Aflibercept suppresses ovarian hyperstimulation syndrome: an experimental study in rats

SUMMARY OBJECTIVE: In this study, we aimed to determine the impact of the antiangiogenic medications, namely, aflibercept and cabergoline in the prevention and treatment of ovarian hyperstimulation syndrome in a rat model. METHODS: A total of 36 female Wistar rats were randomly allocated to one of the five groups, including disease-free and ovarian hyperstimulation syndrome controls: Group no OHSS (control, n=6) received saline only intraperitoneally (i.p.); group just OHSS (ovarian hyperstimulation syndrome only, n=6) received 10 IU pregnant mare serum gonadotropin and 30 IU human chorionic gonadotropin subcutaneously to produce ovarian hyperstimulation syndrome; group cabergoline+OHSS (cabergoline+ovarian hyperstimulation syndrome, n=8) received 100 μg/kg oral cabergoline; group aflibercept (12.5 mg/kg)+OHSS (aflibercept+ovarian hyperstimulation syndrome, n=8) received 12.5 mg/kg i.p. aflibercept; and group aflibercept (25 mg/kg)+OHSS (aflibercept+ovarian hyperstimulation syndrome, n=8) received 25 mg/kg i.p. aflibercept. The groups were compared for ovarian weight, immunohistochemical vascular endothelial growth factor expression, spectrophotometric vascular permeability evaluated with methylene blue solution in peritoneal lavage, and body weight growth. RESULTS: Vascular endothelial growth factor immunoexpression was substantially greater in the just OHSS group (22.00±10.20%) than in the aflibercept (12.5 mg/kg)+OHSS (7.87±6.13%) and aflibercept (25 mg/kg)+OHSS (5.63±4.53%) groups (p=0.008 and p=0.005, respectively). Post-hoc tests indicated that cabergoline, 12.5 mg/kg aflibercept, and 25 mg/kg aflibercept decreased vascular permeability compared to the untreated ovarian hyperstimulation syndrome group (p=0.003, p=0.003, and p=0.001, respectively). JOH group had the heaviest ovaries, whereas aflibercept (25 mg/kg)+OHSS group had the lightest. In terms of body weight gain, cabergoline+OHSS group was substantially greater than the aflibercept (12.5 mg/kg)+OHSS and aflibercept (25 mg/kg)+OHSS groups (p=0.006 and p=0.007, respectively). CONCLUSION: Aflibercept, an antiangiogenic medication, decreased ovarian hyperstimulation syndrome by lowering the vascular permeability and vascular endothelial growth factor expression.

Importance of epicardial adipose tissue as a predictor of heart failure with preserved ejection fraction

SUMMARY OBJECTIVE: Epicardial adipose tissue is a special form of visceral fat surrounding the heart. It is associated with cardiac and metabolic diseases. Epicardial adipose tissue is associated with risk factors for heart failure with preserved ejection fraction, such as obesity, metabolic syndrome, hypertension, and diabetes. In this study, we examined the importance of Epicardial adipose tissue as a predictor of heart failure with preserved ejection fraction. METHODS: Patients who were admitted to the Dicle University Medicine Faculty Heart Hospital between November 2013 and August 2014 were recruited for the study. The heart failure group consisted of 30 patients who were admitted to the cardiac intensive care unit, and the control group consisted of 30 patients who were admitted to cardiology polyclinics. We care about patients' demographic and clinical features to be similar. Heart failure was diagnosed according to the European Cardiology Society 2012 heart failure guidelines. Epicardial adipose tissue was measured with a transthoracic parasternal long axis with an echocardiography device (GE Vivid S6). We compared the Epicardial adipose tissue measurements between the two groups. RESULTS: Epicardial adipose tissue was higher in patients with heart failure with preserved ejection fraction than in the control group (9.21±0.82 and 7.13±1.39 mm, respectively; p<0.001). Echocardiographic findings associated with left ventricular hypertrophy were intact ventricular septum (13.03±0.57 and 12.11±2.22 mm, respectively; p=0.013) and left ventricular mass index (131.13±18.00 and 117.90±20.30 g/m2, respectively; p=0.010). Findings associated with left ventricular diastolic dysfunction were as follows: left atrial volume index (60.71±21.53 and 44.92±9.93 mL/m2, respectively; p<0.001) and E/è (13.87±3.88 and 10.12±2.44, respectively; p<0.001) were higher in patients with heart failure with preserved ejection fraction than in the control group. Body mass index was not a significant indicator of obesity (p=0.097), but waist circumference was a significant indicator of visceral obesity (p<0.001). Logistic regression analyses indicated that Epicardial adipose tissue, age, left atrial volume index, left ventricular mass index, waist circumference, and E/é were significant in the Heart failure group; Epicardial adipose tissue was significant (p=0.012), and waist circumference significance was borderline (p=0.045). CONCLUSIONS: Epicardial adipose tissue was higher in patients with HF than in the control group, and Epicardial adipose tissue was a predictor of heart failure with preserved ejection fraction. In patients with heart failure with preserved ejection fraction, increased Epicardial adipose tissue means that Epicardial adipose tissue can be used as a biomarker of inflammation in the pathophysiology of heart failure with preserved ejection fraction.

