Endoscopic Cubital Tunnel Release in Leprosy Neuritis of the Ulnar Nerve.

Objectives To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique. Methods A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. Results The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain ( p 0.002), in sensitivity ( p < 0.001), and in strength ( p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. Conclusion The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.

Endoscopic Cubital Tunnel Release in Leprosy Neuritis of the Ulnar Nerve / Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar

Abstract Objectives To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique. Methods A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. Results The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p 0.002), in sensitivity (p< 0.001), and in strength (p< 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. Conclusion The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.

Resumo Objetivos Os objetivos deste estudo foram caracterizar melhor o papel da liberação endoscópica do túnel cubital na neurite hansênica e determinar se há melhora da dor, sensibilidade e força com esta técnica minimamente invasiva. Métodos Um total de 44 procedimentos endoscópicos para descompressão do nervo ulnar no cotovelo foram realizados em pacientes previamente diagnosticados com neurite por hanseníase. Os critérios de inclusão foram indicação cirúrgica para liberação do nervo ulnar e insucesso do tratamento clínico por 4 semanas em pacientes com síndrome do túnel cubital que sofreram deterioração progressiva da função motora ou sensitiva do nervo ulnar apesar do tratamento de 1 mg/kg/dia de prednisona e fisioterapia. A liberação endoscópica foi realizada com CTS Relief Kit (Linvatec. Largo, FL, EUA) e um artroscópio padrão de 4 mm e 30°. Resultados O estudo incluiu 39 pacientes, sendo 29 (74,4%) homens e 10 (25,6%) mulheres. A idade dos pacientes variou de 12 a 64 anos (33 ± 14,97). Cinco pacientes foram submetidos à liberação bilateral. A liberação provocou melhora estatisticamente significativa de dor (p= 0,002), sensibilidade (p <0,001) e força (p <0,001). Os melhores resultados foram obtidos quando a liberação ulnar foi realizada em menos de 6 meses após a indicação da cirurgia. Nenhum procedimento foi convertido de endoscópico para aberto. Não foram relatadas complicações maiores (infecção, lesão vascular e lesão nervosa). Um paciente apresentou subluxação do nervo ulnar. Conclusão A liberação endoscópica do nervo ulnar no cotovelo na neurite hansênica traz benefícios verdadeiros e seguros para o paciente, como melhora da dor, sensibilidade e força.

Sweet Potato New Varieties Screening Based on Morphology, Pulp Color, Proximal Composition, and Total Dietary Fiber Content via Factor Analysis and Principal Component Analysis.

A sample set of 18 sweet potatoes [Ipomoea batatas (L.) Lam] segmented into six registered cultivars and 12 new varieties were evaluated. The 142 tuberous roots were obtained from a sweet potato germplasm bank (BAG-sweet potato; -27.417713768824555 and -49.64874168439556), specifically from plants belonging to a sweet potato breeding program. All samples were characterized according to their morphology, instrumental pulp color, proximate composition, and total dietary fiber. The analytical results were submitted to parametric and non-parametric statistical tests for sample variance data comparison. Moreover, the screening of the cultivars and new varieties was performed by exploratory statistical analysis, factor analysis (FA), and principal component analysis (PCA). From the sixteen independent variables that characterized the samples, the exploratory FA identified thirteen that had a communality greater than 0.7, with 92.08% of assertiveness. The PCA generated 4 principal components able to account for 84.01% of the explanatory variance. So, among the six registered cultivars, SCS372 Marina and SCS370 Luiza showed the capability to be employed as cultivars for production. Among the 12 sweet potato new varieties, samples 17025-13, 17125-10, and 17117 met the requirements for patent and registration. These results will be useful to farmers who wish to use these sweet potatoes in the development of their crops.

Enhanced Performance Stabilization Increases Performance Variability in a Virtual Interception Task.

