Effective brain connectivity related to non-painful thermal stimuli using EEG.

Understanding the brain response to thermal stimuli is crucial in the sensory experience. This study focuses on non-painful thermal stimuli, which are sensations induced by temperature changes without causing discomfort. These stimuli are transmitted to the central nervous system through specific nerve fibers and are processed in various regions of the brain, including the insular cortex, the prefrontal cortex, and anterior cingulate cortex. Despite the prevalence of studies on painful stimuli, non-painful thermal stimuli have been less explored. This research aims to bridge this gap by investigating brain functional connectivity during the perception of non-painful warm and cold stimuli using electroencephalography (EEG) and the partial directed coherence technique (PDC). Our results demonstrate a clear contrast in the direction of information flow between warm and cold stimuli, particularly in the theta and alpha frequency bands, mainly in frontal and temporal regions. The use of PDC highlights the complexity of brain connectivity during these stimuli and reinforces the existence of different pathways in the brain to process different types of non-painful warm and cold stimuli.

Thermal sensation index for elderly people living in Brazil.

With the aging of the human body, some physiological changes occur, compromising thermoregulatory mechanisms, negatively influencing the individual's thermal sensation. Given this fact, the present study aimed to build a predictive model to determine the thermal sensation index for elderly people (TSIEP) in a hot climate region, considering their sensitivity in the perception of climate change in the city of Campina Grande, in the semi-arid region of Paraíba/Brazil. For this purpose, an observational study was carried out from April to December 2016 with elderly people inside their homes. The responses of the sample units (elderly people) to the categories of thermal sensation (hot, comfortable, and cold) were transformed into probit estimates, and, using the multivariate modeling statistical technique (canonical correlation), the TSIEP was determined. Finally, TSIEP showed that the thermal sensation of elderly people residing in Campina Grande tends to be more sensitive to cold and less sensitive to heat.

Vaginal temperature as indicative of thermoregulatory response in Nellore heifers under different microclimatic conditions.

The objective was to evaluate vaginal temperature as a thermoregulatory response of Nellore heifers under different microclimatic conditions. The study was conducted during one year in an experimental area located at 54°37'W, 20°27'S, and 530 m of altitude in Brazil. Twenty-four Nellore females were reared in integrated crop-livestock-forestry systems with different shading patterns. The randomized complete block experimental design was utilized with a sub subdivided plots scheme, with plot corresponding to the production systems, the subplot to the season of the year, and the sub subplot, the hours of the day. To characterize the microclimate, data regarding air and black globe temperatures, and air relative humidity were collected and from them, temperature-humidity index was calculated. Vaginal temperature was obtained by using a bottom-type temperature logger (i-button) attached to an adapted intravaginal device. The black-globe temperature explained the variation on vaginal temperature. Increases on vaginal temperature were only observed, on average, two hours after the increase of black-globe temperature. The microclimatic conditions found in the systems, resulting from the various tree densities, modify the vaginal temperature in different degrees, demonstrating that the shading effect is not always accompanied by improvements in thermal comfort. The system with intermediate density showed a better microclimatic condition and, consequently, a lower increase in vaginal temperature. The interaction between air temperature, humidity and solar radiation resulted in adverse environmental conditions, however, Nellore heifers showed good adaptation to the environment. In conclusion, vaginal temperature is a good indicator to evaluate the thermoregulatory response in Nellore heifers.

Influence of the thermal environment on the stingless bee foraging activity: a mini-review

In tropical environments, stingless bees are an important group of pollinators, helping to maintain plant biodiversity and, consequently, to preserve ecosystems. The foraging activity of these insects is influenced by biotic and abiotic factors. Although air temperature limits activities outside the hive, the natural thermal environment is complex; meteorological variables interact with each other, requiring elaborate thermoregulatory responses from bees. The complexity of the thermal environment has been the subject of recent research on insect thermoregulation. The effects of wind and especially solar radiation should be considered when studying the behavior of stingless bees. In this context, this mini-review aimed to address the main components of the thermal environment that influence the foraging activity of stingless bees.