Mental health and coping strategies of Filipino healthcare workers during the COVID-19 pandemic

Objectives@#This study aimed to determine the mental health of Filipino healthcare workers (HCWs) in terms of their feelings and ability to cope during the COVID-19 pandemic and the factors that motivated them to continue their work. @*Methods and Results@#This was a cross-sectional, descriptive survey, single-center study, conducted in Perpetual Succour Hospital, Cebu City, Philippines, within 3 months from the declaration of the COVID-19 pandemic. Of the 215 respondents, almost 50% thought of quitting their job due to fear of getting infected with COVID-19 and transmitting the disease to their families. Ninety-four percent (94%) of HCWs were nervous and scared and 85% were experiencing physical fatigue and emotional exhaustion. Despite all these, 97% of HCWs felt that their service during the pandemic was part of their professional obligation and ethical duty. HCWs coped with the present pandemic by strictly following safety protocols and the assurance of the safety of their families helped reduce their stress. Family support is their most important source of motivation.@*Conclusion@#Filipino HCWs experience physical and emotional stress during the COVID-19 pandemic but were motivated to work because of their professional obligation with an assurance of safety and support from their family.

A Simple Bone Cyst of the Acromion: Case Report / Cisto ósseo simples do acrômio: Relato de caso

Abstract Simple bone cysts rarely occur in the scapula, and, to our knowledge, they have not been reported in the acromion. In the present report, we present the case of a 24-year-old female patient who was successfully treated by curettage and grafting using xenografting. No recurrence findings were observed during the follow-up six months postoperatively, the patient had recovered full range of motion, and she was able to perform all routine activities satisfactorily.

Resumo Cistos ósseos simples são raros na escápula, e, pelo que sabemos, não foram relatados no acrômio. Aqui, apresentamos uma paciente do sexo feminino, de 24 anos, submetida com sucesso ao tratamento composto por curetagem e xenoenxerto. Não foram observados achados de recidiva no acompanhamento pós-operatório de seis meses, quando a paciente apresentou amplitude total de movimento e foi capaz de realizar todas as atividades rotineiras de maneira satisfatória.

Presystolic Wave is Associated with Subclinical Left Ventricular Dysfunction Assessed by Myocardial Performance Index in Type 2 Diabetes Mellitus / Onda Pressistólica Associada à Disfunção Ventricular Esquerda Subclínica e Avaliada com Base no Índice de Performance Miocárdica em Pacientes com Diabetes Mellitus Tipo 2

