Intervención psicológica pre y post-quirúrgica para pacientes adultos con amputación de miembros superiores y/o inferiores

La presente revisión de la literatura tiene el objetivo de identificar las intervenciones psicológicas pre y postquirúrgicas para pacientes con amputación no traumática. Se identifica que las amputaciones por artropatía diabética son más frecuentes que las causadas por otras enfermedades aunque las amputaciones por cáncer, arterioesclerosis e infección también son prevalentes. La amputación es un evento altamente significativo en el sujeto y demanda un costoso reajuste que se ve influenciado por variables sociodemográficas y que tiene consecuencias psicosociales que requieren de la atención y acompañamiento de un equipo interdisciplinario. En la fase preoperatoria, al manifestarse ansiedad y temores subjetivos con respecto la amputación, las intervenciones se dirigen a favorecer la verbalización e identificación de recursos. En la fase postoperatoria se acompaña el proceso de adaptación y rehabilitación con el manejo de las consecuencias psicosociales más demandantes para el sujeto. La terapia cognitivo conductual en el proceso postoperatorio es la más frecuentemente utilizada.

Enhanced priming for trauma-related material in posttraumatic stress disorder

Intrusive reexperiencing in posttraumatic stress disorder (PTSD) has been linked to perceptual priming for trauma-related material. A prospective longitudinal study (N = 69) investigated perceptual priming for trauma-related, general threat, and neutral words in assault survivors with and without PTSD, using a new version of the word-stem completion task. Survivors with PTSD showed enhanced priming for trauma-related words. Furthermore, priming for trauma-related words measured soon after the trauma was associated with subsequent PTSD severity at 3 6, and 9 months. The enhanced priming effect was specific to trauma-related words. Enhanced perceptual priming for traumatic material appears to be one of the cognitive processes operating in PTSD.

Auditory hallucinations and Posttraumatic Stress Disorder within schizophrenia and substance abuse

There is a high prevalence of traumatic events within individuals diagnosed with schizophrenia, and of auditory hallucinations within individuals diagnosed with posttraumatic stress disorder (PTSD). However, the relationship between the symptoms associated with these disorders remains poorly understood. We conducted a multidimensional assessment of auditory hallucinations within a sample diagnosed with schizophrenia and substance abuse, both with and without co-morbid PTSD. Results suggest a rate of co-morbid PTSD similar to those reported within other studies. Patients who suffered co-morbid PTSD reported more distressing auditory hallucinations. However, the hallucinations were not more frequent or of longer duration. The need for a multidimensional assessment is supported. Results are discussed within current theoretical accounts of traumatic psychosis.

Evidence for interplay between genes and maternal stress in utero: monoamine oxidase A polymorphism moderates effects of life events during pregnancy on infant negative emotionality at 5 weeks

The low activity variant of the monoamine oxidase A (MAOA) functional promoter polymorphism, MAOA-LPR, in interaction with adverse environments (G × E) is associated with child and adult antisocial behaviour disorders. MAOA is expressed during foetal development so in utero G × E may influence early neurodevelopment. We tested the hypothesis that MAOA G × E during pregnancy predicts infant negative emotionality soon after birth. In an epidemiological longitudinal study starting in pregnancy, using a two stage stratified design, we ascertained MAOA-LPR status (low vs. high activity variants) from the saliva of 209 infants (104 boys and 105 girls), and examined predictions to observed infant negative emotionality at 5 weeks post-partum from life events during pregnancy. In analyses weighted to provide estimates for the general population, and including possible confounders for life events, there was an MAOA status by life events interaction (P = 0.017). There was also an interaction between MAOA status and neighbourhood deprivation (P = 0.028). Both interactions arose from a greater effect of increasing life events on negative emotionality in the MAOA-LPR low activity, compared with MAOA-LPR high activity infants. The study provides the first evidence of moderation by MAOA-LPR of the effect of the social environment in pregnancy on negative emotionality in infancy, an early risk for the development of child and adult antisocial behaviour disorders.

