Pulsed Radiofrequency Rhizotomy of the Genicular Nerves of the Knee Guided by Radioscopy and Ultrasonography: Step-By-Step Technique.

Osteoarthritis (OA) of the knee is highly prevalent and causes pain, stiffness, and harms the quality of life of millions of patients. Scientific evidence about radiofrequency ablation or rhizotomy of genicular nerves has been presented with increasing frequency in the literature for the treatment of chronic pain related to knee OA as an alternative to total knee arthroplasty. The main indication for this procedure is symptomatic OA unresponsive to conservative treatment, regardless of the disease evolution, although more common indications are in Kellgren-Lawrence grade III or IV, in post-total knee arthroplasty residual pain without an identified cause, in patients with comorbidities and high surgical risk, and those who do not want to undergo surgery. The aim of this study is to describe the step-by-step rhizotomy technique with pulsed radiofrequency of the 3 genicular nerves, guided by radioscopy and ultrasonography.

Self-Reported High-Cholesterol Prevalence in the Brazilian Population: Analysis of the 2013 National Health Survey.

BACKGROUND:: Data on the prevalence of dyslipidemia in Brazil are scarce, with surveys available only for some towns. OBJECTIVE:: To evaluate the prevalence of the self-reported medical diagnosis of high cholesterol in the Brazilian adult population by use of the 2013 National Health Survey data. METHODS:: Descriptive study assessing the 2013 National Health Survey data, a household-based epidemiological survey with a nationally representative sample and self-reported information. The sample consisted of 60,202 individuals who reported a medical diagnosis of dyslipidemia. The point prevalence and 95% confidence interval (95%CI) for the medical diagnosis of high cholesterol/triglyceride by gender, age, race/ethnicity, geographic region and educational level were calculated. Adjusted odds ratio was calculated. RESULTS:: Of the 60,202 participants, 14.3% (95%CI=13.7-14.8) never had their cholesterol or triglyceride levels tested, but a higher frequency of women, white individuals, elderly and those with higher educational level had their cholesterol levels tested within the last year. The prevalence of the medical diagnosis of high cholesterol was 12.5% (9.7% in men and 15.1% in women), and women had 60% higher probability of a diagnosis of high cholesterol than men. The frequency of the medical diagnosis of high cholesterol increased up to the age of 59 years, being higher in white individuals or those of Asian heritage, in those with higher educational level and in residents of the Southern and Southeastern regions. CONCLUSION:: The importance of dyslipidemia awareness in the present Brazilian epidemiological context must be emphasized to guide actions to control and prevent coronary heart disease, the leading cause of death in Brazil and worldwide. FUNDAMENTO:: A prevalência de hipercolesterolemia no Brasil não é conhecida para todo o país, havendo somente inquéritos em algumas cidades. OBJETIVO:: Avaliar a prevalência de diagnóstico médico de colesterol alto autorreferido na população adulta brasileira, utilizando-se dos dados da Pesquisa Nacional de Saúde (PNS) de 2013. MÉTODOS:: Estudo descritivo que avaliou os dados da PNS de 2013, um inquérito epidemiológico de base domiciliar, representativo para o Brasil, com informações autorreferidas. A amostra compreendeu 60.202 indivíduos entrevistados com autorrelato de diagnóstico médico de colesterol. Calculou-se a prevalência de ponto e o intervalo de confiança de 95% (IC95%) para diagnóstico médico de colesterol/triglicerídeos alto(s) por sexo, idade, cor da pele, região geográfica, escolaridade. Foram calculadas as razões de chance ajustadas. RESULTADOS:: Dos 60.202 participantes adultos, 14,3% (IC95%=13,7-14,8) nunca tiveram colesterol ou triglicerídeos dosados, sendo que um maior número de mulheres, idosos, indivíduos com instrução superior completa e de raça branca relatou aferição há menos de um ano. A prevalência de diagnóstico médico de colesterol alto foi de 12,5%, maior nas mulheres (15,1%) do que nos homens (9,7%). A frequência de diagnóstico médico de colesterol alto foi maior naqueles com idade até 59 anos, em brancos ou aqueles de origem asiática, em pessoas com maior escolaridade e entre os moradores das macrorregiões Sul e Sudeste do país. CONCLUSÃO:: A importância do conhecimento da dislipidemia no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças coronarianas, que representam a primeira causa de óbito no Brasil e no mundo.