Performing a motor task depends on the level of performance stabilization and movement control, and both aspects of motor behavior are related to motor learning (retention and transfer) and adaptation (predictable and unpredictable perturbations). Yet few studies have further investigated the underlying dynamics that may elicit these benefits. In this study, we investigated the effects of two levels of performance stabilization on motor performance and control while learning to intercept a virtual moving target. We randomly divided 40 participants of both sexes (Mage = 26.02 years, SD = 2.02) into a Stabilization Group (SG) and a Superstabilization Group (SSG). We considered the performance stabilized when a moving target was intercepted three times in a row and superstabilized when the same criterion was repeated six times. We analyzed outcome variables related to performance accuracy (absolute spatial error) and variability(coefficient of variation) and motor control (relative time to peak velocity-tPV% and its coefficient of variation) on both the first and last blocks of practice trials. Both groups showed comparable increases in performance accuracy from the first to the last block (p = .001, ηp2 = 1.00), but SSG presented higher variability than SG (p = .05, ηp2 = .70). Concerning motor control, both groups started the experiment with low tPV% and finished with comparably high tPV% and variability. Thus, although practicing two levels of performance stabilization led to similar performance accuracy and movement control, superstabilization resulted in higher performance variability with no loss of accuracy. Enhanced stabilization may increase the ability to adapt to environmental changes, but more research is needed to demonstrate this. These findings add to an understanding of the relationship between levels of performance stabilization and performance variability and may have implications for professional interventions (e.g. sports, rehabilitation) in considering the benefits of practice beyond performance stabilization.

Does exercise-induced muscle damage impair subsequent motor skill learning?

Motor skill learning is a fundamental aspect of human behavior based on the calibration of internal models via sensory information such as proprioception. Some conditions, as exercise-induced muscle damage (EIMD), disrupt proprioceptive information, and may cause learning impairment. Such possible relation between EIMD and motor skill learning has not yet been investigated and it is the aim of this study. For this purpose, thirty male university students (19.3 ±â€¯1.8 years) were equally assigned to two groups: EIMD and CON group. The EIMD group received a treatment to induce muscle damage consisting of a weight lifting protocol directed to the agonist muscles related to the task prior to the pretest and to the learning sessions. EIMD was verified and compared between groups and along the process (0-168 h) by means of the degree of delayed onset muscle soreness (DOMS), perceived total quality recovery and maximal isometric strength (MIS). To investigate motor skill learning, both groups practiced a dart throwing task for four sessions with 150 trials in each session. Recovery status and DOMS were recovered at 96 h in the EIMD group, and MIS was not recovered throughout 168 h. In contrast, muscle damage parameters were not altered across 168 h in the CON group. Accuracy and consistency were compared within and between groups in a pretest posttest design. The EIMD group showed less accurate and consistent results on the long term (delayed posttest). Results confirmed our hypothesis that EIMD, a common condition in sports and in rehab practices, may hinder motor skill learning, possibly due to neurological aspects such as proprioceptive information, its relation to central nervous system reorganization and internal model consolidation.

Evidence for Host Epigenetic Signatures Arising From Arbovirus Infections: A Systematic Review.

Background: Arbovirus infections have steadily become a major pandemic threat. This study aimed at investigating the existence of host epigenetic markers arising from the principal arboviruses infections impacting on human health. We set to systematically review all published evidence describing any epigenetic modifications associated with infections from arboviruses, including, but not limited to, microRNAs, DNA methylation, and histone modifications. Methods: A comprehensive search was conducted using the electronic databases PubMed, Science Direct and Cochrane Library from inception to January 4th, 2018. We included reports describing original in vivo or in vitro studies investigating epigenetic changes related to arbovirus infections in either clinical subjects or human cell lines. Studies investigating epigenetic modifications related to the virus or the arthropod vector were excluded. A narrative synthesis of the findings was conducted, contextualizing comparative evidence from in vitro and in vivo studies. Results: A total of 853 unique references were identified and screened by two independent researchers. Thirty-two studies met the inclusion criteria and were reviewed. The evidence was centered mainly on microRNA and DNA methylation signatures implicated with secondary Dengue fever. Evidence for recent epidemic threats, such as the infections by Zika or Chikungunya viruses is still scant. Conclusions: Major epigenetic alterations found on arboviruses infections were miR-146, miR-30e and the Dicer complex. However, existing studies frequently tested distinct hypotheses resulting in a heterogeneity of methodological approaches. Whilst epigenetic signatures associated with arbovirus infections have been reported, existing studies have largely focused on a small number of diseases, particularly dengue. Validation of epigenetic signatures have an untapped potential, but concerted investigations are certainly required to deliver robust candidates of clinical utility for diagnosis, staging and prognosis of specific arboviral diseases.

Alpha-lipoic acid in the treatment of psychiatric and neurological disorders: a systematic review.

