Efeitos da dipirona, do meloxicam e da associação dipirona e meloxicam sobre a hemostasia em cães conscientes e sobre o controle da dor pós-operatória em cadelas submetidas à ovariosalpingohisterectomia

Pós-graduação em Cirurgia Veterinária - FCAV

Air versus saline in the loss of resistance technique for identification of the epidural space

BackgroundThe success of epidural anaesthesia depends on correct identification of the epidural space. For several decades, the decision of whether to use air or physiological saline during the loss of resistance technique for identification of the epidural space has been governed by the personal experience of the anaesthesiologist. Epidural block remains one of the main regional anaesthesia techniques. It is used for surgical anaesthesia, obstetrical analgesia, postoperative analgesia and treatment of chronic pain and as a complement to general anaesthesia. The sensation felt by the anaesthesiologist from the syringe plunger with loss of resistance is different when air is compared with saline (fluid). Frequently fluid allows a rapid change from resistance to non-resistance and increased movement of the plunger. However, the ideal technique for identification of the epidural space remains unclear.ObjectivesTo evaluate the efficacy and safety of both air and saline in the loss of resistance technique for identification of the epidural space.To evaluate complications related to the air or saline injected.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE, EMBASE and the Latin American and Caribbean Health Science Information Database (LILACS) (from inception to September 2013). We applied no language restrictions. The date of the most recent search was 7 September 2013.Selection criteriaWe included randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) on air and saline in the loss of resistance technique for identification of the epidural space.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsWe included in the review seven studies with a total of 852 participants. The methodological quality of the included studies was generally ranked as showing low risk of bias inmost domains, with the exception of one study, which did not mask participants. We were able to include data from 838 participants in the meta-analysis. We found no statistically significant differences between participants receiving air and those given saline in any of the outcomes evaluated: inability to locate the epidural space (three trials, 619 participants) (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.33 to 2.31, low-quality evidence); accidental intravascular catheter placement (two trials, 223 participants) (RR 0.90, 95% CI 0.33 to 2.45, low-quality evidence); accidental subarachnoid catheter placement (four trials, 682 participants) (RR 2.95, 95% CI 0.12 to 71.90, low-quality evidence); combined spinal epidural failure (two trials, 400 participants) (RR 0.98, 95% CI 0.44 to 2.18, low-quality evidence); unblocked segments (five studies, 423 participants) (RR 1.66, 95% CI 0.72 to 3.85); and pain measured by VAS (two studies, 395 participants) (mean difference (MD) -0.09, 95% CI -0.37 to 0.18). With regard to adverse effects, we found no statistically significant differences between participants receiving air and those given saline in the occurrence of paraesthesias (three trials, 572 participants) (RR 0.89, 95% CI 0.69 to 1.15); difficulty in advancing the catheter (two trials, 227 participants) (RR 0.91, 95% CI 0.32 to 2.56); catheter replacement (two trials, 501 participants) (RR 0.69, 95% CI 0.26 to 1.83); and postdural puncture headache (one trial, 110 participants) (RR 0.83, 95% CI 0.12 to 5.71).Authors' conclusionsLow-quality evidence shows that results do not differ between air and saline in terms of the loss of resistance technique for identification of the epidural space and reduction of complications. Applicability might be compromised, as most of the results described in this review were obtained from parturient patients. This review underlines the need to conduct well-designed trials in this field.

Development of hydrophilic nanocarriers for the charged form of the local anesthetic articaine

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Importância do casqueamento e ferrageamento no cavalo atleta

The trimming and shoeing are of great significance in the performance and longevity of the athlete horse, and if not done or done incorrectly, cause a variety of limb injuries, which may make unusable the animal for sport, a fact of frequent occurrence, due to the small number of trained professionals in this area. The anatomy of the hoof and its functions should be maintained by maintaining the balance of the same (correct hoof trimming) and, if necessary, proper shoeing, all to avoid the hull balance alterations that lead to osteoarthritis, musculoskeletal disorders, chronic pain at the bead, synovitis, pedal osteitis, navicular disease, in addition to increase tension in the flexor tendons, suspensory ligament and proximal sesamoid causing tendinitis, desmitis and sesamoiditis proximal

Avaliação da viabilidade de cateter epidural totalmente implantado em equídeos

Pós-graduação em Cirurgia Veterinária - FCAV

Avaliação do efeito do citral na dor neuropática e na inflamação

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Síndrome da ardência bucal: avaliação e tratamento

