Polidocanol versus hypertonic glucose for sclerotherapy treatment of reticular veins of the lower limbs: study protocol for a randomized controlled trial

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

Pre- and postoperative evaluation by photoplethysmography in patients receiving surgery for lower-limb varicose veins

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

Petrologia e geoquímica das rochas graníticas do maciço do Capão Bonito, SP

The granitic massif Capão Bonito is located in the southwest of the State of São Paulo and is associated with Neoproterozoic evolution of Central Mantiqueira Province. Its rocks outcrop along the edge of the Paraná Basin in a body with elongated shape whose major axis has a general NE-SW, covering an area of approximately 110km2. Occurs in intrusive epimetamorphic rocks of Votuverava Formation, Acungui Group and granitic rocks of the Três Córregos Complex and their placement is related to a brittle tectonics of NE-SW direction shear zones. In metasediments, when preserved from deformational features imposed by mylonitic deformation, preserve up textures and mineralogy of contact metamorphism with development of mineral in albite-epidote and hornblende hornfels facies. The Massif Capão Bonito consists of red syenogranites, holo-leucocratic with biotite and rare hornblende, medium to coarse inequigranulars and isotropic lightly mylonitic and / or cataclastic in marginal regions. Commercially are called Vermelho Capão Bonito and for export as Ruby Red Granite. Rocks belonging to the calcium-alkaline high potassium to shoshonitic series or the series subalkaline potassic and metaluminous to peraluminous character. The magmatism is compatible with granite type A, tardi-orogenic to anorogenic of intraplate environment, from the crust material with lower melting emplacement associated with correlated transtensive structure to shear zones in an extensional environment at the end of collisional event of Orogênese Ribeira. Metamorphism occurred in the region in the greenschist facies, low to medium, generating quartzites, phyllites, schists, and calcium-silicate metabasics

PS-042c is low-dose combined oral contraceptives use associated to lower bone mineral content variation in adolescents over a one-year period?

Background Low dose combined oral contraceptives (COC) can interfere in bone mass acquisition during adolescence. To evaluate bone mineral density (BMD) and bone mineral content (BMC) in female adolescents taking a standard low-dose (EE 20 µg/Desogestrel 150 µg) combination oral contraceptive (COC) over a one-year period and compare with healthy adolescents from the same age group not taking COCs.Methods A non-randomised parallel control study with one-year follow-up. Sixty-seven adolescents from 12 to 20 years of age, divided into COC users (n = 41) taking 20 µg EE/150 µg Desogestrel and non-user controls (n = 26), were evaluated through bone densitometry examinations at baseline and 12 months later. Comparisons between groups at study start was done through the Mann-Whitney test with significance level fixed at 5% or corresponding p value; comparisons between groups at study start and 12 months later used variations in median percentages for bone mass variables.Results COC users presented low bone mass acquisition in the lumbar spine and BMD and BMC median variations between baseline and at 12 months of 2.07% and +1.57% respectively whereas the control group presented variations of +12.16% and +16.84% for BMD and BMC, respectively, over the same period. The total body BMD and BMC presented similar evolution during the study in both groups. Statistical significance (pConclusion The use of a low COC dose (EE 20 µg/Desogestrel 150 µg) was associated to lower bone mass acquisition in adolescents during the study period.Trial registration: (Register Number):RBR-5 h9b3c

Temporal Differences in the Hydrologic Regime of the Lower Platte River, Nebraska, 1895–2006

In cooperation with the Lower Platte South Natural Resources District for a collaborative study of the cumulative effects of water and channel management practices on stream and riparian ecology, the U.S. Geological Survey (USGS) compiled, analyzed, and summarized hydrologic information from long-term gaging stations on the lower Platte River to determine any significant temporal differences among six discrete periods during 1895-2006 and to interpret any significant changes in relation to changes in climatic conditions or other factors. A subset of 171 examined hydrologic indices (HIs) were selected for use as indices that (1) included most of the variance in the larger set of indices, (2) retained utility as indicators of the streamflow regime, and (3) provided information at spatial and temporal scale(s) that were most indicative of streamflow regime(s). The study included the most downstream station within the central Platte River segment that flowed to the confluence with the Loup River and all four active streamflow-gaging stations (2006) on the lower Platte River main stem extending from the confluence of the Loup River and Platte River to the confluence of the Platte River and Missouri River south of Omaha. The drainage areas of the five streamflow-gaging stations covered four (of eight) climate divisions in Nebraska—division 2 (north central), 3 (northeast), 5 (central), and 6 (east central).

