Aspectos de imagem na tendinite calcária pré-vertebral

A tendinite calcária aguda pré-vertebral é uma condição benigna e rara que apresenta calcificação das fibras do músculo longo do pescoço com reação inflamatória local, sendo esta uma das formas de apresentação menos frequentes da doença por deposição de hidroxiapatita de cálcio. Manifesta-se com dor cervical aguda e/ou odinofagia, podendo ser erroneamente diagnosticada como abscesso retrofaríngeo, espondilodiscite ou alteração decorrente de trauma. Os achados radiológicos na tendinite calcária pré-vertebral são patognomônicos. O conhecimento de tais achados é muito importante, pois o correto diagnóstico possibilita a resolução precoce dos sintomas e evita intervenções desnecessárias em um paciente que apresenta afecção com boa resposta ao tratamento conservador.

Ivory vertebra: imaging findings in different diagnoses

Abstract Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases.

Comparação entre injeção na coluna ("on-column") e headspace dinâmico na determinação de benzeno, tolueno e xilenos (BTX) em amostras de água

The analysis of water samples containing volatile organic compounds has become an important task in analytical chemistry. Gas chromatography has been widely used for the analysis of volatile organic compounds in water. The headspace analysis shows as a principal characteristic the possibility of determination of the volatile components in drinking water. Benzene, Toluene and Xylene (BTX) are important compounds usually present in drinking water, from contamination by petroleum derivatives. Since they are toxic compounds even when present in low concentration levels, their determination is important in order to define the quality of the water. The sampling technique using headspace, coupled with gas chromatography as the separation method, showed to be suitable for BTX analysis in several samples at the mug/L (ppb) level.

A sensitive and robust lc-ms/ms method with monolithic column and electrospray ionization for the quantitation of efavirenz in human plasma: application to a bioequivalence study

An LC-MS/MS method has been developed for the determination of efavirenz (EFZ) in human plasma using hydrochlorothiazide as internal standard (I.S.). An ESI negative mode with multiple reaction-monitoring was used monitoring the transitions m/z 313.88→69.24 (EFZ) and 296.02→204.76 (I.S.). Samples were extracted using liquid-liquid extraction. The total run time was 2.0 min. The separation was achieved with HPLC-RP using a monolithic column. The assay was linear in the concentration range of 100 - 5000 ng mL-1. The mean recovery was 83%. Intra- and inter-day precision were < 9.5% and < 8.9%, respectively and accuracy was in the range ± 8.33%. The method was successfully applied to a bioequivalence study.

Evaluation of pesticide adsorption in gas chromatographic injector and column

Components in complex matrices can cause variations in chromatographic response during analysis of pesticides by gas chromatography. These variations are related to the competition between analytes and matrix components for adsorption sites in the chromatographic system. The capacity of the pesticides chlorpyrifos and deltamethrin to be adsorbed in the injector and chromatographic column was evaluated by constructing three isotherms and changing the column heating rate to 10 and 30 ºC min-1. By using ANCOVA to compare the slope of calibration graphs, results showed that the higher the injector temperature (310 ºC) the lower the pesticide adsorption. Also, deltamethrin influenced the adsorption of chlorpyrifos on the column chromatographic.

Multi-component quantitation of loratadine, pseudoephedrine and paracetamol in plasma and pharmaceutical formulations with liquid chromatography-tandem mass spectrometry utilizing a monolithic column

The purpose of this study was to develop a rapid, simple and sensitive quantitation method for pseudoephedrine (PSE), paracetamol (PAR) and loratadine (LOR) in plasma and pharmaceuticals using liquid chromatography-tandem mass spectrometry with a monolithic column. Separation was achieved using a gradient composition of methanol-0.1% formic acid at a flow rate of 1.0 mL min-1. Mass spectral transitions were recorded in SRM mode. System validation was evaluated for precision, specificity and linearity. Limit of detection for pseudoephedrine, paracetamol, and loratadine were determined to be 3.14, 1.86 and 1.44 ng mL-1, respectively, allowing easy determination in plasma with % recovery of 93.12 to 101.56%.

Preparative separation of polyphenols from artichoke by polyamide column chromatography and high-speed counter-current chromatography

An efficient method for the rapid separation and purification of polyphenols from artichoke by polyamide column chromatography in combination with high-speed counter-current chromatography (HSCCC) was successfully built. The crude ethanol extracts from dry artichoke were first pre-separated by polyamide column chromatography and divided in two parts as sample 1 and sample 2. Then, the samples were further separated by HSCCC and yielded 7.8 mg of chlorogenic acid (compound I), 24.5 mg of luteolin-7-O-β-D-rutinoside (compound II), 18.4 mg of luteolin-7-O-β-D-glucoside (compound III), and 33.4 mg of cynarin (compound IV) with purity levels of 92.0%, 98.2%, 98.5%, and 98.0%, respectively, as determined by high-performance liquid chromatography (HPLC) method. The chemical structures of these compounds were identified by electrospray ionization-mass spectrometry (ESI-MS) and nuclear magnetic resonance (NMR).

