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RESUMO Introdução: o câncer de mama é a neoplasia maligna mais comum em mulheres no mundo. A cirurgia tem sido o tratamento tradicional e, geralmente consiste em mastectomia com linfadenectomia, podendo causar dor pós-operatória. Por isso, buscamos estudar técnicas anestésicas regionais que possam minimizar esse efeito, como o bloqueio interpeitoral (PEC). Métodos: estudo controlado randomizado com 82 pacientes com câncer de mama submetidos à mastectomia com linfadenectomia de Janeiro de 2020 a Outubro de 2021, em hospital oncológico. Intervenções: dois grupos randomizados (controle - anestesia geral exclusiva e grupo PECS - anestesia geral e bloqueio PEC com levobupivacaína/ropivacaína). Aplicou-se um questionário com Escala Visual Analógica da dor 24h pós-cirurgia. Utilizamos os testes de Shapiro-Wilk, Mann-Whitney e Quiquadrado e analisamos os dados em R versão 4.0.0. Estudo registrado em Ensaios Clínicos Brasileiros (REBec). Resultados: no grupo PEC, 50% não apresentava dor 24 horas após a cirurgia enquanto no grupo controle, 42,86% negava quadro álgico. A maioria que apresentou dor classificou-a como dor leve (EVA de 1 a 3) - (42,50%) grupo PEC e (40,48%) controle (p=0,28). Apenas 17,50% consumiram opioides no grupo PEC, semelhante ao grupo controle com 21,43%. (p=0,65), (17,50%) grupo PEC e (21,43%) grupo controle (p=0,65). Houve baixo índice de complicações como PONV (náuseas, vômitos, cefaleia) em ambos os grupos. Na análise de subgrupo, não houve diferença estatística entre os grupos que usaram Levobupivacaína ou Ropivacaína quanto a dor pós-operatória e o consumo de opioides. Discussão: o grupo estudado apresentou baixa taxa de dor no pós-operatório e isso influenciou na análise estatística. Não houve diferença estatística quanto a dor pós-operatória entre grupos. Conclusão: não foi possível demonstrar melhores resultados com a associação do bloqueio PEC com analgesia intravenosa total. São necessários novos estudos para avaliar a eficácia do bloqueio anestésico no intraoperatório e pós-operatório.

ABSTRACT Objective: Breast cancer is the most common malignant neoplasm in women worldwide. Surgery has been traditional treatment and, generally, it´s mastectomy with lymphadenectomy, that can causes postoperative pain. Therefore, we seek to study regional anesthesic techniques that can minimize this effect, such as the interpectoral block (PECS). Methods: randomized controlled study with 82 patients with breast cancer who underwent mastectomy with lymphadenectomy from January 2020 to October 2021 in oncology hospital. Interventions: two randomized groups (control - exclusive general anesthesia and PECS group - received PECS block with levobupivacaine/ropivacaine and general anesthesia). We applied a questionnaire with Numeric Rating Scale for pain 24h after surgery. We used Shapiro-Wilk, Mann-Whitney and Chi-square tests, and analyzed the data in R version 4.0.0 (ReBEC). Results: in the PECS group, 50% were pain-free 24h after surgery and in the control group it was 42.86%. The majority who presented pain classified it as mild pain (VAS from 1 to 3) - (42.50%) PECS group and (40.48%) control group (p=0.28). Only 17.50% consumed opioids in the PECS group, similar to the control group with 21.43%. (p=0.65). There was a low rate of complications such as PONV in both groups. In the subgroup analysis, there was no statistical difference between the groups that used levobupivacaine or ropivacaine regarding postoperative pain and opioid consumption. Discussion: the studied group had a low rate of pain in the postoperative period and it influenced the statistical analysis. There wasn´t difference in postoperative pain in groups. Conclusion: was not possible to demonstrate better results with the association of the PECS block with total intravenous analgesia. Need further studies to assess the efficacy of the nerve block.

https://doi.org/10.1590/0100-6991e-20223366-en

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density
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Nunes, Frederico Arthur Pereira

; Farias, Maria Lucia Fleiuss de

; Oliveira, Felipe Peres

; Vieira Neto, Leonardo

; Lima, Luis Felipe Cardoso

; Paranhos Neto, Francisco de Paula

; Mendonça, Laura Maria Carvalho de

; Madeira, Miguel

Archives of Endocrinology and Metabolism

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aug 2021, Volume 65 N. 4 Pages 505 - 511

