Receptors involved in dexketoprofen analgesia in murine visceral pain.

Various animal models, especially rodents, are used to study pain, due to the difficulty of studying it in humans. Many drugs that produce analgesia have been studied and there is evidence among which NSAIDs deserve to be highlighted. Dexketoprofen (DEX) provides a broad antinociceptive profile in different types of pain; therefore, this study was designed to evaluate the profile of antinociceptive potency in mice. Analgesic activity was evaluated using the acetic acid abdominal constriction test (writhing test), a chemical model of visceral pain. Dose-response curves for i.p. DEX administration (1, 3, 10, 30 and 100 mg/kg), using at least six mice in each of at least five doses, was obtained before and 30 min after pre-treatment with different pharmacological agents. Pretreatment of the mice with opioid receptor antagonists was not effective; however, the serotonin receptor antagonist and nitric oxide synthase inhibitor produce a significant increase in DEX-induced antinociception. The data from the present study shows that DEX produces antinociception in the chemical twisting test of mice, which is explained with difficulty by the simple inhibition of COX. This effect appears to be mediated by other mechanisms in which the contribution of the NO and 5-HT pathways has an important effect on DEXinduced antinociception.

Interleukin-1beta in synergism gabapentin with tramadol in murine model of diabetic neuropathy.

Neuropathic pain is a complication of cancer and diabetes mellitus and the most commonly used drugs in the treatment of the diabetic neuropathic pain have only limited efficacy. The aim of this study was to evaluate the role of the biomarker interleukin-1beta (IL-1ß) in the pharmacological interaction of gabapentin with tramadol in a model of diabetic neuropathic pain. CF-1 male mice, pretreated with 200 mg/kg i.p. of streptozocin (STZ), were used and at day 3 and 7 were evaluated by the hot plate test and the spinal cord level of IL-1ß was determined. Antinociceptive interaction of the coadministration i.p. of gabapentin with tramadol, in basic of the fixed the ratio 1:1 of their ED50 values alone, was ascertained by isobolographic analysis. Tramadol was 1.13 times more potent than gabapentin in saline control mice, 1.40 times in STZ mice at 3 days and 1.28 times in STZ at 7 days. The interaction between gabapentin and tramadol was synergic, with an interaction index of 0.30 and 0.22 for mice pretreated with STZ at 3 and 7 days. The combination of gabapentin with tramadol reversed the increased concentration of IL-1ß induced by STZ in diabetic neuropathic mice. These findings could help clarify the mechanism of diabetic neuropathy.

Detection and Molecular Characterization of Yellow Fever Virus, 2017, Brazil.

At the end of 2016, Brazil experienced an unprecedented yellow fever (YF) outbreak. Clinical, molecular and ecological aspects of human and non-human primate (NHP) samples collected at the beginning of the outbreak are described in this study. Spatial distribution analyses demonstrated a strong overlap between human and NHP cases. Through molecular analyses, we showed that the outbreak had a sylvatic origin, caused by the South American genotype 1 YFV, which has already been shown to circulate in Brazil. As expected, the clusters of cases were identified in regions with a low vaccination coverage. Our findings highlight the importance of the synchronization of animal surveillance and health services to identify emerging YF cases, thereby promoting a better response to the vulnerable population.

Hiperdensidad ósea: relevancia clínica / Bone hyperdensity: clinical relevance

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Antinociceptive interaction of gabapentin with minocycline in murine diabetic neuropathy.