Influence of the thermal environment on the stingless bee foraging activity: a mini-review

In tropical environments, stingless bees are an important group of pollinators, helping to maintain plant biodiversity and, consequently, to preserve ecosystems. The foraging activity of these insects is influenced by biotic and abiotic factors. Although air temperature limits activities outside the hive, the natural thermal environment is complex; meteorological variables interact with each other, requiring elaborate thermoregulatory responses from bees. The complexity of the thermal environment has been the subject of recent research on insect thermoregulation. The effects of wind and especially solar radiation should be considered when studying the behavior of stingless bees. In this context, this mini-review aimed to address the main components of the thermal environment that influence the foraging activity of stingless bees.(AU)

Role of TRPM8 Channels in Altered Cold Sensitivity of Corneal Primary Sensory Neurons Induced by Axonal Damage.

The cornea is extensively innervated by trigeminal ganglion cold thermoreceptor neurons expressing TRPM8 (transient receptor potential cation channel subfamily M member 8). These neurons respond to cooling, hyperosmolarity and wetness of the corneal surface. Surgical injury of corneal nerve fibers alters tear production and often causes dry eye sensation. The contribution of TRPM8-expressing corneal cold-sensitive neurons (CCSNs) to these symptoms is unclear. Using extracellular recording of CCSNs nerve terminals combined with in vivo confocal tracking of reinnervation, Ca2+ imaging and patch-clamp recordings of fluorescent retrogradely labeled corneal neurons in culture, we analyzed the functional modifications of CCSNs induced by peripheral axonal damage in male mice. After injury, the percentage of CCSNs, the cold- and menthol-evoked intracellular [Ca2+] rises and the TRPM8 current density in CCSNs were larger than in sham animals, with no differences in the brake K+ current IKD Active and passive membrane properties of CCSNs from both groups were alike and corresponded mainly to those of canonical low- and high-threshold cold thermoreceptor neurons. Ongoing firing activity and menthol sensitivity were higher in CCSN terminals of injured mice, an observation accounted for by mathematical modeling. These functional changes developed in parallel with a partial reinnervation of the cornea by TRPM8(+) fibers and with an increase in basal tearing in injured animals compared with sham mice. Our results unveil key TRPM8-dependent functional changes in CCSNs in response to injury, suggesting that increased tearing rate and ocular dryness sensation derived from deep surgical ablation of corneal nerves are due to enhanced functional expression of TRPM8 channels in these injured trigeminal primary sensory neurons.SIGNIFICANCE STATEMENT We unveil a key role of TRPM8 channels in the sensory and autonomic disturbances associated with surgical damage of eye surface nerves. We studied the damage-induced functional alterations of corneal cold-sensitive neurons using confocal tracking of reinnervation, extracellular corneal nerve terminal recordings, tearing measurements in vivo, Ca2+ imaging and patch-clamp recordings of cultured corneal neurons, and mathematical modeling. Corneal nerve ablation upregulates TRPM8 mainly in canonical cold thermoreceptors, enhancing their cold and menthol sensitivity, inducing a rise in the ongoing firing activity of TRPM8(+) nerve endings and an increase in basal tearing. Our results suggest that unpleasant dryness sensations, together with augmented tearing rate after corneal nerve injury, are largely due to upregulation of TRPM8 in cold thermoreceptor neurons.

Reverse Engineering of a Thermosensing Regulator Switch.

To address the mechanism of thermosensing and its implications for molecular engineering, we previously deconstructed the functional components of the bacterial thermosensor DesK, a histidine kinase with a five-span transmembrane domain that detects temperature changes. The system was first simplified by building a sensor that consists of a single chimerical transmembrane segment that retained full sensing capacity. Genetic and biophysical analysis of this minimal sensor enabled the identification of three modular components named determinants of thermodetection (DOTs). Here we combine and tune the DOTs to determine their contribution to activity. A transmembrane zipper represents the master DOT that drives a reversible and activating dimerization through the formation of hydrogen bonds. Our findings provide the mechanism and insights to construct a synthetic transmembrane helix based on a poly-valine scaffold that harbors the DOTs and regulates the activity. The construct constitutes a modular switch that may be exploited in biotechnology and genetic circuitry.

