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Sample records for palmar hyperhidrosis sympathectomy

  1. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  2. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

    Science.gov (United States)

    Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

    2008-09-01

    Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

  3. CT-Guided, Ethanol Sympatholysis for Primary Axillary–Palmar Hyperhidrosis

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    Tsitskari, Maria, E-mail: mariadote@hotmail.com [American Medical Center, Vascular & Interventional Radiology (Cyprus); Friehs, Gerhard, E-mail: gerhardf@amc.com.cy; Zerris, Vassilis, E-mail: vassilisz@amc.com.cy [American Medical Center, Neurosurgery (Cyprus); Georgiades, Christos, E-mail: g-christos@hotmail.com [Johns Hopkins Hospital, Vascular & Interventional Radiology (United States)

    2016-12-15

    PurposePrimary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.Materials and MethodsNine consecutive patients with axillary–palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6–26 months). Descriptive statistics was used to report the outcomes.ResultsOne procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner’s or compensatory hyperhidrosis were observed.ConclusionsCT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

  4. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Alsantali A

    2018-04-01

    Full Text Available Adel Alsantali Department of Dermatology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia Background: Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. Purpose: To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. Methods: In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Results: Statistically, there was a significant difference in pain control between EMLA cream group and ice application group (p<0.05. The average pain score on the hands where EMLA cream was applied was 8.9 (SD=0.81, whereas it was 4.8 (±0.9 in the ice group. Conclusion: In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.Keywords: ice, local anesthetics, EMLA, palmar hyperhidrosis, Botox injection, pain reduction

  5. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis.

    Science.gov (United States)

    Alsantali, Adel

    2018-01-01

    Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA) cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Statistically, there was a significant difference in pain control between EMLA cream group and ice application group ( p cream was applied was 8.9 (SD=0.81), whereas it was 4.8 (±0.9) in the ice group. In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.

  6. Thoracoscopic sympathectomy ganglia ablation in the management ...

    African Journals Online (AJOL)

    Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution. D Kravarusic, E Freud. Abstract. Background: Hyperhidrosis can cause significant professional and social handicaps. Surgery is the preferred treatment modality for hyperhidrosis.

  7. A single incision transaxillary thoracoscopic sympathectomy

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    Marić Nebojša

    2014-01-01

    Full Text Available Background/Aim. Primary hyperhidrosis causes are unknown. The disorder begins in early childhood. It intensifies in puberty and maturity. It is equally present in both sexes. The symptoms exacerbate when the body temperature rises and due to emotional stimuli affecting the sympathetic nerve system. The aim of this study was to demonstrate that videoassisted thoracoscopic surgery (VATS sympathectomy is a method for primary focal hyperhidrosis permanent treatment. The single incision method in properly selected patients maximizes the intervention effectiveness and minimizes aesthetic side effects. Methods. This prospective study analysed the findings in patients who had been operated on due to primary focal hyperhidrosis (face, palms, and armpits using a single small transaxilarry incision in the third inter-rib space at the level of the anterior axillary line with two 5 mm flexible ports. All the patients, with T2-T5 thoracoscopic sympathectomy of the sympathetic chain using a single small incision in the third inter-rib space in the anterior axillary line, were analysed in the period from September 2009 to November 2010 regarding the postoperative morbidity and outcomes of the operation (clinical evaluation and visual analogue scale with a view to assessing the effectiveness of the surgery conducted in this manner. Results. A total of 47 patients (18 men, 29 women, 18 to 48 years old (29 on average had underwent 94 bilateral video-assisted thoracoscopic sympathectomies. The sympathectomy was indicated in cases of facial blushing and sweating (6.38%, palmary sweating (34.04%, axillary sweating (14.89% or both palmary and axillary sweating (44.68%. The largest percentage of patients (98.6% had left the hospital the following day. The postoperative 30 day’s mortality was 0 and the conversion into open surgery was not necessary. As for complications, there had been an occurrence of partial pneumothorax in two patients treated by means of

  8. Distinguishing hyperhidrosis and normal physiological sweat production

    DEFF Research Database (Denmark)

    Thorlacius, Linnea; Gyldenløve, Mette; Zachariae, Claus

    2015-01-01

    of this study was to establish reference intervals for normal physiological axillary and palmar sweat production. METHODS: Gravimetric testing was performed in 75 healthy control subjects. Subsequently, these results were compared with findings in a cohort of patients with hyperhidrosis and with the results...... 100 mg/5 min. CONCLUSIONS: A sweat production rate of 100 mg/5 min as measured by gravimetric testing may be a reasonable cut-off value for distinguishing axillary and palmar hyperhidrosis from normal physiological sweat production....

  9. Electrocautery versus Ultracision versus LigaSure in Surgical Management of Hyperhidrosis.

    Science.gov (United States)

    Divisi, Duilio; Di Leonardo, Gabriella; De Vico, Andrea; Crisci, Roberto

    2015-12-01

    The aim of the study was to evaluate the sympathectomy procedures for primary hyperhidrosis in terms of complications and effectiveness. From January 2010 to September 2012 we performed 130 sympathectomies in 65 patients, 27 males (42%) and 38 females (58%). Electrocoagulation was used in 20 procedures (15%), ultrasonic scalpel in 54 (42%), and radiofrequency dissector in 56 (43%). Seven patients (11%) underwent bilateral sympathectomy in the same surgical session, while in 58 (89%) the right surgical approach was delayed 30 days from the first procedure. We noticed 12 complications (9%): (a) chest pain in 6 patients (4 with electrocoagulation, 1 with ultrasonic scalpel, and 1 with radiofrequency dissector), which disappeared in 20 ± 1 day; (b) paresthesias in 3 electrocoagulation patients, was solved in 23 ± 5 days; (c) bradycardia in 1 ultrasonic patient, normalized in 4th postoperative hour; (d) unilateral relapse in 2 electrocoagulation patients after the second side approach, positively treated in 1 patient by resurgery in video-assisted thoracoscopy (VAT). The quality-adjusted life year and the quality of life evaluation revealed a statistically significant improvement (p = 0.02) in excessive sweating and general satisfaction after surgery, with Ultracision and LigaSure showing better findings than electrocoagulation. The latest generation devices offered greater efficacy in the treatment of hyperhidrosis, minimizing complications and facilitating the resumption of normal work and social activity of patients. Georg Thieme Verlag KG Stuttgart · New York.

  10. A comparative study of thoracoscopic sympathicotomy versus local surgical treatment for axillary hyperhidrosis

    DEFF Research Database (Denmark)

    Heidemann, Erik; Licht, Peter B

    2013-01-01

    Axillary hyperhidrosis affects approximately 1.4% of the population. Medical management is often frustrating, and the response generally transient. Surgical methods include thoracoscopic sympathectomy or sympathicotomy and local axillary surgery such as suction-curettage or en-bloc skin resection....... Many case series with retrospective follow-up are available in the literature, but no comparative studies between surgical techniques have been published....

  11. Simpatectomia por videotoracoscopia no tratamento da hiperhidrose palmar: implicações anestésicas Simpatectomia por videotoracoscopia en el tratamiento de la hiperhidrosis palmar: implicaciones anestésicas Thoracoscopic sympathectomy to treat palmar hyperhydrosis: anesthetic implications

    Directory of Open Access Journals (Sweden)

    Monia Di Lara Dias

    2005-06-01

    creciente el número de procedimientos. La introducción de la videotoracoscopia mejoró la técnica, redujo la morbidad, el tiempo quirúrgico y el tiempo de permanencia hospitalaria. El adecuado manoseo anestésico, monitorización continuada y las técnicas a disposición permiten que el procedimiento sea realizado con seguridad o se modifiquen las conductas de acuerdo con las observaciones clínicas y las respuestas del paciente a las alteraciones dinámicas consecuentes de la cirugía y terapéutica farmacológica. Sería entonces, deber del anestesiologista disponer con criterio y buen sentido de las alternativas disponibles para asegurar al paciente un procedimiento seguro, una recuperación rápida con la menor morbidad posible.BACKGROUND AND OBJECTIVES: Primary hyperhydrosis is a disorder characterized by excessive diffuse or localized sweating. There are several noninvasive therapeutic methods which in general do not solve the problem generating even more anxiety, and time and money wasting for hyperhydrosis patients. Partial thoracic sympathetic chain resection is indicated for palmar hyperhydrosis and may be performed by thoracoscopic surgery with good results and few complications. This review aimed at discussing possible anesthetic techniques for this procedure, as well as possible complications and their management. CONTENTS: It is estimated that the incidence of primary hyperhydrosis varies from 0.6% to 1%, being more frequent in young patients. While in most cases axillary and plantar sweating causes discomfort only, excessive palmar sweating causes social, professional and psychological problems. Thoracoscopic sympathectomy has been performed in several hospitals and is increasing in number. Unless there are specific counterindications, bilateral sympathectomy is performed under general anesthesia through a double or single lumen catheter, with or without intrapleural carbon dioxide inflation. Major postoperative cares are early pneumothorax or residual

  12. Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy - A quality of life and cost effectiveness analysis.

    Science.gov (United States)

    Gibbons, John P; Nugent, Emmeline; O'Donohoe, Nollaig; Maher, Barry; Egan, Bridget; Feeley, Martin; Tierney, Sean

    2016-10-01

    To estimate cost-effectiveness of botulinum toxin therapy for axillary hyperhidrosis compared to the standard surgical intervention of endoscopic thoracic sympathectomy (ETS). The validated dermatology life quality index questionnaire was given to patients attending for treatment over a 4 month period, to assess their quality of life (QoL) over the preceding week (n = 44). Follow-up was performed 4-6 weeks later by telephone using the same questionnaire to validate the effectiveness of the treatment. The duration of effect of the botulinum toxin treatment was also recorded and this data was used as the basis for cost effectiveness analysis. Using HIPE data, the baseline cost for single intervention using botulinum toxin and ETS was retrieved. Using figures provided by HIPE and expert opinion of the costs of complications, a stochastic model for 10,000 patients was used to evaluate the total costs for ETS including the complications. The results from the QoL analysis show that botulinum toxin therapy is a successful therapy for improvement of symptoms. It was revealed that the mean interval before recurrence of original symptoms after botulinum toxin therapy was 5.6 months. The baseline cost for both treatments are €389 for botulinum toxin and €9389 for uncomplicated ETS. The stochastic model yields a mean cost of €11,390 for ETS including complications. Treatments reached cost equivalence after 13.3 years. However, given the efficacy of the botulinum toxin therapy and the low risk we propose that botulinum toxin therapy for hyperhidrosis should be considered the gold standard. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  13. Primary hyperhidrosis: Implications on symptoms, daily life, health and alcohol consumption when treated with botulinum toxin.

    Science.gov (United States)

    Shayesteh, Alexander; Boman, Jens; Janlert, Urban; Brulin, Christine; Nylander, Elisabet

    2016-08-01

    Primary hyperhidrosis affects approximately 3% of the population and reduces quality of life in affected persons. Few studies have investigated the symptoms of anxiety, depression and hazardous alcohol consumption among those with hyperhidrosis and the effect of treatment with botulinum toxin. The first aim of this study was to investigate the effect of primary hyperhidrosis on mental and physical health, and alcohol consumption. Our second aim was to study whether and how treatment with botulinum toxin changed these effects. One hundred and fourteen patients answered questionnaires regarding hyperhidrosis and symptoms, including hyperhidrosis disease severity scale (HDSS), visual analog scale (VAS) 10-point scale for hyperhidrosis symptoms, hospital anxiety and depression scale (HADS), alcohol use disorder identification test (AUDIT) and short-form health survey (SF-36) before treatment with botulinum toxin and 2 weeks after. The age of onset of hyperhidrosis was on average 13.4 years and 48% described heredity for hyperhidrosis. Significant improvements were noted in patients with axillary and palmar hyperhidrosis regarding mean HDSS, VAS 10-point scale, HADS, SF-36 and sweat-related health problems 2 weeks after treatment with botulinum toxin. Changes in mean AUDIT for all participants were not significant. Primary hyperhidrosis mainly impairs mental rather than physical aspects of life and also interferes with specific daily activities of the affected individuals. Despite this, our patients did not show signs of anxiety, depression or hazardous alcohol consumption. Treatment with botulinum toxin reduced sweat-related problems and led to significant improvements in HDSS, VAS, HADS and SF-36 in our patients. © 2016 Japanese Dermatological Association.

  14. Hyperhidrosis (Excessive Sweating)

    Science.gov (United States)

    ... who have this type are otherwise healthy. In medical terminology, the word “primary” means that the cause is not another medical condition. Secondary hyperhidrosis In medical terminology, “secondary” means that the excessive sweating (hyperhidrosis) has ...

  15. CT-guided percutaneous neurolysis methods. State of the art and first results

    International Nuclear Information System (INIS)

    Schneider, B.; Richter, G.M.; Roeren, T.; Kauffmann, G.W.

    1996-01-01

    We used 21G or 22G fine needles. All CT-guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. All neurolysis methods involve sterile puncture of the ganglia under local anesthesia, a test block with anesthetic and contrast agent to assess the clinical effect and the definitive block with a mixture of 96% ethanol and local anesthetic. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible. Results: Seven of 20 legs showed at least transient clinical improvement after CT-guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. For lumbar sympathectomy, improved perfusion is reported in 39-89%, depending on the pre-selection of the patient group. Discussion: It was recently proved that sympathectomy not only improves perfusion of the skin but also of the muscle. The hypothesis of a steal effect after sympathectomy towards skin perfusion was disproved. Modern aggressive surgical and interventional treatment often leaves patients to sympathectomy whose reservers of collateralization are nearly exhausted. We presume this is the reason for the different results we found in our patient group. For thoracic sympathectomy the clinical treatment depends very much on the indications. Whereas palmar hyperhidrosis offers nearly 100% success, only 60-70% of patients with disturbance of perfusion have benefited. Results in celiac ganglia block also differ. Patients with carcinoma of the pancreas and other organs of the upper abdomen benefit in 80-100% of all cases, patients with chronic pancreatitis in 60-80%. (orig./VHE) [de

  16. Two-Step Incision for Periarterial Sympathectomy of the Hand

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    Seung Bae Jeon

    2015-11-01

    Full Text Available BackgroundSurgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire.MethodsA total of 40 patients (17 men and 23 women with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS and the Wake Forest University rating scale.ResultsThe total patient score was 8.59 (range, 6-15 in the two-step incision group and 9.62 (range, 7-18 in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034 but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03.ConclusionsCompared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

  17. Thoracic sympathectomy

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E P; Licht, Peter B

    2016-01-01

    sympathetic ablation for hypertension is obsolete, and direct endovascular renal sympathectomy still requires adequate clinical trials. There are rare publications of sympathetic ablation for primary phobias, but there is no scientific basis to support sympathetic surgery for any psychiatric indication....

  18. Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia

    International Nuclear Information System (INIS)

    Pieri, Stefano; Agresti, Paolo; Di Cesare, Fabio; Ricci, Guiseppe

    2005-01-01

    Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation [it

  19. The Etiology of Primary Hyperhidrosis

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.

    2017-01-01

    of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies.......Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...

  20. Video-assisted open supraclavicular sympathectomy following air embolism.

    Science.gov (United States)

    Shpolyanski, G; Hashmonai, M; Rudin, M; Abaya, N; Kaplan, U; Kopelman, D

    2012-01-01

    Air embolism is a relatively rare complication of thoracoscopic surgery. Open supraclavicular sympathectomy was indicated to overcome the risk of re-embolization. A novel video-assisted technique was performed. conclusions: The previously prevalent open supraclavicular sympathectomy is a good choice for avoiding air embolism. Laparoscopic instrumentation and technology can be used to improve open procedures, especially when exposure and visibility are limited. Sometimes we should remember to use the experience of our teachers.

  1. Peripheral Sympathectomy for Raynaud's Phenomenon: A Salvage Procedure

    Directory of Open Access Journals (Sweden)

    Wen-Her Wang

    2006-10-01

    Full Text Available We retrospectively reviewed the effectiveness of peripheral sympathectomy for severe Raynaud's phenomenon. In this study, a total of 14 digits from six patients with chronic digital ischemic change were included. All patients had pain, ulcer, or gangrenous change in the affected digits and were unresponsive to pharmacologic or other nonsurgical therapies. In all cases, angiography showed multifocal arterial lesions, so microvascular reconstruction was unfeasible. Peripheral sympathectomy was performed as a salvage procedure to prevent digit amputation. The results were analyzed according to reduction of pain, healing of ulcers, and prevention of amputation. In 12 of the 14 digits, the ulcers healed and amputation was avoided. In the other two digits, the ulcers improved and progressive gangrene was limited. As a salvage procedure for Raynaud's phenomenon recalcitrant to conservative treatment, peripheral sympathectomy improves perfusion to ischemic digits and enables amputation to be avoided.

  2. CT-guided percutaneous neurolysis methods. State of the art and first results; CT-gesteuerte Neurolysen. Stand der Technik und aktuelle Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, B. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Richter, G.M. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Roeren, T. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Kauffmann, G.W. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany)

    1996-09-01

    We used 21G or 22G fine needles. All CT-guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. All neurolysis methods involve sterile puncture of the ganglia under local anesthesia, a test block with anesthetic and contrast agent to assess the clinical effect and the definitive block with a mixture of 96% ethanol and local anesthetic. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible. Results: Seven of 20 legs showed at least transient clinical improvement after CT-guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. For lumbar sympathectomy, improved perfusion is reported in 39-89%, depending on the pre-selection of the patient group. Discussion: It was recently proved that sympathectomy not only improves perfusion of the skin but also of the muscle. The hypothesis of a steal effect after sympathectomy towards skin perfusion was disproved. Modern aggressive surgical and interventional treatment often leaves patients to sympathectomy whose reservers of collateralization are nearly exhausted. We presume this is the reason for the different results we found in our patient group. For thoracic sympathectomy the clinical treatment depends very much on the indications. Whereas palmar hyperhidrosis offers nearly 100% success, only 60-70% of patients with disturbance of perfusion have benefited. Results in celiac ganglia block also differ. Patients with carcinoma of the pancreas and other organs of the upper abdomen benefit in 80-100% of all cases, patients with chronic pancreatitis in 60-80%. (orig./VHE) [Deutsch] Thorakale und lumbale Sympathikolyse sowie die Zoeliakusblockade

  3. Resources for hyperhidrosis sufferers, patients, and health care providers.

    Science.gov (United States)

    Pieretti, Lisa J

    2014-10-01

    The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Hyperhidrosis-psychiatric Study and Behaviour Therapy

    Directory of Open Access Journals (Sweden)

    P V Pradhan

    1984-01-01

    Full Text Available Eleven patients suffering from hyperhidrosis were psychiatrically studied. Seven of them were given behaviour therapy. Majority of the patients had -an unhappy childhood and long - standing and continuing psychological stress. None of them had obvious, coexisting psychiatric condition.. Thus, hyperhidrosis was the sole, expression of their psychological conflicts. Of the 7 patients treated 71% showed improvement with relaxation and systemic desentiziation which,was maintained for a_ period of at least 6 months.

  5. Management of essential hyperhidrosis of upper limbs by ...

    African Journals Online (AJOL)

    Introduction: Essential hyperhidrosis is an idiopathic condition characterized by markedly excessive sweating especially in the hands. Objective: This study was done to evaluate the functional results of radiofrequency thermocoagulation of T2 ganglion in 10 patients suffered from essential hyperhidrosis of both upper limbs.

  6. Management of essential hyperhidrosis of upper limbs by ...

    African Journals Online (AJOL)

    Wael Fouad

    Abstract Introduction: Essential hyperhidrosis is an idiopathic condition characterized by mark- edly excessive sweating especially in the hands. Objective: This study was done to evaluate the functional results of radiofrequency thermocoagu- lation of T2 ganglion in 10 patients suffered from essential hyperhidrosis of both ...

  7. Does surgical sympathectomy improve clinical outcomes in patients with refractory angina pectoris?

    Science.gov (United States)

    Holland, Luke C; Navaratnarajah, Manoraj; Taggart, David P

    2016-04-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In patients with angina pectoris refractory to medical therapy, does surgical sympathectomy improve clinical outcomes? A total of 528 papers were identified using the search protocol described, of which 6 represented the best evidence to answer the clinical question. There were 5 case series and 1 prospective cohort study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All 5 of the case series demonstrated an improvement in symptoms, exercise tolerance or quality of life in patients undergoing surgical sympathectomy. An early case series investigating an open approach had a high morbidity and mortality rate, but the 4 other series used a minimally invasive technique and had low morbidity and zero perioperative mortality rates. The cohort study compared surgical sympathectomy with transmyocardial laser revascularization (TMR) and concluded TMR to be superior. However, this study looked only at unilateral sympathectomy, whereas all 5 case series focused on bilateral surgery. We conclude that the best currently available evidence does suggest that patients report an improvement in their symptoms and quality of life following surgical sympathectomy, but the low level of this evidence does not allow for a statistically proved recommendation. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation.

    Science.gov (United States)

    Kamudoni, P; Mueller, B; Halford, J; Schouveller, A; Stacey, B; Salek, M S

    2017-06-08

    An understanding of the daily life impacts of hyperhidrosis and how patients deal with them, based on qualitative research, is lacking. This study investigated the impact of hyperhidrosis on the daily life of patients using a mix of qualitative research methods. Participants were recruited through hyperhidrosis patient support groups such as the Hyperhidrosis Support Group UK. Data were collected using focus groups, interviews and online surveys. A grounded theory approach was used in the analysis of data transcripts. Data were collected from 71 participants, out of an initial 100 individuals recruited. Seventeen major themes capturing the impacts of hyperhidrosis were identified; these covered all areas of life including daily life, psychological well-being, social life, professional /school life, dealing with hyperhidrosis, unmet health care needs and physical impact. Psychosocial impacts are central to the overall impacts of hyperhidrosis, cutting across and underlying the limitations experienced in other areas of life.

  9. A systematic review of microwave-based therapy for axillary hyperhidrosis.

    Science.gov (United States)

    Hsu, Tzu-Herng; Chen, Yu-Tsung; Tu, Yu-Kang; Li, Chien-Nien

    2017-10-01

    To systematically analyse the literature on the use of the microwave-based device for subdermal thermolysis of the axilla and its efficacy for the treatment of axillary hyperhidrosis. A systematic review was conducted using PubMed, Embase, SCOPUS and Cochrane databases on 2 June 2016. The inclusion criteria including: (1) studies with human subjects, (2) full-text articles published in English, (3) a microwave-based device used to treat axillary hyperhidrosis and (4) trials that precisely evaluated axillary hyperhidrosis. Exclusion criteria were the following: (1) studies that did not fit the inclusion criteria mentioned above and (2) case reports and reviews. We reviewed five clinical trials and 189 patients, all of which were published between 2012 and 2016. There was one randomized controlled trial, one retrospective study and the remainder were prospective studies. Although all of the studies were conducted with a small sample size, the results indicated that microwave-based device treatment of axillary hyperhidrosis had long-term efficacy with mild adverse effects. In addition, most patients were satisfied with the outcomes in these studies. Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

  10. Unilateral hyperhidrosis and hypothermia

    DEFF Research Database (Denmark)

    Dyring-Andersen, B; Kamp, S; Madelung, A

    2016-01-01

    A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left...

  11. African Journal of Paediatric Surgery - Vol 9, No 2 (2012)

    African Journals Online (AJOL)

    Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. D Kravarusic, E Freud, 143-147. http://dx.doi.org/10.4103/0189-6725.99402 ...

  12. Pulse oximeter perfusion index as an early indicator of sympathectomy after epidural anesthesia.

    Science.gov (United States)

    Ginosar, Y; Weiniger, C F; Meroz, Y; Kurz, V; Bdolah-Abram, T; Babchenko, A; Nitzan, M; Davidson, E M

    2009-09-01

    The pulse oximeter perfusion index (PI) has been used to indicate sympathectomy-induced vasodilatation. We hypothesized that pulse oximeter PI provides an earlier and clearer indication of sympathectomy following epidural anesthesia than skin temperature and arterial pressure. Forty patients received lumbar epidural catheters. Patients were randomized to receive either 10 ml 0.5% bupivacaine or 10 ml 0.25% bupivacaine. PI in the toe, mean arterial pressure (MAP) and toe temperature were all assessed at baseline and at 5, 10 and 20 min following epidural anesthesia. The effect of epidural anesthesia over time was assessed by repeated measures analysis of variance. Additionally, we defined clinically evident sympathectomy criteria (a 100% increase in the PI, a 15% decrease in MAP and a 1 degrees C increase in toe temperature). The numbers of patients demonstrating these changes for each test were compared using the McNemar test for each time point. Twenty-nine subjects had photoplethysmography signals that met a priori signal quality criteria for analysis. By 20 min, PI increased by 326%, compared with a 10% decrease and a 3% increase in MAP and toe temperature, respectively. For PI 15/29, 26/29 and 29/29 of the subjects met the sympathectomy criteria at 5, 10 and 20 min, respectively, compared with 4/29, 6/29 and 18/29 for MAP changes and 3/29, 8/29 and 14/29 for toe temperature changes. PI was an earlier, clearer and more sensitive indicator of the development of epidural-induced sympathectomy than either skin temperature or MAP.

  13. [Focal hyperhidrosis.Quality of life, socioeconomic importance and use of internal medicinal therapy].

    Science.gov (United States)

    Rzany, B; Müller, C; Hund, M

    2012-06-01

    Focal hyperhidrosis can have a substantial influence on the professional, physical, emotional and social life of those affected. This becomes clear when the results of quality of life studies and Health Service Research studies are reviewed, e.g. affected patients were prepared to contribute additional money for treatment of hyperhidrosis. The systemic therapy of focal hyperhidrosis with oral anticholinergic agents is a quite economical treatment strategy. These products can be administered continuously or sporadically. However, only good clinical date for the continous treatment exists. Focal hyperhidrosis is a disease which requires our full attention. It should be discussed whether e.g. QoL questionnaires should be used routinelly.

  14. The effect of sympathectomy on bone blood flow in man

    International Nuclear Information System (INIS)

    Lahtinen, T.; Alhava, E.M.; Hyoedynmaa, S.; Hendolin, H.; Oksala, I.

    1982-01-01

    The effect of lumbar sympathectomy on bone blood flow was measured in seven patients with a Xe-133 washout method. On the third postoperative day there was a significant increase of blood flow in the proximal femur and a slight increase in the proximal tibia. Two months after the operation blood flow in the proximal part of the femur was no more significantly increased but in the proximal tibia there was a significant increase. The study suggests that the positive effect of sympathectomy on bone blood flow may be of value in cases where the increase of blood flow to peripheral bones is required

  15. Hyperhidrosis: an update on prevalence and severity in the United States.

    Science.gov (United States)

    Doolittle, James; Walker, Patricia; Mills, Thomas; Thurston, Jane

    2016-12-01

    Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained. The 393 individuals (210 female, 244 non-Hispanic white, 27 black, mean age 40.3, SE 0.64) who indicated that they have hyperhidrosis were asked further questions, including body areas impacted, severity of symptoms, age of onset, and socioemotional impact of the condition. Current results estimate the prevalence of hyperhidrosis at 4.8 %, which represents approximately 15.3 million people in the United States. Of these, 70 % report severe excessive sweating in at least one body area. In spite of this, only 51 % have discussed their excessive sweating with a healthcare professional. The main reasons are a belief that hyperhidrosis is not a medical condition and that no treatment options exist. The current study's findings with regard to age of onset and prevalence by body area generally align with the previous research. However, current findings suggest that the severity and prevalence are both higher than previously thought, indicating a need for greater awareness of the condition and its associated treatment options among medical professionals.

  16. Anaesthesia for left thoracoscopic sympathectomy for refractory long ...

    African Journals Online (AJOL)

    Congenital long QT syndrome (LQTS) is a rare genetic disorder that has been associated with various genetic mutations ... Left thoracoscopic sympathectomy is an effective treatment for patients ... frequency of cardiac events/ICD shocks postoperatively. The ... inheritance, dental abnormalities, clinodactyly, and bidirectional.

  17. Anaesthesia for left thoracoscopic sympathectomy for refractory long ...

    African Journals Online (AJOL)

    ... mutations including life-threatening cardiac arrhythmias and sudden death. Left thoracoscopic sympathectomy is an effective treatment for patients who are refractory to medical therapy or who need frequent epicardial internal cardio defibrillator intervention. The authors report three cases, one adult and two children, who ...

  18. A surprising palmar nevus: A case report

    Directory of Open Access Journals (Sweden)

    Rana Rafiei

    2018-02-01

    Full Text Available Raised palmar or plantar nevus especially in white people is an unusual feature. We present an uncommon palmar compound nevus in a 26-year-old woman with a large diameter (6 mm which had a collaret-shaped margin. In histopathologic evaluation intralymphatic protrusions of nevic nests were noted. This case was surprising to us for these reasons: size, shape, location and histopathology of the lesion. Palmar nevi are usually junctional (flat and below 3 mm diameter and intra lymphatic protrusion or invasion in nevi is an extremely rare phenomenon.

  19. Raynaud's phenomenon: peripheral catecholamine concentration and effect of sympathectomy.

    Science.gov (United States)

    Nielsen, S L; Christensen, N J; Olsen, N; Lassen, N A

    1980-01-01

    The reaction to body and finger cooling was recorded in seven patients with relapse of primary Raynaud's phenomenon after sufficiently performed bilateral upper thoracic sympathectomy and for comparison in eight young women with primary Raynaud's phenomenon as well as in seven normal women. The forearm venous concentration of noradrenaline was lower and adrenaline concentration higher in the sympathectomized patients than in the other groups (p less than 0,05). Noradrenaline showed a significant increase during body cooling in normals and primary Raynaud's (p less than 0,05). There was no significant correlation between the vasoconstrictor response to cooling of a finger and the noradrenaline concentration probably due to the fact that skin vasoconstriction impeded release of noradrenaline from the skin. The relapse of Raynaud's phenomenon after surgically sufficient sympathectomy could not be treated by reserpine or alfa-adrenergic receptor blockers in two patients in whom this was tried.

  20. Anti-dopamine beta-hydroxylase immunotoxin-induced sympathectomy in adult rats

    Science.gov (United States)

    Picklo, M. J.; Wiley, R. G.; Lonce, S.; Lappi, D. A.; Robertson, D.

    1995-01-01

    Anti-dopamine beta-hydroxylase immunotoxin (DHIT) is an antibody-targeted noradrenergic lesioning tool comprised of a monoclonal antibody against the noradrenergic enzyme, dopamine beta-hydroxylase, conjugated to saporin, a ribosome-inactivating protein. Noradrenergic-neuron specificity and completeness and functionality of sympathectomy were assessed. Adult, male Sprague-Dawley rats were given 28.5, 85.7, 142 or 285 micrograms/kg DHIT i.v. Three days after injection, a 6% to 73% decrease in the neurons was found in the superior cervical ganglia of the animals. No loss of sensory, nodose and dorsal root ganglia, neurons was observed at the highest dose of DHIT. In contrast, the immunotoxin, 192-saporin (142 micrograms/kg), lesioned all three ganglia. To assess the sympathectomy, 2 wk after treatment (285 micrograms/kg), rats were anesthetized with urethane (1 g/kg) and cannulated in the femoral artery and vein. DHIT-treated animals' basal systolic blood pressure and heart rate were significantly lower than controls. Basal plasma norepinephrine levels were 41% lower in DHIT-treated animals than controls. Tyramine-stimulated release of norepinephrine in DHIT-treated rats was 27% of controls. Plasma epinephrine levels of DHIT animals were not reduced. DHIT-treated animals exhibited a 2-fold hypersensitivity to the alpha-adrenergic agonist phenylephrine. We conclude that DHIT selectively delivered saporin to noradrenergic neurons resulting in destruction of these neurons. Anti-dopamine beta-hydroxylase immunotoxin administration produces a rapid, irreversible sympathectomy.

  1. "Palmar pivot flap" for resurfacing palmar lateral defects of the fingers.

    Science.gov (United States)

    Yam, Andrew; Peng, Yeong-Pin; Pho, Robert Wan-Heng

    2008-12-01

    Soft tissue defects on the lateral borders of the digits are difficult to reconstruct using local or local-regional flaps. We describe a "palmar pivot flap" to resurface an adjacent defect on the palmar-lateral aspect of the digit. The surgical technique is described. This flap is an axial pattern flap based on the subcutaneous transverse branches of the digital artery. The flap is pivoted up to 90 degrees on the neurovascular bundle in its base, into an adjacent defect. The flap can be raised from either the proximal or the middle phalangeal segments. It can cover defects sited from the level of the proximal interphalangeal joint up to the fingertip. The donor defect is limited to the same digit and is covered with a full-thickness skin graft. We have used this flap on 3 patients with defects at the middle phalangeal segment, the distal interphalangeal joint, and the fingertip. All healed primarily. One patient had a mild flexion contracture of the proximal interphalangeal joint, whereas the other 2 had no complications. The patients with distal interphalangeal joint and fingertip defects had excellent sensation in the flap (2-point discrimination of 5-6 mm). The palmar pivot flap is useful for resurfacing otherwise difficult defects on the lateral borders of the digits around and distal to the proximal interphalangeal joint, including those at the fingertip. It provides sensate, glabrous skin. The donor defect is on the same digit and is well hidden, producing an aesthetic and functional reconstruction.

  2. Two patients with localised hyperhidrosis of the hand based on functional and structural abnormalities of sweat glands

    DEFF Research Database (Denmark)

    Kristiansen, Bjørn H; Lindahl, Kim H; Pallesen, Kristine A U

    2018-01-01

    A 14-year-old girl and a 30-year-old woman presented with localised hyperhidrosis on the dorsal hand and wrist, respectively, provoked by different stimuli such as physical activity and minor trauma to the skin. The skin was seemingly normal in both patients where an iodine-starch test revealed...... a well-demarcated area of hyperhidrosis. Following histopathological examination, the diagnosis was unilateral localised hyperhidrosis in both cases; one with normal histology and one with a nevus sudoriferous. Both patients were successfully treated with botulinum toxin type A. The 30-year-old woman...... additionally used low-dose propantheline bromide periodically and experienced long-term remission on this therapy. Hyperhidrosis may embarrass and interfere with patients' school and careers, and it is therefore important to tailor an effective individual treatment....

  3. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating raynaud,s syndrome after frost bite

    International Nuclear Information System (INIS)

    Khan, M.I.; Rehman, A.; Tariq, M.; Sheen, S.N.

    2008-01-01

    Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene of distal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p<0.05) as compared to conservative management. Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite. (author)

  4. Blue toe syndrome treated with sympathectomy in a patient with acute renal failure caused by cholesterol embolization

    Directory of Open Access Journals (Sweden)

    Min-Gang Kim

    2013-12-01

    Full Text Available Blue toe syndrome is the most frequent manifestation of tissue ischemia caused by cholesterol embolization (CE, which can lead to amputation of affected lower extremities, if severe. However, any effective treatment is lacking. We experienced a case of spontaneously presenting blue toe syndrome and concomitant acute renal failure in a patient with multiple atherosclerotic risk factors. CE was confirmed by renal biopsy. Despite medical treatment including prostaglandin therapy and narcotics, the toe lesion progressed to gangrene with worsening ischemic pain. Therefore, we performed lumbar sympathectomy, which provided dramatic pain relief as well as an adequate blood flow to the ischemic lower extremities, resulting in healing of the gangrenous lesion and avoiding toe amputation. This is the first reported case of a patient with intractable ischemic toe syndrome caused by CE that was treated successfully by sympathectomy. Our observations suggest that sympathectomy may be beneficial in some patients with CE-associated blue toe syndrome.

  5. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite.

    Science.gov (United States)

    Khan, Mohammad Iqbal; Tariq, Mohammad; Rehman, Ahmed; Zafar, Afsheeen; Sheen, Salman Najam

    2008-01-01

    Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p frost bite.

  6. Keratosis Punctata of Palmar Creases

    Directory of Open Access Journals (Sweden)

    T P Thankappan

    1982-01-01

    Full Text Available Five cases of keratosis punctata of palmar creases which isaa variant of keratosis punctata are reported. Two of these cases were associated with psoriasis and one case with dermatitis herpetiformis. Familial tendency was noticed in 4 cases.

  7. Development of a Free-Electron Laser Center and Research in Medicine, Biology and Materials Science,

    Science.gov (United States)

    1992-05-14

    the reduced electron- larons cause localized distortions in an ionic lattice lattice coupling strength leads to molecule emission, which are... syndrome . Health Science Center at San Antonio and the University Buerger’s disease, palmar hyperhidrosis, frostbite and of Mi.imi School of Medicine, Miami

  8. Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis

    Energy Technology Data Exchange (ETDEWEB)

    Brock, Malcolm, E-mail: mabrock@jhmni.edu [Johns Hopkins University, Department of Thoracic Surgery, Center for Sweat Disorders (United States); Chung, Tae Hwan, E-mail: Tchang7@jhmi.edu [Johns Hopkins University, Physical Medicine and Rehabilitation (United States); Gaddam, Sathvika Reddy, E-mail: drsathvikareddy@yahoo.com; Kathait, Anjaneya Singh, E-mail: askathait@gmail.com [Johns Hopkins University, Vascular & Interventional Radiology (United States); Ober, Cecily, E-mail: ceober21@gmail.com [Johns Hopkins University, Department of Thoracic Surgery (United States); Georgiades, Christos, E-mail: cgeorgi@jhmi.edu [Johns Hopkins University, Vascular & Interventional Radiology (United States)

    2016-12-15

    Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.

  9. Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Al-Niaimi Amjad

    2011-02-01

    Full Text Available Abstract Introduction Docetaxel is a chemotherapeutic agent used alone or in combination for the management of many neoplastic conditions. Numerous side effects are well described as a consequence. Palmar-plantar erythrodysesthesia, although a relatively common side effect of some types of chemotherapy, occurs infrequently with docetaxel and is often attributed to other drug agents. Case Presentation We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management. Conclusion Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.

  10. Temperament and character properties of primary focal hyperhidrosis patients

    Directory of Open Access Journals (Sweden)

    Ak Mehmet

    2013-01-01

    Full Text Available Abstract Background Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients’ daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. Methods Fifty-six primary focal hyperhidrosis (22.42 ± 7.80 and 49 control subjects (24.48 ± 5.17 participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. Results In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness , Resourcefulness , Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. Conclusion Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.

  11. Hyperhidrosis Substantially Reduces Quality of Life in Children: A Retrospective Study Describing Symptoms, Consequences and Treatment with Botulinum Toxin

    Directory of Open Access Journals (Sweden)

    Sandra Eriksson Mirkovic

    2017-09-01

    Full Text Available Studies on children with hyperhidrosis are sparse. This retrospective study presents clinical data and quality of life, along with treatment effect and safety of botulinum toxin (BTX. Case reports from 366 children were included to capture the medical history of hyperhidrosis. The total median score of the Dermatology Life Quality Index before treatment was 11 for children aged 16–17 years and 12 for children younger than 16 years. The children described physical, psychosocial and consequence-related symptoms. More than 70% had multifocal hyperhidrosis. BTX-A and/or BTX-B were given to 323 children, 193 of whom received repeated treatments. The highest score in a 5-grade scale concerning treatment effect was reported by 176/193 children, i.e. their “sweating disappeared completely”. No severe adverse events occurred. Focal and multifocal hyperhidrosis in children reduces quality of life considerably. Treatment with BTX-A and/or BTX-B has been performed with success.

  12. A study investigating patients' experience of hospital and home iontophoresis for hyperhidrosis.

    LENUS (Irish Health Repository)

    McAleer, Maeve Aine

    2014-08-01

    Iontophoresis is an effective and safe treatment for hyperhidrosis. We investigated patients\\' experiences with the Idrostar® home iontophoresis unit (STD Pharmaceuticals, Hereford, UK) considering compliance and efficacy.

  13. Retroperitoneal hemorrhage from an unrecognized puncture of the lumbar right segmental artery during lumbar chemical sympathectomy: diagnosis and management.

    Science.gov (United States)

    Shin, Ho-Jin; Choi, Yun-Mi; Kim, Hye-Jin; Lee, Sun-Jae; Yoon, Seok-Hyun; Kim, Kyung-Hoon

    2014-12-01

    Lumbar chemical sympathectomy has been performed using fluoroscopic guidance for needle positioning. An 84 year old woman with atherosclerosis obliterans was referred to the pain clinic for intractable cold allodynia of her right foot. A thermogram showed decreased temperature of both feet compared with temperatures above both ankles. The patient agreed to undergo lumbar chemical sympathectomy using fluoroscopy after being informed of the associated risks of nerve injury, hemorrhage, infection, transient back pain, and transient hypotension. During the procedure and three hours afterward, no abnormal signs or symptoms were found except an increase in right leg temperature. The patient was ambulatory after the procedure. However, one day after undergoing lumbar chemical sympathectomy, she visited our emergency department for abdominal discomfort and postural dizziness. Her blood pressure was 80/50 mmHg, and flank tenderness was noted. Retroperitoneal hemorrhage from the second right lumbar segmental artery was shown on computed tomography and angiography. Vital signs were stabilized immediately after embolization into the right lumbar segmental artery. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Palmar dislocation of scaphoid and lunate

    Directory of Open Access Journals (Sweden)

    Khalid Koulali Idrissi

    2011-11-01

    Full Text Available A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.

  15. Palmar-plantar erythrodysesthesia associated with capecitabine ...

    African Journals Online (AJOL)

    We report a case of a 62 year-old patient who developed Palmar-plantar erythrodysesthesia upon receiving four cycles of capacitabine-based chemotherapy. She was on post surgical adjuvant treatment for invasive well differentiated adenocarcinoma of the colon. The clinical and therapeutic aspects of this ...

  16. Circumscribed palmar or plantar hypokeratosis: report of a Korean case and published work review.

    Science.gov (United States)

    Lee, Sang Eun; Kim, You Chan; Kim, Soo-Chan

    2006-06-01

    Circumscribed palmar or plantar hypokeratosis is a rare dermatosis characterized by a solitary, well-circumscribed patch with scaly borders chiefly on the palm or sole; it usually occurs in middle-aged or elderly women. We report the case of a 52-year-old Korean woman with two characteristic lesions of circumscribed palmar hypokeratosis on the left palm. Clinically, the lesions simulated porokeratosis of Mibelli, but histologically there was no cornoid lamellation in the serial sections and there were the characteristic histopathological features of circumscribed palmar or plantar hypokeratosis including a stair-like configuration with an abrupt thinning of the stratum corneum and a decreased granular layer. We also review the 16 cases of circumscribed palmar or plantar hypokeratosis reported in the published work.

  17. Hyperhidrosis in children and review of its current evidence-based ...

    African Journals Online (AJOL)

    Hyperhidrosis (HH) is excessive sweating that usually interferes with the patient's social life. In more than 80% of the cases, the symptoms start in childhood. Early detection and management can significantly improve the patient's quality of life; however, HH remains widely underdiagnosed and undertreated, particularly ...

  18. Imaging of compound palmar ganglion with pathologic correlation

    Directory of Open Access Journals (Sweden)

    Sourav Talukder

    2014-12-01

    Full Text Available Compound palmar ganglion, or chronic flexor tenosynovitis, most commonly of tuberculousorigin, is a rare extrapulmonary manifestation of tuberculosis (TB. The flexor synovialsheath is not a common site for TB but, once involved, causes rapid involvement of all flexortendons. We discuss the case of a 70-year-old farmer who presented to us with pain and progressive swelling of the palmar aspect of the wrist. On clinical examination, swelling both above and below the proximal wrist crease was found, with positive cross-fluctuation. Onultrasonography and magnetic resonance imaging, features suggestive of compound palmarganglion were present. The patient underwent surgical resection (extensive tenosynovectomyand chemotherapy. Post-operative histopatholgical findings correlated with the radiological features.

  19. Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

    Science.gov (United States)

    Sherlock, C; Mair, T; Blunden, T

    2008-11-01

    Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

  20. A comparison of radiography, computed tomography, and magnetic resonance imaging for the diagnosis of palmar process fractures in foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Koblik, P.D.; Freeman, D.M.; Pool, R.R.; O'Brien, T.R.

    1995-01-01

    The relative sensitivity of radiography, computed tomography, and magnetic resonance imaging for detecting palmar process fractures of the distal phalanx in foals was determined and the imaging findings were compared with histomorphologic evaluations of the palmar processes. Compared to radiography, computed tomography and magnetic resonance imaging did not improve the sensitivity for detection of palmar process fractures. Statistical agreement for palmar process fracture diagnosis was excellent among the three imaging modalities. Histomorphologic evaluations were more sensitive for diagnosis of palmar process fracture than any of the imaging modalities. Three-dimensional image reconstructions and volume measurements of distal phalanges and palmar process fracture fragments from computed tomography studies provided more complete anatomical information than radiography. Magnetic resonance imaging confirmed that the deep digital flexor tendon insertion on the distal phalanx is immediately axial to the site where palmar process fractures occur, and differentiated cartilage, bone, and soft tissue structures of the hoof

  1. Clonidine is effective for the treatment of primary idiopathic hyperhidrosis and hot flushes: a case report.

    Science.gov (United States)

    Albadrani, Ahmed

    2017-01-17

    While primary hyperhidrosis can be seen in men, accompanying hot flushes is rarely seen in men. Primary hyperhidrosis is thought to be related to overactivity of the sympathetic nervous system while hot flushes are believed to be related to altered peripheral vascular reactivity and a narrowed thermoregulatory zone. I report the case of a 29-year-old man of Arab origin who presented to a dermatology clinic with a complaint of generalized sweating, with heavier involvement of his inguinal region, axilla, and lower back. His complaint was associated with a transient hot sensation and erythema over the affected areas. He did not respond to topical antiperspirants containing aluminum chloride, topical aluminum chloride, or to botulinum toxin A injected in both inguinal areas. He was then referred to an endocrinology clinic to rule out secondary causes of hyperhidrosis and hot flushes; a primary diagnosis was confirmed. He did not respond to oral glycopyrrolate and additionally was complaining of its anticholinergic side effects. The glycopyrrolate was then replaced with oral clonidine 0.15 mg twice a day. Clonidine was well tolerated without remarkable side effects and he quickly started to feel marked improvement which was maintained for 2 years. I report an atypical presentation of primary hyperhidrosis and hot flushes that was effectively controlled by clonidine without remarkable side effects. Further research on a large number of patients may be required before recommending clonidine in similar conditions.

  2. Replantation of multi-level fingertip amputation using the pocket principle (palmar pocket method).

    Science.gov (United States)

    Arata, J; Ishikawa, K; Soeda, H; Kitayama, T

    2003-07-01

    Two cases of multi-level fingertip amputation are presented. In each case, replantation was achieved in a two-stage procedure, involving reattachment, de-epithelialisation and insertion into a palmar pocket in stage 1, followed by removal from the palmar pocket 16 days later. The cases are described and the technique is discussed.

  3. Hyperhidrosis in naïve purpose-bred beagle dogs (Canis familiaris).

    Science.gov (United States)

    Carrier, Catherine A; Seeman, Jennifer L; Hoffmann, Guenther

    2011-05-01

    This case study details the unusual clinical findings in a unique paw-pad disorder that recently emerged among 2 male and 1 female naïve purpose-bred beagle dogs (Canis familiaris) newly received into our facility. During acclimation period physical examinations, the affected dogs demonstrated constantly moist, soft paw pads on all 4 feet. No information was available regarding the epidemiology and pathogenesis of this pad condition in beagle dogs. Here, we report the results of physical examination, clinical chemistry analysis, hematology, histopathology, detailed observations, and novel testing techniques performed during the acclimation period. Histopathology of several sections of affected footpads was compared with that of an age-matched dog with clinically normal paw pads. We describe the morphologic features of a distinctive cutaneous canine footpad condition and discuss the possible differential diagnoses. The histologic and clinical features were most consistent with those of hyperhidrosis; to our knowledge, this report is the first description of hyperhidrosis as a distinct condition in purpose-bred beagle dogs.

  4. Treatment of fingertip amputation in adults by palmar pocketing of the amputated part.

    Science.gov (United States)

    Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam

    2012-07-01

    First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  5. Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia; la simpaticolisi TC guidata: alternativa terapeutica delle ischemie critiche

    Energy Technology Data Exchange (ETDEWEB)

    Pieri, Stefano; Agresti, Paolo [Az. Osp. S. Camillo-Forlanini, Roma (Italy). U.O. di radiologia vascolare ed interventistica; Ialongo, Pasquale; Fedeli, Stefano [Radiologia diagnostica Busi, Roma (Italy); Di Cesare, Fabio; Ricci, Guiseppe [Az. Osp. S. Camillo-Forlanini, Roma (Italy). Chirurgia vascolare

    2005-04-01

    Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation. [Italian] Scopo: La

  6. Fingertip Replantation With Palmar Venous Anastomoses in Children.

    Science.gov (United States)

    Wen, Gen; Xu, Jia; Chai, Yi-Min

    2017-06-01

    Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

  7. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available BackgroundFirst suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults.MethodsBetween 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm.ResultsOf a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results.ConclusionsA composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  8. Postvagotomy acid secretion and mucosal blood flow during beta-adrenoceptor stimulation and universal chemical sympathectomy in dogs

    DEFF Research Database (Denmark)

    Hovendal, C P

    1983-01-01

    The aim of the present study was to examine the effect of beta-adrenoceptor stimulation, alpha blockade, and elimination of the adrenergic nerve function on mucosal blood flow and acid secretion in parietal-cell-vagotomized (PCV) gastric fistula dogs. Isoprenaline inhibited pentagastrin-stimulate......The aim of the present study was to examine the effect of beta-adrenoceptor stimulation, alpha blockade, and elimination of the adrenergic nerve function on mucosal blood flow and acid secretion in parietal-cell-vagotomized (PCV) gastric fistula dogs. Isoprenaline inhibited pentagastrin...... to chemical sympathectomy with 6-hydroxy-dopamine, a false neurotransmitter that selectively destroys the adrenergic nerve terminals. Chemical sympathectomy increased the pentagastrin-stimulated gastric acid secretion and stabilized the mucosal blood flow at the level before vagotomy, but with an increased...... ratio between blood flow and acid secretion. One may conclude that the sympathetic nerve system influences gastric function after vagotomy....

  9. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography.

    Science.gov (United States)

    Kaplanoglu, Hatice; Beton, Osman

    2017-04-01

    To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed. The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete. The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

  10. Uruguay project - Metalic silicon manufacturing. Palmar location study

    International Nuclear Information System (INIS)

    2003-01-01

    This work is about the Soriano town possibilities offered to Rima Industrial S.A in relation with the metallic silicon project in Uruguay. In this zone there is the Palmar hydroelectric plant with a capacity of 33 MW and its development is part of the Rio Negro river

  11. Radiographic characteristics of the forelimb distal phalanx and microscopic morphology of the lateral palmar process in foals 3-32 weeks old

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Stover, S.M.; O'Brien, T.R.; Pool, R.R.; Willits, N.H.

    1995-01-01

    Developmental morphology of the forelimb distal phalanges and lateral palmar processes of 9 Thoroughbred foals aged 3–32 weeks was assessed using radiography, microradiography and histology. For inclusion in the study, all distal phalanges had no pathologic radiographic abnormalities.Vascular channels that are characteristically found in the dorsal region of the distal phalanx were not evident radiographically in the palmar process. The proximal and distal angles of the palmar processes were separated by a lucent line continuous with the incisure in foals only through 12 weeks of age. The distal phalanges were triangular-shaped in foals 3–12 weeks of age, and were oval-shaped in older foals.The palmar aspect of the distal phalanx was the major contributor to growth of the distal phalanx in the sagittal plane, especially between 3 and 12 weeks of age. Growth of the lateral palmar process occurred through the means of endochondral ossification. The body and cortices of the lateral palmar process were composed of coarse cancellous bone. Porosity within the lateral palmar process was greater in regions sampled axial, compared to abaxial, to the parietal sulcus and did not change with age.A fracture was identified microradiographically and/or histologically in 9 of 18 (50%) and 10 of 17 (59%), respectively, of the lateral palmar processes examined. The fracture line was consistently associated with the parietal sulcus on the dorsal cortical surface and was always immediately abaxial to the deep digital flexor tendon attachment. No age-related morphological changes of the lateral palmar processes were identified with microradiography or histological examinations

  12. Analysis of the quantitative dermatoglyphics of the digito-palmar complex in patients with multiple sclerosis.

    Science.gov (United States)

    Supe, S; Milicić, J; Pavićević, R

    1997-06-01

    Recent studies on the etiopathogenesis of multiple sclerosis (MS) all point out that there is a polygenetical predisposition for this illness. The so called "MS Trait" determines the reactivity of the immunological system upon ecological factors. The development of the glyphological science and the study of the characteristics of the digito-palmar dermatoglyphic complex (for which it was established that they are polygenetically determined characteristics) all enable a better insight into the genetic development during early embriogenesis. The aim of this study was to estimate certain differences in the dermatoglyphics of digito-palmar complexes between the group with multiple sclerosis and the comparable, phenotypically healthy groups of both sexes. This study is based on the analysis of 18 quantitative characteristics of the digito-palmar complex in 125 patients with multiple sclerosis (41 males and 84 females) in comparison to a group of 400 phenotypically healthy patients (200 males and 200 females). The conducted analysis pointed towards a statistically significant decrease of the number of digital and palmar ridges, as well as with lower values of atd angles in a group of MS patients of both sexes. The main discriminators were the characteristic palmar dermatoglyphics with the possibility that the discriminate analysis classifies over 80% of the examinees which exceeds the statistical significance. The results of this study suggest a possible discrimination of patients with MS and the phenotypically health population through the analysis of the dermatoglyphic status, and therefore the possibility that multiple sclerosis is genetically predisposed disease.

  13. Phytolith analysis in fluvial quaternary sediment (San Salvador and Palmar formation) Uruguay river and Argentina eastern

    International Nuclear Information System (INIS)

    Patterer, N.; Passeggi, E.; Zucol, A.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about two microfossils fluvial units deposited by the Uruguay river during the Quaternary. These are San Salvador and Palmar formation (Plio-Pleistocene - Upper Pleistocene).The Palmar formation is a band of 4-15 km along the right bank of the Uruguay river outcropping from the eastern provinces of Corrientes and Entre Rios, to Concepcion del Uruguay

  14. Zumbi dos Palmares: a afroresiliencia

    Directory of Open Access Journals (Sweden)

    Josué Petrônio Quirino de Oliveira

    2017-10-01

    Full Text Available O artigo buscou fazer uma releitura de Zumbi dos Palmares sob o prisma da resiliência, demonstrando uma visão singular ao olhar para os escravos nos quilombos e suas histórias de superação e transformação perante as adversidades, levando não só a reconstruir o imaginário afrodescendente brasileiro com o caleidoscópio da resiliência, mas revelar que a resiliência sempre foi inerente a história dos negros no Brasil. Para tanto se caracterizou como uma pesquisa exploratória com abordagem qualitativa e procedimentos bibliográficos que foram essenciais para a construção do artigo, amadurecendo e ampliando os conhecimentos envolvidos na temática. Nesta abordagem o quilombo dos Palmares foi um conjunto complexo de condições, atitudes e ações que apesar das adversidades tiveram resultados positivos, os fatos demonstraram que os negros nos quilombos foram uma prova que a resiliência negra não foi apenas um fator individual, mas uma característica comunitária que desencadeou um processo de ruptura e recuperação social, um grito de liberdade em defesa da consciência de uma raça, e de um povo. Zumbi não foi apenas um líder de um movimento libertário que marcou a história dos negros oriundos de Pernambuco e Alagoas, mas a história de uma raça por gerações no país, que se tornou sinônimo de resiliência.

  15. Radiographic and pathologic characterization of lateral palmar intercarpal ligament avulsion fractures in the horse.

    Science.gov (United States)

    Beinlich, Christopher P; Nixon, Alan J

    2004-01-01

    In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondral cystic lesions of the ulnar carpal bone included a variable-sized osseous opacity adjacent to the lucent concavity of the fracture bed and the consistent location within the palmar transition zone at the confluence of LPICL insertion and hyaline cartilage on the palmar surface of the ulnar carpal bone. All 26 horses having surgical removal of the fragments had arthroscopic confirmation that the fragment was within the LPICL. Histologic examination confirmed the fragments were fracture related rather than developmental or the result of dystrophic mineralization. Many of the fragments had attached remnants of a ligament. This study describes the radiographic, surgical, and histologic features in 37 horses which better characterize LPICL avulsion fracture in the carpus and provide differentiating features to assist in separating this syndrome from true osseous cyst-like lesions within the ulnar carpal bone.

  16. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available Background First suggested by Brent in 1979, the pocket principle is an alternative methodfor patients for whom a microsurgical replantation is not feasible. We report the successfulresults of a modified palmar pocket method in adults.Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantationusing palmar pocketing. All patients were adults who sustained a complete fingertip amputationfrom the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crushor avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmarpocketing method following a composite graft in these patients and prepared the pocket in thesubcutaneous layer of the ipsilateral palm.Results Of a total of 10 cases, nine had complete survival of the replantation and one had20% partial necrosis. All of the cases were managed to conserve the fingernails, which led toacceptable cosmetic results.Conclusions A composite graft and palmar pocketing in adult cases of fingertip injuryconstitute a simple, reliable operation for digital amputation extending from the tip to thelunula. These methods had satisfactory results.

  17. A Pseudoaneurysm of the Deep Palmar Arch After Penetrating Trauma to the Hand: Successful Exclusion by Ultrasound Guided Percutaneous Thrombin Injection

    Directory of Open Access Journals (Sweden)

    A. Bosman

    Full Text Available : Introduction: Pseudoaneurysm of the hand is a rare condition; most are treated surgically. Ultrasound guided thrombin injection has not previously been reported as a treatment option for pseudoaneurysms of the deep palmar arch. Report: A man was referred to the emergency department with a swollen, painful hand after penetrating trauma. On physical examination, a pulsating tumor was found on the dorsum of the hand. Imaging revealed a pseudoaneurysm vascularized by the deep palmar arch. Ultrasound guided percutaneous thrombin injection was successfully performed. Conclusion: Thrombin injection might be a safe alternative option in the treatment of pseudoaneurysm of the deep palmar arch. Keywords: Deep palmar arch, Pseudoaneurysm, Thrombin injection

  18. Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration (Dupuytren's Disease)

    NARCIS (Netherlands)

    Karkampouna, S.; Kreulen, M.; Obdeijn, M. C.; Kloen, P.; Dorjée, A. L.; Rivellese, F.; Chojnowski, A.; Clark, I.; Kruithof-de Julio, Marianna

    2016-01-01

    Dupuytren's disease is a connective tissue disorder of the hand causing excessive palmar fascial fibrosis with associated finger contracture and disability. The aetiology of the disease is heterogeneous, with both genetic and environmental components. The connective tissue is abnormally infiltrated

  19. Unilateral Palmar Callus and Irritant Hand Eczema – Underreported Signs of Dependency on Crutches

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2018-01-01

    Full Text Available Leg amputees who can’t use prostheses and patients with arthritis are often dependent on crutches. Their chronic use can exert significant friction forces. The palmar skin will respond by forming a hyperkeratotic callus. We report for the first time unilateral palmar callus formation caused by friction from using crutches. Another possible adverse effect is the triggering of irritant contact dermatitis by the handholes of crutches. We report two cases with hand dermatitis due to the chronic dependence on crutches and discuss treatment options.

  20. Glabrous skin reconstruction of palmar/plantar defects: a case for the ...

    African Journals Online (AJOL)

    DR LEGBO

    Methods: A prospective descriptive study of consecutive patients with benign soft tissue palmar/plantar defects .... cannot be closed by direct suturing. In the authors' view ... splintage ) did not lead to joint stiffness since majority were children ...

  1. Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

    International Nuclear Information System (INIS)

    Vi, Linda; Feng, Lucy; Zhu, Rebecca D.; Wu, Yan; Satish, Latha; Gan, Bing Siang; O'Gorman, David B.

    2009-01-01

    Dupuytren's disease, (DD), is a fibroproliferative condition of the palmar fascia in the hand, typically resulting in permanent contracture of one or more fingers. This fibromatosis is similar to scarring and other fibroses in displaying excess collagen secretion and contractile myofibroblast differentiation. In this report we expand on previous data demonstrating that POSTN mRNA, which encodes the extra-cellular matrix protein periostin, is up-regulated in Dupuytren's disease cord tissue relative to phenotypically normal palmar fascia. We demonstrate that the protein product of POSTN, periostin, is abundant in Dupuytren's disease cord tissue while little or no periostin immunoreactivity is evident in patient-matched control tissues. The relevance of periostin up-regulation in DD was assessed in primary cultures of cells derived from diseased and phenotypically unaffected palmar fascia from the same patients. These cells were grown in type-1 collagen-enriched culture conditions with or without periostin addition to more closely replicate the in vivo environment. Periostin was found to differentially regulate the apoptosis, proliferation, α smooth muscle actin expression and stressed Fibroblast Populated Collagen Lattice contraction of these cell types. We hypothesize that periostin, secreted by disease cord myofibroblasts into the extra-cellular matrix, promotes the transition of resident fibroblasts in the palmar fascia toward a myofibroblast phenotype, thereby promoting disease progression.

  2. Arthroscopic removal of discrete palmar carpal osteochondral fragments in horses: 25 cases (1999-2013).

    Science.gov (United States)

    Lang, Hayley M; Nixon, Alan J

    2015-05-01

    To characterize discrete palmar carpal osteochondral fragmentation in horses and to document the effect of osteoarthritis and surgical removal of these fragments on functional outcome. Retrospective case series. 25 horses. Medical records and radiographic views were reviewed to identify horses that had radiographic evidence of palmar carpal fragmentation, which was subsequently treated by arthroscopic removal. Information collected included cause of fracture, initial and long-term clinical and radiographic findings, and functional outcome. Palmar carpal fragmentation of 30 carpal bones was identified in 25 unilaterally affected horses. A known traumatic event was reported to cause the fragmentation in 17 of the 25 (68%) horses. Of the 25 horses, 17 (68%) had fragmentation involving the antebrachiocarpal joint, 7 (28%) had fragmentation involving the middle carpal joint, and 1 (4%) had fragmentation involving the carpometacarpal joint. The proximal aspect of the radial carpal bone was the most commonly affected site (12/30 fragments), followed by the accessory carpal bone (6/30). Of the 25 horses, 19 (76%) were not lame (sound) after surgery and returned to their intended use, 4 (16%) were considered pasture sound, and 2 were euthanized (because of severe postoperative osteoarthritis or long bone fracture during recovery from anesthesia). Eight of the 14 horses with preoperative evidence of osteoarthritis returned to function after surgery. Twelve of 17 horses with antebrachiocarpal joint fragments and 6 of 7 horses with middle carpal joint fragments returned to their previous use. Results indicated that the prognosis for horses after arthroscopic removal of palmar carpal osteochondral fragments is good. Early intervention, before the development of osteoarthritis, is recommended.

  3. A influência de palmares e parachute na coordenação dos nados

    OpenAIRE

    Thiago Telles

    2012-01-01

    Resumo: A natação é uma modalidade esportiva que, ao longo dos anos, sofreu modificações, atingindo um alto nível de exigência, o que é refletido nas sessões de treinamentos e nas pesquisas sobre a modalidade. Sendo assim, para otimizar o deslocamento nos nadadores pode-se otimizar a força propulsora. Para isso, pode-se utilizar palmares e parachute. Os palmares tem como função promover o aumento artificial da área da mão, desta maneira, aumenta-se a área frontal da mão do sujeito em contato ...

  4. Prevention of palmar-plantar erythrodysesthesia with an antiperspirant in breast cancer patients treated with pegylated liposomal doxorubicin (SAKK 92/08).

    Science.gov (United States)

    Templeton, Arnoud J; Ribi, Karin; Surber, Christian; Sun, Hong; Hsu Schmitz, Shu-Fang; Beyeler, Michael; Dietrich, Daniel; Borner, Markus; Winkler, Annette; Müller, Andreas; von Rohr, Lukas; Winterhalder, Ralph C; Rochlitz, Christoph; von Moos, Roger; Zaman, Khalil; Thürlimann, Beat J K; Ruhstaller, Thomas

    2014-06-01

    Elevated concentrations of doxorubicin are found in eccrine sweat glands of the palms and soles. We therefore evaluated an antiperspirant as preventive treatment for palmar-plantar erythrodysesthesia (hand-foot syndrome) in patients with metastatic breast cancer treated with pegylated liposomal doxorubicin. An antiperspirant containing aluminum chlorohydrate or placebo cream was applied to the left or right hand and foot in a double-blinded manner (intra-patient randomization). The primary endpoint was the rate of grade 2 or 3 palmar-plantar erythrodysesthesia. A secondary endpoint was the patient-reported symptom burden (tingling, numbness, pain, or skin problems). Using McNemar's matched pairs design, 53 patients were needed to detect a 20% difference between the treatment and placebo sides with a significance level of 5% and power of 90%. Grade 2 or 3 PPE occurred in 30 (58%) of 52 evaluable patients; in six patients adverse effects occurred on the placebo side but not on the treatment side, whereas one patient developed palmar-plantar erythrodysesthesia on the treatment side only (P = 0.07). Four patients developed grade 2 or 3 palmar-plantar erythrodysesthesia on their foot on the placebo side but not on the treatment side (P = 0.05). In the cohort with grade 2 or 3 palmar-plantar erythrodysesthesia there was a trend towards fewer dermatologic symptomatologies with the active treatment (P = 0.05), and no difference for other adverse events. Using topical aluminum chlorohydrate as an antiperspirant appears to reduce the incidence of grade 2 or 3 palmar-plantar erythrodysesthesia following pegylated liposomal doxorubicin chemotherapy for metastatic breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Imaginando Palmares: a obra de Gayl Jones Imagining Palmares: the work of Gayl Jones

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    Stelamaris Coser

    2005-12-01

    Full Text Available O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.The long narrative poem Song for Anninho (1981, written by black U.S. writer Gayl Jones, interferes in the narrative of Brazilian colonial history as it highlights the female presence in the Republic of Palmares, rewrites the tale of resistance from the point of view of a black woman in the 17th Century, and, through her, reinvents the everyday lives, loves, disputes, and dreams of common people in the quilombo. The text reflects about historical truth, the constructed character of documents, selections and exclusions in language, and the importance of oral accounts to give visibility to experiences and identities marginalized by official history. In this special version, the dramatic report of the dreams, struggles, and destruction of the most famous Brazilian quilombo uses literary imagination to expand the memory and the archives of one of the most important facts in the history of the Americas, contributing to stimulate

  6. Palmar reconstruction of the triangular fibrocartilage complex for instability of the distal radioulnar joint: a biomechanical study.