OBJECTIVE: Diabetic neuropathy (DN) is the most common complication of diabetes and pain is one of the main symptoms of diabetic neuropathy, however, currently available drugs are often ineffective and complicated by adverse events. The purpose of this research was to evaluate the antinociceptive interaction between gabapentin and minocycline in a mice experimental model of DN by streptozocin (STZ). METHODS: The interaction of gabapentin with minocycline was evaluated by the writhing and hot plate tests at 3 and 7 days after STZ injection or vehicle in male CF1 mice. RESULTS: STZ (150 mg/kg, i.p.) produced a marked increase in plasma glucose levels on day 7 (397.46 ± 29.65 mg/dL) than on day 3 (341.12 ± 35.50 mg/dL) and also developed neuropathic pain measured by algesiometric assays. Gabapentin produced similar antinociceptive activity in both writhing and hot plate tests in mice pretreated with STZ. However, minocycline was more potent in the writhing than in the hot plate test in the same type of mice. The combination of gabapentin with minocycline produced synergistic interaction in both test. CONCLUSION: The combination of gabapentin with minocycline in a 1:1 proportion fulfills all the criteria of multimodal analgesia and this finding suggests that the combination provide a therapeutic alternative that could be used for human neuropathic pain management.

Atividade folicular ovariana em avestruz (Struthio camelus) avaliada por ultrassonografia e sua relação com fotoperíodo e postura / Follicular activity in ostriches (Struthio camelus) evaluated by ultrasonography, and its relation with the photoperiod and egg laying

The objective of the experiment was to verify, through ultrasonography, the follicular activity of ostriches in different seasons of the year, correlating them with photoperiod, number of rainy days in each month and egg laying. Eight females were evaluated monthly, during 12 consecutive months in an ostrich farm located in the Center-West of Minas Gerais, Brazil. It was found that the time of the year for egg laying lasts for eight months, from June to January. The egg laying was positively correlated (r = 0.48; P<0.01) with photoperiod. However, there was no correlation between the egg laying and the follicular activity with the amount of rain. Considering the technique adopted, the right antimere offered better ultrasonographic access. The method was efficient for ovary follicular evaluation in the ostrich, offering adequate subsidies for the evaluation of the reproductive activity of the female.

Caracterización de pacientes operados de metástasis cerebral en el Instituto de Neurocirugía Asenjo (INCA) / Description of patients that underwent brain metastases surgery in Asenjo Neurosurgery Institute (INCA)

Background: Brain metastases are an increasing cause of morbimortality in patients with cancer. There are few national reports about surgical treatment of these patients. Objective: Description of patients that underwent surgical metastases surgery, survival and functionality. Methods: Retrospective study including all patients treated with surgery between 2003 and 2006 in Asenjo Neurosurgery Institute, which histological diagnosis confirmed brain metastasis. After surgery, follow up was made by telephone to determine survival and functional impairment. Results: A total of fifty patients underwent surgery. The most frequent primary tumor was lung with 28 percent. The distribution of lesions in cerebrum, cerebellum and brainstem was: 74 percent, 22 percent and 4 percent respectively Telephone contact after surgery was successful in 17 patients, of whom 10 received postoperative radiotherapy, 4 didrit receive any other treatment and 3 didnt provide information. The overall rate of survival in the 17 patients was 45,7 weeks. When the postoperative radiotherapy subgroup was compared with only surgery subgroup, the mean survival was 46,7 and 31 weeks respectively, with no significant difference (p > 0,2). Functional impairment increased from 4 patients in preoperatory to 8 after surgery. Conclusions: In this group, the combination of surgery plus radiotherapy increased the survival in 3,9 months. The increase in functional impairment after surgery can be explained because of the primary tumor progression. An appropriate selection of patients for surgery would result in an increase in the number of operated patients, and the experience in the management for these patients.