Abstract Background: Myocardial performance index (MPI), demonstrates both systolic and diastolic functions of the left ventricle. Presystolic wave (PSW) is frequently detected on Doppler examination of the left ventricular outflow tract and possible mechanism of PSW is impaired LV compliance and left ventricular stiffness. Objective: To investigate the relationship between PSW and MPI in type 2 diabetic patients. Method: A total of 129 type 2 diabetic patients were included in this study. Patients were divided into two groups according to the presence of PSW on Doppler echocardiography. There were 90 patients (38 male, mean age 57.77 ± 10.91 years) in the PSW-positive group and 39 patients (13 male; mean age: 55.31 ± 11.29 years) in the PSW-negative group. The p values of < 0.05 were considered statistically significant. Results: MPI was higher in PSW- positive group (0.63 ± 0.17vs 0.52 ± 0.13, p < 0.001). In addition, subclinical left ventricle dysfunction (LVD) was higher in the PSW- positive group (p = 0.029). Univariate analysis showed that the presence of PSW associated with abnormal MPI (p = 0.031). Pearson correlation analysis showed that PSW velocity correlated with MPI (r: 0.286, p = 0.006). Conclusion: Presence of the PSW on Doppler examination was associated with subclinical LV dysfunction in patients with DM type 2. This easy-to-perform echocardiographic parameter may be related to subclinical LVD among patients with type 2 DM.

Resumo Fundamento: O índice de performance miocárdica (IPM) avalia as funções sistólica e diastólica do ventrículo esquerdo. A onda pressistólica (OPS) é geralmente detectada no exame Doppler da via de saída do ventrículo esquerdo e seus possíveis mecanismos são complacência prejudicada e rigidez do ventrículo esquerdo. Objetivo: Investigar a relação entre OPS e IPM em pacientes com diabetes tipo 2. Método: 129 pacientes com diabetes tipo 2 foram incluídos no estudo. Os sujeitos foram alocados em dois grupos, com base na presença de OPS no exame ecocardiográfico com Doppler. Foram incluídos 90 pacientes (38 homens, idade média 57,77 ± 10,91 anos) no grupo OPS-positiva e 39 pacientes (13 homens; idade média 55,31 ± 11,29 anos) no grupo OPS-negativa. Valor de p < 0,05 foi considerado para significância estatística. Resultados: O IPM foi mais alto no grupo OPS-positiva (0,63 ± 0,17 vs 0,52 ± 0,13, p < 0,001). Além disso, a disfunção ventricular esquerda subclínica (DVE) foi maior no grupo OPS-positiva (p = 0,029). Análise univariada mostrou associação de OPS com IPM anormal (p = 0,031), assim como o coeficiente de correlação de Pearson mostrou correlação entre velocidade de OPS e IPM (r: 0,286, p = 0,006). Conclusão: Presença de OPS na ecocardiografia com Doppler foi associada à DVE subclínica em pacientes com diabetes tipo 2. Esse exame ecocardiográfico de fácil execução pode ser relacionado à DVE subclínica entre pacientes com diabetes tipo 2.

Presystolic Wave is Associated with Subclinical Left Ventricular Dysfunction Assessed by Myocardial Performance Index in Type 2 Diabetes Mellitus / Onda Pressistólica Associada à Disfunção Ventricular Esquerda Subclínica e Avaliada com Base no Índice de Performance Miocárdica em Pacientes com Diabetes Mellitus Tipo 2

Abstract Background: Myocardial performance index (MPI), demonstrates both systolic and diastolic functions of the left ventricle. Presystolic wave (PSW) is frequently detected on Doppler examination of the left ventricular outflow tract and possible mechanism of PSW is impaired LV compliance and left ventricular stiffness. Objective: To investigate the relationship between PSW and MPI in type 2 diabetic patients. Method: A total of 129 type 2 diabetic patients were included in this study. Patients were divided into two groups according to the presence of PSW on Doppler echocardiography. There were 90 patients (38 male, mean age 57.77 ± 10.91 years) in the PSW-positive group and 39 patients (13 male; mean age: 55.31 ± 11.29 years) in the PSW-negative group. The p values of < 0.05 were considered statistically significant. Results: MPI was higher in PSW- positive group (0.63 ± 0.17vs 0.52 ± 0.13, p < 0.001). In addition, subclinical left ventricle dysfunction (LVD) was higher in the PSW- positive group (p = 0.029). Univariate analysis showed that the presence of PSW associated with abnormal MPI (p = 0.031). Pearson correlation analysis showed that PSW velocity correlated with MPI (r: 0.286, p = 0.006). Conclusion: Presence of the PSW on Doppler examination was associated with subclinical LV dysfunction in patients with DM type 2. This easy-to-perform echocardiographic parameter may be related to subclinical LVD among patients with type 2 DM.