    Science.gov (United States)

    Kataoka, T; Moritomo, H; Omokawa, S; Iida, A; Wada, T; Aoki, M

    2013-06-01

    We developed a new triangular fibrocartilage complex reconstruction technique for distal radioulnar joint instability in which the palmar portion of the triangular fibrocartilage complex was predominantly reconstructed, and evaluated whether such reconstruction can restore stability of the distal radioulnar joint in seven fresh cadaver upper extremities. Distal radioulnar joint instability was induced by cutting all soft-tissue stabilizers around the distal ulna. Using a palmar approach, a palmaris longus tendon graft was sutured to the remnant of the palmar radioulnar and ulnocarpal ligaments. The graft was then passed through a bone tunnel created at the fovea and was sutured. Loads were applied to the radius, and dorsopalmar displacements of the radius relative to the ulna were measured using an electromagnetic tracking device in neutral rotation, 60° supination and 60° pronation. We compared the dorsopalmar displacements before sectioning, before reconstruction and after reconstruction. Dorsopalmar instability produced by sectioning significantly improved in all forearm positions after reconstruction.

  7. Caracterización del nervio digital palmar en el miembro anterior equino

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    Carolina Ortiz

    2017-05-01

    Full Text Available A partir de 60 miembros anteriores de caballos mestizos recolectados de un matadero en Santiago, Chile, se determinó que lo más frecuente es que el nervio digital palmar emita sus ramas dorsal y palmar antes (33% o al comienzo de la articulación metacarpofalángica (33%. En un 60% de los nervios analizados se evidenció la presencia de una a cuatro ramas accesorias y que ésta se presenta de manera similar entre diversas zonas, siendo la presentación más frecuente (26% en la zona de la articulación interfalángica proximal y que se dirigen hacia dorsal. En un 46,66% de las muestras el nervio digital palmar no se relaciona íntimamente con alguna estructura, seguido con 33,33% por la unión de éste al ligamento del espolón. Es muy poco frecuente que el nervio emita ramas superficiales que se dirijan hacia la dermis (6,66%, que se divida en tres grandes ramas en la articulación metacarpofalángica (3,33% o que pase bajo la arteria digital (3,33%, y más frecuente es que éste se disponga sobre la arteria en algún lugar de su recorrido hecho que ocurrió en el 35% de los casos. Estos resultados se presentan de manera relevante de considerar en procedimientos diagnósticos o quirúrgicos en la zona distal del miembro anterior del equino, ya que pueden alterar su sensibilidad y eficacia.

  8. Macro fossils vegetable in Palmar formation (later pleistocene) in Entre Rios - Argentina

    International Nuclear Information System (INIS)

    Ramos, R.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about the macro fossil knowledge preserved like wood fossils in the El Palmar Formation (Late Pleistocene) from a systematic - anatomical as well as paleoecological and paleoclimate point of view.The paleo Flora comes from various fossil located in the province of Entre Rios - Argentina

  9. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

    Science.gov (United States)

    Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

    2007-09-01

    Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

  10. Anaesthesia management of a case of Jervell and Lange-Nielsen syndrome for minimally invasive bilateral thoracoscopic cervicothoracic sympathectomy

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    Preety Mittal Roy

    2016-01-01

    Full Text Available Long QT syndrome (LQTS is an arrhythmogenic cardiac disorder resulting from the malfunction of cardiac ion channels. Patient with LQTS may present with syncope, seizures or sudden cardiac death secondary to polymorphic ventricular tachycardia (VT or torsades de pointes. Patient may be asymptomatic in the pre-operative period but may develop VT for the first time in operation theatre. We are reporting anaesthetic management of a child with LQTS planned for bilateral thoracoscopic cervicothoracic sympathectomy.

  11. Incomplete longitudinal fracture of the proximal palmar cortex of the third metacarpal bone in horses

    International Nuclear Information System (INIS)

    Ross, M.W.; Ford, T.S.; Orsini, P.G.

    1988-01-01

    Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament

  12. Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

    Science.gov (United States)

    Aksoy, Alper; Gungor, Melike; Sir, Emin

    2017-01-01

    The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

  13. Comparison of digito-palmar dermatoglyphic traits in children with cerebral palsy and their close family members.

    Science.gov (United States)

    Polovina-Proloscić, Tajana; Milicić, Jasna; Cvjeticanin, Miljenko; Polovina, Andrea; Polovina, Svetislav

    2009-09-01

    Cerebral palsy is one of the main causes of severe disability in children. Sixty children (30 boys and 30 girls) were included in the study. Quantitative digito-palmar dermatoglyphic traits were analyzed. Prints of digito-palmar dermatoglyphs obtained from the children's parents (60 mothers and 60 fathers) and from 400 phenotypically healthy adults from the Zagreb ware used as control groups. Analysis of quantitative dermatoglyphic traits of the digito-palmar complex revealed statistically significant differences in a number of variables between the fathers and their children suffering from cerebral palsy (TRC 180.3 > 158.6), with a greater number of variables involved in male children with cerebral palsy. Some variables showed statistically significant differences in dermatoglyphic patterns between fathers and control group of healthy males as well as between boys with cerebral palsy and healthy control males. Differences in dermatoglyphic patterns were significantly lower between mothers and girls with cerebral palsy (TRC 152.1 mothers and healthy control females. Study results support the hypothesis on the possible role of genetic predisposition in the occurrence of central nervous system lesion, with a more pronounced paternal impact.

  14. Comminuted Distal Radial Fracture with Large Rotated Palmar Medial Osteochondral Fragment in the Joint.

    Science.gov (United States)

    Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan

    2018-01-01

    Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.

  15. [Circumscribed palmar hypokeratosis (CPM): The diagnostic value of dermoscopy].

    Science.gov (United States)

    Topin-Ruiz, S; Debarre, J-M; Blanchard, E; Kettani, S; Valmier, P-J; Martin, L; Le Corre, Y

    2017-03-01

    Circumscribed palmar hypokeratosis (CPH) is a rare skin disease, first described in 2002, associated with sudden localized reduction of the corneal layer. In most cases, it presents as an isolated rounded erythematous palmar lesion on the thenar eminence. We describe the dermoscopic semiology of CPH in 3 cases. Three patients between the ages of 59 and 72 presented very limited erythematous lesions suggestive of CPH. Dermoscopic examination of these lesions provided similar findings. Biopsy, which was performed in one patient, confirmed the diagnosis of CPH. Two dermoscopic elements of CPH are characteristic: (1) the sides of the lesion have a "stair step" or "geological strata" type of configuration, and the thickness of the different strata varies; (2) the centre of the lesion showed a homogeneous erythematous area with a vascular pattern composed of dotted vessels of the superficial dermis and sometime vascular loops. These dermoscopic aspects are characteristic and enable CPH to be differentiated from Bowen's disease or porokeratosis of Mibelli. In Bowen's disease, there is no stair step like aspect to the sides of lesions; further, the centre of the lesion shows glomerular vessels (coiled vessels) and/or globular vessels (small red clods). In porokeratosis, peripheral keratotic "white track" structures comprise a single pigmented channel or a double white line. There is no "stair step" or central vascular pattern. The dermoscopic semiology of CPH is highly characteristic and enables differentiation from Bowen's disease and porokeratosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Contact sensitivity in palmar hyperkeratotic dermatitis

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    Minocha Y

    1993-01-01

    Full Text Available 230 patients presenting with palmar hyperkeratotic dermatitis were investigated by patch tests against various antigens depending upon occupation of the patients. Contact sensitivity was detected in 130 patients comprising of housewives (55, businessmen (20, farmers (15, teachers / clerks / students (13, doctors and nurses (9, factory workers and labourers (8, massons (7 and motor mechanics (3. Vegetables were found to be the most common agents followed by detergents and metals predominantly affecting housewives. Among the vegetables, garlic and onion were the most potent sensitizers whereas nickel was a common sensitizer among metals. Occupational factors were seen to have some influence in relation to the causative agents as indicated by higher positivity of vegetables in housewives; detergents, metals, rubber, leather, plastics in businessmen, teachers, clerks and students; fertilizers or animal foods in farmers; drugs in doctors and nurses and chromium and cobalt in massons.

  17. Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

    Science.gov (United States)

    Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

    2017-11-01

    Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

  18. The Brahea edulis palm forest in Guadalupe Island: A North American fog oasis? El palmar de Brahea edulis de Isla Guadalupe: ¿Un oasis de niebla en Norteamérica?

    Directory of Open Access Journals (Sweden)

    PEDRO P GARCILLÁN

    2012-03-01

    Full Text Available Fog is a factor that affects deeply the structure of vegetation of coastal deserts. Guadalupe is an oceanic island located 260 km off the coast of Baja California, and is one of the few places of the Sonoran Desert coasts with scarped coastal topography and frequent fog. With the aim to identify the effect of fog on the community of the palm forest (palmar of Brahea edulis located in the northern tip of the island: (1 we analyzed the richness and composition of vascular plants in the palmar compared to the remainder of the island, and (2 we analyzed the altitudinal variation of the abundance of palms, herbs and mosses to identify if there is altitudinal variation of the vegetation. Although species composition was not different between palmar and the rest of island, species richness and vascular plant cover were greater in the palmar. On the other hand, we found a clear altitudinal zonation of the vegetation in the palmar that is similar to that found in South American fog-driven plant communities such as the lomas. Thus, the palmar community of Guadalupe Island may be considered as a fog oasis, one of the very few that occur in North America.La niebla es un factor que afecta profundamente la estructura de la vegetación de los desiertos costeros. Guadalupe es una isla oceánica a 260 km de la costa de Baja California y constituye uno de los pocos lugares de la costa del Desierto Sonorense donde se reúnen una topografía escarpada próxima a la costa y una alta frecuencia de nieblas. Con el objeto de identificar el efecto de la niebla sobre la comunidad del palmar de Brahea edulis presente en la ladera norte de la isla: (1 analizamos la diferencia de la riqueza y la composición de plantas vasculares del palmar respecto del resto de la isla, y (2 analizamos la variación altitudinal de la abundancia de palmas, plantas acompañantes y musgo para determinar si existe variación altitudinal de la vegetación. Encontramos que, aunque la composici

  19. Geological map of Uruguay Esc 1,100,000. Paso del Palmar Sheet N-19

    International Nuclear Information System (INIS)

    Ford, I.; Montana, J.; Morales, H.

    1990-01-01

    This work is about the geological map of Uruguay Esc.1.100.000 (Paso del Palmar) and the explanatory memoranda which describes the geological , lithological and sedimentological characteristics soils belong to Cretaceous, Tertiary and Quaternary period in San Gregorio, Arapey, Mercedes, Asencio and Fray Bentos formations

  20. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

    DEFF Research Database (Denmark)

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens

    2013-01-01

    study in which 83 patients were randomly assigned into 2 groups: (1) conservative treatment with a rigid splint for 2 weeks, (2) surgical reattachment of the palmar plate in local anesthesia followed by 2 weeks of immobilization in a plaster cast. Both groups were thereafter treated by taping...... to the neighboring finger for 3 weeks. With regard to hyperextension instability, stiffness, and pain, there is no significant difference in outcome between patients with traumatic palmar plate lesions and hyperextension instability treated with surgical repair and patients treated conservatively with a splint. We...

  1. Tratamiento videotoracoscópico por puerto único para la hiperhidrosis palmar y axilar idiopática en el niño Videothorascopic sympathicotomy treatment through one port for idiopathic palmar and axillary hyperhidrosis in the child

    Directory of Open Access Journals (Sweden)

    Vivian Vialat Soto

    2013-03-01

    Full Text Available Introducción: la hiperhidrosis primaria es una enfermedad benigna que consiste en la excesiva producción de sudor, principalmente en manos, axilas y pies, y por ello puede llegar a condicionar la vida social y laboral de quien la padece. Objetivo: evaluar los resultados de la técnica simpaticotomía videotoracoscópica por un solo puerto usando oxigenación apneica para lograr el colapso pulmonar. Métodos: estudio descriptivo y transversal a 37 niños operados de enero de 2011 a junio de 2012, con edades comprendidas entre los 11 y 18 años, en el Hospital Pediátrico Universitario de Centro Habana, a los que se analizó: edad, sexo, complicaciones, estadía y grado de satisfacción. Resultados: todos los pacientes tenían las edades mencionadas, fue más frecuente en las hembras (22, 59,5 %, con resultados inmediatos en 36 pacientes (97,3 %, y sequedad e incremento de la temperatura de las manos al finalizar cada hemitórax. No se usaron sonda pleural ni antibióticos posoperatorios. No hubo complicaciones, y la estadía fue corta (97,3 %. El sudor compensatorio se dio en 9 pacientes (24,3 %, y el índice de satisfacción fue del 100 %. Conclusiones: esta técnica quirúrgica pudiera ser una opción terapéutica eficaz para mejorar la calidad de vida desde edades tempranas.Introduction: primary hyperhidrosis is a benign disease that consists of the overproduction of sweating mainly in hands, axillae and feet, which may affect the social and work life of those people who suffer it. Objectives: to evaluate the results of the videothoracoscopic sympathicotomy using apneic oxygenation to reach the pulmonary collapse. Methods: cross-sectional and descriptive study of 37 children aged 11 to 18 years, who were operated on from January 2011 to June 2012 at the university pediatric hospital of Centro Habana. The analyzed variables were sex, age, complications, length of stay at hospital and level of satisfaction. Results: the disease was more

  2. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Directory of Open Access Journals (Sweden)

    Christof David Vinnemeier

    Full Text Available INTRODUCTION: Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. METHODS: In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. RESULTS: Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001 associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. CONCLUSIONS: Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace

  3. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Science.gov (United States)

    Vinnemeier, Christof David; Schwarz, Norbert Georg; Sarpong, Nimako; Loag, Wibke; Acquah, Samuel; Nkrumah, Bernard; Huenger, Frank; Adu-Sarkodie, Yaw; May, Jürgen

    2012-01-01

    Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD) of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART) model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001) associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI) algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace presumptive treatment or laboratory diagnosis.

  4. The first Danish family reported with an AQP5 mutation presenting diffuse non-epidermolytic palmoplantar keratoderma of Bothnian type, hyperhidrosis and frequent Corynebacterium infections

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Hetland, Liv Eline; Clemmensen, Ole

    2016-01-01

    hyperhidrosis of the palms and soles along with palmoplantar keratoderma. He reported a very distinctive feature of the disorder, aquagenic wrinkling, as he developed pronounced maceration of the skin with translucent white papules and a spongy appearance following exposure to water. The patient presented...

  5. Avaliação de populações de Butia capitata de Santa Vitória do Palmar Performance of populations of Butia capitata of Santa Vitória do Palmar

    Directory of Open Access Journals (Sweden)

    Elisane Schwartz

    2010-09-01

    Full Text Available O gênero Butia pertence à família Arecaceae e possui cinco espécies com ocorrência no Rio Grande do Sul. A espécie Butia capitata está recebendo atenção especial, não só pelo seu uso no consumo in natura como também em formas processadas. No entanto, mesmo sendo uma espécie que tem sua utilização registrada desde os tempos pré-históricos, vem sendo explorada apenas de modo extrativista, como a maioria das espécies de frutíferas nativas. Além disso, a espécie está seriamente comprometida em médio prazo pela ausência de regeneração natural e com risco muito alto de extinção num futuro próximo. Nesse sentido, o objetivo deste trabalho foi comparar os frutos, a partir de parâmetros químicos e físicos, e também observar os dados produtivos das plantas de três populações de butiazeiros do município de Santa Vitória do Palmar-RS. Os dados foram obtidos em experimentos conduzidos na safra de 2005/2006 e na safra de 2006/2007, em três propriedades localizadas em Santa Vitória do Palmar. Os resultados permitiram verificar que as propriedades e ou variações genéticas entre as populações de Butia capitata avaliadas propiciaram variabilidade para duração do ciclo, coloração da epiderme dos frutos, volume de suco produzido, relação entre sólidos solúveis totais e acidez titulável, características biométricas de fruto e produtividade anual. Uma das populações, denominada Celina, apresentou maior produtividade e rendimento industrial. As populações Celina e São José apresentaram as melhores características biométricas de fruto. A população Aguiar apresentou a melhor relação entre sólidos solúveis totais e acidez titulável.The genus Butia belongs to the Arecaceae family and shows five species occurring in Rio Grande de Sul. The specie Butia capitata requires special attention, not just for its use as fresh consumption but also as processed product. However, even having its use recorded since

  6. Prevalência da anemia em crianças avaliada pela palidez palmar e exame laboratorial: implicações para enfermagem Sentimientos de mujeres-madres delante de la cirugía neonatal en las malformaciones congénitas Prevalence of anemia in children assessed by clinical method known as "palmar pallor" and the laboratory exam: implications for nursing

    Directory of Open Access Journals (Sweden)

    Ethel Bastos da Silva

    2011-09-01

    Full Text Available Buscou-se analisar a prevalência de anemia ferropriva em crianças e comparar os dados obtidos pelo método clínico "palidez palmar" e exame laboratorial em uma Estratégia de Saúde da Família no município de Panambi/RS. Pesquisa exploratória/descritiva, quantitativa, realizada de março a junho de 2009. Foram sujeitos 41 crianças de 2 meses a 5 anos. Os dados foram analisados pela estatística descritiva. Das crianças, 51,2% eram do sexo masculino; 41,46% estavam na faixa etária de 0 a 12 meses; 53,6% das famílias situavam-se no nível social D e 43,9% dos chefes de família tinham o Ensino Fundamental completo ou o Ensino Médio incompleto. Pela palidez palmar, a prevalência de anemia foi de 51,2% e pelo exame laboratorial, de 58,53%. O estudo mostra que a palidez palmar e o exame laboratorial, quando usados juntos, fornecem um diagnóstico mais preciso da anemia ferropriva, podendo ser inseridos na prática assistencial da enfermagem na ESF.Se intenta analizar la prevalencia de anemia por deficiencia de fierro en niños y comparar el método clínico "palidez palmar" y el examen de laboratorio en una Estrategia de Salud de la Familia en la municipalidad de Panambi-RS. La pesquisa exploratoria, descriptiva y cuantitativa fue realizada de marzo hasta junio de 2009. Los sujetos fueron 41 niños de 2 meses a 5 años de edad. Los datos fueron analizados por la estadística descriptiva. Del total de niños, 51,2% eran del sexo masculino; 41,46% estaban en la franja etaria de 0 a 12 meses; 53,6% de las familias se sitúan en el nivel social D y 43,9% de los jefes de familia tienen la Enseñanza Fundamental Completa o la Enseñanza Media Incompleta. Por la palidez palmar, la prevalencia de anemia fue de 51,2% y por el examen de laboratorio, de 58,53%. El estudio muestra que la palidez palmar y el examen de laboratorio, cuando usados juntos, proveen un diagnóstico más preciso de la anemia por deficiencia de fierro, pudiendo ser inserido

  7. [Reconstruction of combined skin and bilateral artey defects at palmar side of fingers by free posterior interrosseous artery flap in a bridge fashion].

    Science.gov (United States)

    Xu, Bao-cheng; Liang, Gang; Chen, Fu-sheng

    2012-05-01

    To investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers. 6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2.0 cm to 6.5 em x 3.0 cm. The wounds at donor sites were closed directly. All the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months (average, 7 months). Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue. The long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.

  8. Secuencia constructiva de las plazas en el Grupo Principal de El Palmar, Campeche, México Constructive Sequence of Plazas in the Main Group of El Palmar, Campeche, México

    Directory of Open Access Journals (Sweden)

    Kenichiro Tsukamoto

    2012-01-01

    Full Text Available La ubicación y dimensión de los espacios abiertos fueron aspectos considerados al planificar las ciudades de las Tierras Bajas Mayas en el periodo prehispánico. Las plazas eran los espacios políticos donde las élites gobernantes legitimaban a sus autoridades y manifestaban a otros participantes sus capacidades para comunicarse con los ancestros o deidades. Este trabajo se centra en la secuencia constructiva de ocho plazas en el Grupo Principal del sitio arqueológico de El Palmar, Campeche, México. Los resultados obtenidos durante las temporadas de campo en el 2007 y el 2009 indican que las grandes plazas fueron construidas durante la segunda mitad del Clásico Temprano (400-600 d.C. y que en ellas se celebraron ceremonias públicas inscritas en los monumentos conmemorativos.The location and dimension of open spaces were important aspects involved in Maya Lowlands planning during the prehispanic period. Plazas were political spaces in which ruling elites legitimated their authorities and manifested to other participants their capacities of communication with ancestors or deities. This paper focuses on the construction sequence of eight plazas at the Main Group of El Palmar, Campeche, Mexico. The results recovered from the 2007 and 2009 fieldwork seasons indicate that large plazas were build during the second part of the Early Classic period (400-600 AD, with the erection of commemorative monuments narrating public ceremonies.

  9. Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

    International Nuclear Information System (INIS)

    Lloyd, K.C.K.; Koblik, P.; Ragle, C.; Wheat, J.D.; Lakritz, J.

    1988-01-01

    In 4 adult horses, simple, non displaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses

  10. [Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures: comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-Smartlock].

    Science.gov (United States)

    Hakimi, M; Jungbluth, P; Gehrmann, S; Nowak, J; Windolf, J; Wild, M

    2010-03-01

    Due to advances in the development of the unidirectional locking plates there is now an increased use of multidirectional palmar locking plates in the treatment of distal radius factures. The purpose of this study was to evaluate a possible improvement of the treatment and results. This prospective cohort study investigated 40 patients with C1 and C2 Colles' fractures who had been treated with unidirectional and multidirectional locking plates. The average time for the follow-up examinations was 12.3 months (range 12-15 months) after surgery. The intra-operative functional (neutral-zero method), radiological and subjective (DASH score, VAS) results were evaluated. The intra-operative fluoroscopy time of the unidirectional group was 58 s shorter compared to the multidirectional group. All fractures healed without any complication. The radiological, subjective (DASH score) and objective results for both groups were good and showed no differences. Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time.

  11. Avaliação da força de preensão palmar frente à terapia com mobilização neural

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    Bruna Formentão Araujo

    2012-08-01

    Full Text Available INTRODUÇÃO: A mobilização neural é uma técnica que visa a restauração do movimento e da elasticidade do sistema nervoso; contudo, ainda são poucos os estudos que avaliam sua eficácia sobre variáveis clínicas. OBJETIVO: Avaliar a força de preensão palmar em indivíduos submetidos à intervenção com mobilização neural. Metodologia: Estudo cruzado em que compuseram a amostra 20 sujeitos, com média de idade de 19,5 ± 0,92 anos, divididos em dois grupos (G1 e G2 que receberam, a cada semana, uma sessão única de intervenção de forma que o G1 recebeu mobilização neural e o G2 alongamentos convencionais para o supraespinal na primeira semana; o inverso aconteceu na segunda semana, em que o G1 recebeu alongamentos convencionais para o supraespinal e o G2 a mobilização neural. Os alongamentos para o supraespinal serviram apenas como placebo e não impuseram tensão aos nervos em estudo. As mobilizações neurais foram aplicadas nos nervos radial, mediano e ulnar. A força de preensão palmar foi avaliada por meio de um dinamômetro de preensão palmar em vários momentos: antes e imediatamente, 20 minutos e uma hora após cada intervenção. RESULTADOS: Não houve resultados significativos para a mobilização neural, nem para o alongamento. CONCLUSÃO: A mobilização neural não foi eficaz para produzir o aumento da força de preensão palmar em indivíduos saudáveis.

  12. Localized Sympathectomy Reduces Mechanical Hypersensitivity by Restoring Normal Immune Homeostasis in Rat Models of Inflammatory Pain.

    Science.gov (United States)

    Xie, Wenrui; Chen, Sisi; Strong, Judith A; Li, Ai-Ling; Lewkowich, Ian P; Zhang, Jun-Ming

    2016-08-17

    Some forms of chronic pain are maintained or enhanced by activity in the sympathetic nervous system (SNS), but attempts to model this have yielded conflicting findings. The SNS has both pro- and anti-inflammatory effects on immunity, confounding the interpretation of experiments using global sympathectomy methods. We performed a "microsympathectomy" by cutting the ipsilateral gray rami where they entered the spinal nerves near the L4 and L5 DRG. This led to profound sustained reductions in pain behaviors induced by local DRG inflammation (a rat model of low back pain) and by a peripheral paw inflammation model. Effects of microsympathectomy were evident within one day, making it unlikely that blocking sympathetic sprouting in the local DRGs or hindpaw was the sole mechanism. Prior microsympathectomy greatly reduced hyperexcitability of sensory neurons induced by local DRG inflammation observed 4 d later. Microsympathectomy reduced local inflammation and macrophage density in the affected tissues (as indicated by paw swelling and histochemical staining). Cytokine profiling in locally inflamed DRG showed increases in pro-inflammatory Type 1 cytokines and decreases in the Type 2 cytokines present at baseline, changes that were mitigated by microsympathectomy. Microsympathectomy was also effective in reducing established pain behaviors in the local DRG inflammation model. We conclude that the effect of sympathetic fibers in the L4/L5 gray rami in these models is pro-inflammatory. This raises the possibility that therapeutic interventions targeting gray rami might be useful in some chronic inflammatory pain conditions. Sympathetic blockade is used for many pain conditions, but preclinical studies show both pro- and anti-nociceptive effects. The sympathetic nervous system also has both pro- and anti-inflammatory effects on immune tissues and cells. We examined effects of a very localized sympathectomy. By cutting the gray rami to the spinal nerves near the lumbar sensory

  13. AVALIAÇÃO DA IMAGEM TURÍSTICA DE SANTA VITÓRIA DO PALMAR (RS, BRASIL, NA PERSPECTIVA DOS RESIDENTES

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    Melise de Lima Pereira

    2017-06-01

    Full Text Available O presente artigo busca identificar os fatores que compõem a imagem turística do destino Santa Vitória do Palmar (RS, Brasil, na perspectiva dos residentes, como medida de manifestação da identidade. A pesquisa possui caráter exploratório, descritivo, empírico e com abordagem predominantemente quantitativa. Foi utilizada uma amostra, não probabilística por conveniência, composta por 93 respondentes, colhida diretamente no município, durante outubro de 2015. Através de Análise Fatorial Exploratória foram identificados os componentes da imagem turística de Santa Vitória do Palmar, que são: Lugares históricos e serviços ofertados, opções de entretenimento, atrativos turísticos, hotelaria e transmissão da cultura local, higiene e comércio e fama do município.

  14. The effect of renal arteries sympathectomy on refractory hypertension

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    Reza Karbasi-Afshar

    2013-06-01

    Full Text Available Background: Sympathetic complex of over-activation kidneys is one of the main causes of primary hypertension (HTN. We aimed to assess the efficacy and safety of sympathectomy using 5Fr mariner catheter ablation on patients with refractory hypertension.Methods: In this prospective cohort study, patients who received three or more anti-hypertensive medications with 160mmHg systolic blood pressure (BP or more were randomly included and divided into 2 groups. Cases in the first group were undergone to renal denervation and the second group was treated by previous antihypertensive medications. Both groups were followed for six month by assessing BP and adverse effects.Results: One hundred and seventeenth patients (54% out of 212 screened patients were included in the first group (renal denervation and 95 patients as the second group. The mean of BP changes in the first group was 35/15 mmHg with standard deviation of 22/11mmHg. (P<0.001 in the second group, the mean changes of BP was not statistically significant. (5/0mmHg± 22/11, P=0.79 for systolic BP and P=0.96 for diastolic BP. 92% of 117 patients in the first group had a favorable BP decrease, which was defined as a 20mmHg or more decrease in BP, in comparison with 15% of 95 patients as controls (P=0.001. There was no observed complication after denervation in the first group.Conclusion: It seems that the sympathetic renal denervation can be an effective and safe method for treatment of refractory hypertensive patients indeed of routine medications although further studies with longer follow up duration and more cases are suggested for confirming this issue.

  15. An atypical case of postsurgical complex regional pain syndrome in a patient having nonhealing varicose venous ulcer treated by lumbar sympathectomy

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    Kailash Kothari

    2017-01-01

    Full Text Available Complex regional pain syndrome (CRPS of the lower limb is a relatively uncommon entity as compared to CRPS of the upper extremity. Literature search has revealed only 2 retrospective case series and a single case report of lower extremity CRPS type I from 1975 to 2014 on Pubmed, isolated cases of CRPS type I of lower extremity have also been reported following knee surgeries and arthroscopies. This report presents a case of lower limb CRPS type I, following surgery for varicose vein ulcer. Pain was not relieved with medications. Diagnostic lumbar sympathectomy was done and patient had tremendous relief of pain following that, proving sympathetic mediated pain of the involved limb.

  16. Localized palmar-plantar epidermal hyperplasia: a previously undefined dermatologic toxicity to sorafenib.

    Science.gov (United States)

    Beldner, Matthew; Jacobson, Michael; Burges, Gene E; Dewaay, Deborah; Maize, John C; Chaudhary, Uzair B

    2007-10-01

    The development of multitargeted tyrosine kinase inhibitors has provided significant advances in the treatment of renal cell carcinoma. This case describes initial therapy for managing renal cell cancer with the administration of sorafenib, a multitargeted tyrosine kinase inhibitor. We report the development of localized palmar-plantar epidermal hyperplasia, a rare but significant cutaneous adverse event from sorafenib therapy. Mild-to-moderate dermatologic toxicity from sorafenib has been well described in the literature. We also review the current knowledge and the proposed hypothesis for the development of cutaneous events related to tyrosine kinase inhibitors. This particular case represents a unique form of dermatologic toxicity to sorafenib that has not previously been described in the literature.

  17. Percutaneous chemical lumbar sympathectomy for buerger's disease: Results in 147 patients

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    Reena Kothari

    2017-01-01

    Full Text Available Objectives: The objective of this study was to evaluate the efficacy, safety, and clinical outcome of percutaneous chemical lumbar sympathectomy (PCLS in Buerger's disease (thromboangiitis obliterans [TAO]. Design: This was a retrospective comparative study. Methods: TAO patients who underwent PCLS in surgery department of a teaching hospital in Central India. Diagnosis of TAO was made on clinical grounds and color Doppler study. PCLS was done under image guidance after amputation of gangrene or before if a clear line of demarcation was lacking. After PCLS, patients were followed up on next day and after 2, 4, 8, and 12 weeks. Outcome monitored were improvement in rest pain (using visual analog scale and healing of ischemic ulcers. Results: All patients were males, chronic bidi smokers, mostly in the third decade of life. All had involvement of lower limbs either ischemic rest pain or ischemic ulcers or gangrene of toes/forefoot. A total of 167 PCLS (20 bilateral were performed on 147 TAO patients from June 2008 to January 2016. Imaging modalities were computed tomography scan (n = 67, digital X-ray (n = 50, and C-arm fluoroscopy (n = 50. Success rate for chemical neurolysis was > 82%. Excellent long-lasting rest pain relief was obtained in > 80% patients. Ulcer healing was seen in majority of patients. Large number of limbs (103/167 had gangrene of toe/multiple toes/part of forefoot. Those with patent popliteal artery fared better. Conclusions: PCLS can provide safe and efficient treatment for rest pain and healing of ischemic ulcers in TAO.

  18. Emergency management of traumatic collateral palmar digital nerve defect inferior to 30 mm by venous grafting. Report of 12 clinical cases.

    Science.gov (United States)

    Laveaux, C; Pauchot, J; Obert, L; Choserot, V; Tropet, Y

    2011-02-01

    When traumatic collateral palmar digital nerve defect occurs, emergency venous grafting is an alternative to the two-step nervous grafting procedure. During the course of a monocentric retrospective study, 12 cases of emergency venous grafting were reviewed by a single independent examiner 11 months, at least, post-intervention. Clinical and functional evaluation was carried out, together with a self-assessment of the results by the patient. Data were compacted using a filtering method and the final result was considered in terms of "good" or "bad". Good result was observed in ten cases out of 12. Bad results were associated with poor sensory recovery in the two other cases. In one of these, the bad result was also related to severe symptoms in cold conditions and a troublesome hyperesthesia. Through a review of the literature, we justify the emergency treatment of nerve defects of the collateral palmar digital nerves with venous grafting. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. CT-Guided Lumbar Sympathectomy: Results and Analysis of Factors Influencing the Outcome

    International Nuclear Information System (INIS)

    Heindel, Walter; Ernst, Stefan; Manshausen, Gudrun; Gawenda, Michael; Siemens, Peter; Krahe, Thomas; Walter, Michael; Lackner, Klaus

    1998-01-01

    Purpose: To prospectively analyze the effectiveness of computed tomography-guided percutaneous lumbar sympathectomy (CTLS) in patients with peripheral arterial occlusive disease in relation to angiographic findings and vascular risk factors. Methods: Eighty-three patients were treated by CTLS. After clinical evaluation of the risk profile and diagnostic intraarterial digital subtraction arteriography, 14 patients underwent unilateral, and 69 bilateral one-level treatment. Follow-up studies took place on the day following the intervention, after 3 weeks, and after 3 months. Results: A total of 152 interventions were performed in 83 patients. After 3 months, clinical examination of 54 patients (5 patients had died, 24 were lost to follow-up) revealed improvement in 46% (25/54), no change in 39% (21/54), and worsening (amputation) in 15% (8/54). There was no significant statistical correlation among any of the analyzed factors (diabetes mellitus, arterial hypertension, smoking, hyperlipidemia, obesity, hyperuricemia, number of risk factors, ankle-arm index, and angiography score) and the outcome after CTLS. Three major complications occurred: one diabetic patient developed a retroperitoneal abscess 2 weeks after CTLS, and in two other patients ureteral strictures were detected 3 months and 2 years after CTLS, respectively. Conclusion: As no predictive criteria for clinical improvement in an individual patient could be identified, CTLS, as a safe procedure, should be employed on a large scale in patients who are unsuitable for treatment by angioplasty or revascularization

  20. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina)

    OpenAIRE

    Gangenova, Elena; Guzmán, Atilio; Marangoni, Federico

    2012-01-01

    El Parque Nacional El Palmar (PNEP) es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay). En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 ...

  1. Propuesta de un proyecto comunitario como alternativa de desarrollo del recinto El Palmar mediante el Agroturismo

    OpenAIRE

    Pino Panchig, Silvana Fernanda; Rivera Núñez, Lorena Marisol

    2006-01-01

    Given the above problems, it was necessary to raise a proposal that can be developed in rural areas in which it seeks to improve living conditions by promoting community tourism, agrotourism in this case is an activity for the population of El Palmar can be a source of additional income that depend on their main economic activity, becoming a productive heading over the agricultural enterprise. Ante la problemática antes mencionada, fue necesario plantear una propuesta que pueda ser desarro...

  2. Imaginando Palmares: a obra de Gayl Jones

    Directory of Open Access Journals (Sweden)

    Stelamaris Coser

    2005-01-01

    Full Text Available http://dx.doi.org/10.1590/S0104-026X2005000300010 O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.

  3. Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up?

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    Bahareh Abtahi-Naeini

    2016-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution. Objective and Aim: The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR as an alternative permanent treatment for PAH with long-term follow-up. Materials and Methods: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group, and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS at baseline and the end of the study, as well as during the 1 year follow-up phase. Results: HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation of HDSS in the group being treated with radiofrequency was 2.50 (±0.88 after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001. Follow-up results show that there were 10 patients (41.6% with no relapse and 11 patients (45.9% with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI (P = 0.03. Conclusion: Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs. Clinical Trial Registration: IRCT2013111915455N1. Level of Evidences: Level II-1.

  4. ANÁLISIS FITOLÍTICOS EN SUELOS FORMADOS SOBRE ANTIGUAS TERRAZAS DEL RÍO URUGUAY (COLÓN, ENTRE RÍOS: PRIMERA EVIDENCIA DE RETRACCIÓN DE LOS PALMARES DE BUTIA YATAY (MART.. BECC.

    Directory of Open Access Journals (Sweden)

    Patterer, Noelia I.

    2017-06-01

    Full Text Available Los palmares de Butia yatay (Mart. Becc. en el Parque Nacional El Palmar (Colón, Entre Ríos, son comunidades relictuales que se desarrollan sobre los suelos arenosos que pertenecen al orden de los Entisoles. Estos suelos constituyen las terrazas antiguas del río Uruguay. La serie de suelos Puerto Yeruá son suelos arenosos pardos formados sobre terrazas y poseen un mayor desarrollo pedológico. Se ha estudiado la composición fitolítica de la secuencia pedológica de esta serie de suelos con la finalidad de contribuir al conocimiento de la flora que acompañó el desarrollo de los mismos. Las asociaciones fitolíticas observadas reflejan el cambio de dos ciclos pedológicos, que dividen al perfil analizado en dos zonas demarcadas por la presencia de diferentes paleocomunidades: una de palmares asociados a un estrato herbáceo pobre y una superior de pastizales meso-megatérmicos con escasa presencia de microrestos afines a elementos arbóreos. El registro fitolítico descripto en el presente trabajo es el primer antecedente que muestra el posible punto de cambio en la fisonomía del paisaje y la retracción de los palmares de yatay en el área de estudio.

  5. Soft tissue stabilization for palmar midcarpal instability using a palmaris longus tendon graft.

    Science.gov (United States)

    Chaudhry, Tahseen; Shahid, Mohammed; Wu, Feiran; Mishra, Anuj; Deshmukh, Subodh

    2015-01-01

    To report the results of a technique of soft tissue stabilization for palmar midcarpal instability using a palmaris longus graft. In patients' symptomatic wrists with palmar midcarpal instability that had failed conservative management, we used a dorsal approach and stabilized the hamate and triquetrum by reconstructing the dorsal triquetrohamate ligament. The palmaris longus tendon graft was fixed with bone anchors. Seven wrists in 6 patients were available for follow-up at a mean of 28 months (range, 17-37 mo). There was an overall meaningful improvement in function (mean preoperative Disabilities of the Arm, Shoulder, and Hand score, 49 preoperatively, 28 postoperatively). There was a significant increase in grip strength from 15 to 21 kg. At final follow-up, 2 patients had moderate pain. The others had mild or no pain. Four patients returned to their previous occupation or activity. Patients retained full pronation and supination. When compared with the normal side, flexion was reduced to 71%, extension to 81%, radial deviation to 90%, and ulnar deviation to 65% of the opposite side. Although the mean results show an improvement, one patient had a poor result with deterioration in Disabilities of the Arm, Shoulder, and Hand score in spite of a clinically stable wrist, and another had clinical evidence of recurrent instability during pregnancy. One patient had residual symptoms from a prominent bone anchor. Overall, this technique showed good medium-term results in most of our patients. It retained some midcarpal mobility, eliminated clunking in most patients, and provided a noteworthy improvement in grip strength and function. We continue to use this technique for patients with symptomatic midcarpal instability, but it requires further evaluation with larger patient numbers and a longer follow-up to assess its overall value. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    OpenAIRE

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-01-01

    Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay) was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered ...

  7. Two Paraneoplastic Autoimmune Syndromes: Limbic Encephalitis and Palmar Fasciitis in a Patient with Small Cell Lung Cancer.

    Science.gov (United States)

    Lazarev, Irina; Shelef, Ilan; Refaely, Yael; Ariad, Samuel; Ifergane, Gal

    2015-09-07

    Small cell lung cancer (SCLC) is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE) is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS) is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  8. Two paraneoplastic autoimmune syndromes: limbic encephalitis and palmar fasciitis in a patient with small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Irina Lazarev

    2015-09-01

    Full Text Available Small cell lung cancer (SCLC is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  9. Incidence of palmar process fractures of the distal phalanx and association with front hoof conformation in foals.

    Science.gov (United States)

    Faramarzi, B; McMicking, H; Halland, S; Kaneps, A; Dobson, H

    2015-11-01

    Recent studies indicate a high prevalence of fractures of the palmar processes (PP) of the distal phalanx in foals. However, information on the prevalence of such fractures in different breeds and the effect of predisposing factors, such as hoof conformation, is limited. To examine the prevalence of distal phalanx PP fractures in foals and report the relationship of distal limb and hoof conformation with the prevalence of fracture. Longitudinal study. Front hooves of 19 Thoroughbred, Quarter Horse and Arabian foals were examined. Digital radiographic and photographic images of the distal aspect of the forelimbs were taken at ∼2.5 month intervals. Five radiographic projections of each limb were as follows: lateromedial; horizontal beam dorsopalmar; dorso60°proximal-palmarodistal oblique; dorso60°proximo45°lateral-palmarodistomedial oblique; and dorso60°proximo45°medial-palmarodistolateral oblique. The relationship between measurements and the prevalence of fractures was assessed by 3-way ANOVA. Fractures were found in 74% (n = 14) of the foals during the study period. The prevalences of lateral PP and medial PP fractures were not significantly different. Several hoof measurements were associated with PP fractures. Longer dorsal length of the distal phalanx was associated with medial PP fractures, while smaller lateral angle and shorter lateral palmar length were associated with a higher prevalence of lateral PP fractures. This study revealed a high prevalence of PP fractures in young foals, particularly in Thoroughbred foals. The hoof conformation may be one of the contributory factors to PP fractures in foals. © 2014 EVJ Ltd.

  10. Anatomy of the palmar cutaneous branch of the median nerve: clinical significance.

    Science.gov (United States)

    DaSilva, M F; Moore, D C; Weiss, A P; Akelman, E; Sikirica, M

    1996-07-01

    A detailed anatomic, histologic, and immunohistochemical study of the palmar cutaneous branch of the median nerve (PCBMN) and its distal arborization was undertaken on 12 fresh human cadaveric hands. Small unmyelinated fibers terminated in the superficial loose connective tissue of the transverse carpal ligament. There were no nerve fibers detected in the deep, dense collagen aspect of the ligament. Based on these findings, during open carpal tunnel release, the skin incision should be placed along the axis of the ring finger to avoid injury to the superficial branches of the PCBMN. When open release is used, the very small terminal branches in the loose tissue of the ligament will be transected; this may in part be responsible for postoperative soft tissue pain. For endoscopic releases, some risk for transection of the main trunk of the PCBMN at the proximal incision exists. Repeated passes of the endoscopic knife should be avoided in an attempt to limit damage to the small fibers in the superficial aspect of the ligament.

  11. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

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    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.Frecuency of the allele causing the axonal form of autosomal recessive Charcot-Marie-Tooth in Palmares, Costa Rica. The Charcot-Marie-Tooth disease constitutes is among the most frequent hereditary peripheral neuropathies world-wide. We identified a family from Palmares (Alajuela, Costa Rica with 18 affected members. Their neuropathy is axonal, with an autosomal recessive pattern of inheritance; the responsible gene is at the 19q13.33 chromosomal region. Later the mutation was identified in gene MED25. We studied the frequency and geographic distribution of the mutant allele. In a random sample of 103 individuals, six were heterozygote and were widely distributed in Palmares. There was no person in homozigote state for the mutant allele. Clinical characteristics do

  12. Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls.

    Science.gov (United States)

    Carmalt, James L; Borg, Hanna; Näslund, Hans; Waldner, Cheryl

    2014-10-01

    The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing records. The effect of having a POF on race speed compared to radiographically negative control horses was examined using generalised estimating equations. Multivariable regression was used to examine differences in money earned and career longevity. The horses raced a total of 16,448 races. Horses gained speed as a function of race number. There was no difference in racing speed between horses with POF fractures that raced before surgery and control horses. Horses did not slow before, nor speed up after, surgery. There was no difference in the number of days between the last race prior to, or the first race after, the hospital visit between POF and control horses. Career earnings and lifetime starts were not significantly different between groups. The results of this study suggest the need to reevaluate the previously reported benefits of surgical intervention for POF. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation.

    Science.gov (United States)

    Zhou, Xiao; Wang, Libo; Mi, Jingyi; Xu, Yajun; Rui, Yongjun; Xue, Mingyu; Shen, Xiaofang; Qiang, Li

    2015-04-01

    The aim of treating thumb fingertip amputations with no indication for replantation is to reestablish functional and esthetic properties. From March 2005 to October 2008, we treated 14 patients with thumb fingertip amputation using palmar V-Y flaps combined with bone and nail bed grafts. There were 10 men and 4 women, whose ages at surgery ranged from 19 to 63 years (mean 35.8 years). In all, 11 of the injuries occurred in the dominant hand. According to Allen's classification, two were type II, seven were type III, and five were type IV. All patients underwent emergency surgery, with a time delay after injury of 3-12 h (mean 6.4 h). In each case, the amputation was a crush or avulsion injury, making microsurgical replantation not feasible. All of the flaps survived. At 8-17 months (average 12.8 months) of follow-up, the average subjective satisfaction score was 8.64. All patients experienced cold intolerance, and none of the patients complained of dysesthesia. Favorable results (excellent or good) were found in 78.6%. Thin primary nails appeared on the grafted nail bed about 3 weeks after surgery, following which the newly formed nail thickened and developed a more natural appearance. In one case, the new nail plate showed abnormal thickening due to hyperkeratosis. The bone graft healed at 5 weeks. The mean two-point discrimination was 7.5 mm. Grip strength was 10% less than that in the unaffected hand. Metacarpophalangeal and proximal interphalangeal joint mobility losses were less than 10°. All patients returned to their jobs. No patients had postoperative complications. We believe that the combination of palmar V-Y flap and bone and nail bed grafts provides a distinct advantage over other choices. It improves function when replantation is not an option.

  14. Ganglion block. When and how?

    International Nuclear Information System (INIS)

    Bale, R.

    2015-01-01

    Increasing understanding of the anatomy and physiology of neural structures has led to the development of surgical and percutaneous neurodestructive methods in order to target and destroy various components of afferent nociceptive pathways. The dorsal root ganglia and in particular the ganglia of the autonomous nervous system are targets for radiological interventions. The autonomous nervous system is responsible for the regulation of organ functions, sweating, visceral and blood vessel-associated pain. Ganglia of the sympathetic chain and non-myelinized autonomous nerves can be irreversibly destroyed by chemical and thermal ablation. Computed tomography (CT)-guided sympathetic nerve blocks are well established interventional radiological procedures which lead to vasodilatation, reduction of sweating and reduction of pain associated with the autonomous nervous system. Sympathetic blocks are applied for the treatment of various vascular diseases including critical limb ischemia. Other indications for thoracic and lumbar sympathectomy include complex regional pain syndrome (CRPS), chronic tumor associated pain and hyperhidrosis. Neurolysis of the celiac plexus is an effective palliative pain treatment particularly in patients suffering from pancreatic cancer. Percutaneous dorsal root ganglion rhizotomy can be performed in selected patients with radicular pain that is resistant to conventional pharmacological and interventional treatment. (orig.) [de

  15. Palmar dermatoglyphics as diagnostic tool: Mayer-rokintansky-kuster-hauser syndrome

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    Kumar A

    2003-03-01

    Full Text Available The congential anomalies involving Mullerian duct dysgenesis, the MRKH (Mayer-Rokitansky-Kuster-Hauser syndrome overlaps a ′community of syndromes′ which share, apart from a complete absence of uterus and vagina, associated presentations that include developmental abnormalities of skeletal, renal, dental and other dysmorphias. First described more than 400 years ago, this complement of anomalies now rechristened, the MRKH syndrome has been extensively studied. Found to occur once in every 4000 females; estimated on its incidence vary from 1/5000 to 1/20,000. Despite its fairly wide prevalence, this syndrome has remained largely underdiagnosed or cryptic. Social and cultural perceptions have perforce driven, the wide existence of the very personal handicap underground and unacceptable. Accidentally discovered during routine examination, during secondarily associated medical problems, the mullerian agenecies syndrome has been subject of a wide range of clinical and laboratory investigations. The oddity in the syndrome is that the patient appears absolutely normal and that it presents with no genetic marker. We herein report the palmar dermatoglyphic and doctylographic features of a patient with MRKH syndrome. However interpretation, show conclusively, at least in this single case that the MRKH syndrome can be diagnosed through its characteristic dermatography patterns. In our view, routine dermatographic study of all live females births may lead to not only an early but also a cost effective diagnostic method.

  16. Power-assistive finger exoskeleton with a palmar opening at the fingerpad.

    Science.gov (United States)

    Heo, Pilwon; Kim, Jung

    2014-11-01

    This paper presents a powered finger exoskeleton with an open fingerpad, named the Open Fingerpad eXoskeleton (OFX). The palmar opening at the fingerpad allows for direct contact between the user's fingerpad and objects in order to make use of the wearer's own tactile sensation for dexterous manipulation. Lateral side walls at the end of the OFX's index finger module are equipped with custom load cells for estimating the wearer's pinch grip force. A pneumatic cylinder generates assistance force, which is determined according to the estimated pinch grip force. The OFX transmits the assistance force directly to the objects without exerting pressure on the wearer's finger. The advantage of the OFX over an exoskeleton with a closed fingerpad was validated experimentally. During static and dynamic manipulation of a test object, the OFX exhibited a lower safety margin than the closed exoskeleton, indicating a higher ability to adjust the grip force within an appropriate range. Furthermore, the benefit of force assistance in reducing the muscular burden was observed in terms of muscle fatigue during a static pinch grip. The median frequency (MDF) of the surface electromyography (sEMG) signal from the first dorsal interosseous (FDI) muscle displayed a lower reduction rate for the assisted condition, indicating a lower accumulation rate of muscle fatigue.

  17. Role of linoleic acid in arsenical palmar keratosis.

    Science.gov (United States)

    Ahmed, Tarafder S; Misbahuddin, Mir

    2016-03-01

    Chronic arsenic exposure can lead to palmoplantar keratosis. In the stratum corneum of skin, linoleic acid is of the utmost importance to the inflammation, keratinization, and regeneration processes. The aims of this study were: (i) to present quantitative information on the linoleic acid fraction of intercorneocyte lipids, and (ii) to elucidate the role of linoleic acid in the pathophysiology of arsenical keratosis. Lipid extracts were collected from keratotic lesions in seven patients, seven arsenic-exposed subjects, and seven non-exposed control subjects. Linoleic acid levels of the specimens were estimated by reverse-phase high-performance liquid chromatography (RP-HPLC). There was a significant (P keratosis patients (palm: 25.66 ± 4.95 μg/cm(2); dorsum: 28.25 ± 6.20 μg/cm(2)) compared with arsenic-exposed (palm: 2.75 ± 0.85 μg/cm(2); dorsum: 1.96 ± 0.64 μg/cm(2)) and non-exposed (palm: 1.52 ± 0.61 μg/cm(2); dorsum: 1.28 ± 0.39 μg/cm(2)) control subjects. There was no significant difference (P = 0.556) in linoleic acid concentration in the non-affected skin of the dorsum of the hand (28.25 ± 6.20 μg/cm(2)) compared with that in the palmar sites (25.66 ± 4.95 μg/cm(2)) in the patient group. The change in linoleic acid levels in the arsenic-exposed control group did not differ from that in non-exposed controls (P = 1.000). Linoleic acid concentration is elevated in arsenical keratosis; this finding warrants further investigation to ascertain whether linoleic acid plays a direct role in the pathophysiology of arsenical keratosis. © 2015 The International Society of Dermatology.

  18. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina

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    Guzmán, Atilio

    2012-02-01

    Full Text Available El Parque Nacional El Palmar (PNEP es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay. En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 especies de anfibios para el PNEP, distribuidas en 6 familias y 9 géneros. Entre los tipos de ambientes, el pajonal exhibió la mayor diversidad y riqueza de especies. Las abundancias relativas de las especies fueron equitativas dentro de los tres ambientes y existieron diferencias significativas en la composición de especies entre los mismos, siendo el pajonal y el pastizal los más similares. Este trabajo es un aporte significativo al conocimiento de la herpetofauna del PNEP y una base para estudios futuros sobre historia natural de los anfibios. Así también brinda una herramienta para el manejo y conservación del área protegida. El Palmar National Park (NPEP is an important protected area in the eastern of Entre Rios Province, Argentina. It was created for preserving one of the last fragments of yatay palm (Butia yatay. This study examines the biodiversity of the community of anurans that inhabit three types of environments of the Park, the grassland, the straw zone and the gallery forest. Sampling was conducted between the spring-summer 2008 and 2009. There were found 16 species of amphibians for NPEP, belonging to 6 families and 9 genera. Among the types of environments, the straw zone showed the highest diversity and species richness. The relative abundances of the species were equitative in all three environments and there were significant differences in species composition among them being the grassland and pasture the most similar. This work

  19. PRÁTICAS AMBIENTALMENTE CORRETAS EM MEIOS DE HOSPEDAGEM: um estudo sobre a percepção ambiental e perfil dos gestores hoteleiros de Santa Vitória do Palmar/RS

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    Siuza Monteiro Guedes

    2017-09-01

    Full Text Available Este estudo foi realizado no município de Santa Vitória do Palmar, RS, teve por objetivo analisar a percepção das práticas ambientalmente corretas de gestão ambiental e de economia de recursos naturais entre os gestores do setor de hospedagem do Município de Santa Vitória do Palmar. Trata-se de um estudo qualiquantitavo de caráter exploratório, representativo e participante, com aplicação de instrumento de coleta de dados, realizado no período de novembro de 2016 a março de 2017 em empreendimentos do setor de hoteleiro e extra-hoteleiro, na cidade sede do Município e em três dos balneários marítimos do mesmo. Como principal resultado pode ser destacado a falta de planos de gestão ambiental dos empreendimentos pesquisados. O estudo se justifica uma vez que não foram encontrados estudos similares.

  20. PARQUES DE PRODUÇÃO DE ENERGIA EÓLICA E TRANSFORMAÇÕES NA PAISAGEM – ESTUDO DE CASO EM SANTA VITÓRIA DO PALMAR/RS

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    Anelize Milano Cardoso

    2015-07-01

    Full Text Available Numa região das mais isoladas do Estado, no extremo sul do país, logo no início da BR-471, rodovia que liga o município do Chuí ao município de Santa Vitória do Palmar, já estão instalados os primeiros aerogeradores do Complexo Eólico Campos Neutrais, que reúne três grandes parques: Geribatu, Chuí e Hermenegildo. As dez plantas, cada uma com mais de dez aerogeradores do Parque Eólico Geribatu já estão finalizados e em funcionamento, causando uma alteração drástica na fisionomia da paisagem. O objetivo deste trabalho foi compreender, a partir da literatura referente, o crescimento da produção de energia eólica, as características das áreas em que se implantaram parques ou complexos eólicos e os impactos dos objetos técnicos relacionados a esta produção na paisagem. Foi realizado, primeiramente, um levantamento de material bibliográfico sobre os métodos relativos ao estudo da paisagem, destacando-se a abordagem da percepção. Atualmente observa-se que as alterações sentidas na dinâmica do município, devido à instalação do Parque Eólico, não se limitam apenas ao impacto visual, tais como o aumento do fluxo do trânsito e a maior circulação de pessoas. Santa Vitória do Palmar, com a implementação do Parque, vive uma atmosfera de otimismo, ganhando uma nova identidade, alterando assim de forma positiva, a própria relação da comunidade local com o contexto que a circunda. Santa Vitória do Palmar, no imaginário local, passou a contextualizar-se no mundo globalizado através de um símbolo que representa a ideia de desenvolvimento limpo e responsável.

  1. Knowledge about useful entomofauna in the county of La Purísima Palmar de Bravo, Puebla State, Mexico

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    D. H. Zetina

    2007-06-01

    Full Text Available Eighteen species of edible insects belonging to 15 families of six orders of Insecta were recorded in the county of La Purísima Palmar de Bravo in Puebla State, Mexico. They had the following taxonomic distribution among the different families: Lygaeidae, Pentatomidae, Membracidae, Cercopidae, Psocidae, Melolonthidae, Curculionidae, Cossidae, Megathymidae, Pyralidae, Geometridae and Apidae, all with a single recorded species; the families Acrididae, Formicidae and Vespidae with two species in each family. The latter were the most abundant families, and Hymenoptera was the most salient order with five species. Three species were reported as new registers of edible insects for Mexico and also for the world. The nutritive value of insects in terms of macro and micronutrients is discussed.

  2. Quality of life in patients with primary axillary hyperhidrosis before and after treatment with fractionated microneedle radiofrequency

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    Bahareh Abtahi-Naeini

    2015-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a common condition with a great impact on the patient′s quality of life (QOL. It is associated with serious social, emotional, and occupational distress. The aim of this study was to investigate the QOL in patients with PAH before and after treatment with fractionated microneedle radiofrequency (FMR. Materials and Methods: We evaluated 25 patients with severe PAH. Each patient had three sessions of FMR treatment using a novel applicator at 3-week intervals. The study was based on Dermatology Life Quality Index (DLQI Questionnaires. Patients were evaluated at baseline and 3 months after the last session. Results: Our patients included 32% males and 68% females. The mean ± standard deviation (SD age of subjects was 30.2 ± 6.27 years. The mean ± SD of the DLQI before and after treatment was 12.96 ± 5.93, and 4.29 ± 2.21, respectively. There was a statistically significant difference between the before and after intervention (P < 0.001. No major, permanent adverse effects were shown. Conclusion: Treatment with FMR can improve the DLQI of patients with PAH.

  3. Zumbi e a Construção da Identidade Negra: uma Análise sobre a História em Quadrinhos “Zumbi – A Saga de Palmares” * Zumbi and Formation of Black Identity: an Analysis on the Comics "Zumbi - The Saga of Palmares"

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    VINÍCIUS FINGER

    2013-04-01

    Full Text Available Resumo: O objetivo deste artigo é realizar uma análise do personagem de Zumbi encontrado no álbum em quadrinhos “Zumbi - A Saga de Palmares” e sua relação com os princípios, ideologias e políticas que embasaram os movimentos antirracistas ao longo do século XX. Analisa também os modos de construção da figura de Zumbi, através das narrativas propostas pelo Movimento Negro Unificado. Apresentando uma síntese dos movimentos antirracismo mais representativos no Brasil durante o século XX.Palavras-chaves: Zumbi – Palmares – MNU. Abstract: The aim of this article is to analyze Zumbi’s character found in the comic book "Zumbi - The Saga of Palmares" and its relationship with the principles, ideologies and policies which based anti-racist movements throughout the twentieth century. It also analyzes the forms of formation of the figure of Zumbi through the narratives proposed by the Unified Black Movement (Movimento Negro Unificado. It presents a summary of the most significant anti-racism movements in Brazil during the twentieth century.Keywords: Zumbi – Palmares – MNU.

  4. Factores bióticos y abióticos que determinan la seroprevalencia de anticuerpos contra Trypanosoma Cruzi en el municipio de Palmar de Bravo, Puebla, México Biotic and abiotic determinants of seroprevalence of antibodies against Trypanosoma cruzi in Palmar de Bravo, Puebla, Mexico

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    Francisca Sosa-Jurado

    2004-02-01

    Full Text Available OBJETIVO: Determinar la prevalencia de anticuerpos contra Trypanosoma cruzi y su relación con los factores bióticos y abióticos en Palmar de Bravo, Puebla, México. MATERIAL Y MÉTODOS: Estudio transversal efectuado en agosto de 2000 a septiembre de 2001, con una muestra aleatoria simple de 390 voluntarios residentes en Palmar de Bravo, Puebla, México. Se hizo determinación de anticuerpos contra T cruzi con técnicas serológicas validadas, búsqueda del vector y de reservorios domésticos, así como determinación de asociación entre caso positivo y factores de riesgo bióticos y abióticos. El análisis estadístico consistió en índice Kappa para las pruebas diagnósticas, empleando tabla de contingencia de 2 x 2; ji cuadrada corregida de Yates, exacta de Fisher y la razón de posibilidad para estimar la significancia de la asociación de factores bióticos y abióticos. RESULTADOS: La seroprevalencia fue de 4% en la población humana estudiada y de los reservorios (equinos, porcinos y caninos, sólo 10% de los caninos resultaron reactivos. Los vectores identificados fueron T barberi y T pallidipennis, con índice de dispersión e índice de colonización de 55 y 40%, respectivamente. Los factores de riesgo más importantes fueron la altitud (>2 150 y OBJECTIVE: To establish the relationship between seroprevalence for antibodies against Trypanosoma cruzi and its relationship with biotic and abiotic factors. MATERIAL AND METHODS: A cross-sectional study was conducted between August 2000 and September 2001. The study population consisted of a simple random sample of 390 volunteers residing in Palmar de Bravo, Puebla, Mexico. Sample and data collection procedures included assaying antibodies against T cruzi with validated assays, and searching for domestic reservoirs and triatomine bugs. The relationship between biotic and abiotic factors with seropositivity was assessed. Statistical analysis was conducted using Kappa values for

  5. Fossil woods of Detarioideae subfamily (Fabaceae) from El Palmar Formation (Late Pleistocene) in South America

    Science.gov (United States)

    Ramos, R. Soledad; Brea, Mariana; Kröhling, Daniela M.

    2017-11-01

    The main aim of the present paper is to describe the first Detarioideae fossil woods from El Palmar Formation (Late Pleistocene) in the Uruguay River Basin (Entre Ríos, Argentina). This study is based on five silicified wood specimens preserved in fluvial deposits, which were transported from their growth site. Two new genera and species are described: Paraoxystigma concordiensis gen. nov and sp. nov. has medium-sized vessels, paratracheal axial parenchyma, heterocellular and multiseriate rays, and diffuse axial canals similar in size and shape to vessels, and Gossweilerodendroxylon palmariensis gen. nov and sp. nov. has medium-sized vessels, alternate intervessel pits, paratracheal and apotracheal axial parenchyma, homocellular and uni to-multiseriate rays, and small diffuse axial canals. These Detarioideae fossil records in south-eastern South America support the existence of a very old relationship with the extant West African forests. Eco-anatomical features observed in these fossil woods, along with the climatic information available from the Nearest Living Relatives (NLRs) comparison, suggest warm and humid climatic conditions for the upper-middle basin of the Uruguay River during some periods of the Late Pleistocene.

  6. Utilização do tendão do músculo palmar longo em procedimentos cirúrgicos: estudo em cadáveres Use of the tendon of the palmaris longus muscle in surgical procedures: study on cadavers

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Angelini Júnior

    2012-01-01

    Full Text Available OBJETIVO: Demonstrar que o tendão do músculo palmar longo pode ser estimado em relação ao seu comprimento e largura antes de usá-lo como enxerto em procedimento cirúrgico. MÉTODOS: Foram examinados 60 antebraços de 30 cadáveres de etnia negra; mensurou-se o comprimento e a largura do tendão do músculo palmar longo e comparou-se com o comprimento do antebraço. RESULTADOS: Foi constatada a ausência unilateral direita em dois cadáveres do sexo feminino. As médias do comprimento e da largura foram respectivamente 11,9 mais ou menos 15,2mm e 4,1 + 1,5mm. A média total do comprimento do antebraço foi de 275.4mm mais ou menos 17,9mm. CONCLUSÃO: Há uma relação significativa entre o comprimento do tendão e o comprimento do antebraço; assim poder-se-á avaliar o tamanho do tendão do músculo palmar longo quando for necessário usá-lo para enxertos. Nível de Evidências IV, Série de casos.OBJECTIVE: Demonstrate that the tendon of palmar long can be estimated in relation to its length and width before using it as a graft in surgical procedure. METHODS: There were examined 60 forearms of 30 corpses of black ethnicity; measure the length and width of the tendon of the palmaris longus muscle and compared the length of the forearm. RESULTS: There are notes their absence unilateral right in two female corpses. The medium length and width were more or less respectively 11.9, 15.2 mm and 4.1 + 1.5 mm. The total average forearm length of 275.4 was more or less 17.9 mm. CONCLUSION: There is a significant relationship between the length of the tendon and the length of the forearm; so we can evaluate the size of the tendon of the palmaris longus muscle when it is necessary to use it for grafts. Levels of Evidence IV, Case series.

  7. Athymic experimental animals in pharmaco-immonological research

    DEFF Research Database (Denmark)

    Juul, P.; Christensen, H.B.; Hougen, Hans Petter

    1992-01-01

    Nude mice, nude rats, streptozotocin, diabetes mellitus, guanethidine, sympathectomy, toxicology......Nude mice, nude rats, streptozotocin, diabetes mellitus, guanethidine, sympathectomy, toxicology...

