Intravenous regional block is similar to sympathetic ganglion block for pain management in patients with complex regional pain syndrome type I

Sympathetic ganglion block (SGB) or intravenous regional block (IVRB) has been recommended for pain management in patients with complex regional pain syndrome type I (CRPS-I). Forty-five patients were initially selected but only 43 were accepted for the study. The present study evaluated the efficacy of IVRB produced by combining 70 mg lidocaine with 30 µg clonidine (14 patients, 1 male/13 females, age range: 27-50 years) versus SGB produced by the injection of 70 mg lidocaine alone (14 patients, 1 male/13 females, age range: 27-54 years) or combined with 30 µg clonidine (15 patients, 1 male/14 females, age range: 25-50 years) into the stellate ganglion for pain management in patients with upper extremity CRPS-I. Each procedure was repeated five times at 7-day intervals, and pain intensity and duration were measured using a visual analog scale immediately before each procedure. A progressive and significant reduction in pain scores and a significant increase in the duration of analgesia were observed in all groups following the first three blocks, but no further improvement was obtained following the last two blocks. Drowsiness, the most frequent side effect, and dry mouth occurred only in patients submitted to SGB with lidocaine combined with clonidine. The three methods were similar regarding changes in pain intensity and duration of analgesia. However, IVRB seems to be preferable to SGB due to its easier execution and lower risk of undesirable effects.

Influence of cueing on the preparation and execution of untrained and trained complex motor responses

This study investigated the influence of cueing on the performance of untrained and trained complex motor responses. Healthy adults responded to a visual target by performing four sequential movements (complex response) or a single movement (simple response) of their middle finger. A visual cue preceded the target by an interval of 300, 1000, or 2000 ms. In Experiment 1, the complex and simple responses were not previously trained. During the testing session, the complex response pattern varied on a trial-by-trial basis following the indication provided by the visual cue. In Experiment 2, the complex response and the simple response were extensively trained beforehand. During the testing session, the trained complex response pattern was performed in all trials. The latency of the untrained and trained complex responses decreased from the short to the medium and long cue-target intervals. The latency of the complex response was longer than that of the simple response, except in the case of the trained responses and the long cue-target interval. These results suggest that the preparation of untrained complex responses cannot be completed in advance, this being possible, however, for trained complex responses when enough time is available. The duration of the 1st submovement, 1st pause and 2nd submovement of the untrained and the trained complex responses increased from the short to the long cue-target interval, suggesting that there is an increase of online programming of the response possibly related to the degree of certainty about the moment of target appearance.

Emergence of clonal complex 5 (CC5) methicillin-resistant Staphylococcus aureus (MRSA) isolates susceptible to trimethoprim-sulfamethoxazole in a Brazilian hospital

In this study, genotyping techniques including staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and restriction-modification tests were used to compare the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered at two times within a 10-year interval (1998 and 2008) from a tertiary Brazilian hospital. In addition, the antimicrobial susceptibility profiles were analyzed. All 48 MRSA isolates from 1998 and 85.7% from 2008 (48/56 isolates) displayed multidrug-resistance phenotypes and SCCmec III. All but one of the 13 representative SCCmec III isolates belonged to CC8 and had PFGE patterns similar to that of the BMB9393 strain (Brazilian epidemic clone of MRSA; BEC). In 2008, we found an increased susceptibility to rifampicin and chloramphenicol among the SCCmec III isolates. In addition, we detected the entrance of diverse international MRSA lineages susceptible to trimethoprim-sulfamethoxazole (SXT), almost all belonging to CC5. These non-SCCmec III isolates were related to the USA 300 (ST8-SCCmec IV; PFGE-type B), USA 800 (ST5-SCCmec IV; subtype D1), USA 100 (ST5-SCCmec II; subtype D2), and EMRSA-3/Cordobes (ST5-SCCmec I, type C) clones. To the best of our knowledge, this is the first report of the emergence of isolates genetically related to the EMRSA-3/Cordobes clone in southeast Brazil. In this regard, these isolates were the most common non-SCCmec III MRSA in our institution, accounting for 8.9% of all isolates recovered in 2008. Thus, despite the supremacy of BEC isolates in our country, significant changes may occur in local MRSA epidemiology, with possible consequences for the rationality of MRSA empiric therapy.