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

https://doi.org/10.20945/2359-3997000000385 256 downloads

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Abstract: En | Text: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

Avaliação da independência funcional e percepção da qualidade de vida de idosas praticantes de atividades físicas: um estudo piloto
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Santos, Jorge Rollemberg dos

; Costa, Frederico Barros

; Santos, Jymmys Lopes dos

; Oliveira, Andrêssa Nascimento de

; Lima Júnior, Cássio Murilo Almeida

; Silva Neto, Antenor de Oliveira

; Silva, Dilton dos Santos

; Souza, Lúcio Marques Vieira

Motricidade

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sep 2020, Volume 16 Suppl. 1 Pages 64 - 71

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Com o crescimento progressivo da população idosa mundialmente e especificamente no Brasil, há uma necessidade de profissionais competentes que visem trabalhos direcionados para este público com o intuito de obter um diagnóstico precoce e fazer as intervenções necessárias delineando metas que venham a proporcionar autonomia funcional e uma melhor qualidade de vida para esse público alvo com a atividade física. Este trabalho tem como objetivo mensurar a importância da prática de atividade física e a sua influência na qualidade de vida diária de pessoas idosas praticantes de atividades físicas. O presente trabalho caracteriza-se como estudo piloto de caráter exploratório, e foi elaborado a partir de dois questionários: o WHOQOL-bref composto por 26 questões, onde 22% dos idosas apresentaram dor ou desconforto, 45% dos avaliadas fazem o uso contínuo de medicamentos e 20% apresentaram sentimentos negativos, e o índice de Barthel por 10 questões, onde os domínios psicológicos (85,45) e ambiente (80,00) tiveram maior destaque em relação ao físico (79,64) e relações sociais (71,67). As amostras foram colhidas de um grupo de 09 idosas, entre 60 e 80 anos. Com base nos resultados obtidos fica destacado que as idosas avaliadas apresentam uma independência funcional excelente e consequentemente aparentam ter uma boa qualidade de vida.

ABSTRACT With the progressive growth of the elderly population worldwide and specifically in Brazil, there is a need for competent professionals that aim for this public in order to obtain an early diagnosis and make the necessary interventions outlining goals that will provide functional autonomy and a better quality of life for this population through physical activity. This research aims to measure the importance of physical activity and its influence on the quality of daily life of elderly people who practice physical activities. The present work is characterized as a pilot study with an exploratory profile and was developed from two questionnaires: The WHO-QOL-bref, composed of 26 questions, where 22% of the elderly presented pain or discomfort, 45% make continuous use of medicines, and 20% presented negative feelings; and the Barthel Index, composed of 10 questions, where psychological (85,45) and environmental (80,00) domains had a greater highlight when compared to physical (79,64) and social relations (71,67) domains. The samples were collected from a group of 09 elderly women, between 60 and 80 years old. Based on the obtained results, it is clear that the evaluated elderly presented excellent functional independence and, as a consequence, appear to have a good quality of life.

https://doi.org/10.6063/motricidade.22280 97 downloads

Orofacial antinociceptive activity and anchorage molecular mechanism in silico of geraniol
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COSTA, Tereza Karla Vieira Lopes da

; BARROS, Mariana Silva

; BRAGA, Renan Marrinho

; VIANA, Jéssika de Oliveira

; SOUSA, Frederico Barbosa de

; SCOTTI, Luciana

; SCOTTI, Marcus Tullius

; BATISTA, André Ulisses Dantas

; ALMEIDA, Reinaldo Nóbrega de

; CASTRO, Ricardo Dias de

Brazilian Oral Research

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2020, Volume 34 elocation e094