  8. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome Influência do resfriamento nos parâmetros de condução nervosa mista do mediano e ulnar na síndrome do túnel do carpo

    Directory of Open Access Journals (Sweden)

    Rogério Gayer Machado de Araújo

    2007-09-01

    Full Text Available Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU in electrodiagnosis of carpal tunnel syndrome (CTS. Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands. Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands. PMU was obtained at the usual temperature, >32°C, and after wrist/hand cooling to Temperatura é uma variável comum e importante que modifica os parâmetros de condução nervosa na prática eletrodiagnóstica. Neste trabalho nós estudamos o efeito do esfriamento na diferença de latências palmares entre o nervo mediano e ulnar (PMU, segmento palma-pulso, utilizada rotineiramente para o eletrodiagnóstico da síndrome do túnel do carpo (STC. Foram estudados 22 controles (19 mulheres, média de idade 42,1 anos, 44 mãos e 25 pacientes (25 mulheres, média de idade 46,6 anos, 34 mãos com diagnóstico de STC leve. PMU foi obtida em temperatura usual (>32°C, e após resfriamento de mão/pulso em água com gelo (<27°C. Após o resfriamento houve aumento significativo na PMU e na latência mista palmar do nervo ulnar nos pacientes quando comparados aos controles. Nós concluímos que o resfriamento modifica significativamente a PMU e propomos que as latências obtidas em nervos submetidos à compressão reagem de maneira mais acentuada ao frio e isso poderia ser uma arma útil para o eletrodiagnóstico da STC incipiente. Da mesma forma, houve reação mais acentuada ao frio no estudo da latência mista palmar do nervo ulnar nos pacientes mas não nos controles, que poderia levantar a hipótese de compressão subclínica do nervo ulnar.

  9. Resultados clínico-radiológicos en pacientes jóvenes con fractura articular completa de radio distal tratados con placa palmar bloqueada. [Clinical and radiological results in young patients with complete articular distal radius fractures treated with volar locked plate.

    Directory of Open Access Journals (Sweden)

    Pablo De Carli

    2016-02-01

    Conclusión: El tratamiento de las fracturas de radio distal tipo C en pacientes jóvenes con placa palmar bloqueada muestra resultados clínicos y radiológicos favorables con corrección de la mayoría de los escalones articulares.

  10. Is there any place for spontaneous healing in deep palmar burn of the child?

    Science.gov (United States)

    Chateau, J; Guillot, M; Zevounou, L; Braye, F; Foyatier, J-L; Comparin, J-P; Voulliaume, D

    2017-06-01

    Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report

    Directory of Open Access Journals (Sweden)

    Lucchina Stefano

    2013-04-01

    Full Text Available 【Abstract】 Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180°, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K-wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190°. No radio-logical signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal trac-tion can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar. Key words: Finger phalanges; Fractures, bone; Finger joint

  12. Micro-angiographic investigations of revascularisation of fracture in the canine tibia

    Energy Technology Data Exchange (ETDEWEB)

    Kagel, K.O.; Koecher, W.

    1987-03-01

    Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance.

  13. Micro-angiographic investigations of revascularisation of fracture in the canine tibia

    International Nuclear Information System (INIS)

    Kagel, K.O.; Koecher, W.; Ernst-Moritz-Arndt-Universitaet, Greifswald

    1987-01-01

    Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance. (orig.) [de

  14. Improved identification of the palmar fibrocartilage of the navicular bone with saline magnetic resonance bursography.

    Science.gov (United States)

    Schramme, Michael; Kerekes, Zoltan; Hunter, Stuart; Nagy, Krisztina; Pease, Anthony

    2009-01-01

    Fibrocartilage degeneration is the earliest pathologic finding in navicular disease but remains difficult to detect, even with magnetic resonance (MR) imaging. We hypothesized that injection of the navicular bursa with saline would improve accuracy of MR imaging evaluation of palmar fibrocartilage. Thoracic limbs were collected from 11 horses within 6 h of death. Imaging was performed with a 1.5 T magnet using sagittal 2D proton density and transverse 3D FLASH sequences with fat saturation. For the purpose of determining sensitivity and specificity of the MR images, fibrocartilage was classified as normal or abnormal, based on combination of the findings of gross and microscopic pathology. Thickness of fibrocartilage was measured on histologic sections and corresponding transverse FLASH MR images before and after injection of saline. A paired Student's t-test was used for comparison of measurements. Partial thickness fibrocartilage loss was present in 6 of 22 limbs. Sensitivity of precontrast MR images for detection of lesions was 100% while specificity was 6%. Saline MR arthrography resulted in both sensitivity and specificity of 100% based on consensus review. Mean histologic fibrocartilage thickness was 0.75 +/- 0.12 mm. Mean fibrocartilage thickness on precontrast transverse FLASH images was 0.93 +/- 0.065 and 0.73 +/- 0.09 mm on postsaline images. The histologic cartilage thickness was signficantly different from that in precontrast images (Pfibrocartilage can only be evaluated reliably for the presence of partial thickness lesions after intrabursal injection of saline.

  15. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    International Nuclear Information System (INIS)

    Chang, Weiling; Peduto, Anthony J.; Aguiar, Rodrigo O.C.; Trudell, Debra J.; Resnick, Donald L.

    2007-01-01

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  16. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Weiling [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Sharp-Grossmont Hospital, Department of Radiology, La Mesa, CA (United States); Peduto, Anthony J. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Westmead Hospital and Western Clinical School of Sydney University, Department of Radiology, Sydney (Australia); Aguiar, Rodrigo O.C. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Universidade Federal do Rio de Janeiro, Rio de Janerio (Brazil); Trudell, Debra J.; Resnick, Donald L. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States)

    2007-07-15

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  17. LAS COMUNIDADES VEGETALES DE LA SABANA DEL PARQUE NACIONAL EL PALMAR (ARGENTINA

    Directory of Open Access Journals (Sweden)

    William B. Batista

    2014-01-01

    Full Text Available El Parque Nacional El Palmar, Entre Ríos, preserva desde 1965 el mayor remanente de la sabana de Butia yatay , un ecosistema rico en especies amenazado por la actividad humana. Para estudiar el funcio - namiento de este ecosistema y gestionar su preservación, es necesario contar con una adecuada carac - terización de la heterogeneidad de su vegetación. En este trabajo presentamos una clasificación fitoso - ciológica de las comunidades vegetales de la sabana del Parque, describimos su estructura, composición y diversidad florística y detallamos su distribución en el paisaje. Con el fin de estratificar la obtención de datos, delimitamos primero las principales unidades geomorfológicas del paisaje. En la primavera de 1999 y en el verano siguiente, realizamos censos florísticos completos en 73 “stands” de sabana con diferentes historias de incendio, distribuidos en las diferentes unidades geomorfológicas. Utilizamos técnicas de análisis multivariado y clasificación numérica para agrupar los censos en comunidades y las especies en grupos florísticos. Finalmente, resumimos las diferencias entre las comunidades en un esca - lamiento multidimensional métrico. Obtuvimos 7 comunidades, descriptas por 20 grupos florísticos. El patrón de similitudes entre estas comunidades sugiere que la heterogeneidad florística se ordena según dos componentes, uno asociado con diferencias en la textura del suelo y el otro con diferencias en el régimen de humedad del suelo. Tres de las comunidades, afines entre sí, se distribuyen en las terrazas altas e interfluvios que conforman la matriz del paisaje, en correspondencia con diferencias graduales de topografía y suelos. Estas comunidades cambian sucesionalmente por el avance de la lignificación des - encadenada por la exclusión del ganado y mantenida por la escasez de incendios naturales. Las restantes cuatro comunidades aparecen estrictamente asociadas con afloramientos rocosos, dep

  18. Intrapleural analgesia after endoscopic thoracic sympathectomy Analgesia intrapleural após simpatectomia videotoracoscópica

    Directory of Open Access Journals (Sweden)

    Patrícia Gomes da Silva

    2011-12-01

    Full Text Available PURPOSE: To compare analgesia traditionally used for thoracic sympathectomy to intrapleural ropivacaine injection in two different doses. METHODS: Twenty-four patients were divided into three similar groups, and all of them received intravenous dipyrone. Group A received intravenous tramadol and intrapleural injection of saline solution. Group B received intrapleural injection of 0.33% ropivacaine, and Group C 0.5% ropivacaine. The following aspects were analyzed: inspiratory capacity, respiratory rate and pain. Pain was evaluated in the immediate postoperative period by means of the visual analog scale and over a one-week period. RESULTS: In Groups A and B, reduced inspiratory capacity was observed in the postoperative period. In the first postoperative 12 hours, only 12.5% of the patients in Groups B and C showed intense pain as compared to 25% in Group A. In the subsequent week, only one patient in Group A showed mild pain while the remainder reported intense pain. In Group B, half of the patients showed intense pain, and in Group C, only one presented intense pain. CONCLUSION: Intrapleural analgesia with ropivacaine resulted in less pain in the late postoperative period with better analgesic outcomes in higher doses, providing a better ventilatory pattern.OBJETIVO: Comparar a analgesia tradicionalmente utilizada para simpatectomia videotoracoscópica à injeção intrapleural de ropivacaína em duas doses diferentes. MÉTODOS: Vinte e quatro pacientes foram distribuídos em três grupos semelhantes, e todos eles receberam dipirona endovenosa. O grupo A recebeu tramadol endovenoso e injeção intrapleural de solução salina. O grupo B recebeu injeção intrapleural de ropivacaína a 0,33%, e Grupo C ropivacaína a 0,5%. Os aspectos analisados foram: capacidade inspiratória, freqüência respiratória e dor. A dor foi avaliada no período pós-operatório por meio da escala visual analógica e durante o período de uma semana. RESULTADOS

  19. Non-Medical Management of Raynaud’s Disease,

    Science.gov (United States)

    1981-06-29

    initial cold exposure (p< .01). -This therapy offers a practical alternative to traditional treatments with drugs or sympathectomy, without unwarranted...cold and emotional upset; the use of tranquilizers and vasoail. t ing drugs ; or in extreme cases, sympathectomy. 4 There is controversy as to whether the...Disease 3 Pavlovian conditioning is an alternative method of counter-conditioning the autonomic nervous system. Research has shown that vasoconstriction and

  20. Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions.

    Science.gov (United States)

    Smolensky, Michael H; Portaluppi, Francesco; Manfredini, Roberto; Hermida, Ramon C; Tiseo, Ruana; Sackett-Lundeen, Linda L; Haus, Erhard L

    2015-06-01

    The symptom intensity and mortality of human diseases, conditions, and syndromes exhibit diurnal or 24 h patterning, e.g., skin: atopic dermatitis, urticaria, psoriasis, and palmar hyperhidrosis; gastrointestinal: esophageal reflux, peptic ulcer (including perforation and hemorrhage), cyclic vomiting syndrome, biliary colic, hepatic variceal hemorrhage, and proctalgia fugax; infection: susceptibility, fever, and mortality; neural: frontal, parietal, temporal, and occipital lobe seizures, Parkinson's and Alzheimer's disease, hereditary progressive dystonia, and pain (cancer, post-surgical, diabetic neuropathic and foot ulcer, tooth caries, burning mouth and temporomandibular syndromes, fibromyalgia, sciatica, intervertebral vacuum phenomenon, multiple sclerosis muscle spasm, and migraine, tension, cluster, hypnic, and paroxysmal hemicranial headache); renal: colic and nocturnal enuresis and polyuria; ocular: bulbar conjunctival redness, keratoconjunctivitis sicca, intraocular pressure and anterior ischemic optic neuropathy, and recurrent corneal erosion syndrome; psychiatric/behavioral: major and seasonal affective depressive disorders, bipolar disorder, parasuicide and suicide, dementia-associated agitation, and addictive alcohol, tobacco, and heroin cravings and withdrawal phenomena; plus autoimmune and musculoskeletal: rheumatoid arthritis, osteoarthritis, axial spondylarthritis, gout, Sjögren's syndrome, and systemic lupus erythematosus. Knowledge of these and other 24 h patterns of human pathophysiology informs research of their underlying circadian and other endogenous mechanisms, external temporal triggers, and more effective patient care entailing clinical chronopreventive and chronotherapeutic strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Circumscribed palmar or plantar hypokeratosis 10 years after the first description: what is known and the issues under discussion.

    Science.gov (United States)

    Urbina, F; Pérez, A; Requena, L; Rütten, A

    2014-01-01

    This review of the literature on palmoplantar hypokeratosis, a process that was first indentified only 10 years ago, discusses the current state of our understanding, the therapeutic options available, and the debate about etiology. Forty-four publications reporting 69 cases were found. Palmar or plantar hypokeratosis occurs mainly in women (76.8%) and age at the time of a first visit to a physician ranges from 42 to 84 years. Most cases present between the ages of 51 and 70 years. The majority of patients have had solitary lesions usually located on the right palm, particularly in the regions of the thenar (in 44/79 lesions [55.7%]) or hypothenar eminences (in 11/79 lesions [13.9%]). In only 8 cases was there a history of prior trauma at the site. Studies using polymerase chain reaction techniques to identify human papillomavirus involvement were negative in most cases. These hypokeratotic lesions are localized epidermal depressions formed by an abrupt thinning of the stratum corneum, providing a singular histopathologic feature. This condition can currently be considered a localized keratinization disorder affecting zones where there is a thick stratum corneum. The precipitating cause is unknown and a definitive treatment remains to be found. The mechanism would be the localized failure of a clone of keratinocytes during differentiation toward normal palmoplantar hyperkeratinization. Copyright © 2012 Elsevier España, S.L. y AEDV. All rights reserved.

  2. Hyperhidrosis

    Science.gov (United States)

    ... dark blue color wherever there is excess sweat. Paper test. Special paper is placed on the affected area to absorb ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  3. ATIVIDADES RECREATIVAS E LÚDICAS: um estudo nas escolas estaduais da cidade de Santa Vitória do Palmar, RS – Brasil

    Directory of Open Access Journals (Sweden)

    Alex Borges Dias

    2017-11-01

    Full Text Available Os processos educativos são fundamentais para a formação de cidadãos mais conscientes de seu papel na construção de uma sociedade mais justa e igualitária. Em um mundo onde as atividades humanas são constantemente aceleradas pelas práticas capitalistas, se torna cada vez mais necessário pensar o papel da educação na formação de novos cidadãos conscientes de sua importância na sociedade. Desse modo, este trabalho teve por objetivo identificar as atividades recreativas e lúdicas que contribuem nos processos educativos dos alunos do 1º ano das escolas estaduais em Santa Vitória do Palmar, RS - Brasil. Na metodologia foi feita uma pesquisa bibliográfica. Para a coleta de dados foram feitas entrevistas com os professores responsáveis pelas turmas do primeiro ano de cada escola e foi utilizado o método de observação não-participante, além do levantamento fotográfico. Identificou-se que todas as escolas estaduais da cidade possuem atividades recreativas e lúdicas que contribuem para os processos educativos dos alunos matriculados.

  4. "Pollical palmar interosseous muscle" (musculus adductor pollicis accessorius): attachments, innervation, variations, phylogeny, and implications for human evolution and medicine.

    Science.gov (United States)

    Bello-Hellegouarch, Gaelle; Aziz, M Ashraf; Ferrero, Eva M; Kern, Michael; Francis, Nadia; Diogo, Rui

    2013-03-01

    Most atlases and textbooks dealing with human anatomy do not refer to the "pollical palmar interosseous" (PPI) muscle of Henle. In order to undertake a fresh and detailed study of this muscle and to thus better understand human comparative anatomy and evolution, we: 1) analyze the frequency of the PPI in a large sample of human hands; 2) describe the attachments, innervation and varieties of the PPI in these hands; 3) compare the data obtained with the information available in the literature; and 4) discuss the phylogenetic origin of the PPI and the implications of our observations and comparisons for medicine and for the understanding of human evolutionary history. Within the 72 hands dissected by us, the PPI is present in 67 hands (93%), commonly having a single muscular branch, originating from the medial side of the base of metacarpal I only, inserting onto the medial side of the base of the pollical proximal phalanx and/or surrounding structures (e.g., ulnar sesamoid bone, wing tendon of extensor apparatus), and passing at least partially, and usually mainly, medial to the princeps pollicis artery. A careful study of the human PPI, as well as a detailed comparison with other mammals, strongly suggest that the muscle is evolutionarily derived from the adductor pollicis, and namely from its oblique head. Therefore, we propose that PPI should be designated by the name musculus adductor pollicis accessorius, which indicates that the muscle is most likely a de novo structure derived from the adductor pollicis. Copyright © 2012 Wiley Periodicals, Inc.

  5. Digital angiography of camel foot

    International Nuclear Information System (INIS)

    Dehghani, S.N.; Kohkiloyehzadeh, M.; Sazmand, A.

    2011-01-01

    In this study, angiography of normal digits of camel has been accomplished, and the vessels of digits and its distribution have been evaluated to be compared with abnormal digits in the future studies. The thoracic and pelvic limb of 16 camels were collected immediately following slaughter. The palmar and plantar arteries were isolated and catheterised by 18-gauge angiocatheter needle; perfused by 40Ð’–50 ml of iodinated compound injected into each vessel. Angiograms were obtained using dorsopalmer, dorsoplanter and latero-medial projections. In the pelvic limb, above the fetlock joint, the deep palmar arch communicates with the median artery via the anastomotic branch, forming the superfcial palmar arch, from which two branches were clear, 1-palmar common digital artery IV that divides into palmar proper digital arteries IV and V, close to the lateral accessory (ffth) digit. 2-Palmar common digital artery III, produces the first branch and continues distally near the middle of the proximal phalanx, it gives off two palmar branches of the proximal phalanx. Vascular distribution of the pelvic limb was similar to thoracic limb, carrying the name of plantar instead of palmar

  6. TURISMO CEMITERIAL: proposta de roteirização a partir das potencialidades turísticas impressas no cemitério civil de Santa Vitória do Palmar, RS, Brasil

    Directory of Open Access Journals (Sweden)

    Cláudia Brandão Schwab

    2017-09-01

    Full Text Available Este trabalho apresenta projeto elaborado durante estágio curricular obrigatório, no qual se analisaram as possibilidades de transformação do Cemitério Civil de Santa Vitória do Palmar em um atrativo turístico, a partir da realização de trilhas interpretativas em um processo de roteirização, com vistas à preservação de seu patrimônio. A metodologia utilizada foi análise SWOT partindo da inventariação turística. As incursões exploratórias foram desenvolvidas por meio de pesquisa bibliográfica e em periódicos. A pesquisa de campo realizada fez levantamento da infraestrutura, acessibilidade, segurança do espaço e elementos tumulares visando à elaboração do plano final de roteirização.

  7. Pulsed Radiofrequency Treatment of Complex Regional Pain Syndrome: A Case Series

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    Vlad Djuric

    2014-01-01

    Full Text Available BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS. Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS.

  8. Evidence for a local sympathetic venoarteriolar "reflex" in the dog hindleg

    DEFF Research Database (Denmark)

    Henriksen, O; Amtorp, O; Faris, I

    1983-01-01

    24%. In subcutaneous tissue, vascular resistance decreased by 12%. The effect of acute lumbar sympathectomy was studied in another group of seven dogs. Operation caused an immediate decrease in vascular resistance of 40%. The increase in vascular resistance during venous stasis in the total leg......, as well as in muscle and subcutaneous tissue, was not affected. However, acute lumbar sympathectomy combined with injection of phenoxybenzamine into the femoral artery almost abolished the vasoconstriction induced by venous stasis. In muscle, the increase in vascular resistance was still present...

  9. chronic sleep deprevation and ventricular arrhythmias: effect of symphatic nervous system

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    Samira Choopani

    2016-04-01

    Full Text Available Introduction: We assessed the effect of chronic sleep deprivation on incidence of ischemia/reperfusion-induced ventricular arrhythmias (ventricular tachycardia and ventricular fibrillation and the role of the sympathetic nervous system in this respect. Material and methods: Rats were randomly divided into four groups; 1 ischemia/reperfusion group (IR: 30 minutes ischemia followed by 60 minutes reperfusion was induced, 2 control group (CON: rats has been placed in large multiple platforms for 72h prior to ischemia and reperfusion, 3 Chronic sleep deprivation group( SD: 72h sleep deprivation was induced by using small  multiple platform prior to ischemia and reperfusion, 4 Sympathectomy group (SYM: chemical sympathectomy was done 24h before to chronic sleep deprivation and then underwent ischemia and reperfusion. The heart isolated and perfused by langendorff apparatus. After thoracotomy and aorta cannulation, the hearts perfused in the langendorff apparatus using krebs-Henseleit buffer. Hearts were allowed to recovery for 15 min. After recovery period, 15 minutes was considered as baseline prior to 30 minutes ischemia followed by 60 minutes reperfusion.Tow thin stainless stell electrodes fixed on the ventricular apex and right atrium for recording the lead II of electrocardiogram (ECG.Results: There were no significant differences between heart rates between groups, and ventricular tachycardia significantly increased in chronic sleep deprivation group As compared with IR group in ischemia period. Sympathectomy significantly reduced ventricular tachycardia incidence when compared with SD. There is no difference in incidence of ventricular tachycardia between control group and IR group. The incidence of ventricular fibrillation during early reperfusion was significantly augmented (P<0.05 in sleep deprivation group as compared with IR group and Sympathectomy significantly could reverse ventricular fibrillation incidence to IR group level as

  10. Image-guided pain therapy. Sympathicolysis; Bildgestuetzte Schmerztherapie. Sympathikolyse

    Energy Technology Data Exchange (ETDEWEB)

    Burbelko, M.; Wagner, H.J. [Vivantes Klinikum im Friedrichshain, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Gutberlet, M.; Grothoff, M. [Universitaet Leipzig - Herzzentrum, Abteilung fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany)

    2015-06-15

    In the autonomic nerve system most sympathetic neurons synapse peripherally in the ganglia of the sympathetic trunk. A reduction in sympathicotonia by partial elimination of these ganglia is a therapeutic approach that has been used for more than 100 years. In the early 1920s the first attempts at percutaneous sympathicolysis (SL) were carried out. Nowadays, minimally invasive image-guided SL has become an integral part of interventional radiology. Established indications for SL are hyperhidrosis, critical limb ischemia and the complex regional pain syndrome. The standard imaging guidance modality in SL is computed tomography (CT) which allows the exact placement of the puncture needle in the target area under visualization of the surrounding structures. Ethanol is normally used for chemical lysis, which predominantly eliminates the unmyelinated autonomic axons. In order to visualize the distribution of the ethanol during application, iodine-containing contrast medium is added. The sympathetic nervous system (SNS) controls sweat secretion via the efferent neurons; therefore, effective therapy of idiopathic palmar, axillary and plantar hyperhidrosis can be achieved when SL is performed at the corresponding level of the sympathetic trunk. Furthermore, due to the vasomotor innervation of most blood vessels, by reduction of the sympathicotonus an atony of the smooth muscles and therefore vasodilatation occurs, which is used as a palliative therapeutic option in patients with critical limb ischemia. By elimination of the afferent sensory fibers this also results in pain relief. This principle is also used in the SL therapy of the complex regional pain syndrome. After the introduction of CT guidance, major complications have become rare events. In addition to the usual risks of percutaneous interventions there are, however, a number of specific complications, such as syncope caused by irritation of cardiac sympathetic nerves in thoracic SL and ureteral injury in lumbar

  11. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

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    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-10-01

    Full Text Available Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered with bond paper. While crystal bond paper, applied firmly over a wooden pad, was used for recording the inked epidermal ridge patterns. Rolled finger prints were recorded after applying uniform pressure on white bond paper from ulnar to radial side. Complete palm impression, including the hollow or the palm was obtained over paper. Thus one set of finger prints and palm prints was obtained. The prints obtained were immediately examined with hand-lens. Result: Right hand and left hand of the both male and female study group showed more number of arches than controls. Right hand and left hand of the both male and female study group showed more number of Radial loops than controls. The right hand and left hand of both male and female control group showed more number of ulnar loops than study group. The right hand and left hand of the male control group showed more number of Whorls than study, while in females, the right hand study group showed more number of whorls than control group and the left hand study group showed less number of Whorls as compared to control group. Conclusion: The present study indicates that there are some genetic factors which are involved in the causation of essential hypertension and it is possible to certain extent to predict from dermatoglyphics individual’s chance of acquiring essential hypertension. Like clinical history, examination and investigations, the dermatoglyphics will play an important role revealing the genetic

  12. Racing performance in Standardbred trotting horses with proximal palmar/plantar first phalangeal fragments relative to the timing of surgery.

    Science.gov (United States)

    Carmalt, J L; Borg, H; Näslund, H; Waldner, C

    2015-07-01

    Proximal palmar/plantar osteochondral fragmentation of the first phalanx is a frequent radiographic finding in Standardbred horses. These lesions are routinely removed prior to the onset of a racing career with no evidence to support the timing of this surgical intervention. To determine whether horses racing before surgery slowed as they approached surgery date and whether they speeded up after surgery. To investigate the factors affecting whether a horse raced after surgery and compare the performance of horses that did and did not race before surgery. A retrospective study using 193 Swedish Standardbred trotters. Medical records and radiographs of each horse were examined. Racing data were retrieved from official online records. Generalising estimating equations were used to examine presurgery racing performance and determine whether this differed between horses that raced before surgery and those that had not. Multivariable regression was used to examine career earnings and number of career races. Horses racing before surgery neither slowed as they approached surgery, nor speeded up after surgery. Race speed of horses raced before surgery was not different from those that only raced after surgery. Racing before surgery was not associated with whether horses raced following surgery. Only horses with 3 affected legs had slower race speeds than other horses. No other horse level variables affected race speed, number of career races, career earnings or top speed. There was no significant difference in race speed between horses that raced before surgery and those that did not. Horses did not slow down prior to surgery. Horses with 3 affected legs ran slower than those with only a single or 2 affected limbs. There was no association between timing of surgery and race speed or career longevity. The potential benefits of surgical intervention should be critically examined. © 2014 EVJ Ltd.

  13. Múltiplos cornos cutâneos em coxins palmares e plantares de um gato persa Multiple cutaneous horns on the footpads of a persian cat

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    Heloisa Justen Moreira de Souza

    2010-03-01

    Full Text Available Cornos cutâneos são infrequentes em gatos, principalmente em felinos jovens. Neste trabalho, é relatado um caso de um felino da raça Persa, macho, com oito meses de idade e apresentando histórico de espirros. Ao exame clínico, identificaram-se projeções corniformes originadas nos coxins palmares e plantares. A avaliação histológica de biópsia excisional demonstrou hiperqueratose densa, com numerosos queratinócitos sobre epiderme hiperplásica, não sendo identificado nenhum grau de malignidade. Não foi constatada a associação das lesões com a infecção pelo vírus da leucemia felina. O tratamento instituído incluiu excisão parcial mensal dos cornos cutâneos e acompanhamento clínico do animal.Cutaneous horns are seldom seen in cats, especially in young ones. A case of a Persian cat, male, eight months old, with a history of sneezes is described. During physical examination, multiple horns on the all footpads were noticed. The histopathological diagnosis of excisional biopsy was dense hyperkeratosis, with numerous keratinocytes above hyperplastic epidermis and no evidence of malignity. There was no association between the lesions and infection with leukemia virus. The treatment was mensal trimming off the cutaneous horns and clinical follow up of the animal.

  14. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

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    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.

  15. Buerger’s Disease in Tehran University of Medical Sciences Hospitals: A Fifteen Years Study

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    Salimi Javad

    2009-10-01

    Full Text Available Buerger's disease is an occlusive inflammatory disease of the small and medium-sized arteries and accounts for a variable proportion of patients with peripheral vascular disease throughout the world. The aim of this study was to review the records of Buerger's disease patients admitted to surgery wards of our university hospitals. 277 patients with Buerger's disease were surgically treated between 1987 and 2002, in affiliated hospitals of Tehran University of Medical Sciences, in Iran. Two hundred and seventy three (98.6% of the patients were male, aged 41.5 ± 11 years (mean ± SD; 99.6% of which were smokers with an average of 22.9 pack/years tobacco use. The major complaints included: ischemic ulcers in 203 (73.3%, CI 95%: 0.68-0.77 patients, rest pain in 201 (72.6%, CI 95%: 0.64-0.73, paresthesia in 143 (51.3%, CI 95%: 0.48- 0.58. Vascular bypass, sympathectomy and amputation were performed in 9.7% (CI 95%: 0.08-0.14 and 69.3% (CI 95%: 0.51-0.60 and 59.6% (CI 95%: 0.65-0.73 of the patients, respectively. Lumbar sympathectomy was carried out in 177 (63.9% patients, while 15 (5.4% patients underwent thoracic sympathectomy. In our study, afflicted patients were mostly young males, inveterate tobacco smokers. Patients presented frequently with ischemic ulcers or severe rest pain; thrombophlebitis and Raynaud's phenomenon were infrequent. Vascular reconstruction was rarely possible due to distal and segmental involvement; therefore sympathectomy and amputation were inevitable in a large group of patients in this study.

  16. Sympathetic neural modulation of the immune system

    International Nuclear Information System (INIS)

    Madden, K.S.

    1989-01-01

    One route by which the central nervous system communicates with lymphoid organs in the periphery is through the sympathetic nervous system (SNS). To study SNS regulation of immune activity in vivo, selective removal of peripheral noradrenergic nerve fibers was achieved by administration of the neurotoxic drug, 6-hydroxydopamine (6-OHDA), to adult mice. To assess SNS influence on lymphocyte proliferation in vitro, uptake of 125 iododeoxyuridine ( 125 IUdR), a DNA precursor, was measured following 6-OHDA treatment. Sympathectomy prior to epicutaneous immunization with TNCB did not alter draining lymph nodes (LN) cell proliferation, whereas 6-OHDA treatment before footpad immunization with KLH reduced DNA synthesis in popliteal LN by 50%. In mice which were not deliberately immunized, sympathectomy stimulated 125 IUdR uptake inguinal and axillary LN, spleen, and bone marrow. In vitro, these LN and spleen cells exhibited decreased proliferation responses to the T cell mitogen, concanavalin A (Con A), whereas lipopolysaccharide (LPS)-stimulated IgG secretion was enhanced. Studies examining 51 Cr-labeled lymphocyte trafficking to LN suggested that altered cell migration may play a part in sympathectomy-induced changes in LN cell function

  17. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?

    Science.gov (United States)

    Shenefelt, Philip D

    2003-01-01

    Biofeedback can improve cutaneous problems that have an autonomic nervous system component. Examples include biofeedback of galvanic skin resistance (GSR) for hyperhidrosis and biofeedback of skin temperature for Raynaud's disease. Hypnosis may enhance the effects obtained by biofeedback. Cognitive-behavioral methods may resolve dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermatologic therapy. Responsive diseases include acne excoriée, atopic dermatitis, factitious cheilitis, hyperhidrosis, lichen simplex chronicus, needle phobia, neurodermatitis, onychotillomania, prurigo nodularis, trichotillomania, and urticaria. Hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioral methods. Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures.

  18. Interventional management of intractable sympathetically mediated pain by computed tomography-guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures.

    Science.gov (United States)

    Agarwal-Kozlowski, K; Lorke, D E; Habermann, C R; Schulte am Esch, J; Beck, H

    2011-08-01

    We retrospectively evaluated the safety and efficacy of computed tomography-guided placement of percutaneous catheters in close proximity to the thoracic sympathetic chain by rating pain intensity and systematically reviewing charts and computed tomography scans. Interventions were performed 322 times in 293 patients of mean (SD) age 59.4 (17.0) years, and male to female ratio 105:188, with postherpetic neuralgia (n = 103, 35.1%), various neuralgias (n = 88, 30.0%), complex regional pain syndrome (n = 69, 23.6%), facial pain (n = 17, 5.8%), ischaemic limb pain (n = 7, 2.4%), phantom limb pain (n = 4, 1.4%), pain following cerebrovascular accident (n = 2, 0.7%), syringomyelia (n = 2, 0.7%) and palmar hyperhidrosis (n = 1, 0.3%). The interventions were associated with a total of 23 adverse events (7.1% of all procedures): catheter dislocation (n = 9, 2.8%); increase in pain intensity (n = 8, 2.5%); pneumothorax (n = 3, 0.9%); local infection (n = 2, 0.6%); and puncture of the spinal cord (n = 1, 0.3%). Continuous infusion of 10 ml.h(-1) ropivacaine 0.2% through the catheters decreased median (IQR [range]) pain scores from 8 (6-9 [2-10]) to 2 (1-3 [0-10]) (p < 0.0001). Chemical neuroablation was necessary in 137 patients (46.8%). We conclude that this procedure leads to a significant reduction of pain intensity in otherwise obstinate burning or stabbing pain and is associated with few hazards. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  19. REESTRUTURAÇÃO NO PROJETO EDUCAÇÃO PATRIMONIAL EM ESCOLAS MUNICIPAIS DE SANTA VITÓRIA DO PALMAR, RS – BRASIL

    Directory of Open Access Journals (Sweden)

    Viviane Rocha Teixeira

    2016-12-01

    Full Text Available O presente trabalho surgiu de uma nova análise que foi feita através de observação participante dos membros do grupo PET (Programa de Educação Tutorial Turismo. Identificou-se a necessidade de uma reestruturação no projeto Educação Patrimonial para adequar-se melhor ao perfil das crianças. Assim, como principais resultados, diminuiu-se o número de encontros visando otimizar o tempo e foi realizada algumas modificações como o aumento do tempo de realização de atividades que favorecem a interação entre estudantes. O objetivo deste trabalho é descrever como se efetuou a reestruturação no projeto Educação Patrimonial em escolas municipais de Santa Vitória do Palmar, RS – Brasil. O projeto, que tem como sujeitos crianças do 5º ano, propõem-se a sensibilizá-las e que essas multipliquem os conhecimentos construídos com os adultos (familiares, vizinhos, amigos, entre outros. Acredita-se que pode contribuir, também, em relação ao incremento do turismo histórico-cultural e de lazer na cidade. Para a coleta de dados foi utilizado o método de observação participante e uma pesquisa bibliográfica em trabalhos do próprio Grupo PET. Na análise dos resultados encontra-se a descrição detalhada da reestrputuração do projeto e a justificativa da modificação da estrutura. Palavras-chave: Patrimônio.  Turismo.  Reestruturação.

  20. Estudo comparativo experimental da injeção perineural do álcool benzílico 0,75% e do álcool etílico absoluto nos nervos palmares de eqüinos

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    José Luiz de Mello Nicoletti

    2007-12-01

    Full Text Available The clinical and histopathological effects of two alcoholic neurolytics were studied in horses. Normal horses were shod with a designed shoe adaptted with 5 screws to produce solar pain. After gait and lameness score analysis, the palmar nerve of 5 horses was injected with 5 ml of 0,75% benzyl alcohol (Group A and 5 horses were injected with 5 ml of absolute ethyl alcohol (Group B. The animals were submitted to regular lameness evaluation and solar sensibility tests during next six months. The solar sensitivity returned 5 months latter in the group injected with benzyl alcohol 0,75%, while in the group injected with absolute ethyl alcohol, the sole was still desensitized 6 months latter. The histopathological findings showed that the nerve injected with benzyl alcohol 0,75%, resulted in axonotmesis, characterized by axonal nerve degeneration, with possibilities for the nerve conduction recovery. The perineural injection of ethyl alcohol absolute, resulted in neurotmesis with difficult nerve regeneration. It was concluded that chemical neurolysis with alcohol is an option for temporary or permanent nerve blocks in horses.

  1. Adrenergic factors involved in the control of crypt cell proliferation in jejunum and descending colon of mouse.

    Science.gov (United States)

    Kennedy, M F; Tutton, P J; Barkla, D H

    1983-01-01

    The mitotic rates in the crypts of Lieberkühn of the proximal jejunum and descending colon of mouse, following different treatments, were measured using a stathmokinetic technique. Regression coefficients, representing mitotic rates, were then calculated by the method of least squares. Treatment with adrenaline, isoprenaline, phenylephrine, phentolamine, and yohimbine all resulted in decreased mitotic rate of jejunal and colonic crypt cells. Chemical sympathectomy and cryosympathectomy had a similar effect, and chemical sympathectomy was followed by a supersensitivity to clonidine. Intraperitoneal injection of metaraminol, clonidine, propranolol, prazosin, labetolol and simultaneous injection of propranolol and adrenaline all resulted in an increased rate of crypt cell proliferation in both jejunum and colon. A significant increase in mitotic rate was observed in both tissues at night. The amplitude of this diurnal variation was decreased in both jejunum and colon following chemical sympathectomy. In addition, the amplitude of this variation in jejunum was decreased after treatment with yohimbine or phentolamine. The results of the study suggest that the sympathetic nervous system stimulates epithelial cell proliferation in both the small and large intestine and that this effect is mediated by an alpha 2-adrenoceptor. By contrast, stimulation of alpha 1- and beta-adrenoceptors is inhibitory to cell proliferation in these tissues.

  2. Avaliação do questionário de Boston aplicado no pós-operatório tardio da síndrome do tunel do carpo operados pela técnica de retinaculótomo de paine por via palmar Evaluation of Boston questionnaire applied at late pos-operative period of carpal tunnel syndrome operated with the paine retinaculatome through palmar port

    Directory of Open Access Journals (Sweden)

    Lia Miyamoto Meirelles

    2006-01-01

    Full Text Available Entre os anos de 1995 e 1998, foram realizadas 112 cirurgias para tratamento da Síndrome do Túnel do Carpo (STC pela técnica de incisão palmar e utilização do retináculo de Paine. Com o objetivo de avaliar os resultados em longo prazo, os pacientes foram convocados. Houve o retorno de 44 pacientes. Deste total, três pacientes, por terem doenças associadas, foram excluídos, resultando, um total de 53 mãos analisadas. Apresentaremos os resultados da avaliação subjetiva, obtidos através da aplicação de um teste de auto-avaliação chamado de questionário de Boston. Este questionário consiste em perguntas que avaliam a gravidade dos sintomas e o estado funcional no momento da aplicação do mesmo. Através da aplicação do referido questionário encontramos um escore de 1,41 ± 0,57 para gravidade dos sintomas e 1,59 ± 0,93 para o estado funcional. Como este questionário não foi aplicado no pré-operatório deste grupo de pacientes analisados, comparou-se a pontuação obtida com as encontradas na literatura pertinente. Os resultados obtidos demonstraram que as pontuações pós-operatórias são similares àquelas existentes na literatura, mesmo sendo referidas a tempos diferentes de seguimento pós-operatórios, concluindo que havendo uma melhora dos sintomas, o questionário de Boston é sensível a esta mudança clínica.Between the years of 1995 and 1998, 112 surgeries were performed for treating Carpal Tunnel Syndrome (CTS using the technique of palmar incision employing the Paine retinaculum. With the objective of analyzing results in the long-term, the patients were called for review. Forty four patients returned. From these, three patients were excluded due to associated diseases, thus resulting in a total of 53 hands assessed. Here we present the results of the subjective evaluation achieved by applying a self-assessment test called Boston questionnaire. This questionnaire consists of questions evaluating symptoms

  3. Effects of chemical sympathectomy on the increases in plasma catecholamines and dopamine-beta-hydroxylase induced by forced immobilization and insulin-induced hypoglycemia: origin and fate of plasma dopamine-beta-hydroxylase.

    Science.gov (United States)

    Israel, A S; Barbella, Y R; Cubeddu, L X

    1982-06-01

    The effect of acute stresses on plasma norepinephrine, epinephrine and dopamine-beta-hydroxylase (DBH) were evaluated in control and 6-hydroxydopamine-treated, awake cannulated guinea pigs. Forced immobolization for 1 hr caused a 3- and 5-fold increase in plasma DBH and norepinephrine, respectively. Pretreatment with 6-hydroxydopamine (23 mg/kg b.wt.i.a., 72 and 48 hr before stress) reduced by 70% the increase in plasma DBH and totally prevented the rise in plasma catecholamines evoked by the restraining stress. Injection of insulin (5 U/kg b.wt.i.a.) induced a 60% decrease in blood glucose, a 1-fold increase in plasma DBH and a selective 4-fold increase in plasma epinephrine; these effects were not modified by chemical sympathectomy. Our results indicate that forced immobilization and hypoglycemia produce a preferential activation of the sympathetic postganglionic nerves and of the adrenal medulla, respectively, and that in guinea pigs both stresses increase plasma DBH. The kinetics of disappearance of plasma DBH were studied after subjecting the guinea pigs for 1 hr to forced immobilization. Although 7 of 12 animals showed a biphasic rate of fall of plasma DBH, in each case there was a rapid initial fall possibly due to the "distribution" of the enzyme with a T1/2 of 1.65 hr. Similar findings were observed in 6-hydroxydopamine-treated guinea pigs. These results suggest that the distribution of DBH is the most important process in reducing the augmented plasma DBH levels elicited by a short-term stress and that this process is not dependent on the integrity of the sympathetic nerves nor on the adrenal or sympathetic origin of the enzyme. This study supports the view that the ratio, content of releasable DBH present in sympathetic nerves and adrenal glands/total circulating pool of DBH, is the factor that determines whether an increase in plasma DBH would occur in animals exposed to an acute stress.

  4. Sweaty Feet (Hyperhidrosis)

    Science.gov (United States)

    ... RAC) Information OIG Opioid and Chronic Pain Management OSHA Off-Label Use Physician Payment Sunshine Act (Open ... prescription medications, often anticholinergics, can be used. Severe cases of sweaty feet may be treated with a ...

  5. Fracture heuristics: surgical decision for approaches to distal radius fractures. A surgeon's perspective.

    Science.gov (United States)

    Wichlas, Florian; Tsitsilonis, Serafim; Kopf, Sebastian; Krapohl, Björn Dirk; Manegold, Sebastian

    2017-01-01

    Introduction: The aim of the present study is to develop a heuristic that could replace the surgeon's analysis for the decision on the operative approach of distal radius fractures based on simple fracture characteristics. Patients and methods: Five hundred distal radius fractures operated between 2011 and 2014 were analyzed for the surgeon's decision on the approach used. The 500 distal radius fractures were treated with open reduction and internal fixation through palmar, dorsal, and dorsopalmar approaches with 2.4 mm locking plates or underwent percutaneous fixation. The parameters that should replace the surgeon's analysis were the fractured palmar cortex, and the frontal and the sagittal split of the articular surface of the distal radius. Results: The palmar approach was used for 422 (84.4%) fractures, the dorsal approach for 39 (7.8%), and the combined dorsopalmar approach for 30 (6.0%). Nine (1.8%) fractures were treated percutaneously. The correlation between the fractured palmar cortex and the used palmar approach was moderate (r=0.464; p<0.0001). The correlation between the frontal split and the dorsal approach, including the dorsopalmar approach, was strong (r=0.715; p<0.0001). The sagittal split had only a weak correlation for the dorsal and dorsopalmar approach (r=0.300; p<0.0001). Discussion: The study shows that the surgical decision on the preferred approach is dictated through two simple factors, even in the case of complex fractures. Conclusion: When the palmar cortex is displaced in distal radius fractures, a palmar approach should be used. When there is a displaced frontal split of the articular surface, a dorsal approach should be used. When both are present, a dorsopalmar approach should be used. These two simple parameters could replace the surgeon's analysis for the surgical approach.

  6. Raynaud's phenomenon

    DEFF Research Database (Denmark)

    Nielsen, S L; Christensen, N J; Olsen, N

    1980-01-01

    . The forearm venous concentration of noradrenaline was lower and adrenaline concentration higher in the sympathectomized patients than in the other groups (p less than 0,05). Noradrenaline showed a significant increase during body cooling in normals and primary Raynaud's (p less than 0......The reaction to body and finger cooling was recorded in seven patients with relapse of primary Raynaud's phenomenon after sufficiently performed bilateral upper thoracic sympathectomy and for comparison in eight young women with primary Raynaud's phenomenon as well as in seven normal women......,05). There was no significant correlation between the vasoconstrictor response to cooling of a finger and the noradrenaline concentration probably due to the fact that skin vasoconstriction impeded release of noradrenaline from the skin. The relapse of Raynaud's phenomenon after surgically sufficient sympathectomy could...

  7. Optical coherence tomography, In vivo human hand explorer, optical coherence microscope

    CSIR Research Space (South Africa)

    Jonathan, E

    2008-07-01

    Full Text Available The hand palm is an important human body part primarily for physical manipulation of the environment. For example, palmar hyperhidriotics report a low quality of life due to excessive palmar sweating disrupting normal palm use. As a body part...

  8. DOPA, norepinephrine, and dopamine in rat tissues

    DEFF Research Database (Denmark)

    Eldrup, E; Richter, Erik; Christensen, N J

    1989-01-01

    We studied the effect of unilateral sympathectomy on rat quadriceps and gastrocnemius muscle concentrations of endogenous dihydroxyphenylalanine (DOPA), dopamine (DA), and norepinephrine (NE) and assessed the relationships between these catecholamines in several rat tissues. Catecholamines were...

  9. VALIDASI KLASIFIKASI ANEMIA PADA BALITA DENGAN MELIHAT KEPUCATAN TELAPAK TANGAN

    Directory of Open Access Journals (Sweden)

    Yuslely Usman

    2012-10-01

    Full Text Available Childhood Anemia is a major public health problem in Indonesia. Because of lack of laboratory facilities, most of primary health facilities have to rely on physical signs and not laboratory tests to detect anaemic patients who need therapy. The objective of this study was to assess the validity of palmar pallor as diagnosis of anaemia. This study identified anaemia in primary health center by two physicians and two health workers. The samples were children with illnes (6 months < 60 months who came to primary health center. Each sample was examined by two physicians and two health workers by measuring Hemoglobine concentration using by Cyantmeth method. A total of 123 samples were examined: 65 males (52.8%, 58 females (47.2%, The mean of age was 26 months, whereby the youngest was 6 months and the oldest was 59 months. The mean Haemoglobine level among these children was 10.6 g/dl. The minimum concentration of Hb was 4.7 g/dl and the maximum was 14.6 g/dl. The children who were categorized having some palmar pallor and severe palmar pallor were compared to no pallor for hemoglobin level < 11 g/dl had sensitivity 45.7% by physicians, and 52.85% by health workers, Specificity 73.58% by physicians and 68.84% by health workers, Likelihood ratio (+1.8 by physicians and health workers. Children categorized combination some palmar pallor and no palmar pallor were compared to severe pallor for hemoglobin level < 5 g/dl had sensitivity 100% by physicians and health workers, Spesifisity 95.22% by physicians and 95.49% by health workers, Likelihood ratio (+ 41.45 by physicians and 38.39 by health workers. The inter-rater agreement between the study physician once and the other physician for the detection palmar pallor (severe, some, or none were K =0.49 (moderate. The inter­ rater agreement between the study health worker once and the other health worker for the detection palmar pallor (severe, some, or none were K =0.45 (moderate. The inter

  10. Differential control of collagen synthesis by the sympathetic and renin-angiotensin systems in the rat left ventricle.

    Science.gov (United States)

    Dab, Houcine; Hachani, Rafik; Hodroj, Wassim; Sakly, Mohsen; Bricca, Giampiero; Kacem, Kamel

    2009-12-03

    In the present study, we tested the hypothesis of the indirect (via the sympathetic nervous system (SNS)) and direct (via AT1 receptors) contributions of Angiotensin II (Ang II) on the synthesis of collagen types I and III in the left ventricle (LV) in vivo. Sympathectomy and blockade of the Ang II receptor AT1 were performed alone or in combination in normotensive rats. The mRNA and protein synthesis of collagen types I and III were examined by Q-RT-PCR and immunoblotting in the LV. Collagen types I and III mRNA were decreased respectively by 53% and 22% after sympathectomy and only collagen type I mRNA was increased by 52% after AT1 receptor blockade. mRNA was not changed for collagen type I but was decreased by 25% for collagen type III after double treatment. Only collagen protein type III was decreased after sympathectomy by 12%, but collagen proteins were increased respectively for types I and III by 145% and 52% after AT1 receptor blockade and by 45% and 60% after double treatment. Deducted interpretations from our experimental approach suggest that Ang II stimulates indirectly (via SNS) and inhibits directly (via AT1 receptors) the collagen type I at transcriptional and protein levels. For collagen type III, it stimulates indirectly the transcription and inhibited directly the protein level. Therefore, the Ang II regulates collagen synthesis differently through indirect and direct pathways.

  11. Variations in the nerves of the thumb and index finger.

    Science.gov (United States)

    Wallace, W A; Coupland, R E

    1975-11-01

    The digital nerves to the thumb and index finger have been studied by dissecting twenty-five embalmed upper limbs. The palmar digital nerves to the thumb were constant in position and course, with a short lateral cutaneous branch from the radial palmar digital nerve in 30 per cent of cases. The palmar digital nerves to the index finger had a variable pattern, the commonest arrangement, well described in Gray's Anatomy, occurring in 74 per cent of cases. The variations and their frequency are described. By examining histological cross-sections of the index finger it was found that of about 5,000 endoneurial tubes entering the finger, 60 per cent passed beyond the distal digital crease to supply the pulp and nail bed. The depth of the palmar digital nerves was about 3 millimetres, but less at the digital creases, and their diameter lay between 1 and 1.5 millimetres as far as the distal digital crease. Clinical applications of the findings are discussed.

  12. Multiple Arterial Variations in the Right Upper Limb | Vaseethan ...

    African Journals Online (AJOL)

    Anatomy Journal of Africa ... (6) The SUA coursed superficial to the flexor muscles in the forearm and passed superficial to the flexor retinaculum to form incomplete superficial palmar arch (SPA) (7) The SPA gave off three common palmar digital arteries and a common trunk for radialis indicis and princeps pollicis arteries.

  13. An observer-blinded randomized controlled pilot trial comparing localized immersion psoralen-ultraviolet A with localized narrowband ultraviolet B for the treatment of palmar hand eczema.

    Science.gov (United States)

    Brass, D; Fouweather, T; Stocken, D D; Macdonald, C; Wilkinson, J; Lloyd, J; Farr, P M; Reynolds, N J; Hampton, P J

    2017-12-13

    Hand eczema is a common inflammatory dermatosis that causes significant patient morbidity. Previous studies comparing psoralen-ultraviolet A (PUVA) with narrowband ultraviolet B (NB-UVB) have been small, nonrandomized and retrospective. To conduct an observer-blinded randomized controlled pilot study using validated scoring criteria to compare immersion PUVA with NB-UVB for the treatment of chronic hand eczema unresponsive to topical steroids. Sixty patients with hand eczema unresponsive to clobetasol propionate 0·05% were randomized to receive either immersion PUVA or NB-UVB twice weekly for 12 weeks with assessments at intervals of 4 weeks. The primary outcome measure was the proportion of patients achieving 'clear' or 'almost clear' Physician's Global Assessment (PGA) response at 12 weeks. Secondary outcome measures included assessment of the modified Total Lesion and Symptom Score (mTLSS) and the Dermatology Life Quality index (DLQI). In both treatment arms, 23 patients completed the 12-week assessment for the primary outcome measure. In the PUVA group, five patients achieved 'clear' and eight 'almost clear' [intention-to-treat (ITT) response rate 43%]. In the NB-UVB group, two achieved 'clear' and five 'almost clear' (ITT response rate 23%). For the secondary outcomes, median mTLSS scores were similar between groups at baseline (PUVA 9·5, NB-UVB 9) and at 12 weeks (PUVA 3, NB-UVB 4). Changes in DLQI were similar, with improvements in both groups. In this randomized pilot trial recruitment was challenging. After randomization, there were acceptable levels of compliance and safety in each treatment schedule, but lower levels of retention. Using validated scoring systems - PGA, mTLSS and DLQI - as measures of treatment response, the trial demonstrated that both PUVA and NB-UVB reduced the severity of chronic palmar hand eczema. © 2017 British Association of Dermatologists.

  14. Caput medusae in alcoholic liver disease | Hari Kumar | Nigerian ...

    African Journals Online (AJOL)

    Caput medusae and palmar erythema are cardinal signs in cirrhosis of liver with portal hypertension. Palmar erythema is described more often as a marker for alcoholic etiology of chronic liver disease. The peripheral stigmata of chronic liver disease are not routinely seen now a days due to early diagnosis and better ...

  15. Effect of Interleukin 1b on rat thymus microenvironment

    Directory of Open Access Journals (Sweden)

    M Artico

    2009-12-01

    Full Text Available The effect of interleukin 1b on the thymus of control and chemically sympathectomized adult and aged rats was studied with the aim of assessing the importance of adrenergic nerve fibres (ANF in the regulation of some immunological functions.The whole thymus was removed from normal, sympathectomized (with the neurotoxin 6-OH-dopamine and treated (interleukin 1b rats. Thymic slices were stained with eosin orange (for the recognition of microanatomical details of the thymic microenvironment and with Bodian’s method for staining of nerve fibres. Histofluorescence microscopy was employed for staining ANF and immunofluorescence was used for detecting NPY-like immunoreactivity. All images were submitted to quantitative morphometrical analysis and statistical analysis of data. Moreover, the amount of proteins and noradrenaline was measured on thymic homogenates. The results indicate that in normal conditions the formation of the thymic nerve plexi in the rat is complex: the majority of ANF are destroyed after chemical sympathectomy with 6-OH-dopamine and do not change after treatment with interleukin 1b; on the contrary, treatment with interleukin 1b induces substantial changes in the fresh weight of the thymus, the thymic microenvironment, thymic nerve fibers, ANF, NPY-like positive nerve fibres, and on the total amount of proteins and noradrenaline in rat thymic tissue homogenates.Immunostimulation with interleukin 1b induces substantial changes in the whole thymus, in its microenvironment and in ANF and NPY-like nerve fibres. After chemical sympathectomy, no significant immune response was evoked by interleukin 1b, since the majority of ANF was destroyed by chemical sympathectomy.

  16. Point of Technique

    African Journals Online (AJOL)

    .

    Minimally invasive techniques are becoming popular choice for the recent times. These techniques are lowering the cost and giving the best cosmetic results. For cardiovascular surgery these techniques are much more newer and much more unknown. Open lumbar sympathectomy for certain indications is a very well ...

  17. Differential control of MMP and t-PA/PAI-1 expressions by sympathetic and renin-angiotensin systems in rat left ventricle.

    Science.gov (United States)

    Dab, Houcine; Hachani, Rafik; Hodroj, Wassim; Sakly, Mohsen; Bricca, Giampiero; Kacem, Kamel

    2009-10-05

    In the present study, we tested the hypothesis that angiotensin II (Ang II) has both direct (via AT1 receptors) and indirect (via sympathostimulator pathway) actions on the synthesis and activity of the enzymes involved in the extracellular matrix degradation in vivo. For this purpose, sympathectomy and blockade of the Ang II receptor AT1 were performed alone or in combination in normotensive rats. The mRNA of the plasminogen activator (t-PA) and its inhibitor (PAI-1), the mRNA, protein and activity of the matrix metalloproteinases MMP-2 and MMP-9 were examined by Q-RT-PCR, immunoblotting and zymographic methods in the left ventricle. t-PA and PAI-1 mRNA were decreased after sympathectomy and remained unchanged after AT1 receptors blockade. mRNA was increased for t-PA and decreased by similar degree for PAI-1 after double treatment. MMPs mRNA and protein levels were decreased either after sympathectomy or AT1 receptors blockade and an additive effect was acquired after double treatment. MMPs activity was decreased by similar degree in the three treated groups. Deducted interpretations from our experimental approach suggest that Ang II inhibits directly (via AT1 receptors) and indirectly (via sympathostimulator pathway) t-PA mRNA synthesis. It seems unable to influence directly PAI-1 mRNA, but stimulates indirectly PAI-1 mRNA synthesis. Ang II stimulates directly (via AT1 receptors) and indirectly (via sympathostimulator pathway) MMPs synthesis at both transcriptional and protein levels. The enzymatic activity of MMPs does not seem to be influenced directly by Ang II but it could be stimulated indirectly (via sympathostimulator pathway).

  18. Reliability of radiographic measurements for acute distal radius fractures

    International Nuclear Information System (INIS)

    Watson, Narelle J.; Asadollahi, Saeed; Parrish, Frank; Ridgway, Jacqueline; Tran, Phong; Keating, Jennifer L.

    2016-01-01

    The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal radius fracture. Five observers participated. All were routinely involved in making treatment decisions based on distal radius fracture radiographs. Observers performed independent repeated measurements on 30 radiographs for eight anatomical parameters: dorsal shift (mm), intra-articular gap (mm), intra-articular step (mm), palmar tilt (degrees), radial angle (degrees), radial height (mm), radial shift (mm), ulnar variance (mm). Intraclass correlation coefficients (ICCs) and the magnitude of retest errors were calculated. Measurement reliability was summarised as high (ICC > 0.80), moderate (0.60–0.80) or low (<0.60). Intra-observer reliability was high for dorsal shift and palmar tilt; moderate for radial angle, radial height, ulnar variance and radial shift; and low for intra-articular gap and step. Inter-observer reliability was high for palmar tilt; moderate for dorsal shift, ulnar variance, radial angle and radial height; and low for radial shift, intra-articular gap and step. Error magnitude (95 % confidence interval) was within 1–2 mm for intra-articular gap and step, 2–4 mm for ulnar variance, 4–6 mm for radial shift, dorsal shift and radial height, and 6–8° for radial angle and palmar tilt. Based on previous reports of critical values for palmar tilt, ulnar variance and radial angle, error margins appear small enough for measurements to be useful in guiding treatment decisions. Our findings indicate that clinicians cannot reliably measure values ≤1 mm for intra-articular gap and step when interpreting radiographic parameters using the standardised methods investigated in this study. As a guide for treatment selection, palmar tilt, ulnar variance and radial angle

  19. Acute generalized exanthematous pustulosis caused by morphine, confirmed by positive patch test and lymphocyte transformation test

    NARCIS (Netherlands)

    Kardaun, Sylvia H.; de Monchy, Jan G.

    Morphine, an opium alkaloid, frequently causes side effects such as hyperhidrosis and facial flushing, but serious cutaneous adverse drug reactions are seldom observed. Best known are Urticaria, erythema, and pruritus; sometimes pseudoallergic anaphylactoid reactions, and blisters are reported.

  20. The strength of polyaxial locking interfaces of distal radius plates.

    Science.gov (United States)

    Hoffmeier, Konrad L; Hofmann, Gunther O; Mückley, Thomas

    2009-10-01

    Currently available polyaxial locking plates represent the consequent enhancement of fixed-angle, first-generation locking plates. In contrast to fixed-angle locking plates which are sufficiently investigated, the strength of the new polyaxial locking options has not yet been evaluated biomechanically. This study investigates the mechanical strength of single polyaxial interfaces of different volar radius plates. Single screw-plate interfaces of the implants Palmar 2.7 (Königsee Implantate und Instrumente zur Osteosynthese GmbH, Allendorf, Germany), VariAx (Stryker Leibinger GmbH & Co. KG, Freiburg, Germany) und Viper (Integra LifeSciences Corporation, Plainsboro, NJ, USA) were tested by cantilever bending. The strength of 0 degrees, 10 degrees and 20 degrees screw locking angle was obtained during static and dynamic loading. The Palmar 2.7 interfaces showed greater ultimate strength and fatigue strength than the interfaces of the other implants. The strength of the VariAx interfaces was about 60% of Palmar 2.7 in both, static and dynamic loading. No dynamic testing was applied to the Viper plate because of its low ultimate strength. By static loading, an increase in screw locking angle caused a reduction of strength for the Palmar 2.7 and Viper locking interfaces. No influence was observed for the VariAx locking interfaces. During dynamic loading; angulation had no influence on the locking strength of Palmar 2.7. However, reduction of locking strength with increasing screw angulation was observed for VariAx. The strength of the polyaxial locking interfaces differs remarkably between the examined implants. Depending on the implant an increase of the screw locking angle causes a reduction of ultimate or fatigue strength, but not in all cases a significant impact was observed.

  1. The artery blood supply variant of the upper limb

    Science.gov (United States)

    MASLARSKI, IVAN

    2015-01-01

    Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice. The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery. After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch. PMID:26733754

  2. Avaliação da função manual e da força de preensão palmar máxima em indivíduos com diabetes mellitus Hand function and power grip strength assessment in individuals with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kauê Carvalho de Almeida Lima

    2012-12-01

    Full Text Available O sucesso na realização de atividades manipulativas é crucial para um estilo independente. Como os diabéticos podem apresentar alterações sensoriais nas mãos, podem demonstrar alterações funcionais em tarefas manipulativas. Assim, o objetivo deste estudo foi comparar o desempenho de indivíduos diabéticos não neuropatas com o de não diabéticos em tarefas manipulativas e na capacidade de geração de força de preensão palmar máxima. Treze diabéticos sem diagnóstico de neuropatia (48,6±11,51 anos; 79,9±10,88 kg; 1,68 ±0,09 m e 13 controles pareados por sexo e idade (48,5±10,09 anos; 76,44±11,79 kg; 1,69±0,1 m participaram do estudo. A sensibilidade das mãos foi avaliada por meio do kit de monofilamentos Semmes-Weinstein e, em seguida, foram aplicados três testes comumente utilizados para avaliação da função manual na seguinte ordem: teste de função manual Jebsen Taylor (TFMJT, teste dos nove pinos nos buracos (9-PnB e teste de força de preensão palmar máxima (FPmax. Os resultados do teste de sensibilidade cutânea indicaram que oito diabéticos apresentaram sensibilidade cutânea normal e cinco, alguma alteração sensorial detectável pelo monofilamento, a qual, no entanto, não os caracterizavam como neuropatas. Com relação aos testes funcionais, os resultados não indicaram qualquer diferença entre os grupos para os desempenhos nos três testes realizados (diabéticos e controles - TFMJT: 26,15±3,06 e 25,78±1,29 s; 9-PnB: 15,33±1,35 e 15,48±2,39 s; FPmax: 41,15±10,59 e 43,69±12,59 kgf. Assim, podemos concluir que indivíduos diabéticos sem neuropatia diabética periférica não apresentam qualquer alteração funcional nos membros superiores e na capacidade de gerar força de preensão palmar máxima.A successful object manipulation is crucial for living an independent life. As diabetic individuals could present sensory deficits in their hands, they could decrease functional performance in tasks

  3. Alexandria Journal of Medicine - Vol 47, No 3 (2011)

    African Journals Online (AJOL)

    Management of essential hyperhidrosis of upper limbs by radiofrequency thermocoagulation of second thoracic ganglion · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. W Fouad. http://dx.doi.org/10.1016/j.ajme.2011.07.006 ...

  4. Growth hormone deficiency and hyperthermia during exercise

    DEFF Research Database (Denmark)

    Juul, A; Hjortskov, N; Jepsen, Leif

    1995-01-01

    Sweat secretion is often disturbed in patients with GH secretory disorders. Hyperhidrosis is a classic feature of acromegaly, and it has recently been shown that GH-deficient patients exhibit decreased sweating capacity after pilocarpine stimulation of the skin. Thus, patients with GH-deficiency ...

  5. Acroqueratodermia aquagénica associada a uma mutação do gene da fibrose quística

    Directory of Open Access Journals (Sweden)

    V. Coelho-Macias

    2013-05-01

    Full Text Available Resumo: Descrita em 1996, a acroqueratodermia aquagénica é uma entidade rara, caracterizada pelo aparecimento de pápulas edematosas palmares após contacto com água. Múltiplas associações foram enumeradas mas, recentemente, a associação a mutações do gene da fibrose quística foi demonstrada.Descreve-se o caso de uma mulher de 18 anos, saudável, com prurido e edema palmar após imersão em água. O exame objetivo inicial não mostrava alterações mas, 5 min após imersão em água, observavam-se múltiplas pápulas esbranquiçadas palmares. O estudo do gene da fibrose quística (CFTR revelou uma mutação F508del num dos alelos. A doente negava outras queixas ou história familiar relevante.A acroqueratodermia aquagénica é uma entidade provavelmente subdiagnosticada que poderá constituir uma manifestação de mutações do gene CFTR, o que possibilitaria a identificação de portadores e aconselhamento genético. Abstract: Reported for the first time in 1996, aquagenic keratoderma is a rare condition which is characterized by edematous flat-topped papules appearing on palmar skin after water immersion. Multiple anecdotal associations have been described but, recently, the association with cystic fibrosis gene mutations (CFTR has been highlighted.The authors describe an 18 year-old female, with one-month complaints of pruritus and swelling of palmar skin after water immersion. On examination, palmar skin was unremarkable but, 5 minutes after water immersion, multiple whitish papules became apparent. CFTR genotype study showed a F508del mutation in one alelle. She had no other symptoms and no relevant family history.Aquagenic keratoderma is probably an under-diagnosed entity that might represent a manifestation of CFTR mutations, making carrier state identification and genetic counseling possible. Palavras-chave: Acroqueratodermia aquagénica, Fibrose quística, Aconselhamento genético, Keywords: Aquagenic keratoderma, Cystic

  6. Aquagenic keratoderma associated with a mutation of the cystic fibrosis gene

    Directory of Open Access Journals (Sweden)

    V. Coelho-Macias

    2013-05-01

    Full Text Available Reported for the first time in 1996, aquagenic keratoderma is a rare condition which is characterized by edematous flat-topped papules appearing on palmar skin after water immersion. Multiple anecdotal associations have been described but, recently, the association with cystic fibrosis gene mutations (CFTR has been highlighted.The authors describe an 18-year-old female, with one-month complaints of pruritus and swelling of palmar skin after water immersion. On examination, palmar skin was unremarkable but, 5 min after water immersion, multiple whitish papules became apparent. CFTR genotype study showed a F508del mutation in one allele (nonhomozygous. She had no other symptoms and no relevant family history.Aquagenic keratoderma is probably an under-diagnosed entity that might represent a manifestation of CFTR mutations, making carrier state identification and genetic counseling possible. Resumo: Descrita em 1996, a acroqueratodermia aquagénica é uma entidade rara, caracterizada pelo aparecimento de pápulas edematosas palmares após contacto com água. Múltiplas associações foram enumeradas mas, recentemente, a associação a mutações do gene da fibrose quística foi demonstrada.Descreve-se o caso de uma mulher de 18 anos, saudável, com prurido e edema palmar após imersão em água. O exame objetivo inicial não mostrava alterações mas, 5 min após imersão em água, observavam-se múltiplas pápulas esbranquiçadas palmares. O estudo do gene da fibrose quística (CFTR revelou uma mutação F508del num dos alelos. A doente negava outras queixas ou história familiar relevante.A acroqueratodermia aquagénica é uma entidade provavelmente subdiagnosticada que poderá constituir uma manifestação de mutações do gene CFTR, o que possibilitaria a identificação de portadores e aconselhamento genético. Keywords: Aquagenic keratoderma, Cystic fibrosis, Genetic counseling, Palavras-chave: Acroqueratodermia aquagénica, Fibrose qu

  7. Discussion: Reconstruction of Fingertip Amputation: Necrosis Is Expected

    OpenAIRE

    Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam; Ki, Sae Hwi

    2012-01-01

    Background First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation ...