Resumo Fundamento: O índice de performance miocárdica (IPM) avalia as funções sistólica e diastólica do ventrículo esquerdo. A onda pressistólica (OPS) é geralmente detectada no exame Doppler da via de saída do ventrículo esquerdo e seus possíveis mecanismos são complacência prejudicada e rigidez do ventrículo esquerdo. Objetivo: Investigar a relação entre OPS e IPM em pacientes com diabetes tipo 2. Método: 129 pacientes com diabetes tipo 2 foram incluídos no estudo. Os sujeitos foram alocados em dois grupos, com base na presença de OPS no exame ecocardiográfico com Doppler. Foram incluídos 90 pacientes (38 homens, idade média 57,77 ± 10,91 anos) no grupo OPS-positiva e 39 pacientes (13 homens; idade média 55,31 ± 11,29 anos) no grupo OPS-negativa. Valor de p < 0,05 foi considerado para significância estatística. Resultados: O IPM foi mais alto no grupo OPS-positiva (0,63 ± 0,17 vs 0,52 ± 0,13, p < 0,001). Além disso, a disfunção ventricular esquerda subclínica (DVE) foi maior no grupo OPS-positiva (p = 0,029). Análise univariada mostrou associação de OPS com IPM anormal (p = 0,031), assim como o coeficiente de correlação de Pearson mostrou correlação entre velocidade de OPS e IPM (r: 0,286, p = 0,006). Conclusão: Presença de OPS na ecocardiografia com Doppler foi associada à DVE subclínica em pacientes com diabetes tipo 2. Esse exame ecocardiográfico de fácil execução pode ser relacionado à DVE subclínica entre pacientes com diabetes tipo 2.

Do N-terminal pro-brain natriuretic peptide levels determine the prognosis of community acquired pneumonia? / Os níveis de pró-peptídeo natriurético cerebral N-terminal determinam o prognóstico de pneumonia adquirida na comunidade?

ABSTRACT Objective: Pneumonia is a leading cause of mortality worldwide, especially in the elderly. The use of clinical risk scores to determine prognosis is complex and therefore leads to errors in clinical practice. Pneumonia can cause increases in the levels of cardiac biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP). The prognostic role of the NT-proBNP level in community acquired pneumonia (CAP) remains unclear. The aim of this study was to evaluate the prognostic role of the NT-proBNP level in patients with CAP, as well as its correlation with clinical risk scores. Methods: Consecutive inpatients with CAP were enrolled in the study. At hospital admission, venous blood samples were collected for the evaluation of NT-proBNP levels. The Pneumonia Severity Index (PSI) and the Confusion, Urea, Respiratory rate, Blood pressure, and age ≥ 65 years (CURB-65) score were calculated. The primary outcome of interest was all-cause mortality within the first 30 days after hospital admission, and a secondary outcome was ICU admission. Results: The NT-proBNP level was one of the best predictors of 30-day mortality, with an area under the curve (AUC) of 0.735 (95% CI: 0.642-0.828; p < 0.001), as was the PSI, which had an AUC of 0.739 (95% CI: 0.634-0.843; p < 0.001), whereas the CURB-65 had an AUC of only 0.659 (95% CI: 0.556-0.763; p = 0.006). The NT-proBNP cut-off level found to be the best predictor of ICU admission and 30-day mortality was 1,434.5 pg/mL. Conclusions: The NT-proBNP level appears to be a good predictor of ICU admission and 30-day mortality among inpatients with CAP, with a predictive value for mortality comparable to that of the PSI and better than that of the CURB-65 score.

