Comparative Cytogenetics Analysis Among Peckoltia Species (Siluriformes, Loricariidae): Insights on Karyotype Evolution and Biogeography in the Amazon Region

Peckoltia is widely distributed genus in the Amazon and Orinoco basins and the Guiana Shield, containing 18 valid species, and distinct morphotypes still needing description in the scientific literature due to its great taxonomic complexity. This study performed a comparative chromosomal analysis of two undescribed Peckoltia species (Peckoltia sp. 3 Jarumã and Peckoltia sp. 4 Caripetuba) from the Brazilian Amazon using conventional chromosome bands methods and in situ localization of the repetitive DNA (5S and 18S rRNA and U1 snRNA genes and telomeric sequences). Both species presented 2n = 52 but differed in their karyotype formula, probably due to inversions or translocations. The nucleolus organizer regions (NORs) showed distal location on a probably homeologous submetacentric pair in both species, besides an extra signal in a subtelocentric chromosome in Peckoltia sp. 4 Caripetuba. Heterochromatin occurred in large blocks, with different distributions in the species. The mapping of the 18S and 5S rDNA, and U1 snDNA showed differences in locations and number of sites. No interstitial telomeric sites were detected using the (TTAGGG)n probes. Despite 2n conservationism in Peckoltia species, the results showed variation in karyotype formulas, chromosomal bands, and locations of repetitive sites, demonstrating great chromosomal diversity. A proposal for Peckoltia karyotype evolution was inferred in this study based on the diversity of location and number of chromosomal markers analyzed. A comparative analysis with other Peckoltia karyotypes described in the literature, their biogeography patterns, and molecular phylogeny led to the hypothesis that the derived karyotype was raised in the left bank of the Amazon River.

Visual Capture of a Tactile Sensation is Influenced by Repeated, Structured Exposure of a Visual Stimulus in Virtual Reality

Phantom limb pain is commonly known as a neurological condition, where an amputee will continue to feel a limb that is no longer present in a painful fashion. Virtual mirror therapy (VMT) has been suggested as a method for alleviating phantom limb pain. The inclusion of tactile sensation in VMT has shown to be beneficial; however, delivering a tactile sensation to a phantom limb, without the use of invasive procedures, can be difficult. The current approach for transferring a tactile sensation to a phantom limb is called visual capture. The ability to establish visual capture has been demonstrated in VMT applications. However, there is little research into whether an established visual capture effect can be relocated to a more distal location for phantom limb pain management. This paper investigates whether a passive vibrotactile sensation can be moved to a distal location from its veridical location using a series of distally located lights presented in either a random or a structured fashion. Eight non-amputee participants were tasked with localising a static tactile sensation on a virtual arm. These vibrotactile sensations were presented simultaneously with a visual light stimulus, either co-located or located distally at three different locations. Findings show that a tactile sensation without a visual stimulus was difficult for participants to localise; however, when a visual stimulus was added, they were better able to locate the veridical tactile position. The structured group exhibited a larger range of tactile relocation responses than the random group. However, this result was unreliable, with the majority of the responses situated at the vibrotactile actuator. There was a significant difference between the random and structured group’s ability to retain a visual capture at the veridical vibrotactile location when the lights were located distally. The random group did not express a visual capture response when the lights were presented distally while the structured group did, suggesting the structured group developed a more robust association between the visual stimulus and the vibrotactile stimulus. Findings may be of use where increasing tactile acuity without significant alteration of a veridical location is a desired therapeutic outcome.

Distal Transradial “Snuffbox” Approach

The distal radial or “snuffbox” approach is a modification of the traditional radial approach that uses a more distal location of the radial artery for puncture. The radial artery at this location is beyond the palmer arch thus puncturing has a theoretically lower risk of hand or thumb ischemia. In addition, the hand is positioned in the neutral position so it is more comfortable for the patient. Finally, the compression times are shorter so the patient can be discharged earlier after diagnostic procedures. This was originally an interventional cardiology innovation because of the frequent use of left radial access in interventional cardiology, but the approach has benefits for right radial access in neurointervention as well. The patient positioning and technical nuances of the snuffbox approach are reviewed.

Management of esophagopulmonary fistula after gunshot – case report and literature review

Introduction: An esophagorespiratory fistula is a pathological communication between the esophagus and respiratory tract. The most common type is a communication with the trachea, while the least common is with lung parenchyma. These fistulas are classified as congenital or acquired while etiology is benign or malignant. Aim: We present a case report of a patient who developed esophagopulmonary fistula several years after gunshot in the right side of the chest. Additionally, we discuss the treatment methods and compare the outcomes with other case studies and analyses from world literature. Case study: A 48-year-old male patient was admitted to the Department of Thoracic Surgery and Transplantation due to bleeding from the respiratory tract. Radiological images revealed a fistula between the esophagus and right lung parenchyma. Furthermore, bronchiectasis in the right lung was found. Tissues of the fistula, right middle and lower lobes were resected. The patient required renewed hospitalization due to pleural empyema. Furthermore, recurrence of the fistula was observed. Results and discussion: Treatment of esophagorespiratory fistula depends on the etiology and location of the pathological communication. Surgery provides the best possible outcomes in patients with a benign fistula. Proximal location requires cervicotomy, while distal location a thoracotomy. In addition, a distal fistula may damage lung parenchyma. Conclusions: A long-term distal fistula may require pulmonary resection, but early diagnosis would help to avoid more invasive procedures. As symptoms are non-specific and benign etiology is not frequent, thorough examination in search of malignancy is required.

