RESUMO
INTRODUCTION: Mirror hand syndrome is a very rare congenital deformity, also called cubital dimelia, characterized by the absence of the thumb, as well as the duplication of the fingers in a symmetrical image and, in some cases, with a duplication of the bones of the forearm. METHODS: The current treatment consists of a thumb reconstruction through thumb pollicization, although there are alternatives such as rotating osteotomy, syndactylization or conservative treatment. In this article we present the case of a girl with a non-classic bilateral mirror hand, the clinical and radiological findings, the bilateral surgical technique in two surgical times with six months of difference and two years follow-up. RESULTS: Complete mobility arches, as well as a good hand holding function were achieved with metacarpophalangeal thumb flexion 0-40o, interphalangeal 5-45o and abduction-adduction 0-50o. We achieved a complete opposition of the new thumb with respect to the other fingers. The strength of the clamp between the fingers was 75.2% of the normal force for her given age, while the strength of the lateral clamp of 66.3% and that of the grip of the fist was 69.1%. CONCLUSION: The surgical technique in the present case (pollicization of the thumb) is an excellent option, achieving objectives of fine and gross motor skills, and good cosmetic results.
INTRODUCCIÓN: Mano en espejo es una deformidad congénita muy rara, en ocasiones conocida como dimelia cubital, caracterizada por la ausencia del dedo pulgar, así como la duplicación de los dedos en imagen simétrica y, de forma clásica, también de los huesos del antebrazo. MÉTODOS: El tratamiento actual consiste en una reconstrucción del pulgar mediante pulgarización, aunque existen alternativas como osteotomía rotadora, sindactilización o el tratamiento conservador. En este artículo se presenta el caso de una niña con mano en espejo no clásica bilateral, los hallazgos clínicos, radiológicos, la reconstrucción quirúrgica de ambas manos consistente en pulgarización tipo Buck-Gramcko bilateral en dos tiempos quirúrgicos con seis meses de diferencia y el seguimiento a corto plazo. RESULTADOS: Presentó arcos de movilidad completos, así como una buena función de sujeción de la mano, se lograron con la flexión del pulgar metacarpofalángica 0-40o, interfalángica 5-45o y abducción-aducción 0-50o. Logramos una oposición del nuevo pulgar con respecto a los otros dedos. La fuerza de la pinza entre los dedos fue del 75.2% de la fuerza normal para la edad, mientras que la fuerza de la pinza lateral fue de 66.3% y la de la empuñadura fue de 69.1%. CONCLUSIÓN: La técnica quirúrgica utilizada en el presente caso demuestra una excelente opción, logrando objetivos de pinza gruesa, pinza fina y agarres, así como un buen resultado cosmético.
Assuntos
Deformidades Congênitas da Mão , Polegar , Feminino , Dedos , Seguimentos , Deformidades Congênitas da Mão/diagnóstico por imagem , Deformidades Congênitas da Mão/cirurgia , Humanos , Amplitude de Movimento Articular , Polegar/cirurgiaRESUMO
Recent studies have shown that it should be possible to control lipid bioavailability through food structural approaches. Nevertheless, the gastrointestinal-tract physiological conditions must also be considered. To get a better understanding of this phenomenon, we evaluated the effect of emulsification, as well as the use of sodium caseinate or chitosan, on the postprandial bioavailability of interesterified-lipids in O/W emulsions after oral gastric feeding Sprague-Dawley rats. We verified that emulsification may increase lipid absorption, as determined after feeding sodium-caseinate emulsions. However, this result could not be generalised. Interesterified-lipids that were emulsified with chitosan were equally absorbed as those contained in non-emulsified interesterified-lipids/distilled-water blends.
Assuntos
Biomarcadores/sangue , Caseínas/química , Quitosana/química , Emulsões/química , Lipídeos/química , Animais , Disponibilidade Biológica , Masculino , Ciências da Nutrição , Período Pós-Prandial , Ratos , Ratos Sprague-Dawley , Reologia , Água/químicaRESUMO
La colonización del Estreptococo grupo B en la embarazada está relacionada a patologías perinatales, constituyéndose en una causa muy importante de morbi-mortalidad neonatal. De manera a reducir dicha morbi-mortalidad, el Centro de Control y Prevención de Enfermedades Infecciosas de Estados Unidos desarrolló una estrategia que consiste en realizar el cultivo de muestra tanto vaginal como ano-rectal de todas las mujeres entre 35 y 37 semanas de gestación. El objetivo de este trabajo fue determinar la frecuencia de colonización por Estreptococo β hemolítico grupo B en mujeres gestantes entre las 35-37 semanas de embarazo que concurrieron al Hospital Materno-Infantil San Pablo, Centro de Salud Nº 5, desde abril del 2010 a agosto del 2011. Se realizó un estudio con diseño observacional descriptivo de corte transverso. Las muestras fueron tomadas mediante hisopado de introito vaginal y ano-rectal, colocadas en medio de transporte Stuart y remitidas al Instituto de Investigaciones en Ciencias de la Salud para el cultivo en agar sangre, previo enriquecimiento en caldo Todd Hewitt. La identificación bacteriana se realizó mediante pruebas bioquímicas convencionales y la confirmación mediante aglutinación con látex. La frecuencia de colonización obtenida fue relativamente alta, de 23,6%. Los resultados de este estudio permiten dimensionar la problemática en nuestro país y evidenciar la necesidad de la implementación de un programa a nivel nacional para la detección del Estreptococo grupo B de forma rutinaria en las embarazadas. De esta manera, se podrá disminuir la morbi-mortalidad perinatal y materna con la administración oportuna del tratamiento profiláctico.
