The effect of medicinal electroapplication of the biologically active agent "Pelamine" from the ELAV-8 device on microcirculation in the rabbit ear

The study was the first to study the effect of pulsed electric currents from the ELAV–8 device and the biologically active substance "Pelamine" on microcirculation in the rabbit ear. It was found that pulsed currents from the ELAV-8 device with a frequency of 100 Hz, as well as the biologically active agent "Pelamine" injected into the rabbit's paravertebral region by means of pulsed currents, have a vasodilatory effect on the vascular bed of the rabbit's ear. At the same time, transdermal administration of the biologically active agent "Pelamine" with the help of currents from the ELAV-8 device has a more prolonged effect on vasodilation. Key words: Microcirculation, rabbit ear, paravertebral region, vascular diameter, "Pelamine", ELAV-8 device.

Histopathological characteristics of cervical extensor tissue in patients with dropped head syndrome

Background To date, the histopathologic characteristics of dropped head syndrome (DHS) have not been reported sufficiently. The present study investigates the histopathology of biopsy specimens from the cervical paravertebral region in patients with DHS. Methods Histopathological parameters were evaluated in biopsy specimens of the cervical paravertebral soft tissue from 15 patients with DHS. Results Among the 15 cases of DHS examined, skeletal muscle was identified in 7 cases, all of which showed necrosis, microvessel proliferation and atrophy. The ligament was identified in 12 cases, 8 of which showed degeneration. The lag time between the onset of symptoms and the performance of a biopsy in all 8 cases, which showed degeneration was over 3 months. Microvessel proliferation in the ligament was observed in 1 of the 4 cases, in which the lag time between the onset of symptoms and the performance of a biopsy was less than 3 months (acute or subacute phase), and in 7 of the 8 cases, in which the lag time between the symptoms and the performance of a biopsy was over 3 months (chronic phase). Chronic inflammation in the ligament was identified in 1 of the 12 cases. Conclusions The identification of necrosis, microvessel proliferation, and atrophy in the skeletal muscle of patients with DHS and the presence of ligament degeneration and microvessel proliferation in the chronic but not acute or subacute phases may suggest that persistent skeletal muscle damage of the cervical paravertebral region causes subsequent ligament damage in patients with DHS.

A new species of wood lizard (Hoplocercinae, Enyalioides) from the Río Huallaga Basin in Central Peru

We report the discovery of a new species of Enyalioides from the premontane forest of the Río Huallaga basin in central Peru. The most similar and phylogenetically related species are E. binzayedi and E. rudolfarndti. However, the new species differs from E. binzayedi (state of character in parentheses) by having dorsal scales strongly keeled on paravertebral region and feebly keeled or smooth elsewhere (prominent medial keel on each dorsal scale), more dorsals in transverse row between dorsolateral crests at midbody 26–39, x̄ = 30.44 (22–31, x̄ = 27.57), and a conspicuous posteromedial black patch in the gular region of males (absent). Contrarily, adult males of the new species and E. rudolfarndti are readily distinguished by having a conspicuous posteromedial black patch in the gular region, absent in E. rudolfarndti, and by lacking a conspicuous orange blotch (faint if present) on the antehumeral region, as in E. rudolfarndti. We also present an updated molecular phylogenetic tree of hoplocercines, which strongly supports both referral of the newly discovered species to Enyalioides and its status as distinct from those recognized previously.

Hemicrania continua secondary to neurogenic paravertebral tumor- a case report

Objectives Hemicrania continua (HC) is one of the trigeminal autonomic cephalalgias (TAC), where sympathetic dysfunction and autonomic dysfunction resulting in parasympathetic over activation with some evidence of sympathetic inhibition have been suggested as probable causes. However, cases of hemicrania continua secondary to sympathetic dysfunction due to neurogenic paravertebral tumor impinging on the sympathetic chain has not been previously reported. In this case, the probability of the sympathetic dysfunction was more likely based on the clinical features and management. Case presentation A 23-year-old female presented with a chief complaint of right unilateral pain in the retro-bulbar, head and facial region for the past three years. An initial MRI of the brain was negative, whereas an MRI of the spine was advised to rule out a cervicogenic origin of the pain. The MRI revealed a well-defined mass lesion within right paravertebral region at T3 indicative of a neurogenic tumor. The patient was diagnosed with probable hemicrania continua secondary to neurogenic tumor impinging on adjacent sympathetic chain. A trial of indomethacin 75 mg/day was advised, which provided complete relief of the headache. The patient was referred to a neurologist for management of the neurogenic tumor. Conclusions Headache disorders may be secondary to pathologies and comprehensive evaluation and accurate diagnosis are essential. Knowledge of neuroanatomy is paramount to understand and explain underlying pathophysiological mechanisms. Multidisciplinary management is essential in complex orofacial cases.