Cognitive emotion regulation as a mediator between posttraumatic stress symptoms and hypomanic personality within a non-clinical population

Background: There is a high prevalence of traumatic life events within individuals diagnosed with bipolar disorder. However, currently there is limited theoretical understanding of this relationship. Aims: To explore whether non-clinical symptoms of posttraumatic stress have a direct effect on the non-clinical symptoms of bipolar disorder, or whether this relationship is mediated by cognitive emotion regulation strategies. Method: A cross-sectional design within non-clinical participants completing an online survey including the Impact of Events Scale, Cognitive Emotion Regulation Questionnaire and the Hypomanic Personality Scale. Results: Posttraumatic stress symptoms were associated with hypomanic personality. Intrusive memories contributed a small but significant proportion of the variance between these two measures. Rumination of negative emotions mediated the relationship between posttraumatic stress and hypomanic personality. Conclusions: The relationship between traumatic events and an increased prevalence of bipolar disorder remains poorly understood. Further research should explore rumination as a potential target for treatment within those suffering from both posttraumatic stress and bipolar disorder.

Effects of oxidative stress on the cardiac myocyte proteome: modifications to peroxiredoxins and small heat shock proteins

Endogenous oxidative stress is a likely cause of cardiac myocyte death in vivo. We examined the early (0-2 h) changes in the proteome of isolated cardiac myocytes from neonatal rats exposed to H2O2 (0.1 mM), focussing on proteins with apparent molecular masses of between 20 and 30 kDa. Proteins were separated by two-dimensional gel electrophoresis (2DGE), located by silver-staining and identified by mass spectrometry. Incorporation of [35S]methionine or 32Pi was also studied. For selected proteins, transcript abundance was examined by reverse transcriptase-polymerase chain reaction. Of the 38 protein spots in the region, 23 were identified. Two families showed changes in 2DGE migration or abundance with H2O2 treatment: the peroxiredoxins and two small heat shock protein (Hsp) family members: heat shock 27 kDa protein 1 (Hsp25) and alphaB-crystallin. Peroxiredoxins shifted to lower pI values and this was probably attributable to 'over-oxidation' of active site Cys-residues. Hsp25 also shifted to lower pI values but this was attributable to phosphorylation. alphaB-crystallin migration was unchanged but its abundance decreased. Transcripts encoding peroxiredoxins 2 and 5 increased significantly. In addition, 10 further proteins were identified. For two (glutathione S-transferase pi, translationally-controlled tumour protein), we could not find any previous references indicating their occurrence in cardiac myocytes. We conclude that exposure of cardiac myocytes to oxidative stress causes post-translational modification in two protein families involved in cytoprotection. These changes may be potentially useful diagnostically. In the short term, oxidative stress causes few detectable changes in global protein abundance as assessed by silver-staining.

Redox-sensitive prosurvival and proapoptotic protein expression in the myocardial remodeling post-infarction in rats

In this study, we investigated the oxidative stress influence in some prosurvival and proapoptotic proteins after myocardial infarction (MI). Male Wistar rats were divided in two groups: Sham-operated (control) and MI. MI was induced by left coronary artery occlusion. 28-days after surgery, echocardiographic, morphometric, and hemodynamic parameters were evaluated. Redox status (reduced to oxidized glutathione ratio, GSH/GSSG) and hydrogen peroxide levels (H(2)O(2)) were measured in heart tissue. The p-ERK/ERK, p-Akt/Akt, p-mTOR/mTOR and p-GSK-3 beta/GSK-3 beta ratios, as well as apoptosis-inducing factor (AIF) myocardial protein expression were quantified by Western blot. MI group showed an increase in cardiac hypertrophy (23%) associated with a decrease in ejection fraction (38%) and increase in left ventricular end-diastolic pressure (82%) when compared to control, characterizing ventricular dysfunction. Redox status imbalance was seen in MI animals, as evidenced by the decrease in the GSH/GSSG ratio (30%) and increased levels of H(2)O(2) (45%). This group also showed an increase in the ERK phosphorylation and a reduction of Akt and mTOR phosphorylation when compared to control. Moreover, we showed a reduction in the GSK-3 beta phosphorylation and an increase in AIF protein expression in MI group. Taken together, our results show increased H(2)O(2) levels and cellular redox imbalance associated to a higher p-ERK and AIF immunocontent, which would contribute to a maladaptive hypertrophy phenotype.