RESUMO Objetivo: A pneumonia é uma das principais causas de mortalidade no mundo, especialmente em idosos. O uso de escores de risco clínico para determinar o prognóstico é complexo e, portanto, leva a erros na prática clínica. A pneumonia pode causar aumento nos níveis de biomarcadores cardíacos, como o N-terminal pro-brain natriuretic peptide (NT-proBNP, pró-peptídeo natriurético cerebral N-terminal). O papel prognóstico do nível de NT-proBNP na pneumonia adquirida na comunidade (PAC) continua incerto. O objetivo deste estudo foi avaliar o papel prognóstico do nível de NT-proBNP em pacientes com PAC, bem como sua correlação com escores de risco clínico. Métodos: Pacientes consecutivos internados com PAC foram incluídos no estudo. Na internação hospitalar, foram coletadas amostras de sangue venoso para avaliação dos níveis de NT-proBNP. Foram calculados o Pneumonia Severity Index (PSI, Índice de Gravidade de Pneumonia) e o escore Confusão mental, Ureia, frequência Respiratória, Blood pressure (pressão arterial) e idade ≥ 65 anos (CURB-65). O desfecho primário de interesse foi mortalidade por todas as causas nos primeiros 30 dias após a admissão hospitalar, e um desfecho secundário foi admissão na UTI. Resultados: O nível de NT-proBNP foi um dos melhores preditores de mortalidade em 30 dias, com uma área sob a curva (ASC) de 0,735 (IC95%: 0,642-0,828; p < 0,001), assim como o PSI, que teve uma ASC de 0,739 (IC95%: 0,634-0,843; p < 0,001), enquanto CURB-65 teve uma ASC de apenas 0,659 (IC95%: 0,556-0,763; p = 0,006). O nível de corte do NT-proBNP que mostrou ser o melhor preditor de admissão na UTI e de mortalidade em 30 dias foi de 1.434,5 pg/ml. Conclusões: O nível de NT-proBNP parece ser um bom preditor de admissão na UTI e de mortalidade em 30 dias entre pacientes internados com PAC, com um valor preditivo para mortalidade comparável ao do PSI e superior ao do CURB-65.

Paraoxonase (PON1) L55M and Q192R polymorphisms in major depression and bipolar affective disorder

Abstract Background Oxidative and nitrosative stress pathways, along with immune-inflammatory response, might play an important role in the pathogenic mechanisms underlying major depression and bipolar disorder. Objective The aim of the present study is to investigate paraoxonase 1 polymorphisms and its correlations with disease parameters in patients with major depression and bipolar affective disorder. Methods PON1 L55M and Q192R single nucleotide polymorphisms were analyzed in a group consisted of 100 patients with major depression, and 100 patients with bipolar affective disorder and 96 healthy controls. Polymorphisms were analyzed by using polymerase chain reaction. Results Our findings reported no association between Q192R and L55M polymorphisms of PON1 and major depression and bipolar disorder. Additionally, there was no association between the PON1 genotypes and disease variables in both depressed and bipolar patients. Discussion Evaluating the different stages of patients with affective disorders and and investigating the connection between PON1 polymorphisms and treatment outcomes will help us to clarify the relationship between PON1 and mood disorders.

Evaluation of the effects of intra-arterial sugammadex and dexmedetomidine: an experimental study / Avaliação dos efeitos de sugamadex e dexmedetomidina intra-arterial: estudo experimental