Introducción: Las metástasis cerebrales son una causa en aumento de morbilidad y mortalidad en pacientes con cáncer, sin embargo, la experiencia nacional en el tratamiento quirúrgico de estos pacientes es escasa. Objetivo: Caracterización de pacientes operados de metástasis cerebral, sobrevida y funcionalidad. Métodos: Estudio retrospectivo del total de pacientes operados entre los años 2003 y 2006 en el Instituto de Neurocirugía Asenjo, cuyo diagnóstico histológico confirmó metástasis cerebral. Seguimiento telefónico para determinar sobrevida y funcionalidad. Resultados: Un total de 50 pacientes fueron operados. El tumor primario más frecuente fue el pulmón con 28 por ciento). La ubicación de las lesiones en el cerebro, cerebelo y tronco fue: 74 por ciento, 22 por ciento y 4 por ciento respectivamente. Sólo pudo realizarse seguimiento telefónico a 17 pacientes, de los cuales 10 recibieron radioterapia postquirúrgica, 4 no recibieron ningún otro procedimiento y 3 no aportaron información. La sobrevida global de los 17 pacientes fue 45,7 semanas. Al comparar el grupo que recibió radioterapia postquirúrgica con el que no, la sobrevida fue de 46,7 y 31 semanas respectivamente, diferencia no significativa (p > 0,2). La incapacidad funcional aumentó de 4 pacientes en el prequirúrgico a 8 pacientes en el postquirúrgico. Conclusión: En esta serie, la combinación de cirugía y radioterapia aumentó la sobrevida en 3,9 meses. El aumento de la incapacidad funcional en el postquirúrgico puede explicarse por una progresión de la enfermedad de base. Una adecuada selección de los candidatos a cirugía podría resultar en un mayor número de pacientes operados y mayor experiencia en el manejo de estos pacientes.

Simple approach to prenatal diagnosis of transposition of the great arteries.

OBJECTIVE: To analyze the most relevant anomalies, seen in a sequential segmental transverse views approach to imaging the fetal heart, that provide clues to the diagnosis of complete transposition of the great arteries (TGA). METHODS: We reviewed retrospectively all the cases of isolated TGA diagnosed in our center or submitted for a second opinion through the spatio-temporal image correlation (STIC) telemedicine (TELE-STIC) program. Only transverse cardiac sweeps were obtained. Digital video clips and STIC volumes were reviewed. The abnormal features on four-chamber, five-chamber, three-vessel (3V) and three vessels and trachea (3VT) views were analyzed. RESULTS: The study population consisted of eight fetuses with TGA with normal extracardiac anatomy. The gestational age ranged from 13 to 32 (mean, 23) weeks. The maternal age ranged from 25 to 42 (mean, 32) years. A normal four-chamber view was seen in seven cases. Only one case demonstrated a significant ventricular septal defect. At the level of the five-chamber view a straight course arterial vessel arose from the left ventricle with lateral branches in all fetuses. In the 3V view, the ascending aorta was seen reaching more anteriorly than was the pulmonary artery in six cases. At the level of the 3VT view, two vessels (transverse aortic arch and superior vena cava) rather than three were seen in all cases. CONCLUSION: Our proposed sequential segmental approach to imaging the fetal heart apparently allows, in five-chamber and 3VT views, clear and confident signs to be detected that aid diagnosis of TGA.

Spatio-temporal image correlation (STIC): a new tool for the prenatal screening of congenital heart defects.

OBJECTIVE: To assess the feasibility and capability of STIC acquisition, performed by a general obstetrician performing antenatal ultrasound, to visualize fetal cardiac structures in women undergoing routine obstetric ultrasound examination, in order to obtain information to confirm normality of the fetal heart during intrauterine life. METHODS: This was a prospective study of one hundred fetuses with echocardiographically confirmed normal hearts and no extracardiac anomalies with gestational ages ranging between 18 and 37 weeks. A general obstetrician was invited to acquire the STIC volumes. The four-chamber view was obtained as a starting point. A standard 7.5-s acquisition time and 30 degrees angle of acquisition were used and the resulting STIC was stored for later offline analysis by a fetal echocardiologist. For each patient, the stored STIC data were first evaluated by sweeping from the initial acquisition plane, in the caudal direction and then cranially, zooming, slowing or stopping the cardiac motion to visualize views and structures. If a structure or view was rated as inadequate or not identifiable, a multiplanar three-dimensional (3D) examination of the STIC volume was taken in order to try to visualize it adequately. The rates obtained using just the STIC sweeps were compared independently, and then the 3D multiplanar study was added. RESULTS: STIC acquisition was possible in all cases. The mean time required for STIC acquisition was 7.5 min. A complete cardiac examination according to the set criteria was achieved in 94.2% (95% confidence interval (CI), 90-99) of cases. We obtained a 94.2% success rate of visualizing different structures and views of the fetal heart using the STIC sweep alone (95% CI, 90-99) and 96.2% adding 3D multiplanar examination (95% CI, 92-100). CONCLUSION: STIC acquisition of the fetal heart is feasible with high success rates in visualization of the principal connections. The STIC data acquired by a general obstetrician can subsequently be used by a fetal echocardiologist for prenatal confirmation of normal cardiac structure or exclusion of major cardiac malformations.

