Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 4 uppsatser + 4 appendix.

Ulm, Univ., Diss., 2007.

Thesis (M.S.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains viii, 115 p. : ill. (some col.). Includes abstract. Includes bibliographical references.

archives@tulane.edu / The prevalence of HIV-associated neurocognitive disorders (HAND) has increased in the era of combination anti-retroviral therapy (cART). Despite this and documented neurocognitive impairment, there is a lack of pathology of HIV-encephalitis (HIVE), specifically multi-nucleated giant cells (MNGCs), in children and SIV-encephalitis (SIVE) in rhesus macaques infected pre-, peri-, and post-parturition. In this dissertation, we show that the lack of MNGCs seen is most likely due to innate differences in the blood-brain and blood-CSF barriers, and a robust pro- and anti-inflammatory response in neonatal rhesus macaques. Using a rhesus macaque model of HIV, we examined the plasma viral load, brain tissue viral load, and monocyte turnover, using PCR and flow cytometry, respectively. We also performed immunohistochemistry for monocyte, macrophage, tight junction, and aging markers of the choroid plexus. We sought to create a choroid plexus epithelial cell model to monitor the effects of inflammatory markers and virus on the tight junctions of the blood-CSF barrier in real-time. We demonstrated that neonates do not develop encephalitis, despite comparable viral load and monocyte turnover, previously established correlates of SIV-encephalitis (SIVE). However, we noted that uninfected adult rhesus macaques have an increase in virus susceptible cells in the brain, SIV-infected adults have a leakier blood-brain barrier than infected neonates, and adults with encephalitis have a greater viral burden in brain tissue compared to adults without encephalitis. In the choroid plexus, we discovered that despite the lack of encephalitis, neonates have an increase in monocytes and macrophages of the choroid plexus, indicating a strong immune response. While our choroid plexus epithelial cell model is still in preliminary stages, initial results are promising. Our work indicates a possible viral threshold needed for the development of encephalitis, and that the blood-brain barrier may play a role in this threshold due to lower levels of virus susceptible cells and a tighter blood brain barrier in neonates. In the choroid plexus, the strong pro- and anti-inflammatory macrophage response seen in neonates may offer an extra layer of protection development of SIVE. Our data also indicates that SIV causes a marked decrease in the expression of klotho, the anti-aging hormone that is produced in high levels in the choroid plexus in the brain. This could potentially explain the premature inflammaging phenotype seen in chronic infections. / 1 / Elizabeth Delery

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Reproduction de : Mémoire de Sage-femme : Médecine : Nantes : 2008. / Bibliogr.