  8. Acute Effects of Tai Chi Training on Cognitive and Cardiovascular Responses in Late Middle-Aged Adults: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Tiffany C. Y. Cheung

    2018-01-01

    Full Text Available This study explored the immediate effects of Tai Chi (TC training on attention and meditation, perceived stress level, heart rate, oxygen saturation level in blood, and palmar skin temperature in late middle-aged adults. Twenty TC practitioners and 20 nonpractitioners volunteered to join the study. After baseline measurements were taken, the TC group performed TC for 10 minutes while their cognitive states and cardiovascular responses were concurrently monitored. The control group rested for the same duration in a standing position. Both groups were then reassessed. The participants’ attention and meditation levels were measured using electroencephalography; stress levels were measured using Perceived Stress Scale; heart rate and blood oxygenation were measured using an oximeter; and palmar skin temperature was measured using an infrared thermometer. Attention level tended to increase during TC and dropped immediately thereafter (p<0.001. Perceived stress level decreased from baseline to posttest in exclusively the TC group (p=0.005. Heart rate increased during TC (p<0.001 and decreased thereafter (p=0.001. No significant group, time, or group-by-time interaction effects were found in the meditation level, palmar skin temperature, and blood oxygenation outcomes. While a 10-minute TC training could temporarily improve attention and decrease perceived stress levels, it could not improve meditation, palmar skin temperature, or blood oxygenation among late middle-aged adults.

  9. Aquagenic keratoderma. Two new case reports and a new hypothesis

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2014-01-01

    Full Text Available Aquagenic keratoderma has been described as a transient condition affecting predominantly young females and defined clinically by the appearance of palmar hyper-wrinkling accentuated after immersion in water. We present two new cases with aquagenic palmoplantar acrokeratoderma - a child and a young male. A significant clinical improvement was achieved after topical treatment with aluminum salts. Aquagenic palmar keratoderma may be a clue to cystic fibrosis in adolescents and young adults. We developed a new hypothesis on its pathogenesis.

  10. Propantheline bromide is effective against dog drooling

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Thyssen, Jacob P

    2015-01-01

    Hyperhidrosis is a common condition characterized by extensive sweat secretion. Systemic treatment with anticholinergics might prove effective, but patients often suffer from side effects, e.g. dryness of the mouth. We present a clinical case of severe polydipsia in a six-month-old puppy who had ...

  11. [Kinematics of the triangular fibrocartilage complex during forearm rotation in vivo].

    Science.gov (United States)

    Xu, Jing; Tang, Jin-bo; Jia, Zhong-zheng; Xie, Ren-guo

    2009-11-01

    To investigate three-dimensional kinematics of the superficial and deep portion of triangular fibrocartilage complex (TFCC) in different parts of the forearm rotation. Six wrists of 6 volunteers were used to obtain CT scans at different positions of the wrist. The wrists were scanned from 90 degrees of pronation to 90 degrees of supination at an interval of 30 degrees. The 3-dimensional radius and ulna were reconstructed with customized software and changes in length of the superficial and deep portion of TFCC during forearm rotation. In forearm pronation, the superficial dorsal portion and the deep palmar portion of the TFCC were tight. While the superficial palmar portion and the deep dorsal potion of the TFCC were lax. In supination, the changes in length of all these fibers were reverse. In forearm rotation one portion fibers of dorsal TFCC and one portion fibers of palmar TFCC are tight, and this mechanism controls stability during DRUJ rotation.

  12. Acute Effects of Tai Chi Training on Cognitive and Cardiovascular Responses in Late Middle-Aged Adults: A Pilot Study.

    Science.gov (United States)

    Cheung, Tiffany C Y; Liu, Karen P Y; Wong, Janet Y H; Bae, Young-Hyeon; Hui, Stanley Sai-Chuen; Tsang, William W N; Cheng, Yoyo T Y; Fong, Shirley S M

    2018-01-01

    This study explored the immediate effects of Tai Chi (TC) training on attention and meditation, perceived stress level, heart rate, oxygen saturation level in blood, and palmar skin temperature in late middle-aged adults. Twenty TC practitioners and 20 nonpractitioners volunteered to join the study. After baseline measurements were taken, the TC group performed TC for 10 minutes while their cognitive states and cardiovascular responses were concurrently monitored. The control group rested for the same duration in a standing position. Both groups were then reassessed. The participants' attention and meditation levels were measured using electroencephalography; stress levels were measured using Perceived Stress Scale; heart rate and blood oxygenation were measured using an oximeter; and palmar skin temperature was measured using an infrared thermometer. Attention level tended to increase during TC and dropped immediately thereafter ( p training could temporarily improve attention and decrease perceived stress levels, it could not improve meditation, palmar skin temperature, or blood oxygenation among late middle-aged adults.

  13. Anterior fracture displacement in Colles’ fractures after Kapandji wiring in women over 59 years

    Science.gov (United States)

    Verdonk, René

    2006-01-01

    The aim of this study was to assess the radiological results of Colles’ fractures treated with Kapandji wiring and to determine the frequency of postoperative anterior fracture displacement. The X-rays of 89 fractures in women over 59 years of age were evaluated. Five weeks after injury, palmar shift of the distal fracture fragments and/or palmar tilt of more than 20° were observed in 26 patients. In ten wrists dorsal tilt was not sufficiently corrected and measured more than 10°. Increase in ulnar variance was more than 2 mm in 37 wrists and more than 5 mm in six wrists; this was more pronounced when the palmar tilt was not corrected properly or when anterior fracture displacement was present. We conclude that Kapandji wiring may not be able to prevent anterior fracture displacement in almost one-third of Colles’ fractures in osteoporotic elderly patients. PMID:16865364

  14. Bilateral Symmetry of Distortions of Tactile Size Perception.

    Science.gov (United States)

    Longo, Matthew R; Ghosh, Arko; Yahya, Tasneem

    2015-01-01

    The perceived distance between touches on the limbs is generally bigger for distances oriented across the width of the limb than for distances oriented along the length of the limb. The present study aimed to investigate the coherence of such distortions of tactile size perception across different skin surfaces. We investigated distortions of tactile size perception on the dorsal and palmar surfaces of both the left and right hands as well as the forehead. Participants judged which of two tactile distances felt larger. One distance was aligned with the proximodistal axis (along the body), the other with the mediolateral axis (across the body). Clear distortions were found on all five skin surfaces, with stimuli oriented across the width of the body being perceived as farther apart than those oriented along the length of the body. Consistent with previous results, distortions were smaller on the palmar than on the dorsal hand surface. Distortion on the forehead was intermediate between the dorsal and palmar surfaces. There were clear correlations between distortion on the left and right hands, for both the dorsal and palmar skin surfaces. In contrast, within each hand, there was no significant correlation between the two skin surfaces. Distortion on the forehead was not significantly correlated with that on any of the other skin surfaces. These results provide evidence for bilaterally symmetric representations underlying tactile size perception. © The Author(s) 2015.

  15. Interaction between sympathetic nervous system and renin angiotensin system on MMPs expression in juvenile rat aorta.

    Science.gov (United States)

    Dab, Houcine; Hachani, Rafik; Hodroj, Wassim; Sakly, Mohsen; Bricca, Giampiero; Kacem, Kamel

    2011-09-01

    The aim of our present study is to investigate the interaction between angiotensin II (ANG II) and sympathetic nervous system (SNS) on matrix metalloproteinase MMP-2 and MMP-9 expression and activity in juvenile rat aorta under normal conditions. Sympathectomy with guanethidine and blockade of the ANG II receptors (AT1R) by losartan were performed alone or in combination on new-born rats. mRNA, protein expression and activity of MMP-2 and MMP-9 were examined by Q-RT-PCR, immunoblotting and zymography, respectively. MMP-2 mRNA and protein amount were decreased after sympathectomy or AT1R blockade and an additive effect was observed after combined treatment. However, MMP-9 expression was reduced to the same level in the three treated groups. There were some detectable gelatinolytic activity of the MMPs in both control and treated rats. We concluded that ANG II stimulates directly and indirectly (via sympathostimulator pathway) the MMP-2 expression but seems unable to affect MMP-9 expression through direct pathway. Combined inhibition of SNS and ANG II were more efficient than a single inhibition in reducing MMP amounts in rat vessels.

  16. Radiography of syndactylous limbs of cattle

    International Nuclear Information System (INIS)

    Taura, Y.; Takeuchi, A.; Uchino, T.

    1985-01-01

    Fore and hind limbs of 4-month-old Holstein-Friesian cattle ♀ (No.I) and those of 1-month-old Holstein-Friesian×Japanese Black cattle ♀ (No.II) suffering from syndactyly were dissected by means of radiographic examinations. The details were reported as follows. 1. The phalanges of both fore and left hind limbs of No.II cattle were completely fused. But, all the phalanges of left fore limb and proximal phalanges of right fore limb in No.I and the distal phalanges of right hind limb in No.II were normal, the others being of partial synostosis. 2. The distal parforating canal was absent in the metacarpus and the right metatarsus in No.II cattle. Also, in No.II on the distal part of the metacarpal or metatarsal, bone vestiges were noted, not only of the fifth and second metacarpus or metatarsus, but also the mutually jointed phalanges. 3. In No.I cattle, the left fore limb and 4 proximal sesamoid bones and 2 distal sesamoid bones, but the right limb had 4 sesamoid bones and 0 distal one. In No.II cattle, the fore limbs had 2 proximal and 0 distal sesamoid bones, left hind limb had 3 proximal and 0 distal ones, right hind limb had 3 proximal and 1 distal ones. 4. The arteries accommodated the syndactylous deformities. The median and radial arteries were fixed to be descended on to the palmar side of the metacarpus and mutually anastomosed to form a deep palmar arch. arising from the deep palmar arch, two branches (palmar proper digital aa. III and IV) were terminated by the lateral and medial palmar surfaces of the digit, where some anastomosing arches were formed by them. The arteries of the hind limbs were also similar to those of the fore limbs. 5. In radiographic examinations of syndactyly (in No.II) after 7-month feeding, hoof and digital bones were noted to have been developed, but distal phalanges were destructed and left in suspicion of bad prognosis

  17. [Comparative study on the strength of different mechanisms of operation of multidirectionally angle-stable distal radius plates].

    Science.gov (United States)

    Rausch, S; Hoffmeier, K; Gueorguiev, B G; Klos, K; Gras, F; Hofmann, G O; Mückley, T

    2011-12-01

    Polyaxial angle-stable plating is thought to be particularly beneficial in the management of complex intra-articular fractures of the distal radius. The present study was performed to investigate the strength of polyaxial locking interfaces of distal radius plates. We tested the polyaxial interfaces of 3 different distal radius plates (2.4 mm Variable Angle LCP Two-Column Volar Distal Radius Plate, Synthes, Palmar Classic, Königsee Implantate and VariAx Plate Stryker). The strength of 0° and 10° screw locking angle was obtained during static loading. The strength of Palmar Classic with a 0° locking angle is significantly the best of all tested systems. With a 10° locking angle there is no significant difference between Palmar Classic, Two column Plate and VariAx Plate. The strength of polyaxial interfaces differs between the tested systems. A reduction of ultimate strength is due to increases of screw locking angle. The design of polyaxial locking interfaces should be investigated in human bone models. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Ganglion block. When and how?; Ganglienblockade. Wann und wie?

    Energy Technology Data Exchange (ETDEWEB)

    Bale, R. [Medizinische Universitaet Innsbruck, Sektion fuer Mikroinvasive Therapie Universitaetsklinik fuer Radiologie, Innsbruck (Austria)

    2015-10-15

    Increasing understanding of the anatomy and physiology of neural structures has led to the development of surgical and percutaneous neurodestructive methods in order to target and destroy various components of afferent nociceptive pathways. The dorsal root ganglia and in particular the ganglia of the autonomous nervous system are targets for radiological interventions. The autonomous nervous system is responsible for the regulation of organ functions, sweating, visceral and blood vessel-associated pain. Ganglia of the sympathetic chain and non-myelinized autonomous nerves can be irreversibly destroyed by chemical and thermal ablation. Computed tomography (CT)-guided sympathetic nerve blocks are well established interventional radiological procedures which lead to vasodilatation, reduction of sweating and reduction of pain associated with the autonomous nervous system. Sympathetic blocks are applied for the treatment of various vascular diseases including critical limb ischemia. Other indications for thoracic and lumbar sympathectomy include complex regional pain syndrome (CRPS), chronic tumor associated pain and hyperhidrosis. Neurolysis of the celiac plexus is an effective palliative pain treatment particularly in patients suffering from pancreatic cancer. Percutaneous dorsal root ganglion rhizotomy can be performed in selected patients with radicular pain that is resistant to conventional pharmacological and interventional treatment. (orig.) [German] Anatomische und physiologische Kenntnisse ueber die Funktion von Schmerzbahnen fuehrten zur Entwicklung chirurgischer und perkutaner destruktiver Verfahren, um einzelne Komponenten afferenter Schmerzbahnen anzusteuern bzw. auszuschalten. Neben anderen nervalen Strukturen gelten Hinterstrangganglien und insbesondere die Ganglien des autonomen Nervensystems als Ziele fuer radiologische Interventionen. Das vegetative Nervensystem ist fuer die Organfunktion durch Regulation des Gefaesstonus und fuer die Leitung

  19. Carpal tunnel syndrome in the elderly: nerve conduction parameters Síndrome do túnel do carpo em idosos: parâmetros de condução nervosa

    Directory of Open Access Journals (Sweden)

    Thiago Guimarães Naves

    2010-02-01

    Full Text Available OBJECTIVE: To establish nerve conduction parameters for carpal tunnel syndrome (CTS electrodiagnosis in the elderly. METHOD: Thirty healthy subjects (65-86 years, 9 male and 21 female, were studied. Routine median and ulnar sensory and motor nerve conduction studies, median mixed palmar latency, comparative latency techniques median to ulnar (sensory, mixed and motor lumbrical-interossei, median to radial (sensory, and combined sensory index (CSI were performed in both hands. RESULTS: The upper limits of normality (97.5% were: median sensory distal latency 3.80 ms (14 cm; median motor distal latency 4.30 ms (8 cm; median palmar latency 2.45 ms (8 cm; lumbrical-interossei latency difference 0.60 ms (8 cm; comparative median to radial 0.95 ms (10 cm; comparative median to ulnar 0.95 ms (14 cm; comparative palmar median to ulnar 0.50 ms (8 cm; and CSI 2.20 ms. Sensory and mixed latencies were measured at peak. CONCLUSION: Our results establish new nerve conduction parameters for mild CTS electrodiagnosis in the elderly and will be helpful to reduce the number of false positive cases in this age.OBJETIVO: Estabelecer parâmetros de condução nervosa para o eletrodiagnóstico da síndrome do túnel do carpo (STC em idosos. MÉTODO: Foram estudadas 30 pessoas idosas (65-86 anos saudáveis. Foi realizado estudo de condução nervosa sensitiva e motora rotineira dos nervos mediano e ulnar, latência palmar mista do mediano, técnicas de comparação de latências mediano-ulnar (sensitivo, misto e motor lumbrical-interósseo e mediano-radial (sensitivo e índice sensitivo combinado (ISC em ambas as mãos. RESULTADOS: Os limites superiores de normalidade, 97,5% foram: latência distal sensitiva do mediano 3,80 ms (14 cm; latência distal motora do mediano 4,30 ms (8 cm, latência palmar do mediano 2,45 ms (8 cm, diferença de latência lumbrical-interósseo 0,60 ms (8 cm, comparação mediano-radial 0,95 ms (10 cm, comparação mediano-ulnar 0,95 ms (14

  20. Does Ondansetron Modify Sympathectomy Due to Subarachnoid Anesthesia?

    DEFF Research Database (Denmark)

    Terkawi, Abdullah S; Mavridis, Dimitris; Flood, Pamela

    2016-01-01

    to the overall quality and statistical power of the meta-analyses. METHODS: The authors used a standard and a newer method of meta-analysis, trial sequential analysis (TSA), to estimate adjusted CIs based on how much information has been accrued. They also used random-effects meta-analyses techniques, small...... randomized placebo-controlled trials (1,045 subjects) were identified and analyzed. By using conventional meta-analyses, the authors determined that ondansetron was associated with reduction in the incidence of hypotension (relative risk = 0.62 [95% CI, 0.46 to 0.83], P = 0.001; TSA-adjusted CI, 0.34 to 1.......12; I = 60%, P = 0.002) and bradycardia (relative risk = 0.44 [95% CI, 0.26 to 0.73], P = 0.001; TSA-adjusted CI, 0.05 to 3.85; I = 0%, P = 0.84). However, the authors found indications of bias among these trials. TSAs demonstrated that the meta-analysis lacked adequate information size and did...

  1. Dermatoglyphs and brachial plexus palsy.

    Science.gov (United States)

    Polovina, Svetislav; Cvjeticanin, Miljenko; Milicić, Jasna; Proloscić, Tajana Polovina

    2006-09-01

    Perinatal brachial plexus palsy (PBPP) is a handicap quite commonly encountered in daily routine. Although birth trauma is considered to be the major cause of the defect, it has been observed that PBPP occurs only in some infants born under identical or nearly identical conditions. The aim of this study was to test the hypothesis of genetic predisposition for PBPP. It is well known that digito-palmar dermatoglyphs can be used to determine hereditary roots of some diseases. Thus, we found it meaningful to do a study analysis of digito-palmar dermatoglyphs in this disease as well, conducting it on 140 subjects (70 males and 70 females) diagnosed with PBPP. The control group was composed of fingerprints obtained from 400 adult and phenotypically healthy subjects (200 males and 200 females) from the Zagreb area. The results of multivariate and univariate analysis of variance have shown statistically significant differences between the groups observed. In spite of lower percentage of accurately classified female subjects by discriminant analysis, the results of quantitative analysis of digito-palmar dermatoglyphs appeared to suggest a genetic predisposition for the occurrence of PBPP.

  2. Structural variation of the distal condyles of the third metacarpal and third metatarsal bones in the horse

    International Nuclear Information System (INIS)

    Riggs, C.M.; Whitehouse, G.H.; Boyde, A.

    1999-01-01

    This study examined 3-dimensional (3D) distribution of sectors with contrasting density in the equine third metacarpal (McIII) and third metatarsal (MtIII) bones with a view to explaining the aetiology of distal condylar fractures. Macroradiography and computed tomographic (CT) imaging were used in the nondestructive study of bones obtained from horses, most of which were Thoroughbreds in race training. Distal condylar regions of McIII and MtIII were also studied in microradiographs of 100 mu m thick mediolateral sections cut perpendicular to the dorsal and palmar/plantar articular surfaces. Qualitative and quantitative results from all methods used (radiography, CTand microradiographic stereology) demonstrated densification (sclerosis) of subchondral bone located in the palmar/plantar regions of the medial and lateral condyles of both McIII and MtIII, Substantial density gradients between the denser condyles and the subchondral bone of the sagittal groove were shown to equate with anatomical differences in loading intensity during locomotion. It is hypothesised that such differences in bone density results in stress concentration at the palmar/plantar aspect of the condylar grooves, which may predispose to fracture

  3. Didatic approach of ultrasonographic examination for evaluation of the carpal joint in horses

    Directory of Open Access Journals (Sweden)

    Maria Cristina Ferrarini Nunes Soares Hage

    2017-11-01

    Full Text Available ABSTRACT: The carpus is a complex articulation, which is often involved in injuries in equine athletes. The objective of this study was to suggest a didactic approach for ultrasonography training for the examination of the carpal joint in horses. Ultrasonograhy examination was performed in a healthy 14-year-old horse. The images were compared with those of a dissected anatomic specimen of the carpal region of a senior horse and with those reported in the literature. Identifiable structures were as follows: (dorsal tendon of the muscle extensor carpi radialis, tendon of the muscle extensor carpi obliquus, tendon of the muscle commom digital extensor, dorsal synovial outpouchings, joint capsule and fat cushion, (lateral tendon of the muscle lateral digital extensor, lateral collateral ligament (deep and superficial components, (medial medial collateral ligament (deep and superficial components and (palmar palmar intercarpal ligament, carpal sheath, carpal tunnel, superficial digital flexor tendon, proximal origin of the deep digital flexor tendon, and palmar carpal ligament. Prior knowledge of the anatomy in combination with the study of anatomical specimens is essential for recognizing musculoskeletal structures during ultrasound examination, contributing to the training and learning processes.

  4. Development of emotional sweating in the newborn infant.

    Science.gov (United States)

    Harpin, V A; Rutter, N

    1982-09-01

    Sweating from the palm and sole occurs independently of ambient temperature but is influenced by emotional factors. It thus provides a useful objective measure of emotional state. The development of this emotional sweating in the newborn was investigated by measuring palmar water loss and relating it to the infant's state of arousal. Although 433 individual measurements were made on 124 babies of gestational age 25 to 41 weeks and postnatal age 15 hours to 9 weeks. Palmar water loss was also recorded continuously in 22 infants undergoing heel prick for routine blood sampling. In babies of 37 weeks' gestation or more, there was a clear relationship between palmar water loss and arousal from the day of birth, and by the third week levels on vigorous crying were comparable with those of an anxious adult. Less mature babies did not show emotional sweating at birth; it was first seen at the equivalent of 36 to 37 weeks' gestation regardless of maturity. Continuous recordings confirmed the cross-sectional data and illustrated the abrupt nature of the response. Emotional sweating could be a useful tool for the assessment of emotional state of the newborn.

  5. The deep lymphatic anatomy of the hand.

    Science.gov (United States)

    Ma, Chuan-Xiang; Pan, Wei-Ren; Liu, Zhi-An; Zeng, Fan-Qiang; Qiu, Zhi-Qiang

    2018-04-03

    The deep lymphatic anatomy of the hand still remains the least described in medical literature. Eight hands were harvested from four nonembalmed human cadavers amputated above the wrist. A small amount of 6% hydrogen peroxide was employed to detect the lymphatic vessels around the superficial and deep palmar vascular arches, in webs from the index to little fingers, the thenar and hypothenar areas. A 30-gauge needle was inserted into the vessels and injected with a barium sulphate compound. Each specimen was dissected, photographed and radiographed to demonstrate deep lymphatic distribution of the hand. Five groups of deep collecting lymph vessels were found in the hand: superficial palmar arch lymph vessel (SPALV); deep palmar arch lymph vessel (DPALV); thenar lymph vessel (TLV); hypothenar lymph vessel (HTLV); deep finger web lymph vessel (DFWLV). Each group of vessels drained in different directions first, then all turned and ran towards the wrist in different layers. The deep lymphatic drainage of the hand has been presented. The results will provide an anatomical basis for clinical management, educational reference and scientific research. Copyright © 2018 Elsevier GmbH. All rights reserved.

  6. Palmar Dermatoglyphs of South Mrican Indians

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... Interracial Comparisons. Indian males had a significantly higher (O,OOS>P>. 0,001) number of thenar features than had Black males, although, taken separately, the right and left hands were not significantly different. There was no such discrepancy between Indian and Coloured males, and there were no.

  7. Asymptomatic loss of intraepidermal nerve fibers with preserved thermal detection thresholds after repeated exposure to severe cold

    DEFF Research Database (Denmark)

    Krøigård, Thomas; Wirenfeldt, Martin; Svendsen, Toke K.

    2018-01-01

    Background: Cold-induced peripheral neuropathy has been described in individuals exposed to severe cold resulting in pain, hypersensitivity to cold, hyperhidrosis, numbness, and skin changes. Nerve conduction studies and thermal detection thresholds are abnormal in symptomatic patients......-induced peripheral neuropathy may be prevalent in subjects living in or near polar regions which could have implications for the recruitment of healthy subjects....

  8. Angiografia in vivo para avaliação da vascularização do casco de eqüinos In vivo angiography for evaluation of equine foot vasculature

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Maciel Brunner

    2008-02-01

    Full Text Available A proposta deste trabalho foi estabelecer a angiografia digital palmar como método de avaliação qualitativa in vivo da vascularização distal laminar em eqüinos em posição quadrupedal. Foram realizadas 15 angiografias de eqüinos mestiços, sendo seis machos castrados e nove fêmeas, com idade variando entre seis e oito anos. As angiografias foram realizadas, após bloqueio anestésico perineural do nervo digital palmar lateral ou medial, por meio da aplicação de 20mL de contraste na veia digital palmar lateral ou medial garroteada por atadura elástica e torniquete. Imediatamente depois, foi realizada a primeira exposição radiológica em incidência dorso-palmar. Após a dispersão do contraste, o mesmo procedimento foi realizado com o casco submetido ao tratamento térmico com água aquecida e com água resfriada. Em quatro animais, obteve-se imagem radiopaca, com bordas maldefinidas, de aspecto sombreado, ao redor de cada lâmina dérmica, que foi creditada à vasodilatação ocasionada pelo calor. Quando da vasoconstrição ocasionada pelo tratamento com frio, observou-se redução da imagem radiopaca laminar. Esse aspecto pôde ser comprovado em quatro radiografias, porém não se repetiu em todas as angiografias realizadas. Em sete radiografias, houve falha de preenchimento de contraste, o que inviabilizou a comparação entre tratamentos térmicos, sendo que as radiografias realizadas sem nenhum tratamento térmico possuíam preenchimento de contraste adequado. A angiografia digital em eqüinos mostrou-se um método sensível para evidenciar vasoconstrição e vasodilatação in vivo dentro do estojo córneo, porém inúmeros fatores podem contribuir para o aparecimento de artefatos de técnica, o que inviabiliza a comparação de alterações da perfusão laminar do casco por esse método.This study was aimed at establishing the palmar digital angiography as an in vivo qualitative method of evaluation the laminar digital

  9. Botulinum toxin

    Directory of Open Access Journals (Sweden)

    Nigam P

    2010-01-01

    Full Text Available Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C 1 , C 2 , D, E, F and G. All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about three months. Botulinum toxins now play a very significant role in the management of a wide variety of medical conditions, especially strabismus and focal dystonias, hemifacial spasm, and various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond only partially to medical treatment. The list of possible new indications is rapidly expanding. The cosmetological applications include correction of lines, creases and wrinkling all over the face, chin, neck, and chest to dermatological applications such as hyperhidrosis. Injections with botulinum toxin are generally well tolerated and side effects are few. A precise knowledge and understanding of the functional anatomy of the mimetic muscles is absolutely necessary to correctly use botulinum toxins in clinical practice.

  10. Clinico epidemiological study of pitted keratolysis

    Directory of Open Access Journals (Sweden)

    Naik Chandra

    2007-01-01

    Full Text Available Background: Pitted keratolysis is a common dermatological condition. However, very few studies are available on the clinical characteristics and epidemiological features of this disorder from India and abroad. Materials and Methods: Fifty patients from rural area of Kolar at Sri R.L.J.H. and S.N.R. Hospital, presenting with clinically distinctive lesions of pitted keratolysis were included in the study. Cases were interviewed with particular emphasis on triggering factors and findings were recorded. Investigations like Gram′s stain, culture studies, Wood′s ultraviolet light examination, histopathology etc, was done in selected cases to ascertain the clinical diagnosis. Results: Age of the patients varied from 20 to 40 years in 52% with male preponderance in 82% of cases. Duration of the disease varied from 15 days to five years, most of the patients were bare-footed farmers (62% of cases. Hyperhidrosis and pruritus were most frequently observed symptoms in 70% and 60% of patients. Most of the patients presented with the characteristic pits which varied from 1 to 50 in number in 56 % of cases, located predominantly on the pressure bearing areas in 92% of cases and depth of the pits varied from 1 to 2 mm in 60% of cases. Associated skin conditions recorded in present study were fissuring of soles in 38%, psoriasis 10%, dermatophyte infections in 6%, planter warts 6% and Corynebacterial triad and corn in 2% of patients each. Discussion: Affection of bare-footed individuals, male preponderance, presence of hyperhidrosis and occurrence of lesions over pressure bearing areas of soles, observed in the present study were consistent with earlier studies on the subject. However, pruritus as commonest presenting symptom reported by 60% patients in the present study, has not been documented in the previous studies. Conclusion: Pitted keratolysis is fairly common in bare footed male farmers of rural India. The condition is predominantly seen over the

  11. Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures.

    Science.gov (United States)

    Han, L R; Jin, C X; Yan, J; Han, S Z; He, X B; Yang, X F

    2015-03-31

    This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. In conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

  12. Concept and Design of a 3D Printed Support to Assist Hand Scanning for the Realization of Customized Orthosis.

    Science.gov (United States)

    Baronio, Gabriele; Volonghi, Paola; Signoroni, Alberto

    2017-01-01

    In the rehabilitation field, the use of additive manufacturing techniques to realize customized orthoses is increasingly widespread. Obtaining a 3D model for the 3D printing phase can be done following different methodologies. We consider the creation of personalized upper limb orthoses, also including fingers, starting from the acquisition of the hand geometry through accurate 3D scanning. However, hand scanning procedure presents differences between healthy subjects and patients affected by pathologies that compromise upper limb functionality. In this work, we present the concept and design of a 3D printed support to assist hand scanning of such patients. The device, realized with FDM additive manufacturing techniques in ABS material, allows palmar acquisitions, and its design and test are motivated by the following needs: (1) immobilizing the hand of patients during the palmar scanning to reduce involuntary movements affecting the scanning quality and (2) keeping hands open and in a correct position, especially to contrast the high degree of hypertonicity of spastic subjects. The resulting device can be used indifferently for the right and the left hand; it is provided in four-dimensional sizes and may be also suitable as a palmar support for the acquisition of the dorsal side of the hand.

  13. Dupuytren’s and Ledderhose Diseases in a Family with LMNA-Related Cardiomyopathy and a Novel Variant in the ASTE1 Gene

    Directory of Open Access Journals (Sweden)

    Michael V. Zaragoza

    2017-11-01

    Full Text Available Dupuytren’s disease (palmar fibromatosis involves nodules in fascia of the hand that leads to flexion contractures. Ledderhose disease (plantar fibromatosis is similar with nodules of the foot. While clinical aspects are well-described, genetic mechanisms are unknown. We report a family with cardiac disease due to a heterozygous LMNA mutation (c.736C>T, p.Gln246Stop with palmar/plantar fibromatosis and investigate the hypothesis that a second rare DNA variant increases the risk for fibrotic disease in LMNA mutation carriers. The proband and six family members were evaluated for the cardiac and hand/feet phenotypes and tested for the LMNA mutation. Fibroblast RNA studies revealed monoallelic expression of the normal LMNA allele and reduced lamin A/C mRNAs consistent with LMNA haploinsufficiency. A novel, heterozygous missense variant (c.230T>C, p.Val77Ala in the Asteroid Homolog 1 (ASTE1 gene was identified as a potential risk factor in fibrotic disease using exome sequencing and family studies of five family members: four LMNA mutation carriers with fibromatosis and one individual without the LMNA mutation and no fibromatosis. With a possible role in epidermal growth factor receptor signaling, ASTE1 may contribute to the increased risk for palmar/plantar fibromatosis in patients with Lamin A/C haploinsufficiency.

  14. Concept and Design of a 3D Printed Support to Assist Hand Scanning for the Realization of Customized Orthosis

    Directory of Open Access Journals (Sweden)

    Gabriele Baronio

    2017-01-01

    Full Text Available In the rehabilitation field, the use of additive manufacturing techniques to realize customized orthoses is increasingly widespread. Obtaining a 3D model for the 3D printing phase can be done following different methodologies. We consider the creation of personalized upper limb orthoses, also including fingers, starting from the acquisition of the hand geometry through accurate 3D scanning. However, hand scanning procedure presents differences between healthy subjects and patients affected by pathologies that compromise upper limb functionality. In this work, we present the concept and design of a 3D printed support to assist hand scanning of such patients. The device, realized with FDM additive manufacturing techniques in ABS material, allows palmar acquisitions, and its design and test are motivated by the following needs: (1 immobilizing the hand of patients during the palmar scanning to reduce involuntary movements affecting the scanning quality and (2 keeping hands open and in a correct position, especially to contrast the high degree of hypertonicity of spastic subjects. The resulting device can be used indifferently for the right and the left hand; it is provided in four-dimensional sizes and may be also suitable as a palmar support for the acquisition of the dorsal side of the hand.

  15. Alkaptonuria

    Directory of Open Access Journals (Sweden)

    G K Tharini

    2011-01-01

    Full Text Available A case of alkaptonuria, a rare disorder with autosomal recessive inheritance, is reported here. The patient had palmar pigmentation in addition to the usual features of alkaptonuria.

  16. CLINICAL APPLICATION OF BOTULINUM TOXIN TYPE B IN MOVEMENT DISORDERS AND AUTONOMIC SYMPTOMS

    Institute of Scientific and Technical Information of China (English)

    Xin-hua Wan; Kevin Dat Vuong; Joseph Jankovic

    2005-01-01

    Objective To evaluate efficacy and safety of botulinum toxin type B (BTX-B) in treatment of movement disorders including blepharospasm, oromandibular dystonia, hemifacial spasm, tremor, tics, and hypersecretory disorders such as sialorrhea and hyperhidrosis.Methods A retrospective study of BTX-B injections in treatment of 58 patients with various neurological disorders was performed. The mean follow-up time was 0.9 ± 0.8 years. Results of the first and last treatment of patients with at least 3injection sessions were compared.Results The response of 58 patients to a total of 157 BTX-B treatment sessions was analyzed. Of the 157 treatment sessions, 120 sessions (76.4%) resulted in moderate or marked improvement while 17 sessions (10.8%) had no response.The clinical benefits after BTX-B treatment lasted an average of 14 weeks. Of the 41 patients with at least 3 injection sessions (mean 10 ± 8.6), most patients needed increased dosage upon the last session compared to the first session. Nineteen patients (32.8%) with 27 sessions (17.2%) reported adverse effects with BTX-B treatment.Conclusios Though most patients require increased dosage to maintain effective response after repeated injections,BTX-B is an effective and safe treatment drug for a variety of movement disorders, as well as drooling and hyperhidrosis.

  17. Odonto-onycho-dermal dysplasia in a patient homozygous for a WNT10A nonsense mutation and mild manifestations of ectodermal dysplasia in carriers of the mutation.

    Science.gov (United States)

    Krøigård, Anne Bruun; Clemmensen, Ole; Gjørup, Hans; Hertz, Jens Michael; Bygum, Anette

    2016-03-10

    Odonto-onycho-dermal dysplasia (OODD) is a rare form of ectodermal dysplasia characterized by severe oligodontia, onychodysplasia, palmoplantar hyperkeratosis, dry skin, hypotrichosis, and hyperhidrosis of the palms and soles. The ectodermal dysplasias resulting from biallelic mutations in the WNT10A gene result in highly variable phenotypes, ranging from isolated tooth agenesis to OODD and Schöpf-Schulz-Passarge syndrome (SSPS). We identified a female patient, with consanguineous parents, who was clinically diagnosed with OODD. Genetic testing showed that she was homozygous for a previously reported pathogenic mutation in the WNT10A gene, c.321C > A, p.Cys107*. The skin and nail abnormalities were for many years interpreted as psoriasis and treated accordingly. A thorough clinical examination revealed hypotrichosis and hyperhidrosis of the soles and dental examination revealed agenesis of permanent teeth except the two maxillary central incisors. Skin biopsies from the hyperkeratotic palms and soles showed the characteristic changes of eccrine syringofibroadenomatosis, which has been described in patients with ectodermal dysplasias. Together with a family history of tooth anomalies, this lead to the clinical suspicion of a hereditary ectodermal dysplasia. This case illustrates the challenges of diagnosing ectodermal dysplasia like OODD and highlights the relevance of interdisciplinary cooperation in the diagnosis of rare conditions.

  18. The Austrian prize list; Le palmares autrichien

    Energy Technology Data Exchange (ETDEWEB)

    Jonas, A.; Gortler, F. [LK Oberosterreich (Austria)

    1999-06-01

    The Austria took stock on the wood furnaces from 1983 to 1997. Many tables present the annual power of automatic installations and networks, the installations number and their localization. Facing the fossil energies competition, the development of this energy needs a government financial assistance to keep its increase. (A.L.B.)

  19. Comparison of blood volume pulse and skin conductance responses to mental and affective stimuli at different anatomical sites

    International Nuclear Information System (INIS)

    Kushki, Azadeh; Fairley, Jillian; Merja, Satyam; King, Gillian; Chau, Tom

    2011-01-01

    Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human–machine interfaces. To date, palmar surfaces remain the primary site for these measurements. Placement of sensors on palmar surfaces, however, is undesirable when recordings are fraught with motion and pressure artifacts. These artifacts are frequent when the human participant has involuntary movements as in hyperkinetic cerebral palsy. This motivates the use of alternative measurement sites. The present study examined the correlation between measurements of blood volume pulse and skin conductance obtained from three different sites on the body (fingers, toes and ear for BVP; fingers, toes and arch of the foot for skin conductance) in response to cognitive and affective stimuli. The results of this pilot study indicated significant inter-site correlation among signal features derived from different sites, with the exception of BVP amplitude, the number of electrodermal reactions and the slope of the electrodermal activity response. We attribute these differences in part to inter-site discrepancies in local skin conditions, such as skin temperature. Despite these differences, significant changes from baseline were present in the responses to the cognitive and affective stimuli at non-palmar sites, suggesting that these sites may provide viable signal measurements for use in affective computing and human–machine interface applications

  20. UMA PROPOSTA DE CONTÍNUO PARAMÉTRICO NO PORTUGUÊS: FATOS SÓCIO-HISTÓRICOS

    Directory of Open Access Journals (Sweden)

    Ícaro Bismarck Lopes (Faculdade Pitágoras

    2016-12-01

    Full Text Available O presente estudo visa descrever um possível contínuo de variação de gênero do crioulo falado em Cabo Verde ao português falado atualmente no Brasil, tanto na zona urbana, quanto nas comunidades rurais afrodescendentes de Muquém (situada em Alagoas, mais especificamente em União dos Palmares, tida como o berço do Quilombo dos Palmares e de um momento histórico importante para a história do Brasil, e de Helvécia (localizada no Município de Nova Viçosa, na microrregião de Porto Seguro, extremo sul da Bahia. Com essa comparação, verificaram-se as semelhanças e diferenças na marcação do gênero, estabelecendo paralelos entre processos de mudança na morfossintaxe nessas comunidades que passaram por um amplo e profundo contato linguístico em sua história.PALAVRAS-CHAVE: Concordância. Gênero. Contínuo. Contato. Abstract The present study aims to describe a possible continuum of gender variation of the Creole spoken in Cape Verde to the Portuguese currently spoken in Brazil, both in the urban and in the rural Afro-descendant communities of Muquém (located in Alagoas, more specifically in União dos Palmares, considered the birthplace of the Quilombo dos Palmares and an important moment in the history of Brazil, and Helvécia (located in Nova Viçosa, in the microregion of Porto Seguro, southern Bahia. With this comparison verifies the similarities and differences with gender marking, establishing parallels between processes of morphosyntax change in these communities, which have undergone a broad and deep language contact in their history. To do so, firstly, it is a socio-historical review of the aforementioned communities in order to build this continuum of gender marking.KEYWORDS: Agreement. Gender. Continuous. Contact.

  1. Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first six months

    Directory of Open Access Journals (Sweden)

    Brittany L Thomas

    2015-01-01

    Full Text Available The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first six months of life and subjects the movements to analyses of body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal including the hips, legs, and feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged contacts included palmar and eventually grasp and manipulatory contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. In contrast, developmental increases in self grasping emerged a few weeks after the increases observed in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows for the coordination of the Reach and the Grasp prior to their use under visual

  2. Independent development of the Reach and the Grasp in spontaneous self-touching by human infants in the first 6 months.

    Science.gov (United States)

    Thomas, Brittany L; Karl, Jenni M; Whishaw, Ian Q

    2014-01-01

    The Dual Visuomotor Channel Theory proposes that visually guided reaching is a composite of two movements, a Reach that advances the hand to contact the target and a Grasp that shapes the digits for target purchase. The theory is supported by biometric analyses of adult reaching, evolutionary contrasts, and differential developmental patterns for the Reach and the Grasp in visually guided reaching in human infants. The present ethological study asked whether there is evidence for a dissociated development for the Reach and the Grasp in nonvisual hand use in very early infancy. The study documents a rich array of spontaneous self-touching behavior in infants during the first 6 months of life and subjected the Reach movements to an analysis in relation to body target, contact type, and Grasp. Video recordings were made of resting alert infants biweekly from birth to 6 months. In younger infants, self-touching targets included the head and trunk. As infants aged, targets became more caudal and included the hips, then legs, and eventually the feet. In younger infants hand contact was mainly made with the dorsum of the hand, but as infants aged, contacts included palmar contacts and eventually grasp and manipulation contacts with the body and clothes. The relative incidence of caudal contacts and palmar contacts increased concurrently and were significantly correlated throughout the period of study. Developmental increases in self-grasping contacts occurred a few weeks after the increase in caudal and palmar contacts. The behavioral and temporal pattern of these spontaneous self-touching movements suggest that the Reach, in which the hand extends to make a palmar self-contact, and the Grasp, in which the digits close and make manipulatory movements, have partially independent developmental profiles. The results additionally suggest that self-touching behavior is an important developmental phase that allows the coordination of the Reach and the Grasp prior to and

  3. Malignant melanoma of the skin in black South Africans: A 15-year ...

    African Journals Online (AJOL)

    Trauma. 76. VOL 48, NO. 3, AUGUST 2010 SAJS. Acral lentiginous melanomas develop on palmar, plantar and subungual ... the mucous membranes of the face or anus and therefore not ..... inguinale veldefekte na radikale limfadenektomie.

  4. Direct and indirect cardiovascular actions of cathinone and MDMA in the anaesthetized rat.

    Science.gov (United States)

    Alsufyani, Hadeel A; Docherty, James R

    2015-07-05

    The stimulants cathinone (from Khat leaves) and methylenedioxymeth-amphetamine (MDMA) produce adrenoceptor mediated tachycardia and vasopressor actions that may be the result of direct receptor stimulation, actions on the noradrenaline transporter, and/or displacement of noradrenaline from nerve terminals. Effects of cathinone or MDMA were compared with those of the indirect sympathomimetic tyramine. Male Wistar rats were anaesthetized with pentobarbitone for blood pressure and heart rate recording. Some rats were sympathectomised by treatment with 6-hydroxydopamine. In the anaesthetised rat, cathinone, MDMA and tyramine (all 0.001-1 mg/kg) produced marked tachycardia, tyramine produced marked pressor responses and MDMA produced small pressor responses. The tachycardia to cathinone and MDMA was almost abolished by propranolol (1mg/kg). Pretreatment with cocaine (1mg/kg) did not significantly affect the tachycardia to cathinone or MDMA, but reduced the response to tyramine. However, in sympathectomised rats, the tachycardia to cathinone or MDMA was markedly attenuated, but the tachycardia to tyramine was only partially reduced. Blood pressure effects of tyramine and MDMA were also markedly attenuated by sympathectomy. The results demonstrate firstly that cocaine may not be the most suitable agent for assessing direct versus indirect agonism in cardiovascular studies. Secondly, the use of chemical sympathectomy achieved the desired goal of demonstrating that cardiac β-adrenoceptor mediated actions of cathinone and MDMA are probably largely indirect. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Regulation of aortic extracellular matrix synthesis via noradrenergic system and angiotensin II in juvenile rats.

    Science.gov (United States)

    Dab, Houcine; Hachani, Rafik; Dhaouadi, Nedra; Sakly, Mohsen; Hodroj, Wassim; Randon, Jacques; Bricca, Giampiero; Kacem, Kamel

    2012-10-01

    Extracellular matrix (ECM) synthesis regulation by sympathetic nervous system (SNS) or angiotensin II (ANG II) was widely reported, but interaction between the two systems on ECM synthesis needs further investigation. We tested implication of SNS and ANG II on ECM synthesis in juvenile rat aorta. Sympathectomy with guanethidine (50 mg/kg, subcutaneous) and blockade of the ANG II AT1 receptors (AT1R) blocker with losartan (20 mg/kg/day in drinking water) were performed alone or in combination in rats. mRNA and protein synthesis of collagen and elastin were examined by Q-RT-PCR and immunoblotting. Collagen type I and III mRNA were increased respectively by 62 and 43% after sympathectomy and decreased respectively by 31 and 60% after AT1R blockade. Combined treatment increased collagen type III by 36% but not collagen type I. The same tendency of collagen expression was observed at mRNA and protein levels after the three treatments. mRNA and protein level of elastin was decreased respectively by 63 and 39% and increased by 158 and 15% after losartan treatment. Combined treatment abrogates changes induced by single treatments. The two systems act as antagonists on ECM expression in the aorta and combined inhibition of the two systems prevents imbalance of mRNA and protein level of collagen I and elastin induced by single treatment. Combined inhibition of the two systems prevents deposit or excessive reduction of ECM and can more prevent cardiovascular disorders.

  6. [Neurolitic block of the lumbar sympathetic chain improves chronic pain in a patient with critical lower limb ischemia].

    Science.gov (United States)

    Barreto Junior, Elton Pereira de Sá; Nascimento, Jedson Dos Santos; de Castro, Anita Perpetua Carvalho Rocha

    Sympathectomy is one of the therapies used in the treatment of chronic obstructive arterial disease (COAD). Although not considered as first-line strategy, it should be considered in the management of pain difficult to control. This clinical case describes the evolution of a patient with inoperable COAD who responded properly to the lumbar sympathetic block. A female patient, afro-descendant, 69 years old, ASA II, admitted to the algology service due to refractory ischemic pain in the lower limbs. The patient had undergone several surgical procedures and conservative treatments without success. Vascular surgery considered the case as out of therapeutic possibility, unless limb amputation. At that time, sympathectomy was indicated. After admission to the operating room, the patient was monitored, positioned and sedated. The blockade was performed with the aid of radioscopy, bilaterally, at L2-L3-L4 right and L3 left levels. On the right side, at each level cited, 3mL of absolute alcohol with 0.25% bupivacaine were injected without vasoconstrictor, and on the left side only local anesthetic. The procedure was performed uneventfully. The patient was discharged with complete remission of the pain. Neurolitic block of the lumbar sympathetic chain is an effective and safe treatment option for pain control in patients with critical limb ischemia patients in whom the only possible intervention would be limb amputation. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Comparison of the circadian variation in cell proliferation in normal and neoplastic colonic epithelial cells.

    Science.gov (United States)

    Kennedy, M F; Tutton, P J; Barkla, D H

    1985-09-15

    Circadian variations in cell proliferation in normal tissues have been recognised for many years but comparable phenomena in neoplastic tissues appear not to have been reported. Adenomas and carcinomas were induced in mouse colon by injection of dimethylhydrazine (DMH) and cell proliferation in these tumors was measured stathmokinetically. In normal intestine cell proliferation is fastest at night whereas in both adenomas and carcinomas it was found to be slower at night than in the middle of the day. Chemical sympathectomy was found to abolish the circadian variation in tumor cell proliferation.

  8. Electrophysiologic studies of cutaneous nerves of the forelimb of the cat.

    Science.gov (United States)

    Kitchell, R L; Canton, D D; Johnson, R D; Maxwell, S A

    1982-10-01

    The cutaneous innervation of the forelimb was investigated in 20 barbiturate-anesthetized cats by using electrophysiological techniques. The cutaneous area (CA) innervated by each cutaneous nerve was delineated in at least six cats by brushing the hair in the CA with a small watercolor brush while recording from the nerve. Mapping of adjacent CA revealed larger overlap zones (OZ) than were noted in the dog. Remarkable findings were that the brachiocephalic nerve arose from the axillary nerve and the CA comparable to that supplied by the cutaneous branch of the brachiocephalic nerve in the dog was supplied by a cutaneous branch of the suprascapular nerve. The CA supplied by the communicating branch from the musculocutaneous to the median nerve was similar in both species except that the communicating branch arose proximal to any other branches of the musculocutaneous nerve in the cat, whereas it was a terminal branch in the dog. The superficial branch of the radial nerve gave off cutaneous brachial branches in the cat proximal to the lateral cutaneous antebrachial nerve. The CA of the palmar branches of the ulnar nerve did not completely overlap the CA of the palmar branches of the median nerve as occurred in the dog; thus an autonomous zone (AZ) for the CA of the palmar branches of the median nerve is present in the cat, whereas no AZ existed for the CA of this nerve in the dog.

  9. Diversidad alfa y beta de la comunidad de reptiles en el complejo cenagoso de Zapatosa, Colombia

    Directory of Open Access Journals (Sweden)

    Guido Fabián Medina-Rangel

    2011-06-01

    Full Text Available La diversidad es una propiedad de las comunidades, permite describir, caracterizar y entender el funcionamiento de los ecosistemas. Para estudiar la riqueza, abundancia y el recambio de especies de reptiles entre hábitats circundantes al complejo cenagoso de Zapatosa, se realizaron cuatro salidas de campo (noviembre de 2006 y octubre de 2007. Se invirtieron 640h/hombre de muestreo repartido en cinco tipos de hábitat: bosque casmófito, bosque seco, bosque de ribera, palmar y sabana arbolada. Se encontraron 847 individuos de 48 especies, la familia más rica fue Colubridae, se registraron cinco especies endémicas y ocho con algún grado de amenaza en conservación a nivel nacional. El hábitat más diverso fue el bosque de ribera. La representatividad del muestreo en total y para cada hábitat fue superior al 80%, con excepción del palmar (<75%. La composición de especies fue diferente entre la sabana arbolada y los hábitats bosque de ribera, palmar y bosque seco. El recambio promedio de especies fue del 50%. El bosque casmófito mostró la mayor complementariedad y número de especies únicas. El complejo cenagoso presentó 2/3 de los reptiles registrados hasta hoy para la región Caribe y más del 80% de los encontrados para el departamento del Cesar.

  10. Tegumentary manifestations of Noonan and Noonan-related syndromes

    Directory of Open Access Journals (Sweden)

    Caio Robledo D'Angioli Costa Quaio

    2013-01-01

    Full Text Available OBJECTIVES: Noonan and Noonan-related syndromes are common autosomal dominant disorders with neuro-cardio-facial-cutaneous and developmental involvement. The objective of this article is to describe the most relevant tegumentary findings in a cohort of 41 patients with Noonan or Noonan-related syndromes and to detail certain aspects of the molecular mechanisms underlying ectodermal involvement. METHODS: A standard questionnaire was administered. A focused physical examination and a systematic review of clinical records was performed on all patients to verify the presence of tegumentary alterations. The molecular analysis of this cohort included sequencing of the following genes in all patients: PTPN1, SOS1, RAF1, KRAS, SHOC2 and BRAF. RESULTS: The most frequent tegumentary alterations were xeroderma (46%, photosensitivity (29%, excessive hair loss (24%, recurrent oral ulcers (22%, curly hair (20%, nevi (17%, markedly increased palmar and plantar creases (12%, follicular hyperkeratosis (12%, palmoplantar hyperkeratosis (10%, café-au-lait spots (10% and sparse eyebrows (7%. Patients with mutations in PTPN11 had lower frequencies of palmar and plantar creases and palmar/plantar hyperkeratosis compared with the other patients. CONCLUSIONS: We observed that patients with mutations in genes directly involved in cell proliferation kinase cascades (SOS1, BRAF, KRAS and RAF1 had a higher frequency of hyperkeratotic lesions compared with patients with mutations in genes that have a more complex interaction with and modulation of cell proliferation kinase cascades (PTPN11.

  11. Analysing deltamethrin susceptibility and pyrethroid esterase activity variations in sylvatic and domestic Triatoma infestans at the embryonic stage

    Directory of Open Access Journals (Sweden)

    Pablo Luis Santo-Orihuela

    2013-12-01

    Full Text Available The aim of the present work was to study the deltamethrin susceptibility of eggs from Triatoma infestans populations and the contribution of pyrethroid esterases to deltamethrin degradation. Insects were collected from sylvatic areas, including Veinte de Octubre and Kirus-Mayu (Bolivia and from domiciliary areas, including El Palmar (Bolivia and La Pista (Argentina. Deltamethrin susceptibility was determined by dose-response bioassays. Serial dilutions of deltamethrin (0.0005-1 mg/mL were topically applied to 12-day-old eggs. Samples from El Palmar had the highest lethal dose ratio (LDR value (44.90 compared to the susceptible reference strain (NFS, whereas the Veinte de Octubre samples had the lowest value (0.50. Pyrethroid esterases were evaluated using 7-coumaryl permethrate (7-CP on individually homogenised eggs from each population and from NFS. The El Palmar and La Pista samples contained 40.11 and 36.64 pmol/min/mg protein, respectively, and these values were statistically similar to NFS (34.92 pmol/min/mg protein and different from Kirus-Mayu and Veinte de Octubre (27.49 and 22.69 pmol/min/mg protein, respectively. The toxicological data indicate that the domestic populations were resistant to deltamethrin, but no statistical contribution of 7-CP esterases was observed. The sylvatic populations had similar LDR values to NFS, but lower 7-CP esterase activities. Moreover, this is the first study of the pyrethroid esterases on T. infestans eggs employing a specific substrate (7-CP.

  12. Case report

    African Journals Online (AJOL)

    abp

    successful closed reduction: review of the literature and anatomic reevaluation. J Hand Surg. 1986;11(4):521-525. PubMed | Google Scholar. 2. Buzby BF .Palmar carpometacarpal dislocation of the fifth metacarpal. Ann Surg. 1934;100:555-557.

  13. A method for the measurement of physiologic evaporative water loss.

    Science.gov (United States)

    1963-10-01

    The precise measurement of evaporative water loss is essential to an accurate evaluation of this avenue of heat loss in acute and chronic exposures to heat. In psychological studies, the quantitative measurement of palmar sweating plays an equally im...

  14. Pediatric Dupuytren's disease: case report and review of the literature

    African Journals Online (AJOL)

    children, delayed diagnosis of DD can result in debilitating disease and ... 1). The boy was subsequently taken to the operating room, where a Bruner incision was made on the palmar aspect of ... history, diabetes mellitus, and sex. However ...

  15. Wet and dry hands after video-assisted thoracoscopic pleurectomy

    NARCIS (Netherlands)

    Brakel, T.J. van; Barendregt, W.B.

    2013-01-01

    Damage to the thoracic sympathic chain is a rare complication of video-assisted thoracic surgery (VATS) pleurectomy. We report our experience with a patient who underwent parietal pleurectomy and bullectomy by VATS and postoperatively suffered from palmar anhydrosis and compensatory controlateral

  16. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 9990 ...

    African Journals Online (AJOL)

    Prof Kakande

    The optimal technique depends on the level of injury, the type of tissue lostdestroyed ... on its vascular pedicle And used to cover web ... dorsal arteries) were also damaged as well as the terminal radial artery feed into the deep palmar arch.

  17. Further delineation of the odonto-onycho-dermal dysplasia syndrome.

    Science.gov (United States)

    Mégarbané, Hala; Haddad, May; Delague, Valérie; Renoux, Julien; Boehm, Nelly; Mégarbané, André

    2004-08-30

    We report on three boys, two brothers and their maternal cousin, presenting with dry hair, pilar keratosis, severe hypodontia, smooth tongue, onychodysplasia, and keratoderma and hyperhidrosis of palms and soles. Histology of the skin showed orthokeratotic, hyperkeratosis, hypergranulosis, and mild acanthosis in the epidermis. Scanning electron microscopic examination of the hair showed longitudinal depressions in some hair. These features are close to a rare entity: the odonto-onycho-dermal dysplasia but with some differing features. Copyright 2004 Wiley-Liss, Inc.

  18. In vivo sweat film layer thickness measured with Fourier-domain optical coherence tomography

    CSIR Research Space (South Africa)

    Jonathan, E

    2008-01-01

    Full Text Available s Centre form the f th s pr t fi d id Keywords: Fourier-domain optical coherence tomography; Human sweat secretion; Sweat gland; Sweat duct; Hyperhidrosis growing list of triggers include cancer, glucose control disorder, mental stress, social..., that is, the gland, duct and pore(s). However, due to a slow imaging time, COCT is largely restricted to morphometry of human tissue and thickness measurement of biologic and biologic samples [12,13]. ARTICLE IN PRESS Fourier-domain optical coherence...

  19. Studies on topical antiperspirant control of axillary hyperhidrosis.

    Science.gov (United States)

    Shelley, W B; Hurley, H J

    1975-01-01

    Axillary hyperhidrotics is reviewed from the standpoint of anatomical factors, physiological mechanisms and the history of methods of control. Anhydrous aluminum chloride and anhydrous zirconium tetrachloride are shown to be superior topical agents for partial control of axillary sweating when applied as a powder or in anhydrous nonreactive vehicles. Complete anhidrosis as demonstrated by sustained garment armpit dryness could be achieved in hyperhidrotics within 48 hours by the following trinary antiperspirant system: (1) a saturated solution of aluminum chloride hexahydrate or zirconyl chloride in absolute ethanol or isopropyl alcohol, (2) application to the dry axilla at times of sleep or other prolonged non-sweating period, (3) water vapor occlusion of area for 6 to 8 hours by means of Saran wrap. The hypothesis is presented that metallic antiperspirants act by reflux entrance into the terminal intraepidermal eccrine duct, slowly combining with the intraductal keratin, to produce a fibrillar contraction (super contraction) of keratin and hence functional closure, not histologically evident. This altered keratin is shed weeks later, with the consequent return of ductal patency and sweating.

  20. Atuação fisioterapêutica em um indivíduo com lúpus eritematoso sistêmico associado à artrite reumatoide e à fibromialgia

    Directory of Open Access Journals (Sweden)

    Matheus Santos Gomes Jorge

    2017-04-01

    Full Text Available Introdução: As doenças reumáticas podem manifestar-se de forma isolada ou concomitante, como, por exemplo, o lúpus eritematoso sistêmico, que pode associar-se à artrite reumatoide e à fibromialgia, comprometendo a funcionalidade e a qualidade de vida. O objetivo deste estudo foi verificar os efeitos da fisioterapia na dor, na força de preensão palmar, no equilíbrio postural, no nível de incapacidade e na qualidade de vida de um indivíduo com lúpus eritematoso sistêmico associado à artrite reumatoide e à fibromialgia. Relato de caso: Mulher, 56 anos, diagnosticada com lúpus eritematoso sistêmico, artrite reumatoide e fibromialgia há 14 anos. Sua queixa principal era dor generalizada e intensa em diversos pontos do corpo. Foram avaliados a dor, a força de preensão palmar, o equilíbrio postural, o nível de incapacidade e a qualidade de vida. O indivíduo realizou 30 sessões de fisioterapia (cinesioterapia e hidrocinesioterapia, duas vezes por semana, entre os meses de agosto e novembro de 2015, na Clínica e Fisioterapia da Universidade de Passo Fundo. Após a intervenção, houve diminuição da dor em 5 pontos e da incapacidade em 30%; aumento da força de preensão palmar em 2,2 kgf (mão direita e 1,2 kgf (mão esquerda; e do equilíbrio postural em 6 pontos. Como consequência, a qualidade de vida do indivíduo melhorou. Conclusão: A fisioterapia demonstrou-se eficaz na diminuição da dor e da incapacidade, no aumento da força de preensão palmar bilateral e do equilíbrio postural e na melhora da qualidade de vida em um indivíduo com lúpus eritematoso sistêmico associado à artrite reumatoide e à fibromialgia.

  1. Rooted Rights Systems in Turbulent Water: The Dynamics of Collective Fishing Rights in La Albufera, Valencia, Spain

    NARCIS (Netherlands)

    Boelens, R.A.; Claudin, V.

    2015-01-01

    Valencia's Albufera Lake is a wetlands area where different sociolegal systems interact. Its El Palmar community is governed by customary laws for fishing and territorial control. These exist alongside, yet in tension with, governmental laws. This article examines the dynamics of fishing rights,

  2. Rooted rights systems in turbulent waters: the dynamics of collective fishing rights in La Albufera, Valencia, Spain

    NARCIS (Netherlands)

    Boelens, R.; Claudin, V.

    2015-01-01

    Valencia's Albufera Lake is a wetlands area where different sociolegal systems interact. Its El Palmar community is governed by customary laws for fishing and territorial control. These exist alongside, yet in tension with, governmental laws. This article examines the dynamics of fishing rights,

  3. Infrared thermography based on artificial intelligence as a screening method for carpal tunnel syndrome diagnosis.

    Science.gov (United States)

    Jesensek Papez, B; Palfy, M; Mertik, M; Turk, Z

    2009-01-01

    This study further evaluated a computer-based infrared thermography (IRT) system, which employs artificial neural networks for the diagnosis of carpal tunnel syndrome (CTS) using a large database of 502 thermal images of the dorsal and palmar side of 132 healthy and 119 pathological hands. It confirmed the hypothesis that the dorsal side of the hand is of greater importance than the palmar side when diagnosing CTS thermographically. Using this method it was possible correctly to classify 72.2% of all hands (healthy and pathological) based on dorsal images and > 80% of hands when only severely affected and healthy hands were considered. Compared with the gold standard electromyographic diagnosis of CTS, IRT cannot be recommended as an adequate diagnostic tool when exact severity level diagnosis is required, however we conclude that IRT could be used as a screening tool for severe cases in populations with high ergonomic risk factors of CTS.

  4. Fingertip replantation at the eponychial level with venous anastomosis: an anatomic study and clinical application.

    Science.gov (United States)

    Cheng, L; Chen, K; Chai, Y-M; Wen, G; Wang, C-Y

    2013-11-01

    We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertip amputations at the eponychial level were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.

  5. HIGH ORIGIN OF SUPERFICIAL ULNAR ARTERY- A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Anjana Jayakumaran Nair

    2017-03-01

    Full Text Available BACKGROUND High origin and superficially placed ulnar artery is a rare anatomical variant that usually arises either in the axilla or arm and runs a superficial course in the forearm, enters the hand and participates in the formation of superficial palmar arch. During routine dissection of cadavers in our department, we observed a unilateral case of high origin and superficial ulnar artery in a human male cadaver. It originated from the brachial artery in the lower third of arm 4 cm above its bifurcation. From its origin, it passed downwards along the medial aspect of forearm, superficial to the flexors, entered hand superficial to the flexor retinaculum and formed superficial palmar arch. The knowledge of existence of a superficial ulnar artery is important during vascular and reconstructive surgery and also in evaluation of angiographic images. Superficial position makes it more vulnerable to trauma and more accessible to cannulation.

  6. Palmar, Patellar, and Pedal Human Remains from Pavlov

    Czech Academy of Sciences Publication Activity Database

    Trinkaus, E.; Wojtal, P.; Wilczyński, J.; Sázelová, Sandra; Svoboda, Jiří

    2017-01-01

    Roč. 2017, June (2017), s. 73-101 ISSN 1545-0031 Institutional support: RVO:68081758 Keywords : Gravettian * human remains * isolated bones * anatomically modern humans * Upper Paleolithic Subject RIV: AC - Archeology, Anthropology, Ethnology OBOR OECD: Archaeology http://paleoanthro.org/media/journal/content/PA20170073.pdf

  7. Functional classification of grasp strategies used by hemiplegic patients.

    Directory of Open Access Journals (Sweden)

    Alicia García Álvarez

    Full Text Available This study aimed to identify and qualify grasp-types used by patients with stroke and determine the clinical parameters that could explain the use of each grasp. Thirty-eight patients with chronic stroke-related hemiparesis and a range of motor and functional capacities (17 females and 21 males, aged 25-78, and 10 healthy subjects were included. Four objects were used (tissue packet, teaspoon, bottle and tennis ball. Participants were instructed to "grasp the object as if you are going to use it". Three trials were video-recorded for each object. A total of 456 grasps were analysed and rated using a custom-designed Functional Grasp Scale. Eight grasp-types were identified from the analysis: healthy subjects used Multi-pulpar, Pluri-digital, Lateral-pinch and Palmar grasps (Standard Grasps. Patients used the same grasps with in addition Digito-palmar, Raking, Ulnar and Interdigital grasps (Alternative Grasps. Only patients with a moderate or relatively good functional ability used Standard grasps. The correlation and regression analyses showed this was conditioned by sufficient finger and elbow extensor strength (Pluri-digital grasp; thumb extensor and wrist flexor strength (Lateral pinch or in forearm supinator strength (Palmar grasp. By contrast, the patients who had severe impairment used Alternative grasps that did not involve the thumb. These strategies likely compensate specific impairments. Regression and correlation analyses suggested that weakness had a greater influence over grasp strategy than spasticity. This would imply that treatment should focus on improving hand strength and control although reducing spasticity may be useful in some cases.

  8. Fractures of the distal phalanx and associated soft tissue and osseous abnormalities in 22 horses with ossified sclerotic ungual cartilages diagnosed with magnetic resonance imaging.