[Laparoscopic adrenalectomy. Initial results of a Chilean experience]. / Adrenalectomía laparoscópica. Resultados de una experiencia chilena inicial.

BACKGROUND: Laparoscopic adrenal approach was introduced in 1992 and is becoming the surgical method of choice for several adrenal diseases. AIM: To report the initial Chilean experience in laparoscopic adrenalectomy. MATERIAL AND METHODS: A retrospective review of 17 patients subjected to the surgical procedure by the authors. RESULTS: The preoperative diagnosis were adenomas (8 patients), pheochromocytoma (3), cystic lesions (2), adrenal metastases (2), hyperaldosteronism (1) and a pituitary Cushing (1). The average lesion size was 5.4 cm, the operative time 2.5 hours and the hospital stay 2.5 days. Eight patients were discharged in less than 48 hours. Pain was managed with non steroidal antiinflammatory drugs in 14 patients. One subject required conversion to open surgery. Transfusions were required in complex cases with a diaphragmatic hamartoma, Cushing disease and in a combined adrenal and renal resection. One patient had to be re admitted due to a pancreatic pseudo cyst that was drained percutaneously. There have been no recurrences after a mean follow up of 2 years. CONCLUSIONS: This early experience with laparoscopic adrenalectomy shows good results. A good patient selection and experience with advanced laparoscopic surgery are requisites for a successful use of this surgical technique.

Cirugía laparoscópica avanzada / Advanced laparoscopic surgery

El vertiginoso y exitoso desarrollo de la colecistectomía laparoscópica ha orientado este abordaje hacia la resolución de otras patologías quirúrgicas. Es lo que se conoce como cirugía laparoscópica avanzada. Iniciamos un registro prospectivo en el programa Epi Info 5.01, en diciembre de 1996. Hasta julio de 1997 hemos operado 17 pacientes, 10 mujeres y 7 hombres, de 27 a 56 años. Fueron 6 vagotomías supraselectivas, 4 fundoplicaturas, 2 de ellas con hernia hiatal, se les agregó cierre del hiato, 4 gastroplastias en obesidad mórbida, una quistoperiquistectomía parcial en quiste hidatídico hepático y 7 coledocostomías. No hubo morbimortalidad atribuibles a las técnicas empleadas. Hubo satisfacción en los enfermos operados, no hay a la fecha recidiva ulcerosa ni de reflujo gastroesofágico. Los obesos mórbidos han bajado 8 kg por mes y aún no alcanzan su estabilización ponderal. Consideramos que la cirugía laparoscópica avanzada puede ser empleada por cualquier cirujano diestro en colecistectomía laparoscópica y con experiencia en las técnicas de cirugía convencional

[Immune modulating effect of intravenous gamma globulin in a patient with overlapping syndrome]. / Efecto inmunomodulador de gamaglobulina endovenosa en un caso de síndrome de sobreposición.

We report a 46 years old woman with a diagnosis of systemic lupus erythematosus and scleroderma overlapping syndrome. During treatment with steroids and azathioprine, the appearance of paresthesias and a progressive invalidating proximal weakness was interpreted as a steroidal myopathy. Steroidal treatment was progressively discontinued, but lupic activity and esophageal involvement exacerbated. Therefore, the use of immune modulating doses of intravenous gamma globulin (2 g/kg/total dose) was decided. The patient received this dose in two consecutive days and, 48 hours later, a notable improvement in esophageal function and general condition was verified. After six months of follow up, the disease remains inactive.