Made available in DSpace on 2014-06-11T19:30:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-12-02Bitstream added on 2014-06-13T20:21:08Z : No. of bitstreams: 1 pitombo_pf_dr_botfm.pdf: 492340 bytes, checksum: 2e00b59ad524d16f61ae2f6959e10700 (MD5) / Universidade Estadual Paulista (UNESP) / As cirurgias de ombro apresentam grande potencial para causar dor pós-operatória. O bloqueio interescalênico do plexo braquial é a técnica anestésica mais utilizada para estes procedimentos. Apesar da eficácia comprovada, alguns efeitos adversos e a extensa paralisia do membro superior são motivos comuns de preocupação e desconforto por parte dos pacientes. Os nervos supraescapular e axilar são os principais responsáveis pelo suprimento sensitivo-motor da articulação. Bloqueio isolado do nervo supraescapular é bem descrito e utilizado, porém, apresenta efetividade variável. Escassas publicações em levantamentos de bancos de dados de saúde (Pubmed) descrevem e atestam a segurança e a eficácia analgésica na associação de bloqueio dos nervos axilar e supraescapular em cirurgias do ombro. Este estudo se propõe a avaliar uma nova técnica anestésica de bloqueio seletivo dos nervos supraescapular e axilar, com relação à qualidade da analgesia e, secundariamente, com relação à intensidade e desconforto do bloqueio motor, complicações e/ou efeitos adversos, satisfação, aceitabilidade e duração da analgesia, comparando-a com a abordagem interescalênica do plexo braquial. 68 pacientes portadores de lesão do manguito rotador e/ou luxação recidivante escapulo-umeral foram divididos em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI) e grupo seletivo (GS), sendo ambas as técnicas realizadas com neuroestimulador. GI foi submetido a bloqueio interescalênico do plexo braquial pela técnica de Winnie, e após haver resposta motora dos músculos deltóide ou bíceps, foram injetados 30 mL de bupivacaína em excesso enantiomérico a 0,33% com epinefrina 1:200000. GS foi submetido a bloqueio dos nervos supraescapular e axilar pelas técnicas de Feigl e Price... / Shoulder surgery carries great potential to cause post-operative pain. Interscalene brachial plexus block is the anaesthetic technique most utilized in these procedures. Despite its proven efficacy, certain adverse effects and the extensive paralysis of the upper limb are common causes of concern and discomfort for the patient. The suprascapular and axillary nerves are the main nerves responsible for the sensory-motor supply of the joint. Isolated suprascapular nerve block is well described and utilized, its effectiveness, however, is variable. In a survey of health databases (Pubmed) few publications describe and attested to the safety and analgesic efficacy in associating suprascapular and axillary nerve block with shoulder surgery. This study aims to assess selective suprascapular and axillary nerve block compared to the interscalene brachial plexus block approach, primarily in terms of analgesic quality and secondly in relation to motor block intensity and discomfort, complications and/or adverse effects, satisfaction, acceptability and analgesic duration. Sixty-eight patients with rotator cuff injury and/or recurrent scapulohumeral dislocation were divided into two groups of 34 each, depending on the technique utilized: interscalene group (IG) and selective group (SG). Both groups were subjected to neurostimulation techniques. The IG was subjected to the interscalene brachial plexus block using the Winnie technique. Following motor response from the deltoid or biceps muscles we injected 30 mL of 0.33% enantiomeric excess bupivacaine with 1:200000 epinephrine. The SG was subjected to the suprascapular and axillary nerve block using the Feigl and Price techniques respectively. Following response from the supraspinatus, and/or infraspinatus (suprascapular nerve) and deltoid (axillary nerve) we injected 15 mL... (Complete abstract click electronic access below)

Orientador: Norma Sueli Pinheiro Módolo / Banca: Eliana Marisa Ganem / Banca: Leandro Gobbo Braz / Banca: Luiz Vicente Garcia / Banca: Tolomeu Artur Assunção Casali / Resumo: As cirurgias de ombro apresentam grande potencial para causar dor pós-operatória. O bloqueio interescalênico do plexo braquial é a técnica anestésica mais utilizada para estes procedimentos. Apesar da eficácia comprovada, alguns efeitos adversos e a extensa paralisia do membro superior são motivos comuns de preocupação e desconforto por parte dos pacientes. Os nervos supraescapular e axilar são os principais responsáveis pelo suprimento sensitivo-motor da articulação. Bloqueio isolado do nervo supraescapular é bem descrito e utilizado, porém, apresenta efetividade variável. Escassas publicações em levantamentos de bancos de dados de saúde (Pubmed) descrevem e atestam a segurança e a eficácia analgésica na associação de bloqueio dos nervos axilar e supraescapular em cirurgias do ombro. Este estudo se propõe a avaliar uma nova técnica anestésica de bloqueio seletivo dos nervos supraescapular e axilar, com relação à qualidade da analgesia e, secundariamente, com relação à intensidade e desconforto do bloqueio motor, complicações e/ou efeitos adversos, satisfação, aceitabilidade e duração da analgesia, comparando-a com a abordagem interescalênica do plexo braquial. 68 pacientes portadores de lesão do manguito rotador e/ou luxação recidivante escapulo-umeral foram divididos em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI) e grupo seletivo (GS), sendo ambas as técnicas realizadas com neuroestimulador. GI foi submetido a bloqueio interescalênico do plexo braquial pela técnica de Winnie, e após haver resposta motora dos músculos deltóide ou bíceps, foram injetados 30 mL de bupivacaína em excesso enantiomérico a 0,33% com epinefrina 1:200000. GS foi submetido a bloqueio dos nervos supraescapular e axilar pelas técnicas de Feigl e Price... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Shoulder surgery carries great potential to cause post-operative pain. Interscalene brachial plexus block is the anaesthetic technique most utilized in these procedures. Despite its proven efficacy, certain adverse effects and the extensive paralysis of the upper limb are common causes of concern and discomfort for the patient. The suprascapular and axillary nerves are the main nerves responsible for the sensory-motor supply of the joint. Isolated suprascapular nerve block is well described and utilized, its effectiveness, however, is variable. In a survey of health databases (Pubmed) few publications describe and attested to the safety and analgesic efficacy in associating suprascapular and axillary nerve block with shoulder surgery. This study aims to assess selective suprascapular and axillary nerve block compared to the interscalene brachial plexus block approach, primarily in terms of analgesic quality and secondly in relation to motor block intensity and discomfort, complications and/or adverse effects, satisfaction, acceptability and analgesic duration. Sixty-eight patients with rotator cuff injury and/or recurrent scapulohumeral dislocation were divided into two groups of 34 each, depending on the technique utilized: interscalene group (IG) and selective group (SG). Both groups were subjected to neurostimulation techniques. The IG was subjected to the interscalene brachial plexus block using the Winnie technique. Following motor response from the deltoid or biceps muscles we injected 30 mL of 0.33% enantiomeric excess bupivacaine with 1:200000 epinephrine. The SG was subjected to the suprascapular and axillary nerve block using the Feigl and Price techniques respectively. Following response from the supraspinatus, and/or infraspinatus (suprascapular nerve) and deltoid (axillary nerve) we injected 15 mL... (Complete abstract click electronic access below) / Doutor

