RESUMO Neste estudo, objetiva-se avaliar a influência do enxerto omental livre sem microanastomose vascular (FOGWVA) na cicatrização cutânea experimental em coelhos. Por meio de celiotomia, foi coletado fragmento omental livre de 9cm2 em 36 coelhos, com posterior produção de ferida cutânea profunda linear na linha média dorsal medindo 3cm. Apenas em 18 animais, do grupo omento (GO), o fragmento omental coletado foi fixado no subcutâneo com seis pontos simples interrompidos utilizando fio poliamida 4-0. Em ambos os grupos, tratado e controle (GC), efetuou-se dermorrafia intradérmica com fio poliamida 4-0. As feridas experimentais foram avaliadas clinicamente todos os dias. Cada um dos grupos foi dividido em três subgrupos, com seis animais cada, para avaliação anatomopatológica no sétimo, 14º e 28o dias de pós-operatório. Nas feridas do GO, destacou-se aumento de volume (ativação do omento) a partir do segundo dia pós-operatório. A macroscopia evidenciou reação orgânica ao enxerto no dia sete, com redução progressiva, além de neovascularização em direção ao enxerto omental. Intensa presença de células mononucleares e deposição de colágeno no dia sete demonstraram acelerado processo de remodelamento e reparo tecidual. O FOGWVA manteve-se viável e influenciou positivamente na cicatrização cutânea de feridas experimentais em coelhos.

ABSTRACT This study aims to evaluate the influence of free omental graft without vascular microanastomosis (FOGWVA) on experimental skin healing in rabbits. Through celiotomy, a 9cm2 free omental fragment was collected in 36 rabbits, with subsequent production of a deep linear cutaneous wound in the dorsal midline measuring 3cm. In 18 animals from the omental group (OG), the omental fragment collected was fixed subcutaneously with six simple interrupted stitches using a 4-0 polyamide thread. In both treated and control (CG) groups, intradermal dermorrhaphy was performed with 4-0 polyamide thread. Experimental wounds were clinically evaluated every day. Each of the groups was divided into three subgroups of 6 animals each for histopathological evaluation on the 7th, 14th, and 28th days of postoperative. In the OG wounds, the increase in volume (omentum activation) stood out after the second postoperative day. Macroscopy showed an organic reaction to the graft on day 7, with a progressive reduction in addition to neovascularization towards the omental graft. The intense presence of mononuclear cells and collagen deposition on day 7 demonstrated an accelerated process of tissue remodeling and repair. The FOGWVA omental graft remained viable and positively influenced the cutaneous healing of the experimental wounds in rabbits.

The objective of this prospective study was to determine the plasma levels of nitric oxide (NO) in women with chronic pelvic pain secondary to endometriosis (n=24) and abdominal myofascial pain syndrome (n=16). NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM) were lower in healthy volunteers (47.0±12.7) than in women with myofascial pain (64.2±5.0, P=0.01) or endometriosis (99.5±12.9, P<0.0001). After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002). A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85), P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14), P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.

We have shown that myocardial dysfunction induced by food restriction is related to calcium handling. Although cardiac function is depressed in food-restricted animals, there is limited information about the molecular mechanisms that lead to this abnormality. The present study evaluated the effects of food restriction on calcium cycling, focusing on sarcoplasmic Ca2+-ATPase (SERCA2), phospholamban (PLB), and ryanodine channel (RYR2) mRNA expressions in rat myocardium. Male Wistar-Kyoto rats, 60 days old, were submitted to ad libitum feeding (control rats) or 50% diet restriction for 90 days. The levels of left ventricle SERCA2, PLB, and RYR2 were measured using semi-quantitative RT-PCR. Body and ventricular weights were reduced in 50% food-restricted animals. RYR2 mRNA was significantly decreased in the left ventricle of the food-restricted group (control = 5.92 ± 0.48 vs food-restricted group = 4.84 ± 0.33, P < 0.01). The levels of SERCA2 and PLB mRNA were similar between groups (control = 8.38 ± 0.44 vs food-restricted group = 7.96 ± 0.45, and control = 1.52 ± 0.06 vs food-restricted group = 1.53 ± 0.10, respectively). Down-regulation of RYR2 mRNA expressions suggests that chronic food restriction promotes abnormalities in sarcoplasmic reticulum Ca2+ release.

