Reduction of blood nitric oxide levels is associated with clinical improvement of the chronic pelvic pain related to endometriosis

The objective of this prospective study was to determine the plasma levels of nitric oxide (NO) in women with chronic pelvic pain secondary to endometriosis (n=24) and abdominal myofascial pain syndrome (n=16). NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM) were lower in healthy volunteers (47.0±12.7) than in women with myofascial pain (64.2±5.0, P=0.01) or endometriosis (99.5±12.9, P<0.0001). After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002). A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85), P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14), P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.

Leucoencefalomalacia multicística na evoluçäo de uma encefalopatia hipóxico-isquêmica neonatal: relato de um caso / Multicystic leucoencephalomalacia in the course of a neonatal hypoxic-ischaemic encephalopathy neonatal: a case report

O artigo apresenta o caso de um RN que apresentou uma encefalopatia hipóxico-isquêmica neonatal grave e evoluiu para uma leucoencefalopatia multicística, documentada pelos exames ultra-sonográficos evolutivos. A reabsorçäo do parênquima cerebral foi täo extensa que o aspecto tomográfico com 3 meses de idade lembrava um caso de hidranencefalia. A criança evoluiu com crises convulsivas que foram controladas com medicaçäo anticonvulsivante e coma que regrediu lentamente. Por ocasiäo da alta hospitalar apresentava um exame neurológico francamente anormal, com tetraplegia espástica e contacto pobre com o meio