Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers / Límites y posibilidades vividas por enfermeras en el tratamiento de mujeres con úlcera venosa crónica / Limites e possibilidades vivenciados por enfermeiras no tratamento de mulheres com úlcera venosa crônica

Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions. .

Objetivo Comprender las experiencias y expectativas de enfermeras en el tratamiento de mujeres con úlcera venosa crónica. Método Investigación fenomenológica fundamentada en Alfred Schutz, que buscó Se realizó entrevista semiestructurada con siete enfermeras, en enero del 2012. Resultados La enfermera revela dificultades presentadas por la mujer para realizar el autocuidado, percibe limitaciones en el tratamiento relacionadas con la desmotivación, los valores y las creencias de las mujeres. Refiere frustración profesional debido a la recidiva de la lesión, a la falta de insumos, al deficiente trabajo interdisciplinar y a la limitada capacitación del equipo de enfermeras. Espera la adhesión de la mujer al tratamiento y resalta la necesidad del cuidado continuo, del autocuidado apoyado y de estandarizar conductas de tratamiento. Conclusión El tratamiento de la úlcera venosa crónica es un desafío que requiere contribución colectiva, involucrando a las mujeres, a los profesionales, a los gestores y a las instituciones de salud. .

Objetivo Compreender as experiências e expectativas de enfermeiras no tratamento de mulheres com úlcera venosa crônica na Atenção Primária à Saúde. Método Pesquisa fundamentada na fenomenologia social de Alfred Schütz, com depoimentos obtidos em janeiro de 2012, por meio de entrevista semiestruturada com sete enfermeiras. Resultados As enfermeiras revelam dificuldades apresentadas pelas mulheres com úlcera venosa crônica para realizar o autocuidado, percebem limitações na terapêutica ancoradas na desmotivação e nos valores e crenças das mulheres. Referem frustração profissional em razão da recidiva da lesão, falta de insumos e tecnologia, de trabalho interdisciplinar e da capacitação da equipe de enfermagem. Esperam a adesão das mulheres ao tratamento e ressaltam a necessidade do cuidado contínuo, do autocuidado apoiado e da padronização de condutas no tratamento. Conclusão O tratamento da úlcera venosa crônica constitui-se em um desafio que requer investimento coletivo, envolvendo a mulher, os profissionais, os gestores e as instituições de saúde. .

Afferent projections from motoneurons innervating extraocular muscles to the cerebellum demonstrated by the retrograde double-labeling technique.

The objective of this study was to investigate the characteristics and distributions of neuronal origin of cerebellar afferents from motor cranial nerve nuclei innervating extraocular muscles by the method of retrograde transport of two fluorescence tracers in rats. Under deep anesthesia and aseptic conditions, 5 microl of 3% solution of Fluoro-Gold (FG) in phosphate buffer solution (PBS) was injected into the bellies of the six extraocular muscles to study the labeling of motoneurons innervating corresponding extraocular muscles. The cerebellum was exposed by craniotomy, and 0.3 microl of 10% solution of Dextran Tetramethyl Rhodamine Biotin (Micro Ruby: or MR) in PBS was injected into many regions of the anterior vermis (lobule I, II) and the posterior vermis (lobule VI, VII, IX, X), the flocculus, the paraflocculus and the deep cerebellar nuclei. Multiple injections were made to cover the entire cerebellum in order to obtain a near maximum labeling of cerebellar afferent neurons. In other cases, only small single or a few injections were made in specific areas of the cerebellum to study specific distributions and topographic organization. In one group of rats, injections were made both in the extraocular muscles with FG and in the cerebellum with MR to study the double labeling of neurons, which project their axons to both the extraocular muscle and the cerebellum. Another group of rats were injected in both sites with only PBS and served as the control for auto-fluorescence background. After 3 days postoperative survival time, all animals were deeply reanesthetized and perfused with heparinized normal saline solution, followed by 4% paraformaldehyde in 0.1 M phosphate buffer, pH 7.4, and 30% sucrose solution in PBS. The brainstem and the cerebellum were removed immediately, and stored in sucrose solution in PBS at 4 degrees C. Serial transverse sections of the brainstem and sagittal sections of the cerebellum were obtained by a freezing microtome at 40 microm thickness, collected on uncoated glass slides, and immediately dried. All sections were examined under an epifluorescence or confocal microscope equipped with filter systems for FG and MR. The presence of both single and double retrograde labeled neurons in the Oculomotor (CN 3), Trochlear (CN 4) and Abducens (CN 6) nuclei was recorded, photographed, stored as computer images files and printed out as hard copies. The labeling neurons in the vicinity of the CN 3, 4, 6 from all sections were plotted onto diagrams and counted Neurons labeled only with MR retrogradely transported from injection sites in the cerebellum were found bilaterally and scattered throughout in the Oculomotor, Trochlear and Abducens nuclei. These neurons labeled only with MR were small and medium-sized interneurons and represented only a small proportion of the entire population. Neurons labeled only with FG retrogradely transported from injection sites in the extraocular muscles were the most numerous, and distributed almost throughout the entire population of small, medium-sized and large motoneurons, which innervate the extraocular muscles. A smaller proportion of small and medium-sized FG labeled neurons within these nuclei were also double labeled with MR, indicating that they project their axon collaterals to both extraocular muscles and the cerebellum. In conclusion, the present findings provide clear anatomical evidence that a small population of motoneurons in the Oculomotor, Trochlear and Abducens nuclei of the rat project their axon collaterals directly to the cerebellum and the extraocular muscle, in addition to the cerebellar afferents from other interneurons within these nuclei. The findings also indicate that cerebellar neuronal circuits play more direct roles in monitoring and controlling eye movements than previously known.