Assuntos
Infecções Estreptocócicas , Gestantes , Streptococcus agalactiaeRESUMO
Fatty acid (FA) profile is a critical factor in the nutritional properties of fats, but, stereochemistry may also play a fundamental role in the rate and extent to which FAs are absorbed and become available. To better understand this phenomenon, we evaluated the bioavailability of FAs in linseed-oil and palm-stearin blends compared to their interesterified mix, using a sn-1,3 stereospecific lipase, to determine if there was any difference in terms of FA availability when using this technology. Test meals were fed through an intragastric feeding tube on Sprague-Dawley male rats after 18 h fasting. Postprandial blood samples were collected after meal or physiological serum (control) administration and the FA profile of plasma lipids was determined. Results showed that modification of the melting profile through interesterification, without altering the bioavailability determined by sn-2 stereochemistry, could delay lipid absorption at the beginning, but had no effect on total lipid absorption.
Assuntos
Ácidos Graxos/metabolismo , Lipídeos/química , Animais , Disponibilidade Biológica , Esterificação , Jejum , Ácidos Graxos/química , Metabolismo dos Lipídeos , Masculino , Estrutura Molecular , Ratos , Ratos Sprague-DawleyRESUMO
The aim of this study was to examine the requirement of luteal progesterone or luteal estrogen for the establishment of pregnancy in the Cebus monkey and to test in a primate species the synergism between RU 486 and letrozole (LTZ) found in rodents for inhibiting implantation. Exposure of target tissues to either hormone was suppressed during the mid-luteal phase of mating cycles by subcutaneous administration of the antiprogestin (RU 486), the aromatase inhibitor LTZ or the antiestrogen (ICI 182780) on days 4-7 of the luteal phase. Administration of 0.1 or 0.5 mg/kg of LTZ on days 5-7 of the luteal phase caused a profound drop in the levels of E(2) in all animals, whereas administration of ICI 182780 0.2 mg/kg on days 4-6 of the luteal phase had the opposite effect. The pregnancy rate in vehicle treated cycles of the same females was (58.3%). Treatment with RU 486, 0.8 mg/kg/day on days 5-7 of the luteal phase-induced endometrial bleeding in 3/5 mated females none of which became pregnant, whereas pregnancy was confirmed in one of the two animals that did not bled. Treatment with RU 486, 0.4 mg/kg/day alone or with LTZ on days 5-7 or ICI 182780 alone, on days 4-6 of the luteal phase failed to induce bleeding, allowing the establishment of pregnancy in 50.0-66.6% of the animals in these groups. We conclude that in Cebus monkeys, progesterone but not luteal estradiol is required for the establishment of pregnancy and that RU 486 and LTZ do not exhibit in this species the synergism found in rodents.
Assuntos
Cebus/metabolismo , Estradiol/metabolismo , Fase Luteal/metabolismo , Prenhez/metabolismo , Progesterona/metabolismo , Animais , Inibidores da Aromatase/farmacologia , Implantação do Embrião/efeitos dos fármacos , Estradiol/análogos & derivados , Estradiol/sangue , Estradiol/farmacologia , Antagonistas de Estrogênios/farmacologia , Feminino , Fulvestranto , Letrozol , Fase Luteal/efeitos dos fármacos , Masculino , Mifepristona/farmacologia , Nitrilas/farmacologia , Gravidez , Taxa de Gravidez , Progesterona/antagonistas & inibidores , Progesterona/sangue , Triazóis/farmacologiaRESUMO
Few reports on the reproductive physiology of Cebus apella have been published. In this study we characterized menstrual cycle events by means of vaginal cytology, ultrasonography (US), and hormonal measurements in serum during three consecutive cycles in 10 females, and assessed the probability that ovulation would occur in the same ovary in consecutive cycles in 18 females. The lengths and phases of the cycles were determined according to vaginal cytology. Taking the first day of endometrial bleeding as the first day of the cycle, the mean cycle length +/- SEM was 19.5+/-0.4 days, with follicular and luteal phases lasting 8.2+/-0.2 and 11.3+/-0.4 days, respectively. The follicular phase included menstruation and the periovulatory period, which was characterized by the presence of a large number of superficial eosinophilic cells in the vaginal smear. The myometrium, endometrium, and ovaries were clearly distinguished on US examination. During each menstrual cycle a single follicle was recruited at random from either ovary. The follicle grew from 3 mm to a maximum diameter of 8-9 mm over the course of 8 days, in association with increasing estradiol (E(2)) serum levels (from 489+/-41 to 1600+/-92 pmol/L). At ovulation, the mean diameter of the dominant follicle usually decreased by >20%, 1 day after the maximum E(2) level was reached. Ovulation was associated with an abrupt fall in E(2), a decreased number of eosinophilic cells, the presence of leukocytes and intermediate cells in the vaginal smear, and a progressive increase in progesterone (P) levels that reached a maximum of 892+/-65 nmol/L on days 3-6 of the luteal phase. The menstrual cycle of Cebus apella differs in several temporal and quantitative aspects from that in humans and Old World primates, but it exhibits the same correlations between ovarian endocrine and morphologic parameters.