Diatom stratigraphy of the lower Pliocene part of the Sisquoc Formation, Harris Grade section, California

Lower Pliocene diatoms were studied from the Sisquoc Formation and lowermost Foxen Mudstone, exposed along Hams Grade north of Lompoc, California, to refine the diatom biostratigraphy of post-Monterey Formation sediments in California. Sixty-seven diatom taxa were identified in the 25 samples examined from the 790-m thick (2950-ft) section. The diatoms are assignable to the uppermost Nitzschia reinholdii Zone and Thalassiosira oestrupii Zone of Damn (1981), and five tentative subzones for local correlation are proposed. Regional correlations and taxon occurrence are discussed, and the base of the Nitzschia reinholdii Zone is redefined as at the last occurrence of Thalassionema schraderi.

Review of the genus Microphilypnus Myers, 1927 (Teleostei: Gobioidei: Eleotridae) from the lower Amazon basin, with description of one new species

Microphilypnus Myers, 1927 is a genus with three nominal species (M. amazonicus and M. macrostoma from the lower Amazon basin, and M. ternetzi from Orinoco), and is among the most poorly studied groups of Neotropical fishes. In this paper, M. ternetzi and M. macrostoma are redescribed and validated and M. amazonicus is regarded as synonym of M. ternetzi. Also, a new species, M. acangaquara, is described from the lower Amazon.

Comparison of Laser Versus Sclerotherapy in the Treatment of Lower Extremity Telangiectases: A Prospective Study

BACKGROUND Lower extremity telangiectasia affects approximately 40% of women. The demand for aesthetic treatment of these veins continues to grow. Few studies have compared laser and sclerotherapy to treat leg telangiectasias. OBJECTIVE To compare the efficacy of conventional sclerotherapy and neodymium-doped yttrium aluminum garnet (Nd:YAG) laser in the treatment of leg telangiectasias. METHODS AND MATERIALS Thirty women were enrolled in the study. One leg was randomly assigned laser treatment and the other sclerotherapy with 75% glucose solution. All patients were photographed before and after treatment. The applying physician and two independent observers rated photographic improvement of the treated areas. Complications and adverse effects were noted during follow-up. Patients answered a questionnaire that addressed pain, clearing of the vessels, and satisfaction with the results. RESULTS There was a significant difference between the modes of treatment regarding pain. Twelve patients using laser and 16 using sclerotherapy considered the clearing of the vessels to be good to excellent after three sessions of both laser and scleratherapy. Mean scores after photographic assessment were 7.9 for laser and 7.0 for sclerotherapy. CONCLUSION Lower extremity telangiectases may be treated equally well using Nd:YAG 1064-nm laser or conventional sclerotherapy.

PHOTOELASTIC ANALISYS IN THE LOWER REGION OF VERTEBRAL BODY L4

Objective: To analyze the shear forces on the vertebral body L4 when submitted to a compression force by means of transmission photoelasticity. Methods: Twelve photoelastic models were divided into three groups, with four models per group, according to the positioning of the sagittal section vertebrae L4-L5 (sections A, B and C). The simulation was performed using a 15N compression force, and the fringe orders were evaluated in the vertebral body L4 by the Tardy compensation method. Results: Photoelastic analysis showed, in general, a homogeneous distribution in the vertebral bodies. The shear forces were higher in section C than B, and higher in B than A. Conclusion: The posterior area of L4, mainly in section C, showed higher shear concentrations, corresponding to a more susceptible area for bone fracture and spondylolisthesis. Economic and Decision Analyses Development of an Economic or Decision Model. Level I

WATER VAPOR CONDUCTANCE OF THE LOWER CRETACEOUS DINOSAURIAN EGGS FROM SANAGASTA, LA RIOJA, ARGENTINA: PALEOBIOLOGICAL AND PALEOECOLOGICAL IMPLICATIONS FOR SOUTH AMERICAN FAVEOLOOLITHID AND MEGALOOLITHID EGGS

