Protective facemask impact on human thermoregulation: an overview

The use of protective facemasks (PFMs) negatively impacts respiratory and dermal mechanisms of human thermoregulation through impairment of convection, evaporation, and radiation processes. The relatively minor reported increases in core temperature directly attributable to the wearing of PFMs suggest that associated perceptions of increased body temperature may have a significant psychological component or that regional or global brain temperature changes are involved. Modifications in PFM structure, components, and materials might allow for improved heat dissipation and enhanced compliance with use.     

Longitudinal assessment of grip strength using bulb dynamometer in Duchenne Muscular Dystrophy

BACKGROUND:

Grip strength is used to infer functional status in several pathological conditions, and the hand dynamometer has been used to estimate performance in other areas. However, this relationship is controversial in neuromuscular diseases and studies with the bulb dynamometer comparing healthy children and children with Duchenne Muscular Dystrophy (DMD) are limited.

OBJECTIVE:

The evolution of grip strength and the magnitude of weakness were examined in boys with DMD compared to healthy boys. The functional data of the DMD boys were correlated with grip strength.

METHOD:

Grip strength was recorded in 18 ambulant boys with DMD (Duchenne Group, DG) aged 4 to 13 years (mean 7.4±2.1) and 150 healthy volunteers (Control Group, CG) age-matched using a bulb dynamometer (North Coast- NC70154). The follow-up of the DG was 6 to 33 months (3-12 sessions), and functional performance was verified using the Vignos scale.

RESULTS:

There was no difference between grip strength obtained by the dominant and non-dominant side for both groups. Grip strength increased in the CG with chronological age while the DG remained stable or decreased. The comparison between groups showed significant difference in grip strength, with CG values higher than DG values (confidence interval of 95%). In summary, there was an increment in the differences between the groups with increasing age. Participants with 24 months or more of follow-up showed a progression of weakness as well as maintained Vignos scores.

CONCLUSIONS:

The amplitude of weakness increased with age in the DG. The bulb dynamometer detected the progression of muscular weakness. Functional performance remained virtually unchanged in spite of the increase in weakness.     

Cirugía de las metástasis en la glándula suprarrenal: resultados de una serie de 35 pacientes

IntroductionThe objectives of this study are to present the results of adrenalectomies due to metastasis, and to analyse the prognostic factors that may help to predict long-term survival in this patient group.Patients and methodsA retrospective study was conducted on 35 patients who underwent adrenalectomy for metastases in the Hospital de Cruces from 1996 to January 2010. The survival analysis was performed using the Kaplan and Meier method.ResultsNon-small cell lung cancer (NSCLC) was the most frequent primary tumour, with 18 cases. In 15 patients the diagnosis of adrenal metastasis was synchronous with the primary tumour, and in 20 cases it was metachronous. Only 7 patients survived without disease for 12, 22, 26, 58, 60, 65 and 120 months after the adrenalectomy. The disease free survival at 5 years was 16% in the whole series, and 27% in the NSCLC sub-group. None of the prognostic factors evaluated (size greater than 4.5 cm, cell type, differentiation grade, chemotherapy, surgical technique, disease free interval) was statistically significant in the overall survival, either in the general series or in the sub-group of patients with NSCLC. However, in the general series with tumour recurrence, the difference in survival between metachronous and synchronous metastasis was statistically significant (P=.05), in favour of the former.ConclusionsAdrenalectomy improves the expected survival particularly in patients with NSCLC. Patients with metachronous metastases do not have a higher rate of disease free survival at 5 years than those with synchronous metastases, although they do have a longer survival with the disease. When there is tumour recurrence, it is usually early.     