Effect of selective β-adrenoceptor blockade and surgical resection of the celiac-superior mesenteric ganglion complex on delayed liquid gastric emptying induced by dipyrone, 4-aminoantipyrine, and antipyrine in rats

There is evidence for participation of peripheral β-adrenoceptors in delayed liquid gastric emptying (GE) induced in rats by dipyrone (Dp), 4-aminoantipyrine (AA), and antipyrine (At). The present study aimed to determine whether β-adrenoceptors are involved in delayed GE induced by phenylpyrazole derivatives and the role of the prevertebral sympathetic nervous system in this condition. Male Wistar rats weighing 220-280 g were used in the study. In the first experiment rats were intravenously pretreated with vehicle (V), atenolol 30 mg/kg (ATE, β1-adrenergic antagonist), or butoxamine 25 mg/kg (BUT, β2-adrenergic antagonist). In the second experiment, rats were pretreated with V or SR59230A 2 mg/kg (SRA, β3-adrenergic antagonist). In the third experiment, rats were subjected to surgical resection of the celiac-superior mesenteric ganglion complex or to sham surgery. The groups were intravenously treated with saline (S), 240 µmol/kg Dp, AA, or At, 15 min after pretreatment with the antagonists or V and nine days after surgery. GE was determined 10 min later by measuring the percentage of gastric retention (%GR) of saline labeled with phenol red 10 min after gavage. The %GR (means±SE, n=6) values indicated that BUT abolished the effect of Dp (BUT+Dp vs V+Dp: 35.0%±5.1% vs 56.4%±2.7%) and At (BUT+At vs V+At: 33.5%±4.7% vs 52.9%±2.6%) on GE, and significantly reduced (P<0.05) the effect of AA (BUT+AA vs V+AA: 48.0%±5.0% vs 65.2%±3.8%). ATE, SRA, and sympathectomy did not modify the effects of treatments. These results suggest that β2-adrenoceptor activation occurred in delayed liquid gastric emptying induced by the phenylpyrazole derivatives dipyrone, 4-aminoantipyrine, and antipyrine. Additionally, the released neurotransmitter did not originate in the celiac-superior mesenteric ganglion complex.

Histidine-tryptophan-ketoglutarate solution decreases mortality and morbidity in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease: an 11-year experience from a single institution

Cardioplegic reperfusion during a long term ischemic period interrupts cardiac surgery and also increases cellular edema due to repeated solution administration. We reviewed the clinical experiences on myocardial protection of a single perfusion with histidine-tryptophan-ketoglutarate (HTK) for high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease. This retrospective study included 101 high-risk patients undergoing arterial switch operation between March 2001 and July 2012. We divided the cohort into two groups: HTK group, myocardial protection was carried out with one single perfusion with HTK solution; and St group, myocardial protection with conventional St. Thomas' crystalloid cardioplegic solution. The duration of cardiopulmonary bypass did not differ between the two groups. The mortality, morbidity, ICU stay, post-operative hospitalization time, and number of transfusions in HTK group were lower than those in St group (P<0.05). Univariate and multivariate analysis showed that HTK is a statistically significant independent predictor of decreased early mortality and morbidity (P<0.05). In conclusion, HTK solution seems to be an effective and safe alternative to St. Thomas' solution for cardioplegic reperfusion in high-risk patients with complex congenital heart disease.