The water vapor conductance (G(H20)) of the neosauropod eggs from the Lower Cretaceous Sanagasta nesting site in La Rioja Province, Argentina, was examined and compared with other Cretaceous Argentinean oological material. The 2900 mgH(2)O/day.Torr G(H2O) of the Sanagasta eggshells confirms an extremely moist nesting environment and supports field observations of dug-out nests in a geothermal setting. The observed thinning of the outer eggshell surface during incubation increases gas conductance and concomitantly decreases eggshell mechanical resistance during the late ontogenetic stages, thus facilitating embryonic development and hatching. The Sanagasta and Entre Rios Province faveoloolithid eggs display the highest and comparable 61120 values and share several morphological and diagenetic characters, indicating comparable nesting strategy in geothermal settings. However, the faveoloolithid Yamintie and La Pampa Province specimens cluster together with lower G(H20) values closer to the megaloolithid eggs. The Gnu) of the megaloolithid egg Megaloolithus patagonicus was reconsidered and new results are now congruent with other reported megaloolithid GH2O values. Additionally, we hypothesize that V-shaped pore canals of M. patagonicus, which upper sections reach only the top third or half eggshell thickness and, a wider section in the middle would not compromise the overall egg mechanical resistance like vertical pores connecting directly the outer to the inner eggshell surfaces. Such pore spatial arrangement and geometry would enhance, as the eggshell thins during incubation, a greater G(H2O), G(O2) and G(CO2) and facilitate embryonic development in high moisture nesting contents. Overall, data suggests that neosauropod nesting and brooding behaviors were dependent on elevated moisture nesting environments.

An integrated stratigraphic record of the Palaeocene-lower Eocene at Gubbio (Italy): new insights into the early Palaeogene hyperthermals and carbon isotope excursions

Terra Nova, 24, 380386, 2012 Abstract A high-resolution, integrated stratigraphic framework (stable isotope stratigraphy, standard calcareous nannofossil and foraminiferal biostratigraphy, magnetostratigraphy) together with geochemical and rock magnetic properties analyses of a complete and well-preserved succession at Contessa Valley (Gubbio, central Italy) have offered an excellent opportunity to identify and constrain the Palaeocene to early Eocene hyperthermals and carbon isotope excursions (CIEs). In addition, we provide the first evidence in the Tethys Ocean of CIEs, previously identified in the Pacific, Atlantic and Southern Oceans, highlighting their global significance and of some unknown CIEs. Their characteristics are compared with those reported for deep-sea cores and other land-based sections to test whether the signature associated with CIEs documented in our composite section might give evidence for tracing them over wider areas. The Contessa composite section thus represents a reference succession also for insight into the magnetobiochronostratigraphy and the magnitude of early Palaeogene hyperthermals and CIEs.

Leukocytes from wheezing infants release lower amounts of IL-12 and IFN-gamma compared to non-wheezing infants

Objective This study investigated environmental endotoxin exposure during early life, sensitization to aeroallergens, the production of cytokines by LPS-stimulated leukocytes, and the development of a wheezing phenotype in a prospective cohort of infants with high risk of developing allergic diseases. Materials and Methods Eighty-four infants were followed from birth until 30 months of age. We assessed endotoxin concentration in house dust of their homes during the first 6 months of life. At age 30 months they were clinically evaluated to determine the development of wheezing and other clinical events, were skin prick tested, and had blood samples collected for the evaluation of cytokine release by LPS-stimulated peripheral blood mononuclear cells (PBMC). Results The level of endotoxin exposure during early life was not associated with development of a wheezing phenotype. On the other hand a higher incidence of respiratory infections occurred among recurrent wheezing (RW) infants. PBMC from RW children exposed to higher levels of environmental endotoxin (above 50?EU/mg) released less Interleukin (IL)-12p70 and IFN-? compared to the non-RW group. TNF-a, IL-10, IL-4, IL-5, and IL17 production by LPS-stimulated PBMC from RW and non-RW children was equivalent in both groups of environmental endotoxin exposure. Conclusion In this prospective cohort of infants with high risk of developing allergic diseases we observed that RW and non-RW children were exposed to similar levels of endotoxin early in life. LPS-stimulated PBMC from RW infants exposed to higher levels of endotoxin released significantly less IL-12 and IFN-? compared to non-RW infants. Pediatr Pulmonol. 2012. 47:10541060. (C) 2012 Wiley Periodicals, Inc.

Relationship Between Oral Health-Related Quality of Life and the Position of the Lower Third Molar: Postoperative Follow-Up

