ABSTRACT
OBJECTIVES: The intrathecal route has not yet been thoroughly standardized and evaluated in an experimental model of spinal cord injury (SCI) in Wistar rats. The objective of this study was to standardize and evaluate the effect of intradural injection in this animal model. METHOD: The animals were divided into 6 groups: 1) laminectomy and intradural catheter; 2) laminectomy, intradural catheter and infusion; 3) only SCI; 4) SCI and intradural catheter; 5) SCI, intradural catheter and infusion; and 6) control (laminectomy only). Motor evaluations were performed using the Basso, Beattie and Bresnahan (BBB) scale and the horizontal ladder test; motor evoked potentials were measured for functional evaluation, and histological evaluation was performed as well. All experimental data underwent statistical analysis. RESULTS: Regarding motor evoked potentials, the groups with experimental SCI had worse results than those without, but neither dural puncture nor the injection of intrathecal solution aggravated the effects of isolated SCI. Regarding histology, adverse tissue effects were observed in animals with SCI. On average, the BBB scores had the same statistical behaviour as the horizontal ladder results, and at every evaluated timepoint, the groups without SCI presented scored significantly better than those with SCI (p<0.05). The difference in performance on motor tests between rats with and without experimental SCI persisted from the first to the last test. CONCLUSIONS: The present work standardizes the model of intradural injection in experimental SCI in rats. Intrathecal puncture and injection did not independently cause significant functional or histological changes.
Subject(s)
Animals , Rats , Spinal Cord Injuries , Reference Standards , Spinal Cord , Rats, Wistar , Evoked Potentials, Motor , Recovery of Function , Disease Models, AnimalABSTRACT
Purpose: To report our experience with the use of the botulinum toxin-A (BoNT/A) formulations Botox® and Prosigne® in the treatment of neurogenic detrusor overactivity (NDO). Materials and methods: At a single institution, 45 consecutive patients with refractory urinary incontinence due to NDO received a single intradetrusor (excluding the trigone) treatment with botulinum toxin type A 200 or 300 units. Botox was used for the first 22 patients, and Prosigne for the subsequent 23 patients. Evaluations at baseline and week 12 included assessment of continence and urodynamics. Safety evaluations included monitoring of vital signs, hematuria during the procedure, hospital stay, and spontaneous adverse event reports. Results: A total of 42 patients were evaluated (74 percent male; mean age, 34.8 years). Significant improvements from baseline in maximum cystometric capacity (MCC), maximum detrusor pressure during bladder contraction, and compliance were observed in both groups (P < 0.05). Improvement in MCC was significantly greater with Botox versus Prosigne (+103.3 percent vs. +42.2 percent; P = 0.019). Continence was achieved by week 12 in 16 Botox recipients (76.2 percent) and 10 Prosigne recipients (47.6 percent; P = 0.057). No severe adverse events were observed. Mild adverse events included 2 cases of transient hematuria on the first postoperative day (no specific treatment required), and 3 cases of afebrile urinary tract infection. Conclusions: Botox and Prosigne produce distinct effects in patients with NDO, with a greater increase in MCC with Botox. Further evaluation will be required to assess differences between these formulations.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Botulinum Toxins, Type A/therapeutic use , Neuromuscular Agents/therapeutic use , Urinary Bladder, Neurogenic/drug therapy , Urinary Bladder, Overactive/drug therapy , Urinary Incontinence/drug therapy , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
Foi realizado trabalho experimental com ratos da raça Wistar para avaliar a influência da calcitonina de salmao e da desnutriçao protéica, isoladas e associadas, na resistência mecânica e na rigidez do tecido ósseo. Os ratos foram divididos em quatro grupos: dieta normal, dieta normal mais calcitonina, desnutridos, desnutridos mais calcitonina. Após duas semanas, foram submetidos a fratura manual da tíbia direita e, ao término de seis semanas, sacrificados. Foram avaliados os parâmetros mecânicos de resistência e rigidez óssea das tíbias fraturadas e nao fraturadas (controle) dos quatro grupos. Concluiu-se que: a administraçao de calcitonina reduziu a resistência máxima das tíbias-controle do grupo com dieta normal; a resistência e rigidez das tíbias fraturadas (processo de consolidaçao) e controle (processo de remodelaçao) foram prejudicadas pela desnutriçao protéica; no grupo desnutrido, a administraçao de calcitonina nao compensou a diminuiçao da resistência e da regidez das tíbias, mas reduziu a ocorrência de pseudartrose.
