Abstract Hematuria is a common condition that can range from an incidental finding to a significant symptom requiring immediate treatment. It can be associated with a variety of conditions, but once urinary tract and renal disease have been excluded, vascular causes, including nutcracker syndrome (NCS), should be considered. NCS is a diagnosis of exclusion, and Doppler ultrasound is recommended as first-line investigation. Hematuria associated with NCS is an underestimated entity, which the authors aim to raise awareness of with this case.

Resumo A hematúria é uma condição comum que pode ser assintomática ou bastante sintomática e com necessidade de tratamento imediato. Pode estar associada a várias doenças, mas quando a patologia renal e urinária são excluídas, deve ser considerada a patologia vascular, nomeadamente a síndrome de quebra-nozes. Esta síndrome representa um diagnóstico de exclusão, sendo a ecografia com Doppler o exame complementar de diagnóstico de primeira linha. A hematúria associada à síndrome de quebra-nozes é uma entidade subestimada, para o qual os autores pretendem alertar com o presente caso clínico.

ABSTRACT PURPOSE: To evaluate the effects of levobupivacaine on neuromuscular transmission and neuromuscular blockade produced by pancuronium in vitro. METHODS: Thirty rats were distributed into groups (n = 5) according to the drug used alone or in combination: Group I - levobupivacaine (5 µg.mL-1); Group II - pancuronium (2 µg.mL-1); Group III - pancuronium (2 µg.mL-1) + levobupivacaine (5µg.mL-1). The following parameters were evaluated: 1) amplitude of diaphragmatic response to indirect stimulation, before and 60 minutes after the addition of levobupivacaine and pancuronium alone, and after the addition of levobupivacaine combined with pancuronium; 2) membrane potentials (MP) and miniature endplate potentials (MEPP). RESULTS: Levobupivacaine alone did not alter the amplitude of muscle response and MP. In preparations previoulsy exposed to levobupivacaine, the block with pancuronium was significantly denser (90.2 ± 15.2%), showing a significant difference (p=0.031) in comparison to the block produced by pancuronium alone (48.9% ± 9.8%). There was a decrease in the frequency and amplitude of MEPPs. CONCLUSION: Levobupivacaine potentiated the neuromuscular blockade produced by pancuronium, confirming a presynaptic action by a decrease in miniature endplate potentials.

OBJETIVO: Validar a versão em português do Questionário de Hábitos de Sono das Crianças (CSHQ-PT) e compará-la às versões de outros países. MÉTODOS: O questionário foi anteriormente adaptado para o português de acordo com as diretrizes internacionais. 500 questionários foram entregues aos pais de uma amostra populacional portuguesa de crianças com idade entre 2 e 10 anos. 370 (74%) questionários válidos foram obtidos, 55 crianças apresentaram critérios de exclusão e 315 foram aceitas no estudo de validação. RESULTADOS: A consistência interna do CSHQ-PT (α de Cronbach) foi de 0,78 para a escala completa e variou de 0,44 a 0,74 nas subescalas. A confiabilidade teste-reteste das subescalas (correlações de Pearson, n = 58) variou de 0,59 a 0,85. Nossos dados não foram compatíveis com a estrutura original de 8 domínios na Análise Fatorial Confirmatória, porém a Análise Fatorial Exploratória extraiu 5 fatores que correspondem a subescalas do CSHQ. CONCLUSÃO: O CSHQ-PT apresentou propriedades psicométricas comparáveis às versões de outros países e adequadas para triagem de problemas do sono em crianças de 2 a 10 anos de idade.

OBJECTIVE: To validate the Portuguese version of the Children's Sleep Habits Questionnaire (CSHQ-PT) and compare it to the versions from other countries. METHODS: The questionnaire was previously adapted to the Portuguese language according to international guidelines. 500 questionnaires were delivered to the parents of a Portuguese community sample of children aged 2 to 10 years old. 370 (74%) valid questionnaires were obtained, 55 children met exclusion criteria and 315 entered in the validation study. RESULTS: The CSHQ-PT internal consistency (Cronbach's α) was 0.78 for the total scale and ranged from 0.44 to 0.74 for subscales. The test-retest reliability for subscales (Pearson's cor-relations, n=58) ranged from 0.59 to 0.85. Our data did not adjust to the original 8 domains structure in Confirmatory Factor Analysis but the Exploratory Factor Analysis extracted 5 factors that have correspondence to CSHQ subscales. CONCLUSION: The CSHQ-PT evidenced psychometric properties that are comparable to the versions from other countries and adequate for the screening of sleep disturbances in children from 2 to 10 years old.

PURPOSE: To assess the probable actions of ropivacaine, 50% enantiomeric excess bupivacaine mixture (S75-R25) and levobupivacaine on neuromuscular transmission in vitro. METHODS: Thirty rats were distributed into groups (n=5) according to the drug used: ropivacaine, bupivacaine (S75-R25) and levobupivacaine. The concentration used for the three local anesthetics (LA) was 5 µg.mL.-1The following parameters were evaluated: 1) LA effects on membrane potential (MP) and miniature end plate potential (MEPP). A chick biventer cervicis preparation was also used to evaluate LA effects on the contracture response to acetylcholine. RESULTS: LA did not alter MP values and decreased the frequency and amplitude of MEPP. In a chick biventer cervicis preparation, bupivacaine (S75-R25) and levobupivacaine decreased the contracture response to acetylcholine with statistical significance, in comparison to ropivacaine. CONCLUSIONS: In the concentrations used, levobupivacaine and bupivacaine (S75-R25) exhibited presynaptic and postsynaptic actions evidenced by alterations in miniature end plate potentials and contracture response to acetylcholine. Ropivacaine only had a presynaptic action.