    Science.gov (United States)

    Selberg, Kurt; Werpy, Natasha

    2011-01-01

    Ungual cartilage ossification in the forelimb is a common finding in horses. Subtle abnormalities associated with the ungual cartilages can be difficult to identify on radiographs. Magnetic resonance (MR) imaging findings of 22 horses (23 forelimbs) with a fracture of the distal phalanx and ossified ungual cartilage were characterized and graded. All horses had a forelimb fracture. Eleven involved a left forelimb (seven medial; four lateral), and 12 involved a right forelimb (five medial; seven lateral). All fractures were nonarticular, simple in configuration, and nondisplaced. The fractures were oriented in an axial proximal to abaxial distal and palmar to dorsal direction, and extended from the base of the ossified ungual cartilage into the distal phalanx. The fracture involved the fossa of the collateral ligament on the distal phalanx in 17 of 23 limbs. The palmar process and ossified ungual cartilage was abnormally mineralized in all horses. Ligaments and soft tissues adjacent to the ossified ungual cartilages were affected in all horses. The routine site of fracture in this study at the base of the ossified ungual cartilage extending into the distal phalanx suggests a biomechanical cause or focal stress point from cycling. The ligamentous structures associated with the ungual cartilages were often affected, showed altered signal intensity as well as enlargement and were thought to be contributing to the lameness. In conclusion, ossified ungual cartilages may lead to fracture of the palmar process of the distal phalanx and injury of the ungual cartilage ligaments. © 2011 Veterinary Radiology & Ultrasound.

  9. Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature.

    Science.gov (United States)

    Aragão, José Aderval; da Silva, Ana Caroline Ferreira; Anunciação, Caio Barretto; Reis, Francisco Prado

    2017-01-01

    A persistent median artery is a rare anomaly. It accompanies the median nerve along its course in the forearm and is of variable origin. It is associated with other local anatomical variations and may contribute significantly towards formation of the superficial palmar arch. In embryos, it is responsible mainly for the blood supply to the hand. The objective of this study was to research the frequency, type (forearm or palmar) and origin of the median artery in fetuses, correlating its presence with sex and body side. Red-colored latex was injected into 32 brachial arteries of human fetuses until its arrival in the hand could be seen. Twenty-four hours after the injection, the median arteries were dissected without the aid of optical instruments. Among the 32 forearms dissected, the median artery was present in 81.25 % (26) of the cases, and it was found more frequently in females and on the left side. Regarding origin, most of the median arteries originated in the common interosseous artery (38.5 %) and anterior interosseous artery (34.6 %). The mean length of the median arteries was 21.1 mm for the palmar type and 19.8 mm for the forearm type. The median artery has a high rate of persistence. It is important to be aware of this anatomical variation, since its presence may give rise to difficulties during routine surgical procedures on the wrist. Its presence may cause serious functional complications in the carpal tunnel, anterior interosseous nerve, round pronator syndromes, and ischemia of the hand.

  10. Delayed healing at transurethral resection of bladder tumour sites after immediate postoperative mitomycin C instillation

    DEFF Research Database (Denmark)

    Aagaard, Mark F; Mogensen, Karin; Hermann, Gregers G

    2014-01-01

    The most common reactions to mitomycin C are dysuria and drug-related palmar and genital desquamation. This report describes two cases of delayed healing of the mucosa at resection sites after transurethral resection of bladder tumours, most likely due to immediate postoperative mitomycin C...

  11. Assessment of burn size in obese adults; a literature review

    DEFF Research Database (Denmark)

    Borhani-Khomani, Kaveh; Partoft, Søren; Holmgaard, Rikke

    2017-01-01

    : The current literature was reviewed using relevant electronic databases. The initial search yielded 247 results. Relevant articles were then reviewed. A total of seven publications fulfilled the inclusion criteria. Results: The palmar surface area ranged between 0.59%–1.22%, depending on BMI, gender...

  12. Chronic active hepatitis at Baragwanath Hospital

    African Journals Online (AJOL)

    1983-04-16

    Apr 16, 1983 ... ingestion of a drug, absence of other aetiological factors and regression of the disease following withdrawal of the initiating agent; (iv) alcohol-induced CAH - history of alcohol abuse, appropriate clinical features, including Dupuytren's contrac- . ture, bilateral parotid enlargement, palmar erythema, spider.

  13. Behandling af Dupuytrens kontraktur

    DEFF Research Database (Denmark)

    Raundrup Kornø, Maj; Søe, Niels Henrik; Dahlin, Lars B

    2015-01-01

    Dupuytren’s disease treatment Dupuytren’s disease is a hereditary fibroproliferative disease commonly affecting the palmar fascia of the hand, which results in progressive and irreversibly fixed flexion contractures of the hand. It may occur in the sole of the foot or in the penis. Gen...

  14. Costello syndrome: report and review

    NARCIS (Netherlands)

    van Eeghen, A. M.; van Gelderen, I.; Hennekam, R. C.

    1999-01-01

    We describe a 34-year-old woman with mental retardation, short stature, macrocephaly, a "coarse" face, hoarse voice, and redundant skin with deep palmar and plantar creases who had evident Costello syndrome. Lacking papillomata, she had wart-like lesions of the skin. The previously reported patients

  15. Elevated transforming growth factor β and mitogen-activated protein kinase pathways mediate fibrotic traits of Dupuytren's disease fibroblasts

    NARCIS (Netherlands)

    Krause, Carola; Kloen, Peter; ten Dijke, Peter

    2011-01-01

    ABSTRACT: Dupuytren's disease is a fibroproliferative disorder of the palmar fascia. The treatment used to date has mostly been surgery, but there is a high recurrence rate. Transforming growth factor β (TGF-β) has been implicated as a key stimulator of myofibroblast activity and fascial contraction

  16. Innervated boomerang flap for finger pulp reconstruction.

    Science.gov (United States)

    Chen, Shao-Liang; Chiou, Tai-Fung

    2007-11-01

    The boomerang flap originates from the dorsolateral aspect of the proximal phalanx of an adjacent digit and is supplied by the retrograde blood flow through the vascular arcades between the dorsal and palmar digital arteries. To provide sensation of the boomerang flap for finger pulp reconstruction, the dorsal sensory branch of the proper digital nerve and the superficial sensory branch of the corresponding radial or ulnar nerve are included within the skin flap. After transfer of the flap to the injured site, epineural neurorrhaphies are done between the digital nerves of the pulp and the sensory branches of the flap. We used this sensory flap in five patients, with more than 1 year follow-up, and all patients achieved measurable two-points discrimination. The boomerang flap not only preserves the proper palmar digital artery but also provides an extended and innervated skin paddle. It seems to be an alternative choice for one-stage reconstruction of major pulp defect.

  17. Accuracy and reliability of wrist-cuff devices for self-measurement of blood pressure.

    Science.gov (United States)

    Kikuya, Masahiro; Chonan, Kenichi; Imai, Yutaka; Goto, Eiji; Ishii, Masao

    2002-04-01

    Self-measurement of blood pressure (BP) might offer some advantages in diagnosis and therapeutic evaluation and in patient management of hypertension. Recently, wrist-cuff devices for self-measurement of BP have gained more than one-third of the world market share. In the present study, we validated wrist-cuff devices and compared the results between wrist- and arm-cuff devices. The factors affecting the accuracy of wrist-cuff devices were also studied. The research group to assess the validity of automated blood pressure measuring device consisted of 13 institutes in Japan, which validated two wrist-cuff devices (WC-1 and WC-2) and two arm-cuff devices (AC-1 and AC-2). They used a crossover method, where the comparison was done between auscultation, by two observers by means of a double stethoscope on one arm and the device on the opposite arm or wrist. There was good inter-observer agreement for the auscultation method in each institute (systolic blood pressure (SBP), -0.1 +/- 2.8 mmHg; diastolic blood pressure (DBP), -0.1 +/- 2.6 mmHg, n = 498). The mean difference between auscultation and the device was minimal both in arm-cuff devices (mean difference for AC-1, 2.2/1.9 mmHg, n = 97 and for AC-2, 5.1/2.9 mmHg, n = 136, SBP/DBP) and wrist-cuff devices (mean difference for WC-1, -2.1/1.2 mmHg, n = 173 mmHg and for WC-2, -2.3/-5.6 mmHg, n = 92). The standard deviation of the difference (SDD) in wrist-cuff devices, however (SDD for WC-1, 9.7/7.3 mmHg and for WC-2, 10.2/8.6 mmHg), was larger than that of the arm-cuff devices (SDD for AC-1, 5.6/6.6 mmHg and for AC-2, 6.3/5.1 mmHg). Grading of AC-1 and AC-2 based on criteria of British Hypertension Society was A/A and B/A, respectively, while that of WC-1 and WC-2 was C/B and D/B, respectively. Using the same validation protocol, the results of validation for one device were divergent in each institute. In wrist-cuff devices, the BP value obtained in palmar flexion was significantly higher and that obtained in palmar

  18. Malignant Catatonia

    Directory of Open Access Journals (Sweden)

    Ayca Ozkul

    2010-12-01

    Full Text Available Catatonia is a syndrome characterized by mutism, immobility, negativism, stereotypy, mannerisms, echophenomena, perseveration and passive obedience. The underlying causes can be psychiatric or may be associated with general medical status or neurological diseases. Additionally catatonia has two subtypes as malignant and nonmalignant catatonia. Main symptoms of malignant catatonia are hyperthermia and autonomic symptoms such as tachycardia, tachypnea and hyperhidrosis. It is important to make the diagnosis as early as possible for an appropriate medical treatment. Clinicians should be aware of the fatal outcome of the disease.

  19. Odonto-onycho-dermal dysplasia in a patient homozygous for a WNT10A nonsens mutation and mild manifestations of ectodermal dysplasia in carriers of the mutation

    DEFF Research Database (Denmark)

    Bruun Krøigård, Anne; Clemmensen, Ole; Gjørup, Hans

    2016-01-01

    was homozygous for a previously reported pathogenic mutation in the WNT10A gene, c.321C > A, p.Cys107*. The skin and nail abnormalities were for many years interpreted as psoriasis and treated accordingly. A thorough clinical examination revealed hypotrichosis and hyperhidrosis of the soles and dental...... history of tooth anomalies, this lead to the clinical suspicion of a hereditary ectodermal dysplasia. CONCLUSION: This case illustrates the challenges of diagnosing ectodermal dysplasia like OODD and highlights the relevance of interdisciplinary cooperation in the diagnosis of rare conditions....

  20. Gorlin‑Goltz Syndrome | Mehta | Annals of Medical and Health ...

    African Journals Online (AJOL)

    The Gorlin‑Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome) is a rare autosomal dominant syndrome caused due to mutations in the patched gene found on chromosome arm 9 q. It shows high penetrance and variable expressivity; is characterized by basal cell carcinomas, odontogenic keratocysts, palmar ...

  1. Interstitial deletion of the short arm of chromosome 3. Fetal pathology and exclusion of the gene for beta-galactosidase-1 (GLB-1) from 3(p11----p14.2)

    DEFF Research Database (Denmark)

    Hertz, Jens Michael; Coerdt, W; Hahnemann, N

    1988-01-01

    A de novo interstitial deletion of the short arm of chromosome 3 was prenatally diagnosed in a male fetus, karyotype 46,XY,del(3)(pter----p14.2::p11----qter). The fetus had craniofacial dysmorphisms, a single transverse palmar crease, ulnar deviation in the wrists, cardiovascular anomalies...

  2. The Effect of Two Different Hand Exercises on Grip Strength, Forearm Circumference, and Vascular Maturation in Patients Who Underwent Arteriovenous Fistula Surgery

    Science.gov (United States)

    Kong, Sangwon; Lee, Kyung Soo; Kim, Junho

    2014-01-01

    Objective To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery. Methods We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb. Results All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups. Conclusion The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball. PMID:25379494

  3. Role of dermatoglyphics as an indicator of precancerous and cancerous lesions of the oral cavity

    Directory of Open Access Journals (Sweden)

    Ambika Gupta

    2013-01-01

    Full Text Available Background: Oral squamous cell carcinoma (SCC is one name that causes panic and holds an undeserved high ranking as a killer. Another important condition which has become a major public health issue in South East Asia is oral submucous fibrosis (OSF. Not all the people using tobacco suffer from these diseases. Genetic predisposition might explain such an individual variability that can be predicted by using various cytogenetic markers. However, these studies are far more costly and complicated. So, dermatoglyphics may be of immense clinical significance to segregate those individuals who are at an increased risk for developing these diseases. Aim: The present study was conducted to analyze the palmar dermatoglyphics in SCC and OSF and find a "dermatoglyphic marker", if any. Study Design: Cross sectional study. Materials and Methods: 120 individuals were divided into four groups based upon their habits of tobacco/areca nut usage and presence of OSF/SCC. Dermatoglyphic patterns were recorded using standard ink method. Various patterns were analysed statistically in the four groups. Results and Conclusion: In SCC, there was an increase in frequency of arch and ulnar loop patterns on fingertips, decrease in frequency of simple whorl patterns on fingertips, decrease in frequency of palmar accessory triradii on right and left hands. Significant findings in OSF included an increase in frequency of arch and ulnar loop pattern, decrease in frequency of simple whorl patterns on fingertips, decrease in atd angle on right hand, decrease in frequency of palmar accessory triradii on right hand. The results revealed that the field of dermatoglyphics holds promising results for determining the genetic susceptibility of individuals to develop SCC and OSF.

  4. The role of botulinum toxin in vasospastic disorders of the hand.

    Science.gov (United States)

    Neumeister, Michael W

    2015-02-01

    Raynaud phenomenon may be a primary disorder or associated with a variety of other autoimmune processes. Raynaud phenomenon produces digital vasospasm, which can lead to ischemia and ulceration. The treatment of Raynaud phenomenon has been difficult because multiple medical treatments have not provided uniform resolution of symptoms. Many patients have turned to surgery and sympathectomies for the treatment of unrelenting vasospasm. Botulinum toxin has been shown to be an effective alternative to surgery, with a single treatment being capable of resolving pain and healing ulcer. This article reviews the use of botulinum toxin for the treatment of Raynaud phenomenon. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Dupuytren's contracture: a retrospective database analysis to assess clinical management and costs in England.

    Science.gov (United States)

    Gerber, Robert A; Perry, Richard; Thompson, Robin; Bainbridge, Christopher

    2011-04-12

    Dupuytren's disease is a fibro-proliferative disorder affecting ~3-5% of the UK population. Current surgical treatments for Dupuytren's contracture (DC) include fasciectomy and fasciotomy. We assessed the clinical management of DC in England over a 5-year period; associated NHS costs were assessed for a 1-year period. Hospital Episode Statistics were extracted from April 2003 to March 2008 for patients with Palmar Fascial Fibromatosis (ICD10=M720) and DC-related procedures. Variables included demographics, OPCS, patient status and physician specialty. To estimate 2010-2011 costs, HRG4 codes and the National Schedule of Tariff 2010-11-NHS Trusts were applied to the 2007-2008 period. Over 5 years, 75,157 DC admissions were recorded; 64,506 were analyzed. Mean admissions per year were 12,901 and stable. Day cases increased from 42% (2003-2004) to 62% (2007-2008). The percent of patients having two or more admissions per year increased from 5.5% in 2003-2004 to 26.1% in 2007-2008. Between 2003 and 2007, 91% of procedures were Fasciectomy. Revision of Fasciectomy and Fasciotomy each accounted for ~4%; Amputation for 1%. In 2007, classification was extended to identify Digital Fasciectomy, its Revision and Dermofasciectomy. In 2007-2008, admissions were: 70% Palmar Fasciectomy, 16% Digital Fasciectomy, 1.3% Other Fasciectomy, 4.4% Revision of Palmar Fasciectomy, 1.3% Revision of Digital Fasciectomy, 3.8% Division of Palmar Fascia, 2.6% Dermofasciectomy and 1.1% Amputation. 79% of cases were overseen by trauma and orthopaedic surgeons, 19% by plastic surgeons. Mean (±SD) inpatient hospital length of stay was 1.5 (±1.4) days in 2003-2004 and 1.0 (±1.3) days in 2007-2008. Total estimated costs for 1 year (2010-2011) were £41,576,141. Per-patient costs were £2,885 (day case) and £3,534 (inpatient). Costs ranged from £2,736 (day-case Fasciectomy) to £9,210 (day-case Revision Digital). Between 2003 and 2008, fasciectomy was the most common surgical procedure for DC in

  6. [Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

    Science.gov (United States)

    Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

    2011-07-01

    To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

  7. Turner/Down mosaicism

    African Journals Online (AJOL)

    Brushfield Spots and flat nasal bridge. The mouth and teeth were normal. The thorax, cardiovascular system and external genitalia were normal. The upper limbs showed a simian palmar crease in the left hand, moderate brachydactylia and clinodactyly. The first two toes of the left foot were widely spaced. Moderate hallux ...

  8. Pustular Palmoplantar Psoriasis Successfully Treated with Nb-UVB Monochromatic Excimer Light: A Case-Report

    Directory of Open Access Journals (Sweden)

    Serena Gianfaldoni

    2017-07-01

    Full Text Available Barber’s palmoplantar pustulosis (PPP is a form of localised pustular psoriasis, affecting the palmar and plantar surfaces. It is a chronic disease, with a deep impact on the patients’ quality of life. The Authors discuss a case of Baber Psoriasis successfully treated with monochromatic excimer light.

  9. Presence of Multiple Tendinous Insertions of Palmaris Longus: A ...

    African Journals Online (AJOL)

    Case Details: We report here a unique case of palmaris longus presenting variation distally as its tendon divides to gain multiple attachments with the fascia covering the abductor pollicis brevis, flexor retinaculum and the tendon of flexor carpi ulnaris. In addition, it also continues as palmar aponeurosis as its normal course.

  10. Dupuytren's Diathesis in an African Male

    African Journals Online (AJOL)

    Dupuytren's diathesis is a severe form of Dupuytren's disease that presents with palmar contractures at a young age and is usually bilateral and may involve ectopic sites including, plantar aspect of the foot. (Ledderhose disease) and penis (Peyronies disease). (1). Although the rate of Dupuytrens reported in the Caucasian ...

  11. Contribution to the Doctrine Governing Hospitalization in Nationwide Defensive Warfare (1). Wartime Military Medical Equipment for Care of the Sick (2). Present-Day Trends in the Development of Chemical Weapons (3). Pharmacological and Toxicological Properties of Present-Day Combat Poisons Which Cause Malaise (CS, CR)

    Science.gov (United States)

    1975-10-31

    which con ribute to optinalmi uti .1 zation of capacity and to ra:L• ing the "L evel of utilization" of c.npacity, such as the maneuverabil- ity of Che...THE SICK Medical Colonel Aleksander lhranilovic, docent and graduate pharmacist , and Medical Colonel Ivan Palmar, docent and doctor The process of

  12. Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience

    International Nuclear Information System (INIS)

    Boutry, Nathalie; Lapegue, Franck; Demondion, Xavier; Masi, Laetitia; Cotten, Anne; Claret, Antoine

    2005-01-01

    To determine normal anatomy of extrinsic and intrinsic carpal ligaments at ultrasonography (US). In the first part of the study, two musculoskeletal radiologists retrospectively reviewed in consensus the photographs of anatomic sections and dissections derived from 20 cadaveric wrists. This cadaveric study gave the two readers the opportunity to learn the anatomy and orientation of the various extrinsic and intrinsic carpal ligaments and, thus, to develop a US protocol to facilitate the recognition of each carpal ligament. In the second part of the study, these two radiologists prospectively and independently evaluated the visibility of extrinsic and intrinsic carpal ligaments in 30 wrists of volunteers, using the same US protocol. With regard to extrinsic carpal ligaments, the radioscaphocapitate ligament (partially visible, 38%; completely visible, 62%), the radiolunotriquetral ligament (partially visible, 27%; completely visible, 73%), the palmar ulnotriquetral ligament (partially visible, 12%; completely visible, 88%), and the dorsal radiotriquetral ligament (partially visible, 7%; completely visible, 93%) were visualized at US. The dorsal ulnotriquetral ligament (partially visible, 21%; completely visible, 74%), the ulnolunate ligament (partially visible, 5%; completely visible, 70%), and the radial collateral ligament (partially visible, 18%; completely visible, 12%) were more difficult to recognize. The radioscapholunate ligament was never seen. With regard to intrinsic carpal ligaments, the dorsal (partially visible, 11%; completely visible, 89%) and palmar (partially visible, 38%; completely visible, 62%) scaphotriquetral ligaments as well as the dorsal scapholunate ligament (partially visible, 3%; completely visible, 97%) were visualized at US. The dorsal lunotriquetral ligament (partially visible, 39%; completely visible, 61%) and the palmar scapholunate ligaments (partially visible, 12%; completely visible, 81%) were more difficult to recognize. US may

  13. Detailed Joint Region Analysis of the 7-Joint Ultrasound Score: Evaluation of an Arthritis Patient Cohort over One Year

    Directory of Open Access Journals (Sweden)

    S. Ohrndorf

    2013-01-01

    Full Text Available Objective. The main objective of this study was to evaluate the 7-joint ultrasound (US7 score by detailed joint region analysis of an arthritis patient cohort. Methods. The US7 score examines the clinically most affected wrist, MCP and PIP II, III, MTP II, and V joints for synovitis, tenosynovitis/paratenonitis, and erosions. Forty-five patients with rheumatoid arthritis (RA (84.4% and spondyloarthritis with polyarticular peripheral arthritis (PsA 13.3%; AS 2.2% with a median disease duration of 6.5 yrs (range 7.5 mths–47.6 yrs were included and examined at baseline and 3, 6, and 12 months after starting or changing therapy (DMARD/biologic. In this study, detailed US7 score joint region analysis was firstly performed. Results. The joint region analysis performed at baseline disclosed synovitis in 95.6% of affected wrists in the dorsal aspect by greyscale (GS US where Grade 2 (moderate was most often (48.9% detected. Palmar wrist regions presented Grade 1 (minor capsule elevation in 40% and Grade 2 (moderate synovitis in 37.8%. Tenosynovitis of the extensor carpi ulnaris (ECU tendon was found in 40%, with PD activity in 6.6%. Most of the erosions in MCP II were detected in the radial (68.9%, followed by the dorsal (48.9% and palmar (44.4% aspects. In MTP V, erosions were seen in 75.6% from lateral. Conclusions. Synovitis in GSUS was more often detected in the wrist in the dorsal than in the palmar aspect. ECU tendon involvement was frequent. Most erosions were found in the lateral scan of MTP V and the medial (radial scan of MCP II.

  14. Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

    Directory of Open Access Journals (Sweden)

    Hye Mi Yoo

    2015-05-01

    Full Text Available BackgroundAn anatomical analysis of the transverse carpal ligament (TCL and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings.MethodsUsing 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months.ResultsIn the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were 35.30±2.59 mm and 9.50±2.13 mm, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, 4.00±0.57 mm. The 13 surgeries performed in the clinical settings yielded satisfactory results.ConclusionsThis peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.

  15. Optimization of conventional X-ray images for the detection of hook of hamate fractures; Optimierung von konventionellen Roentgenaufnahmen zur Erkennung von Hamulus ossis hamati Frakturen

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, R.; Adam, C. [Abt. fuer Bildgebende Diagnostik und Interventionelle Radiologie, KMG Klinikum Guestrow, Akademisches Lehrkrankenhaus der Univ. Rostock, Guestrow (Germany); Radmer, S. [Abt. fuer Orthopaedie und Rheumachirurgie, Immanuel Krankenhaus, Akademisches Lehrkrankenhaus der FU-Berlin (Germany); Scheufler, O. [Abt. fuer Plastische, Rekonstruktive und Aesthetische Chirurgie, Universitaetsspital Basel (Switzerland); Bogusch, G. [Inst. fuer Anatomie des Universitaetsklinikums Charite, Humboldt Univ. zu Berlin (Germany)

    2006-07-01

    Fractures of the hook of the hamate are a rare event. The fracture cannot always be detected clinically and standard radiographs do not always provide an overlap-free image of the hook of the hamate, so that fractures can easily be overlooked. The objective of the present study was to examine if the sensitivity of detecting hamulus ossis hamati fractures can further be improved by a modified conventional radiographic projection. After dissection of the hook of the hamate on 10 cadaver hands, a fracture was produced close to the base using a surgical chisel. Conventional radiographs were then performed in four different projections (dorso-palmar, lateral, carpal-tunnel and oblique view). The oblique view was obtained in a 45 supination position, slight extension and radial duction, with the tube tilted from distal to proximal by 30 . An axial spiral CT was used as a reference for detection of the fracture. The highest sensitivity of the conventional radiographs, with 8/10 identified fractures (80%), was achieved by the oblique view. The carpal-tunnel view with 4/10 (40%) and the dorso-palmar projection with 3/10 (30%) were much lower. All fractures were missed in the lateral projection. If all of the conventional radiographic projections are taken into account, the sensitivity is increased to 90%. All of the fractures were reliably detected in the axial CT-image. If a hamulus ossis hamati fracture is suspected clinically, in addition to the dorso-palmar and carpal-tunnel view, the special oblique view described here should be performed as a third projection plane, while the lateral view can be dispensed with. However, even if all projections are taken into account, a negative finding in the conventional radiographic imaging does not exclude a fracture with absolute certainty. In such cases, a CT or MRI should be performed to exclude a fracture. (orig.)

  16. Optimization of conventional X-ray images for the detection of hook of hamate fractures

    International Nuclear Information System (INIS)

    Andresen, R.; Adam, C.; Radmer, S.; Scheufler, O.; Bogusch, G.

    2006-01-01

    Fractures of the hook of the hamate are a rare event. The fracture cannot always be detected clinically and standard radiographs do not always provide an overlap-free image of the hook of the hamate, so that fractures can easily be overlooked. The objective of the present study was to examine if the sensitivity of detecting hamulus ossis hamati fractures can further be improved by a modified conventional radiographic projection. After dissection of the hook of the hamate on 10 cadaver hands, a fracture was produced close to the base using a surgical chisel. Conventional radiographs were then performed in four different projections (dorso-palmar, lateral, carpal-tunnel and oblique view). The oblique view was obtained in a 45 supination position, slight extension and radial duction, with the tube tilted from distal to proximal by 30 . An axial spiral CT was used as a reference for detection of the fracture. The highest sensitivity of the conventional radiographs, with 8/10 identified fractures (80%), was achieved by the oblique view. The carpal-tunnel view with 4/10 (40%) and the dorso-palmar projection with 3/10 (30%) were much lower. All fractures were missed in the lateral projection. If all of the conventional radiographic projections are taken into account, the sensitivity is increased to 90%. All of the fractures were reliably detected in the axial CT-image. If a hamulus ossis hamati fracture is suspected clinically, in addition to the dorso-palmar and carpal-tunnel view, the special oblique view described here should be performed as a third projection plane, while the lateral view can be dispensed with. However, even if all projections are taken into account, a negative finding in the conventional radiographic imaging does not exclude a fracture with absolute certainty. In such cases, a CT or MRI should be performed to exclude a fracture. (orig.)

  17. Camphor Burns on the Palm: An Unusual New Presentation

    African Journals Online (AJOL)

    in the center), and Type 3 (a full‑thickness burn exposing the palmar fascia). Conclusion: Different types of camphor burns on the palm are described in this study. This is the first study to report ring‑shaped blisters and ring‑shaped partially thick camphor burns caused on the palm. KEYWORDS: Camphor, palm burn, ring ...

  18. Infrared thermography based on artificial intelligence for carpal tunnel syndrome diagnosis.

    Science.gov (United States)

    Jesensek Papez, B; Palfy, M; Turk, Z

    2008-01-01

    Thermography for the measurement of surface temperatures is well known in industry, although is not established in medicine despite its safety, lack of pain and invasiveness, easy reproducibility, and low running costs. Promising results have been achieved in nerve entrapment syndromes, although thermography has never represented a real alternative to electromyography. Here an attempt is described to improve the diagnosis of carpal tunnel syndrome with thermography using a computer-based system employing artificial neural networks to analyse the images. Method reliability was tested on 112 images (depicting the dorsal and palmar sides of 26 healthy and 30 pathological hands), with the hand divided into 12 segments and compared relative to a reference. Palmar segments appeared to have no beneficial influence on classification outcome, whereas dorsal segments gave improved outcome with classification success rates near to or over 80%, and finger segments influenced by the median nerve appeared to be of greatest importance. These are preliminary results from a limited number of images and further research will be undertaken as our image database grows.

  19. Ultraviolet and visible light penetration of epidermis

    International Nuclear Information System (INIS)

    Eggset, G.; Kavli, G.; Volden, G.; Krokan, H.

    1984-01-01

    Light penetration in untanned skin and skin tanned with UVB (middlewave ultraviolet light) or PUVA (Psoralen photochemotherapy) was compared. Transmission at different wavelengths was measured through sheets of intact epidermis isolated by a suction blister technique. Thick epidermis was collected from a newly formed palmar friction bulla. For these studies a monochromator was used and the range of wavelengths examined was 280-700 nm. The transmission was considerably lower in tanned skin and the difference was most pronounced in the UV range. In the UVB range (290-320 nm), transmission was 13-43% for untanned epidermis, 8-12% for UVB tanned and slightly lower for PUVA tanned epidermis. At wavelengths below 325 nm only a few per cent of light penetrate through thick palmar epidermis. Both UVB and PUVA induce increased melanin content and thickening of the epidermis. Our results indicate that melanin is the most efficient protection against UVA while thickening of epidermis may be as important as the increased melanin content for the protection of living basal cells against the harmful UVB rays. (Auth)

  20. A new species of Cymadusa Savigny, 1816 (Crustacea: Amphipoda: Ampithoidae from northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Luiz F. Andrade

    Full Text Available A new species of the amphipod family Ampithoidae Stebbing, 1899 is described from the northeastern Brazilian waters. The new described taxon is grouped in the genus Cymadusa Savigny, 1816, since it presents all the diagnostic characteristics of the genus. The examined material was collected by scuba diving in the Rocas Atoll, off Rio Grande do Norte state coast, Camamu Bay and Todos os Santos Bay, Bahia state. The new species described here is close to C. filosa Savigny, 1816, type species of the genus, by presenting anterior margin of gnathopod 1 poorly setose, male gnathopod 2 densely setose, with palmar corner not defined by a spine and dactylus subequal in length to palm, being considered part of the C. filosa complex. Among the species of this complex, the one which most resembles to the new taxon is C. imbroglio Rabindranath, 1972, which is distinguished by the absence of both the trapezoid process in the palm and spine at the palmar corner in the gnathopod 2. This is the second species of the genus Cymadusa recorded from Brazilian waters.

  1. Pathology of the distal condyles of the third metacarpal and third metatarsal bones of the horse

    International Nuclear Information System (INIS)

    Riggs, C.M.; Whitehouse, G.H.; Boyde, A.

    1999-01-01

    This study examined material from Thoroughbred horses, the majority of which had been in race training, for evidence of pathology in the third metacarpal (McIII) and third metatarsal (MtIII) bones which might be related to the occurrence of distal condylar fractures. Whole bone samples were studied and documented by macrophotography prior to macroradiography and computed tomographic (CT) imaging. Microradiographs were made from 100 microm thick mediolateral sections cut perpendicular to the dorsal and palmar/plantar articular surfaces of distal condylar regions of McIII and MtIII. Blocks were prepared for morphological imaging using the backscattered electron mode of scanning electron microscopy (BSE SEM). Linear defects in mineralised articular cartilage and subchondral bone were found in the palmar/plantar aspects of the condylar grooves adjacent to the sagittal ridge. These were closely related to the pattern of densification of the subchondral bone and were associated with intense focal remodelling of the immediately adjacent and subjacent bone. Parasagittal fractures of the condyles originated in similar defects. A unifying hypothesis for the aetiopathogenesis of these fractures is presented

  2. Touraine Solente Gole syndrome: The elephant skin disease

    Directory of Open Access Journals (Sweden)

    T. M. Sheeja Rajan

    2013-01-01

    Full Text Available Touraine Solente Gole syndrome is a rare hereditary syndrome of primary pachydermoperiostosis, with the characteristic triad of pachydermia (or elephant like skin, periostosis and acropachia. A 27-year-old patient presented with aesthetic deformity of forehead due to deep skin folds and coarsening of facial features due to progressive thickening of skin. Associated palmoplantar hyperkeratosis with broadened of finger and toe tips and digital clubbing were noticed. Dermatologic evaluation revealed cutis verticis gyrata of scalp, seborrhoeic hyperplasia of face and hyperhidrosis. Natural history of the disease and aetiopathogenesis were reviewed. Aesthetic correction of forehead through frontal rhytidectomy was attempted.

  3. Rare high origin of the radial artery: a bilateral, symmetrical case ...

    African Journals Online (AJOL)

    Arterial variations in the upper limb can occur at the level of the axillary, brachial, radial and ulnar arteries as well as the palmar arches. This is a report of bilateral, symmetrical high origin of the radial artery from the axillary artery. Knowledge of such variations is important in vascular and reconstructive surgery. (Nig J Surg ...

  4. Optimal Scoring Methods of Hand-Strength Tests in Patients with Stroke

    Science.gov (United States)

    Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

    2011-01-01

    The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods…

  5. The Acute Effect of Aerobic Exercise on Measures of Stress.

    Science.gov (United States)

    Fort, Inza L.; And Others

    The immediate response of stress to aerobic exercise was measured by utilizing the Palmar Sweat Index (PSI) and the State-Trait Anxiety Inventory (STAI). Forty subjects (20 male and 20 female) from the ages of 18-30 sustained a single bout of aerobic activity for 30 minutes at 60 percent of their maximum heart rate. Pre-treatment procedures…

  6. Long-term high-dose oral morphine in phantom limb pain with no addiction risk

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-01-01

    Full Text Available Chronic phantom limb pain (PLP is a type of neuropathic pain, which is located in the missing/amputated limb. Phantom pain is difficult to treat as the exact basis of pain mechanism is still unknown. Various methods of treatment for PLP have been described, including pharmacological (NSAIDs, opioids, antiepileptic, antidepressants and non-pharmacological (TENS, sympathectomy, deep brain stimulation and motor cortex stimulation. Opioids are used for the treatment of neuropathic pain and dose of opioid is determined based on its effect and thus there is no defined ceiling dose for opioids. We report a case where a patient receiving high-dose oral morphine for chronic cancer pain did not demonstrate signs of addiction.

  7. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-01-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  8. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-12-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  9. Anti-asialo GM1 antibodies prevents guanethidine-induced sympathectomy in athymic rats

    DEFF Research Database (Denmark)

    Thygesen, P; Hougen, H P; Christensen, H B

    1992-01-01

    Guanethidine sulphate induces destruction of peripheral sympathetic neurons and infiltration of mononuclear cells in rat sympathetic ganglia. The effect of guanethidine is believed to be an autoimmune reaction. In order to determine the effect of anti-asialo GM1, an antibody that binds to the gly......Guanethidine sulphate induces destruction of peripheral sympathetic neurons and infiltration of mononuclear cells in rat sympathetic ganglia. The effect of guanethidine is believed to be an autoimmune reaction. In order to determine the effect of anti-asialo GM1, an antibody that binds...... to the glycolipid asialo GM1 expressed on rodent natural killer cells, athymic Lewis rats received guanethidine 40 mg/kg i.p. daily from day 1 to 14 and anti-asialo GM1 i.p. 1 mg/rat on day -2, 0, 2, 6, and 10 in the study period. Saline and anti-asialo GM1 were given alone in the same doses as control. The number...... of neurons in the sympathetic ganglia were counted and the ganglionic volume determined. The presence of natural killer cells in the ganglia were determined by immunohistochemical methods. Our results shows that anti-asialo GM1 can prevent guanethidine-induced reduction of sympathetic neurons...

  10. Gorlin-Goltz Syndrome: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Adrianne Rahde Bischoff

    2014-10-01

    Full Text Available Description of a case report of Gorlin-Goltz Syndrome diagnosed in a male newborn who presented increased head circumference and bifid ribs. Mother and grandmother presented typical physical findings of the syndrome, including palmar pits, odontogenic cysts, and history of multiple skin cancer resections. The diagnosis was based on clinical findings of three relatives. A literature review is also presented.

  11. A Glove for Tapping and Discrete 1D/2D Input

    Science.gov (United States)

    Miller, Sam A.; Smith, Andy; Bahram, Sina; SaintAmant, Robert

    2012-01-01

    This paper describes a glove with which users enter input by tapping fingertips with the thumb or by rubbing the thumb over the palmar surfaces of the middle and index fingers. The glove has been informally tested as the controller for two semi-autonomous robots in a a 3D simulation environment. A preliminary evaluation of the glove s performance is presented.

  12. Botulinum toxin for treatment of glandular hypersecretory disorders.

    LENUS (Irish Health Repository)

    Laing, T A

    2012-02-03

    SUMMARY: The use of botulinum toxin to treat disorders of the salivary glands is increasing in popularity in recent years. Recent reports of the use of botulinum toxin in glandular hypersecretion suggest overall favourable results with minimal side-effects. However, few randomised clinical trials means that data are limited with respect to candidate suitability, treatment dosages, frequency and duration of treatment. We report a selection of such cases from our own department managed with botulinum toxin and review the current data on use of the toxin to treat salivary gland disorders such as Frey\\'s syndrome, excessive salivation (sialorrhoea), focal and general hyperhidrosis, excessive lacrimation and chronic rhinitis.

  13. Dynamics of Total Microcystin LR Concentration in Three Subtropical Hydroelectric Generation Reservoirs in Uruguay, South America.

    Science.gov (United States)

    González-Piana, Mauricio; Fabián, Daniel; Piccardo, Andrea; Chalar, Guillermo

    2017-10-01

    This study analyzed the temporal dynamics of total microcystin LR concentrations between the years of 2012 and 2015 in the Bonete, Baygorria and Palmar hydroelectric generation reservoirs in the central region of the Negro River, Uruguay. The three reservoirs showed differents total microcystin LR concentration, with no significant differences among them. Over 20 sampling dates, the three reservoirs exhibited total microcystin LR concentrations on eight occasions that corresponded to a slight to moderate human health risk according to WHO guideline values for recreational waters. By determining the concentration of microcystin LR in cyanobacterial biomass, we identified cyanobacterial populations that occurred over time with varying degrees of toxin production (maximal 85.4 µg/mm 3 ). The microcystin LR concentration in Bonete was positively correlated with temperature (r = 0.587) and cyanobacterial biomass (r = 0.736), in Baygorria with cyanobacterial biomass (r = 0.521), and in Palmar with temperature (r = 0.500) and negatively correlated with ammonia (r = -0.492). Action is needed to reduce the presence of toxic cyanobacteria in these systems. A decrease in the use of agrochemicals and management changes in the reservoir basins could be successful long-term measures.

  14. Hormone-sensitive lipase (HSL) expression and regulation in skeletal muscle

    DEFF Research Database (Denmark)

    Langfort, J; Ploug, T; Ihlemann, J

    1998-01-01

    Because the enzymatic regulation of muscle triglyceride metabolism is poorly understood we explored the character and activation of neutral lipase in muscle. Western blotting of isolated rat muscle fibers demonstrated expression of hormone-sensitive lipase (HSL). In incubated soleus muscle...... epinephrine increased neutral lipase activity by beta-adrenergic mechanisms involving cyclic AMP-dependent protein kinase (PKA). The increase was paralleled by an increase in glycogen phosphorylase activity and could be abolished by antiserum against HSL. Electrical stimulation caused a transient increase...... in activity of both neutral lipase and glycogen phosphorylase. The increase in lipase activity during contractions was not influenced by sympathectomy or propranolol. Training diminished the epinephrine induced lipase activation in muscle but enhanced the activation as well as the overall concentration...

  15. Compound palmar ganglion causing compressive neuropathy of the median nerve

    Directory of Open Access Journals (Sweden)

    Tribhuwan Narayan Singh Gaur

    2017-01-01

    Full Text Available Tuberculosis (TB of synovial sheath of tendon is uncommon, it is a severe form of extrapulmonary TB, diagnosis is obvious on clinical grounds in later stages, but is always confirmed by histopathology. Here, we are presenting a case of a 50-year-old female, who presented to us with gradual increasing swelling in her left hand and wrist and numbness over left thenar eminence. The patient was successfully treated with debulking operation and anti-tubercular drugs. Tubercular tenosynovitis of wrist and hand is a severe form of extrapulmonary TB. Intraoperatively, the presence of rice body or melon seed bodies is pathognomonic for confirming the diagnosis. Early diagnosis and intervention give good prognosis.

  16. Efecto de diferentes regímenes de fertilización sobre la relación fitoplancton-bacteríoplancton en mesocosmos

    OpenAIRE

    Monserrate Vite, Marita Elizabeth

    2003-01-01

    Efecto de diferentes regímenes de fertilización sobre la relación fitoplancton-bacterioplancton en mesocosmos Se estudió el efecto de la adición de fertilizantes inorgánicos y orgánicos sobre la relación bacterioplancton – fitoplancton en mesocosmos (24 tanques de una tonelada de capacidad), llenados con agua del canal reservorio de la camaronera COFIMAR (Palmar, Ecuador).

  17. Development of osteochondrosis in the tarsocrural joint and osteochondral fragments in the fetlock joints of Standardbred trotters. I. A radiological survey

    International Nuclear Information System (INIS)

    Carlsten, J.; Sandgren, B.; Dalin, G.

    1993-01-01

    In a longitudinal study 77 Standardbred foals were examined 6 times from birth to the age of 16 months. The radiological examination included 9 views, selected to demonstrate the time of occurrence and the appearance of early radiographic signs of osteochondrosis in the tarsocrural joints (OC), palmar/plantar osteochondral fragments in the fetlock joints (POF) and ununited proximal palmar/plantar eminences of the proximal phalanx (UPE). Subchondral bone defects with a diameter >5 mm and/or osseous fragments were considered significant radiographic findings and were correlated to clinical signs.Eight horses (10.4%) showed OC in the tarsocrural joints at the age of 12 months. All 8 horses showed radiographic changes indicating early OC lesions that were detectable before the age of 3 months. In 4 of these horses subchondral bone defects and/or fragments at the intermediate ridge of the distal tibia were visible before 1 month of age. Eleven horses showed radiographic changes first detected between 1 and 3 months of age that reverted to normal appearance at 8 months of age. In no case was a significant radiographic finding first detected between the age of 8 and 16 months. The radiographic findings of permanent hock OC were significantly correlated with the presence of tarsocrural joint effusions but did not correlate with lameness.At the age of 12 months, 11 horses (14.3%) showed significant radiographic changes with defects and/or osseous fragments in the metacarpo- and metatarsophalangeal (fetlock) joints. In all of these horses early indications of these changes were detected before the age of 5 months. In 7 horses early radiographic signs of abnormal ossification reverted to a normal appearance before the age of 8 months. No additional significant radiographic findings were detected after the age of 8 months. There was no correlation between radiographic findings and fetlock joint synovial effusion or lameness.Osteochondrosis of the tarsocrural joints and palmar

  18. Can high-resolution peripheral quantitative computed tomography imaging of subchondral and cortical bone predict condylar fracture in Thoroughbred racehorses?

    Science.gov (United States)

    Trope, G D; Ghasem-Zadeh, A; Anderson, G A; Mackie, E J; Whitton, R C

    2015-07-01

    High-resolution 3D imaging may improve the prediction and/or early identification of condylar fractures of the distal metacarpus/tarsus and reduce the frequency of breakdown injury in racehorses. To test the hypotheses that horses suffering condylar fractures have higher bone volume fraction (BV/TV) of the distal metacarpal epiphysis, greater subchondral bone thickness at the fracture site and higher second moment of inertia in the metacarpal midshaft as identified with high-resolution 3D imaging. Cross-sectional study using cadaver material. Thoroughbreds that died on racetracks were grouped as: 1) horses with third metacarpal (McIII) fractures with a condylar component (cases, n = 13); 2) horses with no limb fracture (controls, n = 8); 3) horses with fractures in other bones or suspensory apparatus disruption (other fatal injuries, n = 16). The palmar condyles of McIII and the midshaft were examined with high resolution peripheral quantitative computed tomography (HR-pQCT). Statistical analysis included logistic regression and Spearman's correlation. There were no significant differences in BV/TV of distal McIII and second moment of inertia of the midshaft between cases and controls. Epiphyseal bone BV/TV was greater in injured limbs of horses with any fatal limb injury (Groups 1 and 3 combined) compared with controls (odds ratio = 1.20, 95% confidence interval 1.01-1.42, P = 0.034). An epiphyseal BV/TV>0.742 resulted in a sensitivity of 82.8% and specificity of 62.5% in identifying horses with fatal limb injury. In horses without condylar fracture, increased subchondral bone thickness was associated with palmar osteochondral disease lesions in the adjacent condyle (rs = 0.65, Phorses at risk of any fatal breakdown injury but not metacarpal condylar fractures. Measurement of parasagittal groove subchondral bone thickness is complicated by adjacent palmar osteochondral disease lesions. Thus, high-resolution imaging of the distal metacarpus appears to have limited

  19. Diploposthe laevis (Bloch Jacobi (Eucestoda, Hymenolepididae from Netta peposaca (Vieillot (Aves: Anatidae: first record for the Neotropical Region and a new host Diploposthe laevis (Bloch Jacobi (Eucestoda: Hymenolepididae em Netta peposaca (Vieillot (Aves, Anatidae: primeiro registro para Região Neotropical e novo hospedeiro

    Directory of Open Access Journals (Sweden)

    Eliane F. da Silveira

    2008-03-01

    Full Text Available One hundred eight rosy-billed pochards, Netta peposaca (Vieillot, 1816, collected in Brazil and Argentina were examined for endoparasites. Collection sites included the municipalities of Santa Vitória do Palmar and Jaguarão, Rio Grande do Sul State, Brazil (wintering site and Alvear, Corrientes Province, northern Argentina (nesting site. Birds were frozen in dry ice after collection. During necropsy they were categorized according to sex and maturation, either adult or juvenile. The cestode Diploposthe laevis (Bloch Jacobi, 1896 was found (prevalence 68.5%, mean infection was 2. The mean prevalence of D. laevis in Alvear (25.9% was higher than found in Jaguarão and Santa Vitória do Palmar, Rio Grande do Sul (19%, and could be related to the nesting site and to the period when the birds may ingest a higher amount of food. This is the first record of a species of the genus Diploposthe in anatideans from South America, and the first record of the species in N. peposaca. Details of the cirrus pouch and vagina were described based on histological sections.Com o objetivo de conhecer a helmintofauna do marrecão, Netta peposaca (Vieillot, 1816, na América do Sul, 108 aves foram amostradas. Os pontos de captura foram os municípios de Santa Vitória do Palmar e Jaguarão, no Estado do Rio Grande do Sul, sul do Brasil (pólo de invernia, e em Alvear, Província de Corrientes, região norte da Argentina (pólo de nidificação, entre 2002 e 2004. As aves foram congeladas em gelo seco logo após o abate. Durante o procedimento de necropsia tiveram o sexo identificado, e foram classificadas de acordo com estado de maturação sexual, em juvenil e adulto. O cestóide Diploposthe laevis (Bloch Jacobi, 1896 foi encontrado com prevalência média de 68,5% e intensidade média de infecção de dois espécimes por hospedeiro. A prevalência média de D. laevis em Alvear (25,9% foi maior do que a encontrada em Jaguarão e Santa Vitória do Palmar, Rio Grande

  20. Gorlin-goltz syndrome: a rare case.

    Science.gov (United States)

    Ganguly, Satyaki; Jaykar, Kranti C; Kumar, Rajesh; Jha, Abhijeet Kumar; Banerjee, P K

    2015-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  1. Gorlin-Goltz Syndrome: A Rare Case

    OpenAIRE

    Ganguly, Satyaki; Jaykar, Kranti C; Kumar, Rajesh; Jha, Abhijeet Kumar; Banerjee, PK

    2015-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  2. Nevoid basal cell carcinoma syndrome; Naevoid Basalzellkarzinom-Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Grgic, A.; Heinrich, M.; Heckmann, M.; Kramann, B. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Aliani, S. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Kinder- und Jugendmedizin; Dill-Mueller, D. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Hautklinik und Poliklinik; Uder, M. [Erlange-Nuernberg Univ. (Germany). Inst. fuer Diagnostische Radiologie

    2005-07-01

    Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an autosomal-dominant disorder characterized by multiple basal cell carcinomas, jaw cysts, palmar/plantar pits, calcification of the falx cerebri, and spine and rib anomalies. The combination of clinical, imaging, and histological findings is helpful in identifying NBCCS patients. Imaging plays a crucial role in evaluation of these patients. We present a wide variety of clinical and radiological findings characteristic of this disease. (orig.)

  3. Robust experiment design for estimating myocardial β adrenergic receptor concentration using PET

    International Nuclear Information System (INIS)

    Salinas, Cristian; Muzic, Raymond F. Jr.; Ernsberger, Paul; Saidel, Gerald M.

    2007-01-01

    Myocardial β adrenergic receptor (β-AR) concentration can substantially decrease in congestive heart failure and significantly increase in chronic volume overload, such as in severe aortic valve regurgitation. Positron emission tomography (PET) with an appropriate ligand-receptor model can be used for noninvasive estimation of myocardial β-AR concentration in vivo. An optimal design of the experiment protocol, however, is needed for sufficiently precise estimates of β-AR concentration in a heterogeneous population. Standard methods of optimal design do not account for a heterogeneous population with a wide range of β-AR concentrations and other physiological parameters and consequently are inadequate. To address this, we have developed a methodology to design a robust two-injection protocol that provides reliable estimates of myocardial β-AR concentration in normal and pathologic states. A two-injection protocol of the high affinity β-AR antagonist [ 18 F]-(S)-fluorocarazolol was designed based on a computer-generated (or synthetic) population incorporating a wide range of β-AR concentrations. Timing and dosage of the ligand injections were optimally designed with minimax criterion to provide the least bad β-AR estimates for the worst case in the synthetic population. This robust experiment design for PET was applied to experiments with pigs before and after β-AR upregulation by chemical sympathectomy. Estimates of β-AR concentration were found by minimizing the difference between the model-predicted and experimental PET data. With this robust protocol, estimates of β-AR concentration showed high precision in both normal and pathologic states. The increase in β-AR concentration after sympathectomy predicted noninvasively with PET is consistent with the increase shown by in vitro assays in pig myocardium. A robust experiment protocol was designed for PET that yields reliable estimates of β-AR concentration in a population with normal and pathologic

  4. Adrenergic effects on secretion of epidermal growth factor from Brunner's glands

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1985-01-01

    The influence of the sympathetic nervous system and adrenergic agonists on flow rate and secretion of epidermal growth factor (EGF) from Brunner's glands has been investigated in the rat. Chemical sympathectomy by administration of 6-hydroxydopamine increased volume secretion and output of EGF from...... Brunner's glands but depleted the glands of EGF. Infusion of noradrenaline, an alpha-adrenergic agonist, inhibited basal and vasoactive intestinal polypeptide (VIP) stimulated flow rate and output of EGF from Brunner's glands and increased the amount of EGF in the tissue. Vasoactive intestinal polypeptide...... also increased the amount of EGF in Brunner's gland tissue and this was unchanged after simultaneous infusion of VIP and noradrenaline as well as VIP and isoproterenol, a beta-adrenergic agonist. Isoproterenol had no effect on basal and VIP stimulated secretion of EGF from Brunner's glands...

  5. The influence of dibutyryl adenosine cyclic monophosphate on cell proliferation in the epithelium of the jejunal crypts, the colonic crypts and in colonic carcinomata of rat.

    Science.gov (United States)

    Tutton, P J; Barkla, D H

    1980-01-01

    1. Cell proliferation in the jejunal crypts, the colonic crypts and in dimethylhydrazine (DMH)-induced adenocarcinomata of rat colon was measured using a stathmokinetic technique. 2. Dibutryl cyclic adneosine monophosphate (dibutyryl cAMP) was found to inhibit cell proliferation in colonic crypts and in colonic adenocarcinomata. 3. Dibutryl cAMP at very high doses was found to inhibit jejunal crypt cell proliferation but at lower doses was found to accelerate jejunal crypt cell proliferation. 4. Neither bilateral adrenalectomy nor chemical sympathectomy was found to abolish the ability of dibutryl cAMP to stimulate jejunal crypt cell proliferation. 5. The present results are difficult to interpret in terms of known hormonal influences on cell proliferation in the tissues examined and of established actions, of these hormones on cyclic nucleotide metabolism in other tissues.

  6. /sup 99m/Tc radionuclide angioscintigraphic perfusion analysis in the assessment and follow-up of peripheral vascular diseases of the lower limbs

    International Nuclear Information System (INIS)

    Bencini, C.; Mazzuca, N.; Bertelli, P.; Pulera, N.; Mariani, G.

    1986-01-01

    Peripheral arterial diseases (PADs) of the lower limbs such as thromboangitis obliterans (TAO) (Buerger's disease), arteriosclerosis obliterans (ASO) and diabetes mellitus, produce trophic disturbances occurring most often in the toes. Perfusion analysis of the foot and toes was previously reported. The analysis utilized radionuclide arteriography (RNA) during reactive hyperaemia to obtain peak activity in RNA time-activity curves (TACs). RNA was also used to assess healing capability of skin ulcers of the calf and ankle, which depends on localized enhancement of capillary blood flow. On these bases, detection of capillary blood flow assumes primary importance in the assessment of peripheral vascular disease (PVD). The purpose of this study was to determine whether RNA of the toes at rest could provide adequate assessment of microcirculation in PVD and of microcirculatory changes induced by lumbar sympathectomy (LS)

  7. Muscle and liver glycogen, protein, and triglyceride in the rat

    DEFF Research Database (Denmark)

    Richter, Erik; Sonne, Bente; Joensen Mikines, Kari

    1984-01-01

    in skeletal muscle was accompanied by increased breakdown of triglyceride and/or protein. Thus, the effect of exhausting swimming and of running on concentrations of glycogen, protein, and triglyceride in skeletal muscle and liver were studied in rats with and without deficiencies of the sympatho......-adrenal system. In control rats, both swimming and running decreased the concentration of glycogen in fast-twitch red and slow-twitch red muscle whereas concentrations of protein and triglyceride did not decrease. In the liver, swimming depleted glycogen stores but protein and triglyceride concentrations did...... not decrease. In exercising rats, muscle glycogen breakdown was impaired by adrenodemedullation and restored by infusion of epinephrine. However, impaired glycogen breakdown during exercise was not accompanied by a significant net breakdown of protein or triglyceride. Surgical sympathectomy of the muscles did...

  8. Imaging Features of Superficial and Deep Fibromatoses in the Adult Population

    Directory of Open Access Journals (Sweden)

    Eric A. Walker

    2012-01-01

    Full Text Available The fibromatoses are a group of benign fibroblastic proliferations that vary from benign to intermediate in biological behavior. This article will discuss imaging characteristics and patient demographics of the adult type superficial (fascial and deep (musculoaponeurotic fibromatoses. The imaging appearance of these lesions can be characteristic (particularly when using magnetic resonance imaging. Palmar fibromatosis demonstrates multiple nodular or band-like soft tissue masses arising from the proximal palmar aponeurosis and extending along the subcutaneous tissues of the finger in parallel to the flexor tendons. T1 and T2-weighted signal intensity can vary from low (higher collagen to intermediate (higher cellularity, similar to the other fibromatoses. Plantar fibromatosis manifests as superficial lesions along the deep plantar aponeurosis, which typically blend with the adjacent plantar musculature. Linear tails of extension (“fascial tail sign” along the aponeurosis are frequent. Extraabdominal and abdominal wall fibromatosis often appear as a heterogeneous lesion with low signal intensity bands on all pulse sequences and linear fascial extensions (“fascial tail” sign with MR imaging. Mesenteric fibromatosis usually demonstrates a soft tissue density on CT with radiating strands projecting into the adjacent mesenteric fat. When imaging is combined with patient demographics, a diagnosis can frequently be obtained.

  9. 'Culture and memory of the Sto. Antonio do Morro Grande/MG Quilombola community' program - case study: environmental licensing progress for the Rio de Janeiro-Belo Horizonte Gas Pipeline (GASBEL II)

    Energy Technology Data Exchange (ETDEWEB)

    Ismerio, Marcia [Pallos Environmental Consulting, Rio de Janeiro, RJ (United States); Bartolini, Marcia [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    The 'Culture and Memory of the Sto. Antonio do Morro Grande Quilombola Community' Program was included in the environmental licensing process of the Rio de Janeiro-Minas Gerais gas pipeline ('GASBEL II'), as requested by the Palmares Cultural Foundation (Fundacao Cultural Palmares), which stipulates the elaboration and implementation of this program as a condition for obtaining the installation license. To develop the program and submit it to this institution, we used methodological procedures in the form of an anthropological social research, such as: interviews with the community's older or most active residents, and a preliminary recognition of the territory and the local culture; all in order to learn more about the community's history and current needs and to identify the remaining 'quilombolas' still living in the community. Analyzing the information raised the need for guided actions designed to rescue the community's cultural memory as an ethnic group and to contribute to its process of affirmation as a Traditional Rural 'Quilombola' Community. This led to the creation of the proposed 'Culture and Memory of the Sto. Antonio do Morro Grande Quilombola Community' Program, currently being developed for the Quilombola Community located in Ressaquinha, in the State of Minas Gerais. (author)

  10. Palmaris Longus Muscle in the South Indian Population – A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Lydia S. Quadros

    2017-07-01

    Full Text Available Introduction: Palmaris longus, one of the superficial flexor muscles of the anterior compartment of the forearm is the most variable muscle of the upper limb. Purpose: To note the variations of palmaris longus for tendon grafts. Methods: Forty formalin-fixed upper limb specimens of South Indian population were dissected to note the variations of Palmaris longus muscle. Results: Out of the forty upper limb specimens, two variants of the palmaris longus were noted. In one specimen, a reversed palmaris longus was noted. It had a long tendinous origin with a muscle belly and a short flat tendon at insertion. The tendon inserted partly into the flexor retinaculum and partly into palmar aponeurosis. In another specimen, apart from the normal palmaris longus muscle, an additional smaller muscle was noted. It was the Palmaris profundus. This muscle took origin in the form of a tendon from the middle of the shaft of the radius, continued as a muscle belly and then terminated as a tendon which later inserted into the flexor retinaculum, close to the tendon of palmaris longus muscle. At its insertion, the superficial palmar branch of radial artery hooked it. The anterior interosseous nerve supplied the Palmaris profundus. Conclusion: These variations are worthy to be noted for tendon grafts.

  11. Trabecular architecture of the manual elements reflects locomotor patterns in primates.

    Science.gov (United States)

    Matarazzo, Stacey A

    2015-01-01

    The morphology of trabecular bone has proven sensitive to loading patterns in the long bones and metacarpal heads of primates. It is expected that we should also see differences in the manual digits of primates that practice different methods of locomotion. Primate proximal and middle phalanges are load-bearing elements that are held in different postures and experience different mechanical strains during suspension, quadrupedalism, and knuckle walking. Micro CT scans of the middle phalanx, proximal phalanx and the metacarpal head of the third ray were used to examine the pattern of trabecular orientation in Pan, Gorilla, Pongo, Hylobates and Macaca. Several zones, i.e., the proximal ends of both phalanges and the metacarpal heads, were capable of distinguishing between knuckle-walking, quadrupedal, and suspensory primates. Orientation and shape seem to be the primary distinguishing factors but differences in bone volume, isotropy index, and degree of anisotropy were seen across included taxa. Suspensory primates show primarily proximodistal alignment in all zones, and quadrupeds more palmar-dorsal orientation in several zones. Knuckle walkers are characterized by having proximodistal alignment in the proximal ends of the phalanges and a palmar-dorsal alignment in the distal ends and metacarpal heads. These structural differences may be used to infer locmotor propensities of extinct primate taxa.

  12. Gorlin-Goltz syndrome: A rare case

    Directory of Open Access Journals (Sweden)

    Satyaki Ganguly

    2015-01-01

    Full Text Available Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is characterized by multiple basocellular epitheliomas, keratocysts in the jaws, bifid ribs, palmar and/or plantar pits and ectopic calcifications of the falx cerebri. We describe a case of Gorlin-Goltz syndrome illustrating the importance of a thorough examination including the examination of palms and soles and detailed investigations in a patient having lesions suggestive of basal cell carcinoma and multiple naevi.

  13. Resident rounds. Part III: case report: temporary traumatic discoloration from handling moss-covered firewood.

    Science.gov (United States)

    Zitelli, Kristine B; Adams, Brian B

    2013-07-01

    Pattern recognition remains a valuable tool in the accurate diagnosis of dermatologic disease. A comprehensive patient history and physical examination denote cornerstones of medical evaluation, and in our specialty, dermoscopy can supplement data gathering to allocate cutaneous eruptions into appropriate categories. We present a case of acute onset palmar discoloration occurring in an otherwise healthy patient. Correct diagnosis transpired in the clinical setting with tailored questioning based on careful examination and adjunct dermatoscopic evaluation.

  14. Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients.

    Science.gov (United States)

    Marie, Isabelle; Hervé, Fabien; Primard, Etienne; Cailleux, Nicole; Levesque, Hervé

    2007-11-01

    Hypothenar hammer syndrome (HHS) is an uncommon form of secondary Raynaud phenomenon, occurring mainly in subjects who use the hypothenar part of the hand as a hammer; the hook of the hamate strikes the superficial palmar branch of the ulnar artery in the Guyon space, leading to occlusion and/or aneurysm of the ulnar artery. In patients with HHS, such injuries of the palmar ulnar artery may lead to severe vascular insufficiency in the hand with occlusion of digital artery. To date, only a few series have analyzed the long-term outcome of patients with HHS. This prompted us to conduct the current retrospective study to 1) evaluate the prevalence of HHS in patients with Raynaud phenomenon and 2) assess the short-term and long-term outcome in patients with HHS. From 1990 to 2006, 4148 consecutive patients were referred to the Department of Internal Medicine at the University of Rouen medical center for evaluation of Raynaud phenomenon using nailfold capillaroscopy. HHS was diagnosed in 47 of these 4148 patients (1.13% of cases).Forty-three patients (91.5%) had occupational exposure to repetitive palmar trauma. The more common occupations were factory worker (21.3%), mason (12.8%), carpenter (10.6%), and metal worker (10.6%); the mean duration of occupational exposure to repetitive palmar trauma at HHS diagnosis was 21 years. One patient (2.1%) had recreational exposure (aikido training) to repetitive trauma of the palmar ulnar artery, and 3 other patients (6.4%) developed HHS related to a single direct injury to the hypothenar area. Clinical manifestations were more often unilateral (87.2%) involving the dominant hand (93%). HHS complications included digital ischemic symptoms (ischemia: n = 21, necrosis: n = 20) and irritation of the sensory branch of the ulnar nerve (n = 11). In HHS patients, angiography demonstrated occlusion of the ulnar artery in the area of the Guyon space (59.6%), aneurysm of the ulnar artery in the area of the Guyon space (40.4%), and embolic

  15. Validação da escala motora funcional EK para a língua portuguesa Validation of the EK functional motor scale in the Portuguese language

    Directory of Open Access Journals (Sweden)

    José Antônio Baddini Martinez

    2006-10-01

    Full Text Available OBJETIVO: Validar uma versão traduzida para o português da escala funcional EK (Egen Klassifikation, desenvolvida na Dinamarca, visando aplicação em pacientes com distrofia muscular de Duchenne e atrofia muscular espinhal. MÉTODOS: Uma versão em inglês da escala EK foi traduzida para o português falado no Brasil. Tal escala foi aplicada a 26 pacientes do sexo masculino (idade média = 12,7 ± 4,0 anos, com diagnóstico de distrofia muscular de Duchenne. Os pacientes também responderam questões referentes a uma versão em língua portuguesa do índice de Barthel e tiveram medidas a força de preensão palmar direita e esquerda, com emprego de um dinamômetro de mão. Os escores da escala EK foram correlacionados com a idade, escores do índice de Barthel e as forças palmares. RESULTADOS: O escore total médio da escala EK foi de 8,1 ± 7,3 e do índice de Barthel de 54,0 ± 26,2. A força de preensão palmar direita foi de 12,7 ± 17,2% e a esquerda de 14,6 ± 19,8% do previsto. Os escores da escala EK correlacionaram-se de maneira altamente significante com a idade (r= 0,596, p= 0,0013, força de preensão palmar direita (r= -0,556, p= 0,0032 e esquerda (r= -0,623, p=0,0007, e com o índice de Barthel (r= -0,928, p OBJECTIVE: To validate a Portuguese version of the EK scale (Egen Klassifikation, that was developed in Denmark for patients with Duchenne muscular dystrophy, and spinal muscular atrophy. METHODS: An English version of the EK scale was translated into the Portuguese language as spoken in Brazil. This scale was applied to 26 male patients (mean age = 12.7 ± 4.0 years with Duchenne muscular dystrophy. Patients also answered questions of a Portuguese version of the Barthel index questionnaire, and had their right and left hand grip forces measured with a dynamometer. RESULTS: The mean total EK scale score was 8.1 ± 7.3 and the Barthel index 54.0 ± 26.2. The mean hand grip force was 12.7 ± 17.2 % predicted for the right

  16. An old woman with chronic palmar dermatosis, rheumatism, and nail changes

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2017-02-01

    Full Text Available Psoriasis is a chronic inflammatory condition with variable changes on the skin and nails, sometimes associated with osteoarticular manifestations characterizing the psoriatic arthritis. This arthritis may precede, follow, or be concomitant with the skin lesions of psoriasis. Unsuspected psoriatic arthritis may be misdiagnosed by other seronegative spondyloarthritis, mainly in primary care attention, and ominous outcomes are related to late and inadequate management. Therefore, diagnostic exercises with base on significant clinical and radiological images might contribute to enhance the suspicion index about these challenging conditions.