Purpose: The aim of this study was to verify possible associations between oral health-related quality of life (QoL) and the position of the lower third molar among patients undergoing lower third molar surgery during the first postoperative week. Materials and Methods: We performed an interventional prospective study of 86 patients for whom the preoperative treatment plan included the removal of 2 third molar teeth from the same side in a 1-time procedure. The patients were divided into 2 groups depending on the position of the lower third molar. QoL was evaluated before and after the surgical procedure (during the first 7 days) with the Oral Health Impact Profile (OHIP) 14 questionnaire. Data were treated according to Stata 10.0 (StataCorp, College Station, TX). Variables were evaluated by use of split-plot analysis of variance for the repeated-measures analysis to identify the association between QoL and the position of the lower third molar. Results: Patients can have deterioration in their QoL immediately after surgery, especially during the first and second postoperative days, and subsequently show rapid improvement. The variation in the total OHIP score during the days after surgery was significant, whereas a decrease in QoL was observed immediately after the procedure (P = .001), which returned to initial value (preoperative) levels after the sixth postoperative day. The OHIP domains with higher scores (ie, those that had an impact) were physical pain, psychological discomfort, and physical disability (domains 2, 3, and 4, respectively). Conclusions: Teeth considered to be associated with technical difficulties for extraction based on their position had a higher score on the OHIP-14 questionnaire and worse health-related QoL score. QoL outcomes may be as important as clinical signs in decisions regarding third molar extractions. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:779-786, 2012

Effect of Functional Stabilization Training on Lower Limb Biomechanics in Women

BALDON, R. D. M., D. F. M. LOBATO, L. P. CARVALHO, P. Y. L. WUN, P. R. P. SANTIAGO, and F. V. SERRAO. Effect of Functional Stabilization Training on Lower Limb Biomechanics in Women. Med. Sci. Sports Exerc., Vol. 44, No. 1, pp. 135-145, 2012. Purpose: This study aimed to verify the effects of functional stabilization training on lower limb kinematics, functional performance, and eccentric hip and knee torques. Methods: Twenty-eight women were divided into a training group (TG; n = 14), which carried out the functional stabilization training during 8 wk, and a control group (CG; n = 14), which carried out no physical training. The kinematic assessment of the lower limb was performed during a single-leg squat, and the functional performance was evaluated by way of the single-leg triple hop and the timed 6-m single-leg hop tests. The eccentric hip abductor, adductor, lateral rotator, medial rotator, and the knee flexor and extensor torques were measured using an isokinetic dynamometer. Results: After 8 wk, the TG significantly reduced the values for knee abduction (from -6.86 degrees to 1.49 degrees), pelvis depression (from -10.21 degrees to -7.86 degrees) and femur adduction (from 7.08 degrees to 5.19 degrees) as well as increasing the excursion of femur lateral rotation (from -0.55 degrees to -3.67 degrees). Similarly, the TG significantly increased the values of single-leg triple hop (from 3.52 to 3.92 m) and significantly decreased the values of timed 6-m single-leg hop tests (from 2.43 to 2.14 s). Finally, the TG significantly increased the eccentric hip abductor (from 1.31 to 1.45 N center dot m center dot kg(-1)), hip lateral rotator (from 0.75 to 0.91 N center dot m center dot kg(-1)), hip medial rotator (from 1.45 to 1.66 N center dot m center dot kg(-1)), knee flexor (from 1.43 to 1.55 N center dot m center dot kg(-1)), and knee extensor (from 3.46 to 4.40 N center dot m center dot kg(-1)) torques. Conclusions: Strengthening of the hip abductor and lateral rotator muscles associated with functional training improves dynamic lower limb alignment and increases the strength and functional performance.

Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients

Background: Inspiratory muscle training (IMT) has been shown to increase diaphragm thickness. We evaluated the effect of IMT on mid-respiratory pressure (MRP) in patients with gastroesophageal reflux disease (GERD) and hypotensive lower esophageal sphincter (LES), and compared the results with a sham group. Methods: Twenty consecutive patients (progressive loading group) and 9 controls (sham group) were included. All patients had end expiratory pressure (EEP) between 5 and 10 mmHg, underwent esophageal manometry and pulmonary function tests before and after 8 weeks of training, and used a threshold IMT twice daily. The threshold IMT was set at 30% of the maximal inspiratory pressure for the progressive loading group; while, the threshold for sham-treated patients was set at 7 cmH(2)O for the whole period. Results: There was an increase in MRP in 15 (75%) patients in the progressive loading group, with an average gain of 46.6% (p<0.01), and in six (66%) patients in the sham group with a mean increase of 26.2% (p<0.01). However, there was no significant difference between the groups (p = 0.507). The EEP also increased compared with measurements before training (p<0.01), but it did not differ between groups (p = 0.727). Conclusion: IMT increased LES pressure in patients with GERD, in both the treatment and sham groups, after an eight-week program. Although there was no statistically significant difference between groups, suggesting the pressure increase in LES occurs regardless of the resistance load of the threshold IMT. These findings need to be confirmed in further studies with a larger sample. Registration number: 0922/09. (C) 2012 Elsevier Ltd. All rights reserved.