Abstract Background: Intra-arterial injection of medications may cause acute and severe ischemia and result in morbidity and mortality. There is no information in the literature evaluating the arterial endothelial effects of sugammadex and dexmedetomidine. The hypothesis of our study is that sugammadex and dexmedetomidine will cause histological changes in arterial endothelial structure when administered intra-arterially. Methods: Rabbits were randomly divided into 4 groups. Group Control (n = 7); no intervention performed. Group Catheter (n = 7); a cannula inserted in the central artery of the ear, no medication was administered. Group Sugammadex (n = 7); rabbits were given 4 mg/kg sugammadex into the central artery of the ear, and Group Dexmedetomidine (n = 7); rabbits were given 1 µg/kg dexmedetomidine into the central artery of the ear. After 72 h, the ears were amputated and histologically investigated. Results: There was no significant difference found between the control and catheter groups in histological scores. The endothelial damage, elastic membrane and elastic fiber damage, smooth muscle hypertrophy and connective tissue increase scores in the dexmedetomidine and sugammadex groups were significantly higher than both the control and the catheter groups (p < 0.05). There was no significant difference found between the dexmedetomidine and sugammadex groups in histological scores. Conclusion: Administration of sugammadex and dexmedetomidine to rabbits by intra-arterial routes caused histological arterial damage. To understand the histological changes caused by sugammadex and dexmedetomidine more clearly, more experimental research is needed.

Resumo Justificativa: A injeção intra-arterial de medicamentos pode causar isquemia aguda e grave e resultar em morbidade e mortalidade. Não há informações na literatura que avaliem os efeitos endoteliais arteriais de sugamadex e dexmedetomidina. A hipótese de nosso estudo foi que dexmedetomidina e sugamadex causariam alterações histológicas na estrutura endotelial arterial quando administrados por via intra-arterial. Método: Os coelhos foram randomicamente divididos em quatro grupos: grupo controle (n = 7), sem intervenção; grupo cateter (n = 7), uma cânula foi inserida na artéria central da orelha e medicamentos não foram administrados; grupo sugamadex (n = 7), receberam 4 mg/kg de sugamadex na artéria central da orelha; grupo dexmedetomidina (n = 7), receberam 1 µg/kg de dexmedetomidina na artéria central da orelha. Após 72 horas, as orelhas foram amputadas e histologicamente examinadas. Resultados: Não houve diferença significativa entre os grupos controle e cateter referente aos escores histológicos. Os escores do dano causado ao endotélio e à membrana e fibra elásticas, da hipertrofia do músculo liso e do aumento do tecido conjuntivo foram significativamente maiores nos grupos dexmedetomidina e sugamadex do que nos grupos controle e cateter (p < 0,05). Não houve diferença significativa entre os grupos dexmedetomidina e sugamadex nos escores histológicos. Conclusão: A administração de sugamadex e dexmedetomidina a coelhos por via intra-arterial causou danos arteriais histológicos. Para entender as alterações histológicas causadas por sugamadex e dexmedetomidina com mais clareza, estudos experimentais adicionais são necessários.

Circulating levels of irisin is elevated in hypothyroidism, a case-control study

Objective Our objective in this study was to determine the relationship between irisin hormone, which has a similar effect with thyroid hormones on adipose tissue and the metabolism, and the thyroid functions and the obesity secondary to thyroid disease. Subjects and methods Seventy-four patients were included in the study, of the patients, 37 were newly diagnosed with Hashimoto’s thyroiditis related hypothyroidism but not started on a treatment yet, and the remaining 37 were healthy volunteers without a known disease. Serum thyroid stimulating hormone (TSH), free thyroxin (fT4), anti-thyroglobulin and anti-thyroid peroxidase were measured and thyroid ultrasonography was performed in both groups. Serum irisin levels were measured using the commercially available ELISA kit. The hypothyroidism group had higher levels of irisin compared to the control group (2.77 ng/mL vs. 2.15 ng/mL respectively; p = 0.017). Results The hypothyroidism group had higher median levels of irisin in the obese patients than those in the control group (3.10 ng/mL vs. 2.10 ng/mL respectively; p = 0.013). Irisin level was negatively correlated with age in the whole population and patients with hypothyroidism (r = -0.255, p = 0.028; r = -0.346, p = 0.036 respectively). Irisin level was positively correlated with TSH (r = 0.247, p = 0.034) but negatively correlated with the fT4 (r = -0.316, p = 0.006) in the whole population. Obesity, fT4 and irisin levels were identified to be independent predictors in the diagnosis of hypothyroidism in the multivariable logistic regression analysis. Conclusion To the best of our knowledge, this study is the first in literature to identify that obesity, irisin level and fT4 level are independent risk factors for hypothyroidism.