Degeneration of primary afferent terminals following brachial plexus extensive avulsion injury in rats / Degeneración de los terminales aferentes primarios de rata luego de lesión extensa por avulsión del plexo braquial

Important breakthroughs in the understanding regeneration failure in an injured CNS have been made by studies of primary afferent neurons. Dorsal rhizotomy has provided an experimental model of brachial plexus (BP) avulsion. This is an injury in which the central branches of primary afferents are disrupted at their point of entry into the spinal cord, bringing motor and sensory dysfunction to the upper limbs. In the present work, the central axonal organization of primary afferents was examined in control (without lesion) adult Wistar rats and in rats subjected to a C3-T3 rhizotomy. Specific sensory axon subtypes were recognized by application of antibodies to the calcitonin gene-related peptide (CGRP), the P2X3 purinoreceptor, the low-affinity p75-neurotrophin receptor and the retrograde tracer cholera toxin subunit beta (TCbeta ). Other subtypes weres labeled with the lectin Griffonia simplicifolia IB4. Using immunohistochemistry and high resolution light microscopy, brachial plexus rhizotomy in adult rats has proven a reliable model for several neural deficits in humans. This lesion produced different degrees of terminal degeneration in the several types of primary afferents which define sub-populations of sensitive neurons. Between the C6 and C8 levels of the spinal cord,,deafferentation was partial for peptidergic GCRP-positive fibers, in contrast with elimination of non peptidergic and myelinated fibers. Dorsal rhizotomy has provided an adequate experimental model to study sensory alterations such as acute pain and allodynia as well as factors that affect regeneration into the CNS., Therefore, the differential deafferentation response must be considered inr the evaluation of therapies for nociception (pain) and regeneration for brachial plexus avulsion. The anatomical diffierences among the primary afferent subtypes also affect their roles in normal and damaged conditions.

El uso de las neuronas sensoriales primarias ha aportado avances en el entendimiento de las razones por las cuales falla la regeneración cuando el sistema nervioso central (SNC) es dañado. La rizotomía dorsal se puede usar como un modelo experimental de las lesiones por avulsión del plexo braquial, una lesión en la cual son desprendidas, en su punto de entrada en la médula espinal, las ramas centrales de los aferentes primarios causando una disfunción motora y sensorial grave e irreversible del miembro superior. En el presente trabajo, se examinó la organización central de los aferentes primarios en ratas Wistar adultas. Éstas fueron divididas en controles normales no lesionados y en animales rizotomizados entre los niveles cervical 3 y torácico 3 (C3-T3). Se estudió la deaferentación de los subtipos de axones sensoriales utilizando anticuerpos específicos contra el péptido relacionado con el gen de la calcitonina (CGRP), el receptor purinérgico (P2X3), el receptor de baja afinidad p75 para el factor de crecimiento nervioso (NGF) y contra la subunidad ®de la toxina de cólera (TCbeta ). Otro subtipo fue marcado con la lectina Griffonia simplicifolia IB4. La inmunohistoquímica y la microscopía óptica de alta resolución demostraron que el modelo animal de rizotomía completa del plexo braquial reproduce diversos déficit observados en las lesiones humanas. Esta lesión produce diferentes grados de degeneración terminal entre los diversos tipos de aferentes primarios que definen subpoblaciones de neuronas sensoriales. En los niveles de la médula espinal estudiados (entre C6 y C8), la deaferentación fue parcial para las fibras peptidérgicas GCRPpositivas, en contraste con la eliminación de las fibras no peptidérgicas y las mielinizadas. La rizotomía dorsal es un modelo experimental apropiado para estudiar las alteraciones sensoriales como el dolor agudo y la alodinia, así como los factores que podrían afectar la regeneración en el SNC. Por tanto, la respuesta de deaferentacion diferencial debe ser tenida en cuenta para la evaluación de terapias antinociceptivas y regenerativas tras la avulsión del plexo braquial. Se discute la anatomía de los subtipos de aferentes primarios y su papel en condiciones normales y después de la lesión.