Surgical therapy of lithiasis in horseshoe kidney

ObjectiveTo present our centre‘s experience in the surgical treatment of lithiasis in patients with horseshoe kidney.Material and methodsFrom October 2007 to March 2011 we treated 10 patients with renal lithiasis in their horseshoe kidneys. Retrospectively, we reviewed the symptoms, medical and surgical history, the characteristics of the stones (size, location, composition) and treatments that were carried out. In all the cases, the study was carried out by CT, with volume reconstruction and with an angiographic study. A percutaneous nephrolithotomy (PCNL) or an endoscopic retrograde intrarrenal surgery (RIRS) was carried out, depending on the size and location of the stone.ResultsThree percutaneous nephrolithotomies were carried out (2 on staghorn lithiasis stones, 1 pseudocoraliform stone) with a combined rigid and flexible single-access nephroscopy. In one case there was haemorrhage that required treatment by selective embolization. In the rest, RIRS was carried out, all with stones < 30 mm in their greatest diameter without any complications. The mean surgical times were 120 (60-180) minutes for the percutaneous route and of 105 (65-160) minutes for the retrograde route. In all the cases the treatment achieved a complete elimination of the stones or remains of less than 5 mm.ConclusionsThe treatment of renal lithiasis in horseshoe kidneys is complex, given their peculiar anatomy. The usual surgical techniques can be reproduced in these cases with good results. We opt for PCNL in complete staghorn stone and pseudocoraiform stones, whereas RIRS is a valid option in cases with stones < 3 cm.     

Effects of Spray and Stretch on Postneedling Soreness and Sensitivity After Dry Needling of a Latent Myofascial Trigger Point

Objectives

To investigate (1) the effect of spray and stretch versus control on reducing postneedling soreness of 1 latent myofascial trigger point (MTrP) and (2) whether higher levels of psychological distress are associated with increased postneedling pain intensity.

Design

A 72-hour follow-up, single-blind randomized controlled trial.

Setting

University community.

Participants

Healthy volunteers (N=70; 40 men, 30 women) aged 18 to 36 years (mean age, 21±4y) with latent MTrP in 1 upper trapezius muscle.

Intervention

All subjects received a dry needling application over the upper trapezius muscle. Then, participants were randomly divided into 2 groups: an intervention group, which received spray and stretch over the needled trapezius muscle, and a control group, which did not receive any intervention.

Main Outcome Measures

Visual analog scale (at postneedling, posttreatment, and 6, 12, 24, 48, and 72h after needling), pressure pain threshold (at preneedling, postneedling, and 24 and 48h after needling). Psychological distress was evaluated by using the Symptom Checklist-90-Revised.

Results

Repeated-measures analysis of variance demonstrated a significant interaction between group and time (F_3,204.8=3.19; P<.05; η_p²=.04) for changes in postneedling soreness. Between-group differences were significant only immediately after intervention (P=.002), and there were no differences found between groups after 6 hours of the intervention (P>.05). Repeated measures of covariance showed that none of the psychological covariates affected these results. Somatization, anxiety, interpersonal sensitivity, and hostility were significantly correlated (P<.05) with postneedling pain intensity. Repeated-measures analysis of variance did not show a significant effect of spray and stretch on mechanical hyperalgesia (F_2.6,175=1.9; P=.131; η_p²=.02).

Conclusions

The spray and stretch had a short-term (<6h) effect in reducing postneedling soreness of a latent MTrP. Pressure pain threshold did not significantly change after spray and stretch. Psychological factors are related to postneedling pain.     

Neurogenic thoracic outlet syndromes: a comparison of true and nonspecific syndromes after surgical treatment

BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) is attributed to compression of the brachial plexus at the scalene hiatus. Patients with true NTOS (TNTOS) have typical clinical and electrophysiological changes and are considered to respond well to surgical treatment, but patients with nonspecific NTOS (NNTOS) have predominantly sensory signs, not well-defined electrophysiological changes, and are thought not to respond favorably to surgical treatment. The postsurgical outcome of patients with cervicobrachialgia diagnosed as TNTOS and as NNTOS is analyzed. METHODS: Seven patients with typical electrophysiological features of TNTOS and 11 with nonspecific signs (NNTOS--extraspinal compression of C5-T1) were treated from 1986 to 2001. Age, duration of symptoms, and follow-up were similar in both groups. All patients underwent unilateral (14) or bilateral (4) supraclavicular decompression of the brachial plexus, for a total of 22 procedures. Clinical outcome was evaluated based on sensory and motor signs and on functional capacity. The Mann-Whitney U test and Fisher exact test were used to compare demographic data and proportions, respectively. RESULTS: Improvement of pain/paresthesias, sensory loss, atrophy, and muscular weakness after surgery was similar in the two groups. Regarding functional capacity, 57.1% of patients with TNTOS and 63.6% of patients with NNTOS became normal or reacquired their previous condition with slight limitation. Surgery-related complications were paresthesias and paresis in the arm, sympathetic dystrophy, pneumothorax, and lymphatic collections, all in patients with NNTOS. CONCLUSIONS: Patients with NNTOS with electrophysiological signs of extraspinal radicular impairment had the same chances of improvement after surgical treatment as patients with TNTOS.     

Hybrid layer thickness and morphology: the influence of cavity preparation with Er:YAG laser

Dentinal surfaces prepared with Er:YAG laser have significantly different characteristics from those prepared with conventional instruments. Different hybrid layer morphologies and thicknesses occur, which may result in differences in the quality of restorations placed on dentinal surfaces prepared with a diamond bur when compared with using an Er:YAG Laser. This study compared the hybrid layer thickness and morphology formed utilizing Scotchbond Multipurpose Plus (SBMP) on dentin prepared with a diamond bur in a high speed handpiece and dentin prepared with an Er:YAG laser. Flat dentin surfaces obtained from five human teeth were treated with the two methods and then with the dentin adhesive system according to the manufacturer's instructions. After a layer of composite was applied, the specimens were sectioned, flattened, polished and prepared for SEM observation. Ten different measurements of hybrid layer thickness were obtained along the bonded surface in each specimen. Results showed that SBMP produced a 3.43 +/- 0.75 microm hybrid layer in dentin prepared with a diamond bur. This hybrid layer was regular and constantly found. In the laser group, the dentin adhesive system produced a 1.54 +/- 0.35 microm hybrid layer that was very irregular and not found constantly. Statistical analysis of variance (p < 0.05) showed that there was a statistically significant difference between the groups. These data indicate that the Er:YAG laser, with parameters used in the experiment, is not a preparation method that allows for a thick hybrid layer formation, which is in opposition to using a diamond bur in a high speed turbine.     

MicroRNA9 regulates neural stem cell differentiation by controlling Hes1 expression dynamics in the developing brain

Earlier studies show that Hes1 expression is oscillatory in neural stem cells but sustained and high in the roof plate and the floor plate, and that such different dynamics of Hes1 expression (oscillatory versus sustained) regulate different proliferation and differentiation characteristics of these cells (active in neural stem cells but rather dormant in roof/floor plate cells). The mechanism of how different dynamics of Hes1 expression is controlled remains to be determined. Here, we found that the seed sequence of microRNA‐9 (miR‐9) is complementary to the 3′‐UTR sequence of Hes1 mRNA. MiR‐9 is highly expressed in the ventricular zone of the developing brain, which contains neural stem cells, but it is not expressed in the roof plate or the floor plate. Over‐expression of miR‐9 negatively regulates the Hes1 protein expression by interacting with the 3′‐UTR of Hes1 mRNA, thereby inducing cell cycle exit and neuronal differentiation. Conversely, knockdown of miR‐9 inhibits neuronal differentiation. Furthermore, knockdown of miR‐9 inhibits the oscillatory expression of Hes1 mRNA in neural stem cells. These results indicate that miR‐9 regulates the proliferation and differentiation of neural stem cells by controlling the dynamics of Hes1 expression in the developing brain.