Trochlear nerve palsy associated with claude bernard-horner syndrome after brainstem stroke

The association of unilateral trochlear nerve palsy with Claude Bernard-Horner syndrome represents a rare clinical condition. We present the case of a patient with this unusual presentation. The investigation performed implicated cerebrovascular disease as the underlying cause of the condition in this patient. © 2011 S. Karger AG, Basel.

Study of polypropylene surface modification by air dielectric barrier discharge operated at two different frequencies

In this work, air dielectric barrier discharge (DBD) operating at the line frequency (60 Hz) or at frequency of 17 kHz was used to improve the wetting properties of polypropylene (PP). The changes in the surface hydrophilicity were investigated by contact angle measurements. The plasma-induced chemical modifications of PP surface were studied by X-ray photoelectron spectroscopy (XPS) and Fourier-transformed infrared spectroscopy (FTIR). The polymer surface morphology and roughness before and after the DBD treatment were analyzed by atomic force microscopy (AFM). To compare the plasma treatment effect at different frequencies the variation of the contact angle is presented as a function of the deposited energy density. The results show that both DBD treatments leaded to formation of water-soluble low molecular weight oxidized material (LMWOM), which agglomerated into small mounts on the surface producing a complex globular structure. However, the 60 Hz DBD process produced higher amount of LMWOM on the PP surface comparing to the 17 kHz plasma treatment with the same energy dose. The hydrophilic LMWOM is weakly bounded to the surface and can be easily removed by polar solvents. After washing the DBD-treated samples in de-ionized water their surface roughness and oxygen content were reduced and the PP partially recovered its original wetting characteristics. This suggested that oxidation also occurred at deeper and more permanent levels of the PP samples. Comparing both DBD processes the 17 kHz treatment was found to be more efficient in introducing oxygen moieties on the surface and also in improving the PP wetting properties. © 2012 Elsevier B.V. All rights reserved.

In vitro adhesion of Candida glabrata to denture base acrylic resin modified by glow-discharge plasma treatment

This study evaluated the potential of plasma treatments to modify the surface chemistry and hydrophobicity of a denture base acrylic resin to reduce the Candida glabrata adhesion. Specimens (n=54) with smooth surfaces were made and divided into three groups (n=18): control - non-treated; experimental groups - submitted to plasma treatment (Ar/50W; AAt/130W). The effects of these treatments on chemical composition and surface topography of the acrylic resin were evaluated. Surface free energy measurements (SFE) were performed after the treatments and after 48h of immersion in water. For each group, half (n=9) of the specimens were preconditionated with saliva before the adhesion assay. The number of adhered C. glabrata was evaluated by cell counting after crystal violet staining. The Ar/50W and AAt/130W treatments altered the chemistry composition, hydrophobicity and topography of acrylic surface. The Ar/50W group showed significantly lower C. glabrata adherence than the control group, in the absence of saliva. After preconditioning with saliva, C. glabrata adherence in experimental and control groups did not differ significantly. There were significant changes in the SFE after immersion in water. The results demonstrated that Ar/50W treated surfaces have potential for reducing C. glabrata adhesion to denture base resins and deserve further investigation, especially to tailor the parameters to prolong the increased wettability. © 2012 Blackwell Verlag GmbH.

Incomplete mandibular fracture after lateralization of the inferior alveolar nerve for implant placement

PURPOSE: The present case describes an inferior alveolar nerve lateralization for implant placement that caused mandible fracture a few days after surgery. CLINICAL REPORT: In this case, a 56-year-old female patient who had a severely atrophied jaw and showing bone height less than 7 mm from the bone crest and the mandibular canal was submitted to surgery lateralization of the inferior alveolar conducted with piezzo. Even with all postoperative care, the patient suffered an incomplete fracture of the mandible a few days after lateralization of the inferior alveolar nerve for implant placement. The patient was treated with soft diet and medications for pain and antibiotics, besides removing the implant associated with the fracture. CONCLUSION: It is suggested that this procedure may be conducted in 2 operative periods: firstly, the lateralization of the inferior alveolar; and secondly, after a period of 3 months, the implant placement in a situation of more bone stability. Copyright © 2013 by Mutaz B. Habal, MD.