Inflammatory disease of the costotransverse joints: US evaluation in 15 symptomatic patients

The costotransverse joints (CTJs) are small arthrodial joints which articulate with the costal tuberosity on the transverse process of the thoracic vertebrae. CTJs are composed of oval-shaped facets with a major axis, vertical at the upper vertebrae and almost horizontal at the lower vertebrae. This position explains the different movements of the ribs: the cranial ribs move on the sagittal plane and the caudal ribs on the transverse plane. Movements in directions other than these usual CTJ spatial planes can cause inflammation resulting in a stinging pain in the space between the scapula and thoracic spine. We studied 15 subjects with paravertebral pain compatible with CTJ pathology. Mean age was 29 years, 11 females/4 males. In 12 patients, the non-dominant limb was affected. US imaging was carried out using linear 12 MHz and 9 MHz probes. Scanning was performed following the long axis of the rib (transverse plane) and the short axis (sagittal plane). Sagittal scanning is the method of choice for detection of possible joint effusion and comparison with undamaged joints above and below. US identified joint effusion correlating with the site of pain in all patients. Thickening of the posterior costotransverse capsular ligament was detected in six patients mainly affecting the first thoracic vertebrae. Power Doppler showed intraarticular hypervascularization in four patients. US imaging should be performed as a first-line examination in the evaluation of patients with stinging pain in the paravertebral region. US evidence of effusion within the joints is a sure sign of involvement of these structures.

Histopathological characteristics of cervical extensor tissue in patients with dropped head syndrome

Background To date, the histopathologic characteristics of dropped head syndrome (DHS) have not been reported sufficiently. The present study investigates the histopathology of biopsy specimens from the cervical paravertebral region in patients with DHS. Methods Histopathological parameters were evaluated in biopsy specimens of the cervical paravertebral soft tissue from 15 patients with DHS. Results Among the 15 cases of DHS examined, skeletal muscle was identified in 7 cases, all of which showed necrosis, microvessel proliferation and atrophy. The ligament was identified in 12 cases, 8 of which showed degeneration. The lag time between the onset of symptoms and the performance of a biopsy in all 8 cases, which showed degeneration was over 3 months. Microvessel proliferation in the ligament was observed in 1 of the 4 cases, in which the lag time between the onset of symptoms and the performance of a biopsy was less than 3 months (acute or subacute phase), and in 7 of the 8 cases, in which the lag time between the symptoms and the performance of a biopsy was over 3 months (chronic phase). Chronic inflammation in the ligament was identified in 1 of the 12 cases. Conclusions The identification of necrosis, microvessel proliferation, and atrophy in the skeletal muscle of patients with DHS and the presence of ligament degeneration and microvessel proliferation in the chronic but not acute or subacute phases may suggest that persistent skeletal muscle damage of the cervical paravertebral region causes subsequent ligament damage in patients with DHS.

A new medium-sized rupicolous Cnemaspis Strauch, 1887 (Squamata: Gekkonidae) of the C. bangara clade from granite boulder habitats in Krishnagiri, Tamil Nadu, India

We describe a new species of the Cnemaspis bangara clade from a rocky hillock near Kugai Periya Mariamman Temple, Krishnagiri fort, Krishnagiri District of Tamil Nadu, India. Cnemaspis krishnagiriensis sp. nov. can be diagnosed from all other peninsular Indian congeners by its medium body size (maximum SVL 40 mm), heterogeneous dorsal pholidosis, spine-like tubercles absent on flanks; presence of four femoral pores on each thigh separated on either side by nine or 10 poreless scales from three continuous precloacal pores in males; tail with enlarged, strongly keeled, conical tubercles forming four whorls on anterior portion, six tubercles in first whorl, four tubercles in second to fourth whorls, enlarged tubercles restricted to only paravertebral region on rest of the tail; median row of sub-caudals smooth and distinctly enlarged, and a unique colour pattern. The new species can be diagnosed from members of C. bangara clade by the number of dorsal tubercles rows at mid-body, the number of enlarged tubercles in paravertebral rows, the number of ventral scales across belly at mid-body, the number longitudinal ventral scales from mental to cloaca, the number of femoral and precloacal pores and poreless scales separating these series, and subtle colour pattern differences; besides 9.2–17.6 % uncorrected ND2 sequence divergence. Cnemaspis krishnagiriensis sp. nov. is the fourth member of the recently described bangara clade and is the first that is known to be distributed <900 m asl.. The discovery of yet another endemic species of Cnemaspis from lower elevations of the Mysore Plateau once again highlights the need of dedicated systematic sampling to uncover the true diversity of Cnemaspis. We also address a nomenclatural issue related to the recently described Cnemaspis stellapulvis Khandekar, Thackeray & Agarwal.

A Case Report of a Malignant Peripheral Nerve Sheath Tumor of the Paravertebral Region

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a type of connective tissue cancer, which may also have genetic backgrounds. More than half of patients have neurofibromatosis. The treatment of this tumor is a combination of surgery, radiotherapy, and chemotherapy. As usual, the tumor may be present anywhere with several manifestations. Case Presentation: A 4-year old boy presented with sweating and pain in the right forearm that was diagnosed with MPNST developed in the paravertebral region after laboratory and radiographic evaluation. Conclusions: The patient was treated successfully and followed up for one year without any complications.