  17. Effect of hot bag application on the extremities in angiography of patients with Raynaud's syndrome

    International Nuclear Information System (INIS)

    Won, Je Hwan; Han, Kyong Lim; Kim, Chan

    2004-01-01

    It is sometimes difficult to evaluate the angiographic findings pertaining to spasm of the arteries in the hands and feet in patients with Raynaud's syndrome. The purpose of this study is to investigate the effectiveness of applying a hot bag to the hands and/or feet for the control of vasospasm in patients with Raynaud's syndrome during angiography. Forty five cases (hands: feet=15:30) in forty patients (M:F=9:31, mean age; 39 years) with Raynaud's syndrome whose conventional angiography demonstrated the presence of vasospasm were included. First, digital subtraction angiography of the extremities was performed at room temperature (20 to 21 degrees Celsius). Then a hot bag was applied for 5 minutes on the hand or foot, and a post-hot bag angiography of the extremity was performed. The angiographic findings were classified into 6 grades in the case of the feet (0; anterior/posterior tibial artery, 1; dorsalis pedis /lateral plantar artery, 2; arcuate artery/plantar arch, 3; metatarsal artery, 4; digital artery, 5; blushing of toe tip) and 5 grades in the case of the hands (0; ulnar/radial artery, 1; palmar arch, 2; common palmar artery, 3; proper palmar artery, 4; blushing of finger tip) according to the level of the visualized vessels on the angiography. The time and the time difference to maximal visualization of the vessels between the measurements taken at room temperature and those taken after the hot bag application were calculated. In all cases, more. vessels were visualized after the hot bag application than at room temperature. After the application of the hot bag, the grade of vessel visualization was increased in both the feet (range; 1-4, mean; 2.3) and hands (range; 1-2, mean; 1.4). The time to the maximal visualization of the vessels was faster after the hot bag application than at room temperature. The time difference between the two groups ranged from 1 to 33 seconds (mean; 12.3 seconds) in the feet and 2 to 26 seconds (mean; 11.8 seconds) in the

  18. Hidradenocarcinoma of the Scrotum with Lymph Node Metastasis

    OpenAIRE

    Maria Inês Simões; Isabel Marcão; Mário Toscano; Luís Borges

    2018-01-01

    Hidradenocarcinoma is a rare neoplasm of the eccrine cells of the sweat glands, usually asymptomatic with slow growing and higher incidence between 50 and 80 years, occurring in both sexes and preferentially located in the palmar, plantar, frontal, axillary and nuchal regions. It has an aggressive behavior, with high rate of local recurrence and distance metastasis, associated with a poor prognosis. We present a case of hidradenocarcinoma of the scrotum manifested by lymph node metastasis thr...

  19. Sympathicotomy for isolated facial blushing

    DEFF Research Database (Denmark)

    Licht, Peter Bjørn; Pilegaard, Hans K; Ladegaard, Lars

    2012-01-01

    Background. Facial blushing is one of the most peculiar of human expressions. The pathophysiology is unclear, and the prevalence is unknown. Thoracoscopic sympathectomy may cure the symptom and is increasingly used in patients with isolated facial blushing. The evidence base for the optimal level...... of targeting the sympathetic chain is limited to retrospective case studies. We present a randomized clinical trial. Methods. 100 patients were randomized (web-based, single-blinded) to rib-oriented (R2 or R2-R3) sympathicotomy for isolated facial blushing at two university hospitals during a 6-year period...... between R2 and R2-R3 sympathicotomy for isolated facial blushing. Both were effective, and QOL increased significantly. Despite very frequent side effects, the vast majority of patients were satisfied. Surprisingly, many patients experienced mild recurrent symptoms within the first year; this should...

  20. Adrenergic effects on renal secretion of epidermal growth factor in the rat

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Nexø, Ebba

    1985-01-01

    Urinary epidermal growth factor (EGF) has been demonstrated recently to originate from the kidneys. The present study was undertaken to investigate the adrenergic and cholinergic influence on secretion of renal EGF. beta-Adrenergic agonists increased the level of urinary EGF, while propranolol......, a beta-adrenergic blocking agent, decreased basal and beta-adrenergic stimulated total output of urinary EGF. Acetylcholine and the anticholinergic agent atropine had no effect on the output of EGF in urine. Also chemical sympathectomy induced by 6-hydroxydopamine reduced the urinary output of EGF. None...... of the experimental groups had a median serum concentration above the detection limit of the assay. The present study shows that secretion of renal EGF is under the influence of the sympathetic nervous system and release of EGF is stimulated by activation of beta-adrenergic receptors in the kidneys....

  1. Toxina botulínica tipo A tópica con iontoforesis para el tratamiento de la hiperhidrosis axilar: Efecto y persistencia Topic type A botulinum toxin with iontophoresis in the treatment of armpit hyperhidrosis: effect and persistency

    Directory of Open Access Journals (Sweden)

    J.F. Silva-Gavarrete

    2011-09-01

    exocrine glands is termed Hyperhidrosis (HH and frequently become a dermatologic and social problem for humans. Nowadays, we have multiple treatments that controls the armpit HH. Botulinum toxin type A (TXB-A is known to be the best treatment to eliminate this problem but the needing of multiple injections in the armpit limits patients´ acceptance. Clinical iontophoresis method uses galvanic current to introduce many transdermal medications. We perform a simple blind clinical assay over 10 patients with armpit HH in who we apply an inert gel blended with Botulinum toxin type A (TXB-A Dysport® using one session of iontopheresis in one armpit; in the same moment the other armpit was injected with the toxin in the conventional way. The results where evaluated and compare by Minor Test (starch-iodine test in each patient at day 10th, 2 months and 5 months after the application. The same number of units and dilution of TXB-A where used in the topic and injected administration way. Results shows a diminished armpit HH in both sides over the whole study, been higher percentage of the effect in the injected way. In general a 74.67% decrease of armpit sweat for the topical way with iontopheresis and 90.33% of decrease of armpit sweat for the injected way. In the 5 months control of the persistency of the effect, both ways of administration of TXB-A reports with statistical significant results. Therefore in the present study we conclude that TXB-A apply topically with iontopheresis improves the armpit HH and shows a persistency of the effect at least for 5 months period.

  2. [Gorlin-Goltz syndrome: review of the neuroradiological and maxillofacial features illustrated with two clinical cases].

    Science.gov (United States)

    Safronova, Marta Maia; Arantes, Mavilde; Lima, Iva; Domingues, Sara; Almeida, Marta; Moniz, Pedro

    2010-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is a rare hereditary autosomal-dominant disorder characterized by multiple basal cell carcinomas in young patients, odontogenic keratocysts, palmar or plantar pits, calcification of the falx cerebri and skeletal malformations. This syndrome is due to mutations in PTCH1 (patched homolog 1 da Drosophila), a tumor suppressor gene. Diagnostic criteria were defined by Evans, revised by Kimonis and include major and minor criteria. The authors review in particular the neuroradiological and maxillofacial characteristics of the syndrome. The authors describe the clinical presentation of two children with Gorlin-Goltz syndrome without affected first degree relatives. In both the clinical suspicion of the syndrome is raised by the presence of multiple odontogenic cysts surgically removed. Histopathological exam revealed keratocysts. None of the patients has basal cell carcinomas but both present with skeletal anomalies, namely marked pectus deformity. The absence of major diagnostic criteria like basal cell carcinomas or palmar or plantar pits in young patients delay the early diagnosis and the correct screening for medulloblastoma, basal cell carcinomas and cardiac fibromas. Odontogenic keratocysts are the most consistent clinical finding in Gorlin-Goltz syndrome in the first one or two decades of life. These patients are very sensitive to ionizing radiation, being able to develop basal cell carcinomas and meningiomas. Treatment should accomplish the complete resection of the tumors.

  3. The effectiveness of long-pulse 1064 nm neoymium-doped yttrium aluminum garnet laser for recalcitrant palmoplantar and ungual warts

    Directory of Open Access Journals (Sweden)

    Ali Balevi

    2015-12-01

    Full Text Available Background and Design: Some of palmoplantar and ungual warts are resistant to conventional treatments. In this study, we aimed to investigate the efficacy of non-ablative 1064 nm long pulsed neoymium-doped yttrium aluminum garnet (Nd: YAG laser treatment on recalcitrant palmoplantar and ungual warts. Materials and Methods: Sixty-three patients with recalcitrant palmar, plantar and ungual warts were included in the study. Laser is applied in 4 sessions at 4-week intervals. The study employed the Nd: YAG (80 W. The following parameters were used: spot size: 4 mm; pulse duration: 15 msec; and fluence: 150 J/cm2. Treatment responses were evaluated statistically and side effects were recorded. Results: The number of patients who were completely cleaned and partially cleaned were 37 (66% and 15 (26%, respectively. Four patients (4% did not respond to treatment. In statistical analysis, there were no significant differences in palmar, plantar or ungual sites in term of complete clearance (p=0.20, p=0.82 and p=0.94, respectively. In addition, there was no association between the number of lesions and complete clearance (p=0.97. Conclusion: Long-pulsed Nd: YAG laser, which does not affect daily activity, is a safe and alternative method and may be recommended for patients with recalcitrant palmoplantar and ungual warts.

  4. NUEVA ESPECIE DE RANA BROMELÍCOLA DEL GÉNERO PRISTIMANTIS (AMPHIBIA: CRAUGASTORIDAE, MESETA DE LA CORDILLERA DEL CÓNDOR, ECUADOR

    Directory of Open Access Journals (Sweden)

    JORGE BRITO M.

    Full Text Available RESUMEN Describimos una especie pequeña de rana bromelícola del género Pristimantis (longitud rostro-cloaca en hembras 20.3-23.3 mm; en machos 16.1-17.4 mm, proveniente de una remota meseta de arenisca de la Cordillera del Cóndor, en el sureste de Ecuador, con un rango altitudinal de 2.045-2.860 m. Una filogenia en base a secuencias de ADN (genes mitocondriales y nucleares muestra que la nueva especie forma parte del grupo P. orestes y está más cercanamente relacionada con una especie de Pristimantis aún no descrita de la vertiente sur oriental ecuatoriana. Difiere de sus congéneres de Ecuador, por su coloración dorsal y ventral predominantemente negra; superficie palmar amplia y robusta con dedos cortos y gruesos; presencia de un surco profundo y amplio extendido desde la base anterior del I dedo manual hasta la base posterior del tubérculo palmar; tubérculos subarticulares divididos, tubérculos supernumerarios agrandados y con granulaciones pequeñas. Todos los individuos registrados estuvieron en bromelias terrestres. Las llamadas son cortas, de frecuencia modulada, conformada por una nota con duración de 5-15 ms. Los insectos representaron el 80% de la dieta de la especie nueva.

  5. Força de preensão palmar e pinça digital em diferentes grupos de pilotos da Academia da Força Aérea brasileira Grip and pinch strength among different groups of Brazilian Air Force pilots

    Directory of Open Access Journals (Sweden)

    Gláucia Helena Gonçalves

    2010-06-01

    Full Text Available Pilotos da Academia de Força Aérea (AFA brasileira, durante vôos, realizam movimentos com grande solicitação da musculatura da mão que comanda o manche, o que pode modificar a força muscular. Este estudo teve por objetivo analisar as forças musculares isométricas de preensão palmar e pinças polpa-a-polpa, trípode e lateral de três grupos de pilotos da AFA. Foram avaliados 15 pilotos da Esquadrilha da Fumaça (EDA, 16 instrutores de vôo (PI e 6 pilotos em treinamento (PT, todos do sexo masculino. Para a avaliação, o posicionamento corporal dos pilotos seguiu a padronização da Sociedade Americana de Terapeutas da Mão e a ordem dos movimentos analisados foi predefinida, evitando fadiga muscular. A força muscular isométrica máxima foi coletada em uma contração sustentada por 6 segundos. Os resultados mostram diferenças significativas na preensão, com superioridade das mãos dominantes em relação às não-dominantes em todos os grupos, tendo ainda o grupo EDA obtido valores significativamente superiores em relação aos demais. Nas medidas da pinça trípode, o grupo EDA apresentou significativos valores superiores aos do grupo PT, sendo encontrados valores das mãos dominantes superiores aos das não-dominantes nos grupos EDA e PI. Conclui-se que o treino específico da musculatura da mão durante o vôo, a especificidade e o período de treinamento interferem na força muscular isométrica da mão.Pilots from Brazilian Air Force Academy (AFA perform strentgth- and accuracy-demanding hand movements, which may modify muscle strength. The aim of this study was to analyse hand isometric strength of grip and pulp-to-pulp, tripode and lateral pinch in three groups of male AFA pilots: ADS (Air Demonstration Squadron, n=15; IP (instructor pilots, n=16; and TP (training pilots, n=6. Pilots body positioning during tests followed the standards of the American Society of Hand Therapists; the sequence of assessed movements was

  6. Sífilis secundaria de recidiva: A propósito de un caso Secondary syphilis of relapse: Report of a case

    OpenAIRE

    S López; ME Delgado; B Gómez; AM Lorenz

    2011-01-01

    La sífilis secundaria se caracteriza por su gran variabilidad clínica, la que puede simular muchas otras enfermedades, retrasando su diagnóstico. Las manifestaciones secundarias desaparecen sin tratamiento en varias semanas o meses. Un 25% de los pacientes no tratados presentan recidiva de las lesiones de secundarismo. Se presenta el caso de una paciente de sexo femenino, con lesiones eritematosas de bordes levemente infiltrados, que se localizan en región palmar y dorso de pie de varios mese...

  7. Papillon-Lefévre Syndrome: Report of Two Cases in a Family

    Directory of Open Access Journals (Sweden)

    C Vani

    2010-01-01

    Full Text Available This report presents two cases of Papillon-Lefévre syndrome (PLS affecting two girls among five siblings belonging to a south Indian Muslim family. The patients were 12 and 14 years old. The patients presented with palmar-plantar hyperkeratosis which started around the age of two years. The elder patient was edentulous due to severe destructive periodontitis causing premature loss of teeth. The younger patient had severe destructive periodontitis with multiple periodontal abscess and loose teeth.

  8. A comparison between 133Xenon washout technique and Laser Doppler flowmetry in the measurement of local vasoconstrictor effects on the microcirculation in subcutaneous tissue and skin

    DEFF Research Database (Denmark)

    Kastrup, J; Bülow, J; Lassen, N A

    1987-01-01

    Changes in skin blood flow measured by Laser Doppler flowmetry and changes in subcutaneous blood flow measured by 133Xenon washout technique were compared during activation of the local sympathetic mediated veno-arteriolar vasoconstrictor reflex by lowering the area of investigation below heart...... forearm, and on the calf with preserved sympathetic nerve supply. The Laser Doppler method registered a 23% reduction in skin blood flow during lowering of the extremities independently of the sympathetic nerve supply to the skin. The 133Xenon method recorded a 44% decrease in blood flow in innervated...... level. The measurements were performed in tissue with and without sympathetic innervation. In five subjects, who all had been cervically sympathectomized for manual hyperhidrosis, the Laser Doppler and 133Xenon blood flow measurements were performed simultaneously on the sympathetically denervated...

  9. Noradrenergic lesioning with an anti-dopamine beta-hydroxylase immunotoxin

    Science.gov (United States)

    Picklo, M. J.; Wiley, R. G.; Lappi, D. A.; Robertson, D.

    1994-01-01

    Sympathectomy has been achieved by a variety of methods but each has its limitations. These include lack of tissue specificity, incomplete lesioning, and the age range of susceptibility to the lesioning. To circumvent these drawbacks, an immunotoxin was constructed using a monoclonal antibody against the noradrenergic specific enzyme dopamine beta-hydroxylase (D beta H) coupled via a disulfide bond to saporin, a ribosomal inactivating protein. Three days after intravenous injection of the anti-D beta H immunotoxin (50 micrograms) into adult Sprague-Dawley rats, 66% of neurons in the superior cervical ganglia were chromatolytic. Superior cervical ganglia neurons were poisoned in 1 day old and 1 week old (86% of neurons) neonatal rats following subcutaneous injection of 3.75 and 15 micrograms, respectively. The anti-D beta H immunotoxin will be a useful tool in the study of the peripheral noradrenergic system in adult and neonatal animals.

  10. Gorlin-Goltz Syndrome

    Directory of Open Access Journals (Sweden)

    M K Sunil

    2010-01-01

    Full Text Available Gorlin-Goltz syndrome, also known as basal cell nevus syndrome, is an uncommon autosomal dominant inherited disorder characterized by numerous basal cell carcinomas, odontogenic keratocysts, and musculoskeletal malformation. It is occasionally associated with aggressive basal cell carcinoma and internal malignancies. It is about a muttisystemic process characterized by the presence of multiple pigmented basocellular carcinomas, keratocysts in the jaws, palmar and/or plantar pits and calcification of the falxcerebri. Hence, present a case report and a review of Gorlin-Goltz syndrome.

  11. Anaesthetic management in Gorlin-Goltz syndrome.

    Science.gov (United States)

    Gosavi, Kundan S; Mundada, Surbhi D

    2012-07-01

    Gorlin-Goltz syndrome is a rare autosomal-dominant syndrome related to mutation in "Patched" tumour suppressor gene on chromosome 9. Basocellular carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri are its major features, along with more than 100 minor features. Odontogenic cysts, notorious for recurrence, can make endotracheal intubation difficult, requiring modification of the standard intubation technique. We report such a case managed successfully by awake fibreoptic intubation. Direct laryngoscopy under anaesthesia later confirmed that it was a good decision.

  12. Nevoid basal cell carcinoma syndrome in a black child.

    Science.gov (United States)

    Hall, J; Johnston, K A; McPhillips, J P; Barnes, S D; Elston, D M

    1998-02-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is rare in black persons. We describe an 11-year-old black boy with NBCCS who presented with exotropia and a painful, expanding, cystic mass in the left posterior alveolar ridge. Further examination revealed odontogenic keratocysts with palmar and plantar pitting. Less than 5% of reported patients with NBCCS are black. To our knowledge, this is the first report of a black patient with NBCCS presenting with exotropia and an impacted molar displaced into the orbit by an odontogenic keratocyst.

  13. Palynomorphs in Holocene sediments from a paleolagoon in the coastal plain of extreme southern Brazil

    OpenAIRE

    Ebráilon Masetto; Maria Luisa Lorscheitter

    2014-01-01

    This paper presents the results of a qualitative palynological analysis of a 140 cm-thick section of Holocene sediments from a paleolagoon, representing the last 2600 years, taken from an outcrop at Hermenegildo Beach (33º42'S; 53º18'W), located in the municipality of Santa Vitória do Palmar, in the state of Rio Grande do Sul, Brazil. Samples were treated with hydrochloric acid, hydrofluoric acid and potassium hydroxide, after which they were subjected to acetolysis and mounted on glycerin-co...

  14. Incomplete fracture of the proximo-palmar aspect of the third metacarpal bone

    International Nuclear Information System (INIS)

    Riggs, C.M.

    1994-01-01

    Previous descriptions of incomplete longitudinal fractures and fatigue injury of the proximopalmar aspect of the third metacarpal bone (McIII) have focused on diagnostic imaging findings, especially in racehorses. Objectives: To document the case details, clinical features, response to diagnostic analgesia, diagnostic imaging findings and follow-up data in a large group of horses with an incomplete longitudinal fracture or fatigue injury of the proximopalmar medial aspect of the McIII. Materials And Methods: Horses were included in the study if pain was localised to the proximopalmar aspect of the metacarpal region, with radiological evidence of an incomplete longitudinal fracture or generalised increased radiopacity in the proximopalmar medial aspect of the McIII, or focal increased radiopharmaceutical uptake (IRU) in the proximopalmar aspect of the McIII. Age, breed, gender, height, bodyweight, work discipline, work history, duration of lameness, clinical signs and responses to diagnostic analgesia were recorded. Radiographic and scintigraphic images were assessed subjectively and objectively. Results: There were 55 horses representing a broad spectrum of ages and work disciplines, 73% of which had radiological abnormalities. The majority had no localising clinical signs, although 73% of horses with radiological abnormalities showed a characteristic pattern of lameness. Lameness was generally worse in straight lines than in circles. Increased radiopharmaceutical uptake ranged from mild to intense in the lame limb; 14% of nonlame limbs had mild IRU. Of horses for which long-term follow-up was available, 98% returned to full athletic function. Conclusions And Potential Relevance: Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the McIII may occur in horses of many types and sports disciplines, and are not confined to immature performance horses. They should be considered an important differential diagnosis for proximal metacarpal region pain

  15. Extensor and flexor digit synovial sheath, sac and synovial capsule in the distal part of the limbs in buffalos and camels and its relation of surgical interference

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    S. AL-sadi

    2010-01-01

    Full Text Available Sixty one samples of the distal parts of limbs were obtained from different ages of buffalo and camels of both sex to study the synovial structures to determine the suitable sites for injection of surgical interference. The result showed that extensor digit synovial sheath was extend between middle or distal part of metacarpal (metatarsal to the extensor processes and this formed with synovial capsule dorsal pouches which serve in surgical interference. The flexor digit synovial sheath extended to palmar (planter between distal extremity of metacarpal (metatarsal to the middle of second phalanx in buffalo while in camel it extended to the proximal extremity of second phalanx, that sheath was formed with suspensory ligament and sessamoid bone palmar or planter pouches which were serve the surgical interference. Fourth synovial bursa observed situated dorsally between the extensor digit laterals tendon and capsule of fetlock joint, forms site of injection during surgical interference, while the other two synovial bursa were located to palmer (planter between deep flexor tendon and distal sessamoid bone in buffalo while in camel these bursa were located between deep flexor tendon and cartilage of the second phalanx, these bursa were served for surgical interference. The synovial capsule which serve the surgical interference through digit cushion these were shown extended from the claw capsule. The result show that surgical interference was form six pouches in buffalo and eight pouches in camel, which formed by synovial structures and the tissue associated with them.

  16. Anaesthetic management in Gorlin-Goltz syndrome

    Directory of Open Access Journals (Sweden)

    Kundan S Gosavi

    2012-01-01

    Full Text Available Gorlin-Goltz syndrome is a rare autosomal-dominant syndrome related to mutation in " Patched" tumour suppressor gene on chromosome 9. Basocellular carcinomas, odontogenic keratocysts, palmar and/or plantar pits and ectopic calcifications of the falx cerebri are its major features, along with more than 100 minor features. Odontogenic cysts, notorious for recurrence, can make endotracheal intubation difficult, requiring modification of the standard intubation technique. We report such a case managed successfully by awake fibreoptic intubation. Direct laryngoscopy under anaesthesia later confirmed that it was a good decision.

  17. Genotypic and clinical spectrum of self-improving collodion ichthyosis: ALOX12B, ALOXE3, and TGM1 mutations in Scandinavian patients

    DEFF Research Database (Denmark)

    Vahlquist, Anders; Bygum, Anette; Gånemo, Agneta

    2010-01-01

    Infants born with autosomal recessive congenital ichthyosis (ARCI) are often encapsulated in a collodion membrane, which shows a lamellar or erythrodermic type of ichthyosis upon shedding. However, some babies show a nearly normal underlying skin after several weeks, a phenotype called "self...... scaling, palmar hyperlinearity with keratoderma, and a frequent appearance of red cheeks and anhidrosis. Thus, we propose replacing SHCB with the term "self-improving collodion ichthyosis" (SICI). In conclusion, ALOX12B mutations are the leading cause of SICI in Scandinavia, followed by ALOXE3 mutations...

  18. Genotypic and Clinical Spectrum of Self-Improving Collodion Ichthyosis: ALOX12B, ALOXE3, and TGM1 Mutations in Scandinavian Patients

    DEFF Research Database (Denmark)

    Vahlquist, Anders; Bygum, Anette; Gånemo, Agneta

    2009-01-01

    Infants born with autosomal recessive congenital ichthyosis (ARCI) are often encapsulated in a collodion membrane, which shows a lamellar or erythrodermic type of ichthyosis upon shedding. However, some babies show a nearly normal underlying skin after several weeks, a phenotype called "self...... scaling, palmar hyperlinearity with keratoderma, and a frequent appearance of red cheeks and anhidrosis. Thus, we propose replacing SHCB with the term "self-improving collodion ichthyosis" (SICI). In conclusion, ALOX12B mutations are the leading cause of SICI in Scandinavia, followed by ALOXE3 mutations...

  19. [Hidradenocarcinoma of the Scrotum with Lymph Node Metastasis].

    Science.gov (United States)

    Simões, Maria Inês; Marcão, Isabel; Toscano, Mário; Borges, Luís

    2018-03-29

    Hidradenocarcinoma is a rare neoplasm of the eccrine cells of the sweat glands, usually asymptomatic with slow growing and higher incidence between 50 and 80 years, occurring in both sexes and preferentially located in the palmar, plantar, frontal, axillary and nuchal regions. It has an aggressive behavior, with high rate of local recurrence and distance metastasis, associated with a poor prognosis. We present a case of hidradenocarcinoma of the scrotum manifested by lymph node metastasis through an exercise of clinical and histological differential diagnosis of an inguinal adenopathy in a young adult.

  20. Hidradenocarcinoma do Escroto com Metastização Ganglionar

    OpenAIRE

    Simões, MI; Marcão, I; Toscano, M; Borges, L

    2018-01-01

    O hidradenocarcinoma é uma neoplasia rara das células écrinas das glândulas sudoríparas, geralmente assintomática e de crescimento lento, com maior incidência entre os 50 e os 80 anos, atingindo ambos os sexos e com localização preferencial nas regiões palmar, plantar, frontal, axilar e nuca. Tem um comportamento agressivo, com alta taxa de recorrência local e metastização à distância, associando-se a mau prognóstico. Apresentamos um caso raro de hidradenocarcinoma do escroto manifestado por ...

  1. Significance of adrenergic receptors for the development of nevus flammeus and nevus anemicus

    Energy Technology Data Exchange (ETDEWEB)

    Raff, M [Vienna Univ. (Austria). 2. Hautklinik

    1981-01-01

    Examination of patients with nevus flammeus or nevus anemicus showed disturbed sensibility in the area of the nevus in the majority of cases. Histologically and with special technique of histochemistry and fluorescence microscopy there was no evidence for neurogenic lesions. However, signs of vegetative disfunction were present: hyperhidrosis and absent reactivity of vasculature in the nevus area to vasoconstrictive and vasodilatatory stimuli. Based on these findings a disturbed regulation of vascular intramural adrenergic receptors seemed possible and really could be demonstrated by means of autoradiography. In both types of nevi only one of the adrenergic receptors could be marked with specific antagonists. Therefore, the persistent vascular dilatation and constriction can be accounted for by the absence of one of these receptors. This abnormal distribution of receptors could be due to a developmental defect influenced by the ''nerve growth factor''.

  2. The significance of adrenergic receptors for the development of nevus flammeus and nevus anemicus

    International Nuclear Information System (INIS)

    Raff, M.

    1981-01-01

    Examination of patients with nevus flammeus or nevus anemicus showed disturbed sensibility in the area of the nevus in the majority of cases. Histologically and with special technique of histochemistry and fluorescencemicroscopy there was no evidence for neurogenic lesions. However, signs of vegetative disfunction were present: hyperhidrosis and absent reactivity of vasculature in the nevus area to vasoconstrictive and vasodilatatory stimuli. Based on these findings a disturbed regulation of vascular intramural adrenergic receptors seemed possible and really could be demonstrated by means of autoradiography. In both types of nevi only one of the adrenergic receptors could be marked with specific antagonists. Therefore, the persistent vascular dilatation and constriction can be accounted for by the absence of one of these receptors. This abnormal distribution of receptors could be due to a developmental defect influenced by the ''nerve growth factor''. (author)

  3. Adrenergic nerve fibres and mast cells: correlation in rat thymus.

    Science.gov (United States)

    Artico, Marco; Cavallotti, Carlo; Cavallotti, Daniela

    2002-10-21

    The interactions between adrenergic nerve fibres and mast cells (MCs) were studied in the thymus of adult and old rats by morphological methods and by quantitative analysis of images (QAIs). The whole thymus was drawn in adult (12 months old) rats: normal, sympathectomized or electrostimulated. Thymuses from the above-mentioned animals were weighed, measured and dissected. Thymic slices were stained with eosin orange for detection of microanatomical details and with Bodian's method for identification of the whole nerve fibres. Thymic MCs were stained with Astrablau. Histofluorescence microscopy was used for staining of adrenergic nerve fibres. Finally, all morphological results were submitted to the QAIs and statistical analysis of data. Our results suggest that after surgical sympathectomy, the greater part of adrenergic nerve fibres disappear while related MCs appear to show less evident fluorescence and few granules. On the contrary, electrostimulation of the cervical superior ganglion induced an increase in the fluorescence of adrenergic nerve fibres and of related MCs.

  4. Effect of age on upregulation of the cardiac adrenergic beta receptors

    International Nuclear Information System (INIS)

    Tumer, N.; Houck, W.T.; Roberts, J.

    1990-01-01

    Radioligand binding studies were performed to determine whether upregulation of postjunctional beta receptors occurs in sympathectomized hearts of aged animals. Fischer 344 rats 6, 12, and 24 months of age (n = 10) were used in these experiments. To produce sympathectomy, rats were injected with 6-hydroxydopamine hydrobromide (6-OHDA; 2 x 50 mg/kg iv) on days 1 and 8; the animals were decapitated on day 15. The depletion of norepinephrine in the heart was about 86% in each age group. 125I-Iodopindolol (IPIN), a beta adrenergic receptor antagonist, was employed to determine the affinity and total number of beta adrenergic receptors in the ventricles of the rat heart. The maximal number of binding sites (Bmax) was significantly elevated by 37%, 48%, and 50% in hearts from sympathectomized 6-, 12-, and 24-month-old rats, respectively. These results indicate that beta receptor mechanisms in older hearts can respond to procedures that cause upregulation of the beta adrenergic receptors

  5. The added value of measuring thumb and finger strength when comparing strength measurements in hypoplastic thumb patients.

    Science.gov (United States)

    Molenaar, H M Ties; Selles, Ruud W; de Kraker, Marjolein; Stam, Henk J; Hovius, Steven E R

    2013-10-01

    When interventions to the hand are aimed at improving function of specific fingers or the thumb, the RIHM (Rotterdam Intrinsic Hand Myometer) is a validated tool and offers more detailed information to assess strength of the involved joints besides grip and pinch measurements. In this study, strength was measured in 65 thumbs in 40 patients diagnosed with thumb hypoplasia. These 65 thumbs were classified according to Blauth. Longitudinal radial deficiencies were also classified. The strength measurements comprised of grip, tip, tripod and key pinch. Furthermore palmar abduction and opposition of the thumb as well as abduction of the index and little finger were measured with the RIHM. For all longitudinal radial deficiency patients, grip and pinch strength as well as palmar abduction and thumb opposition were significantly lower than reference values (P<0.001). However, strength in the index finger abduction and the little finger abduction was maintained or decreased to a lesser extent according to the degree of longitudinal radial deficiency. All strength values decreased with increasing Blauth-type. Blauth-type II hands (n=15) with flexor digitorum superficialis 4 opposition transfer including stabilization of the metacarpophalangeal joint showed a trend toward a higher opposition strength without reaching statistical significance (P=0.094),however compared to non-operated Blauth-type II hands (n=6) they showed a lower grip strength (P=0.019). The RIHM is comparable in accuracy to other strength dynamometers. Using the RIHM, we were able to illustrate strength patterns on finger-specific level, showing added value when evaluating outcome in patients with hand related problems. © 2013.

  6. EL SER HUMANO COMO CONSUMIDOR: APLICACIÓN A INVESTIGACIÓN DE MERCADO DE GUAYABA EN EL DEPARTAMENTO DEL ATLÁNTICO - THE HUMAN BEING AS A CONSUMER: APPLICATION TO MARKETING RESEARCH OF GUAVA IN THE DEPARTAMENTO OF ATLANTICO

    Directory of Open Access Journals (Sweden)

    HILDA ESTRADA LÓPEZ

    2010-06-01

    Full Text Available From the consumer’s perspective, this article shows the results of two marketing researches which take part in a project funded by private and public companies to support small enterprises. For the former, 127 surveys were made to people responsible for shopping at hotels, grocery stores and other grocery dealers. For the latter, 64 final customers were surveyed. The information gathered was used to evaluate the way consumers receive the products made by the manufacturer and trading company, Profrutal, located in Palmar de Varela, Atlantico; this fact gave rise to a marketing plan. The process presented may be an example to stimulate managerial abilities of other small artisanal companies, thus increasing its capacity to create new employment opportunities.ResumenEste artículo presenta, desde la perspectiva del consumidor, los resultados de dos investigaciones de mercado y hacen parte de un proyecto financiado por entidades privadas y públicas para apoyar a la microempresa. Para la primera, se hicieron 127 encuestas a losresponsables de las compras en hoteles, tiendas de barrio y otros distribuidores. Para la segunda, se tomaron 64 compradores finales. La información recopilada permitió evaluar la forma como los consumidores perciben los productos elaborados por la empresa procesadora y comercializadora de frutas Profrutal, ubicada en Palmar de Varela, Atlántico, lo que dio origen a un plan de mercadeo. El proceso presentado puede servir de ejemplo para otras microempresas artesanales al incrementar su capacidad de gestión y, en consecuencia, su potencial de generación de empleo.

  7. A clinical evaluation of a headless, titanium, variable-pitched, tapered, compression screw for repair of nondisplaced lateral condylar fractures in thoroughbred racehorses.

    Science.gov (United States)

    Galuppo, Larry D; Simpson, Edwin L; Greenman, Sylvia L; Dowd, Joseph P; Ferraro, Gregory L; Meagher, Dennis M

    2006-07-01

    To report clinical evaluation of headless compression screws for repair of metacarpal/metatarsal (MC/MT3) condylar fractures in horses. Retrospective case study. Racing Thoroughbreds (n=16) with nondisplaced lateral condylar fractures of MC/MT 3. Medical records (1999-2004) of horses with nondisplaced longitudinal fractures of the lateral condyle of MC/MT3 were reviewed. Pre-operative variables retrieved were: patient age, gender, limb involvement, injury occurrence, fracture length, and width, evidence of palmar comminution and degenerative joint disease, number of pre-injury starts, and pre-injury earnings. Post-operative variables retrieved were: surgical complications, surgical time, number of race starts, and post-operative earnings. MC3 (n=11) and MT3 (5) nondisplaced longitudinal fractures of the lateral condyle were repaired with Acutrak Equine (AE) screws. Left front limb fractures were most common (8) followed by left hind (5) and right front (3). Nine fractures occurred during training and 7 during racing; 4 fractures had palmar comminution. No surgical complications occurred. Of 15 horses that returned to training, 11 (73%) raced 306+/-67 days after injury and had greater mean (+/-SD) post-injury earnings/start ($5290.00+/-$8124.00) than pre-injury ($4971.00+/-$2842.00). Screw removal was not required in any horse. The AE screw is a viable option for repair of nondisplaced lateral condylar MC/MT3 fractures in Thoroughbred racehorses. Adequate stability of nondisplaced lateral condylar fractures can be achieved with a headless tapered compression screw while avoiding impingement on the collateral ligaments and joint capsule of the fetlock joint.

  8. Plantar fibromatosis and Dupuytren’s contracture in an adolescent

    Directory of Open Access Journals (Sweden)

    Nikolić Jelena

    2011-01-01

    Full Text Available Background. Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren` s disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose`s disease or plantar fibromatosis is plantar equivalent of Dupuyten`s disease most often affecting middle- aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Case report. We presented a 19-year old adolescent that turned to a plastic surgeon complaining to his small finger contracture. He noticed palmar thickening with nodule over the metacarpophalangeal joint of small finger of his right hand when he was 16 years old. A year later a finger started to band. During physical checkup we noticed plantar nodule that also had his father and grandmother. Magnetic resonance and tumor biopsy confirmed a suspicion on plantar fibromatosis - Ledderhose`s disease. Clinical exam of the hand clearly led to a conclusion that the patient had Dupuytren`s contracture with pretendinous cord over the small finger flexor tendons and lack of extension of proximal interphalangeal (PIP joint. On the extensor side of the PIP joints there were Garrod`s nodes. The patient refused surgical treatment of plantar tumor, but agreed to surgical correction of finger contracture. Conclusion. Despite the fact that Dupuytren`s disease and plantar fibromatosis are diseases of adults, the possibility of conjoint appearance of these forms of fibromatosis in adolescent period of life should be kept in mind especially in patients with strong genetic predisposition.

  9. Palmar and plantar lichen planus: a case report and review of the literature

    OpenAIRE

    Velez, Ana Maria Abreu; Howard, Michael S; Pereyo, Neville

    2015-01-01

    AbstractPalmoplantar lichen planus is an uncommon dermatosis. We present a case of 38-year-old Caucasian male with a history of pruritic, scaly lesions on the right plantar foot. Physical examination revealed whitish plaques and numerous spiny hyperkeratotic papules and focal scaling. A biopsy demonstrated orthohyperkeratosis and acanthosis of the epidermis. Immunohistochemical staining revealed positivity within the epidermis and/or lichenoid infiltrate with CD3, CD8, CD45, CD68, myeloid his...

  10. Palmar and plantar lichen planus: a case report and review of the literature*

    Science.gov (United States)

    Velez, Ana Maria Abreu; Howard, Michael S; Pereyo, Neville

    2015-01-01

    Palmoplantar lichen planus is an uncommon dermatosis. We present a case of 38-year-old Caucasian male with a history of pruritic, scaly lesions on the right plantar foot. Physical examination revealed whitish plaques and numerous spiny hyperkeratotic papules and focal scaling. A biopsy demonstrated orthohyperkeratosis and acanthosis of the epidermis. Immunohistochemical staining revealed positivity within the epidermis and/or lichenoid infiltrate with CD3, CD8, CD45, CD68, myeloid histiod antigen, BCL2, p27, p53, HLA-DPDQDR, metallothionein and tissue inhibitor of metalloproteinases 1. The diagnosis of PPLP was thus confirmed; this case illustrates that PPLP should be considered in the differential diagnosis of uncommon foot dermatoses with a significant junctional inflammatory component. PMID:26312708

  11. Palmar and plantar lichen planus: a case report and review of the literature.

    Science.gov (United States)

    Abreu Velez, Ana Maria; Howard, Michael S; Pereyo, Neville

    2015-01-01

    Palmoplantar lichen planus is an uncommon dermatosis. We present a case of 38-year-old Caucasian male with a history of pruritic, scaly lesions on the right plantar foot. Physical examination revealed whitish plaques and numerous spiny hyperkeratotic papules and focal scaling. A biopsy demonstrated orthohyperkeratosis and acanthosis of the epidermis. Immunohistochemical staining revealed positivity within the epidermis and/or lichenoid infiltrate with CD3, CD8, CD45, CD68, myeloid histiod antigen, BCL2, p27, p53, HLA-DPDQDR, metallothionein and tissue inhibitor of metalloproteinases 1. The diagnosis of PPLP was thus confirmed; this case illustrates that PPLP should be considered in the differential diagnosis of uncommon foot dermatoses with a significant junctional inflammatory component.

  12. Two injection digital block versus single subcutaneous palmar injection block for finger lacerations.

    Science.gov (United States)

    Okur, O M; Şener, A; Kavakli, H Ş; Çelik, G K; Doğan, N Ö; Içme, F; Günaydin, G P

    2017-12-01

    We aimed to compare two digital nerve block techniques in patients due to traumatic digital lacerations. This was a randomized-controlled study designed prospectively in the emergency department of a university-based training and research hospital. Randomization was achieved by sealed envelopes. Half of the patients were randomised to traditional (two-injection) digital nerve block technique while single-injection digital nerve block technique was applied to the other half. Score of pain due to anesthetic infiltration and suturing, onset time of total anesthesia, need for an additional rescue injection were the parameters evaluated with both groups. Epinephrin added lidocaine hydrochloride preparation was used for the anesthetic application. Visual analog scale was used for the evaluation of pain scores. Outcomes were compared by using Mann-Whitney U test and Student t-test. Fifty emergency department patients ≥18 years requiring digital nerve block were enrolled in the study. Mean age of the patients was 33 (min-max: 19-86) and 39 (78 %) were male. No statistically significant difference was found between the two groups in terms of our main parameters; anesthesia pain score, suturing pain score, onset time of total anesthesia and rescue injection need. Single injection volar digital nerve block technique is a suitable alternative for digital anesthesias in emergency departments.

  13. Sleep deprivation: cardiovascular effects for anesthesiologists

    Directory of Open Access Journals (Sweden)

    Ali Dabbagh

    2016-03-01

    Full Text Available Sleep and anesthesia have some common or "overlapping" neural pathways. Both involve wakefulness; while they are not the same; anesthesia is an iatrogenic, reversible, pharmacologic-based coma; which could affect the CNS neural pathways at many levels. In the current era of modern anesthesiology, the practice and science of anesthesia is composed of 4 basic elements; (1: 1. hypnosis (i.e. iatrogenic pharmacologicinduced coma 2. amnesia (not to remember the events of the operation 3. analgesia (being painless 4. akinesia (lack of movements to stimuli The first two ingredients of anesthesia could have common points with sleep. Thalamic nuclei are involved both in sleep and anesthesia (2, 3; though, they are not the same phenomena (4. However, could there be any clinical concern if some of our patients have abnormalities in sleep? In fact, the effects of sleep deprivation have long been studied in patients undergoing anesthesia for surgical operations (4, 5. Sleep deprivation causes altered neurohumoral activity, neuroendocrine dysregulations, abnormalities in the immune system and impairments in cardiac autonomic function (6, 7. Sleep deprivation may affect the clinical effects of the anesthetics or it may create unpredicted changes in the clinical response to a determined dose of anesthetic drugs (8. In this volume of the Journal, Choopani et al have published their results regarding sleep deprivation; they have demonstrated that in rats, if sleep deprivation is induced prior to an ischemia/reperfusion event, it can increase the chance for ventricular tachycardia and ventricular fibrillation; also, they have shown that this untoward effect could be eliminated using chemical sympathectomy (9. In clinical practice, the main message from this study could be that when anesthesiologists perform anesthesia for their patients, they should be aware of effects of acute or chronic sleep deprivation. Undoubtedly, sleep deprivation could occur during the

  14. A Case Report of Gorlin-goltz Syndrome

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    Shima Nafarzadeh

    2016-04-01

    Full Text Available Nevoid basal cell carcinoma syndrome (Gorlin syndrome is an autosomal dominant inherited condition that exhibits high penetrance and variable expressivity. The syndrome is caused by mutations in patched (PTCH, a tumor suppressor gene that has been mapped to chromosome 9q22.3-q31. Gorlin-goltz syndrome (GGS is characterised by the presence of multiple odontogenic keratocysts in the jaws, basal cell carcinomas, palmar and plantar pits and intracranial calcifications. Here, we present a case of familial GGS, characterised by multiple odontogenic keratocysts, broad nasal ridge, hypertelorism, enlarged head circumference and dermoid cysts.

  15. Distribución, tamaño y estructura poblacional de Jubaea chilensis en "Las Palmas", comuna de Petorca, región de Valparaíso - Chile

    OpenAIRE

    Youlton, Cristian; Hormazabal, Cristina; Schiappacasse, Ignacio; Contreras, Patricia; Poblete-Echeverría, Carlos

    2016-01-01

    La palma chilena (Jubaea chilensis) es una especie endémica de Chile central, clasificada en categoría de conservación vulnerable. De su área de distribución original subsisten algunas agrupaciones (palmares), encontrándose una de ellas en la comuna de Petorca, en el límite norte de la región de Valparaíso. El sector "Las Palmas" fue declarado "Sitio Prioritario para la Conservación de la Biodiversidad", sin embargo, se desconoce el número de palmas presentes, su distribución etaria y espacia...

  16. Irrigación arterial del músculo interóseo y del ligamento accesorio del músculo flexor digital profundo en la mano del caballo Arterial blood supply to the interosseus muscle and accessory ligament of the deep digital flexor tendon in the horse hand

    OpenAIRE

    J. NATALI; R.M. MOINE; M.S. GIGENA; A.M. GALÁN; E. MARTÍN

    1999-01-01

    El objetivo de este trabajo es el estudio del origen y distribución de las ramas arteriales al músculo interóseo y al ligamento accesorio del músculo flexor digital profundo de la mano del caballo. Se disecaron 20 manos a las que les fue inyectada la arteria mediana con látex coloreado. Las ramas arteriales entran al músculo interóseo por la cara dorsal y palmar del cuerpo y por sus bordes medial y lateral. Cada tendón de inserción del músculo interóseo recibió importantes ramas arteriales po...

  17. Un nuevo caso de resistencia a un bismuto oleo-soluble: curación por una sal insoluble

    Directory of Open Access Journals (Sweden)

    Ch. Petouraud

    1934-07-01

    Full Text Available Acabamos de observar, simple coincidencia o efecto de la casualidad, un nuevo caso de bismuto resistencia que recuerda al que uno de nosotros encontró recientemente con el Profesor Nicolas. S. Joseph, 24 años, es visto por primera vez el 6 de mayo de 1933, en la consulta del servicio hospitalario de Dermato-Syphiligraphie de Antiquille (ficha Nv 5886, Dr. Gaté, para accidentes secundarios típicos; roséola discreta, sifilides papulosas y córneas de las regiones palmares, ganglios supraepitrccleanos y oervicales, reacción de Wassermann muy positiva en la sangre.

  18. Distal fingertip replantation without skeletal fixation.

    Science.gov (United States)

    Sabapathy, S Raja; Venkatramani, Hari; Bharathi, R Ravindra; Sebastin, Sandeep J

    2005-01-01

    The replantation of fingertip amputation (through the nail bed) requires repair of the artery and vein on the palmar side. These structures are present in different planes, with the artery being deeper and the veins superficial. The authors believe that vascular repair in such cases is facilitated by stabilization of the amputated part by nail-bed repair alone. This provides a certain degree of flexibility, which allows for easier placement of clamps in the limited space available. Although Kirschner wires were not used for bony fixation, bony union was achieved in all five cases in which this technique was used.

  19. Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy

    Science.gov (United States)

    Bonilla, Alvaro G.; Santschi, Elizabeth M.

    2015-01-01

    A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with antibiotics and long-term supportive bandaging. PMID:25694665

  20. Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy.

    Science.gov (United States)

    Bonilla, Alvaro G; Santschi, Elizabeth M

    2015-02-01

    A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with antibiotics and long-term supportive bandaging.

  1. Hidradenocarcinoma of the Scrotum with Lymph Node Metastasis

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    Maria Inês Simões

    2018-03-01

    Full Text Available Hidradenocarcinoma is a rare neoplasm of the eccrine cells of the sweat glands, usually asymptomatic with slow growing and higher incidence between 50 and 80 years, occurring in both sexes and preferentially located in the palmar, plantar, frontal, axillary and nuchal regions. It has an aggressive behavior, with high rate of local recurrence and distance metastasis, associated with a poor prognosis. We present a case of hidradenocarcinoma of the scrotum manifested by lymph node metastasis through an exercise of clinical and histological differential diagnosis of an inguinal adenopathy in a young adult.

  2. The clinical presentation and surgical treatment of verrucous dermatitis lesions in a draught horse.

    Science.gov (United States)

    Poore, Luke A B; Else, Rod W; Licka, Theresia L

    2012-02-01

    Verrucous pastern dermatitis is a progressive inflammatory skin disease commonly involving the palmar or plantar aspects of the pasterns of horses. There are no reports of successful surgical treatment for multifocal circumscribed verrucous masses in the chronic stages of verrucous pastern dermatitis. A combination of sharp dissection and electrocautery was used to resect numerous multifocal circumscribed verrucous masses from the distal hindlimb of an 11-year-old gelding draught horse. There was no evidence of significant regrowth or complications at a 24 month postoperative examination. © 2011 The Authors. Veterinary Dermatology. © 2011 ESVD and ACVD.

  3. Locking plate versus external fixation for type C distal radius fractures: A meta-analysis of randomized controlled trials

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    Dong Wang

    2018-04-01

    Full Text Available Purpose: Distal radial fracture is one of the most common fractures. Up to now, locking plates (LP and external fixation (EF are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two interventions by this meta-analysis. Methods: We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow: radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results: Seven studies included 162 patients (LP group and 190 patients (EF group. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI (0.17, 3.50, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [(WMD = 3.61, 95% CI (0.00, 7.23, p = 0.05; WMD = 0.05, 95% CI (−0.99, 1.09, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI (−6.88, 26.96, p = 0.24; WMD = 12.53, 95% CI (−9.99, 35.06, p = 0.28]. Conclusion

  4. Pitted keratolysis – a frequently misdiagnosed, mild, infectious disorder of soles

    Directory of Open Access Journals (Sweden)

    Zuzanna Lewicka-Potocka

    2016-05-01

    Full Text Available Introduction . Pitted keratolysis (PK is a mild infectious skin disorder caused by Corynebacterium spp., Kytococcus sedentarius or Dermatophilus congolensis . These bacteria produce enzymes that digest keratin, causing superficial lesions in the plantar surface. The disease is predominantly observed in young men. Objective . Pitted keratolysis despite the characteristic presentation of skin lesions is often misdiagnosed. In this article we aimed to remind readers of its clinical aspects and treatment by presenting a typical PK case. Case report. A 35-year-old man was admitted to the dermatological clinic due to skin lesions on both soles. In the physical examination we found multiple crateriform pits, associated with hyperhidrosis and malodour diagnosed as PK. Remission of lesions was observed after treatment with oral erythromycin. Conclusions . The differential diagnosis of plantar skin lesions should include PK. Due to typical clinical manifestation the diagnosis is based on physical examination.

  5. Acquired Ulcero-Mutilating Bilateral Acro-Osteopathy (Bureau-Barrière Syndrome

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    Georgi Tchernev

    2017-07-01

    Full Text Available We present a 35-year-old male patient with Bureau-Barrière syndrome. Bureau-Barrière syndrome is an ulcero-mutilating acropathy almost invariably associated with excessive alcohol intake. It presents with a triad of trophic skin changes with recurrent ulcerations, bone lesions and nerve damage. The clinical presentation includes chronic painless plantar ulcerations with periulcerous hyperkeratosis, hyperhidrosis, livedoid skin colour, nail dystrophy, widening and infiltration of the toes and common interdigital mycoses. Other non-specific skin changes related to the alcohol consumption are commonly observed as well. The condition affects mainly middle-aged men suffering from alcoholism. Often a bilateral location at the lower limb of male alcoholics has been described, as in our patient. Successful treatment of the Bureau-Barrière syndrome requires an interdisciplinary approach. Cessation of alcohol intake and smoking is of paramount importance.

  6. Development of future indications for BOTOX.

    Science.gov (United States)

    Brin, Mitchell F

    2009-10-01

    Since the late 1970s, local injections of BoNT have provided clinical benefit for patients with inappropriately contracting muscles with or without pain or sensory disturbance. Marketing authorization for some BoNTs, depending on country, include core indications of dystonia (blepharospasm and cervical dystonia), large muscle spastic disorders (not yet approved in the United States, e.g., adult post-stroke spasticity and equinus foot deformity), hyperhidrosis and aesthetic. Subsequent development has extended to selected conditions characterized by recurrent or chronic pain (migraine headache), and urologic indications (neurogenic/idiopathic overactive bladder; prostate hyperplasia), with multiple additional opportunities available. Portfolio management requires a careful individual opportunity assessment of scientific and technical aspects (basic science foundation, potential to treat unmet medical need, product-specific risk in specific populations, therapeutic margin/safety profile, and probability of successful registration pathway). This article describes ongoing development targets for BOTOX.

  7. Efficacy of ketamine hydrochloride administered as a basilar sesamoid nerve block in alleviating foot pain in horses caused by natural disease.

    Science.gov (United States)

    Schumacher, J; DeGraves, F; Cesar, F; Duran, S

    2014-09-01

    A local anaesthetic agent capable of temporarily resolving lameness after being administered perineurally would be helpful because rapid return of lameness would allow for other analgesic techniques to be performed within a short period of time. To determine if a 3% solution of ketamine hydrochloride (HCl), administered around the palmar nerves at the level of the base of the proximal sesamoid bones, can improve naturally occurring lameness that can be improved or abolished with a basilar sesamoid nerve block performed using lidocaine HCl and to compare the change in gait produced using lidocaine to the change in gait produced using ketamine by using objective lameness assessment. Experimental trial using research horses with naturally occurring lameness. Seven horses, chronically lame on a thoracic limb, were chosen for the study. A wireless, inertial, sensor-based, motion analysis system was used to evaluate lameness before and after administration of 2% lidocaine and later, before and after administration of 3% ketamine over the palmar digital nerves at the base of the proximal sesamoid bones (a basilar sesamoid nerve block) at 5 min intervals for 30 min. Lameness scores obtained before and after administration of lidocaine and ketamine HCl were compared using repeated measures analysis. Gait significantly improved after basilar sesamoid nerve blocks using 2% lidocaine, but gait did not significantly improve after performing the same nerve block using 3% ketamine HCl. Ketamine (3%) administered perineurally for regional anaesthesia of the digit does not desensitise the digit to the same extent as does lidocaine and thus 3% ketamine appears to have no value as a local anaesthetic agent for diagnostic regional anaesthesia. © 2013 EVJ Ltd.

  8. Comparative study of 2 commissural dorsal flap techniques for the treatment of congenital syndactyly.

    Science.gov (United States)

    Mallet, Cindy; Ilharreborde, Brice; Jehanno, Pascal; Litzelmann, Estelle; Valenti, Philippe; Mazda, Keyvan; Penneçot, Georges-François; Fitoussi, Franck

    2013-03-01

    Many commissural reconstruction techniques have been described for the treatment of syndactyly. This study is the first to compare long-term results of 2 commissural dorsal flap procedures (T-flap and omega-flap). Fifty-nine web-spaces in 39 patients, operated on between 1991 and 2008, were retrospectively analyzed. Thirty-six T-flap and 23 omega-flap procedures were performed using full-thickness skin graft in every case for digital resurfacing. Factors that could affect the long-term outcome were collected, including development of web-creep, clinodactyly, and flexion contracture. Patients were reviewed with a mean follow-up of 5 years and 8 months. Preoperative complexity of syndactyly influenced the development of clinodactyly and flexion contracture. Among the patients who developed clinodactyly, 96% had surgery for complex syndactyly. No difference was found between the 2 flap methods concerning digital deformation and mobility. However, web-creep occurred more frequently after T-flap than after omega-flap procedures (17% vs. 5%). The combination of either dorsal commissural T-flaps or omega-flaps with full-thickness graft to resurface digits is a reliable technique for the treatment of syndactyly with satisfactory functional and cosmetic results. Long-term results are not influenced by the type of flap. Nevertheless, the omega-flap technique, using 2 triangular lateral-palmar flaps, avoids use of skin graft to cover lateral-palmar aspects of the new commissure, consequently reducing the incidence of web-creep. In cases of syndactyly, the primary prognostic factor is whether the patient has simple or complex syndactyly. In complex syndactyly, the risk of long-term unfavorable results is higher. When complex complicated syndactyly is involved, postoperative complication rates increase. Level III.

  9. Characterisation of osseous bodies of the distal phalanx of foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; O'Brien, T.R.; Redden, R.F.; Stover, S.M.; Pool, R.R.

    1993-01-01

    The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred foals 3-32 weeks of age were radiographed to identify those limbs with osseous bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles) were identified radiographically in 19% of the foals. Sixteen of the 32 foals were selected for microradiographic and histological evaluation: 6 foals with radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the PP were observed radiographically. Ossicles were either a triangular bone fragment at the palmar aspect of the distal angle of the PP, or an oblong bone fragment separated from P3 by a radiolucent line extending 1-3 cm from the incisure of the PP to the solar margin. One foal had radiographic evidence of bilateral distal metacarpal physitis. Seventeen of 35 PPs examined microradiographically were considered normal, in that the dorsal and solar cortices were thin with trabecular bone orientated parallel to the cortical surfaces, and there was a depression in the dorsal cortical surface (i.e. parietal sulcus). Abnormal microradiographic findings in the other 18 PPs included a fracture line extending from the dorsal cortical surfaces and trabecular bridging of the fracture gap. The fracture line was often continuous with the parietal sulcus. Microradiographic evidence of a fracture was found in 75% of foals evaluated. Normal histological findings in 16 PPs included thin dorsal and solar cortices with trabeculae orientated parallel to the cortical surfaces, parallel-fibred dense connective tissue attachments of the deep digital flexor tendon to the solar cortical surfaces, and a neurovascular bundle associated with the parietal sulcus

  10. Fugas, quilombos e fujões nas Américas (séculos XVI-XIX Escapes, quilombos and fugitives in the Americas (sixteenth-nineteenth centuries

    Directory of Open Access Journals (Sweden)

    Manolo Florentino

    2012-04-01

    Full Text Available O presente trabalho parte da constatação da natureza relativamente anódina dos estudos acerca dos quilombos em sociedades escravistas nas Américas, os quais não raro juntam numa única categoria (quilombos, cumbes, palenques, mainels, etc. estruturas que podiam englobar menos de uma dezena de fugitivos e durar semanas ou meses, ou, como no caso de Palmares, congregar até 11 mil quilombolas e persistir por quase um século. Semelhante anomalia conceptual revela a falta de taxonomias que encarem os quilombos como estruturas efetivamente históricas que podiam circunscrever-se a meras hordas, ou evoluir para a condição de comunidades autossustentáveis, capazes de se autorreproduzirem económica e demograficamente por longos períodos.This work attempts to address the lack of a systematic study of the communities of runaway slaves in the Americas. Characteristically, there is a tendency to put together under the same category settlements that accommodated fewer than ten or twelve fugitives and lasted for only a few weeks or months and others (such as was the case of Palmares that included up to 11,000 settlers and lasted for almost a century. This conceptual anomaly is here taken as a sign that we are in bad need of a taxonomy that allows for a study of quilombos (settlements of runaway slaves as truly historical structures which may be no more than a small band of refugees but may also evolve to include communities that achieved a considerable measure of economic and populational self-sufficiency.

  11. Hypothenar hammer syndrome from ice hockey stick-handling.

    Science.gov (United States)

    Zayed, Mohamed A; McDonald, Joey; Tittley, Jacques G

    2013-11-01

    Ulnar artery thrombosis and hypothenar hammer syndrome are rare vascular complications that could potentially occur with repeated blows or trauma to the hand. Although initially reported as an occupational hazard among laborers and craftsmen, it has been observed more recently among recreationalists and athletes. Until now, it has never been reported as a complication in ice hockey players. In this case report, a 26-year-old Canadian professional ice hockey player presented with acute dominant right hand paleness, coolness, and pain with hand use. The patient used a wooden hockey stick with a large knob of tape at the end of the handle, which he regularly gripped in the palm of his right hand to help with face-offs and general stick-handling. Sonographic evaluation demonstrated no arterial flow in the distal right ulnar artery distribution, and ulnar artery occlusion with no aneurysmal degeneration was confirmed by magnetic resonance angiogram. Intraarterial thrombolytic therapy was initiated, and subsequent serial angiograms demonstrated significant improvement in distal ulnar artery flow as well as recanalization of right hand deep palmar arch and digital arteries. The patient's symptoms resolved, and he was maintained on therapeutic anticoagulation for 3 months prior to returning to playing ice hockey professionally, but with a padded glove and no tape knob at the handle tip. This case highlights a unique presentation of hockey stick-handling causing ulnar artery thrombosis that was likely from repeated palmar hypothenar trauma. Appropriate diagnostic imaging, early intraarterial thrombolysis, and postoperative surveillance and follow-up were crucial for the successful outcome in this patient. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Reduction of Blood Pressure Following After Renal Artery Adventitia Stripping During Total Nephroureterectomy: Potential Effect of Renal Sympathetic Denervation.

    Science.gov (United States)

    Okamura, Keisuke; Satou, Shunsuke; Setojima, Keita; Shono, Shinjiro; Miyajima, Shigero; Ishii, Tatsu; Shirai, Kazuyuki; Urata, Hidenori

    2018-05-16

    BACKGROUND Catheter-based renal sympathetic denervation has been reported to be effective for treatment resistance hypertension in Australia and Europe. However, in the blinded SYMPLICITY HTN-3 trial, renal denervation did not achieve a significant decrease in blood pressure (BP) in comparison to sham controls. There have been various discussions on the factors that influenced this result. CASE REPORT Two men on antihypertensive therapy underwent unilateral radical nephroureterectomy for cancer of the renal pelvis. When the renal artery adventitia was stripped and cauterized just before renal artery ligation, the measured BP of the 2 men increased after stripping adventitia and decreased gradually after cauterization of the renal artery. This was presumably due to removal of renal artery sympathetic nerves, similar to the mechanism of catheter-based renal sympathetic denervation, although anesthesia, fluid infusion, and/or mesenteric traction may have had an influence. CONCLUSIONS A similar strategy involving thoracolumbar sympathectomy was reported about 50 years ago. The clinically significant blood pressure reduction in these patients suggests renal denervation is effective.

  13. Syndrome in question: Gorlin-Goltz syndrome.

    Science.gov (United States)

    Ribeiro, Pauline Lyrio; Souza, João Basílio de; Abreu, Karina Demoner de; Brezinscki, Marisa Simon; Pignaton, Christine Chambo

    2016-01-01

    The Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an uncommon disorder caused by a mutation in Patched, tumor suppressor gene. It is mainly characterized by numerous early onset basal cell carcinomas, odontogenic cysts of jaw and skeletal abnormalities. Due to the wide clinical spectrum, treatment and management of its modalities are not standardized and should be individualized and monitored by a multidisciplinary team. We report a typical case in a 30-year-old man with multiple basal cell carcinomas, keratotic pits of palmar creases and bifid ribs, with a history of several corrective surgeries for keratocystic odontogenic tumors, among other lesions characteristic of the syndrome.

  14. Considerations for double-hand replantation in a resource-constrained healthcare facility

    Directory of Open Access Journals (Sweden)

    Bibhuti Bhusan Nayak

    2016-01-01

    Full Text Available Bilateral-hand amputation is extremely rare and double-hand replantation is even rarer. Only one case of successful double replantation at arm level has been reported from India. We present a case of double-hand replantation at proximal palmar level in a young adult executed in a small nursing home. The patient presented 5 h after injury with limbs preserved well in ice. There were difficulties in executing such an unusual case in a small nursing home set-up. The patient is performing his activities of daily living and basic functions independently. We share our experience of this double-hand replantation with special emphasis on problems encountered.

  15. A rare case of recurrent pyogenic liver abscess since childhood: A case of Papillon-Lefèvre syndrome

    Directory of Open Access Journals (Sweden)

    Somak K Das

    2013-01-01

    Full Text Available Recurrent pyogenic liver abscess since childhood is an uncommon finding in clinical medicine. Papillon-Lefèvre syndrome (PLS is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis, and severe periodontal destruction involving both the primary and permanent dentitions. Till date, more than 200 cases have been reported worldwide. In addition to the skin and oral findings, patients may have immune suppression and an increased susceptibility to bacteria, associated with recurrent pyogenic infections of the skin. Pyogenic liver abscess is an uncommon presentation of this rare syndrome. We present a case of PLS presenting as recurrent pyogenic liver abscess since childhood.

  16. Dental management of Rapp-Hodgkin syndrome associated with oral cleft and hypodontia

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Karthikeyani

    2016-01-01

    Full Text Available Rapp-Hodgkin syndrome (RHS is a rare type of autosomal dominant disorder characterized by association of ectodermal dysplasia (ED with cleft lip/palate. The main features include dry, brittle hair with alopecia in adulthood, dental anomalies (hypodontia, microdontia with delayed eruption, fissured tongue, and retruded maxilla, hypohidrosis, dysplastic nails, and clefting. Palmar-plantar keratoderma is seen frequently. RHS has signs and symptoms that overlap considerably with those of ankyloblepharon-ED-clefting syndrome and ectrodactyly-ED-clefting syndrome. This manuscript discusses a case of RHS, one of the four members in three generations who had ED with variable degree of involvement of hair, teeth, nail, and sweat glands.

  17. Costello syndrome

    Directory of Open Access Journals (Sweden)

    Madhukara J

    2007-01-01

    Full Text Available Costello syndrome is a rare, distinctive, multiple congenital anomaly syndrome, characterized by soft, loose skin with deep palmar and plantar creases, loose joints, distinctive coarse facial features and skeletal and cardiac abnormalities. The affected patients have a predisposition to develop malignancy, developmental delays and mental retardation. Recently, a 7-year-old male child born to normal nonconsanguineous parents presented to us with abnormal facial features, arrhythmia, mitral valve dysfunction and growth retardation. His cutaneous examination revealed lax and pigmented skin over hands and feet with deep creases, acanthosis nigricans and short curly hairs. Its differentiation from other syndromes with similar clinical features is discussed in this article.

  18. Recurrent neuroma formation after lateral arm free flap coverage with neurorraphy to the posteroantebrachial nerve.

    Science.gov (United States)

    Peterson, Steven L; Gordon, Michael J

    2004-09-01

    We report a patient with previous wrist trauma and development of a symptomatic neuroma of the palmar cutaneous branch of the median nerve. The patient had previously been successfully treated with lateral arm free flap coverage with neurorrhaphy to a segment of the posteroantebrachial cutaneous nerve carried with the flap. Two years following this procedure the patient experienced re-onset of symptoms prompting surgical exploration of the area. At the time of operation a recurrent neuroma was found at the free distal terminus of the transferred posteroantebrachial cutaneous nerve. The neuroma was repositioned into the distal radius via a burr hole with relief of symptoms.