Artificial neural network model of discharge lamps in the power quality context

This paper presents a methodology for modeling high intensity discharge lamps based on artificial neural networks. The methodology provides a model which is able to represent the device operating in the frequency of distribution systems, facing events related to power quality. With the aid of a data acquisition system to monitor the laboratory experiment, and using $$\text{ MATLAB }^{\textregistered }$$ software, data was obtained for the training of two neural networks. These neural networks, working together, were able to represent with high fidelity the behavior of a discharge lamp. The excellent performance obtained by these models allowed the simulation of a group of lamps in a distribution system with shorter simulation time when compared to mathematical models. This fact justified the application of this family of loads in electric power systems. The representation of the device facing power quality disturbances also proved to be a useful tool for more complex studies in distribution systems. © 2013 Brazilian Society for Automatics - SBA.

Caracterização das atividades de PLA2s Lys49, isoladas de venenos de serpentes do gênero Bothrops, em preparação neuromuscular de camundongos e influência de agentes neutralizadores

Pós-graduação em Ciências Biológicas (Farmacologia) - IBB

Incapacidade física em pessoas afetadas pela hanseníase: estudo após alta medicamentosa

A incapacidade física é o principal problema da hanseníase. Apesar do sucesso da poliquimioterapia (PQT) no tratamento da doença, sabe-se que cerca de 25% a 50% dos pacientes podem ter algum dano do nervo e desenvolver incapacidades físicas, classificada pela Organização Mundial de Saúde (OMS) como grau de incapacidade física (GIF) 0 para sensibilidade normal, sem deformidades visíveis, 1 para a sensibilidade diminuída, sem alterações visíveis, ou 2 para deficiências visíveis / deformidade. De 2004 a 2010 o Brasil registrou 21,7% dos casos como sendo GIF 1 e 7% como GIF 2, enquanto que no Estado do Pará, 15,3% dos pacientes foram diagnosticados com GIF 1, e 5,1% com GIF 2 no momento do diagnóstico de hanseníase. A fim de investigar as incapacidades físicas em pacientes curados, examinamos as funções sensitivo-motoras de 517 pessoas afetadas pela hanseníase, notificados 2004 a 2010 em oito municípios hiperendêmicos da Amazônia brasileira, correlacionando os achados com aspectos epidemiológicos e sócio-econômico, e comparando com os dados encontrados no Sistema Nacional de Informação de Agravos de Notificação (SINAN). Adicionalmente, 2164 contatos intradomiciliares dos pacientes visitados foram avaliados clinicamente em busca de sinais e sintomas da doença. As visitas domiciliares dos pacientes constaram de avaliação clínica, avaliação neurológica simplificada e determinação do GIF, realização de entrevista sobre suas características demográficas e sócio-econômicas. O GIF 1 foi encontrado em 16,2% e DG 2 em 12,4% dos pacientes avaliados. Foi encontrada uma correlação estatisticamente significativa entre as formas multibacilares (MB) e o GIF 1 ou 2 (p <0,001), incapacidade física e o sexo masculino (p <0,001); incapacidade ocorreu em casos acima de 40 anos de idade (p <0,001). Mais da metade (50,5%) dos casos não tinha cicatriz de BCG, correlacionada com idades mais elevadas (p <0,001), casos MB (p <0,001), e com incapacidade (p <0,005). Por fim, embora SINAN informe apenas 5,6% de casos com GIF 2, encontramos 12,4% durante nossas visitas. Entre os contatos, foram diagnosticados 181 casos novos, 127 (70,2%) foram diagnosticados como multibacilares e 17,1% apresentaram incapacidade física, sendo 5,5% GIF 2. A ocorrência de deficiência física foi predominante em pacientes MB, homens,> 40 anos de idade e sem cicatriz de BCG, todos os fatores de risco importantes para o desenvolvimento de deficiência. As diferenças de GIF encontradas no SINAN e no nosso estudo sugerem piora das funções sensório-motor após a alta da PQT, indicando a importância do acompanhamento destes pacientes por anos depois de terminar o tratamento MDT. A alta taxa de detecção de casos novos diagnosticados neste estudo reflete o baixo índice de avaliação de contatos no estado do Pará (58,8%), perpetuando o diagnóstico tardio. Os achados clínicos sugerem a existência de prevalência oculta e alto índice de infecção subclínica na amostra estudada, indicando necessidade de avaliação clínica periódica.