Longevity and germination of Syagrus romanzoffiana (Arecaceae) seeds and its ecological implications / Longevidad y germinación de semillas de Syagrus romanzoffiana (Arecaceae) y sus implicaciones ecológicas

Syagrus romanzoffiana is a palm tree native and widely distributed of South America. The present study investigated the longevity and germination of the buried seeds of this species in an experimental seed bank. Laboratory germination and viability tests were performed for comparison with field results. Pyrenes (seeds enclosed by the endocarp) were buried in a forest fragment edge in July 2012 (dry season) and exhumed monthly during one year, for the assessment of water content and percentage of germinated and viable seeds. Germination tests were conducted in a Mangelsdorf-type germinator at 30°C under constant light and the viability was assessed by the tetrazolium test. An additional sample of pyrenes was buried to evaluate the percentage of seedling emergence and survival. Climatic and soil moisture data were recorded. In the laboratory, the pyrenes were stored for one year in a temperature-controlled room at 20ºC and 75% (±10%) relative air humidity to assess changes in the percentage of germination and viability over time. In the field, a reduction in seed viability was observed over the study period, with a total loss of viability of non-germinated seeds at seven months after burial. The maximum germination (close to 26%) was observed in the samples that were exhumed between five and seven months after burial. In the field, seedling emergence did not exceed 10% and seedling mortality was not observed. The percentages of germination and of viable seeds decreased both in burial and stored seeds. The stored seeds maintained viability at up to six months, with marked reduction thereafter. After the germination tests (four months) in the laboratory, all of the remaining seeds were nonviable. The ecological, physiological and reproductive characteristics of the species are discussed, and we concluded that S. romanzoffiana seeds have short longevity after imbibition, and low potential for soil seed bank formation. Rev. Biol. Trop. 63 (2): 333-340. Epub 2015 June 01.

Syagrus romanzoffiana (Arecaceae) es una palma nativa y ampliamente distribuida de América del Sur. El presente estudio investigó la longevidad y la germinación de las semillas enterradas de esta especie en un banco experimental. Se realizaron pruebas de germinación y viabilidad de laboratorio para hacer una comparación con los resultados de campo. Pirenos (semillas encerradas por el endocarpio) fueron enterrados en el borde de un fragmento de bosque en julio (época seca) y exhumados mensualmente por un año, para la evaluación del contenido de agua y del porcentaje de semillas germinadas y viables. Las pruebas de germinación se realizaron en un germinador tipo Mangelsdorf a 30°C bajo luz constante y la evaluación de la viabilidad se realizó con la prueba de tetrazólio. Una muestra adicional de pirenos fue enterrada para evaluar el porcentaje de emergencia de las plántulas. Se tomaron los datos climáticos y se determinó la humedad del suelo. En el laboratorio, los pirenos se almacenaron durante un año en una sala de temperatura controlada a 20°C y 75% (±10%) de humedad relativa del aire, para evaluar los cambios en el porcentaje de germinación y la viabilidad en el tiempo. En el campo, se observó una reducción de la viabilidad de las semillas durante el período de estudio, con una pérdida total de la viabilidad de las semillas no germinadas a los siete meses después del entierro. La germinación máxima (cerca de 26%) se observó en las muestras que fueron exhumadas entre cinco y siete meses después del entierro. En el campo, la emergencia de las plántulas no superó el 10% y no se observó mortalidad de plántulas. Los porcentajes de germinación y de semillas viables disminuyeron tanto en el suelo como en el laboratorio. Las semillas almacenadas mantuvieron la viabilidad hasta por seis meses de almacenamiento, con una reducción marcada a partir de entonces. Después de las pruebas de germinación (cuatro meses) en el laboratorio, todas las semillas restantes eran inviables. Discutimos las características ecológicas, fisiológicas y reproductivas de la especie, y llegamos a la conclusión de que las semillas de S. romanzoffiana tienen corta duración después de la imbibición y bajo potencial de formación del banco de semillas en el suelo.