Reproducibility of quantitative sensory testing applied to musculoskeletal orofacial region: Site and sex differences.

BACKGROUND: This study estimated the inter-rater reliability and agreement of the somatosensory assessment performed at masseter and temporomandibular joint (TMJ) region in a group of healthy female and male participants. METHODS: Forty healthy participants (20 men and 20 women) were evaluated in two sessions by two different examiners. Cold detection threshold (CDT), warm detection threshold (WDT), thermal sensory limen (TSL), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) were assessed on the skin overlying TMJ and masseter body. Mixed ANOVA, intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were applied to the data (α = 5%). Nonoverlapping 95% confidence intervals (95% CI) of ICCs were considered significantly different. RESULTS: The ICCs of 77% of all quantitative sensory testing (QST) measurements were considered fair to excellent (ICCs: 0.47-0.97), and WUR presented the lowest values. The reliability of WDT, TSL and HPT of masseter was significantly higher than TMJ, whereas the MDT reliability of TMJ was higher than masseter. In addition, the following combination of test/sites presented significantly lower ICCs for women: HPT, MDT of TMJ and MPT of both TMJ and masseter. Finally, the highest SEM values were presented for CPT and MPT. CONCLUSION: The overall somatosensory assessment of the masticatory structures performed by two examiners can be considered sufficiently reliable to discriminate participants, except WUR. Possible site and sex influences on the reproducibility parameters should be taken into account for an appropriate interpretation and clinical application of QST. SIGNIFICANCE: The test site and participant's sex can significantly influence the relative reliability and agreement of quantitative sensory testing applied to musculoskeletal orofacial region, which affect the capacity to discriminate participants and to evaluate changes over time.

Sensing membrane thickness: Lessons learned from cold stress.

The lipid bilayer component of biological membranes is important for the distribution, organization, and function of bilayer spanning proteins. These physical barriers are subjected to bilayer perturbations. As a consequence, nature has evolved proteins that are able to sense changes in the bilayer properties and transform these lipid-mediated stimuli into intracellular signals. A structural feature that most signal-transducing membrane-embedded proteins have in common is one or more α-helices that traverse the lipid bilayer. Because of the interaction with the surrounding lipids, the organization of these transmembrane helices will be sensitive to membrane properties, like hydrophobic thickness. The helices may adapt to the lipids in different ways, which in turn can influence the structure and function of the intact membrane proteins. We review recent insights into the molecular basis of thermosensing via changes in membrane thickness and consider examples in which the hydrophobic matching can be demonstrated using reconstituted membrane systems. This article is part of a Special Issue entitled: The cellular lipid landscape edited by Tim P. Levine and Anant K. Menon.

TRPM8-Dependent Dynamic Response in a Mathematical Model of Cold Thermoreceptor.

Cold-sensitive nerve terminals (CSNTs) encode steady temperatures with regular, rhythmic temperature-dependent firing patterns that range from irregular tonic firing to regular bursting (static response). During abrupt temperature changes, CSNTs show a dynamic response, transiently increasing their firing frequency as temperature decreases and silencing when the temperature increases (dynamic response). To date, mathematical models that simulate the static response are based on two depolarizing/repolarizing pairs of membrane ionic conductance (slow and fast kinetics). However, these models fail to reproduce the dynamic response of CSNTs to rapid changes in temperature and notoriously they lack a specific cold-activated conductance such as the TRPM8 channel. We developed a model that includes TRPM8 as a temperature-dependent conductance with a calcium-dependent desensitization. We show by computer simulations that it appropriately reproduces the dynamic response of CSNTs from mouse cornea, while preserving their static response behavior. In this model, the TRPM8 conductance is essential to display a dynamic response. In agreement with experimental results, TRPM8 is also needed for the ongoing activity in the absence of stimulus (i.e. neutral skin temperature). Free parameters of the model were adjusted by an evolutionary optimization algorithm, allowing us to find different solutions. We present a family of possible parameters that reproduce the behavior of CSNTs under different temperature protocols. The detection of temperature gradients is associated to a homeostatic mechanism supported by the calcium-dependent desensitization.

