The ultimate technique for posterior rib fractures: the parascapular sub-iliocostalis plane block - A series of cases

We report retrospectively a series of four cases involving the successful use of the recently described parascapular sub-iliocostalis plane block (PSIP), for lateral-posterior rib fractures. The efficacy of the PSIP block may potentially depend on different mechanisms of action: (1) direct action in the fracture site by craniocaudal myofascial spread underneath the erector spinae muscle (ESM); (2) spread to deep layers through tissue disruption caused by trauma, to reach the proximal intercostal nerves; (3) medial spread below the ESM, to reach the posterior spinal nerves; and (4) lateral spread in the sub-serratus (SS) plane to reach the lateral cutaneous branches of the intercostal nerves; while avoiding significant negative hemodynamic effects and other possible complications associated to other techniques leading that the PSIP may be considered an alternative in some clinical scenarios to the Erector Spinae Plane block or the Paravertebral block.

Adsorbed fibrinogen leads to improved bone regeneration and correlates with differences in the systemic immune response

Designing new biomaterials that can modulate the inflammatory response instead of attempting just to reduce it constitutes a paradigm change in regenerative medicine. This work aimed to investigate the capacity of an immunomodulatory biomaterial to enhance bone regeneration. For that purpose we incorporated a molecule with well-established pro-inflammatory and pro-healing roles, fibrinogen, in chitosan scaffolds. Two different incorporation strategies were tested, leading to concentrations of 0.54±0.10mg fibrinogen g(-1) scaffold immediately upon adsorption (Fg-Sol), and 0.34±0.04mg fibrinogen g(-1) scaffold after washing (Fg-Ads). These materials were implanted in a critical size bone defect in rats. At two months post-implantation the extent of bone regeneration was examined by histology and the systemic immune response triggered was evaluated by determining the percentages of myeloid cells, T and B lymphocytes in the draining lymph nodes. The results obtained indicate that the fibrinogen incorporation strategy conditioned the osteogenic capacity of biomaterials. Fg-Ads scaffolds led to more bone formation, and the presence of Fg stimulated angiogenesis. Furthermore, animals implanted with Fg-Ads scaffolds showed significant increases in the percentages of B lymphocytes and myeloid cells in the draining lymph nodes, while levels of T lymphocytes were not significantly different. Finally, a significant increase in TGF-β1 was detected in the plasma of animals implanted with Fg-Ads. Taken together the results presented suggest a potential correlation between the elicited immune response and biomaterial osteogenic performance.

Transcriptome analysis of Taenia solium cysticerci using Open Reading Frame ESTs (ORESTES)

BACKGROUND

Human infection by the pork tapeworm Taenia solium affects more than 50 million people worldwide, particularly in underdeveloped and developing countries. Cysticercosis which arises from larval encystation can be life threatening and difficult to treat. Here, we investigate for the first time the transcriptome of the clinically relevant cysticerci larval form.

RESULTS

Using Expressed Sequence Tags (ESTs) produced by the ORESTES method, a total of 1,520 high quality ESTs were generated from 20 ORESTES cDNA mini-libraries and its analysis revealed fragments of genes with promising applications including 51 ESTs matching antigens previously described in other species, as well as 113 sequences representing proteins with potential extracellular localization, with obvious applications for immune-diagnosis or vaccine development.

CONCLUSION

The set of sequences described here will contribute to deciphering the expression profile of this important parasite and will be informative for the genome assembly and annotation, as well as for studies of intra- and inter-specific sequence variability. Genes of interest for developing new diagnostic and therapeutic tools are described and discussed.

Taenia solium DNA is present in the cerebrospinal fluid of neurocysticercosis patients and can be used for diagnosis

Neurocysticercosis is the most frequent parasitic infection of the CNS and the main cause of acquired epilepsy worldwide. Seizures are the most common symptoms of the disease, together with headache, involuntary movements, psychosis and a global mental deterioration. Absolute diagnostic criteria include the identification of cysticerci, with scolex, in the brain by MRI imaging. We demonstrate here, for the first time, that T. solium DNA is present in the cerebrospinal fluid of patients. The PCR amplification of the parasite DNA in the CSF enabled the correct identification of 29/30 cases (96.7 %). The PCR diagnosis of parasite DNA in the CSF may be a strong support for the diagnosis of neurocysticercosis.

Absence of antihyperglycemic effect of jambolan in experimental and clinical models

The use of alternative therapies to treat diabetes, including teas prepared with different vegetables, is widespread in Brazil. In Porto Alegre, a southern city of Brazil, the tea prepared from leaves of Syzygium cumini (L.) Skeels or S. jambos (L.) Alst has been report to be used frequently by diabetic patients. We investigated the postulated antihyperglycemic effect of the S. cumini (L.) Skeels in three experiments. In the first, a randomized, parallel, placebo controlled trial, tea prepared from leaves of S. cumini did not present any antihyperglycernic effect in 30 non-diabetic young volunteers submitted to a glucose blood tolerance test. In the animal experiments, we tested the effect of increasing doses of the crude extract prepared from leaves of S. cumini administrated for 2 weeks, on the post-prandial blood glucose level of normal rats and rats with streptozotocin-induced diabetes mellitus. The treatment did not produce any antihyperglycernic effect in both models. These results do not rule out hypoglycemic effects in patients with type 2 diabetes mellitus, but strongly suggest that, for a while, the jambolan can not be recommended as an antihyperglycemic treatment.

Street food vending in Latin America

Despite occasional attempts to repress it, street food vending in Latin America appears to be on the rise--encouraged by growing marginal urban populations, the unemployed status of innumerable potential street vendors, lengthening commutes for workers, public demand for cheap and culturally appropriate food near workplaces, and a shortage or absence of regular establishments serving such food. Besides placing a hidden burden on public services, the generally unregulated and quasi-clandestine street food industry tends to observe poor hygienic practices and to pose significant public health problems. Within this context, Latin America's cholera epidemics have drawn increasing attention to street food's potential for disease transmission and have created growing support for attempts to resolve these troubles. What appears needed at this point, rather than futile attempts at abolition, is a new and more positive approach wherein countries change their regulations so as to permit peaceful and constructive adaptation of street food vending to a new style of Latin American social life. This implies legal reorganization directed at structurally developing street food vending and permitting application of measures--especially provision and use of safe water--that will foster good hygiene and safe foods. It also implies creating programs to provide appropriate training for inspectors as well as health education for both vendors and consumers of street food; and it implies promoting and adopting improved methods for preparing and selling such food. There is no reason to suppose these measures will provide an immediate panacea for the street food vending problem; but there is good reason to think they can immensely improve the situation that exists today.

Plague in Brazil during two years of bacteriological and serological surveillance

In north-east Brazil, where plague infection is endemic, bacteriological and serological methods were employed during a two-year period to determine accurately the occurrence of human infection and to define certain epidemiological features of both human and rodent infection. There were 67 confirmed cases of plague, predominantly among males and children. Most of these cases occurred in two inland rural plateaux of Ceara State. Clustering of cases in place and time was common, as was a history of contact with rats. Peak occurrence was in November 1978, during the warm, harvest time of year. Rodent surveillance resulted in isolation of Yersinia pestis from 33 animals, most of them from the field rodent, Zygodontomys pixuna, in the States of Pernambuco and Ceara. Our results indicate a decline in the number of human cases from previous years but show that several foci remain active and that serological testing, in addition to routine bacteriological testing, can assist workers in maintaining the surveillance of both human and rodent plague in Brazil.