. This vital or homeostatic reaction of the organism can be scientifically explained by the rebound effect of drugs, resulting in worsening of symptoms after suspension of treatment. Bisphosphonates (BPs) reduce 'typical' fractures in patients with osteoporosis, but recent studies report 'atypical' fractures of the femur after stopping the BPs, a rebound effect may be the causal mechanism. Method: Review of the literature concerning the relationship between atypical femoral fractures and antiresorptive drugs (bisphosphonates), identifying the pathogenesis of this adverse event. Results: Several studies have described multiple cases of 'atypical' low-impact subtrochanteric stress fractures or complete fractures of the femur. These fractures are often bilateral, preceded by pain in the affected thigh, may have a typical X-ray appearance, and may delayed healing. Rebound of osteoclastic activity after suspension of antiresorptive drugs is a plausible mechanism to explain this phenomenon. Conclusion: As for other classes of drugs, the rebound effect of antiresorptive drugs supports Hahnemann's similitude principle (primary action of the drugs followed by secondary and opposite action of the organism), and clarifies this 'unresolved' issue. Unfortunately, the rebound effect is little discussed among health professionals, depriving them of important knowledge ensure safe management of drugs. Homeopathy (2012) 101, 231-242.

Muscle Atrophy and Functional Deficits of Knee Extensors and Flexors in People With Chronic Stroke

Background. Further clarification is needed with regard to the degree of atrophy in individual muscle groups and its possible relationship to joint torque deficit poststroke. Objective. The purpose of this study was to investigate quadriceps and hamstring muscle volume and strength deficits of the knee extensors and flexors in people with chronic hemiparesis compared with a control group. Design. This was a cross-sectional study. Methods. Thirteen individuals with hemiparesis due to chronic stroke (hemiparetic group) and 13 individuals who were healthy (control group) participated in this study. Motor function, quadriceps and hamstring muscle volume, and maximal concentric and eccentric contractions of the knee extensors and flexors were assessed. Results. Only the quadriceps muscle of the paretic limb showed reduced muscle volume (24%) compared with the contralateral (nonparetic) limb. There were no differences in muscle volume between the hemiparetic and control groups. The peak torque of the paretic-limb knee extensors and flexors was reduced in both contraction modes and velocities compared with the nonparetic limb (36%-67%) and with the control group (49%-75%). The nonparetic limb also showed decreased extensor and flexor peak torque compared with the control group (17%-23%). Power showed similar deficits in strength (12%-78%). There were significant correlations between motor function and strength deficits (.54-.67). Limitations. Magnetic resonance imaging coil length did not allow measurement of the proximal region of the thigh. Conclusions. There were different responses between quadriceps and hamstring muscle volumes in the paretic limb that had quadriceps muscle atrophy only. However, both paretic and nonparetic limbs showed knee extensor and flexor torque and power reduction.

Effect of natural antioxidant combinations on lipid oxidation in cooked chicken meat during refrigerated storage

The effect of combinations of sage, oregano and honey on lipid oxidation in cooked chicken meat during refrigeration at 4 degrees C for 96 h was determined. Chicken samples (thigh and breast) were then separated into five groups; control; butylated hydroxytoluene; oregano + sage; oregano + sage + 5%honey and oregano + sage + 10%honey. Quantitative measurements of thiobarbituric acid reactive substances, conjugated dienes, hexanal, fatty acids, cholesterol and cholesterol oxides were used as indicators of lipid oxidation. Acceptability and preference were also evaluated. The effectiveness of the natural antioxidants for reducing the velocity of lipid oxidation in cooked chicken thigh and breast was demonstrated after 48 and 96 h of refrigeration at 4 degrees C. The treatments that presented the lowest hexanal values after 96 h of refrigeration were oregano + sage + 5%honey and oregano + sage + 10%honey. Only traces of free cholesterol oxides were found (25-OH, 7-k, 7 alpha-OH and 7 beta-OH). The natural antioxidants protected cooked chicken meat from oxidation processes and resulted in great acceptability. (C) 2012 Elsevier Ltd. All rights reserved.