A lipid-mediated conformational switch modulates the thermosensing activity of DesK.

The thermosensor DesK is a multipass transmembrane histidine-kinase that allows the bacterium Bacillus subtilis to adjust the levels of unsaturated fatty acids required to optimize membrane lipid fluidity. The cytoplasmic catalytic domain of DesK behaves like a kinase at low temperature and like a phosphatase at high temperature. Temperature sensing involves a built-in instability caused by a group of hydrophilic residues located near the N terminus of the first transmembrane (TM) segment. These residues are buried in the lipid phase at low temperature and partially "buoy" to the aqueous phase at higher temperature with the thinning of the membrane, promoting the required conformational change. Nevertheless, the core question remains poorly understood: How is the information sensed by the transmembrane region converted into a rearrangement in the cytoplasmic catalytic domain to control DesK activity? Here, we identify a "linker region" (KSRKERERLEEK) that connects the TM sensor domain with the cytoplasmic catalytic domain involved in signal transmission. The linker adopts two conformational states in response to temperature-dependent membrane thickness changes: (i) random coiled and bound to the phospholipid head groups at the water-membrane interface, promoting the phosphatase state or (ii) unbound and forming a continuous helix spanning a region from the membrane to the cytoplasm, promoting the kinase state. Our results uphold the view that the linker is endowed with a helix/random coil conformational duality that enables it to behave like a transmission switch, with helix disruption decreasing the kinase/phosphatase activity ratio, as required to modulate the DesK output response.

Thermal tolerance in anuran embryos with different reproductive modes: relationship to altitude.

Anurans are ectothermic animals very sensitive to temperature, mainly during the embryonic stage. In addition, environmental temperature decreases with altitude, and the amphibian fauna changes. Therefore, we studied the relationship between the embryonic thermal tolerances of twelve species of anurans and the temperatures of their microhabitat along an altitudinal gradient from 430 m to 2600 m. We hypothesized that there is a strong thermal adjustment of embryos to their microhabitat and, consequently, that temperature could be a limiting factor of altitudinal distribution of the anurans. We also compared the embryonic thermal tolerances according to six postulated reproductive modes of the study species. We found a significant relationship between the maximum and minimum thermal tolerances of the anuran embryos and the maximum and minimum temperatures of their microhabitat and altitudinal distribution. We also found a wide range of embryonic thermal tolerances for aquatic breeding species and a narrower range for terrestrial breeding species. Particularly, embryos of direct development species were the most sensitive to temperature. These results show the strong thermal adjustment of anuran embryos to their microhabitat and elevation and do not reject the hypothesis that temperature can be a limiting factor of their altitudinal distribution.

Effect of infrared laser in the prevention and treatment of paresthesia in orthognathic surgery.

Orthognathic surgery is the surgical procedure that makes correcting deformities of the bones in the region of the maxilla and mandible a reality in the Brazilian dentistry. However, this type of surgery usually involves paresthesia in the postoperative period, concerning the surgeons who perform them and generating discomfort to patients. This study aimed at evaluating the effect of infrared laser (830 nm) in the prevention and treatment of paresthesias after orthognathic surgery. Six patients underwent orthognathic surgery: the experimental group composed of 4 patients and the control group that did not receive laser therapy composed of 2 patients. The experimental group received laser applications during the transoperative and 12 postoperative sessions. Tests for mechanical (deep and shallow) and thermal (cold) sensitivity were performed in the preoperative and postoperative period (during 12 sessions) in the lip and chin areas by the same operator. The paresthesia was classified into 1, strong; 2, moderate; 3, mild; and 4, absent, through the patient's response to stimuli. The results showed that all patients had no disturbance of sensitivity in the preoperative period, but paresthesia was presented at various levels in the postoperative period. Both groups showed recovery of deep mechanical sensitivity within a shorter time interval compared with the superficial mechanical and thermal sensitivity. However, at the 12th assessment, patients who underwent the laser therapy showed better reduction in the level of paresthesia or even complete regression of this. The laser, therefore, brought benefits to the treatment of paresthesia, accelerating the return of neurosensorial sensitivity.