Separation and purification of three stilbenes from the radix of Polygonum cillinerve (Nakai) Ohwl by macroporous resin column chromatography combined with high-speed counter-current chromatography

An effective method for the rapid separation and purification of three stilbenes from the radix of Polygonum cillinerve (Nakai) Ohwl by macroporous resin column chromatography combined with high-speed counter-current chromatography (HSCCC) was successfully established. In the present study, a two-phase solvent system composed of chloroform-n-butanol-methanol-water (4:1:4:2, v/v/v/v) was used for HSCCC separation. A one-step separation in 4 h from 150 mg of crude extract produced 26.3 mg of trans-resveratrol-3-O-glucoside, 42.0 mg of pieceid-2"-O-gallate, and 17.9 mg of trans-resveratrol with purities of 99.1%, 97.8%, and 99.4%, respectively, as determined by high-performance liquid chromatography (HPLC). The chemical structures of these compounds were identified by nuclear magnetic resonance (NMR) spectroscopy.

Epidemiologia do traumatismo da coluna vertebral

OBJETIVO: Avaliação epidemiológica retrospectiva de 100 casos de traumatismo da coluna vertebral. MÉTODO: Estudo transversal de dados colhidos por levantamento de prontuário, segundo protocolo de decodificação local. RESULTADOS: Predomínio etário de 20 a 40 anos em 64% dos casos; sexo masculino em 86%; segmento toracolombar mais comumente atingido 64% e 36% para o segmento cervical; principais causas foram às quedas em 40%, seguidas de acidentes automobilísticos em 25% e quedas da laje 23%. A prevalência dos ferimentos por arma de fogo foi de 7%, mergulho em águas rasas 3% e agressões 2%. Houve análise complementar com cruzamentos entre idade, sexo, causa e segmento da coluna vertebral acometido, observando que o segmento cervical teve grande predomínio nas mulheres em relação aos homens em 85,7% X 14,3%. CONCLUSÃO: O traumatismo da coluna vertebral ocorreu predominantemente em homens entre 20 e 40 anos e o segmento cervical foi o mais acometido nas mulheres em relação aos homens na proporção de 6:1.

Manejo das neoplasias metastáticas da coluna vertebral - uma atualização

O aumento da sobrevivência do paciente oncológico decorrente da melhoria e do avanço das modalidades terapêuticas promove progressivo aumento da prevalência das neoplasias metastáticas da coluna vertebral, tornando o seu conhecimento condição sine qua non para os profissionais da área de saúde. As metástases na coluna vertebral são usualmente procedentes de neoplasia maligna da mama, pulmão e próstata, o gênero masculino é o mais acometido e a dor é o sintoma inicial em mais de 90% dos pacientes. Estima-se que 30-90% dos pacientes com câncer em estágio terminal apresentem metástase em algum segmento da coluna vertebral. A alta prevalência das neoplasias malignas e a significativa experiência dos autores no tratamento das metástases na coluna vertebral motivaram uma atualização do tema. Acreditamos que a padronização da conduta e o conhecimento pormenorizado dos principais aspectos da doença, podem promover a melhor opção terapêutica. O presente estudo visa à revisão e descrição didática dos principais aspectos relacionados à fisiopatologia, diagnóstico e tratamento desta entidade.

Safety and tolerability of controlled-release oxycodone on postoperative pain in patients submitted to the oncologic head and neck surgery

Objective: To evaluate the safety and tolerability of controlled-release oxycodone in the treatment of postoperative pain of head and neck oncologic resections.Methods: We conducted a prospective, observational and open study, with 83 patients with moderate to severe pain after head and neck oncological operations. All patients received general anesthesia with propofol, fentanyl and sevoflurane. Postoperatively, should they have moderate or severe pain, we began controlled-release oxycodone 20 mg 12/12 b.i.d on the first day and 10 mg b.i.d. on the second. We assessed the frequency and intensity of adverse effects, the intensity of postoperative pain by a verbal numeric scale and the use of rescue analgesia from 12 hours after administration of the drug and between 7 and 13 days after the last oxycodone dose.Results: The most common adverse events were nausea, vomiting, dizziness, pruritus, insomnia, constipation and urinary retention, most mild. No serious adverse events occurred. In less than 12 hours after the use of oxycodone, there was a significant decrease in the intensity of postoperative pain, which remained until the end of the study. The rescue medication was requested at a higher frequency when the opioid dose was reduced, or after its suspension.Conclusion: Controlled release oxycodone showed to be safe and well tolerated and caused a significant decrease in post-operative pain.