Biometry and fetal weight estimation by two-dimensional and three-dimensional ultrasonography: an intraobserver and interobserver reliability and agreement study

Objective To evaluate and compare the intraobserver and interobserver reliability and agreement for the biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) obtained by two-dimensional ultrasound (2D-US) and three-dimensional ultrasound (3D-US). Methods Singleton pregnant women between 24 and 40 weeks were invited to participate in this study. They were examined using 2D-US in a blinded manner, twice by one observer, intercalated by a scan by a second observer, to determine BPD, AC and FL. In each of the three examinations, three 3D-US datasets (head, abdomen and thigh) were acquired for measurements of the same parameters. We determined EFW using Hadlock's formula. Systematic errors between 3D-US and 2D-US were examined using the paired t-test. Reliability and agreement were assessed by intraclass correlation coefficients (ICCs), limits of agreement (LoA), SD of differences and proportion of differences below arbitrary points. Results We evaluated 102 singleton pregnancies. No significant systematic error between 2D-US and 3D-US was observed. The ICC values were higher for 3D-US in both intra- and interobserver evaluations; however, only for FL was there no overlap in the 95% CI. The LoA values were wider for 2D-US, suggesting that random errors were smaller when using 3D-US. Additionally, we observed that the SD values determined from 3D-US differences were smaller than those obtained for 2D-US. Higher proportions of differences were below the arbitrarily defined cut-off points when using 3D-US. Conclusion 3D-US improved the reliability and agreement of fetal measurements and EFW compared with 2D-US.

Seroprevalence and isolation of Toxoplasma gondii from free-range chickens from Espirito Santo state, southeastern Brazil

Prevalence of Toxoplasma gondii infection in 510 free-range (FR) chickens (380 from 33 small farms, and 130 from a slaughter house for FR chickens) from Espirito Santo state, southeastern Brazil, was investigated. Antibodies to T. gondii were sought using commercial indirect haemagglutination (IHAT, Imuno-HAI Toxo (R), Wama Diagnostica, Sao Paulo, Brazil, cut-off 1:16) and the modified agglutination test (MAT, cut-off 1:25) tests. Attempts were made to isolate viable T. gondii from seropositive chickens by bioassay in mice. Pooled samples of brain, heart and quadriceps muscle of one thigh (total 40 g) from 64 chickens with IHAT titers of >= 1:16 were minced, digested in pepsin and bioassayed in mice. Antibodies to T. gondii were found in 40.4% (206/510) FR chickens by IHAT (titer >= 1:16) and 38.8% (198/510) by MAT (titer >= 1:25); concordance between IHAT and MAT was 81.6% (kappa index = 0.614). Viable T. gondii was isolated (designated TgCkBr234-281) from 48 of 64(75%) seropositive (IHAT titers >= 1:32) FR chickens. Most isolates of T. gondii were virulent for mice; 100% of mice inoculated with 44 of 48 isolates died of toxoplasmosis within 30 days post inoculation (p.i). An epidemiological investigation revealed that people living in rural areas have little knowledge about the parasite and about the risk of acquiring it from raw meat. Results indicated that the locally available IHAT was useful for screening of chicken sera for T. gondii antibodies. (C) 2012 Elsevier B.V. All rights reserved.

Análise eletromiográfica dos músculos da coxa no exercício agachamento afundo até a exaustão

O agachamento afundo possui um posicionamento dos membros inferiores diferencial em relação ao agachamento padrão, necessitando de maiores esclarecimentos acerca das participações dos músculos envolvidos. O objetivo foi analisar a atividade eletromiográfica dos músculos vastus lateralis (VL), vastus medialis (VM), bíceps femoris (BF) e semitendinosus (ST) durante a execução do agachamento afundo até à exaustão com o membro inferior posicionado frontalmente e posteriormente. Participaram do estudo nove mulheres ativas com média (DP) de idade de 22 (3,4) anos e massa corporal 60,3 (4,1) kg. O agachamento afundo foi dividido em duas etapas, diferindo apenas o posicionamento do membro inferior dominante (randomizado). Os sinais eletromiográficos foram captados utilizando um eletromiógrafo e analisados os valores "root mean square" (RMS) na fase concêntrica. Os resultados indicaram um aumento significativo do RMS em função do tempo para o membro inferior posicionado frontalmente e posteriormente (p< 0,001). No membro posicionado frontalmente, o aumento do RMS correspondeu a 50% para o VL, 54% para o VM e 48% para o BF. O membro posicionado posteriormente apresentou um aumento de 75% para o VL, 113% para o VM, 62% para o BF e 48% para o ST. O RMS também foi significativamente maior no músculo VM em relação ao ST no membro inferior posicionado anteriormente (p = 0,03) e em relação ao ST e BF no membro inferior posicionado posteriormente (p = 0,02). Não ocorreu interação significativa entre o efeito do tempo e músculo na atividade eletromiográfica. O RMS normalizado não apresentou diferenças estatisticamente significativas no que se refere ao posicionamento do membro inferior dominante. A atividade muscular foi semelhante em ambos os posicionamentos do membro inferior, apresentando maior aumento de ativação dos músculos VL e VM em relação ao BF e ST.