  19. Development of a Cardiovascular Simulator for Studying Pulse Diagnosis Mechanisms

    Directory of Open Access Journals (Sweden)

    Min Jang

    2017-01-01

    Full Text Available This research was undertaken to develop a cardiovascular simulator for use in the study of pulse diagnosis. The physical (i.e., pulse wave transmission and reflection and physiological (i.e., systolic and diastolic pressure, pulse pressure, and mean pressure characteristics of the radial pulse wave were reproduced by our simulator. The simulator consisted of an arterial component and a pulse-generating component. Computer simulation was used to simplify the arterial component while maintaining the elastic modulus and artery size. To improve the reflected wave characteristics, a palmar arch was incorporated within the simulator. The simulated radial pulse showed good agreement with clinical data.

  20. Electrical measurement of sweat activity

    International Nuclear Information System (INIS)

    Tronstad, Christian; Grimnes, Sverre; Martinsen, Ørjan G; Gjein, Gaute E; Fosse, Erik; Krogstad, Anne-Lene

    2008-01-01

    A multichannel logger for long-term measurements of sweat activity is presented. The logger uses skin surface electrodes for unipolar admittance measurements in the stratum corneum. The logger is developed with emphasis on clinical use. The portability of the logger enables recording of sweat activity under circumstances such as daily errands, exercise and sleep. Measurements have been done on 24 healthy volunteers during relaxation and exercise with heart rate monitoring. Recordings of sweat activity during sleep have been done on two healthy subjects. Early results show good agreement with the literature on sweating physiology and electrodermal activity. Results are presented showing measurements related to physical exercise, dermatomes, distribution of sweat glands and sympathetic activity. This study examines the normal sweating patterns for the healthy population, and we present results with the first 24 healthy volunteers. Comparing these results with similar measurements on hyperhidrosis patients will make it possible to find the most useful parameters for diagnosis and treatment evaluation

  1. Cyclic Bicytopenia in a Patient with Shapiro Syndrome

    Directory of Open Access Journals (Sweden)

    Lindsey E. Roeker

    2013-01-01

    Full Text Available Shapiro syndrome and periodic hypothermia have been reported approximately fifty times in the literature. Shapiro syndrome is defined as the constellation of periodic hypothermia and hyperhidrosis along with agenesis of the corpus callosum by Shapiro et al. in 1969. Periodic hypothermia is a more broad diagnosis with a number of proposed mechanisms; it occurs in patients without structural brain abnormalities. Hematologic abnormalities beyond iron-deficiency anemia have not been documented in any of the reported cases of Shapiro syndrome or periodic hypothermia. Though accidental and therapeutic hypothermia have been associated with thrombocytopenia, this is, to our knowledge, the first reported case of periodic intrinsic hypothermia causing bicytopenia. In this report, we present the case of a patient with Shapiro syndrome who experienced cyclic bicytopenia mirroring hypothermic episodes. We address the differential diagnosis of bicytopenia, review the mechanisms proposed for cytopenias related to hypothermia, and propose possible mechanisms for the finding in this case.

  2. Clinical manifestations of primary hyperthyroidism in the elderly patients at the out-patient clinic of Srinagarind Hospital.

    Science.gov (United States)

    Limpawattana, Panita; Sawanyawisut, Kittisak; Mahankanukrau, Ajanee; Wongwipaporn, Chaiyasit

    2006-02-01

    The authors reviewed the outpatient charts diagnosed as hyperthyroidism at Srinagarind Hospital from June 1998-June 2004. The objective was to compare the clinical features of hyperthyroidism in patients older and younger than 60 years old. There were 922 cases enrolled, 84 cases (9.11%) were 60 years old and above. The female: male ratio was 3.4:1 and 4:1 and the mean ages were 64.2 +/- 3.7 and 37.4 +/- 11.2 years old in the elder and younger group, respectively. The common presentations were dyspnea (94.1, 96.5%), weight loss (93.8, 87.9%) and palpitation (83.3, 93.1%) in the elder and younger, respectively. The more significant clinical presentations in the elder group were atrial fibrillation, weakness and anorexia whereas exophthalmos, goiter, heat intolerance and hyperhidrosis were not as frequent. Thus, the classic presentations often lacked in the elder group. Therefore, unexplained AF, weakness and anorexia should not exclude hyperthyroidism even with paucity of typical clinical features.

  3. [Digitalisation of palmar pattern configurations. Practicability in the anthropologic-heredobiological expert opinion (author's transl)].

    Science.gov (United States)

    Berghaus, G; Baitsch, H

    1980-01-01

    A half-automatic technique for extracting characteristics from handprints is presented. Characteristics of the mainline system are defined from the co-ordinate aggregates. The practicability of the method in the anthropologic-heredobiological expert opinion is discussed.

  4. Fractura de radio distal: abordaje mininvasivo con preservación del pronador cuadrado. [Distal radius fracture: minimally invasive approach with pronator quadrates preservation.

    Directory of Open Access Journals (Sweden)

    Gabriel Clembosky

    2015-05-01

    Full Text Available Objetivo Describir y analizar una técnica de osteosíntesis palmar de radio distal con preservación del pronador cuadrado. Material y Métodos Se revisaron, en forma retrospectiva, 24 pacientes operados con esta técnica (16 mujeres y 8 hombres; edad promedio 65 años. Doce fracturas eran de tipo A; 7, de tipo B y 5, de tipo C. La técnica quirúrgica consiste en practicar una incisión cutánea de 25 mm y profundizar hasta observar el pronador cuadrado. Sin seccionarlo, se realiza una disección de su borde distal, a fin de introducir la placa bloqueada volar por debajo del músculo. Se colocan los tornillos distales bajo visión directa y los tornillos proximales, en forma percutánea. La evaluación posoperatoria se llevó a cabo mediante análisis clínico-funcional y radiográfico. Resultados En el último control, todos los pacientes presentaban signos clínicos y radiográficos de consolidación ósea. El puntaje en la escala DASH fue, en promedio, de 4,8. Se observó una inclinación palmar posoperatoria de la superficie articular del radio de 14,3º promedio y una inclinación radial de 26,3º promedio. No se detectaron complicaciones relacionadas con la fractura, el implante o la herida quirúrgica en ninguno de los controles posoperatorios. Conclusiones Sin bien no existe bibliografía que demuestre que la técnica mininvasiva sea superior, sostenemos que el hecho de obtener resultados similares con ambos abordajes (mininvasivo y convencional justifica llevar a cabo esta técnica con preservación del pronador cuadrado, sobre todo en los pacientes preocupados por el aspecto cosmético de la cicatriz.

  5. Tratamento da pseudo-artrose do terço distal do rádio Treatment of nounion in the third distal of the radio

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Sertório Grecco

    2005-01-01

    Full Text Available Os autores apresentaram um estudo prospectivo de quatro pacientes portadores de pseudo-artrose no terço distal do rádio. Dois eram do sexo feminino e dois do masculino, com idade média de 42,5 anos. O diagnóstico de pseudo-artrose foi realizado em média com 5,3 meses após o trauma. Um paciente apresentava, como antecedente mórbido pessoal, epilepsia e osteoporose, outros dois relataram tabagismo e obesidade e o quarto, fratura exposta. O tratamento consistiu de osteossíntese interna e enxertia com osso autógeno. Todos foram submetidos à avaliação clínica pré e pós-operatória quanto à força de preensão palmar e arco de movimentos do punho. Houve 100% de consolidação das fraturas do terço distal do rádio em pseudo-artrose e retorno dos pacientes às atividades profissionais.The authors presented a prospective study of four patients presenting pseudarthrosis at the distal third of the radius. Two patients were females and two were males, aged between 29 and 51 years with a mean age of 42.5 year old. The diagnosis of pseudarthrosis was provided within an average of 5.3 months after trauma. One patient presented as personal morbid history, epilepsy and osteoporosis, two patients were smokers and obese, and the fourth had an open fracture. The treatment consisted of internal osteosynthesis and autogenous bone graft. All patients were submitted to pre- and post operative clinical evaluation for palmar holding force and movement arch of the wrist. 100% of the radius distal-third fractures in pseudarthrosis have been united, with all patients returning to their respective professional activities.

  6. The status of dermatoglyphics as a biomarker of Tel Hashomer camptodactyly syndrome: a review of the literature.

    Science.gov (United States)

    Wijerathne, Buddhika T B; Meier, Robert J; Agampodi, Suneth B

    2016-09-20

    Tel Hashomer camptodactyly syndrome is a rare disease and only a few cases have been reported. Dermatoglyphics potentially provide relevant phenotypic biomarkers that were initially noted as a vital clinical feature of this disease. Dermatoglyphics possibly can indicate growth disturbances that took place during early fetal development at the time when epidermal ridges were being formed into discernable patterns. Consequently, these intrauterine effects might well have occurred in association with the expression of the Tel Hashomer camptodactyly syndrome. Therefore, this review was undertaken to provide, as far as we know, the first attempt to broadly assess dermatoglyphic features that are connected with the Tel Hashomer camptodactyly syndrome. If a developmental association between dermatoglyphics and Tel Hashomer camptodactyly can be firmly established, this would probably document that Tel Hashomer camptodactyly disease has its origins during the early fetal period. A systematic literature search was conducted using articles from PubMed (Medline), POPLINE, Trip Database, Cochrane Library, and gray literature up to 31 March 2015. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Fourteen relevant publications were included in the review. There were 23 cases of patients with Tel Hashomer camptodactyly syndrome that were described in these published articles. We reviewed the dermatoglyphics of 21 available cases out of all of the published and electronically available cases of Tel Hashomer camptodactyly. Eight cases reported whorls to be the most common digital pattern with an expected rise of ridge count. Two cases show significantly high frequencies of arch patterns. Further, there were increased numbers of palmar creases, along with abnormal flexion creases or other palmar dermatoglyphic abnormalities reported in all cases. This review highlighted the desirability of thoroughly observing and

  7. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kimonis, V.E.; Yang, M.L.; Bale, S.J. [National Institute of Arthritis and Musculoskeletal and Skin Disease, Bethesda, MD (United States)] [and others

    1997-03-31

    Nevoid basal cell carcinoma syndrome (NBCC; Gorlin syndrome), an autosomal dominant disorder linked to 9q22.3-q31, and caused by mutations in PTC, the human homologue of the Drosophila patched gene, comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies and calcification of the falx cerebri. We reviewed the findings on 105 affected individuals examined at the NIH since 1985. The data included 48 males and 57 females ranging in age from 4 months to 87 years. Eighty percent of whites (71/90) and 38% (5/13) of African-Americans had at least one basal cell carcinoma (BCC), with the first tumor occurring at a mean age of 23 (median 20) years and 21 (median 20) years, respectively. Excluding individuals exposed to radiation therapy, the number of BCCs ranged from 1 to >1,000 (median 8) and 1 to 3 (median 2), respectively, in the 2 groups. Jaw cysts occurred in 78/105 (74%) with the first tumor occurring in 80% by the age of 20 years. The number of total jaw cysts ranged from 1 to 28 (median 3). Palmar pits and plantar pits were seen in 87%. Ovarian fibromas were diagnosed by ultrasound in 9/52 (17%) at a mean age of 30 years. Medulloblastoma occurred in 4 patients at a mean age of 2.3 years. Three patients had cleft lip or palate. Physical findings include {open_quotes}coarse face{close_quotes} in 54%, relative macrocephaly in 50%, hypertelorism in 42%, frontal bossing in 27%, pectus deformity in 13%, and Sprengel deformity in 11%. This study delineates the frequency of the clinical and radiological anomalies in NBCC in a large population of US patients and discusses guidelines for diagnosis and management. 48 refs., 3 figs., 5 tabs.

  8. Exceptional bone metastasis of basal cell carcinoma in Gorlin-Goltz syndrome.

    Science.gov (United States)

    Lamon, Tatiana; Gerard, Stephane; Meyer, Nicolas; Losfeld, Benjamin; Abellan van Kan, Gabor; Balardy, Laurent; Vellas, Bruno

    2010-01-01

    Basal cell carcinoma (BCC), the most prevalent form of cancer worldwide, is a malignant skin neoplasm. It is locally invasive, with an exceptional incidence of reported metastasis. It can also be part of the Gorlin-Goltz syndrome, an autosomal dominant genetic disorder with high penetrance and variable expressivity, which is principally characterized by cutaneous BCC, odontogenic keratocysts, palmar and/or plantar pits, and falx cerebri calcification. We report the exceptional clinical observation of a 54-year-old man presenting bone metastasis from BCC in Gorlin-Goltz syndrome. Less than 300 cases of metastatic BCC have been reported in the literature. The present case is the second associated with Gorlin-Goltz syndrome. Copyright 2009 S. Karger AG, Basel.

  9. Gorlin-Goltz syndrome and neoplasms: a case study.

    Science.gov (United States)

    Lopes, Nilza N F; Caran, Eliana M; Lee, Maria Lucia; Silva, Nasjla Saba; Rocha, André Caroli; Macedo, Carla R D

    2010-01-01

    Gorlin syndrome is a rare autosomal dominant disorder exhibiting high penetrance and variable expressivity. It is characterized by facial dysmorphism, skeletal anomalies, multiple basal cell carcinomas, odontogenic keratocysts (OKC), palmar and plantar pits, bifid ribs, vertebral anomalies and a variety of other malformations. Various neoplasms, such as medulloblastomas, meningiomas, ovarian and cardiac fibromas are also found in this syndrome. To describe a twelve-year-old patient with Gorlin-Goltz syndrome, with basal cell carcinomas and promyelocytic leukemia developed after receiving craniospinal radiation for a medulloblastoma. Bifid ribs as well as mandibular and maxillar OKC were also diagnosed Conclusion: The patient with Gorlin-Goltz syndrome should receive close follow-up for early detection of malformations nd malignant neoplasias.

  10. Paraneoplastic addisonian pigmentation and acquired ichthyosis as presenting features of multiple myeloma

    International Nuclear Information System (INIS)

    Dar, N.R.; Raza, N.

    2010-01-01

    Black brown hyperpigmentation of the mucosae, sun exposed skin, palmar creases and frictional sites (Addisonian pigmentation) is characteristic of Addison disease. However, it can also occur as a para neoplastic manifestation of tumours like bronchogenic carcinoma. Acquired ichthyosis starts later in life and can also be a para neoplastic presentation.We report a unique combination of para neoplastic Addisonian pigmentation and acquired ichthyosis as presenting features in a patient with undiagnosed multiple myeloma. To the best of our knowledge this combination of para neoplastic dermatosis has not been documented before in multiple myeloma. It is concluded that the presence of more than one suspicious dermatosis may be an indicator of being para neoplastic requiring necessary work-up. (author)

  11. Observações sobre o comportamento de Liolaemus occipitalis em cativeiro (Sauria, Tropiduridae Observations on the behavior of Liolaemus occipitaus in captivity (Sauria, Tropiduridae

    Directory of Open Access Journals (Sweden)

    Clóvis Souza Bujes

    1998-12-01

    Full Text Available Liolaemus occipitalis (Boulenger, 1885 is an abundant lizard lbundalong lhe coastal dunes of Rio Grande do Sul, Brazil. Fourteen individuais were manually captured in the dunes of Quintão beach (Palmares do Sul, Rio Grande do Sul and studied in captivity from 23/VII/92 to 30/VII/93. They were kept in a terrarium with sand substrate and vegetation collected in their habitat. Snout-vent length (SVL and wcighted were measured weekly. They received Tenebrio molitor (Linnaeus, 1758 worms as food; water was abundant. Combats between males for food and territory, and other behavioral displays were observed, like copulation and nesting behaviors. Growth curves for each lizard were analyzed.

  12. A case of a double variant of the arterial system in the upper extremity: Arteria brachialis accessoria et arteria comitans nervi mediani

    Directory of Open Access Journals (Sweden)

    Kachlik D.

    2011-01-01

    Full Text Available A thorough knowledge of arteries of the upper extremity is necessary for catheterization, graft harvesting, shunt application, and Astrup’s examination. Coincidences of two different variants are rather rare. We present a case of the coincidental presence of arteria brachialis accessoria stemming from the arteria axillaris and reuniting with the arteria brachialis 1.5cm below the origin of the arteria collateralis ulnaris inferior; and arteria comitans nervi median originated in association with the arteria interossea communis from the arteria ulnaris, passing into the palm and towards the arteriae digitales palmares to the thumb, index and lateral side of the third finger. Such coincidence has never been reported before.

  13. Neuroblastoma in a patient with Coffin-Siris syndrome.

    Science.gov (United States)

    Pollono, Daniel; Drut, Ricardo; Cecotti, Norma; Pollono, Agustina

    2009-01-01

    We report the case of an 8-year-old boy with the phenotypic features of Coffin-Siris syndrome diffuse hypertrichosis, flat occiput, scant scalp hair, flat supraorbital arch, triangular eyebrows, horizontal palpebral fissure, anteverted nares, triangular philtrum, coarse lips, high-arched palate, micrognathia, low set and dorsaly rotated ears, short neck, wide thorax, widely set nipples, transverse palmar crease, psychomotor delay, urinary malformations (paraurethral diverticulum, hypoplasia of left kidney associated with vesicoureteral reflux grade 3-4), bilateral inguinal hernia, and dorsolumbar kyphoscoliosis. In the follow-up he presented a retroperitoneal neuroblastoma. Although this type of tumor has been referred to develop in several genetic and mutimalformative syndromes, it seems that present association has not been previously reported.

  14. The inhalation of radioactive materials as related to hand contamination

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, J.C.; Rohr, R.C.

    1953-09-15

    Tests performed to determine the hazard associated with the inhalation of radioactive materials as the result of smoking with contaminated hands indicate that for dry uranium compounds adhering to the palmar surfaces of the hands, approximately 1.0% of the material may be transferred to a cigarette, and that of this approximately 0.2% may appear in the smoke which is inhaled. Most of the contamination originally placed in a cigarette was found in the ash, and only 11% of the material was not recovered following burning; approximately half of this loss may be attributed to normal losses inherent in the analytical process, the recovery efficiency for which was found by supplementary experiments to be 95%.

  15. Ocorrência de Lesões de Punho e Mão e Análise Álgica em Praticantes de Jiu-jítsu

    OpenAIRE

    Ribeiro Neto, Nelson Coimbra; Santos, Hélio Gustavo; Carreiro, Brenda; Campanha, Gleica Prenholato Dias; Liduíno, Lorena; Leal, Isaías

    2016-01-01

    No jiu-jítsu predominam técnicas de luta sobre a imposição da força bruta e, juntamente com os princípios biomecânicos, otimiza a força muscular do lutador, anula a do oponente e utiliza as valências físicas deste contra ele próprio. Desse modo, buscou-se identificar a ocorrência de lesões de punho e mão e análise da dor em praticantes de jiu-jítsu. Esta é uma pesquisa de campo, descritiva, de análise quali-quantitativa, com 6 participantes avaliados em sua preensão palmar, goniometria de pun...

  16. Evaluation of Chronic Physical and Psychological Stress Induction on Cardiac Ischemia / Reperfusion Injuries in Isolated Male Rat Heart: The Role of Sympathetic Nervous System

    Directory of Open Access Journals (Sweden)

    Kamran Rakhshan

    2015-10-01

    Full Text Available Exposure to stress leads to physiological changes called “stress response” which are the result ofthe changes in the adrenomedullary hormone system, hypothalamus-pituitary-adrenal (HPA and sympatheticnervous system (SNS activity. In the present study, the effects of chronic physical and psychological stressand also the role of sympathetic system effects in stress on ischemia/reperfusion (I/R injuries have beenstudied in isolated rat heart. Rat heart was isolated and subjected to 30 min regional ischemia and 120 minreperfusion. The daily stress was induced for one week prior to I/R induction. Sympathectomy was donechemically by injection of hydroxyl-dopamine prior to stress induction. There were no significant changes inheart rate and Coronary Flow between groups. Left ventricular developed pressure (LVDP and rate productpressure (RPP in both physical and psychological stress groups decreased significantly compared to those incontrol group (Pgroups. Infarct size significantly increased in both physical and psychological stress groups and control group(Pas compared with stress groups (Ppsychological stress prior to ischemia/reperfusion causes enhancement of myocardial injuries and it seemsthat increased sympathetic activity in response to stress is responsible for these adverse effects of stress onischemic/reperfused heart.

  17. Renal Sympathetic Denervation: Hibernation or Resurrection?

    Science.gov (United States)

    Papademetriou, Vasilios; Doumas, Michael; Tsioufis, Costas

    The most current versions of renal sympathetic denervation have been invented as minimally invasive approaches for the management of drug-resistant hypertension. The anatomy, physiology and pathophysiology of renal sympathetic innervation provide a strong background supporting an important role of the renal nerves in the regulation of blood pressure (BP) and volume. In addition, historical data with surgical sympathectomy and experimental data with surgical renal denervation indicate a beneficial effect on BP levels. Early clinical studies with transcatheter radiofrequency ablation demonstrated impressive BP reduction, accompanied by beneficial effects in target organ damage and other disease conditions characterized by sympathetic overactivity. However, the failure of the SYMPLICITY 3 trial to meet its primary efficacy end point raised a lot of concerns and put the field of renal denervation into hibernation. This review aims to translate basic research into clinical practice by presenting the anatomical and physiological basis for renal sympathetic denervation, critically discussing the past and present knowledge in this field, where we stand now, and also speculating about the future of the intervention and potential directions for research. © 2016 S. Karger AG, Basel.

  18. Vagal modulation of high mobility group box-1 protein mediates electroacupuncture-induced cardioprotection in ischemia-reperfusion injury.

    Science.gov (United States)

    Zhang, Juan; Yong, Yue; Li, Xing; Hu, Yu; Wang, Jian; Wang, Yong-qiang; Song, Wei; Chen, Wen-ting; Xie, Jian; Chen, Xue-mei; Lv, Xin; Hou, Li-li; Wang, Ke; Zhou, Jia; Wang, Xiang-rui; Song, Jian-gang

    2015-10-26

    Excessive release of high mobility group box-1 (HMGB1) protein from ischemic cardiomyocytes activates inflammatory cascades and enhances myocardial injury after reperfusion. Here we report evidence that electroacupuncture of mice at Neiguan acupoints can inhibit the up-regulation of cardiac HMGB1 following myocardial ischemia and attenuate the associated inflammatory responses and myocardial injury during reperfusion. These benefits of electroacupuncture were partially reversed by administering recombinant HMGB1 to the mice, and further potentiated by administering anti-HMGB1 antibody. Electroacupuncture-induced inhibition of HMGB1 release was markedly reduced by unilateral vagotomy or administration of nicotinic receptor antagonist, but not by chemical sympathectomy. The cholinesterase inhibitor neostigmine mimicked the effects of electroacupuncture on HMGB1 release and myocardial ischemia reperfusion injury. Culture experiments with isolated neonatal cardiomyocytes showed that acetylcholine, but not noradrenaline, inhibited hypoxia-induced release of HMGB1 via a α7nAchR-dependent pathway. These results suggest that electroacupuncture acts via the vagal nerve and its nicotinic receptor-mediated signaling to inhibit HMGB1 release from ischemic cardiomyocytes. This helps attenuate pro-inflammatory responses and myocardial injury during reperfusion.

  19. The influence of autonomic interventions on the sleep-wake-related changes in gastric myoelectrical activity in rats.

    Science.gov (United States)

    Huang, Y M; Yang, C C H; Lai, C J; Kuo, T B J

    2011-06-01

    Significant changes in autonomic activity occur at sleep-wake transitions and constitute an ideal setting for investigating the modulatory role of the autonomic nervous system on gastric myoelectrical activity (GMA). Using continuous power spectral analysis of electroencephalogram, electromyogram, and electrogastromyogram (EGMG) data from freely moving rats that had undergone chemical sympathetomy and/or truncal vagotomy, sleep-wake-related fluctuations in GMA were compared among the intervention groups. The pattern and extent of fluctuations in EGMG power across the sleep-wake states was blunted most significantly in rats undergoing both chemical sympathectomy and truncal vagotomy. The effect of these interventions also varied with respect to the transition between different sleep-wake states. The most prominent influences were observed between active waking and quiet sleep and between paradoxical sleep and quiet sleep. The sleep-wake-related fluctuations in EGMG power are a result of joint contributions from both sympathetic and vagal innervation. Vagotomy mainly resulted in a reduction in EGMG power, while the role of sympathetic innervation was unveiled by vagotomy and this was reflected most obviously in the extent of the fluctuations in EGMG power. © 2011 Blackwell Publishing Ltd.

  20. BIOMETRIC EVALUATION OF THE HOOF BALANCE OF EQUIDS USED TO PULL WAGONS IN BELO HORI¬ZONTE CITY, BRAZIL AVALIAÇÃO BIOMÉTRICA DO EQUILÍBRIO PODAL DE EQÜÍDEOS DE TRAÇÃO NO MUNICÍPIO DE BELO HORIZONTE

    Directory of Open Access Journals (Sweden)

    Ubiratan Pereira de Melo

    2007-07-01

    Full Text Available The hoof balance of 58 equids used to pull wagons in the city of Belo Horizonte was evaluated, by measuring length and width of sole and frog, length of heels and length of hoof wall and toe angle from the four hooves. Significant differences were not observed between right and left fore and hindlimbs, for both equines and mules. The difference of toe angle among opposite members was not significant, however, 46,5% of the animals presented some difference among the angle of the opposite forelimb, varying from the degree 1 to the 3, while 41,3% presented angle diffe¬rence among the hindlimb, varying from the degree 1 to the 3. A total of 31,30% of medium-lateral imbalance of the heels was observed, and foot contraction varied from 67,86 to 78,18% to the different studied members. A high correlation between body weight and toe length, sole length and sole width. Also, 79,30% of the animals worn rubber shoes manufactured from car tires. Based on the results, this study found that the incidence of dorso-palmar/plantar foot imbalance in equids used to pull wagons in the Belo Horizonte city is higher than the medium-lateral form. KEY-WORDS: Equines and mules, hoof, hoof imbalance, wagons. Avaliou-se o equilíbrio podal de 58 animais de tra¬ção em atividade no município de Belo Horizonte por meio da mensuração do comprimento e largura da sola e ranilha, comprimento da pinça e dos talões e ângulo da pinça dos quatro cascos. Não se observaram diferenças significativas entre as medidas dos cascos contralaterais de eqüinos e muares. A diferença de angulação da pinça entre membros contralaterais não foi significativa. Entretanto, 46,5% dos animais apresentaram diferença entre a angulação dos cascos contralaterais anteriores, variando do grau 1 ao 3, enquanto 41,3% apresentaram diferença de angulação entre os cascos posteriores, variando do grau 1 ao 3. Observou-se o índice de 31,30% de desnivelamento médio-lateral dos talões, e

  1. A comparison between 133Xenon washout technique and Laser Doppler flowmetry in the measurement of local vasoconstrictor effects on the microcirculation in subcutaneous tissue and skin

    International Nuclear Information System (INIS)

    Kastrup, J.; Buelow, J.; Lassen, N.A.

    1987-01-01

    Changes in skin blood flow measured by Laser Doppler flowmetry and changes in subcutaneous blood flow measured by 133 Xenon washout technique were compared during activation of the local sympathetic mediated veno-arteriolar vaso-constrictor reflex by lowering the area of investigation below heart level. The measurements were performed in tissue with and without sympathetic innervation. In five subjects, who all had been cervically sympathectomized for manual hyperhidrosis, the Laser Doppler and 133 Xenon blood flow measurements were performed simultaneously on the sympathetically denervated forearm, and on the calf with preserved sympathetic nerve supply. The Laser Doppler method registered a 23% reduction in skin blood flow during lowering of the extremities independently of the sympathetic nerve supply to the skin. The 133 Xenon method recorded a 44% decrease in blood flow in innervated and unchanged blood flow in denervated subcutaneous tissue during lowering of the extremities. Our results indicate that the Laser Doppler method and 133 Xenon method are not comparable, and that the Laser Doppler method is not useful in measuring local sympathetic mediated blood flow changes. (author)

  2. Comparison between /sup 133/Xenon washout technique and Laser Doppler flowmetry in the measurement of local vasoconstrictor effects on the microcirculation in subcutaneous tissue and skin

    Energy Technology Data Exchange (ETDEWEB)

    Kastrup, J.; Buelow, J.; Lassen, N.A.

    1987-10-01

    Changes in skin blood flow measured by Laser Doppler flowmetry and changes in subcutaneous blood flow measured by /sup 133/Xenon washout technique were compared during activation of the local sympathetic mediated veno-arteriolar vaso-constrictor reflex by lowering the area of investigation below heart level. The measurements were performed in tissue with and without sympathetic innervation. In five subjects, who all had been cervically sympathectomized for manual hyperhidrosis, the Laser Doppler and /sup 133/Xenon blood flow measurements were performed simultaneously on the sympathetically denervated forearm, and on the calf with preserved sympathetic nerve supply. The Laser Doppler method registered a 23% reduction in skin blood flow during lowering of the extremities independently of the sympathetic nerve supply to the skin. The /sup 133/Xenon method recorded a 44% decrease in blood flow in innervated and unchanged blood flow in denervated subcutaneous tissue during lowering of the extremities. Our results indicate that the Laser Doppler method and /sup 133/Xenon method are not comparable, and that the Laser Doppler method is not useful in measuring local sympathetic mediated blood flow changes.

  3. Clinical Uses of Botulinum Neurotoxins: Current Indications, Limitations and Future Developments

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    Sheng Chen

    2012-10-01

    Full Text Available Botulinum neurotoxins (BoNTs cause flaccid paralysis by interfering with vesicle fusion and neurotransmitter release in the neuronal cells. BoNTs are the most widely used therapeutic proteins. BoNT/A was approved by the U.S. FDA to treat strabismus, blepharospam, and hemificial spasm as early as 1989 and then for treatment of cervical dystonia, glabellar facial lines, axillary hyperhidrosis, chronic migraine and for cosmetic use. Due to its high efficacy, longevity of action and satisfactory safety profile, it has been used empirically in a variety of ophthalmological, gastrointestinal, urological, orthopedic, dermatological, secretory, and painful disorders. Currently available BoNT therapies are limited to neuronal indications with the requirement of periodic injections resulting in immune-resistance for some indications. Recent understanding of the structure-function relationship of BoNTs prompted the engineering of novel BoNTs to extend therapeutic interventions in non-neuronal systems and to overcome the immune-resistance issue. Much research still needs to be done to improve and extend the medical uses of BoNTs.

  4. Huriez syndrome with superadded dermatophyte infection

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    Trupti Surana

    2016-01-01

    Full Text Available Palmoplantarkeratodermas (PPKs are a heterogeneous group of hereditary and acquired disorders with underlying gene defects, and characterized by hyperkeratosis of palms and soles with or without other ectodermal and systemic abnormalities. Huriez syndrome is a rare autosomal dominant transgradient type of PPK with high frequency of squamous cell carcinoma in the affected skin. We hereby describe a case of a very rare autosomal dominant PPK in a 40-year-old male patient presenting since birth with PPK extending onto the dorsal aspects of hands and feet with peeling of the skin. The complaints were associated with sclerodactyly, hyperhidrosis, and nail abnormalities. Also superadded dermatophyte infection was observed involving abdomen. No history of loss of any digit. No mucosal, dental, or any systemic involvement was present. No sign of malignancy was noted. Baseline investigations, including ultrasonography of abdomen were normal. Histological findings were nonspecific with only orthohyperkeratosis and acanthosis. Diagnosis was mainly done on clinical grounds. The patient is better with oral retinoids and topical emollients and keratolytics along with antifungal treatment for dermatophyte infection. He is under follow up.

  5. Gorlin-Goltz Syndrome: An Uncommon Cause of Facial Pain and Asymmetry.

    Science.gov (United States)

    Pickrell, Brent B; Nguyen, Harrison P; Buchanan, Edward P

    2015-10-01

    Gorlin-Goltz syndrome is an underdiagnosed autosomal dominant disorder with variable expressivity that is characterized by an increased predisposition to tumorigenesis of multiple types. The major clinical features include multiple basal cell carcinomas (BCCs) appearing in early childhood, palmar and plantar pits, odontogenic keratocysts of the oral cavity, skeletal defects, craniofacial dysmorphism, and ectopic intracranial calcification. The authors present the clinical course of a 12-year-old girl presenting with facial asymmetry and pain because of previously undiagnosed Gorlin-Goltz syndrome. Early diagnosis and attentive management by a multidisciplinary team are paramount to improving outcomes in patients with this disorder, and this report serves as a paradigm for maintaining a high clinical suspicion, which must be accompanied by an appropriate radiologic workup.

  6. Tendon transfer for median nerve palsy

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    K Sridhar

    2011-01-01

    Full Text Available The article describes the approach practiced by the author from 1995. Mainly Hansen′s patients and lower forearm injuries formed the bulk of these. In Opponen′s transfer ECU was used only when others were not available as the wrist developed a tendency to radial deviation even when FCU was acting. PL with palmar aponeurosis as extension was used again in limited cases. The main stay was FDS and EIP. The Guyan′s canal and lower end of ulna were the common pulleys. APB and EPL two slip inserts yielded good results. The approach describes the procedure under three distinct headings of choosing motor, Pulley and insert. Varying combinations of these can be used as per requirement.

  7. Hand ultrasound: a high-fidelity simulation of lung sliding.

    Science.gov (United States)

    Shokoohi, Hamid; Boniface, Keith

    2012-09-01

    Simulation training has been effectively used to integrate didactic knowledge and technical skills in emergency and critical care medicine. In this article, we introduce a novel model of simulating lung ultrasound and the features of lung sliding and pneumothorax by performing a hand ultrasound. The simulation model involves scanning the palmar aspect of the hand to create normal lung sliding in varying modes of scanning and to mimic ultrasound features of pneumothorax, including "stratosphere/barcode sign" and "lung point." The simple, reproducible, and readily available simulation model we describe demonstrates a high-fidelity simulation surrogate that can be used to rapidly illustrate the signs of normal and abnormal lung sliding at the bedside. © 2012 by the Society for Academic Emergency Medicine.

  8. Radiological appearance of air introduced during equine regional limb anaesthesia

    International Nuclear Information System (INIS)

    Kirberger, R.M.; Gottschalk, R.D.; Guthrie, A.J.

    1996-01-01

    Twelve horses were injected intra-articularly into the metacarpophalangeal joint and extra-articularly in the region of the lateral palmar digital nerve with 1 ml air and local anaesthetic to simulate gas accidentally introduced during regional anaesthesia. Half the horses underwent limited exercise after which all horses were radiographed at 15 and 45 min and then every 24 h until all evidence of gas had disappeared. Intra-articular gas appeared as gas capped radiolucencies (GCR) in the proximal aspect of the joint. Extra-articular gas appeared as linear radiolucencies (LR) which initially tended to migrate proximally. There was no significant difference in gas resorption in exercised and nonexercised horses. All gas was resorbed within 96 h with most of the gas already gone at 48 h

  9. Dowling–Degos disease with reticulate acropigmentation of Kitamura: Extended spectrum of a single entity

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    Shyam Govind Rathoriya

    2016-01-01

    Full Text Available Dowling–Degos disease (DDD and reticulate acropigmentation of Kitamura (RAK are rare genodermatoses inherited as an autosomal dominant trait with variable penetrance. They are considered to be part of a spectrum of reticulate pigmentary dermatoses, characterized by the presence of hyperpigmented macules coalescing in a reticular fashion. The authors describe a 28-year-old male patient having hyperpigmented macules on the axillae, neck and face, reticulate acropigmentation of dorsum of the hands, forearms and feet, palmar pitting, and comedo-like lesions over back. The patient showed the unique clinical as well as histopathological overlap of both the rare diseases (DDD and RAK, substantiating the hypothesis that they represent two different features of a single entity with variable phenotypic expression.

  10. Accumulation of FDG in axillary sweat glands in hyperhidrosis: a pitfall in whole-body PET examination

    International Nuclear Information System (INIS)

    Jacobsson, H.; Celsing, F.; Ingvar, M.; Stone-Elander, S.; Larsson, S.A.

    1998-01-01

    A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin's disease demonstrated bilateral uptake of [2- 18 F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes. (orig.)

  11. Single stage bilateral uniportal videothoracoscopic sympathicotomy for hyperhidrosis: can it be managed as an outpatient procedure?

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    Ahmet Demirkaya

    2016-05-01

    Full Text Available Introduction : The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis. Aim: To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure. Material and methods: Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis. The level of sympathicotomy was T2 in 2 (2.2% patients, T2 to T3 in 31 (33% patients, T2 to T4 in 46 (50% patients and T3 to T4 in 12 (13% patients. Demographic data, length of postoperative stay, substitution index (SI, admission rate (AR and readmission rate (RR, complications and patient satisfaction were reviewed retrospectively. Results: Two (2.2% patients suffered from chest pain, while 4 (4.3% patients complained about pain at the port site. Mean discharge time after surgery was 5.1 h (range: 4–6 h, mean duration of hospital stay was 0.15 days (0–3 days postoperatively and the mean operation time was 43.6 min (15–130 min. In 8 (8.6% patients, pneumothorax was detected on postoperative chest X-ray, while 5 (5.4% patients required chest tube drainage. Mild or moderate compensatory sweating developed in 32 (34.7% patients. No recurrence was observed, and the satisfaction rate was 96.7%. Substitution index and admission rate were 91.3% and 11% respectively, while RR was 0%. Conclusions : Bilateral video-assisted thoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.

  12. Comparative study between endoscopic technique by a proximal port and mini palmary incision in the surgical treatment of carpal tunnel syndrome Estudo comparativo entre a técnica endoscópica pelo portal proximal e a técnica de mini-incisão palmar no tratamento cirúrgico da síndrome do túnel do carpo

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    Eduardo A.R. Pereira

    2003-01-01

    Full Text Available The authors present a prospective study comparing two surgical techniques for carpal tunnel release. A minimal - incision open decompression(3 is compared with an endoscopic release(2, that utilizes only a single proximal portal. There were operated on, 28 wrists in 28 patients, with clinical signs and EMG changes consistent on idiopathic carpal tunnel syndrome, that failed under previous conservative treatment. They were randomized into two groups , undertaken surgical treatment, either by endoscopic release or by open decompression. Grip strength (measured by dynamometric, sensitivity (measured by Semmes-Weinstein monofilaments, presence of pain and paresthesia, date of return to activities of daily living and complications were evaluated pre-operative and at 1, 2, 4, 6, 12 weeks after surgery. After 12 months average follow up, the results indicated that this proximal portal endoscopic technique can be safely performed, showing advantages over open conventional method, in terms of sooner return of grip strength, date of return to activities of daily living, and less incidence of pillar pain. No differences in paresthesia resolution, sensibility improvement or complications incidence were found.Os autores apresentam estudo prospectivo onde comparam duas técnicas cirúrgicas empregadas no tratamento de pacientes acometidos pela síndrome do túnel do carpo. A técnica de descompressão por via aberta, através de mini-incisão palmar(3, é analisada em relação à técnica por via endoscópica, descrita por Agee et al.(2, que utiliza apenas um único portal proximal. Foram operados, de forma randomizada, 28 punhos em 28 pacientes com o diagnóstico clínico e eletromiográfico de síndrome do túnel do carpo idiopático, e que não obtiveram melhora com o tratamento conservador prévio. Os seguintes parâmetros, foram analisados no pré-operatório e na primeira, segunda, quarta, sexta e décima segunda semanas de pós-operatório: força de

  13. Dilemas e desafios diante do acesso ao Programa Brasil Quilombola: A realidade vivenciada pela comunidade Marques (Dilemmas and challenges facing access to the Quilombola Brazil Program: The reality experienced by the Marques community

    Directory of Open Access Journals (Sweden)

    Sidimara Cristina Souza

    2017-12-01

    Full Text Available Este artigo tem como objetivo avaliar o acesso aos benefícios ofertados pelo Programa Brasil Quilombola, no interior da comunidade Marques no município de Carlos Chagas, situado no Vale do Mucuri no estado de Minas Gerais, Brasil. Esta comunidade foi certificada em 2005 pela Fundação Cultural Palmares como “remanescente de quilombos”. Para a realização da pesquisa que deu origem a este artigo, utilizou-se como técnica a entrevista individual semiestruturada, bem como a observação de campo. A análise dos dados permite afirmar que o acesso aos benefícios ofertados pelo Programa Brasil Quilombola é extremamente restrito, e que a falta de comunicação entre os executores do programa e os possíveis usuários, assim como as falhas de execução, são os principais responsáveis pela ineficiência e inacessibilidade ao programa. Palavras-chave: Programa Brasil Quilombola. Comunidade Marques. Remanescente de Quilombo.  ABSTRACT This article aims to evaluate the access to the benefits offered by the Brasil Quilombola Program, within the Marques community in the municipality of Carlos Chagas, located in the Mucuri Valley in the State of Minas Gerais, Brazil. This community was certified in 2005 by the Palmares Cultural Foundation as "remnants of quilombos". For the accomplishment of the research that originated this article, it was used as technique the semi-structured individual interview, as well as the field observation. The analysis of the data allows to affirm that the access to the benefits offered by the Brasil Quilombola Program is extremely restricted, and that the lack of communication between the executor of the program and the possible users, as well as the execution failures, are the main ones responsible for the inefficiency and inaccessibility to the program.Keywords: Brazil Quilombola Program. Community Marques. Remnant of Quilombo. 

  14. The III working days of the Cenozoic

    International Nuclear Information System (INIS)

    2012-06-01

    The third working days in geology were organized by the Uruguayan Society of geology and took place in DINAMIGE in June - 2012. The lectures were given by national and foreign professionals and included important topics such as mineral raw materials used in the archaeological artifacts in Guayacas - Dayman - Paysandu . The Holocene in the coastal zone of Uruguay. Aspect of the early human occupation in Uruguay. Change effects in the land use about the mineral clay (eucalyptus forestation, illite). Paleoclimatic and paleoenvironmental reconstruction for middle and late holocene (Rocha). Gas hydrate resource quantification in Uruguay. Application of the geophysical techniques in the environmental pollution in Montevideo - Piriapolis. Environmental evolution and builders of small hills in India Muerta zone. Human or natural forcing in the geomorphological processes in Pocitos and Ramirez beaches (80 years of aerophotographic records).Tipology and nomenclature proposal for technological soil. Quarries reconditioning methodology. Hydraulic conductivity in sugar cane cultivated in soils previous vinaza application. Paleosoils and pedogenic calcretes formations in Fray Bentos (Oligocene - early miocene) Raigon (late pliocene and Middle pleistocene) and Libertad (early - middle pleistocene). Tectonics and sedimentary process in the continental talud in Uruguay. Rio de la Plata as paleoenvironmental focus using diatomos as proxies. Oleistocene mammals in the late-early Holocene in Santa Lucia river basin (Uruguay southern). Anthropization in Montevideo Bay during the Holocene. Paleocene stratigraphic plays in Uruguay offshore. Continental Influence versus marine transition in Rio de la Plata zone - internal continental shelf of the South Atlantic - a multiproxy study. Macrofossils vegetable in Palmar formation (later pleistocene) in Entre Rios - Argentina. Phytolith analysis in quaternary fluvial sediment (plio-pleistocene) in San Salvador and Palmar formation - Uruguay

  15. Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound

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    Setyo Handryastuti

    2018-03-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice. Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP. Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjects’ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist. Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice. Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

  16. Escore US7 modificado na avaliação de sinovite em pacientes com artrite reumatoide inicial

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    José Alexandre Mendonça

    2014-07-01

    Full Text Available Objetivo: Avaliar o escore US7 modificado (escore MUS7 SIN na avaliação de pacientes com artrite reumatoide inicial (ARI. Além disso, foram examinados recessos dorsais e palmares dos punhos, bem como pequenas articulações das mãos e dos pés, para o diagnóstico de sinovite, mediante uma avaliação global das articulações. Métodos: A amostra do estudo compreendeu 32 pacientes tratados para artrite, com 13 meses como duração média da doença. Foi utilizado um aparelho de ultrassonografia (US com transdutor de alta frequência. As mãos dos participantes também foram radiografadas e analisadas pelo escore de Larsen. Resultados: Nas 832 articulações examinadas, detectou-se sinovite em 173 (20,79%, tenossinovite em 22 (4,91% e erosões em três (1,56%. A sinovite foi predominantemente detectada no recesso dorsal (73,38% das articulações MCF e IFP, quando comparado com o recesso palmar (26%. A presença de sinovite nas articulações avaliadas teve correlação com os resultados clínicos (HAQ-DI, DAS28, laboratoriais (anti-PCC, FR, PCR e ultrassonográficos (r = 0,37 a r = 0,42; p = 0,04 a p = 0,003. Encontramos correlação do escore MUS7 SIN para US na técnica da escala de cinzas (gray scale ou na técnica de Doppler de amplitude (power Doppler com os valores do instrumento DAS28 (PCR (r = 0,38; p = 0,0332 e com os resultados da PCR (r = 0,39; p = 0,0280, respectivamente. Conclusão: O recesso dorsal, o punho e as pequenas articulações podem ser considerados como locais importantes para a detecção de sinovite pelo escore MUS7 SIN em pacientes com ARI.

  17. Distal radius: anatomical morphometric gender characteristics. Do anatomical pre-shaped plates pay attention on it?

    Science.gov (United States)

    Oppermann, Johannes; Bredow, Jan; Beyer, Frank; Neiss, Wolfram Friedrich; Spies, Christian K; Eysel, Peer; Dargel, Jens; Wacker, Max

    2015-01-01

    The purpose of the study was to investigate differences in the osseous structure anatomy of male and female distal radii. Morphometric data were obtained of 49 distal human cadaveric radii. An imprint of the distal edge was attained using silicone mass and the palmar cortical angle (PCA) of the lateral and intermediate column, here declared as medial, according to the concept of Rikli and Rigazzoni. The lateral and medial length and five widths were digitally measured by three observers. In order to compare the measurements an unpaired t test was used. To prove the reliability of the measurements an intraclass correlation analyses was done. Overall mean medial PCA was 148.25° (SD ± 6.83) and mean lateral PCA 156.07° (SD ± 7.00). In male specimens, the mean medial PCA was 147.38° (SD ± 6.01) and mean lateral PCA was 153.6° (SD ± 6.20) whereas in female specimens, the mean medial PCA was 149.41° (SD ± 7.79) and the mean lateral PCA 159.37° (SD ± 6.78), with statistical significance for the female lateral PCA. No gender significant difference for the medial PCA and no significant side difference for the PCA's could be found. The ICC of the observers was r = 0.936 and 0.976 for the medial and for lateral PCA 0.957-0.984. The palmar cortical length of the distal radius was significantly longer in male specimens. For all widths, larger values for male radii were measured, being statistically significant in all cases. Male dimensions concerning the wide were significantly larger when compared with females. Regarding the PCA at the medial and lateral column, we found significant difference for lateral PCA concerning the gender. Overall, study results demonstrated an angle of 148.25° ± 6.83 for the medial PCA and 156.07° ± 7.00 for the lateral PCA.

  18. Intervenção fonoaudiológica e fisioterapêutica em uma mulher após acidente vascular cerebral isquêmico = Speech therapy and physiotherapy intervention in a woman after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Rosa, Tábada Samantha Marques

    2015-01-01

    Full Text Available Objetivos: Relatar um caso em que houve intervenção conjunta entre fonoaudiólogo e fisioterapeuta na reabilitação de uma paciente com acidente vascular cerebral isquêmico. Descrição do caso: Paciente de 48 anos de idade, sexo feminino, acometida por acidente vascular cerebral do tipo isquêmico, há sete meses. Apresentou-se com disartrofonia e alterações do sistema estomatognático e sua funcionalidade, comprometimento sensorial, parestesia da mão direita, diminuição da coordenação motora grossa e fina em ambos os membros superiores, dificuldade na preensão palmar e fraqueza da musculatura intrínseca da mão direita, diminuição da consciência corporal e da propriocepção. Foi submetida a 12 sessões com a periodicidade de uma vez por semana de tratamento fonoterápico e fisioterapêutico. Após as intervenções a paciente apresentou aumento dos tempos máximos de fonação; melhora da coordenação pneumofonoarticulatória, da qualidade vocal e do foco de ressonância vertical; adequação e modulação da loudness; modulação do pitch; melhora da coordenação motora grossa e fina, da sensibilidade tátil e dolorosa, da oposição dos dedos, da preensão palmar, da consciência corporal, da propriocepção e da postura corporal global; e aumento da força muscular dos membros superiores. Conclusões: A intervenção interdisciplinar da fonoaudiologia e fisioterapia proporcionou benefícios à paciente acometida por acidente vascular cerebral isquêmico, sendo que a mesma voltou a exercer sua atividade profissional e suas atividades de vida diária com efetividade e melhorou a comunicação com seus familiares

  19. Usefulness of additional nerve conduction techniques in mild carpal tunnel syndrome Utilidade de técnicas adicionais de condução nervosa para o dignóstico de síndrome do túnel do carpo leve

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    2002-12-01

    Full Text Available This study was done to assess the percentage of abnormality in additional nerve conduction techniques after normal median distal latency (routine in mild carpal tunnel syndrome (CTS. Bilateral nerve conduction studies were carried out in 116 consecutive symptomatic CTS patients (153 hands. Mild cases were based on normal routine (Este estudo foi realizado para avaliação da percentagem de anormalidade de técnicas adicionais de condução nervosa no síndrome do túnel do carpo (STC leve quando o valor de latência distal sensitiva do nervo mediano (rotina está dentro dos limites normais. Condução nervosa bilateral foi realizada em 116 pacientes consecutivos com STC sintomático (153 mãos. A seleção foi feita baseada na rotina normal (< 3,7 ms, medida no pico, 14 cm e, pelo menos uma técnica anormal entre as seguintes: diferença sensitiva mediano-radial (MR; diferença sensitiva mediano-ulnar (MU4; diferença mediano-ulnar palmar (MUP; latência palmar do mediano (PW; e latência distal motora do mediano (MDL. Os valores normais da rotina foram separados em grupos desde 3,1 até 3,6 ms (< 3,7 ms, obtendo-se valores anormais entre 86,6 e 93,4% (MR, 40 e 81.7% (MU4, 20 e 71,2% (MUP, 0 e 41,1% (PW e 0 e 19,6% (MDL. A associação anormal mais frequente foi MR com MU4 em 90,1%, seguido de MR com MUP e MU4 com MUP. A técnica adicional isolada anormal mais frequente foi MR seguida de MU4 e MUP. O percentual de anormalidade da técnica MR foi muito elevada, independentemente do valor de corte na condução rotina (3,1 a 3,6 ms.

  20. Postoperative imaging of orthopaedic hardware in the hand and wrist: is there an added value for tomosynthesis?

    Science.gov (United States)

    De Silvestro, A; Martini, K; Becker, A S; Kim-Nguyen, T D L; Guggenberger, R; Calcagni, M; Frauenfelder, T

    2018-02-01

    To prospectively investigate digital tomosynthesis (DTS) as an alternative to digital radiography (DR) for postoperative imaging of orthopaedic hardware after trauma or arthrodesis in the hand and wrist. Thirty-six consecutive patients (12 female, median age 36 years, range 19-86 years) were included in this institutional review board approved clinical trial. Imaging was performed with DTS in dorso-palmar projection and DR was performed in dorso-palmar, lateral, and oblique views. Images were evaluated by two independent radiologists for qualitative and diagnosis-related imaging parameters using a four-point Likert scale (1=excellent, 4not diagnostic) and nominal scale. Interobserver agreement between the two readers was assessed with Cohen's kappa (k). Differences between DTS and CR were tested with Wilcoxon's signed-rank test. A p-value <0.05 was considered statistically significant. Regarding image quality, interobserver agreement was higher for DTS compared to DR, especially for fracture-related parameters (delineation osteosynthesis material [OSM]: K DTS 0.96 versus K DR 0.45; delineation fracture margins: K DTS 0.78 versus K DR 0.35). Delineation of fracture margins and delineation of adjacent joint spaces scored significant better for DTS compared to DR (delineation fracture margins: DTS1.54, DR2.28, p0.001; delineation adjacent joint spaces: DTS1.31, DR2.24, p0.001). Regarding diagnosis-related findings, interobserver agreement was almost equal. DTS showed a significant higher sharpness of fracture margins (DTS1.94, DR2.33, p0.04). Mean dose area product (DAP) for DTS was significant higher compared to DR (mean DR0.219 Gy·cm 2 , mean DTS0.903 Gy·cm 2 , p0.001). Fracture healing is more visible and interobserver agreement is higher for DTS compared to DR in the postoperative assessment of orthopaedic hardware in the hand and wrist. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. [NITINOL shape memory staple for osteosynthesis of the scaphoid].

    Science.gov (United States)

    Winkel, Reiner; Schlageter, Michael

    2009-11-01

    Reconstruction of the scaphoid with use of NITINOL shape "memory" staples. Unstable fractures and nonunion of the middle third of the scaphoid, which need open reduction and internal fixation from palmar. The staples can only be used, if the arms of the staples can be inserted parallel to and at a distance of 3 mm to the fracture line. Allergy to nickel. Cases in which the arms of the staple cannot be inserted parallel to and at best 3 mm apart from the fracture line. In fractures, open reduction of the scaphoid through a palmar approach. If necessary, interposition of a bone graft and Kirschner wire transfixation. Drilling of the drill holes parallel and at a distance of 3 mm to the fracture line. Insertion of the NITINOL staple. In nonunion, excision of the fibrous nonunion, refreshening of the fracture surfaces, interposition of a bone graft and, if needed, fixation with a Kirschner wire. Drilling of the drill holes for the NITINOL staple and insertion of the staple. Within a few minutes the warming-up staple contracts and thereby compresses the scaphoid. Immobilization in a short cast with thumb support for 6 weeks. Control for bone healing by radiographs or computed tomography. Staples, which do not cause hardware problems, are not removed. Kirschner wires are removed after bone healing. From October 1995 to December 2006, the authors used NITINOL staples for 65 osteosyntheses of the scaphoid. Indications were 15 unstable fractures, 47 nonunions, and three partial necroses. 61 out of 65 scaphoids healed without further surgery, three of the 61 patients showed a delayed healing. Two of the four nonunions were related to the use of the NITINOL staples. Seven staples were removed, one for loosening. NITINOL shape memory staples have proven to be very helpful for osteosynthesis in fractures and nonunion of the scaphoid, if the prerequisites are given for their use.

  2. Qualitative assessment of bone density at the distal articulating surface of the third metacarpal in Thoroughbred racehorses with and without condylar fracture.

    Science.gov (United States)

    Loughridge, A B; Hess, A M; Parkin, T D; Kawcak, C E

    2017-03-01

    Changes in subchondral bone density, induced by the repetitive cyclical loading of exercise, may potentiate fatigue damage and the risk of fracture. To use computed tomography (CT) to characterise bone density patterns at the articular surface of the third metacarpal bone in racehorses with and without lateral condylar fractures. Case control METHODS: Computed tomographic images of the distal articulating surface of the third metacarpal bone were obtained from Thoroughbred racehorses subjected to euthanasia in the UK. Third metacarpal bones were divided into 3 groups based on lateral condyle status; fractured (FX, n = 42), nonfractured contralateral condyle (NFX, n = 42) and control condyles from horses subjected to euthanasia for reasons unrelated to the third metacarpal bone (control, n = 94). Colour CT images were generated whereby each colour represented a range of pixel values and thus a relative range of bone density. A density value was calculated qualitatively by estimating the percentage of each colour within a specific region. Subchondral bone density was assessed in 6 regions from dorsal to palmar and 1 mm medial and lateral to the centre of the lateral parasagittal groove in NFX and control condyles and 1 mm medial and lateral to the fracture in FX condyles. Bone density was significantly higher in the FX and NFX condyles compared with control condyles for all 6 regions. A significantly higher bone density was observed in FX condyles relative to NFX condyles in the lateral middle and lateral palmar regions. Fractured condyles had increased heterogeneity in density among the 6 regions of interest compared with control and NFX condyles. Adjacent to the fracture, a focal increase in bone density and increased heterogeneity of density were characteristic of limbs with lateral condylar fractures compared with control and NFX condyles. These differences may represent pathological changes in bone density that increase the risk for lateral condylar fractures in

  3. Exame clínico e radiológico do terceiro metacarpeano em potros Puro Sangue de Corrida em treinamento Clinical and radiographic evaluation of the third metacarpal bone in 2-year-old thoroughbred horses in raining

    Directory of Open Access Journals (Sweden)

    Flávio Gomes de Oliveira

    2007-12-01

    Full Text Available A avaliação clínica e radiológica do terceiro metacarpeano (McIII de 42 potros Puro Sangue de Corrida de dois anos de idade, em treinamento, realizou-se a cada 15 dias. Vinte e cinco potros foram acompanhados durante dois meses e 17 durante os quatro meses anteriores a sua participação na primeira corrida. Nas radiografias (projeção lateromedial, foram avaliadas o córtex dorsal (CD do McIII e a espessura do CD, do córtex palmar e da zona medular para determinação do índice radiológico (IR. Não foram observadas alterações radiológicas no CD do McIII nos potros que manifestaram periostite metacarpeana dorsal (PM aguda. O aumento tanto do CD, como do IR, entre as avaliações foi significativo (PThe third metacarpal bones (McIII of 42 2-year-old thoroughbreds in training were evaluated clinically and radiologically every 15 days. The evaluation was performed during 2 and 4 month, prior to the first race of 25 and17 horses, respectively. X-rays were taken using latero-medial projection. Dorsal cortex (DC was evaluated on the X-rays and DC, palmar cortex and medular zone were measured in order to determine the radiologic index (RI. No radiographic changes were observed on the DC of the McIII of horses clinically affected by dorsal metacarpal disease (DMD. There was a significant increase (P<0.05 in DC thickness and RI between evaluations of both, healthy and DMD affected McIII. DC thickness also showed a significant increase between affected and not affected McIII. A larger increase in DC thickness was observed at evaluation before the one in which DMD was diagnosed. In conclusion, the increase in DC thickness could be used as a diagnostic tool for early recognition of DMD allowing adoption of preventive measures.

  4. Contribución al conocimiento de los reservorios del Trypanosoma cruzi (Chagas,1909 en la Provincia de Corrientes, Argentina Contribution to knowledge of reservoirs of Trypanosoma cruzi (Chagas, 1909 in Corrientes Province, Argentina

    Directory of Open Access Journals (Sweden)

    María Esther Bar

    1999-06-01

    Full Text Available Con el propósito de identificar a reservorios del Trypanosoma cruzi se investigaron 60 mamíferos en los Departamentos Capital y San Luis del Palmar. Se examinaron: primates, roedores, marsupiales, carnívoros y edentados; 40 vivían en cautiverio y 20 fueron capturados mediante trampas en una comunidad rural forestal. Los mamíferos fueron analizados por xenodiagnóstico, empleándose ninfas de 3o o 4o estadío de Triatoma infestans ayunadas durante 2 semanas. Las heces de los triatominos fueron observadas al microscopio (400x a los 30, 60 y 90 días post-alimentación. En 2 Saimiri sciureus y en 1 Cebus apella se constató infección por tripanosomas cruziformes. Se concluye que la parasitemia detectada fue baja. La presencia de Didelphis albiventris, reservorio potencial del Trypanosoma cruzi , en una zona de transmisión activa del parásito representa un factor de riesgo, por lo que son necesarias futuras investigaciones epidemiológicas para determinar la real diagnosis de esta parasitosis en la provincia de Corrientes, Argentina.In order to identify Trypanosoma cruzi reservoirs in transmission areas, 60 mammals in Capital and San Luis del Palmar Departments, Corrientes, Argentina were studied. Primates, rodents, carnivores, marsupials and edentates were investigated, 40 of them living in captivity and 20 caught with traps in a rural area. The mammals were examined by xenodiagnosis and third or fourth instars nymphs of Triatoma infestans starved for 2 weeks were used. The feces were microscopically observed (400x for Trypanosoma cruzi infection at 30, 60 and 90 days after feeding. Trypanosoma cruzi-like parasites were identified in 2 Saimiri sciureus and 1 Cebus apella analyzed by xenodiagnosis. It was concluded that parasitemia was low. Howewer, the presence in a forest area of Didelphis albiventris, potential reservoir of the parasite, indicates a risk factor and deserves further epidemiological study for a true diagnosis of this

  5. Deep learning-based artificial vision for grasp classification in myoelectric hands

    Science.gov (United States)

    Ghazaei, Ghazal; Alameer, Ali; Degenaar, Patrick; Morgan, Graham; Nazarpour, Kianoush

    2017-06-01

    Objective. Computer vision-based assistive technology solutions can revolutionise the quality of care for people with sensorimotor disorders. The goal of this work was to enable trans-radial amputees to use a simple, yet efficient, computer vision system to grasp and move common household objects with a two-channel myoelectric prosthetic hand. Approach. We developed a deep learning-based artificial vision system to augment the grasp functionality of a commercial prosthesis. Our main conceptual novelty is that we classify objects with regards to the grasp pattern without explicitly identifying them or measuring their dimensions. A convolutional neural network (CNN) structure was trained with images of over 500 graspable objects. For each object, 72 images, at {{5}\\circ} intervals, were available. Objects were categorised into four grasp classes, namely: pinch, tripod, palmar wrist neutral and palmar wrist pronated. The CNN setting was first tuned and tested offline and then in realtime with objects or object views that were not included in the training set. Main results. The classification accuracy in the offline tests reached 85 % for the seen and 75 % for the novel objects; reflecting the generalisability of grasp classification. We then implemented the proposed framework in realtime on a standard laptop computer and achieved an overall score of 84 % in classifying a set of novel as well as seen but randomly-rotated objects. Finally, the system was tested with two trans-radial amputee volunteers controlling an i-limb UltraTM prosthetic hand and a motion controlTM prosthetic wrist; augmented with a webcam. After training, subjects successfully picked up and moved the target objects with an overall success of up to 88 % . In addition, we show that with training, subjects’ performance improved in terms of time required to accomplish a block of 24 trials despite a decreasing level of visual feedback. Significance. The proposed design constitutes a substantial

  6. Magnetic resonance imaging findings of the proximal metacarpus in Quarter Horses used for cutting: Retrospective analysis of 32 horses 2009-2012.

    Science.gov (United States)

    Barrett, M F; Manchon, P T; Hersman, J; Kawcak, C E

    2018-03-01

    Injury to the proximal suspensory ligament is a common cause of lameness in cutting horses. Radiographic and ultrasonographic imaging of lesions responsible for lameness can provide ambiguous results. MRI provides the most comprehensive diagnostic imaging evaluation of lesions specifically affecting cutting horses. To describe the distribution and severity of bone and soft tissue lesions present in the proximal metacarpus of Quarter Horse cutting horses and to assess the impact of these lesions on return to competition. Retrospective case series. Retrospective analysis of 32 cutting horses referred for MRI of the proximal metacarpus between 2009 and 2012 with a 2-year follow-up period. MRI studies were evaluated by a board-certified veterinary radiologist; the severity of lesions was graded from 0 (absent) to 3 (severe). A total of 20 right and 24 left forelimbs (12 bilateral studies) of 32 horses were evaluated. The most common findings were: third metacarpal (McIII) sclerosis at the proximal suspensory ligament (PSL) origin (42/44), McIII resorption at the PSL origin (32/44), PSL dorsal margin fibre irregularity (30/44) and McIII bone contusion (22/39). Of the 30 horses, 22 horses successfully returned to competition, irrespective of severity of injury. Strong correlation exists between the degree of resorption in the palmar cortex of proximal McIII, degree of McIII sclerosis and severity of dorsal margin fibre irregularity. Statistical significance was limited by small study population. Further analysis of prognosis was limited by availability of comprehensive medical records. Cutting horses with proximal metacarpal pain have significant pathological change within the proximal suspensory ligament and its enthesis on the palmar cortex of McIII. Severity of lesions and degree of lameness at the time of diagnosis does not influence return to performance. Accurate diagnosis of proximal metacarpal lesions based on MRI offers clinicians the capacity to select

  7. Gorlin Goltz syndrome: A clinicopathological case report

    Directory of Open Access Journals (Sweden)

    Shobha C Bijjaragi

    2014-01-01

    Full Text Available The Gorlin-Goltz syndrome is an infrequent multisystemic disease, which is inherited in an autosomal dominant manner. This shows a high level of penetrance and variable expressiveness, characterized by multiple basal cell nevi or carcinomas, odontogenic keratocysts, palmar and / or plantar pits, calcification of the falx cerebri, and is occasionally associated with internal malignancies. It is fundamental to know the major and minor criteria for the diagnosis and early preventive treatment of this syndrome. Here we report a case of a 30-year-old male with major and minor features of the Gorlin-Goltz syndrome, such as, strabismus, barrel-shaped chest, with drooping shoulders and mild kyphosis, polydactyly, hypertelorism, multiple basal cell carcinomas, calcification of the falx cerebri, C5-C7 bifida spine, and fusion of T1 and T2.

  8. Statistical analysis of general, clinical and radiographic parameters of navicular disease in the horse

    International Nuclear Information System (INIS)

    Langfeldt, N.; Hertsch, B.

    1988-01-01

    With 20,4 % the syndrome navicular disease has a remarkable part of lameness in the equine fore limb. Although intensive investigations of the last years, there is no uniform opinion in the clinical diagnosis of navicular disease. At first there is a differential description of the diagnosis of navicular disease and a presentation of the importance of this disease from the whole patients of the equine hospital of the Tierärztliche Hochschule Hannover about five years (1980-1984). After that, the importance of the identification of pain with pain provocation test and the elimination of pain by anesthetic nerve blocking are described. The result of the anesthetic block of the ''Ramus pulvinus'' of the medial and lateral palmar digital nerves is a necessary part in clinical diagnosis of navicular disease [de

  9. Radiographic anatomy of soft tissue attachments in the equine metacarpophalangeal and proximal phalangeal region

    International Nuclear Information System (INIS)

    Weaver, J.C.B.; Stover, S.M.; O'Brien, T.R.