Relação entre qualidade de vida e fratura vertebral em mulheres idosas residentes no Sul do Brasil

OBJETIVO: Verificar a relação entre qualidade de vida e fratura vertebral em mulheres com mais de 60 anos em uma cidade do Sul do Brasil. MÉTODOS: Realizado estudo caso-controle com aplicação do questionário WHOQOL-bref em 100 mulheres residentes na cidade Chapecó (SC), com idade superior a 60 anos, na pós-menopausa de raça branca ou caucasoide, sem prejuízo cognitivo importante ou história pessoal doenças que sabidamente afetem o metabolismo ósseo ou neoplasias malignas. A população foi dividida em dois grupos dependendo da existência ou não de fraturas vertebrais na radiografia de coluna. Foram analisadas variáveis relacionadas à historia médica atual e pregressa, hábitos de vida e história familiar de fraturas, e os domínios e facetas que compõe o WHOQOL-bref. RESULTADOS: Observou-se que as mulheres com fratura tinham maior média de idade do que as sem fraturas (p<0,05). Também pareceu haver tendência a pertencerem a classe social mais alta, terem mais anos de estudo, maior renda familiar, e maior frequência de utilização de bebida alcoólica (p>0,05). Na avaliação dos domínios que compõem o WHOQOL-bref, a maior média deste grupo foi no psicológico (..=63,6±13,0), e a menor no meio ambiente (..=58,8±9,3). No grupo sem fratura, a maior média também ocorreu no domínio psicológico (..=67,2±9,3), já a menor ocorreu no das relações sociais (..=57,5±7,7). A análise estatística não mostrou correlação significativa entre as médias das facetas que compõem os domínios entre os grupos com e sem fraturas. CONCLUSÃO: Este estudo sugere não haver prejuízo na qualidade de vida de idosas com fratura vertebral, mas sua relação com o tempo de ocorrência e gravidade das fraturas deve ser melhor avaliada. Ambos grupos tiveram escores mais elevados no domínio psicológico, mostrando que as entrevistadas se apóiam em crenças pessoais, espiritualidade e religião, aceitam sua aparência física mantendo a autoestima e a capacidade de pensar, aprender e concentrar-se, independentemente da existência do agravo. Não houve diferença estatisticamente significativa entre os grupos, e nem entre os domínios no mesmo grupo.

Irritable bowel syndrome in women with chronic pelvic pain in a Northeast Brazilian city

PURPOSES: To determine the prevalence of irritable bowel syndrome (IBS) in women with chronic pelvic pain (CPP) and its associated features; to determine whether IBS and CPP constitute the same syndrome. METHODS: Cross-sectional population survey with systematic sequential sampling according to census districts in which 1470 women were interviewed with respect to the sample calculation. The participants resided in their own homes, were at least 14 years of age, experienced menarche and presented CPP according to the American College of Obstetrics and Gynaecology. The dependent variable was IBS based on Rome III criteria in women with CPP, and the following independent variables were possibly associated with IBS: age, schooling, duration of pain, sedentary lifestyle, migraine, depression, insomnia, back pain, dysmenorrhea, dyspareunia, depression, history of violence, and intestinal symptoms. The sample was subdivided into groups with and without IBS. After the descriptive analysis of the variables was performed, the respective frequencies were evaluated using GraphPad Prism 5 software. To evaluate the association between the dependent variable and the independent variables, the χ² test was used with a significance level of 5%. RESULTS: The prevalence of IBS in women with CPP was 19,5%. Pain duration (p=0.03), back pain (p=0.002), history of physical or sexual abuse (p=0.002), and intestinal complaints were more prevalent in the group with IBS and CPP. There was no difference between the groups regarding other criteria. CONCLUSION: The data confirmed the literature, identified several aspects that were shared between the pathologies and supported the hypothesis that both pathologies can constitute the same syndrome.

Efficacy of paraspinal anesthetic block in patients with chronic pelvic pain refractory to drug therapy: a randomized clinical trial

PURPOSE: To determine whether paraspinal block reduces pain scores compared to placebo in women with chronic pelvic pain refractory to drug therapy.METHODS: Subjects with chronic pelvic pain due to benign conditions and refractory to drug therapy were invited to participate in a randomized, double blind, superiority trial at a tertiary reference center. Subjects were randomly allocated to receive paraspinal anesthetic block with 1% lidocaine without epinephrine or placebo (control). Lidocaine was injected along the spinal process of the painful segment in the supra- and interspinal ligaments using a 25G X 2" needle. Placebo consisted of introduction of the needle in the same segment without injecting any substance. The main outcome measured was the pain score based on a visual analog scale at T0 (baseline), T1 (within 15 min after the procedure) and T2 (one week after the procedure). Data were statistically analyzed by ANOVA and the 95% confidence interval (95%CI).RESULTS: Mean age was similar for both groups, i.e., 51.2 (paraspinal anesthetic block) and 51.8 years (control). A blind examiner measured the degree of pain according to the visual analog scale from 0 (no pain) to 10 (worst pain imaginable). Based on the visual analog scale, the mean pain scores of the paraspinal anesthetic block group at T0, T1 and T2 were 5.50 (SD=2.92; 95%CI 3.84-7.15), 2.72 (SD=2.10; 95%CI 1.53-3.90), and 4.36 (SD=2.37; 95%CI 1.89-6.82), respectively. The difference between T0 and T1 was statistically significant, with p=0.03.CONCLUSIONS:Paraspinal anesthetic block had a small effect on visual analog scale pain score immediately after the injections, but no sustained benefit after one week. Further studies are needed to determine the efficacy of paraspinal anesthetic block with different lidocaine doses for the treatment of visceral pain of other causes.