Magister Scientiae (Physiotherapy) - MSc(Physio) / Background: Erb's Palsy results from excessive displacement of the head during birth causing traction on the Brachial plexus. In order to define optimal management for Erb's Palsy, reliable data is needed. Aim: The aim of the study was therefore to determine the profile of and caregiver experiences of infants with Erb' Palsy seen at Groote Schuur Hospital. Method: The study was carried out at Groote Schuur Hospital (GHS) in the Western Cape, South Africa. The study used both quantitative and qualitative approaches. A record review was conducted to collect quantitative data which was retrieved from patient files and captured on a data extraction sheet. A convenient sample of caregivers of children with Erb's Palsy were recruited and interviewed for the qualitative component of the study. Quantitative data was analyzed and presented in tables, figures and qualitative data was analyzed thematic and presented narratively. Ethical approval was obtained from the Ethics Committee at the University of the Western Cape and the University of Cape Town. In addition, permission was obtained from the hospital management. Results: The total sample size for the quantitative part was ninety-six (96) files of children with Erb's Palsy. The mean age of the study sample was 3.8 months. The majority (53.1%) of the participants received a mean of 4.1 (SD=1.7) physiotherapy session. In the qualitative phase eight participants were interviewed. Analysis of qualitative data yielded three themes including "experience of mothers as it relates to Erb's Palsy", "mothers' engagement with health care providers" and "personal and environmental factors". Conclusion: The study within this setting indicated that Erb's Palsy was most common among females. The most common documented forms of physiotherapy techniques provided for children with Erb's Palsy in setting were stretching and strengthening exercises as well as therapeutic massage. exercise. Caring for a child with Erb's Palsy resulted in emotional challenges experienced by the mothers of these children.

Electrophysiological studies of myenteric neurons in the guinea-pig antrum suggest that different neuroactive compounds are involved in synaptic transmission. It is not known what neurotransmitters and neuropeptides are present and to what extent they colocalize. Immunohistochemical stainings were performed on whole-mount preparations of the guinea-pig antrum. Immunoreactivity for neuron-specific enolase was used as a general marker and was set at 100%. There was no overlap between cholinergic and nitrergic neurons, resulting in two separate subpopulations. The presence of choline acetyltransferase immunoreactivity was used to identify the cholinergic subset, which accounted for 56% of the cells. Immunoreactivity for nitric oxide synthase, on the other hand, was displayed in 40.7% of the neurons. Substance-P immunoreactivity was present in 37.4% of the cells and vasoactive intestinal peptide and neuropeptide Y in 21.7% and 28.6%, respectively. Small subsets of neurons had immunoreactivity for serotonin (3.9%), calretinin (6.8%) and calbindin (0.5%). Colocalization studies revealed several subgroups of neurons, containing one or more of the screened markers. Though some similarity is found in the chemical coding of the antrum compared to that of the small intestine and the corpus, remarkable differences can be seen in the occurrence of some subpopulations. Cholinergic neurons are not as predominant as in other parts of the gut, serotonin presence is doubled and some vasointestinal-peptide-positive neurons express substance P. These differences might reflect the highly specialized function of the antrum; however, the exact role of these classes remains to be established.