Extracellular adenosine 5'-triphosphate concentrations changes in rat spinal cord associated with the activation of urinary bladder afferents. A microdialysis study. / Variação da concentração extracelular de 5'-trifosfato de adenosina na medula espinal de rata associadas a fibras aferentes vesicais. Um estudo com microdiálise

ABSTRACT Objective To determine adenosine 5’-triphosphate levels in the interstice of spinal cord L6-S1 segment, under basal conditions or during mechanical and chemical activation of urinary bladder afferents. Methods A microdialysis probe was transversally implanted in the dorsal half of spinal cord L6-S1 segment in female rats. Microdialysate was collected at 15 minutes intervals during 135 minutes, in anesthetized animals. Adenosine 5’-triphosphate concentrations were determined with a bioluminescent assay. In one group of animals (n=7) microdialysate samples were obtained with an empty bladder during a 10-minutes bladder distension to 20 or 40cmH2O with either saline, saline with acetic acid or saline with capsaicin. In another group of animals (n=6) bladder distention was performed and the microdialysis solution contained the ectonucleotidase inhibitor ARL 67156. Results Basal extracellular adenosine triphosphate levels were 110.9±35.34fmol/15 minutes, (mean±SEM, n=13), and bladder distention was associated with a significant increase in adenosine 5’-triphosphate levels which was not observed after bladder distention with saline solution containing capsaicin (10µM). Microdialysis with solution containing ARL 67156 (1mM) was associated with significantly higher extracellular adenosine 5’-triphosphate levels and no further increase in adenosine 5’-triphosphate was observed during bladder distension. Conclusion Adenosine 5’-triphosphate was present in the interstice of L6-S1 spinal cord segments, was degraded by ectonucleotidase, and its concentration increased following the activation of bladder mechanosensitive but not of the chemosensitive afferents fibers. Adenosine 5’-triphosphate may originate either from the central endings of bladder mechanosensitive primary afferent neurons, or most likely from intrinsic spinal neurons, or glial cells and its release appears to be modulated by capsaicin activated bladder primary afferent or by adenosine 5’-triphosphate itself.

RESUMO Objetivo Determinar as concentrações extracelulares do 5’-trifosfato de adenosina no interstício dos segmentos medulares L6-S1, em condições basais ou durante a ativação mecânica e química das fibras aferentes vesicais. Métodos Um cateter de microdiálise foi implantado no sentido transversal na parte dorsal da medula espinal, entre os segmentos L6-S1 de ratas. O microdialisado foi coletado em intervalos de 15 minutos, durante 135 minutos, com os animais anestesiados. A concentração de 5’-trifosfato de adenosina nas amostras foi determinada mediante ensaio de bioluminescência. Em um grupo de animais (n=7), as amostras de microdialisado foram obtidas com a bexiga vazia, com distensão da bexiga para volume de 20 ou 40cmH2O, com solução salina, solução salina com ácido acético, ou solução salina com capsaicina. Em outro grupo (n=6), foi realizada com a bexiga distendida, e a solução para microdiálise continha o inibidor de ectonucleotidase ARL 67156. Resultados Os níveis extracelulares de trifosfato de adenosina no início do estudo foram 110,9±35,36fmol/15 minutos (média±EPM, n=13), e a distensão da bexiga causou um aumento nos níveis de 5’-trifosfato de adenosina, o que não foi observado após a distensão da bexiga com solução salina contendo capsaicina (10µM). A microdiálise com solução contendo ARL 67156 (1mM) foi associada com significante aumento dos níveis de trifosfato de adenosina extracelular, e nenhum aumento do trifosfato de adenosina foi observado durante a distensão da bexiga. Conclusão O 5’-trifosfato de adenosina está presente no interstício do segmento L6-S1 da medula espinal, é degradado por ectonucleotidases, e sua concentração aumentou com a ativação das fibras aferentes mecanossensíveis da bexiga, mas não das quimiossensíveis. O 5’-trifosfato de adenosina pode ter sido liberado das terminações centrais dos neurônios aferentes primários mecanossensíveis ou, mais provavelmente, de neurônios espinais intrínsecos, ou ainda de células gliais. Sua liberação parece ser modulada por fibras aferentes primárias da bexiga ativadas pela capsaicina ou pelo próprio 5’-trifosfato de adenosina.