Sediment deformation in Miocene and post-Miocene strata, Northeastern Brazil: Evidence for paleoseismicity in a passive margin

Stratigraphic intervals characterized by varied and complex styles of soft-sediment deformation structures are well preserved in Miocene and Late Pleistocene to Holocene deposits of a sedimentary basin located in Northeastern Brazil. The Miocene strata, represented by the Barreiras Formation, record only brittle structures, including numerous faults and fractures with straight and high angle-dipping planes that are often filled with sands derived from overlying beds. Folds consisting of broad anticlines and synclines are also present in this unit. The late Pleistocene to Holocene deposits, named Post-Barreiras Sediments, contain an indurated sandy package with a large variety of ductile and brittle deformation structures (i.e., massive sandstones with isolated sand fragments and breccias, undulatory strata, sand dykes and diapirs, sinks and bowls, pebbly pockets, plunged sediment mixtures, fitted sand masses, cone-shaped cracks, fault grading and sedimentary enclaves). These features, confined to sharp-based stratigraphic horizons that progressively grade downward into undisturbed deposits, are related to seismic shocks of high surface-wave magnitude (i.e., Ms>5 or 6). Amalgamated seismites suggest that previously formed seismites were affected by subsequent seismic-wave propagation. Seismic waves caused by activity along one, or most likely, several tectonic structures would have propagated throughout the depositional environment, producing laterally extensive seismites. The close proximity to earthquake epicenters would have promoted pervasive re-sedimentation due to pore overpressure, resulting high volumes of massive sandstones and breccia. The similarity between deposits with correlatable strata from many other areas along the Brazilian coast allows raise the hypothesis that the seismic episodes might have affected sedimentation patterns in a large (i.e., extension of several hundreds of kilometers) geographic area. Thus, the modern seismicity recorded along Northeastern Brazil was recurrent during the Quaternary and, perhaps, also in the Pliocene. The estimated high magnitude of the seismic events and the great regional extent of the affected area demonstrate that the Brazilian coast experienced tectonic stress through the last geological episodes of its evolution, which would have favored sediment accumulation and penecontemporaneous re-sedimentation. This geological context is unexpected in a passive margin, inducing to revisit the debate on how active is a passive margin. (C) 2010 Elsevier B.V. All rights reserved.

Incubation and rearing temperature effects on Hsp70 levels and heat stress response in broilers

Incubation temperature (IT) was changed to evaluate if 6-wk-old birds become more tolerant to heat stress. After 13 d of incubation, 470 eggs were submitted to low (36.8degreesC), normal (37.8degreesC) and high (38.8degreesC) temperatures. At day 7 post-hatching, 144 birds were allocated to three rearing temperatures (48 birds/treatment): control/thermoneutral (35-24degreesC), high (33-30degreesC) or low (27-18degreesC) according to the age of the birds. Hsp70 levels in tissues of birds (1 d and 42 d), stress response (42 d) and performance were evaluated. High IT decreased brain (P < 0.01) and liver (P < 0.01) Hsp70 levels, whereas low IT decreased brain (P < 0.01) but increased heart (P < 0.01) Hsp70 levels in 1-d-old chicks. Birds incubated at a low temperature had higher (P < 0.05) feed intake (1-42d). High rearing temperature decreased feed intake (P<0.01) and liveweight (P<0.01). Colonic temperature was lower in birds incubated at a low temperature (P < 0.05) and higher in birds reared in a high temperature (P < 0.05) before heat stress. Birds reared in low temperature had higher increase in colonic temperature after heat stress (P < 0.05). Tissue Hsp70 levels were differently affected by rearing temperature, which affected broiler performance more than IT. Lower IT seemed to increase the sensitivity of birds to heat stress at market age.

Effect of water stress on herbicide efficiency applied to Urochloa decumbens

M.R. Rocha-Pereira, A.E. Klar, D. Martins, G.S. Ferreira de Souza, and J. Villalba. 2012. Effect of water stress on herbicide efficiency applied to Urochloa decumbens. Cien. Inv. Agr. 39(1): 211-220. This project aimed to measure the control efficiency of Acctil Coenzime A Carboxilase (ACCase)-inhibiting herbicides post-emergence applied to Urochloa decumbens (Stapf) R.D. Webster under different soil water contents. The experiment was conducted in a greenhouse at the Department of Plant Production, Faculty of Agronomic Sciences, UNESP, Botucatu, Silo Paulo. The experimental design was a completely randomized design with four replications, consisting of a 9 x 4 factorial, combined with three water management systems (-0.03, -0.07 and -1.5 MPa) and three herbicides (fluazifop-p-butyl, haloxyfop-methyl and sethoxydim + oil using four doses (100, 50, 25 and 0% of the recommended dose). Herbicide applications were conducted at two vegetative stages for all species: a 4-6 leaf stage and a 2-3 tiller stage. The physiological parameters evaluated were as follows: photosynthetic rate, stomatal conductance, transpiration, leaf temperature and plant dry matter. The visual assessments of phytotoxicity were performed 28 days after herbicide application. The control efficiency was lower in plants grown under soil water potential conditions of -1.5 MPa, regardless of the herbicide used during the two application stages; however, none reached 100% control. Fractionation of the recommended herbicide doses reduced effectiveness, with the exception of the 50%-dose application of sethoxydim and fluazifop-p-butyl herbicides, which were also effective in the 4-6 leaf plant control under normal water conditions.