The burning mouth syndrome (BMS) is a relevant pathology that has been defined as a chronic pain with difficult diagnosis and treatment. The prevalence of BMS is estimate to be 15% of the general population, being more common in the elderly and middle-aged. Characterized by a burning sensation in more than one area, more frequently on the two thirds of the tongue, on the anterior half of the hard palate and on the mucosa of the upper lip, the BMS is associated with clinical signs of normality and normal laboratory findings. For several studies the BMS etiology is controversial because it is multifactorial since it can be caused by local, neuropathic, psychological and/or systemic factors. These controversies make the diagnosis more difficult, especially if the dentist does not have knowledge about the syndrome. Thus, the aim of this paper is to present, by means of a literature review, the main features of BMS, indicating the procedures that may be useful for diagnosis, and also the available therapeutic modalities in order to increasing the knowledge of health professionals so that patients with BMS may benefit from appropriate treatment, support and professional confidence, always aiming to better quality of life.

Determinação fenotípica das haptoglobinas em pacientes com dor crônica causadas por desordens temporomandibulares

The phenotypes of the hemoglobin-haptoglobin (HbHp) system were measured in 124 subjects, 100 patients with chronic pain in temporomandibular disorders and 24 normal, without any bodily pain during the years 2000 -2003. The system Hb-Hp showed polymorphism Hp1-1, Hp2-1 and Hp2-2, at 100% and 85% respectively; anahaptoglobinemia (Hp0) in 15% of the sample studied. Hp1-1 genotype was present significantly (p < 0, 0001) in patients with TMDs, regardless the clinical type TMD, suggesting that Hp1-1 and likely genetic marker of susceptibility for the development of chronic pain in TMD.

Duloxetina para melhoria na qualidade de recuperação anestésica em histerectomia abdominal

Pós-graduação em Anestesiologia - FMB

Diagnósticos de enfermagem prevalentes em geriatria segundo o grau de dependência

This is a quantitative study conducted at the Outpatient Clinic of the Geriatrics and Gerontology Academic League of Botucatu School of Medicine. It aimed at learning about the profile of elderly patients and their level of disability in relation to basic activities of daily living. Based on this information, nursing diagnoses for the population under study were made, and the most frequent diagnosed were selected with the purpose of composing a stage of the instrument for nursing consultation in geriatric. It was found that the disabled elderly patients were predominantly females and widowed. They had a mean age of 81 years and had completed the first 4 grades of elementary school. Chronic pain related to physical disability and impaired ambulation related to the presence of osteoarticular diseases are examples of the most common diagnoses in the studied population. It is important that geriatric nurses implement Nursing Care Systematization based on the knowledge of the population to which they attend by considering the level of disability of elderly patients with respect to basic activities of daily living, so that full and individualized care can be provided and the patients’ remaining autonomy can be preserved.

Avaliação da dor crônica e locomoção de cães com displasia coxofemoral submetidos à acupuntura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise retrospectiva de casuística de hernioplastia inguinal videolaparoscópica TAPP

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação da dor crônica e locomoção de cães com displasia coxofemoral submetidos à acupuntura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise retrospectiva de casuística de hernioplastia inguinal videolaparoscópica TAPP

Pós-graduação em Bases Gerais da Cirurgia - FMB

Can the `yin and yang` BDNF hypothesis be used to predict the effects of rTMS treatment in neuropsychiatry?

Repetitive transcranial magnetic stimulation (rTMS) is a novel technique of non-invasive brain stimulation which has been used to treat several neuropsychiatric disorders such as major depressive disorder, chronic pain and epilepsy. Recent studies have shown that the therapeutic effects of rTMS are associated with plastic changes in local and distant neural networks. In fact, it has been suggested that rTMS induces long-term potentiation (LTP) and long-term depression (LTD) - like effects. Besides the initial positive clinical results; the effects of rTMS are stilt mixed. Therefore new toots to assess the effects of plasticity non-invasively might be useful to predict its therapeutic effects and design novel therapeutic approaches using rTMS. In this paper we propose that brain-derived neurotrophic factor (BDNF) might be such a tool. Brain-derived neurotrophic factor is a neurotrophin that plays a key role in neuronal survival and synaptic strength, which has also been studied in several neuropsychiatric disorders. There is robust evidence associating BDNF with the LTP/LTD processes, and indeed it has been proposed that BNDF might index an increase or decrease of brain activity - the `yin and yang` BDNF hypothesis. In this article, we review the initial studies combining measurements of BDNF in rTMS clinical trials and discuss the results and potential usefulness of this instrument in the field of rTMS. (C) 2008 Elsevier Ltd. All rights reserved.