Análise do dano neural em pacientes hansenianos e na coinfecção HIV/ Hanseníase através de duas coortes clínicas

No Brasil onde a hanseníase é endêmica e onde a infecção pelo HIV continua expandindo-se e interiorizando-se, espera-se encontrar um aumento da prevalência de indivíduos convivendo simultaneamente com hanseníase e HIV/aids, porém são poucos os relatos sobre o dano neurológico que essa sobreposição pode causar. O objetivo deste estudo foi investigar o dano neural hansenico em pacientes hansenianos coinfectados com o vírus da imunodeficiência humana, comparando com hansenianos não coinfectados no inicio do tratamento e por ocasião da alta, através de duas coortes clínicas. A amostra constou de 99 pacientes dos quais 46 possuíam coinfecção MH/HIV e 53 apenas a hanseníase, esses pacientes foram atendidos no ambulatório do Núcleo de Medicina Tropical e avaliados pela Técnica Simplificada durante seis anos. Como resultado houve predominância do sexo masculino, faixa etária entre 15 e 45 anos e a procedência da Região Metropolitana de Belém. No grupo coinfecção MH/HIV houve predominância dos pacientes Paucibacilares e nestes a presença de neurite, alteração de sensibilidade, alteração motora, presença de incapacidade e de dano neural foi superior nesse que no grupo MH. Quando comparado com o grupo MH predominou pacientes Multibacilares e nestes a presença de neurite, alteração de sensibilidade, alteração motora, presença de incapacidade e de dano neural foi superior nesse que no grupo coinfectados MH/HIV. No acompanhamento dos pacientes coinfectados MH/HIV houve uma pequena redução da incapacidade e do dano neural, enquanto no acompanhamento do grupo MH a presença de incapacidade se manteve e o dano neural aumentou. A análise de sobrevivência de Kaplan-Meier identificou que nos pacientes MH houve a manutenção da chance de o paciente permanecer sem dano neural, já no grupo dos pacientes coinfectados, observou-se uma redução na chance de o paciente se manter sem dano neural ao término do tratamento. Dessa forma conclui-se que o dano neural comporta-se de maneira diferente nos dois grupos, predominando no grupo coinfectado nos pacientes paucibacilares e nos não coinfectados nos pacientes multibacilares, porém com a mesma gravidade, o que é preocupante uma vez que diagnosticar esse dano no inicio do aparecimento da hanseníase ainda é um problema para a saúde pública.

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Introduction Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.

Treatment of polycarbonate by dielectric barrier discharge (DBD) at atmospheric pressure

Generally most plastic materials are intrinsically hydrophobic, low surface energy materials, and thus do not adhere well to other substances. Surface treatment of polymers by discharge plasmas is of great and increasing industrial application because it can uniformly modify the surface of sample without changing the material bulk properties and is environmentally friendly. The plasma processes that can be conducted under ambient pressure and temperature conditions have attracted special attention because of their easy implementation in industrial processing. Present work deals with surface modification of polycarbonate (PC) by a dielectric barrier discharge (DBD) at atmospheric pressure. The treatment was performed in a parallel plate reactor driven by a 60Hz power supply. The DBD plasmas at atmospheric pressure were generated in air and nitrogen. Material characterization was carried out by contact angle measurements, and X-ray photoelectron spectroscopy (XPS). The surface energy of the polymer surface was calculated from contact angle data by Owens-Wendt method using distilled water and diiodomethane as test liquids. The plasma-induced chemical modifications are associated with incorporation of polar oxygen and nitrogen containing groups on the polymer surface. Due to these surface modifications the DBD-treated polymers become more hydrophilic. Aging behavior of the treated samples revealed that the polymer surfaces were prone to hydrophobic recovery although they did not completely recover their original wetting properties.

Inferior Alveolar Nerve Function After Sagittal Split Osteotomy by Reciprocating Saw or Piezosurgery Instrument: Prospective Double-Blinded Study

Purpose: The aim of this prospective study was to objectively evaluate inferior alveolar nerve (IAN) sensory disturbances in patients who underwent sagittal split ramus osteotomy (SSRO) by comparing 1 side treated with a reciprocating saw with the other side treated with a piezosurgery device.Materials and Methods: Clinical evaluation of IAN sensory disturbance was undertaken preoperatively and at 1 week, 4 weeks, 2 months, and 6 months postoperatively in 20 patients who underwent SSROat the Division of Oral and Maxillofacial Surgery, Araraquara Dental School, Sao Paulo State University. The 20 patients were examined at all periods for IAN functionality by Semmes-Weinstein testing; neither the patients nor the examiner knew which side was treated using piezosurgery or a reciprocating saw.Results: The mean age of the patients was 28.4 years (range, 20 to 48 yr). Before surgery, no patient had impaired function of the IAN in any of the 8 zones in the mental and inferior lip areas. All patients reported feeling the first monofilament at the time of the preoperative test. Seven days postoperatively, all patients reported some kind of altered sensitivity in at least 1 zone evaluated.Conclusions: The results of this study suggest there was no statistically significant difference in the sensitivity of the labiomental area regarding the instrument used to perform the osteotomy. Future studies will focus on enlarging the sample and evaluating the results. (C) 2014 American Association of Oral and Maxillofacial Surgeons