Características morfológicas y electrofisiológicas de las neuronas del ganglio vestibular en cultivo / Morphologic and electrophysiologic characteristics of cultured vestibular ganglia neurons

Vestibular afferent neurons have been classified on the basis of their spontaneous activity as regular and irregular; this has been attributed to their synaptic input, but it remains to be defined the participation of some intrinsical properties of the afferent neurons in the determination of their discharge pattern. In this work, we have developed tissue cultures of the rat vestibular ganglia. Isolated cells were plated using poly-D-lysine or collagen as substrates and L-15 or Neurobasal as culture media. After 48 hrs cells in the four experimental conditions give forth neurites of variable longitude. By using antibodies against the neurofilaments 160 kDa the cell structure was studied. Monopolar (30.6), bipolar (63.9) and multipolar (5.5) cells were found. By using the voltage and current clamp procedures the voltage dependence and kinetics of the tetrodotoxin sensitive Na+ current was fully characterized. Cultured cells were shown to generate action potentials under electrical stimulation, and they were capable of repetitive spike discharge under the influence of 4-aminopyridine. These results demonstrate that tissue cultures constitute an excellent system to study the intrinsical properties of vestibular afferent neurons.

Apoptosis of sensory neurons and satellite cells after sciatic nerve transection in C57BL/6J mice

The rate of axonal regeneration, after sciatic nerve lesion in adult C57BL/6J mice, is reduced when compared to other isogenic strains. It was observed that such low regeneration was not due just to a delay, since neuronal death was observed. Two general mechanisms of cell death, apoptosis and necrosis, may be involved. By using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) technique, we demonstrated that a large number of sensory neurons, as well as satellite cells found in the dorsal root ganglia, were intensely labeled, thus indicating that apoptotic mechanisms were involved in the death process. Although almost no labeled neurons or satellite cells were observed one week after transection, a more than ten-fold increase in TUNEL labeling was detected after two weeks. The results obtained with the C57BL/6J strain were compared with those of the A/J strain, which has a much higher peripheral nerve regeneration potential. In A/J mice, almost no labeling of sensory neurons or satellite cells was observed after one or two weeks, indicating the absence of neuronal loss. Our data confirm previous observations that approximately 40 percent of C57BL/6J sensory neurons die after sciatic nerve transection, and indicate that apoptotic events are involved. Also, our observations reinforce the hypothesis that the low rate of axonal regeneration occurring in C57BL/6J mice may be the result of a mismatch in the timing of the neurons need for neurotrophic substances, and production of the latter by non-neuronal cells in the distal stump

Factor de crecimiento neuronal y sus posibles implicaciones terapéuticas en la actualidad / Nerve growth factor and its possible therapeutical implications today

Desde 1934 se realizaron estudios analizando los efectos que sobre las células sensitivas y neuronas motoras espinales que inervaban las extremidades de animales, producía la extirpación de primordios nerviosos. Las observaciones obtenidas de estos estudios (después de algunos años) permitieron el descubrimiento de un factor promotor del crecimiento neuronal, al cual se designó como factor de crecimiento neuronal (NGF). El NFG es la sustancia mejor caracterizada dentro de una familia de moléculas que se requieren para la supervivencia y el desarrollo de neuronas durante etapas embrionarias del crecimiento y durante la vida adulta. Se ha observado que, bajo ciertas circunstancias, la infusión exógena de BGF puede promover la supervivencia neuronal y la regeneración axonal, por lo cual, en la actualidad, se ha intentado la utilización de este factor para mejorar algunas condiciones patológicas en las cuales el principal componente es el daño neuronal, pudiendo producirse este último por diferentes mecanismos. Dado lo anterior, se ha postulado que la administración de BGF recombinante humano pudiera ser, en el futuro, de utilidad para el tratamiento de enfermedades del sistema nervioso central y periférico, ya que en algunos de los estudios realizados se ha demostrado que este factor puede tener efectos benéficos

The petrosal ganglion of the adult cat: neuronal count, sectional area, and their respective distributions

The petrosal ganglion contains most of the perikarya of sensory neurons of the glossopharyngeal nerve. We studied the number and size of neuronal somata in 4 petrosal ganglia from adult cats. Ganglia were serially sectioned in length at 8 microns, sections drawn through a projection microscope, and those neuronal profiles presenting nuclei and nucleoli on each section were counted and their areas measured. The number of neurons ranged from 2311 to 3429 (2908 +/- 271; mean +/- SEM). Neurons were symmetrically distributed around the longitudinal axes of most ganglia, with a skewed distribution in only one ganglion. The sectional area of most neurons (> 98 percent) ranged between 250 and 1725 microns 2, with median values of 667-963 microns 2. Area distributions were significantly different, but differences never exceeded 8.2 percent in related area bins. The ganglion presenting a skewed count distribution and the highest median area departed from the rest, with differences surpassing 25 percent. We conclude that the neuronal population of the petrosal ganglion of the cat is regular both with respect to the number and the size of its constituents, with departures from this pattern probably reflecting individual variations