Medicinas tradicionales andinas y su despenalización: entrevista con Walter Álvarez Quispe / Decriminalizing traditional Andean medicine: an interview with Walter Álvarez Quispe

Walter Álvarez Quispe, terapeuta kallawaya y biomédico especializado en cirugía general y ginecología, presenta la lucha de los terapeutas tradicionales y alternativos por la depenalización de estos sistemas médicos andinos realizada entre 1960 y 1990. Bolivia se torna el primer país en América Latina y el Caribe en despenalizar la medicina tradicional antes de los planteamientos de la Conferencia Internacional sobre Atención Primaria de Salud (Alma-Ata, 1978). Los datos aportados por el entrevistado aseguran que los logros alcanzados, principalmente por los kallawayas, responden a un proyecto propio y autónomo. Estas conquistas no se deben a las políticas oficiales de interculturalidad en salud, aunque busquen atribuirse para sí los logros alcanzados.

Walter Álvarez Quispe, a Kallawaya healer and biomedical practitioner specializing in general surgery and gynecology, presents the struggle of traditional and alternative healers to get their Andean medical systems depenalized between 1960 and 1990. Bolivia was the first country in Latin America and the Caribbean to decriminalize traditional medicine before the proposals of the International Conference on Primary Health Care (Alma-Ata, 1978). The data provided by the interviewee show that the successes achieved, mainly by the Kallawayas, stem from their own independent initiative. These victories are not the result of official policies of interculturality in healthcare, although the successes achieved tend to be ascribed to them.

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. .

Sertraline inhibits formalin-induced nociception and cardiovascular responses

The objective of the present study was to determine the antihyperalgesic effect of sertraline, measured indirectly by the changes of sciatic afferent nerve activity, and its effects on cardiorespiratory parameters, using the model of formalin-induced inflammatory nociception in anesthetized rats. Serum serotonin (5-HT) levels were measured in order to test their correlation with the analgesic effect. Male Wistar rats (250-300 g) were divided into 4 groups (N = 8/per group): sertraline-treated group (Sert + Saline (Sal) and Sert + Formalin (Form); 3 mg·kg-1·day-1, ip, for 7 days) and saline-treated group (Sal + Sal and Sal + Form). The rats were injected with 5 percent (50 µL) formalin or saline into the right hind paw. Sciatic nerve activity was recorded using a silver electrode connected to a NeuroLog apparatus, and cardiopulmonary parameters (mean arterial pressure, heart rate and respiratory frequency), assessed after arterial cannulation and tracheotomy, were monitored using a Data Acquisition System. Blood samples were collected from the animals and serum 5-HT levels were determined by ELISA. Formalin injection induced the following changes: sciatic afferent nerve activity (+50.8 ± 14.7 percent), mean arterial pressure (+1.4 ± 3 mmHg), heart rate (+13 ± 6.8 bpm), respiratory frequency (+4.6 ± 5 cpm) and serum 5-HT increased to 1162 ± 124.6 ng/mL. Treatment with sertraline significantly reduced all these parameters (respectively: +19.8 ± 6.9 percent, -3.3 ± 2 mmHg, -13.1 ± 10.8 bpm, -9.8 ± 5.7 cpm) and serum 5-HT level dropped to 634 ± 69 ng/mL (P < 0.05). These results suggest that sertraline plays an analgesic role in formalin-induced nociception probably through a serotonergic mechanism.