Despite the existence of many preclinical studies, scientific evidence is lacking on the clinical use of alpha-lipoic acid (ALA) for central nervous system disorders. Therefore, we aimed at revising the literature concerning the use of ALA for the treatment of psychiatric and neurological conditions and to point out what is missing for the introduction of this antioxidant to this purpose. For this systematic review we performed a search using PubMed and SCOPUS databases with the following keywords: "alpha-Lipoic Acid AND central nervous system OR psychiatric disorders OR neurological disorders OR mood disorders OR anxiety OR psychosis OR Alzheimer OR Parkinson OR stroke". The total number of references found after automatically and manually excluding duplicates was 1061. After primary and secondary screening 32 articles were selected. Regarding psychiatric disorders, the studies of ALA in schizophrenia are advanced being ALA administration related to the improvement of schizophrenia symptoms and side effects of antipsychotic medication. In neurological disorders, ALA as a supplement was effective in the prevention of Alzheimer disease progression. For stroke, the use of the supplement ALAnerv® (containing 300 mg ALA) presented important results, since it was observed a reversal of clinical parameters and oxidative imbalance in these patients. For other neurological conditions, such as encephalopathy, multiple sclerosis, traumatic brain injury, mitochondrial disorders and migraine, the results are still preliminary. Overall, there is a need of well-designed clinical trials to enhance the clinical evidences of ALA effects for the treatment of neurological and psychiatric conditions.

Uncertainties Associated with Arithmetic Map Operations in GIS.

Arithmetic map operations are very common procedures used in GIS to combine raster maps resulting in a new and improved raster map. It is essential that this new map be accompanied by an assessment of uncertainty. This paper shows how we can calculate the uncertainty of the resulting map after performing some arithmetic operation. Actually, the propagation of uncertainty depends on a reliable measurement of the local accuracy and local covariance, as well. In this sense, the use of the interpolation variance is proposed because it takes into account both data configuration and data values. Taylor series expansion is used to derive the mean and variance of the function defined by an arithmetic operation. We show exact results for means and variances for arithmetic operations involving addition, subtraction and multiplication and that it is possible to get approximate mean and variance for the quotient of raster maps.

Neuroprotective evidence of alpha-lipoic acid and desvenlafaxine on memory deficit in a neuroendocrine model of depression.

Cognitive impairment is present in patients with depression. We hypothesized that alpha-lipoic acid (ALA) can reduce cognitive impairment, especially when combined to antidepressants. Female mice received vehicle or corticosterone (CORT) 20 mg/kg, s.c. for 14 days. From the 15th to 21st day, the animals were divided in groups: vehicle, CORT, CORT+desvenlafaxine (DVS) 10 or 20 mg/kg, ALA 100 or 200 mg/kg, DVS10+ALA100, DVS20+ALA100, DVS10+ALA200, or DVS20+ALA200. Tail suspension (TST), social interaction (SIT), novel object recognition (NOR), and Y-maze tests were conducted. Acetylcholinesterase activity (AChE) was measured in the prefrontal cortex (PFC), hippocampus (HC), and striatum (ST). CORT caused depressive-like behavior, impairment in SIT, and cognitive deficits. Alpha-lipoic acid and DVS, alone or combined, reversed CORT effect on TST. In the NOR, ALA200 alone, DVS10+ALA100, or DVS10+ALA200 reversed the deficits in short-term memory, while DVS20 alone or DVS20+ALA200 reversed the deficits in long-term memory. In the Y-maze test, ALA200 alone, DVS20+ALA100, or DVS20+ALA200 reversed the deficits caused by CORT in the working memory. CORT increased AChE in the PFC, HC, and ST. ALA200 alone or DVS20+ALA200 reversed this effect in the PFC, while DVS20 or DVS20+ALA100 reversed this effect in the HC. In the ST, DVS10 or 20, alone or combined, and ALA100 reversed the effects of CORT. These results suggest that DVS+ALA, by reversing CORT-induced memory and social deficits, seems to be a promising therapy for the treatment of depression and reversal of cognitive impairment observed in this disorder.