Efeito da rotação da cabeça na pressão intraocular em decúbito ventral: estudo randomizado / The effect of head Rotation on intraocular pressure in prone position: a randomized trial / Efecto de la rotación de la cabeza en la presión intraocular en decúbito ventral: estudio aleatorio

JUSTIFICATIVA E OBJETIVOS: A elevação da pressão intraocular (PIO), que diminui a pressão de perfusão do nervo óptico, é aumentada pelo posicionamento em decúbito ventral. O objetivo de nosso estudo foi comparar o efeito da rotação lateral da cabeça a 45º em decúbito ventral no aumento da PIO de olhos posicionados para cima e olhos posicionados para baixo em pacientes submetidos à nefrolitotomia percutânea (NLPC). MÉTODOS: Quarenta e cinco pacientes foram randomicamente alocados em dois grupos. A PIO dos pacientes foi registrada bilateralmente em posição supina antes do início da operação. Os pacientes foram posicionados em decúbito ventral. A cabeça foi posicionada sobre um apoio sem compressão externa direta em ambos os olhos. Os pacientes do Grupo I foram estritamente mantidos em pronação neutra, enquanto os pacientes do Grupo II foram posicionados em pronação com rotação da cabeça a 45º para o lado direito. No fim da operação, os pacientes foram reposicionados em decúbito dorsal e a PIO foi imediatamente medida. RESULTADOS: Não houve diferença entre os dados demográficos, na duração da cirurgia, perda de sangue e reposição de líquido dos pacientes. Os valores pós-cirúrgicos da PIO em decúbito ventral aumentaram significativamente em comparação com os valores pré-operatórios em ambos os grupos (p < 0,05). Após a cirurgia em decúbito ventral, os valores da PIO nos olhos posicionados para cima no Grupo II foram significativamente menores do que no Grupo I e nos olhos posicionados para baixo no Grupo II (p < 0,05). CONCLUSÃO: A posição em decúbito ventral aumenta a PIO. Nos pacientes posicionados em decúbito ventral com rotação lateral da cabeça a 45º, a PIO nos olhos posicionados para cima foi significativamente menor.

BACKGROUND AND OBJECTIVES: The increased intraocular pressure (IOP) - which decreases perfusion pressure on the optic nerve - increases by prone positioning (1). The aim of our study was to compare the effect of head rotation 45o laterally in prone position on the increase in IOP of upper placed and lower placed eyes in patients undergoing percutaneous nephrolithotomy (PCNL). METHODS: Forty-five patients were randomly divided into 2 Groups. IOP of the patients were recorded bilaterally in supine position before the operation had started. Patients were turned to prone position. The head was placed on a prone headrest without external direct compression to both eyes. Patients in Group I were kept in strictly neutral prone position where as patients in Group II were placed prone with their heads rotated 45º laterally to the right side. At the end of the operation, patients were turned to supine position and their IOP was measured immediately. RESULTS: There was no difference related to demographics, duration of surgery, blood loss and fluid input data. IOP values after surgery in prone position increased significantly compared to preoperative values in both groups (p < 0.05). After surgery in prone position IOP values of the upper positioned eyes in Group II were significantly lower than Group I and lower positioned eyes in Group II (p < 0.05). CONCLUSION: prone positioning increases IOP. In patients with prone position with a head rotation of 45o laterally, IOP in the upper positioned eye was significantly lower.

