Standardization of an experimental model of intradural injection after spinal cord injury in rats.

OBJECTIVES: The intrathecal route has not yet been thoroughly standardized and evaluated in an experimental model of spinal cord injury (SCI) in Wistar rats. The objective of this study was to standardize and evaluate the effect of intradural injection in this animal model. METHOD: The animals were divided into 6 groups: 1) laminectomy and intradural catheter; 2) laminectomy, intradural catheter and infusion; 3) only SCI; 4) SCI and intradural catheter; 5) SCI, intradural catheter and infusion; and 6) control (laminectomy only). Motor evaluations were performed using the Basso, Beattie and Bresnahan (BBB) scale and the horizontal ladder test; motor evoked potentials were measured for functional evaluation, and histological evaluation was performed as well. All experimental data underwent statistical analysis. RESULTS: Regarding motor evoked potentials, the groups with experimental SCI had worse results than those without, but neither dural puncture nor the injection of intrathecal solution aggravated the effects of isolated SCI. Regarding histology, adverse tissue effects were observed in animals with SCI. On average, the BBB scores had the same statistical behaviour as the horizontal ladder results, and at every evaluated timepoint, the groups without SCI presented scored significantly better than those with SCI (p<0.05). The difference in performance on motor tests between rats with and without experimental SCI persisted from the first to the last test. CONCLUSIONS: The present work standardizes the model of intradural injection in experimental SCI in rats. Intrathecal puncture and injection did not independently cause significant functional or histological changes.

Standardization of an experimental model of intradural injection after spinal cord injury in rats

OBJECTIVES: The intrathecal route has not yet been thoroughly standardized and evaluated in an experimental model of spinal cord injury (SCI) in Wistar rats. The objective of this study was to standardize and evaluate the effect of intradural injection in this animal model. METHOD: The animals were divided into 6 groups: 1) laminectomy and intradural catheter; 2) laminectomy, intradural catheter and infusion; 3) only SCI; 4) SCI and intradural catheter; 5) SCI, intradural catheter and infusion; and 6) control (laminectomy only). Motor evaluations were performed using the Basso, Beattie and Bresnahan (BBB) scale and the horizontal ladder test; motor evoked potentials were measured for functional evaluation, and histological evaluation was performed as well. All experimental data underwent statistical analysis. RESULTS: Regarding motor evoked potentials, the groups with experimental SCI had worse results than those without, but neither dural puncture nor the injection of intrathecal solution aggravated the effects of isolated SCI. Regarding histology, adverse tissue effects were observed in animals with SCI. On average, the BBB scores had the same statistical behaviour as the horizontal ladder results, and at every evaluated timepoint, the groups without SCI presented scored significantly better than those with SCI (p<0.05). The difference in performance on motor tests between rats with and without experimental SCI persisted from the first to the last test. CONCLUSIONS: The present work standardizes the model of intradural injection in experimental SCI in rats. Intrathecal puncture and injection did not independently cause significant functional or histological changes.

Lead poisoning by intradiscal firearm bullet: a case report.

STUDY DESIGN: The report of a rare case of lead poisoning by an intradiscal firearm bullet is presented. OBJECTIVE: To describe and discuss the clinical and radiologic features (by computed tomography and magnetic resonance imaging) of a gunshot wound in the L2-L3 space which caused lead poisoning 5 years afterwards. SUMMARY OF BACKGROUND DATA: Lead poisoning from firearm bullets is rare, but the possibility should be investigated in the case of bullets lodged in the joints. METHODS: A 30-year-old man presented to the emergency room with an intense lumbar pain complaint, colic, intestinal constipation, insomnia, and progressive headache for 20 days. He had a history of a gunshot wound 5 years previously, and the bullet was left in situ, in the intravertebral disc between L2 and L3, as confirmed by radiographs, computed tomography, and magnetic resonance imaging. The hypothesis of lead poisoning was confirmed by the laboratory results. Chelation treatment with calcium versenate (disodium ethylenediaminetetraacetate, or CaNa (2) EDTA) was indicated. The patient was admitted and treated once again, before surgical removal of the bullet. RESULTS: After removal of the bullet, the patient had an episode of recurrence, and a new chelation cycle was performed, with complete resolution. CONCLUSION: Lead poisoning can result in severe clinical disorders that require rapid treatment. In this case, both clinical and surgical treatments led to complete resolution of the symptoms.

Alívio da dor crônica näo neoplásica com opiáceos / Non oncologic chronic pain relief with opioids

o uso de opiáceos para o controle da dor crôncia näo relacionada ao câncer é controverso. Avaliar o alívio da dor e as mudanças nas atividades de vida diárias advindas da infusäo intratecal de opiáceos em 11 doentes, com dor crônica näo neoplásica, foram os objetivos deste estudo. Todos os doentes haviam previamente sido submetidos a diversas modalidades terapêuticas sem alívio significativo. Os doentes foram solicitados a avaliar as características da dor e as atividades de vida diária comparando-as antes e após o tratamento com opiáceo intratecal por meio de sistemas implantados. Observou-se alívio da dor. No entanto, melhora da funcionalidade näo foi observada com a mesma magnitude.

Dor no atendimento em pronto socorro: avaliacao do conhecimento da equipe de saude sobre dor, analgesia e procedimentos prescritos para o controle / Pain in the emergence room: evaluation of the health team knowledgment about pain and analgesia and of the procedures prescribed for its control

Como sintoma ou doenca, a dor e frequentemente objeto de procura pelo sistema de saude. Medidas objetivando esclarecer a importancia da dor como sintoma e como doenca, que necessita ser avaliada e tratada com atencao especial sao ainda necessarias, para que mais empenho seja imprimido ao campo educacional nas escolas, nas sociedades cientificas e na comunidade. Conceitos fundamentais a respeito dos mecanismos de dor e de suas repercussoes, de possibilidades diagnosticas e sobre principios de terapeutica devem ser conhecidos por todos aqueles que atuam em qualquer campo das ciencias da saude

Opiáceo intratecal na dor crônica näo neoplasica: alívio e qualidade de vida / Intrathecal opioids in chronic non-malignat pain: relief and life quality

O uso de agentes morfínicos para o controle da dor crônica nao relacionada a câncer é controverso. Este estudo aferiu o alívio da dor e as mudanças nas atividades de 11 doentes com dor crônica nao associada ao câncer, tratados pela infusao intratecal de fármacos morfínicos através de bombas implantáveis. A dor era neuropática em 5 doentes e miofascial em 6. A duraçao média da queixa álgica foi 5,3 anos. A média da intensidade da dor antes da infusao foi 8,6. Sete doentes apresentavam dor durante 6 ou mais horas por dia. Após o tratamento, a média de intensidade da dor reduziu-se para 3,9. Somente 1 doente manteve dor com duraçao superior a 6 horas. O tratamento melhorou o desempenho de 36,36 por cento dos aspectos funcionais avaliados. O tempo médio de tratamento foi 19,6 meses. A infusao crônica de agentes morfínicos por via intratecal proporcionou alívio da dor, mas nao melhorou a funcionalidade com a mesma magnitude.