Assuntos
Cebus/metabolismo , Cebus/fisiologia , Ciclo Menstrual/metabolismo , Ciclo Menstrual/fisiologia , Animais , Estradiol/sangue , Feminino , Folículo Ovariano/diagnóstico por imagem , Folículo Ovariano/crescimento & desenvolvimento , Progesterona/sangue , América do Sul , Ultrassonografia , Útero/diagnóstico por imagem , Esfregaço VaginalRESUMO
PURPOSE: To study the reaction of a series of Hantzsch dihydropyridines with pharmacological significance such as, nifedipine, nitrendipine, nisoldipine, nimodipine, isradipine and felodipine, with electrogenerated superoxide in order to identify products and postulate a mechanism. METHODS: The final pyridine derivatives were separated and identified by gas chromatography/mass spectrometry (GC-MS). The intermediates, anion dihydropyridine and the HO2*/HO2- species, were observed from voltammetric studies and controlled potential electrolysis was used to electrogenerate O2*-. RESULTS: The current work reveals that electrogenerated superoxide can quantitatively oxidize Hantzsch dihydropyridines to produce the corresponding aromatized pyridine derivatives. CONCLUSIONS: Our results indicate that the aromatization of Hantzsch dihydropyridines by superoxide is initiated by proton transfer from the N1-position on the 1,4-dihydropyridine ring to give the corresponding anion dihydropyridine, which readily undergoes further homogeneous oxidations to provide the final aromatized products. The oxidation of the anionic species of the dihydropyridine is more easily oxidized than the parent compound.
Assuntos
Nifedipino , Superóxidos , Bloqueadores dos Canais de Cálcio/química , Felodipino , Nifedipino/química , Nimodipina/química , Nitrendipino/químicaRESUMO
BACKGROUND: Experimental evidence to disprove the belief that emergency contraception with levonorgestrel (LNG) prevents pregnancy by interfering with post-fertilization events is lacking. Here we determined the effect of post-coital and pre-ovulatory administration of LNG on fertility and ovulation, respectively, in the Cebus monkey. METHODS: To determine the effect on fertility, LNG 0.75 mg or vehicle were administered orally or s.c. once or twice within the first 24 h after mating occurring very close to the time of ovulation. Females that became pregnant were aborted with mifepristone and re-entered the study after a resting cycle until each of 12 females had contributed, in a randomized order, two LNG and two vehicle-treated cycles. To determine the effect on ovulation, LNG 0.75 mg or vehicle were injected twice coinciding with follicles smaller or larger than 5 mm in diameter. Six females contributed five treated cycles each. RESULTS: The pregnancy rate was identical in vehicle- and LNG-treated cycles. LNG inhibited or delayed ovulation only when treatment coincided with a follicle <5 mm diameter. CONCLUSION: In Cebus monkeys, LNG can inhibit or delay ovulation but, once fertilization has taken place, it cannot prevent the establishment of pregnancy. These findings do not support the hypothesis that emergency contraception with LNG prevents pregnancy by interfering with post-fertilization events.
Assuntos
Anticoncepcionais Sintéticos Pós-Coito/farmacologia , Fertilidade/efeitos dos fármacos , Levanogestrel/farmacologia , Ovulação/efeitos dos fármacos , Animais , Cebus , Anticoncepcionais Sintéticos Pós-Coito/administração & dosagem , Feminino , Fase Folicular , Levanogestrel/administração & dosagem , Masculino , Folículo Ovariano/diagnóstico por imagem , Ovário/diagnóstico por imagem , Gravidez , Taxa de Gravidez , Fatores de Tempo , UltrassonografiaRESUMO
Chagas' disease constitutes a therapeutic challenge because presently available drugs have wide toxicity to the host and are generally ineffective in the chronic stages of the disease. A series of oxazolo(thiazolo)pyridene derivatives were studied on Trypanosoma cruzi epimastigote growth and oxygen consumption and their electrochemical (redox) potentials and lipophilicity. The derivatives produced different degrees of parasite growth and respiration inhibition on CL Brener, LQ, and Tulahuen strains of T. cruzi epimastigotes. Respiratory chain inhibition appears to be a determinant of the trypanosomicidal activity of these compounds, since a significant correlation between respiration and culture growth inhibition was found. A similar correlation was found, within the different structural subfamilies, between toxic effects and the ability of the compounds to be oxidized in aqueous media. The inhibition of respiration and of parasite growth in culture increases with the lipophilicity of the substituents on the oxazolopyridine nucleus. No difference in the action of these derivatives was found among the different parasite strains. It is concluded that these compounds may have a potential usefulness in the treatment of Chagas' disease.