Naltrexone in the Treatment of Broadly Defined Behavioral Addictions: A Review and Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: Broadly defined behavioral addiction is a conceptual framework including behaviors characterized by loss of control and continuation despite significant negative consequences. Broadly defined behavioral addictions share many similarities with substance use disorders. As naltrexone is one of the most studied treatment for substance use disorders, we conducted a meta-analysis of randomized placebo-controlled trials (RCT) assessing the effectiveness of naltrexone in the treatment of broadly defined behavioral addictions. METHOD: We conducted a literature search and selection, up to January 1, 2017, according to previously set inclusion criteria. The selected trials underwent a quality assessment before data extraction and statistical analysis, which used fixed and random effects models. Standardized mean differences (SMD) were calculated using Hedge's adjusted g. RESULTS: A total of 6 RCTs (n = 356) were included. Of these, 3 assessed naltrexone effectiveness in the treatment of pathological gambling, and 3 tested its benefits in broadly defined behavioral addictions other than pathological gambling (kleptomania, trichotillomania, and impulsive compulsive disorders). The meta-analysis of the whole sample resulted in a statistically significant score improvement under naltrexone versus placebo (fixed effect model: SMD = -0.27, 95% CI [-0.51 to -0.03], z = 2.23; p = 0.025). CONCLUSION: The results of our meta-analysis suggest a beneficial effect of naltrexone in the treatment of broadly defined behavioral addictions.

Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies.

BACKGROUND: The neurotrophic hypothesis postulates that mood disorders such as bipolar disorder (BD) are associated with a lower expression of brain-derived neurotrophic factor (BDNF). However, its role in peripheral blood as a biomarker of disease activity and of stage for BD, transcending pathophysiology, is still disputed. In the last few years an increasing number of clinical studies assessing BDNF in serum and plasma have been published. Therefore, it is now possible to analyse the association between BDNF levels and the severity of affective symptoms in BD as well as the effects of acute drug treatment of mood episodes on BDNF levels. METHODS: We conducted a systematic review and meta-analysis of all studies on serum and plasma BDNF levels in bipolar disorder. RESULTS: Through a series of meta-analyses including a total of 52 studies with 6,481 participants, we show that, compared to healthy controls, peripheral BDNF levels are reduced to the same extent in manic (Hedges' g = -0.57, P = 0.010) and depressive (Hedges' g = -0.93, P = 0.001) episodes, while BDNF levels are not significantly altered in euthymia. In meta-regression analyses, BDNF levels additionally negatively correlate with the severity of both manic and depressive symptoms. We found no evidence for a significant impact of illness duration on BDNF levels. In addition, in plasma, but not serum, peripheral BDNF levels increase after the successful treatment of an acute mania episode, but not of a depressive one. CONCLUSIONS: In summary, our data suggest that peripheral BDNF levels, more clearly in plasma than in serum, is a potential biomarker of disease activity in BD, but not a biomarker of stage. We suggest that peripheral BDNF may, in future, be used as a part of a blood protein composite measure to assess disease activity in BD.

Role of preoperative retrograde enema on inflammatory and healing parameters in colonic anastomosis: experimental study in dogs / Papel do enema pré-operatório em parâmetro de inflamação e cicatrização em anastomose cólica: estudo experimental em cães

Objective: The purpose of this experimental study was to compare the inflammatory and wound healing response of dogs submitted to colonic anastomosis with and without preoperative retrograde enema. Methods: The study included two groups of 31 female dogs (Canis familiaris). G-I (control): no preoperative bowel preparation; G-II (study): preoperative retrograde enema using a 10% glycerin solution. All the animals were submitted to laparotomy and colotomy at 20 cm from the anal verge, followed by closure with a running extramucosal single-layer suture (Prolene® 000). The animals were then anesthetized and euthanized on the 7th (n = 10) or 21st (n = 20) postoperative day (POD) to remove the anastomosed colon segment for histological and immunohistochemical analysis evaluating the parameters: anastomotic edema, vasoproliferation, abdominal adhesions, type I and III collagen, nitric oxide and myeloperoxidase. The observed differences were analyzed with the Mann-Whitney test for nonparametric data and Student's t test for unpaired samples and parametric data. Results: One animal from G-I and one from G-II died on POD 7 and POD 10 due to anastomotic complications and sepsis, respectively The groups did not differ significantly with regard to inflammatory and healing parameters, although the levels of mature collagen were significantly lower in the animals submitted to preoperative bowel preparation. Conclusion: It has been shown that both procedures are safe to be used, however, the group with bowel preparation showed a lower amount of mature collagen in the immediate postoperative period and may be constituted a preventive factor for surgical complications for this type of surgical procedure, although no evidence in this study could be determined. (AU)