Current and future heat stress in Nicaraguan work places under a changing climate.

While climate change continues to increase ambient temperatures, the resulting heat stress exposure to workers in non-climate controlled settings is not well characterized, particularly in low and middle income countries. This preliminary report describes current heat stress in Nicaraguan work places and estimates occupational heat stress in 2050. From over 400 measurements of heat exposure using wet bulb globe temperature, more than 10% of all measurements exceeded the safety threshold for the combination of light work and rest at the ratio of 25:75. By 2050, that percentage of "over-heated" days is projected to increase to over 15%. These findings support the idea that common working conditions in Nicaragua already represent a threat to the health and safety of the workers and that climate change driven trends could mean either a necessary curbing of economic productivity or an increased threat to worker health and safety.

Potenciais impactos da variabilidade climática sobre a morbidade respiratória em crianças, lactentes e adultos / Potential impacts of climate variability on respiratory morbidity in children, infants, and adults

OBJETIVO: Estudar a relação existente entre a o número de internações por doenças do aparelho respiratório em lactentes, crianças e adultos e as variações meteorológicas na cidade de Campo Grande (MS). MÉTODOS Foram utilizados dados diários de internações por doenças respiratórias, precipitação, temperatura do ar, umidade e velocidade dos ventos entre 2004 e 2008. Foram calculados os índices de conforto térmico humano, temperatura efetiva e temperatura efetiva com velocidade do vento com base nas variáveis meteorológicas. Foram realizados modelos lineares generalizados utilizando o modelo múltiplo de regressão de Poisson para predizer as internações por doenças respiratórias. RESULTADOS: Foram observados valores relativamente elevados dos coeficientes de correlação entre as variáveis estudadas e internações por pneumonia em crianças (R² = 68,4%), lactentes (R² = 71,8%) e adultos (R² = 81,8%). CONCLUSÕES: Os resultados aqui apresentados indicam em termos quantitativos o risco para um aumento no número de hospitalizações de crianças, lactentes e adultos de acordo com o aumento ou a diminuição das temperaturas, umidade, precipitação, velocidade dos ventos e índice de conforto térmico na cidade de Campo Grande.

OBJECTIVE: To determine whether climate variability influences the number of hospitalizations for respiratory diseases in infants, children, and adults in the city of Campo Grande, Brazil. METHODS: We used daily data on admissions for respiratory diseases, precipitation, air temperature, humidity, and wind speed for the 2004-2008 period. We calculated the thermal comfort index, effective temperature, and effective temperature with wind speed (wind-chill or heat index) using the meteorological data obtained. Generalized linear models, with Poisson multiple regression, were used in order to predict hospitalizations for respiratory disease. RESULTS: The variables studied were (collectively) found to show relatively high correlation coefficients in relation to hospital admission for pneumonia in children (R² = 68.4%), infants (R² = 71.8%), and adults (R² = 81.8%). CONCLUSIONS: Our results indicate a quantitative risk for an increase in the number of hospitalizations of children, infants, and adults, according to the increase or decrease in temperature, humidity, precipitation, wind speed, and thermal comfort index in the city under study.