Traumatic surdural hygroma - Five cases with changed density and spontaneous resolution

Thirty-four consecutive adult patients with subdural traumatic hygroma were analysed for clinical evolution, serial computed tomography scan (CT), and magnetic resonance imaging (MRI) over a period of several months. Five of the patients presented CT scan and MRI evolution data showing increasing density over a period of 11 days to 6 months post trauma. In these five patients, final clinical and CT scan data were benign, with complete spontaneous resolution. Descriptions in literature of evolving traumatic subdural hygroma have presented CT scan density modifications changing into chronic subdural hematoma. Our patients show another possibility, density transformation, which sometimes show as subdural hematoma in CT scan and MRI, but with final evolution where clinical condition and CT scan return to normal.

Iatrogenic cortical aneurysm post-craniotomy

Taking into account the number of craniotomies performed every day around the world, iatrogenic aneurysm post-craniotomy is extremely rare with only anecdotal cases reported in literature. We report an iatrogenic aneurysm affecting a cortical vessel which probably developed during dural closure of a conventional craniotomy. The aneurysm was discovered 6 months after surgery on a routine control angiography. The patient was successfully treated by trapping the parent vessel and excising the aneurysm. Histopathological findings were compatible with a true type of traumatic aneurysm. The possibility of this rare condition occurring highlights the risk of arterial injury during craniotomy.

Conditioning of stress in Nile tilapia

A Pavlovian conditioning paradigm was used to induce a connection between a conditioned stimulus, light (CS), associated with an unconditioned stimulus, confinement (US) in Nile tilapia Oreochromis niloticus, which resulted in a conditioned endocrine response (CR) to the CS alone manifested as an increase in plasma cortisol. Individual isolated Nile tilapia were submitted for 10 days to the conditioning treatment consisting of turning on a light (CS) for I min with subsequent 30 min confinement (US). on the 10th day of the experiment, plasma cortisol was not increased when fish were subjected to no handling at all, or only light, or even a daily stressor for the 9 days. on the other hand, at the 10th day cortisol was significantly increased only when light was presented either with or without pairing with the stressor. These results confirmed that the cue, light (CS), was not stressful in itself, but when given as the CS in the absence of the US post conditioning the hypothalamus-pituitary-interrenal axis was activated. Therefore, it was concluded that memory of a previous experience with a stressor can be recalled by a conditioned stimulus and induce stress, which is the first demonstration of a memory-induced stress in fishes. (C) 2004 the Fisheries Society of the British Isles.

Performance and egg quality of Japanese quails submitted to cyclic heat stress

Aiming at evaluating the influence of cyclic temperatures on the performance and egg quality of Japanese quails an experiment was carried out with 480 birds after egg production peak. Birds were housed in a bioclimatic chamber with automatic temperature control that contained two rooms, one maintained at thermoneutral temperature (21 ºC) and the other adjusted for the tested cyclic temperatures (24, 27, 30, 33 and 36 ºC at a time). Each room had a battery of five floors and ten cages, with a capacity of 24 birds per cage, totaling 240 birds per battery. Birds were fed iso-nutritious and iso-caloric diets. Data obtained under the tested cyclic temperatures were compared with those obtained under thermoneutral temperature. At the end of each experimental period (14 days) performance and egg quality parameters were evaluated. A completely randomized experimental design with two treatments (thermoneutral temperature and tested temperature) and ten replicates of 24 birds each. Cyclic increases of 27 ºC and higher in environmental temperature negatively affected bird performance, with reduced feed intake and consequent reductions in egg weight and mass. A cyclic increase of the environmental temperature to 36 ºC reduced the percentage of saleable eggs and egg production.

Finite element analysis and fracture resistance testing of a new intraradicular post

Objectives: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the Sao Jose dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. Materials and and methods: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. Results: The fracture test presented the following averages and standard deviation: G1 (45.63 +/- 8.77), G2 (49.98 +/- 7.08), G3 (43.84 +/- 5.52), G4 (47.61 +/- 7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. Conclusions: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008PA/CEP).