Treatment of Reticulated Vitreous Carbon by Dielectric Barrier Discharge Plasma for Electrodes Production

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

Facial Reanimation Utilizing Combined Orthodromic Temporalis Muscle Flap and End-to-Side Cross-Face Nerve Grafts

Individuals with facial paralysis of 6 months or more without evidence of clinical or electromyographic improvement have been successfully reanimated utilizing an orthodromic temporalis transfer in conjunction with end-to-side cross-face nerve grafts. The temporalis muscle insertion is released from the coronoid process of the mandible and sutured to a fascia lata graft that is secured distally to the commissure and paralyzed hemilip. The orthodromic transfer of the temporalis muscle overcomes the concave temporal deformity and zygomatic fullness produced by the turning down of the central third of the muscle (Gillies procedure) while yielding stronger muscle contraction and a more symmetric smile. The muscle flap is combined with cross-face sural nerve grafts utilizing end-to-side neurorrhaphies to import myelinated motor fibers to the paralyzed muscles of facial expression in the midface and perioral region. Cross-face nerve grafting provides the potential for true spontaneous facial motion. We feel that the synergy created by the combination of techniques can perhaps produce a more symmetrical and synchronized smile than either procedure in isolation.Nineteen patients underwent an orthodromic temporalis muscle flap in conjunction with cross-face (buccal-buccal with end-to-side neurorrhaphy) nerve grafts. To evaluate the symmetry of the smile, we measured the length of the two hemilips (normal and affected) using the CorelDRAW X3 software. Measurements were obtained in the pre- and postoperative period and compared for symmetry.There was significant improvement in smile symmetry in 89.5 % of patients.Orthodromic temporalis muscle transfer in conjunction with cross face nerve grafts creates a synergistic effect frequently producing an aesthetic, symmetric smile.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.spinger.com/00266.

Acetylene plasma polymer treated by atmospheric dielectric barrier discharge

Plasma polymer films are very attractive for industrial applications in several sectors such as in the electronic, mechanic, biomedic, coating and others, due to its good adhesion, being insoluble in mild acids and bases and having a high crosslinking structure. This work reports the physical, structural, and surface properties of the polymer obtained from an acetylene plasma polymerization technique and treated by dielectric barrier discharge (DBD). The film was deposited in a reactor supplied by a radio-frequency power source at low pressure. After deposition, the nanofilms were treated in a DBD plasma reactor operating in air. The treatment times varied from 1 to 5 min. The analysis of molecular structure of the samples was investigated by FTIR spectroscopy, showing absorption bands in 3480, 2930, 1720, 1450 and 1380 cm(-1). The water contact-angle was investigated by goniometric technique and presented values from 5 to 65 degrees. The aging effect of these films was also studied. The alteration in the films surface morphology was assessed by an atomic force microscopy (AFM) which indicated that the roughness increased from 60 nm to 160 nm as a result of the DBD treatment. The refractive index of the samples presented values near 1.7, measured by UV-Visible spectroscopy. (C) 2014 Elsevier Ltd. All rights reserved.

Continental degassing of He-4 by surficial discharge of deep groundwater

Radiogenic He-4 is produced by the decay of uranium and thorium in the Earths mantle and crust. From here, it is degassed to the atmosphere(1-5) and eventually escapes to space(1,5,6). Assuming that all of the He-4 produced is degassed, about 70% of the total He-4 degassed from Earth comes from the continental crust(2,-5,7). However, the outgoing flux of crustal He-4 has not been directly measured at the Earths surface(2) and the migration pathways are poorly understood(2-4,7,8). Here we present measurements of helium isotopes and the long-lived cosmogenic radio-isotope Kr-81 in the deep, continental-scale Guarani aquifer in Brazil and show that crustal He-4 reaches the atmosphere primarily by the surficial discharge of deep groundwater. We estimate that He-4 in Guarani groundwater discharge accounts for about 20% of the assumed global flux from continental crust, and that other large aquifers may account for about 33%. Old groundwater ages suggest that He-4 in the Guarani aquifer accumulates over half- to one-million-year timescales. We conclude that He-4 degassing from the continents is regulated by groundwater discharge, rather than episodic tectonic events, and suggest that the assumed steady state between crustal production and degassing of He-4, and its resulting atmospheric residence time, should be re-examined.