Actividad espontánea de nociceptores cutáneos en pacientes con neuropatía de fibras delgadas / Spontaneous activity of cutaneous nociceptors in patients with painful polyneuropathy. Report of three patients

Background: Painful polyneuropathy may result from selective impairment of small diameter nerve fibers, while tactile and motor functions are preserved. In these patients clinical and electrophysiological assessment is usually unrevealing. We report three patients with a pure painful polyneuropathy. One of them had neurogenic pruritus additionally. Quantitative sensory analysis disclosed a slight warm hypoesthesia (3/3) and paradoxical hot sensation (2/3) in the feet. Intraneural recordings from the peroneal nerve demonstrated abnormal spontaneous activity in 8 of 17 nociceptive afferents. One of them displayed double firing reflecting impulse multiplication. These results support the notion that patients with pain or pruritus with a distal distribution similar to a polyneuropathy, could have small diameter afferent fiber damage, despite normal function of large diameter fibers.

Respostas produtivas, comportamentais e fisiológicas de vacas criadas sob sistema biodinâmico em diferentes ambientes de pré ordenha e níveis de produção leiteira

O objetivo desse trabalho foi avaliar a influência do ambiente de pastejo sobre o comportamento e de dois ambientes de pré-ordenha sobre as respostas produtivas, fisiológicas, hormonais e a qualidade do leite de vacas da raça Pardo-Suíça criadas em sistema Biodinâmico de produção. A pesquisa foi dividida em quatro capítulos. No capítulo I, por meio da literatura vigente, buscou-se informações sobre a importância da utilização do sombreamento natural e artificial na pastagem, e ainda, a eficiência da sombra e dos sistemas de resfriamento na pré-ordenha de vacas leiteiras, verificando-se, serem estratégias importantes para o conforto e a produção látea desses animais. No capítulo II, foi realizada uma revisão bibliográfica sobre as características produtivas e a qualidade do leite bovino produzido ecológica e convencionalmente, observando-se que a leve inferioridade na produção e nos constituintes do leite ecológico foi devido a baixa utilização de tecnologias no manejo geral desse sistema. No capítulo III, Avaliou-se a influência do ambiente de pastejo sobre o comportamento alimentar, ruminação e ócio, noturna e diuturnamente (Ensaio I) de 32 vacas, divididas nos níveis de alta e baixa produção láctea, e o efeito dos ambientes de pré-ordenha de sombra e sol (ensaio II) sobre as variáveis fisiológicas desses animais. As vacas de baixa produção alimentaram-se por mais tempo nas horas quentes do dia, quando comparados aos de alta, mas os animais de ambos os níveis produtivos pastejaram mais durante o dia que à noite (Ensaio I). [...] Assim, verificou-se, que o fornecimento de sombra por 1,5 horas antes da ordenha da tarde a vacas leiteiras Pardo-Suíças criadas em sistema Biodinâmico de produção, embora reduza as intempéries climáticas sobre as mesmas, não altera a sua produção e composição láctea .

The objective this work were to assess on grazing in two different environments of pre milking about the behavior in milk from cows of Brown Swiss on the productive responses, physiological, hormonal and quality from the biodynamic production system. That study was put in four chapters. Into the first chapter, we looked for information about the importance in to use the natural and artificial shading in grasslands and about the shadow efficiency and about the cooling systems on the milking in the milkmaid to confirm about the importance strategy for the comfort and the milk production. On the chapter II, we did the review in the papers about the production characterize and the milk qualify from the cattle form the ecological and traditional system to observe about the low in the production and the composition in the ecological milk was because the short technology in the handling in the used system. Into the chapter III we look for to evaluate the influence about the ambience on grazing about the food behavior rumination and resting, day and night (test I) of 32 cows, we had 16 in low and 16 in up production and look for about action of ambiences in pre milking on the sun and in without sun. [...] In fact, it was found, that shade for 1.5 hours before the pre milking afternoon the cows in Brown Swiss from biodynamic production system, while reducing the influence weather in the cows, does not improve its yield and the composition milk .

Thermal threshold: research study on small fiber dysfunction in distal diabetic polyneuropathy.