Los péptidos opioides en la integración sensorial y los trastornos perceptuales del dolor en la médula espinal / Opioid peptides in pain sensorial integration and perceptual dysfunction in the spinal cord

Se revisan las evidencias de la localización anatómica y el papel de los péptidos opioides en el procesamiento de la información sensorial nociceptiva y no nociceptiva en la médula espinal. En particular se analizan algunos de los mecanismos que se constituyen per se, en generadores de estados complejos de nocicepción , como la alodinia, es decir estímulos sensoriales no nociceptivos que producen dolor. se propone un modelo experimental con el cual se obtienen resultados prolongados (más de 2 h.) de actividad unicelular, de neuronas registradas en el asta dorsal de la médula espinal de la rata íntegra y anestesiada (uretano, 1500mg/kg). La preparación permite la indentificación de las neuronas registradas, por medio de la activación directa de su campo sensorial. Los cambios en la codificación sensorial se inducen mediante la infiltración subcutánea de carragenina (200 µl, al 1 por ciento) en el mismo campo. Los resultados muestran un incremento de la frecuencia de disparo de las neuronas, que en situación control responden sólo a estimulación táctil suave o al movimiento del pelo. Este incremento es lo que consideramos dolor, dado que se revirtió con la administración de naloxona (1 mg/kg iv) incrementó la frecuencia, después de 80 min. de infiltrada la carragenina. Se puede concluir que con el abordaje experimental presentado se han obtenido datos que reproducen el fenómeno de la alodinia y que éste se encuentra mediado por el sistema opioide

Apertura palpebral prematura experimental y desarrollo neuronal en la rata recién nacida / Experimental premature eyelid openingand neuron development in new-born rats

Los extractos de glándula submaxilar (EGS) de ratón induce apertura prematura de los párpados en ratas recién nacidas. En animales sometidos a ciclos alternos de luz-obscuridad y con EGS, las neuronas de la corteza visual exhiben, en la dendrita principal, más espinas y un mayor grado de ramificación que los controles, en tanto que en animales mantenidos en obscuridad total y con EGS, únicamente disminuyen las espinas dendríticas, mientras que el grado de ramificación es mayor comparado con los controles.

Urinary bladder serosal chemoreceptor induced cardio-respiratory responses: possible pathway.

There is limited experimental information about pain originating from the urinary bladder. In the present study application of 3-5 ml of 1% ammonium oxalate, 1% potassium chloride, 100m M citric acid, IM ammonium chloride, 1% oxalic acid, 0.5% sodium hydroxide, or 2 micrograms/ml bradykinin, to the serosal surface of the urinary bladder in anaesthetized dogs, resulted in an increase in heart rate, rise of both systolic and diastolic blood pressures and increase in respiratory rate and depth. These facilitatory cardio-respiratory responses were coupled with powerful contractions of the urinary bladder wall. By contrast, mucosal application of the chemicals did not bring about any significant change. The cardio-respiratory responses obtained were completely abolished on serosal application of procaine (1%), section of the hypogastric nerves or by spinalectomy at T8. Bilateral cervical vagotomy and pelvic nerve section did not modify the responses. However, the blood pressure responses were abolished by the administration of tolazoline hydrochloride, indicating a major role of sympathetics in this nociceptive reflex.

A study of nerve conduction velocity in patients on diphenylhydantoin therapy.

Peripheral nerve conduction studies were performed in 30 epileptics, treated with DPH and results were compared with age and sex matched controls. There was significant reduction in the amplitude of sensory nerve action potential of median (26.65 +/- 14.71 mu v) and superficial radial nerve (25.65 +/- 10.08 mu v) (p < 0.001) in DPH treated group as compared to controls, (median nerve 42.64 +/- 15.93 uv and superficial radial nerve 40.72 +/- 24.74 mu v). The results suggest that DPH causes a subclinical distal axonal neuropathy in therapeutic dosage.

Effect of caffeine administration on latent learning ability of male rats in a simple maze task

The proximal and distal stumps of severed mouse sciatic nerves were inserted into opposite ends of polyethylene tubes. The tubes were implanted either empty ofr filled with collagen alone or in combination with interleukin-1 (IL1). Six weeks later, neurons in the L3-L5 dorsal root ganglia were back-filled with HRP. The number of HRP reactive sensory neurons detected in the IL1-treated animals was significantly greater than that seen in the other experimental groups. Thus, exogenous IL1 may partially mimic the effects obtained with in vivo administration of nerve growth factor in protecting sensory neurons from lesion-induced death