Microparticles obtained by complex coacervation: influence of the type of reticulation and the drying process on the release of the core material

Microparticles obtained by complex coacervation were crosslinked with glutaraldehyde or with transglutaminase and dried using freeze drying or spray drying. Moist samples presented Encapsulation Efficiency (%EE) higher than 96%. The mean diameters ranged from 43.7 ± 3.4 to 96.4 ± 10.3 µm for moist samples, from 38.1 ± 5.36 to 65.2 ± 16.1 µm for dried samples, and from 62.5 ± 7.5 to 106.9 ± 26.1 µm for rehydrated microparticles. The integrity of the particles without crosslinking was maintained when freeze drying was used. After spray drying, only crosslinked samples were able to maintain the wall integrity. Microparticles had a round shape and in the case of dried samples rugged walls apparently without cracks were observed. Core distribution inside the particles was multinuclear and homogeneous and core release was evaluated using anhydrous ethanol. Moist particles crosslinked with glutaraldehyde at the concentration of 1.0 mM.g-1 protein (ptn), were more efficient with respect to the core retention compared to 0.1 mM.g-1 ptn or those crosslinked with transglutaminase (10 U.g-1 ptn). The drying processes had a strong influence on the core release profile reducing the amount released to all dry samples

Action of gibberellic acid (GA3) on dormancy and activity of alpha-amylase in rice seeds

To evaluate the effectiveness of gibberellic acid (GA3) in breaking rice seed dormancy and the use of alpha-amylase enzyme activity as an indicator of the dormancy level, seed from the intensively dormant irrigated cultivar Urucuia were used. The seeds were submitted to a pre-drying process in a forced air circulation chamber under 40ºC during 7 days and submersed in 30 mL of GA3 solution under 0, 10, 30 and 60 mg/L H2O concentrations, during 2, 24 and 36 hours. After the treatments, the alpha-amylase activity was determined by using the polyacrilamide electrophoresis and spectrophotometry. At the same time, the germination test was made. The results indicated a gain in germination and in alpha-amylase activity in higher concentrations and soaking time of seeds in GA3. These observations support the conclusion that soaking seed in 60 mg GA3/L during 36 hours can be used as a quick and efficient treatment in breaking rice seed dormancy and is equivalent to the forced air circulation chamber at 40ºC during 7 days. The alpha-amylase enzyme activity proved to be as an efficient marker of the seeds dormancy level.

Methods of overcoming dormancy in Schizolobium amazonicum Huber ex Ducke (Leguminosae - Caesalpinioideae) seeds

Seed dormancy is a frequent phenomenon in tropical species, causing slow and non-uniform germination. To overcome this, treatments such as scarification on abrasive surface and hot water are efficient. The objective of this study was to quantify seed germination with no treatment (Experiment 1) and identify an efficient method of breaking dormancy in Schizolobium amazonicum Huber ex Ducke seeds (Experiment 2). The effects of manual scarification on electric emery, water at 80ºC and 100ºC and manual scarification on wood sandpaper were studied. Seeds were sown either immediately after scarification or after immersion in water for 24h in a sand and sawdust mixture. Germination and hard seed percentages and germination speed were recorded and analyzed in a completely randomized design. Analysis of germination was carried out at six, nine, 12, 15, 18, 21 and 24 days after sowing as a 4x2 factorial design and through regression analysis. Treatment means of the remaining variables were compared by the Tukey test. Seed germination with no treatment started on the 7th day after sowing and reached 90% on the 2310th day (Experiment 1). Significant interaction between treatments to overcome dormancy and time of immersion in water was observed (Experiment 2). In general, immersion in water increased the germination in most evaluations. The regression analyses were significant for all treatments with exception of the control treatment and immersion in water at 80ºC. Germination speed was higher when seeds were scarified on an abrasive surface (emery and sandpaper) and, in these treatments, the germination ranged from 87% to 96%, with no hard seeds. S. amazonicum seeds coats are impermeable to water, which hinders quick and uniform germination. Scarification on electric emery followed by immediate sowing, scarification on sandpaper followed by immediate sowing and sowing after 24h were the most efficient treatments for overcoming dormancy in S. amazonicum seeds.