Tratamento das dismorfias coxofemorais em pacientes ex-obesos

INTRODUÇÃO: Os pacientes que apresentam perda poderal maciça evoluem com sobras dermogordurosas em várias áreas corporais, incluindo os membros inferiores. Diante da heterogeneidade de localização, forma e conteúdo das dismorfias coxofemorais, este trabalho oferece um roteiro de planejamento e sistematização para tratamento de cada uma das deformidades. MÉTODO: Foram avaliadas 28 pacientes do sexo feminino que realizaram coxoplastias e que apresentavam basicamente 3 tipos de deformidade, que poderiam envolver apenas o terço superior, os terços superior e médio ou toda a face medial das coxas. Para cada tipo de deformidade foi aplicada técnica específica; além disso, quando necessário, foi associada suspensão da face lateral das coxas e lipoaspiração. A satisfação das pacientes com os resultados cirúrgicos foi avaliada por meio da aplicação de questionários e notas atribuídas a cada resposta. Foram enumerados intercorrências, complicações e tratamento aplicado. RESULTADOS: Os itens mobilidade, higiene, desempenho sexual, vestimentas e cicatrizes foram avaliados como ótimo (80,5%), bom (14,5%) e regular (5%). CONCLUSÕES: Considerando-se a grande heterogeneidade de dismorfias das coxas em pacientes ex-obesos, um roteiro de tratamento relacionando a deformidade ao tratamento deve ser incorporado ao arsenal cirúrgico.

Biphasic positive airway pressure minimizes biological impact on lung tissue in mild acute lung injury independent of etiology

Abstract Introduction Biphasic positive airway pressure (BIVENT) is a partial support mode that employs pressure-controlled, time-cycled ventilation set at two levels of continuous positive airway pressure with unrestricted spontaneous breathing. BIVENT can modulate inspiratory effort by modifying the frequency of controlled breaths. Nevertheless, the optimal amount of inspiratory effort to improve respiratory function while minimizing ventilator-associated lung injury during partial ventilatory assistance has not been determined. Furthermore, it is unclear whether the effects of partial ventilatory support depend on acute lung injury (ALI) etiology. This study aimed to investigate the impact of spontaneous and time-cycled control breaths during BIVENT on the lung and diaphragm in experimental pulmonary (p) and extrapulmonary (exp) ALI. Methods This was a prospective, randomized, controlled experimental study of 60 adult male Wistar rats. Mild ALI was induced by Escherichia coli lipopolysaccharide either intratracheally (ALIp) or intraperitoneally (ALIexp). After 24 hours, animals were anesthetized and further randomized as follows: (1) pressure-controlled ventilation (PCV) with tidal volume (Vt) = 6 ml/kg, respiratory rate = 100 breaths/min, PEEP = 5 cmH2O, and inspiratory-to-expiratory ratio (I:E) = 1:2; or (2) BIVENT with three spontaneous and time-cycled control breath modes (100, 75, and 50 breaths/min). BIVENT was set with two levels of CPAP (Phigh = 10 cmH2O and Plow = 5 cmH2O). Inspiratory time was kept constant (Thigh = 0.3 s). Results BIVENT was associated with reduced markers of inflammation, apoptosis, fibrogenesis, and epithelial and endothelial cell damage in lung tissue in both ALI models when compared to PCV. The inspiratory effort during spontaneous breaths increased during BIVENT-50 in both ALI models. In ALIp, alveolar collapse was higher in BIVENT-100 than PCV, but decreased during BIVENT-50, and diaphragmatic injury was lower during BIVENT-50 compared to PCV and BIVENT-100. In ALIexp, alveolar collapse during BIVENT-100 and BIVENT-75 was comparable to PCV, while decreasing with BIVENT-50, and diaphragmatic injury increased during BIVENT-50. Conclusions In mild ALI, BIVENT had a lower biological impact on lung tissue compared to PCV. In contrast, the response of atelectasis and diaphragmatic injury to BIVENT differed according to the rate of spontaneous/controlled breaths and ALI etiology.