Objetivo: O objetivo deste estudo experimental foi comparar a resposta inflamatória e cicatrização de feridas em cães submetidos a anastomose cólica com e sem enema retrógrada pré-operatório. Métodos: O estudo incluiu dois grupos de 31 cães fêmeas (Canis familiaris). G-I (controle): sem preparo intestinal pré-operatório; G-II (estudo): Enema retrógrada pré-operatória com uma solução de glicerina a 10%. Todos os animais foram submetidos à laparotomia e colotomia a 20 cm da borda anal, seguido de fechamento em sutura extramucosa contínua (Prolene ® 000). Os animais foram anestesiados e, em seguida, submetidos à eutanásia no 7° (n = 10) ou 21 (n = 20) pós-operatório (DPO) para remover o segmento de cólon anastomosado para análise histológica e imunohistoquímica avaliando os parâmetros: edema da anastomose, vasoproliferação, aderências abdominais, colagénio tipo I e III, o óxido nítrico e a mieloperoxidase. As diferenças observadas foram analisadas com o teste de Mann-Whitney para os dados não paramétricos e teste t de Student para amostras não pareadas e dados paramétricos. Resultados: Um animal do GI e um do G-II morreu no dia 7 e 10° DPO devido a complições de anastomose e sepse, respectivamente. Os grupos não diferiram significativamente em relação aos parâmetros inflamatórios e de cura, embora os níveis de colágeno maduro foram significativamente menores nos animais submetidos ao preparo intestinal pré-operatório. Conclusão: Demonstrou-se que ambos os procedimentos são seguros para serem usados, no entanto, o grupo com a preparação do intestino mostrou uma menor quantidade de colágeno maduro no período pós-operatório imediato, podendo ser constituído um fator preventivo para compliçães cirúrgicas para este tipo de procedimento cirúrgico, embora nenhuma evidência neste estudo. (AU)

Landfill mining from a deposit of the chlorine/organochlorine industry as source of dioxin contamination of animal feed and assessment of the responsible processes.

In 1997, the Polychlorinated dibenzo-para-dioxin (PCDD)/Polychlorinated dibenzofuran (PCDF) concentrations in dairy products in Germany and other European countries increased. The PCDD/PCDF source was contaminated lime used in Brazilian citrus pulp pellets. The contaminated lime was mined from an industrial dump site. However, the detailed origin of the PCDD/PCDFs in the lime was not revealed. This paper investigates the contamination origin and describes the link between lime milk from the dumpsite of a chlorine/organochlorine industry and the contaminated lime. The contaminated lime stem from mining at the corporate landfill of Solvay Indupa in Sao Paulo. The landfill was used for 40 years for deposition of production residues and closed in 1996. The factory operated/operates at least two processes with potentially high PCDD/PCDFs releases namely the oxychlorination process for production of ethylene dichloride (EDC) and the chlor-alkali process. The main landfilled waste was lime milk (1.4 million tons) from the vinyl chloride monomer production (via the acetylene process) along with residues from other processes. The PCDD/PCDF fingerprint revealed that most samples from the chemical landfill showed an EDC PCDD/PCDF pattern with a characteristic octachlorodibenzofuran dominance. The PCDD/PCDF pattern of a Rio Grande sediment samples downstream the facility showed a chlor-alkali pattern with a minor impact of the EDC pattern. The case highlights that PCDD/PCDF- and persistent organic pollutants-contaminated sites need to be identified in a comprehensive manner as required by the Stockholm Convention (article 6) and controlled for their impact on the environment and human health. Landfill mining and reuse of materials from contaminated deposits should be prohibited.

Associação entre tempo de reação e de movimento em jogadores de futsal / Association between reaction and movement time in indoor soccer players

O objetivo do presente estudo foi verificar a associação entre tempo de reação (TR) simples e o tempo de movimento (TM) em jogadores de futsal jovens (13,8 ± 0,5 anos, n = 16). O TR simples foi medido no aparelho Multipsy 821, pressionando com o dedo indicador uma tecla em resposta a um sinal luminoso.O TM, giro do corpo para direita ou esquerda, foi mensurado por meio de um sistema composto por um tapete de contato, fixado ao solo, e dois pares de fotocélulas. O início e o final do movimento foram registrados pela perda de contato do pé do atleta com o tapete de contato e quando o atleta ultrapassava um par de fotocélulas duplas, respectivamente. A distância entre o tapete de contato e o primeiro par de fotocélulas foi de 1,45 m. A análise estatística não indicou correlação significativa entre as duas variáveis. Uma possível explicação para os resultados está relacionada com a estrutura dos testes utilizados e a mensuração do TR e TM em ações motoras distintas. Pode-se concluir, que o desempenho do TR simples não deve ser associado à potencialidade do atleta em realizar movimentos rápidos de giro.