Sulphuric acid scarification effects on Brachiaria brizantha, B. humidicola and Panicum maximum seed dormancy release

Most tropical forage grass species have dormant seeds, which reduce percentages in germination tests. The objective of this study was to evaluate H2SO4 scarification effects on seed dormancy releasing, through germination time (T50) and variability among germination test replicates, in 630, 94 and 82 seed samples of B. brizantha, B. humidicola and P. maximum, respectively, tested at the Central Seed Testing Laboratory, Campinas, Brazil, from 1991 to 1999. Germination tests used two 4 x 100 replicates of intact and scarified seeds (15-, 10-, 5-minute treatments, respectively). Mean germination time (T50) and variability among germination replicates were also analysed. Statistical analysis was performed by t-test paired samples for means. Scarification promoted general decreases in T50, while variability among germination test replicates was reduced in B. brizantha. Scarification increase germination in B. brizantha and P. maximum, but is deleterious in B. humidicola.

Thermal and moisture content effects on storability and seed dormancy releasing on Brachiaria brizantha cultivars

Brachiaria species normally show a double seed dormancy mechanism, mainly on fresh-harvested seeds, leading to germination percentages lower than those of viability detected by tetrazolium test (TZ) and causing problems as to storage, trading and seed inspection activities. The adoption of the methodology to detect the constants of the viability equation (high storage temperatures and fixed moisture contents) made feasible in this research to isolate the effects of 40, 50 and 65°C on B. brizantha cultivars Marandu, Mulato 1 and Mulato 2 seed dormancy releasing, after storage with moisture contents ranging from 1.9 and 17.8%. Seed samples presented high dormancy levels, detected by TZ and it was complete and partially released by chemical scarification and accelerated ageing test, respectively. No statistical differences were observed as to the speed of germination (T50); however, differences among cultivars were detected as to number of seed per gram. Sorption and desorption isotherm curves were similar for the cultivars. Seed dormancy releasing was better achieved at 40 and 50°C with mc ranging from 7.6 to 10.8%. The temperature of 50°C appears to be adequate for seed dormancy releasing in all mc analyzed. No significant seed dormancy releasing result was observed at 65°C. The cultivar Marandu presented the highest storability throughout the experiment.

Methods for overcoming dormancy in Dinizia excelsa Ducke seeds

The impermeability of seed coat to water is common mechanism in Fabaceae seeds. Treatments to overcome hardseededness include scarification with sulphuric acid, scarification on abrasive surface and soaking in water among others. The objective of this study was to identify an effective method to overcome dormancy in Dinizia excelsa seeds. A pre-test (untreated seed) and three experiments were carried out: immersion of seeds in acid sulphuric for 10, 20, 30, 40, 50 and 60min (experiment 1); scarification on abrasive surface at the positions distal end, near of the mycrophyle and on the lateral tissue and tegument clipping at 1mm of the distal end, near of the mycrophyle and on the lateral tissue (experiment 2); scarification on abrasive surface and immersion in water for 0, 12, 24 and 48h (experiment 3). The experimental design was completely with four replications of 50 seeds for each treatment. The statistical analysis was carried out by ANOVA and regression analysis. Seedlings emergence on untreated seeds started on the 8th day after sowing and reached 52.5% on the 1,709th day. In general, the treatments to overcome dormancy increase emergence. Emergence was higher for seeds treated with sulphuric acid for 20 and 30min with emergence of 93.6% and 86.6%, respectively. For seeds scarified on abrasive surface higher emergences were recorded for scarification on distal end, near of the mycrophyle and on the lateral, 82.7%, 74.3% and 75.7%, respectively. Seeds scarified manually showed higher emergence when not immersed in water (75%), or when immersed for 12 and 24h (75%, 73.6% and 65.6%, respectively). Immersion seeds in sulphuric acid for 20 and 30min and scarification on abrasive surface of distal end are effective to overcome dormancy in D. excelsa.