    1992-01-01

    The sites of bony attachment of the tendons, ligaments, and fibrous portion of the joint capsules of the equine metacarpophalangeal (fetlock) joint region were determined by gross dissection. These sites were transposed to standard radiographic views of the fetlock joint to yield illustrations that can be used as an aid in the diagnosis of soft tissue pathology from radiographs. Evidence of direct attachment of the common digital extensor tendon to the proximal phalanx was not found. Branches of the superficial digital flexor tendon were found to insert only on the middle phalanx. The recently described sites of insertion of the branches of the superficial digital flexor tendon to the proximal phalanx were found to be sites for attachment of the deep axial palmar ligaments of the proximal interphalangeal joint

  10. Static muscle strength trained and untrained of female students

    Directory of Open Access Journals (Sweden)

    Kopanski R.

    2012-12-01

    Full Text Available Static muscle strength is one of the defining characteristics of human motor potential. Standard terms and exclude the impact of short-term measurement techniques for motion and strain measurements, hence the widespread use of Mm measurements in the assessment of fitness of both trained and untrained, healthy subjects and patients undergoing a variety of reasons the process of rehabilitation. The paper deals with static muscle strength (dynamometry back of the hand of female students trained (n = 38 and untrained (n = 213. Examined relationships between individual measurements and body weight in both groups, the degree of asymmetry of the palmar and the differences in the level of power (at the level of the absolute and relative terms between the groups. Disclosed according to form the basis of their conclusions.

  11. História de uma sesmaria e suas aventuras

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    Barbosa Lima Sobrinho

    1977-06-01

    Full Text Available A sesmaria é a 1705, concedida à viuva de Domingos Jorge Velho, D. Jerônima Cardim Froes e oficiais do terço paulista, que acabava de completar a expugnação dos Palmares, vencendo os negros refugiados nos quilombos das serras alagoanas. Quem primeiro nos deu notícia da existência dessa sesmaria foi o historiador pernambucano Pereira da Costa, na sua conhecida e respeitada Cronologia Histórica do Estado do Piauí, publicada em 1909, com o apoio de Anísio de Abreu, que era então Governador daquele Estado. Incluia-se a data de terra entre as sesmarias concedidas pelo Governo de Pernambuco e que Pereira da Costa encontrara nos códices manuscritos, existentes na Biblioteca Pública do Recife.

  12. Uncommon Dorsal Radiocarpal Fracture Dislocation Complicated With Median Nerve Palsy: Case Report, Review of the Literature, and a New Classification System Guiding the Management

    Directory of Open Access Journals (Sweden)

    Hing-Cheong Wong

    2012-06-01

    Full Text Available We report the case of a 36-year-old lorry driver who sustained left dorsal radiocarpal fracture dislocation and left median nerve injury in a traffic accident in 2010. Emergency operation of closed reduction, cross-wrist-bridging external fixation, percutaneous transradial styloid Kirschner wire fixation, decompression of left median nerve, and repair of the partially torn palmar radiocarpal ligament were performed under general anaesthesia. Because of the persistent depressed dorsal articular rim fracture of left distal radius, another operation of open reduction, corticocancellous bone grafting, and dorsal buttress plating was performed 5 days after the initial operation. Six months after the operation, the patient enjoyed good range of wrist motion but weak twisting power, especially in supination. There was no radiological feature of radiocarpal subluxation.

  13. Auricular Oedema and Dyshidrotic Eczema in a Patient with Acute Myeloid Leukaemia Treated with Cytarabine

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    K. Brandt

    2010-10-01

    Full Text Available Cytarabine is an effective drug in the treatment of haematological malignancies. The therapy is associated with various complications. Frequencies of dermatological side-effects range from 2–72% and occur most commonly after high-dose regimens. Although most cutaneous reactions are mild and resolve spontaneously within several days, they may result in an increased risk of infection and alterations in comfort. In some cases, severe life-threatening reactions have been reported. Here we describe the case of a patient with acute myeloid leukaemia, who developed severe exceptional skin toxicity in terms of auricular oedema and palmar dyshidrotic eczema after the application of low-dose cytarabine. Re-administration of the drug resulted in reduced skin toxicity during further cycles of chemotherapy. Negative epicutaneous patch-testing supported the existence of cytarabine-provoked toxicity.

  14. A randomised controlled trial of absorbable versus non-absorbable sutures for skin closure after open carpal tunnel release.

    LENUS (Irish Health Repository)

    Theopold, C

    2012-05-01

    We compared the aesthetic outcome of scars after closure of open carpal tunnel incisions with either absorbable 4-0 Vicryl Rapide or non-absorbable 4-0 Novafil. Patients were recruited in a randomized controlled trial and scars were scored at 6 weeks using a modified Patient and Observer Scar Assessment Scale. Scores demonstrated differences only for pain, vascularity and cross-hatching between both groups, though none of these were statistically significant. The dissolving and falling out of Vicryl Rapide was significantly more comfortable than removal of 4-0 Novafil sutures, assessed on a numerical analogue scale. There was no difference in infection rate between both study groups, supporting overall the use of Vicryl Rapide for the closure of palmar hand incisions, in light of the convenience and cost savings associated with absorbable sutures.

  15. Glucagon-like peptide-1 reduces pancreatic β-cell mass through hypothalamic neural pathways in high-fat diet-induced obese rats.

    Science.gov (United States)

    Ando, Hisae; Gotoh, Koro; Fujiwara, Kansuke; Anai, Manabu; Chiba, Seiichi; Masaki, Takayuki; Kakuma, Tetsuya; Shibata, Hirotaka

    2017-07-17

    We examined whether glucagon-like peptide-1 (GLP-1) affects β-cell mass and proliferation through neural pathways, from hepatic afferent nerves to pancreatic efferent nerves via the central nervous system, in high-fat diet (HFD)-induced obese rats. The effects of chronic administration of GLP-1 (7-36) and liraglutide, a GLP-1 receptor agonist, on pancreatic morphological alterations, c-fos expression and brain-derived neurotrophic factor (BDNF) content in the hypothalamus, and glucose metabolism were investigated in HFD-induced obese rats that underwent hepatic afferent vagotomy (VgX) and/or pancreatic efferent sympathectomy (SpX). Chronic GLP-1 (7-36) administration to HFD-induced obese rats elevated c-fos expression and BDNF content in the hypothalamus, followed by a reduction in pancreatic β-cell hyperplasia and insulin content, thus resulting in improved glucose tolerance. These responses were abolished by VgX and SpX. Moreover, administration of liraglutide similarly activated the hypothalamic neural pathways, thus resulting in a more profound amelioration of glucose tolerance than native GLP-1 (7-36). These data suggest that GLP-1 normalizes the obesity-induced compensatory increase in β-cell mass and glucose intolerance through a neuronal relay system consisting of hepatic afferent nerves, the hypothalamus, and pancreatic efferent nerves.

  16. Sympathetic Denervation Accelerates Wound Contraction but Inhibits Reepithelialization and Pericyte Proliferation in Diabetic Mice

    Directory of Open Access Journals (Sweden)

    Zhifang Zheng

    2017-01-01

    Full Text Available Previous studies focused on the effects of sympathetic denervation with 6-hydroxydopamine (6-OHDA on nondiabetic wounds, but the effects of 6-OHDA on diabetic wounds have not been previously reported. In this study, treated mice received intraperitoneal 6-OHDA, and control mice received intraperitoneal injections of normal saline. Full-thickness wounds were established on the backs of mice. The wounds were sectioned (four mice per group for analysis at 2, 5, 7, 10, 14, 17, and 21 days after injury. The wound areas in the control group were larger than those in the treatment group. Histological scores for epidermal and dermal regeneration were reduced in the 6-OHDA-treated group on day 21. The mast cells (MCs in each field decreased after sympathectomy on days 17 and 21. The expression levels of norepinephrine, epidermal growth factor (EGF, interleukin-1 beta, NG2 proteoglycan, and desmin in the treatment group were less than those in the control group. In conclusion, 6-OHDA delays reepithelialization during wound healing in diabetic mice by decreasing EGF, but increases wound contraction by reducing IL-1β levels and the number of MCs. Besides, 6-OHDA led to reduced pericyte proliferation in diabetic wounds, which might explain the vascular dysfunction after sympathetic nerve loss in diabetic wounds.

  17. Blockade of Adrenal Medulla-Derived Epinephrine Potentiates Bee Venom-Induced Antinociception in the Mouse Formalin Test: Involvement of Peripheral β-Adrenoceptors

    Directory of Open Access Journals (Sweden)

    Suk-Yun Kang

    2013-01-01

    Full Text Available The injection of diluted bee venom (DBV into an acupoint has been used traditionally in eastern medicine to treat a variety of inflammatory chronic pain conditions. We have previously shown that DBV had a potent antinociceptive efficacy in several rodent pain models. However, the peripheral mechanisms underlying DBV-induced antinociception remain unclear. The present study was designed to investigate the role of peripheral epinephrine on the DBV-induced antinociceptive effect in the mouse formalin assay. Adrenalectomy significantly enhanced the antinociceptive effect of DBV during the late phase of the formalin test, while chemical sympathectomy had no effect. Intraperitoneal injection of epinephrine blocked this adrenalectomy-induced enhancement of the DBV-induced antinociceptive effect. Moreover, injection of a phenylethanolamine N-methyltransferase (PNMT inhibitor enhanced the DBV-induced antinociceptive effect. Administration of nonselective β-adrenergic antagonists also significantly potentiated this DBV-induced antinociception, in a manner similar to adrenalectomy. These results demonstrate that the antinociceptive effect of DBV treatment can be significantly enhanced by modulation of adrenal medulla-derived epinephrine and this effect is mediated by peripheral β-adrenoceptors. Thus, DBV acupoint stimulation in combination with inhibition of peripheral β-adrenoceptors could be a potentially novel strategy for the management of inflammatory pain.

  18. Hemodynamic study of ischemic limb by velocity measurement in foot

    International Nuclear Information System (INIS)

    Shionoya, S.; Hirai, M.; Kawai, S.; Ohta, T.; Seko, T.

    1981-01-01

    By means of a tracer technique with 99mTc-pertechnetate, provided with seven zonal regions of interest, 6 mm in width, placed at equal spaces of 18 mm, from the toe tip to the midfoot at a right angle to the long axis of the foot, arterial flow velocity in the foot during reactive hyperemia was measured. The mean velocity in the foot was 5.66 +/- 1.78 cm/sec in 14 normal limbs, 1.58 +/- 1.07 cm/sec in 29 limbs with distal thromboangiitis obliterans (TAO), 0.89 +/- 0.61 cm/sec in 13 limbs with proximal TAO, and 0.97 +/- 0.85 cm/sec in 15 limbs with arteriosclerosis obliterans (ASO). The velocity returned to normal in all 12 limbs after successful arterial reconstruction, whereas the foot or toe blood pressure remained pathologic in 9 of the 12 limbs postoperatively; the velocity reverted to normal in 4 of 13 limbs after lumbar sympathectomy. When the velocity was normalized after operation, the ulceration healed favorably, and the ischemic limb was salvaged. The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage

  19. Global development and current evidence of uniportal thoracoscopic surgery

    Science.gov (United States)

    Tu, Cheng-Che

    2016-01-01

    In the era of video-assisted thoracoscopic surgery (VATS), uniportal and single incision thoracoscopic surgeries are gaining popularity. The spectrum of uniportal VATS indications is now almost equal to that of conventional VATS. For example, successful uniportal sleeve lobectomy, rib segmental resection, and management of intraoperative bleeding have all been reported. According to published data in the English-language literature, more than 9,545 uniportal VATS have been performed to date, including 1,293 lobectomies, 1,024 procedures for pneumothorax, and 6,845 sympathectomies. Of the 192 articles discussing this topic, 35 were conducted in Spain, and there were an increasing number of publications from China, Korea, and other Asian countries. There were 41 technical and review articles, all of which provided an excellent foundation of surgical concept and skill learning. The benefits of uniportal VATS include better surgical geometry and cosmetics. Regarding postoperative outcomes, thirteen out of the 15 articles reviewed showed that uniportal VATS has similar or superior outcomes to conventional VATS. Most studies demonstrated that uniportal VATS produced less postoperative pain and paresthesia. In conclusion, uniportal VATS can produce excellent operative outcome, which is becoming a mature surgical approach in thoracic disease, supported by fast-accumulating and abundant experience. PMID:27014479

  20. Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS).

    Science.gov (United States)

    Birklein, Frank; Schmelz, Martin

    2008-06-06

    This review explains symptoms and nature of neuropeptide signaling and its importance for clinical symptoms of CRPS. Neurogenic inflammation regularly accompanies excitation of primary afferent nociceptors. It has two major components-plasma extravasation and vasodilatation. The most important mediators are the calcitonin gene-related peptide (CGRP) and substance P (SP). After peripheral trauma immune reaction (e.g. cytokines) and the attempts of the tissue to regenerate (e.g. growth factors) sensitize nociceptors and amplify neurogenic inflammation. This cascade of events has been demonstrated in rat models of CRPS. Clinical findings in these animals strongly resemble clinical findings in CRPS, and can be prevented by anti-cytokine and anti-neuropeptide treatment. In CRPS patients, there is meanwhile also plenty of evidence that neurogenic inflammation contributes to clinical presentation. Increased cytokine production was demonstrated, as well as facilitated neurogenic inflammation. Very recently even "non-inflammatory" signs of CRPS (hyperhidrosis, cold skin) have been linked to neuropeptide signaling. Surprisingly, there was even moderately increased neurogenic inflammation in unaffected body regions. This favors the possibility that CRPS patients share genetic similarities. The future search for genetic commonalities will help us to further unravel the "mystery" CRPS.

  1. Subacute motor neuron hyperexcitability with mercury poisoning: a case series and literature review.

    Science.gov (United States)

    Zhou, Zhibin; Zhang, Xingwen; Cui, Fang; Liu, Ruozhuo; Dong, Zhao; Wang, Xiaolin; Yu, Shengyuan

    2014-01-01

    Motor neuron hyperexcitability (MNH) indicates a disorder characterized by an ectopic motor nerve discharge on electromyogram (EMG). Here, we present a series of three cases of subacute MNH with mercury poisoning. The first case showed hyperhidrosis, insomnia, generalied myokymia, cramps, tremor, weight loss, and myokymic and neuromyotonic discharges, followed by encephalopathy with confusion, hallucinations, and memory decrease. The second case was similar to the former but without encephalopathic features. The third case showed widespread fasciculation, fatigue, insomnia, weight loss, and autonomic dysfunction, including constipation, micturition difficulty, and impotence, with multiple fibrillation, unstable fasciculation, widened motor neuron potential, and an incremental response at high-rate stimulation in repetitive nerve stimulation. Based on the symptoms, the three cases were diagnosed as Morvan's syndrome, Isaacs' syndrome, and Lambert-Eaton myasthenic syndrome with ALS-like syndrome, respectively. Mercury poisoning in the three cases was confirmed by analysis of blood and urine samples. All cases recovered several months after chelation therapy and were in good condition at follow-up. Very few cases of MNH linked with mercury exposure have been reported in the literature. The mechanism of mercury-induced MNH may be associated with ion channel dysfunction. © 2014 S. Karger AG, Basel.

  2. Use of Nitrous Oxide in Dermatology: A Systematic Review.

    Science.gov (United States)

    Brotzman, Erica A; Sandoval, Laura F; Crane, Jonathan

    2018-05-01

    Many dermatologic procedures are painful and can be distressing to patients. To determine whether nitrous oxide has been used in dermatology and whether literature supports its use in terms of providing analgesia and anxiety associated with dermatologic procedures. A search of PubMed and Cochrane databases was conducted through July 15, 2016, to identify studies involving nitrous oxide use in dermatology. Eight studies were identified and reviewed. The use of nitrous oxide/oxygen mixture resulted in a significant reduction in pain when used for photodynamic therapy, botulinum toxin therapy for hyperhidrosis of both the palms and axilla, aesthetic procedures involving various laser procedures, and in the treatment of bed sores and leg ulcers. However, pain scores were higher when nitrous oxide/oxygen was used in the debridement of chronic ulcers when compared with the use of topical anesthesia. In addition, nitrous oxide has been reported effective at reducing pain in hair transplants, dermabrasion, excision and repairs, and pediatric procedures. Current literature provides some evidence that nitrous oxide, used alone or as adjunct anesthesia, is effective at providing analgesia for many dermatologic procedures. Nitrous oxide has many potential applications in dermatology; however, further evidence from randomized controlled trials is needed.

  3. Cutaneous manifestations of hyperthyroidism- a study of 50 cases from Lahore, Pakistan

    International Nuclear Information System (INIS)

    Nabi, H.; Hussain, I.; Aamir, S.; Haroon, T.S.

    2001-01-01

    Objective: To assess the pattern of cutaneous changes and associated disorders in patients with hyperthyroidism. Study Design: Cross-sectional Study. Place and Duration of study: Department of dermatology and Thyroid Clinic, Mayo and Jinnah Hospitals, Lahore during the period of one year from December, 1997 to December, 1998. Subject and Methods: 50 diagnosed cases of hyperthyroidism (44 females and 6 males of age ranging 21-40 years) were examined in detail for cutaneous changes and associated disorders. Results: Dermatological abnormalities were observed in 96% patients. Common manifestations of hyperthyroidism were altered skin texture in 48 (96%) and increased skin temperature in 46 (92%) patients. Other cutaneous findings included hyperhidrosis in 34(68%), generalized pruritus in 15 (30%), hyperpigmentation in 15 (30%) and pre tibial myxedema in 2 (4%) patients. Hair and nail changes were observed in 36 (72%) and 25 (50%) patients, respectively. Other associated autoimmune diseases seen were urticaria in 20 (40%) vitiligo in 12 (24%) alopecia areata in 4 (8%) and systemic lupus erythematosus in a 2% patient. Pustulosis palmoplantar is and xanthelasma were seen in one patient each. Conclusion: cultaneous examination can provide important clues to the diagnosis of hyperthyroidism. (author)

  4. Tricho-odonto-onycho-dermal dysplasia and WNT10A mutations.

    Science.gov (United States)

    Kantaputra, P; Kaewgahya, M; Jotikasthira, D; Kantaputra, W

    2014-04-01

    We report on three novel (IVS2+1G>A splice site, c.1066G>T, and c.1039G>T, and one previously reported (c.637G>A) WNT10A mutations in three patients affected with odonto-onycho-dermal dysplasia (OODD; OMIM 275980). OODD is a rare form of autosomal recessive ectodermal dysplasia involving hair, teeth, nails, and skin, characterized by hypodontia (tooth agenesis), smooth tongue with marked reduction of filiform and fungiform papillae, nail dysplasia, dry skin, palmoplantar keratoderma, and hyperhidrosis of palms and soles. The novel IVS+1G>A splice site mutation is predicted to cause significant protein alteration. The other novel mutations we found including c.1066G>T and c.1039G>T are predicted to cause p.Gly356Cys and p.Glu347X, respectively. Barrel-shaped mandibular incisors and severe hypodontia appear to be associated with homozygous or compound heterozygous mutations of WNT10A. The name "tricho-odonto-onycho-dermal dysplasia" is suggested to replace "odonto-onycho-dermal dysplasia" because hair anomalies including hypotrichosis and slow-growing hair have been reported in numerous reported patients with this syndrome. © 2014 Wiley Periodicals, Inc.

  5. Severe dysautonomia as a main feature of anti-GAD encephalitis: Report of a paediatric case and literature review.

    Science.gov (United States)

    Ben Achour, Nedia; Ben Younes, Thouraya; Rebai, Ibtihel; Ben Ahmed, Melika; Kraoua, Ichraf; Ben Youssef-Turki, Ilhem

    2018-05-01

    Anti-glutamic acid decarboxylase (anti-GAD65) antibodies are a rare cause of autoimmune encephalitis. This entity is mainly recognized in adults and very few cases were reported in children. We report on a paediatric case of anti-GAD encephalitis with severe presentation and uncontrollable dysautonomia. A 9-year-old girl was referred to our department for refractory seizures and behavioral disturbances. Brain magnetic resonance imaging (MRI) was normal. Repeat screening for antineuronal antibodies showed negative results for anti-NMDA receptor antibodies but positive results for anti-GAD65 with a low positivity of anti-Ma2 antibodies. Although a transient improvement was noticed after immunomodulatory treatment, the patient developed severe intractable autonomic imbalance including dysrythmia, alternating bradycardia/tachycardia, hypotension/hypertension, hypothermia/hyperthermia and hyperhidrosis. She deceased six months after onset. Our report intends to raise awareness of autoimmune encephalitis with anti-GAD65 antibodies which may involve extralimbic brain regions and manifest with fatal dysautonomia. We highlight the need for prompt diagnosis and aggressive management for this underdiagnosed entity in children. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  6. Evaluation and Prevention of Diabetic Neuropathy

    Directory of Open Access Journals (Sweden)

    Pajouhi M

    2007-07-01

    Full Text Available Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.

  7. Local anesthetic sympathectomy restores fMRI cortical maps in CRPS I after upper extremity stellate blockade: a prospective case study.

    Science.gov (United States)

    Stude, Philipp; Enax-Krumova, Elena K; Lenz, Melanie; Lissek, Silke; Nicolas, Volkmar; Peters, Soeren; Westermann, Amy; Tegenthoff, Martin; Maier, Christoph

    2014-01-01

    Patients with complex regional pain syndrome type I (CRPS I) show a cortical reorganization with contralateral shrinkage of cortical maps in S1. The relevance of pain and disuse for the development and the maintenance of this shrinkage is unclear. Aim of the study was to assess whether short-term pain relief induces changes in the cortical representation of the affected hand in patients with CRPS type I. Case series analysis of prospectively collected data. We enrolled a case series of 5 consecutive patients with CRPS type I (disease duration 3 - 36 months) of the non-dominant upper-limb and previously diagnosed sympathetically maintained pain (SMP) by reduction of the pain intensity of more than > 30% after prior diagnostic sympathetic block. We performed fMRI for analysis of the cortical representation of the affected hand immediately before as well as one hour after isolated sympathetic block of the stellate ganglion on the affected side. Wilcoxon-Test, paired t-test, P CRPS, and that these are rapidly reversible.

  8. [Gorlin-Goltz Syndrome: Diagnosis and Treatment Options].

    Science.gov (United States)

    Mendes-Abreu, João; Pinto-Gouveia, Miguel; Tavares-Ferreira, Cátia; Brinca, Ana; Vieira, Ricardo

    2017-05-31

    The Gorlin-Goltz syndrome is a rare autosomal dominant hereditary condition, with complete penetrance and variable expressivity. Characterized by the appearance of multiple basaliomas, and often the development of keratocyst, it can also express itself by the presence of palmar/plantar depressions, calcification of brain sickle, and skeletal birth defects, although less frequently. This article presents two cases involving direct relatives, referred after the identification of several basaliomas and jaw cysts. After establishing the diagnosis, given the identification of three major criteria, the treatment consisted in the excision of the lesions followed, in one case, with vismodegib treatment resulting in complete remission. Gorlin-Goltz syndrome is therefore a multidisciplinary challenge, whose variable morbidity and high risk of recurrence make treatment and surveillance critical. However, new molecular targeted therapies have brought a new hope in treating these patients.

  9. Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome). Case report.

    Science.gov (United States)

    Fini, G; Belli, E; Mici, E; Virciglio, P; Moricca, L M; D'Itri, L; Leonardi, A; Malavenda, M S; Krizzuk, D; Merola, R; Maturo, A; Pasta, V

    2013-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome (NBCCS) comprises multiple basal cell carcinomas, keratocysts of the jaw, palmar/plantar pits, spine and rib anomalies, calcifications of the falx cerebri etc. The diagnosis is made according to clinical criteria (Kimonis Criteria) and genetic ones. We studied one family where father and then his sun resulted affected by each syndrome. Gorlin-Goltz syndrome is a rare disease diagnosed according to clinical criteria sometimes difficult to integrate. The family case we presented shows how you can get diagnosis even in older age and after numerous surgeries. Patients should be given special attention and therefore should be monitorized and need multidisciplinary treatments continued in time, even a trivial change of signs and symptoms may be an important indicator of a precipitating event which puts the patient's life under threat.

  10. Nintendo related injuries and other problems: review.

    Science.gov (United States)

    Jalink, Maarten B; Heineman, Erik; Pierie, Jean-Pierre E N; ten Cate Hoedemaker, Henk O

    2014-12-16

    To identify all reported cases of injury and other problems caused by using a Nintendo video gaming system. Review. Search of PubMed and Embase in June 2014 for reports on injuries and other problems caused by using a Nintendo gaming system. Most of the 38 articles identified were case reports or case series. Injuries and problems ranged from neurological and psychological to surgical. Traditional controllers with buttons were associated with tendinitis of the extensor of the thumb. The joystick on the Nintendo 64 controller was linked to palmar ulceration. The motion sensitive Wii remote was associated with musculoskeletal problems and various traumas. Most problems are mild and prevalence is low. The described injuries were related to the way the games are controlled, which varies according to the video game console. © Jalink et al 2014.

  11. MR imaging of normal extrinsic wrist ligaments using thin slices with clinical and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, M., E-mail: maryam.shahabpour@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); De Maeseneer, M., E-mail: michel.demaeseneer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Pouders, C. [Department of Experimental Anatomy, Vrije Universiteit Brussel (Belgium); Van Overstraeten, L. [Department of Foot and Hand Surgery, Centre Hospitalier Regional de Wallonie Picarde, Tournai (Belgium); Ceuterick, P. [Department of Hand Surgery, Europa Ziekenhuizen, Brussels (Belgium); Fierens, Y. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Goubau, J. [Department of Orthopaedic Surgery, UZ Brussel, Brussels (Belgium); De Mey, J. [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium)

    2011-02-15

    Eighty-nine MR examinations of the wrist were retrospectively analyzed. MRI results were compared with clinical findings and/or arthroscopy. Thin proton density and T2 weighted sequences and 3D DESS weighted sequences were applied on a 1.5 T scanner. On the palmar side three radiocarpal ligaments are recognized including the radioscaphocapitate, radiolunotriquetral, radioscapholunate, and midcarpal triquetroscaphoidal ligaments. Ulnocarpal ligaments include the ulnolunate ligament and the ulnotriquetral ligament. On the dorsal side three ligaments are recognized: the dorsal radiolunotriquetral, and the midcarpal triquetroscaphoidal and triquetro-trapezoido-trapezial. The collateral ligaments include the radial and ulnar collateral ligament. MR is a valuable technique in the assessment of the extrinsic and midcarpal ligaments. Depiction of the extrinsic ligaments can best be accomplished with coronal 3D DESS sequences and sagittal and transverse proton density and T2 weighted sequences with thin slices.

  12. Closure of digital arteries in high vascular tone states as demonstrated by measurement of systolic blood pressure in the fingers

    DEFF Research Database (Denmark)

    Krähenbühl, B; Nielsen, S L; Lassen, N A

    1977-01-01

    by direct cooling or intra-arterial noradrenaline infusion caused a marked drop in FSP in the exposed fingers, but not in the non-exposed fingers of the same hand. The fact that the non-exposed fingers retained the normal (arm systolic) pressure level is taken to indicate that palmar arch blood pressure......Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers...... also remained normal. In the high vascular tone state, a large transmural pressure difference must apparently be established before the digital arteries are forced open. The lowered opening pressure constitutes a manifestation of the closure phenomenon of the digital arteries described in patients...

  13. Anomalous Medial Branch of Radial Artery: A Rare Variant

    Directory of Open Access Journals (Sweden)

    Surbhi Wadhwa

    2016-10-01

    Full Text Available Radial artery is an important consistent vessel of the upper limb. It is a useful vascular access site for coronary procedures and its reliable anatomy has resulted in an elevation of radial forearm flaps for reconstructive surgeries of head and neck. Technical failures, in both the procedures, are mainly due to anatomical variations, such as radial loops, ectopic radial arteries or tortuosity in the vessel. We present a rare and a unique anomalous medial branch of the radial artery spiraling around the flexor carpi radialis muscle in the forearm with a high rising superficial palmar branch of radial artery. Developmentally it probably is a remanent of the normal pattern of capillary vessel maintenance and regression. Such a case is of importance for reconstructive surgeons and coronary interventionists, especially in view of its unique medial and deep course.

  14. Ultrasound assisted arthroscopic approach for removal of basilar sesamoid fragments of the proximal sesamoid bones in horses.

    Science.gov (United States)

    Barrett, Elizabeth J; Rodgerson, Dwayne H

    2014-08-01

    To describe an ultrasound assisted arthroscopic approach for removal of non-articular basilar sesamoid fragments in Thoroughbred yearlings. Thoroughbred yearlings (n = 7). Basilar sesamoid fragments identified during pre-sale radiographic examination were removed using a palmar/plantar arthroscopic approach to the fetlock joint and ultrasonographic guidance. Complete fragment removal was confirmed by ultrasonography and radiography. Basilar sesamoid fracture fragments were localized and removed successfully using rongeurs and a radiofrequency probe for soft tissue dissection of the fragment. Complete fragment removal was confirmed by ultrasonography and radiography. No intra- or postoperative complications occurred. At 6-8 months follow-up, no fragments or bony proliferation at the base of the sesamoid was observed. Ultrasonographic guidance can be used to facilitate localization, dissection, and confirmation of removal of basilar fragments of the proximal sesamoid bone. © Copyright 2014 by The American College of Veterinary Surgeons.

  15. Surgical treatment of chronic occlusive in peripheral arteries (Review of 100 cases

    Directory of Open Access Journals (Sweden)

    H. AHRARI

    1977-01-01

    slight deterioration during follow up, after femoro-popliteal operations the rate of early success rapidly declined. Aotrto-iliac stenosis is a more promising situation for reconstruction. Either grafting or endarterectomy is available. We abondon endarterectomy in small arteres below the popliteal arteries to avoid reobstruction due to thrombosis. We agree that sympathectomy should be performed at the time of trophic changes in the skin of the foot, and for early gangrene, we remove the third and fourth lumbar ganglia. This operation should increase the circulation to the skin below the knee. We do not recommend sympathectomy as the treatment for claudication. 3- Apart from the data derived from our group, patients gave us the following information. a - many patients come from the northern part of Iran which has a Medite ranean climate . . b - None of them had a hight cholesterol level. c - Only one patient had high blood pressure. d - Half of the patients had occlusion below the popliteal arteries Cmostely Buerger type in character and femoro popliteal obstruction which were segmental occlusion or iliac arteries.

  16. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile.

    Science.gov (United States)

    Oughton, Matthew T; Loo, Vivian G; Dendukuri, Nandini; Fenn, Susan; Libman, Michael D

    2009-10-01

    To evaluate common hand hygiene methods for efficacy in removing Clostridium difficile. Randomized crossover comparison among 10 volunteers with hands experimentally contaminated by nontoxigenic C. difficile. Interventions included warm water with plain soap, cold water with plain soap, warm water with antibacterial soap, antiseptic hand wipes, alcohol-based handrub, and a control involving no intervention. All interventions were evaluated for mean reduction in colony-forming units (CFUs) under 2 contamination protocols: "whole hand" and "palmar surface." Results were analyzed according to a Bayesian approach, by using hierarchical models adjusted for multiple observations. Under the whole-hand protocol, the greatest adjusted mean reductions were achieved by warm water with plain soap (2.14 log(10) CFU/mL [95% credible interval (CrI), 1.74-2.54 log(10) CFU/mL]), cold water with plain soap (1.88 log(10) CFU/mL [95% CrI, 1.48-2.28 log(10) CFU/mL), and warm water with antibacterial soap (1.51 log(10) CFU/mL [95% CrI, 1.12-1.91 log(10) CFU/mL]), followed by antiseptic hand wipes (0.57 log(10) CFU/mL [95% CrI, 0.17-0.96 log(10) CFU/mL]). Alcohol-based handrub (0.06 log(10) CFU/mL [95% CrI, -0.34 to 0.45 log(10) CFU/mL]) was equivalent to no intervention. Under the palmar surface protocol, warm water with plain soap, cold water with plain soap, and warm water with antibacterial soap again yielded the greatest mean reductions, followed by antiseptic hand wipes (26.6, 26.6, 26.6, and 21.9 CFUs per plate, respectively), when compared with alcohol-based handrub. Hypothenar (odds ratio, 10.98 [95% CrI, 1.96-37.65]) and thenar (odds ratio, 6.99 [95% CrI, 1.25-23.41]) surfaces were more likely than fingertips to remain heavily contaminated after handwashing. Handwashing with soap and water showed the greatest efficacy in removing C. difficile and should be performed preferentially over the use of alcohol-based handrubs when contact with C. difficile is suspected or likely.

  17. Relaciones espaciales y alimenticias del ensamblaje de reptiles del complejo cenagoso de Zapatosa, departamento del Cesar (Colombia

    Directory of Open Access Journals (Sweden)

    Guido Fabian Medina-Rangel

    2015-01-01

    Full Text Available Para conocer los factores ambientales que favorece la riqueza y abundancia de especies y grupos de reptiles, su preferencia por microhábitats, dieta de especies y diferencias entre hábitats en parámetros como tamaño de individuos, grado de detección y proporción de depredación, se realizaron salidas en áreas circundantes al complejo cenagoso de Zapatosa, entre noviembre de 2006 y octubre de 2007, abarcando la época de lluvias y la época seca en cinco tipos hábitats. Los hábitats con diferencias significativas entre variables ambientales y estructurales fueron: bosque de ribera, palmar, sabanas arboladas y bosque casmófito; el bosque de ribera y bosque seco no resultaron diferentes. La inclinación del terreno y el grado de intervención antrópica fueron las variables más relacionadas con la abundancia de las especies. Al aumentar la pendiente y la intervención antrópica disminuyó la riqueza y abundancia de reptiles en general y de serpientes y lagartos; con el aumento de la temperatura media ambiental la abundancia de reptiles disminuyó. Con el aumento de la cobertura herbácea y la disminución del diámetro de los árboles, disminuyó la riqueza de lagartos y serpientes. El tamaño corporal de los reptiles no fue diferente entre hábitats, aunque las tallas pequeñas predominaron en todos. Las serpientes presentaron menores valores de detección que los lagartos. El bosque de ribera presentó los valores más altos de detección. Un quinto de todas las lagartijas presentó algún signo de depredación y fue más alta en el palmar. Los reptiles terrestres fueron los más ricos y abundantes en el estudio. Los lagartos presentaron la mayor amplitud en el uso de hábitat y microhábitat, mientras que las serpientes Helicops danieli y Leptodeira septentrionalis y los lagartos Anolis gaigei, Gonatodes albogularis y Cnemidophorus lemniscatus en el uso de alimento. Los lagartos exhibieron mayor solapamiento en el uso de los recursos.

  18. New wrist bones of Homo floresiensis from Liang Bua (Flores, Indonesia).

    Science.gov (United States)

    Orr, Caley M; Tocheri, Matthew W; Burnett, Scott E; Awe, Rokus Due; Saptomo, E Wahyu; Sutikna, Thomas; Jatmiko; Wasisto, Sri; Morwood, Michael J; Jungers, William L

    2013-02-01

    The carpals from the Homo floresiensis type specimen (LB1) lack features that compose the shared, derived complex of the radial side of the wrist in Neandertals and modern humans. This paper comprises a description and three-dimensional morphometric analysis of new carpals from at least one other individual at Liang Bua attributed to H. floresiensis: a right capitate and two hamates. The new capitate is smaller than that of LB1 but is nearly identical in morphology. As with capitates from extant apes, species of Australopithecus, and LB1, the newly described capitate displays a deeply-excavated nonarticular area along its radial aspect, a scaphoid facet that extends into a J-hook articulation on the neck, and a more radially-oriented second metacarpal facet; it also lacks an enlarged palmarly-positioned trapezoid facet. Because there is no accommodation for the derived, palmarly blocky trapezoid that characterizes Homo sapiens and Neandertals, this individual most likely had a plesiomorphically wedge-shaped trapezoid (like LB1). Morphometric analyses confirm the close similarity of the new capitate and that of LB1, and are consistent with previous findings of an overall primitive articular geometry. In general, hamate morphology is more conserved across hominins, and the H. floresiensis specimens fall at the far edge of the range of variation for H. sapiens in a number of metrics. However, the hamate of H. floresiensis is exceptionally small and exhibits a relatively long, stout hamulus lacking the oval-shaped cross-section characteristic of human and Neandertal hamuli (variably present in australopiths). Documentation of a second individual with primitive carpal anatomy from Liang Bua, along with further analysis of trapezoid scaling relative to the capitate in LB1, refutes claims that the wrist of the type specimen represents a modern human with pathology. In total, the carpal anatomy of H. floresiensis supports the hypothesis that the lineage leading to the

  19. Cooling via one hand improves physical performance in heat-sensitive individuals with Multiple Sclerosis: A preliminary study

    Directory of Open Access Journals (Sweden)

    Murray Julie

    2008-05-01

    Full Text Available Abstract Background Many individuals afflicted with multiple sclerosis (MS experience a transient worsening of symptoms when body temperature increases due to ambient conditions or physical activity. Resulting symptom exacerbations can limit performance. We hypothesized that extraction of heat from the body through the subcutaneous retia venosa that underlie the palmar surfaces of the hands would reduce exercise-related heat stress and thereby increase the physical performance capacity of heat-sensitive individuals with MS. Methods Ten ambulatory MS patients completed one or more randomized paired trials of walking on a treadmill in a temperate environment with and without cooling. Stop criteria were symptom exacerbation and subjective fatigue. The cooling treatment entailed inserting one hand into a rigid chamber through an elastic sleeve that formed an airtight seal around the wrist. A small vacuum pump created a -40 mm Hg subatmospheric pressure enviinside the chamber where the palmar surface of the hand rested on a metal surface maintained at 18–22°C. During the treatment trials, the device was suspended from above the treadmill on a bungee cord so the subjects could comfortably keep a hand in the device without having to bear its weight while walking on the treadmill. Results When the trials were grouped by treatment only, cooling treatment increased exercise durations by 33% (43.6 ± 17.1 min with treatment vs. 32.8 ± 10.9 min. without treatment, mean ± SD, p -6, paired t-test, n = 26. When the average values were calculated for the subjects who performed multiple trials before the treatment group results were compared, cooling treatment increased exercise duration by 35% (42.8 ± 16.4 min with treatment vs. 31.7 ± 9.8 min. without treatment, mean ± SD, p Conclusion These preliminary results suggest that utilization of the heat transfer capacity of the non-hairy skin surfaces can enable temperature-sensitive individuals with MS to

  20. Enhanced MRI in carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Hayakawa, Katsuhiko; Nakane, Takashi; Kobayashi, Shigeru; Asai, Takahiro; Wada, Kunio; Yoshizawa, Hidezo

    1998-01-01

    In this study, we performed contrast-enhanced MRI in patients with idiopathic carpal tunnel syndrome and examined the morphologic change in the carpal tunnel. In the transverse section of the opening of carpal tunnel where scaphoid and pisiform bones are figured out, we measured and examined 4 items, viz. the soft carpal tunnel volume, flat rate of median nerve, position of median nerve and thickness of palmer ligaments composing the base of carpal tunnel, with an image analyzer attached to the MRI apparatus. Whereas the average carpal tunnel volume in 12 hands of normal controls was 166.8 mm 2 , that in 74 hands of carpal tunnel syndrome was 207.2 mm 2 , a significant increase compared with the normal controls. The flat rate of median nerve was 46% in the controls, but that was 37.5% in the carpal tunnel syndrome, a significant flattening was noted. We connected the peaks of the scaphoid node and pisiform bone with a line and named it standard line. When we observed the position of median nerve in the carpal tunnel, the nerve in 9 of 12 hands, 75%, lay below the standard line in the controls, but the nerve in 65 of 74 hands, 87.8%, lay above the standard line in the carpal tunnel syndrome, clearly showing that the median nerve had shifted to the palmar side. Regarding these morphologic changes of the carpal tunnel, the internal pressure of the carpal tunnel is considered to be raised with swelling of the soft tissues mainly composing the inside of carpal tunnel, thus the area of cross section of carpal tunnel to be increased, the median nerve to be shifted to the palmar side and the median nerve to be compressed by the transverse carpal ligament at that time. Although we can observe these morphological changes readily in MRI images, these images show only the results of carpal tunnel syndrome after all, and do not specify the direct causes. However, we believe that these facts are important factors in the manifestation of idiopathic carpal tunnel syndrome. (author)

  1. Procedure-Oriented Torsional Anatomy of the Hand for Spasticity Injection.

    Science.gov (United States)

    John, Joslyn; Cianca, John; Chiou-Tan, Faye; Pandit, Sindhu; Furr-Stimming, Erin; Taber, Katherine H

    To provide musculoskeletal ultrasound (MSKUS) images of hand anatomy in the position of hemiparetic flexion as a reference for spasticity injections. After a stroke, spasticity can result in anatomic distortion of the hand. Spasticity may require treatment with botulinum toxin or phenol injections. Anatomic distortion may decrease the accuracy of injections. Standard anatomic references are of limited utility because they are not in this spastic hemiparetic position. There presently is no anatomic reference in the literature for these spastic postures. This study is part three of a series examining torsional anatomy of the body. Ultrasound (US) images were obtained in a healthy subject. The muscles examined included the lumbricals and the flexor pollicis brevis. A marker dot was placed at each dorsal and palmar anatomic injection site for these muscles. The US probe was placed on these dots to obtain a cross-sectional view. A pair of US images was recorded with and without power Doppler imaging: the first in anatomic neutral and second in hemiparetic spastic positions. In addition, a video recording of the movement of the muscles during this rotation was made at each site. On the palmar view, the lumbricals rotated medially. On dorsal view, the lumbricals can be seen deep to the dorsal interossei muscles, with spastic position, and they become difficult to identify. The flexor pollicis brevis (FPB) muscle contracts with torsion, making abductor pollicis brevis (APB) predominately in view. The anatomic location of the lumbrical muscles makes them difficult to inject even with ultrasound guidance. However, recognizing the nearby digital vasculature allows for improved identification of the musculature for injection purposes. The FPB muscle also can be identified by its adjacent radial artery lateral to the flexor pollicus longus tendon. Normal anatomy of hand can become distorted in spastic hemiparesis. Diagnostic ultrasound is able to discern these anatomic

  2. Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001 Características clínicas y de laboratorio de la malaria por Plasmodium vivax, Colombia 2001

    Directory of Open Access Journals (Sweden)

    Marcela Echeverri

    2003-01-01

    Full Text Available A descriptive study was carried out in 104 patients with Plasmodium vivax malaria, from the region of Turbo (Antioquia, Colombia. Clinical features and levels of hemoglobin, glycemia, serum bilirubin, alanine-aminotransferase (ALT, aspartate-aminotransferase (AST, creatinine and complete blood cell profile were established. 65% of the studied individuals were men and their mean age was 23. Of all individuals 59% had lived in the region for > 1 year and 91% were resident in the rural area. 42% were farmers and 35% had a history of malaria. The mean parasitaemia was 5865 parasites/mm³. The evolution of the disease was short (average of 4.0 days. Fever, headache and chills were observed simultaneously in 91% of the cases while the most frequent signs were palmar pallor (46%, jaundice (15%, hepatomegaly (17%, and spleen enlargement (12%. Anemia was found in 39% of the women and in 51% of the men, 8% of individuals had thrombocytopaenia and 41% had hypoglycemia.Se realizó un estudio descriptivo con 104 enfermos de malaria por Plasmodium vivax, en Turbo (Antioquia, Colombia. Se evaluaron las características clínicas y los niveles de hemoglobina, glicemia, bilirrubina sérica, ALT, AST, creatinina y hemograma completo. Los hombres representaron el 65% del grupo, la edad promedio fue 23 años, el 59% tuvo más de un año de residir en el lugar, el 91% residían en zona rural, el 42% realizaba trabajos agrícolas y el 35% tenía antecedentes de malaria. La parasitemia promedio fue de 5865 parásitos/mm³. La evolución de la enfermedad fue corta (mediana de 4,0 días. Fiebre, cefalea y escalofrío estuvieron simultáneamente en 91% de los casos y los signos más frecuentes fueron palidez palmar (46%, ictericia (15%, hepatomegalia (17% y esplenomegalia (12%. La anemia se encontró en el 39% de las mujeres y en el 51% de los hombres, y el 8% presentó trombocitopenia. Los niveles séricos de bilirrubinas directa e indirecta, de enzimas ALT y AST y de

  3. Palynomorphs in Holocene sediments from a paleolagoon in the coastal plain of extreme southern Brazil

    Directory of Open Access Journals (Sweden)

    Ebráilon Masetto

    2014-06-01

    Full Text Available This paper presents the results of a qualitative palynological analysis of a 140 cm-thick section of Holocene sediments from a paleolagoon, representing the last 2600 years, taken from an outcrop at Hermenegildo Beach (33º42'S; 53º18'W, located in the municipality of Santa Vitória do Palmar, in the state of Rio Grande do Sul, Brazil. Samples were treated with hydrochloric acid, hydrofluoric acid and potassium hydroxide, after which they were subjected to acetolysis and mounted on glycerin-coated slides for light microscopy analysis. Among the 48 palynomorphs identified were 25 fungi, eight algae, three bryophytes, and 12 pteridophytes. Brief descriptions and illustrations of each palynomorph are presented, together with ecological data from the organism of origin when possible. Our findings will serve as reference material for paleoenvironmental studies in the coastal plain of southern Brazil.

  4. Gorlin-Goltz Syndrome: Diagnosis and Treatment Options

    Directory of Open Access Journals (Sweden)

    João Mendes-Abreu

    2017-05-01

    Full Text Available The Gorlin-Goltz syndrome is a rare autosomal dominant hereditary condition, with complete penetrance and variable expressivity. Characterized by the appearance of multiple basaliomas, and often the development of keratocyst, it can also express itself by the presence of palmar/plantar depressions, calcification of brain sickle, and skeletal birth defects, although less frequently. This article presents two cases involving direct relatives, referred after the identification of several basaliomas and jaw cysts. After establishing the diagnosis, given the identification of three major criteria, the treatment consisted in the excision of the lesions followed, in one case, with vismodegib treatment resulting in complete remission. Gorlin-Goltz syndrome is therefore a multidisciplinary challenge, whose variable morbidity and high risk of recurrence make treatment and surveillance critical. However, new molecular targeted therapies have brought a new hope in treating these patients.

  5. A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon: A case report.

    Science.gov (United States)

    Lu, Hui; Chen, Qiang; Shen, Hui

    2017-03-01

    Gouty tophi is a rare cause of CTS. We first report a unique case of repeated CTS with gouty tophi in flexor tendon. In the previous literature, the symptoms cases of CTS were gradually increased. We report a 44-year-old male porter presented with mass on his left distal forearm combined a repeated carpal tunnel syndrome for 5 years. He felt numbness in fingers and his left palmar. The CTS symptoms had been eased through rest and dugs medication. It recurred twice. Monosodium urate crystal deposits were found in surgery. Histologic findings confirmed the diagnosis of gout. We removed partial of gouty tophus and retained the integrity of the tendon. Two years after the surgery, the patient had not experienced any symptom recurrence. Early diagnosis and control of gout are necessary to avoid irreversible complications. The surgery combined with decreasing trioxypurine treatment can improve the treatment outcome of gouty tophus.

  6. Contact palm burns in toddlers from glass enclosed fireplaces.

    Science.gov (United States)

    Dunst, C M; Scott, E C; Kraatz, J J; Anderson, P M; Twomey, J A; Peltier, G L

    2004-01-01

    We have seen an alarming increase in the incidence of pediatric palm burns associated with gas fireplaces. The increasing popularity of these units places more children at risk. Medical records of patients under the age of 5 years who sustained hand burns from contact with the glass enclosure of gas fireplaces from 1996 through 2002 were reviewed. Thirty-nine patients were identified, with a mean age of 12.8 months. A 15-fold increase in incidence was observed. Thirty-three patients suffered superficial second-degree burns that were treated conservatively. Twenty-one percent of children developed significant wound complications requiring intensive therapy including extension splinting or surgery. Pediatric burns resulting from palmar contact with the glass enclosures of gas fireplaces have emerged as an avoidable new danger within the home. Although most of these injuries heal with conservative treatment alone, many require surgery or other intensive management to regain acceptable function.

  7. Identification of protein biomarkers in Dupuytren's contracture using surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS).

    Science.gov (United States)

    O'Gorman, David; Howard, Jeffrey C; Varallo, Vincenzo M; Cadieux, Peter; Bowley, Erin; McLean, Kris; Pak, Brian J; Gan, Bing Siang

    2006-06-01

    To study the protein expression profiles associated with Dupuytren's contracture (DC) to identify potential disease protein biomarkers (PBM) using a proteomic technology--Surface Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (SELDI-TOF-MS). Normal and disease palmar fascia from DC patients were analyzed using Ciphergen's SELDI-TOF-MS Protein Biological System II (PBSII) ProteinChip reader. Analysis of the resulting SELDI-TOF spectra was carried out using the peak cluster analysis program (BioMarker Wizard, Ciphergen). Common peak clusters were then filtered using a bootstrap algorithm called SAM (Significant Analysis of Microarrays) for increased fidelity in our analysis. Several differentially expressed low molecular weight (mass standard deviation for both methods of biomarker-rich low molecular weight region of the human proteome. Application of such novel technology may help clinicians to focus on specific molecular abnormalities in diseases with no known molecular pathogenesis, and uncover therapeutic and/or diagnostic targets.

  8. The hands in health and disease of individuals with filaggrin loss-of-function mutations

    DEFF Research Database (Denmark)

    Kaae, Jeanette; Menné, Torkil; Carlsen, Berit C

    2012-01-01

    During the last 2 years, we have performed filaggrin genotyping in patients with eczema seen in our hand eczema clinic. We present pictures of healthy and diseased hands from individuals with filaggrin gene (FLG) mutations to describe a clinical entity of hand eczema. We show that xerosis...... and hyperkeratosis on the dorsal aspects of the hands and fingers, as well as palmar hyperlinearity, should alert the clinician about a possible inherited barrier abnormality of the skin resulting from FLG mutations. The series of photographs range from the hands of an individual with FLG mutations but no history...... of eczema, to the hands of individuals with typical and atypical filaggrin hand eczema, and finally to the hands of an individual with FLG mutations and hand eczema caused by exposure to irritants and allergens. We briefly discuss this possible subtype of hand eczema, present pathomechanisms, and indicate...

  9. Hand and digital ischemia due to arteriosclerosis and thromboembolization in young adults: pathologic features with clinical correlations.

    Science.gov (United States)

    Guarda, L A; Borrero, J L

    1990-11-01

    Twenty young adult patients with hand and digital ischemia were found to have obstructive arterial disease. All patients were surgically explored, and the occluded vessels were resected and by-passed. Eighteen patients had obstruction at the level of the distal ulnar artery and palmar arch, and 12 had obstruction of the common digital and digital proper arteries. Occlusive arteriosclerotic lesions were found in all patients; these lesions were characterized by prominent fibromuscular intimal plaques with superimposed thrombosis. Six patients had also thromboembolism to distal digital vessels. Vasculitis, calcifications, cholesterol deposits, and atheromatous emboli were not observed. Five patients had transmural neovascularization of the lesions in a similar manner to that described in coronary artery lesions. Obstructive lesions due to fibromuscular intimal proliferation with associated thrombosis and/or distal thromboembolization affecting arteries of hands and digits appear to be an important lesion that can affect young patients.

  10. Sulfur mustard-induced poikiloderma: a case report.

    Science.gov (United States)

    Emadi, Seyed Naser; Kaffashi, Mohammad; Poursaleh, Zohreh; Akhavan-Moghaddam, Jamal; Soroush, Mohammad Reza; Emadi, Seyed Emad; Taghavi, Nez'hat-o-Sadat

    2011-06-01

    Sulfur mustard (SM) is a potent chemical warfare agent that was widely used during the First World War and the Iran-Iraq conflict. This vesicant agent causes several acute and chronic effects on the skin, eye, and respiratory system. We report the case of a 41-year-old man who was injured with SM in Iraq chemical attack in 1988. After exposure, he developed severe skin blisters on his upper trunk, dorsum of hands, and genitalia. Based on several clinical observations, such as atrophy, pigmentation, and vascular changes on genitalia with relevant findings in histopathological studies, persistent pigmentation, and damaged skin appendix in hand lesions, a diagnosis of "SM-induced poikiloderma" was postulated. The absence of any complication on the palmar aspect of hands is another remarkable finding in presented case, which suggests a plausible role of the palms as a vector for transporting SM to other sites of the skin.

  11. The Place of Operations upon the Sympathetic System in the Treatment of Poliomyelitis.

    Science.gov (United States)

    Ogilvie, W H

    1933-02-01

    Revived interest in sympathetic surgery originated in orthopaedics. Royle's theories and operations. Their trial, failure and final abandonment. Value of sympathetic operations widely investigated; while finality has not been reached they have proved effective for three main purposes: (1) Relief of pain especially in bladder diseases. (2) Removal of inhibition and sphincteric spasm in alimentary, anal and bladder diseases. (3) Production of vaso-dilatation in (a) vaso-spastic diseases; (b) vaso-degenerative diseases; (c) conditions not due to arterial disease in which increased blood supply is beneficial.Poliomyelitis falls into the last group.-Cause of poor blood supply uncertain; ? lack of function; ? upset of some reflex; ? paralysis of vaso-dilators.TWO PROBLEMS ARISE, BOTH OF WHICH MAY BE TREATED BY OPERATIONS ON THE SYMPATHETIC: (1) The cold, blue limb, which develops chilblains, sores, or even deep ulcers every winter, often stopping treatment and requiring patient to be confined to bed. (2) The limb with considerable and rapidly increasing shortening. Sometimes these limbs show a fair return of power, and were it not for the heavy boot made necessary by the shortening, the patient could be made to walk well.Method of attack.-(1) Periarterial sympathectomy; (2) ramisectomy; (3) ganglionectomy. Physiological basis of each. Criticism of (1) and (2).Details of the operation for ganglionectomy.-Alternative approaches and their advantages. The immediate and late results of the procedure.Five cases discussed briefly.

  12. Radionuclide angiography and blood pool imaging to assess skin ulcer healing prognosis in patients with peripheral vascular disease

    International Nuclear Information System (INIS)

    Alazraki, N.; Lawrence, P.F.; Syverud, J.B.

    1984-01-01

    Several non-invasive diagnostic techniques including segmental limb blood pressures, skin fluoresence, and photo plethysmography, have been evaluated as predictors of skin ulcer healing in patients with peripheral vascular disease, but none are widely used. Using 20mCi of Tc-99m phosphate compounds, four phase bone scans were obtained, including (1) radionuclide angiogram (2) blood pool image (3) 2 hour and 4-6 hour static images and (4) 24 hour static delayed images. The first two phases were used to assess vacularity to the region of distal extremity ulceration; the last two phases evaluated presence or absence of osteomyelitis. Studies were performed in 30 patients with non-healing ulcers of the lower extremities. Perfusion to the regions of ulceration on images was graded as normal, increased, or reduced with respect to the opposite (presumed normal) limb or some other normal reference area. Hypervascular response was interpreted as good prognosis for healing unless osteomyelitis was present. Clinicians followed patients for 14 days to assess limb healing with optimum care. If there was no improvement, angiography and/or surgery (reconstructive surgery, sympathectomy, or amputation) was done. Results showed: sensitivity for predicting ulcer healing was 94%, specificity 89%. Patients who failed to heal their ulcers showed reduced perfusion, no hypervascular response, or osteomyelitis. Microcirculatory adequacy for ulcer healing appear predictable by this technique

  13. Restraint stress enhances arterial thrombosis in vivo--role of the sympathetic nervous system.

    Science.gov (United States)

    Stämpfli, Simon F; Camici, Giovanni G; Keller, Stephan; Rozenberg, Izabela; Arras, Margarete; Schuler, Beat; Gassmann, Max; Garcia, Irene; Lüscher, Thomas F; Tanner, Felix C

    2014-01-01

    Stress is known to correlate with the incidence of acute myocardial infarction. However, the molecular mechanisms underlying this correlation are not known. This study was designed to assess the effect of experimental stress on arterial thrombus formation, the key event in acute myocardial infarction. Mice exposed to 20 h of restraint stress displayed an increased arterial prothrombotic potential as assessed by photochemical injury-induced time to thrombotic occlusion. This increase was prevented by chemical sympathectomy performed through 6-hydroxydopamine (6-OHDA). Blood-born tissue factor (TF) activity was enhanced by stress and this increase could be prevented by 6-OHDA treatment. Vessel wall TF, platelet count, platelet aggregation, coagulation times (PT, aPTT), fibrinolytic system (t-PA and PAI-1) and tail bleeding time remained unaltered. Telemetric analysis revealed only minor hemodynamic changes throughout the stress protocol. Plasma catecholamines remained unaffected after restraint stress. Tumor necrosis factor alpha (TNF-α) plasma levels were unchanged and inhibition of TNF-α had no effect on stress-enhanced thrombosis. These results indicate that restraint stress enhances arterial thrombosis via the sympathetic nervous system. Blood-borne TF contributes, at least in part, to the observed effect whereas vessel wall TF, platelets, circulating coagulation factors, fibrinolysis and inflammation do not appear to play a role. These findings shed new light on the understanding of stress-induced cardiovascular events.

  14. Sympathetic Nervous System Modulation of Inflammation and Remodeling in the Hypertensive Heart

    Science.gov (United States)

    Levick, Scott P.; Murray, David B.; Janicki, Joseph S.; Brower, Gregory L.

    2010-01-01

    Chronic activation of the sympathetic nervous system (SNS) is a key component of cardiac hypertrophy and fibrosis. However, previous studies have provided evidence to also implicate inflammatory cells, including mast cells, in the development of cardiac fibrosis. The current study investigated the potential interaction of cardiac mast cells with the SNS. Eight week old male SHR were sympathectomized to establish the effect of the SNS on cardiac mast cell density, myocardial remodeling and cytokine production in the hypertensive heart. Age-matched WKY served as controls. Cardiac fibrosis and hypertension were significantly attenuated and left ventricular mass normalized while cardiac mast cell density was markedly increased in sympathectomized SHR. Sympathectomy normalized myocardial levels of IFN-γ, IL-6 and IL-10, but had no effect on IL-4. The effect of norepinephrine and substance P on isolated cardiac mast cell activation was investigated as potential mechanisms of interaction between the two. Only substance P elicited mast cell degranulation. Substance P was also shown to induce the production of angiotensin II by a mixed population of isolated cardiac inflammatory cells, including mast cells, lymphocytes and macrophages. These results demonstrate the ability of neuropeptides to regulate inflammatory cell function, providing a potential mechanism by which the SNS and afferent nerves may interact with inflammatory cells in the hypertensive heart. PMID:20048196

  15. Drug therapy in patients with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Müller Thomas

    2012-05-01

    Full Text Available Abstract Parkinson`s disease (PD is a progressive, disabling neurodegenerative disorder with onset of motor and non-motor features. Both reduce quality of life of PD patients and cause caregiver burden. This review aims to provide a survey of possible therapeutic options for treatment of motor and non motor symptoms of PD and to discuss their relation to each other. MAO-B-Inhibitors, NMDA antagonists, dopamine agonists and levodopa with its various application modes mainly improve the dopamine associated motor symptoms in PD. This armentarium of PD drugs only partially influences the onset and occurrence of non motor symptoms. These PD features predominantly result from non dopaminergic neurodegeneration. Autonomic features, such as seborrhea, hyperhidrosis, orthostatic syndrome, salivation, bladder dysfunction, gastrointestinal disturbances, and neuropsychiatric symptoms, such as depression, sleep disorders, psychosis, cognitive dysfunction with impaired execution and impulse control may appear. Drug therapy of these non motor symptoms complicates long-term PD drug therapy due to possible occurrence of drug interactions, - side effects, and altered pharmacokinetic behaviour of applied compounds. Dopamine substituting compounds themselves may contribute to onset of these non motor symptoms. This complicates the differentiation from the disease process itself and influences therapeutic options, which are often limited because of additional morbidity with necessary concomitant drug therapy.

  16. Mutation in WNT10A is associated with an autosomal recessive ectodermal dysplasia: the odonto-onycho-dermal dysplasia.

    Science.gov (United States)

    Adaimy, Lynn; Chouery, Eliane; Megarbane, Hala; Mroueh, Salman; Delague, Valerie; Nicolas, Elsa; Belguith, Hanen; de Mazancourt, Philippe; Megarbane, Andre

    2007-10-01

    Odonto-onycho-dermal dysplasia is a rare autosomal recessive syndrome in which the presenting phenotype is dry hair, severe hypodontia, smooth tongue with marked reduction of fungiform and filiform papillae, onychodysplasia, keratoderma and hyperhidrosis of palms and soles, and hyperkeratosis of the skin. We studied three consanguineous Lebanese Muslim Shiite families that included six individuals affected with odonto-onycho-dermal dysplasia. Using a homozygosity-mapping strategy, we assigned the disease locus to an ~9-cM region at chromosome 2q35-q36.2, located between markers rs16853834 and D2S353, with a maximum multipoint LOD score of 5.7. Screening of candidate genes in this region led us to identify the same c.697G-->T (p.Glu233X) homozygous nonsense mutation in exon 3 of the WNT10A gene in all patients. At the protein level, the mutation is predicted to result in a premature truncated protein of 232 aa instead of 417 aa. This is the first report to our knowledge of a human phenotype resulting from a mutation in WNT10A, and it is the first demonstration of an ectodermal dysplasia caused by an altered WNT signaling pathway, expanding the list of WNT-related diseases.

  17. Insights into thermoregulation: A clinico-radiological description of Shapiro syndrome.

    LENUS (Irish Health Repository)

    Pazderska, Agnieszka

    2013-06-15

    Shapiro syndrome is a rare entity, comprising a triad of recurrent hypothermia, hyperhidrosis and congenital agenesis of the corpus callosum. Fewer than 50 cases have been described, almost invariably in patients presenting in childhood or early adulthood. We present a case of an 80year old woman presenting with recurrent bouts of shivering, sweating and profound malaise, who sought medical attention because the frequency and severity of attacks worsened in her later years. MRI Brain demonstrated agenesis of the corpus callosum; a rigorous work-up excluded other causes for her symptomatology. The intricate interplay of neuronal networks involved in thermoregulation remains to be fully elucidated and as such, little is known about the pathophysiological mechanisms underlying the clinical manifestations of Shapiro syndrome. We present novel data from FDG-PET imaging of our patient, demonstrating hypermetabolism in a number of brainstem and cerebellar regions during the symptomatic phase. These findings imply that aberrant thermoregulation in Shapiro syndrome involves a number of structures remote from the callosal region. We also present neuropsychometric findings in our patient, of which there have been no reports to date. We postulate that the ageing brain may be more susceptible to the paroxysmal neurochemical fluxes implicated in the syndrome.

  18. Flap surgery in a green iguana (Iguana iguana with a non-healing palmar wound – a case presentation

    Directory of Open Access Journals (Sweden)

    Rudolf Kocsis

    2014-12-01

    Full Text Available In this clinical tutorial report for young vets, there is presented the clinical efficiency of a common surgery technique in a non-healing decubitus inflammatory crusted and pyogenic wound to a nine years male green iguana (Iguana iguana. The wound appeared two months before the reptile was presented to control and the bacteriologic culture made revealed a massive bacterial association where Enterococcus faecalis and Staphylococcus epidermidis were dominant. Consequently, the antibiogram was accomplished, the results indicating resistance to penicillin and chloramphenicol and respectively, efficacy to gentamicin, erythromycin and tetracycline. The initial treatment with gentamicin 5%, as topical application was started, but though the massive tissue destruction, the surgical way was chosen. Under anaesthesia, the area was scratched and the wound was debrided with scalpel until the bleeding occurred and skin was primarily closed with a surgical skin stapler, but this technique proven to be totally unsuited to green iguana, because of the skin’s tension developed consequently the intervention. Following, the “twisted flap” surgical technique was accomplished, we considering this way as a choice one in iguana’s case, and skin was sutured with no absorbable 2/0 nylon. After the local and general antibiotic treatment with enrofloxacin, animal was fully recovered, the suture points being removed after five weeks.

  19. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Harun Kütahya

    2013-01-01

    Full Text Available Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%. They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography, MRI (magnetic resonance imagination, and USG (ultrasound are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.

  20. ZONEAMENTO AGROCLIMÁTICO DA PITANGUEIRA PARA TRÊS CENÁRIOS DISTINTOS DE PRECIPITAÇÃO PLUVIAL EM PERNAMBUCO

    Directory of Open Access Journals (Sweden)

    ALEXSANDRO OLIVEIRA DA SILVA

    2011-01-01

    Full Text Available The present work had as objective to carry through the agroclimatic zoning of the culture of surinam cherry in the state of Pernambuco. They had been used given average annual of minimum and maximum pluvial precipitation and pertaining temperatures of air the 201 climatologic station located in the main representative cities of the regions of the State for the elaboration of the water balance and the attainment of the thermal and water limits. The function density of probability of the distribution gamma was used to classify the dry, regular and rainy years. The maps of dry, regular and rainy years had been produced using interpolation for kriging. The results had presented 19 cities with full aptitude for dry years, 50 cities for regular years and 66 cities for rainy years apt to the culture of surinam cherry. The cities of Cortês, Gameleira and Palmares had revealed with better aptitudes agroclimatic for the culture of the surinam cherry in Pernambuco.