Clinical experience with paravertebral ozone and synthesis material withdrawal (transpedicular screws) [abstract]

INTRODUCTION: Among 40% and 80% of patients that underwent to back surgery, continue experiencing persistent pain, a condition known as failed back surgery syndrome. Pathology relatively frequent after an intervention, this doesn't mean that the surgery has been badly done , nor badly indicated but the pain has not disappeared. On the other hand the patient with low back pain that does not improve with surgery will show a worse evolutionary process of that which would be the natural course of their low back pain. The treatment for chronic pain due to failed back surgery syndrome continues being a true challenge for the specialist, standing out by its complexity and by its medical implications and the functional limitations that these represent. This syndrome continues climbing positions all over the world and particularly in the industrialized countries, where it ranks as a real epidemic of our civilization. It represents a high cost for society, so much for the medical expenses (visits, treatment, pharmacy) disability and work activity loss , not to mention the suffering of the patients, a sanitary problem of dimensions difficult to calculate, what forces us to search for new treatment strategies with the aim of diminishing or eliminate pain for a long term. A multi center study in Spain reveals that patients with this pathology have spent more than 900 euros in hospital and ambulatory treatments, which more than 58% have been in pharmacology, 25 % in rehabilitation or interventionist therapy and the rest in doctor's fees. According with other results of the study , 35% of patients are on sick leave due to this pathology and 40% need help for daily activities, during and average of 4,5 hours a day . Affecting not only who suffers from it but the people around them. The failed back syndrome symptoms are Lower back pain, persistent or recurring and /or pain in limbs after one or more spine surgeries . Among the possible organic causes are fibrosis epidural, arachnoiditis, mechanical factors due to inserted implants or badly inserted implants, pressure changes induced in the nervous root , structural changes in the spine and lumbar degenerative disease. The paravertebral ozone therapy, thanks to its anti-inflammatory effects around the disc of the nerve or the rachis ganglion, plus its biochemical and enzymatic actions in the area has been used successfully in the secondary lumbar pain treatment to disc hernia, avoiding surgery therefore eliminating the complications associated with it. PURPOSE: With the aim of offering solutions to this problem we could not help but wonder, based on our experience with the ozone in the back pain treatment, what happens when the pain persists after the surgery? Could the ozone plus the synthesis material withdrawal an effective treatment? MATERIALS AND METHODS: From 2013 to 2015, were treated 10 patients who suffered from persistent spine pain after transpedicular screws surgery at lumbar back level. All were asked new x-rays studies and lumbo sacral spine MRI. A clinical evaluation and of the images were made to all the patients. Three patients had 4 transpediculars screws with its bars at L4-L5 and L5-S1 level and 7 patients had 6 screws with their bars at L3-L4, L4-L5 and L5-S1 level. This group of patients were initially treated with paravertebral ozone therapy with the technique already described and they had remission of neuropathic pain referred to lower limbs but had pain persistency of lumbar pain of the mechanic type. The explanation and interpretation of the pain after revising the imaging studies and the clinical evaluation of the patients, was the translation of the shredding strength to a level immediately superior to the fixation level made, since the levels with transpediculars screws behave like an arthrodesis generating mechanical stress in the area. Through Previous conversation and discussion with the patients, they were proposed as a new treatment the withdrawal of all the synthesis material and fill the spaces formerly occupied by the screws with 20cc of bone allograft in crushed chips with blood. The patients were treated 1 month later with paravertebral ozone in a number of 20 sessions of 10 ml in the right paravertebral region and 10 ml in the left paravertebral region with a 23 G x2 3/8 needle . The concentration used was of 10 micrograms/ml, previously injected 1 ml of Cifarcaina at 1% with a 23 G X 1 1/2 in bilateral paravertebral regions. Immediately cryotherapy localized for 5 minutes. They were made with a frequency of 3 sessions per week. RESULTS: The respond of patients to the treatment received, was the total remission of painful symptoms in 6 months average of post-operation follow up . The patients went back to their regular activities without any functional limitation. CONCLUSION: We recommend to the failed back syndrome patients with persistent mechanical pain that after ozone therapy, would consider the extraction of initial fixation systems and to implement paravertebral ozone therapy as a medical tool of great value managing the failed back syndrome improving the quality of life of the patients.

Contralateral Traumatic Hemopneumothorax

Pneumothorax is the entry of air into the virtual space between the visceral and the parietal pleurae, which can occur spontaneously or to a greater extent in a traumatic way. In daily clinical practice it is frequent to find injuries that generate traumatic pneumothorax that is ipsilateral to the lesion. However, there are case reports of contralateral pneumothorax that occurred in procedures such as insertion of pacemakers, or in cases of pneumonectomy. The following is the case report of a 37-year-old man who was admitted with a sharp wound to the right paravertebral region who developed a left haemopneumothorax due to a tangential course of the injuring agent. Adequate clinical judgment was followed, and several imaging studies were carried out, leading to the diagnosis of traumatic pneumothorax that was contralateral to the described injury.