The aim of the study was to verify the level of association between simple reaction time (RT) and movement time (MT) of young indoor soccer (futsal) players (13.8 ± 0.5 years, n = 16). Simple RT was measured using the Multipsy 821 apparatus with a button pressing movement as an answer to a light stimulus. MT, turning the body to the left or right, was measured by a system composed of a contact carpet, fixed on the ground, and two pairs of doubled-photocells. The beginning of the movement was registered by loss of contact with the contact carpet and the end of the movement was recorded when the player passed through the pair of doubled-photocells. The distance between the contact carpet and the first pair of photocells was 1.45 m. Statistical analysis did not indicate significant correlation for both variables. The results can be explained by differences in the structure of the used tests and by RT and MT measurement in different motor skills. Moreover, these movements have distinct demands related to body mass. To conclude, TR performance cannot be associated with the potentiality of an athlete to perform rapid body rotation movements.

Indicaçöes e resultados do tratamento cirúrgico da tuberculose pulmonar multi-resistente / Results and indications of the surgical treatment of multiresistent pulmonary tuberculosis

Nos últimos anos a incidência de tuberculose pulmonar multi-resistente tem aumentado en todo o mundo. Este estudo foi desenvolvido com o objetivo de avaliar os resultados da ressecçäo pulmonar adjuvante nesses pacientes, identificando que grupo de pacientes poderia melhor beneficiar-se do tratamento cirúrgico. O critério de inclusäo foi o diagnóstico de tuberculose pulmonar confirmada, através do isolamento do Mycobacterium tuberculosis na cultura de escarro, com falência aos esquemas 1 (E-1): Isoniazida (INH) + Rifampicina (RMP) + Pirazinamida (PZA) e 3 (E-3): Estreptomicina (SM) + Etambutol (EMB) + Etionamida (ETH) + Pirazinamida (PZA), definido pelo Ministério da Saúde e de resistência bacteriológica comprovada através de testes de sensibilidade. Foram excluídos do estudo os pacientes com lesöes cavitárias bilaterais determinadas por radiografias do torax em incidências póstero-anterior e lateral ou na tomografia linear. Foram analisados trinta e três pacientes com diagnóstico de tuberculose pulmonar multi-resistente, submetidos à ressecçäo pulmonar. Vinte e sete (81,8 porcento) foram homens e seis (18,2 porcento) foram mulheres, com idade média de 36 anos (variando de 18 a 68 anos). O tempo médio de doença até o tratamento cirúrgico ser realizado foi de 5,5ñ2,7 anos, com mediana de 5 anos (variando de 2 a 14 anos). Os pacientes submetidos à pneumonectomia tiveram tempo médio de doença até o tratamento cirúrgico de 6,2ñ2,7 anos. Os pacientes submetidos à ressecçäo parcial lobectomia, bilobectomia e lobectomia mais segmentectomia) tiveram tempo médio de doença até o tratamento cirúrgico de 4,3ñ2,3 anos. O perfil de resistência do M. tuberculosis, em cultura do escarro, no pré-operatório foi: INH (90,9 porcento), RMP (81,8 porcento), SM (48,5 porcento), EMB (51,5 porcento), PZA (27,3 porcento), ETH (42,4 porcento). Dez pacientes näo converteram o escarro antes da cirurgia a despeito de tratamento com esquema composto por uma quilona (ciprofloxacina ou ofloxacina), amicacina e outras duas ou três drogas dos esquemas tradicionais selecionados pelos testes de sensibilidade. Foram realizadas 21 pneumonectomias, 11 lobectomias, 1 lobectomia mais segmentectomia e 1 bilobectomia. A mortalidade pós-operatória foi de 6,6 porcento. Três pacientes näo converteram a baciloscopia e evoluíram para o óbito nos 4§, 8§ e 24§ meses de pós-operatório, respectivamente...

Analogias: quero, sonho, crio

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