We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program) were attended. This population was predominantly female (68.5%), with a mean (± SD) age of 28.6 ± 4.42 years, not married (71.9%). Most of the subjects were professionals who had not graduated from the Federal University (78.1%). The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44%) causing 4.5% of the subjects to be temporarily suspended from their graduate studies; 19.2% reported that they had used psychotropic drugs within the previous month, and 47.9% referred to sleep disturbances. Suicidal tendencies were mentioned by 18% of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.

OBJETIVO: Analisar retrospectivamente a evolução de pacientes portadores de hifema decorrente de trauma ocular contuso quanto à acuidade visual inicial e final, aumento da pressão intra-ocular, ocorrência de ressangramento, tempo de absorção do coágulo, e necessidade de cirurgia. MÉTODOS: Foram avaliados 54 pacientes com idade superior a 15 anos, com diagnóstico de traumatismo ocular fechado, assistidos no Pronto Socorro de Oftalmologia do Hospital São Paulo, no período de dezembro de 2000 a janeiro de 2002. O hifema foi classificado em cinco subgrupos: microscópico; grau I; grau II; grau III e grau IV (hifema total). Os pacientes foram divididos em dois grupos, de acordo com o comprometimento ou não do segmento posterior, para comparação dos dados pelo teste de Mann-Whitney e o teste exato de Fisher. A acuidade visual final foi avaliada por meio de regressão linear múltipla. RESULTADOS: Noventa e um por cento dos pacientes eram do sexo masculino, com idade média de 32 anos. Na admissão, 37% dos pacientes apresentaram PIO superior a 24 mmHg. O ressangramento ocorreu em 8% deles. Durante a evolução, seis pacientes necessitaram de intervenção cirúrgica. No grupo I (sem lesões de segmento posterior) houve melhora estatisticamente significante da AV (p<0,001), o que não foi observado no grupo II (p=0,4772). CONCLUSÃO: A classificação do hifema permite avaliação da gravidade da lesão, prognóstico e conduta. A baixa de visão persistente correlacionou-se principalmente ao comprometimento do seguimento posterior e à acuidade visual na admissão. O sucesso do tratamento depende da identificação dos fatores de risco, medicação apropriada e indicação cirúrgica precisa.

PURPOSE: To evaluate the evolution of the patients with hyphema resulting from blunt ocular trauma associated with initial and final visual acuity, elevated intraocular pressure, rebleeding, clot absorption and surgical intervention. METHODS: Fifty-four patients aged more than fifteen years, with blunt ocular trauma attended on the Ophthalmology Emergency Room of São Paulo Hospital were studied, between December 2000 to January 2002. The hyphema was classified in to five groups: microscopic; grade I; grade II; grade III; and grade IV (total hyphema). The patients were divided into two groups according to the involvement or not of the posterior segment. The data were compared by Mann-Whitney and the exact Fisher test and the final visual acuity was evaluated by multiple linear regression. RESULTS: Ninety-one percent of the patients were men with an average age of thirty two years. At admission, 37% of patients showed intraocular pressure more than 24 mmHg. During the evolution, six patients required surgical intervention. Rebleeding occurred in 8% of the cases. In Group 1 (no lesions in the posterior segment) a better finally V.A. was statistically significant (p<0.001), a fact not observed in Group 2 (p<0.4772). CONCLUSIONS: Hyphema classification allows to evaluate the severity of damages, prognosis and management. The treatment still remains controversial. The final low visual acuity occurs more commonly associated with posterior segment injuries, and V.A. on admission. The successful treatment depends on identification of risk factors, appropriate medications and precise surgery indication.