Subject(s)
Animals , Male , Female , Rats , Calcitonin/pharmacology , Fracture Healing , Tibial Fractures/physiopathology , Salmon , Tibia/drug effects , Rats, Inbred Strains , Rats, Wistar , Tensile StrengthABSTRACT
Os autores fazem uma revisäo sobre os quadros clínicos provocados pela discopatia cervical, abordando os aspectos de fisiopatologia, história natural, diagnóstico por imagem, diagnóstico diferencial e tratamento, definindo os quadros de cervicobraquialgia e os quadros de mielopatia cervical. Salientam a opçäo pelo tratamento conservador para os casos de cervicobraquialgia e a opçäo pelo tratamento cirúrgico para os casos de meilopatia
Subject(s)
Humans , Spinal Diseases/diagnosis , Intervertebral Disc , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuritis/etiology , Brachial Plexus Neuritis/therapy , Diagnosis, Differential , Spinal Diseases/complications , Spinal Diseases/therapy , Intervertebral Disc Displacement/complications , Spinal Cord/blood supplyABSTRACT
As síndromes dolorosas cervicais säo muito freqüentes e podem se tornar incapacitantes para o paciente. O tratamento fisiátrico é uma dasopçöes terapêuticas para esses quadros. As principais indicaçöes do tratamento säo as artroses cervicais e as síndromes miofasciais. A contra-indicaçäo formal deste tipo de tratamento é a presença de mielopatia. Este artigo faz uma revisäo sobre os principais aspectos do tratamento fisiátrico, o uso e indicaçöes dos agentes físicos e seus efeitos fisiológicos nas principais síndromes dolorosas da coluna cervical
Subject(s)
Humans , Spinal Diseases/rehabilitation , Physical and Rehabilitation Medicine , Myofascial Pain Syndromes/rehabilitation , Pain/rehabilitation , Spinal Osteophytosis/rehabilitation , SyndromeABSTRACT
Quarenta e seis pacientes com escoliose idiopatica na adolescencia foram pelo metodo de Harringtonn com um seguimento pos-operatorio minimo de dois anos. Os pacientes foram operados usando-se a haste de Harrington e realizada a artrodese vertebral com enxerto autogeno do osso iliaco. Foi usado aparelho gessado de Risser-Cotrel e marcha por nove meses. Foi obtido um bom resultado clinico em todos os pacientes. A correcao final da curva foi de 40 por cento. Nao houve pseudoartrose.
Subject(s)
Humans , Male , Female , Adolescent , Spinal Fusion/methods , Scoliosis/surgery , Calcium Sulfate , Follow-Up Studies , Gait , Orthopedic Fixation Devices , Postoperative Care , Prognosis , Scoliosis , Spinal Fusion/instrumentationABSTRACT
O autor faz uma revisao da literatura sobre as complicacoes que podem ocorrer na cirurgia da coluna lombar em especial na cirurgia da hernia discal. Sao revistas as causas e as complicacoes pre-operatorias, operatorias, pos-operatorias imediatas e pos-operatorias tardias. O autor faz comentarios sobre os possiveis fatores que mantem altos os indices de maus resultados cirurgicos, apesar do progresso no diagnostico das diversas patologias da coluna-sacra.
Subject(s)
Humans , Middle Aged , Intervertebral Disc Displacement/surgery , Intraoperative Complications , Laminectomy , Postoperative Complications , Intervertebral Disc Displacement/diagnosis , Myelography , Preoperative Care , Sacrum , Tomography, X-Ray Computed , Lumbar VertebraeABSTRACT
Os autores estudaram em modelo experimental, em vertebras de cäes, a funçäo dos ligamentos alares e transverso na estabilidade entre o atlas e o áxis. Com base nos testes biomecânicos realizados, concluem que a resistência dos ligamentos alares e transverso säo equivalentes e proporcionais e que a ruptura do ligamento transverso só foi obtida nos ensaios em flexocompressäo, enquanto que a ruptura dos alares foi obtida em todos os mecanismos simulados
Subject(s)
Animals , Dogs , Ligaments/physiology , Cervical Vertebrae/injuries , Atlas , Axis, Cervical Vertebra , Rupture , Tensile StrengthABSTRACT
Os autores apresentam 20 casos de tumores metastáticos da coluna cervical atingindo o corpo vertebral. Os pacientes foram submetidos à ressecçäo do tumor e substituçäo do corpo vertebral com prótese de polietileno e metilmetacrilato. Concluem que este método é útil para a estabilizaçäo imediata das lesöes metastáticas quando apenas um corpo vertebral estiver acometido e em pacientes com expectativa limitada de sobrevida