A minimum number of index procedures did not reflect competence in a significant proportion of trainees. A more reliable tool is required for certification.

Background: Practice on Virtual Reality simulators (VRS) have been shown to improve surgical performance. However, VRS are expensive and usually housed in surgical skills centres that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers are inexpensive and can be used anywhere at anytime. This study assesses "take-home" Box Trainers (BT) as an alternative to VRS.Methods: After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT) 25 surgical trainees were randomised to two groups. Trainees were asked to practice 3 basic laparoscopic tasks for 6 weeks (BT group using a "take-home" box trainer; VR group using VRS in clinical skills centres). After the practice period all performed two LC, one on a VRS and one on a BT; (i.e. post-training assessment). VRS provided metrics (total time (TT), number of movements (NOM) instrument tip path length (PL)) and expert video assessment of cholecystectomy in a BT (GOALS score) were recorded. Performance during pre-and post-training assessment was compared.Results: The BT group showed a significant improvement for all VRS metrics (p=0.008) and the efficiency category of GOALS score (p=0.03). Only TT improved in the VRS group and none of the GOALS categories demonstrated a statistically significant improvement after training.

BackgroundSelaginella convoluta (Arn.) Spring (Selaginellaceae), commonly known as “jericó”, is a medicinal plant found in northeastern Brazil. S. convoluta is used in folk medicine as an antidepressant, aphrodisiac, diuretic, analgesic, anti-inflammatory and it is used to combat amenorrhea, coughing and bleeding. This study was performed to evaluate the antinociceptive effects of ethanolic extract from S. convoluta in mice exposed to chemical and thermal models of nociception.MethodsPreliminary phytochemical analysis of the ethanolic extract was performed. The ethanolic extract from Selaginella convoluta (Sc-EtOH) was examined for its intraperitoneal (i.p.) antinociceptive activity at the doses of 100, 200 and 400 mg/kg body weight. Acetic acid-induced writhing, formalin injection and hot plate tests were used to evaluate the antinociceptive activity of Sc-EtOH extract. The rota-rod test was used to evaluate motor coordination.ResultsA preliminary analysis of Sc-EtOH revealed that it contained phenols, steroids, terpenoids and flavonoids. In the acetic acid-induced writhing test, mice treated with Sc-EtOH (100, 200 and 400 mg/kg, i.p.) exhibited reduced writhing (58.46, 75.63 and 82.23%, respectively). Secondly, Sc-EtOH treatment (100, 200 and 400 mg/kg, i.p.) decreased the paw licking time in mice during the first phase of the formalin test (by 44.90, 33.33 and 34.16%, respectively), as well as during the second phase of the test (by 86.44, 56.20 and 94.95%, respectively). Additionally, Sc-EtOH treatment at doses of 200 and 400 mg/kg increased the latency time in the hot plate test after 60 and 90 minutes, respectively. In addition, Sc-EtOH did not impair motor coordination.ConclusionOverall, these results indicate that Sc-EtOH is effective as an analgesic agent in various pain models. The activity of Sc-EtOH is most likely mediated via the inhibition of peripheral mediators and central inhibitory mechanisms. This study supports previous claims of traditional uses for S. convoluta.

The management of the open abdomen can be achieved safely in a district general hospital setting with acceptable outcomes for the non-trauma patients commonly seen in UK practice but it is a resource intensive and expensive undertaking.

Lectin-like oxidized low-density lipoprotein receptor-1 (SR-E1, LOX-1, OLR1) was first discovered as a vascular receptor for modified lipoprotein particles nearly 20 years ago. Since then, in vitro and in vivo studies have demonstrated an association between LOX-1, a soluble form (sLOX-1) and a number of diseases including atherosclerosis, arthritis, hypertension and pre-eclampsia. However, converting such discoveries into tools and drugs for routine clinical use is dependent on translational preclinical and clinical studies but such studies have only begun to emerge in the past decade. In this review, we identify the key clinical applications and corresponding criteria that need to be addressed for the effective use of LOX-1-related probes and molecules for patient benefit in different disease states.

RESUMOIntrodução: A epilepsia é um transtorno neurológico que chega a afetar cerca de 1% da população mundial. Muitas formas de epilepsias não conseguem ser tratadas adequadamente com os fármacos atualmente utilizados na clínica e o desenvolvimento de novas propostas terapêuticas que as tratem, não apenas de forma sintomática, mas em sua gênese, é uma busca constante de novos estudos. Objetivo e Discussão: Nesse sentido, a presente revisão busca fazer um breve levantamento sobre os aspectos científicos mais consistentes acerca do papel dos canais iônicos no desenvolvimento das epilepsias, bem como correlacionar com o estudo de drogas antiepilépticas (DAEs) e mostrar as principais características farmacológicas das DAEs mais utilizadas na clínica atualmente. O papel dos canais de Na + e Ca +2 como alvo de novas DAEs e a participação de outros receptores nesse processo são igualmente discutidos. Conclusão: A compreensão da fisiopatologia das epilepsias e dos possíveis alvos moleculares para novos fármacos é um dos principais focos para o descobrimento de tratamentos mais eficazes e com menos efeitos adversos.Unitermos: epilepsias, canais iônicos, canais de sódio, drogas antiepilépticas. ABSTRACT Ion channels role in epilepsy and considers of the antiepileptic drugs -a short reviewIntroduction: Current epidemiological studies show a prevalence rate for active epilepsy in 0,5-1% of the population. Many forms of epilepsy are intractable to current therapies and there is a pressing need to develop agents and strategies to not only suppress seizures, but also cure epilepsy. Objective and Discussion: The aim of this review was to the recent advances in the physiology of ion channels and other potential molecular targets, in conjunction with new informations on the genetics of idiopathic epilepsies, and current antiepileptic drugs (AEDs). Marketed AEDs predominantly target voltage-gated cation channels (the α-subunits of voltage gated Na + channels and also T-type voltage-gated Ca 2+ channels) or influence GABAmediated inhibition. Conclusion: The growing understanding of the pathophysiology of epilepsy and the structural and functional characterization of the molecular targets provide many opportunities to create improved epilepsy therapies.

Abstract:The chemical composition of the essential oil obtained from the fresh and dried leaves of Lippia gracillis Schauer, Verbenaceae, was analyzed by gas chromatography and gas chromatography/mass spectrometry (GC⁄MS). The yield of essential oil extracted from the dried leaves was significantly higher (p<0.05) when compared to the fresh leaves. Seventeen components were identified. The monoterpenes and sesquiterpene hydrocarbons with 96.26% (w/w) of the total oil obtained of fresh leaves and 86.99% (w/w) of the total oil obtained of dried leaves were the principal compound groups. Thymol was observed dominant (44.42%; 21.3%), followed by carvacrol (22.21%; 21.30%), p-cymene (6.23%; 8.58%), α-pinene (5.65%; 19.42%), β-caryophyllene (5.61%; 3.57%) and other minor constitutes, respectively. Microbiological results obtained by agar diffusion method, micro dilution method and minimum inhibitory concentration (MIC) showed that the essential oil has a relevant antimicrobial activity against E. coli (ATCC 10536), E. coli (Ec 27), Pseudomonas aeruginosa (ATCC 15442), S. aureus (ATCC 12692) and S. aureus (Sa 358), with their inhibition zones ranging from 9 to 13 mm and the MIC ranging from 64 to 512 μg/mL.

Our results show that a dedicated chest tube monitoring clinic is a safe and efficient alternative to formal outpatient clinic review. It can lead to shorter hospital stays and is cost effective.