OBJECTIVE: The most commonly used technique for diagnosis of diabetic neuropathy (DN) is nervous conduction (NC). Our hypothesis is that the use of the thermal threshold (TT) technique to evaluate small fiber damage, which precedes large fiber damage, could enable earlier diagnosis and diminish false negatives. RESEARCH DESIGN AND METHODS: The study involved 70 asymptomatic patients with type 2 diabetes mellitus (T2DM) all being treated with oral hypoglycemic medication, and having negative metabolic control levels with glycosylated hemoglobin A1c greater than 7% and less than 8%. Diabetic neuropathy was their only evident complication. All other complications or other causes of neuropathy were discarded. Their time of evolution was 1 to 48 months since date of diagnosis of diabetes. Both thermal threshold and sensory and motor nervous conduction were determined in upper and lower limbs. RESULTS: Nervous conduction was found normal in 81% and altered in 19% of patients (large fiber neuropathy). Thermal threshold was normal in 57% and altered in 43% of patients (small fiber neuropathy). In those with normal TTs, no case with an altered NC was found (p < 0.001). Patients with altered TTs could have normal (57%) or altered NC (43%). Thus, NC showed a high frequency of false negatives for DN (57% of 30 cases). The frequency of small fiber neuropathy found with the TT test was higher than that of large fiber neuropathy found with the NC test (p < 0.001) and was found at an earlier age. CONCLUSIONS: The TT test demonstrated a higher frequency of neuropathy than the NC test in clinically asymptomatic T2DM patients. We suggest that small fiber should be studied before large fiber function to diagnosis distal and symmetrical DN.

Keratocystic odontogenic tumors and Carnoy's solution: results and complications assessment.

OBJECTIVE: Keratocystic odontogenic tumors (KOTs) can be treated with Carnoy's solution, although this treatment modality is not free from complications. It is important to verify the incidence of complications after the use of Carnoy's solution and compare these with the literature. MATERIALS AND METHODS: This study verified the effects of a complementary treatment for KOTs and assessed the incidence of such complications as recurrence, infection, sequestrum formation, mandibular fracture, dehiscence, and neuropathy. RESULTS: Twenty-two KOTs treated with Carnoy's solution combined with peripheral ostectomy were included, and the follow-up period varied from 12 to 78months with a mean of 42.9months. Complications included recurrence (4.5%), dehiscence (22.7%), infection (4.5%), and paresthesia (18.2%). No difference was found among lesions associated (9.1%) or not (0%) with nevoid basal cell carcinoma syndrome (P>0.05). Dehiscence was influenced by marsupialization (P<0.05), and paresthesia was observed exclusively in cases of mandibular canal fenestration (P<0.01). CONCLUSIONS: Complementary treatment with Carnoy's solution and peripheral ostectomy appear to provide efficient treatment for KOTs. Complications originating from the use of the solution are less frequent and less serious than complications associated with cryotherapy. Neuropathy seems to be related to direct contact between the solution and the epineurium.

[Spontaneous activity of cutaneous nociceptors in patients with painful polyneuropathy. Report of three patients]. / Actividad espontánea de nociceptores cutáneos en pacientes con neuropatía de fibras delgadas.

Painful polyneuropathy may result from selective impairment of small diameter nerve fibers, while tactile and motor functions are preserved. In these patients clinical and electrophysiological assessment is usually unrevealing. We report three patients with a pure painful polyneuropathy. One of them had neurogenic pruritus additionally. Quantitative sensory analysis disclosed a slight warm hypoesthesia (3/3) and paradoxical hot sensation (2/3) in the feet. Intraneural recordings from the peroneal nerve demonstrated abnormal spontaneous activity in 8 of 17 nociceptive afferents. One of them displayed double firing reflecting impulse multiplication. These results support the notion that patients with pain or pruritus with a distal distribution similar to a polyneuropathy, could have small diameter afferent fiber damage, despite normal function of large diameter fibers.