[Prevalence of false seropositivity for syphilis in a population of pregnant women]. / Prevalencia de serología falsa positiva para sífilis en una población de embarazadas.

A retrospective chart review of 439 pregnant women with positive syphilis serology detected with VDRL was made. One hundred twenty two women (27.7%), aged 17 to 43 years and with a gestational age ranging from 8 to 38 weeks, had false positive VDRL tests. None of these patients had a titer over 1:4 and 65% had a weakly reactive VDRL. Forty percent of women were diagnosed as having an early latent syphilis and 20% as late latent syphilis. Due to the high frequency of these later diagnoses in women with VDRL titers below 1:2, with no risk factors and negative sexual partners, post partum follow up is essential to detect cases with false positive FTA-ABs tests.

Detection of ventricular ectopy in patients with coronary heart disease and normal subjects by exercise testing and ambulatory electrocardiography.

Maximal exercise testing and 24-hour ambulatory electrocardiographic recording (Holter monitor) were utilized in the detection of ventricular ectopy in 90 patients with stable chronic coronary heart disease and in 30 normal subjects. Although the occurrence of any ventricular ectopic activity, as detected by either or both methods, was common, the incidence was significantly higher (P less than 0.001) in patients with coronary heart disease (86 percent; 77/90), as compared to that in normal subjects (40 percent; 12/30). Ventricular arrhythmia was more frequently detected by the 24-hour continuous electrocardiographic recording, being found in 70 of the 90 patients with coronary heart disease and in ten of the 30 normal subjects. In comparison, exercise testing disclosed ventricular ectopy in 56 of the 90 patients with coronary heart disease and in two of the 30 normal subjects. Multiform and repetitive patterns of ventricular ectopy were detected twice as commonly by continuous electrocardiographic recording than with exercise testing, and these patterns were present in one-half of the patients with coronary heart disease. Both methods of examination adjunctively disclosed more ventricular ectopy than either method alone.

Ventricular arrhythmia 24 hours before and after maximal treadmill testing.

To determine if maximal exercise treadmill testing influences the occurence of ventricular arrhythmia in the hours after exercise, 45 myocardial infarction and 22 angina pectoris patients (New York Heart Association Class I-II), and 23 normal subjects were examined with 24-hour ambulatory electrocardiographic Holter recordings before and after exercise testing. Comparison of qualitative and quantitative ventricular arrhythmia detected during identical chronological two-, four-, and 20- or more hour periods, before and after exercise testing in each patient, revealed no statistically significant difference in any patient group. The prevalence of ventricular ectopy in 80 per cent of ischemic heart disease patients and 30 per cent of normal subjects as detected by 24-hour Holter recordings was similar to previous studies. It is concluded that in ambulatory ischemic heart disease patients (New York Heart Association Class I-II) and normal subjects, maximal treadmill testing does not significantly affect the occurrence of ventricular arrhythmia in the hours after exercise.

Purification and properties of tRNA nucleotidyl transferase from Musca domestica.

The enzyme tRNA nucleotidyl transferase (EC 2.7.7.25) has been highly purified from whole adult houseflies. A molecular weight of 30 000 has been determined. The enzyme requires Mg2+ and tRNA deprived of the 3' terminal sequence CCA for activity in the incorporation of AMP and CMP onto the tRNA. UMP can be incorporated instead of CMP but the latter has a higher affinity than UMP as shown by competition experiments. A complex between the enzyme and tRNA has been shown by sucrose gradient centrifugation, nitrocellulose binding and protection by tRNA against enzyme denaturation at 50 degrees C. Comparative studies with tRNA nucleotidyl transferase purified from larvae, pupae and adult insects indicate that tRNA nucleotidyl transferase from these three developmental stages have the same molecular weight, sedimentation coefficient and optimum pH while the larval enzyme differs from the pupae and adult enzymes in the elution behaviour from a DEAE-cellulose column.