The Area of Pressure-Induced Referred Pain Is Dependent on the Intensity of the Suprathreshold Stimulus: An Explorative Study

Objective To investigate the pain referral area (number of pixels) and extent (vector length) as elicited from increasing intensities of pressure-induced pain at the shoulder. Design Cross-sectional design. Setting Clinical laboratory setting. Participants Twenty-two healthy men and women participated in two experimental sessions. Methods Delayed onset of muscle soreness (DOMS) was induced in the dominant shoulder and assessed 24 hours later. Participants rated the level of DOMS on a 6-point Likert scale. Four different intensities (pressure pain threshold [PPT]+20%, PPT+30%, PPT+40%, and PPT+50%) were applied to the infraspinatus in a randomized, balanced fashion for 60 seconds from low to high intensity or vice versa. The resulting location, area, and extent of referred pain as drawn by the participants on a digital body chart were extracted and expressed in pixels. The extent of pain was defined as the vector length extending from the ipsilateral earlobe to the most distal location of the pain. Results The referred pain area from PPT+20% was smaller than PPT+30%, PPT+40%, and PPT+50%. The extent of referred pain did not differ between the pressure pain intensities. Conclusions Pressure intensity at PPT+30%, but no more, produces the greatest referred pain area as compared with the traditional pressure intensity of PPT+20%. Thus, the intensity of PPT+30% may be ideal for exploring the mechanisms of referred pain. The extent of the pain represents an independent expression of the intensity of the provoking stimulus and may be more closely related to the location of the stimulus.

Towards Management of Residual Limb Volume: Monitoring the Prosthetic Interface Pressure to Detect Volume Fluctuations—A Feasibility Study

(1) Motivation: Variations in the volume of the residual limb negatively impact various aspects of prosthesis use including the prosthetic socket fit. Although volume adjustment systems mitigate corresponding fit problems to some extent, some users still find the management of these systems challenging. With the ultimate goal of creating a feedback system that assists users with the management of their volume adjustment systems, this study demonstrates the feasibility of detecting variations in the volume of the residual limb. (2) Methods: Measurements of the interface force at the bottom of the prosthetic socket were used as indicators of variations in the volume of the residual limb. Force sensitive resistors (FSRs) were placed at the bottom of participants’ prosthetic sockets to monitor the interface limb–socket force as participants walked on a flat surface. Two phases of experiments were carried out: The first phase considered variations simulated by three prosthetic sock plies, established the feasibility of detecting variations in the volume of the limb based on the interface force, and further determined the locations at which the interface force could be used to detect variations in the limb’s volume. Having validated the effectiveness of the proposed method in the first phase, the second phase was carried out to determine the smallest detectable variation of the limb’s volume using the proposed method. In this phase, variations simulated by one and two prosthetic sock plies were considered. Four and three volunteers with transtibial amputations participated in the first and the second phases, respectively. (3) Results: Results of the first phase showed that an increase in the volume of the limb resulted in a decrease in the force measured at the distal location of the prosthetic sockets of all participants; however, the smallest detected variation could not be statistically confirmed.

The Influence of Aortic Wall Elasticity on the False Lumen in Aortic Dissection: An In Vitro Study

Background: Hemodynamics, dissection morphology, and aortic wall elasticity have a major influence on the pressure in the false lumen. In contrast to aortic wall elasticity, the influence of hemodynamics and dissection morphology have been investigated often in multiple in vitro and ex vivo studies. The purpose of this study was to evaluate the influence of aortic wall elasticity on the diameter and pressure of the false lumen in aortic dissection. Methods: An artificial dissection was created in 3 ex vivo porcine aortas. The aorta models were consecutively positioned in a validated in vitro circulatory system with physiological pulsatile flow. Each model was imaged with ultrasound on 4 positions along the aorta and the dissection. At these 4 locations, pressure measurement was also performed in the true and false lumen with an arterial catheter. After baseline experiments, the aortic wall elasticity was adjusted with silicon and the experiments were repeated. Results: The aortic wall elasticity was decreased in all 3 models after siliconizing. In all 3 siliconized models, the diameters of the true and false lumen increased at proximal, mid, and distal location, while the mean arterial pressure did not significantly change. Conclusions: In this in vitro study, we showed that aortic wall elasticity is an important parameter altering the false lumen. An aortic wall with reduced elasticity results in an increased false lumen diameter in the mid and distal part of the false lumen. These results can only be transferred to corresponding clinical situations to a limited extent.

Diagnostic Ultrasound Detection of Changes in Femoral Muscle Mass Recovery after Tibial Plateau Levelling Osteotomy in Dogs

Objective The goal of this study was to develop a clinically feasible ultrasound (US) protocol that can detect changes in thigh muscle mass in dogs after stifle surgery. The primary aim of this study was to compare previously described US measurement locations of the canine thigh for detecting changes in muscle mass in dogs recovering from tibial plateau levelling osteotomy (TPLO). Study Design This was a prospective, exploratory pilot study. Adult dogs (n = 7) undergoing pet-owner elected TPLO were enrolled. Twelve different US measurements were performed in triplicate by a single experienced observer. Measurements were performed at 0, 2, 4 and 8 weeks after surgery at a proximal and distal location along the femur. Data from all available time points and locations were analysed for the main effect of time within modalities. Results A total of 1,008 US measurements were performed. Measurements of the transverse sectional area of the rectus femoris muscle detected significant (p ≤ 0.05) muscle loss between weeks 0 and 2 at the lateral and medial aspects of the distal location (19% and 15% respectively). Measurements of the thigh muscle thickness were significantly (p < 0.01) increased between 2nd- and 8th- week time points at the lateral aspect of the proximal location (26%). Conclusion The proximal femoral location, measured from the lateral aspect, appears to be the most suitable US measurement for detecting increases in femoral muscle mass in dogs recovering from TPLO. The provided pilot data suggest that further research evaluating this outcome measure is indicated.