JUSTIFICATIVA Y OBJETIVOS: La elevación de la presión intraocular (PIO), que disminuye la presión de perfusión del nervio óptico, es aumentada por el posicionamiento en decúbito ventral. El objetivo de nuestro estudio, fue comparar el efecto de la rotación lateral de la cabeza a 45o en decúbito ventral en el aumento de la PIO de ojos posicionados hacia arriba y ojos posicionados hacia abajo en pacientes sometidos a la nefrolitotomia percutánea (NLPC). MÉTODOS: Cuarenta y cinco pacientes fueron aleatoriamente divididos en dos grupos. La PIO de los pacientes fue registrada bilateralmente en posición supina antes del inicio de la operación. Los pacientes fueron posicionados en decúbito ventral. La cabeza fue posicionada sobre un apoyo sin compresión externa directa en ambos ojos. Los pacientes del Grupo I fueron estrictamente mantenidos en pronación neutra, mientras que los pacientes del Grupo II fueron posicionados en pronación con rotación de la cabeza a 45º hacia el lado derecho. Al final de la operación, los pacientes fueron reposicionados en supinación y la PIO fue inmediatamente medida. RESULTADOS: No hubo diferencia entre los datos demográficos, la duración de la cirugía, la pérdida de sangre y la reposición de líquido de los pacientes. Los valores postquirúrgicos de la PIO en decúbito ventral aumentaron significativamente en comparación con los valores preoperatorios en ambos grupos (p < 0,05). Después de la cirugía en decúbito ventral, los valores de la PIO en los ojos posicionados hacia arriba en el Grupo II fueron significativamente menores que en el Grupo I y en los ojos posicionados hacia abajo en el Grupo II (p < 0,05). CONCLUSIONES: La posición en decúbito ventral aumenta la PIO. En los pacientes posicionados en decúbito ventral con rotación lateral de la cabeza a 45o, la PIO en los ojos posicionados hacia arriba fue significativamente menor.

Analisis biométrico entre mediciones bioantropologicas cefalicas y la arteria basilar / Biometrical analisys between bioanthropological cephalics measurements and the basilar artery

De acuerdo a la literatura anatomo-clinica, se hace necesario disponer de mayor información respecto a las arterias que componen el sistema vertebro-basilar como elementos de la fosa posterior del craneo, dada su importancia en cirugia. El objetivo de este estudio es complementar los datos obtenidos en trabajos previos, estudiando la relación biometrica entre el indice cefalico, la fosa cerebelar, el clivus y la arteria basilar de los especimenes observados. El trabajo se efectuó en el sistema arterial de 70 cerebros formolizados. Los calculos estadisticos fueron realizados usando el programa computacional Prisma 2.3, analisis de varianza, chi cuadrado y test de Student. En el grupo dólico-mesocefalo, la arteria basilar presentó una longitud promedio de 33.3mm, para una longituddelclivus de 55,7 mm, con una fosa cerebelar de 106.1 mm de ancho y de 44.0 mm de alto. En el grupo braquicealo, la arteria basilar presentó una longitudpromedio de 36.9 mm, para una longitud del clivus de 54.4 mm y un ancho 108.0 mm y un alto de 46.0 mm de la fosa cerebelar. Los autores enfatizan la variabilidad que se observa en la arteria basilar, al considerar, ademas del lado y sexo, componentesbio-antropológicos, como el indice cefalico.

A model describing the relationship between electrical conductivity and forage dry matter content

The correlation between dry matter (DM) content, electrical conductivity (EC) and ash content was found to be linear in grass and alfalfa during drying. While minerals in grass and alfalfa were very stable components during drying, their concentrations and EC increase accordingly; therefore, the EC value could serve as a measurement to determine DM content. Results indicated that EC measurement in grass and alfalfa during drying was simple, accurate, fast and easily repeatable, and could serve as an alternative method for DM determination.

A correlação entre o conteúdo da matéria seca (MS), condutividade elétrica (CE) e o conteúdo de cinza revelaram-se lineares na grama e na alfalfa durante a secagem. Os minerais presentes na grama e na alfalfa demonstraram ser componentes muito estáveis durante a secagem. Desta forma as concentrações de minerais e a CE poderiam ser utilizadas como parametros para determinação da MS. Os resultados indicaram que a determinação da CE na grama e na alfalfa durante a secagem era simples, exata, rápida e facilmente repetitível, e poderia ser utilizado como um método alternativo para a determinação de MS.