Abstract: En | Text: En | PDF: En

Abstract We aimed to evaluate the orofacial antinociceptive effect of geraniol in mice and its molecular anchorage mechanism. Seven mice per group (probabilistic sample) were treated with geraniol (12.5, 25 and 50 mg/kg, i.p.), morphine (6 mg/kg, i.p.) and vehicle (saline + Tween 80 at 0.2%, i.p.) 30 minutes prior to the beginning of the experiment. Injecting glutamate (25 μM), capsaicin (2.5 μg) and formalin (2%) into the right upper lip (perinasal) of the mouse induced nociception. Behavioral analysis of the animals considered the friction time (in seconds) of the mentioned region using hind or front paws by a researcher blinded to the treatment groups. The statistical analysis was performed blindly, considering α = 5%. The results showed that in the glutamate and capsaicin tests, concentrations of 25 mg/kg and 50 mg/kg presented antinociceptive activity (p < 0.005, power> 80%). In the formalin test, geraniol was able to reduce nociception at a concentration of 50 mg/kg (p < 0.005, power> 80%). In the molecular anchorage study, high values of binding between the evaluated substance and receptors of glutamate were observed (metabotropic glutamate receptor, -87.8501 Kcal/mol; N-methyl-D-aspartate, -86.4451 Kcal/mol; α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, -85.6755 Kcal/mol). Geraniol presented orofacial antinociceptive activity, probably by interacting with glutamate-related receptors.

https://doi.org/10.1590/1807-3107bor-2020.vol34.0094 467 downloads

Starch digestibility and sensory acceptance of gluten free foods prepared with tannin sorghum flour
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Soares, Raquel Rainier Alves

; Vasconcelos, Christiane Mileib

; Oliveira, Mariane Verônica de

; Minim, Valéria Paula Rodrigues

; Queiroz, Valéria Aparecida Vieira

; Barros, Frederico

Pesquisa Agropecuária Brasileira

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2019, Volume 54 elocation e01205

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: O objetivo deste trabalho foi elaborar biscoitos tipo “cookies” sem glúten e pastéis com farinha de sorgo (Sorghum bicolor) rica em taninos, avaliar a digestibilidade in vitro de seus amidos e verificar como o conhecimento sobre os benefícios do sorgo pode contribuir para a aceitabilidade sensorial de ambos os produtos. Foram determinadas as concentrações de amido rapidamente digerível, amido lentamente digerível e amido resistente. A aceitação sensorial foi avaliada em duas sessões: uma sem informações sobre os benefícios do sorgo para a saúde humana; e outra em que essas informações foram divulgadas. As concentrações de amido resistente e de amido lentamente digerível dos biscoitos (5,07 e 16,22%, respectivamente) foram aproximadamente o dobro daquelas dos pastéis (2,54 e 8,89%, respectivamente), enquanto o oposto foi observado para a concentração de amido rapidamente digerível (9,89 e 19,65%, respectivamente). Os biscoitos e os pastéis foram sensorialmente aceitos, com um aumento significativo nas médias dos escores sensoriais após a divulgação das informações sobre os benefícios do sorgo. Dessa forma, biscoitos tipo “cookies” sem glúten e pastéis preparados com farinha de sorgo contendo taninos apresentam grande potencial comercial, mostrado pela boa aceitação sensorial e pelas concentrações de amido lentamente digerível e amido resistente dos produtos.

Abstract: The objective of this work was to develop gluten-free cookies and savory fried pies using tannin-rich sorghum (Sorghum bicolor) flour, to evaluate their in vitro starch digestibility, and to verify how knowledge of sorghum benefits may contribute to the sensory acceptability of both products. The contents of rapidly digestible starch, slowly digestible starch, and resistant starch were determined. Sensory acceptance was evaluated in two sessions: one without information on sorghum benefits to human health; and another where this information was presented. The resistant starch and slowly digestible starch contents of the cookies (5.07 and 16.22%, respectively) were about twice those of the savory fried pies (2.54 and 8.89%, respectively), whereas the opposite was observed for the rapidly digestible starch contents (9.89 and 19.65%, respectively). The cookies and savory fried pies were sensorially accepted, with a significant increase in the means of the sensory scores after the information on sorghum benefits was disclosed. Therefore, gluten-free cookies and savory fried pies prepared with tannin sorghum flour have a great commercial potential, shown by the good sensory acceptance and by the slowly digestible starch and resistant starch contents of these products.

https://doi.org/10.1590/s1678-3921.pab2019.v54.01205 581 downloads

Evaluation of three recombinant proteins for the development of ELISA and immunochromatographic tests for visceral leishmaniasis serodiagnosis
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Santos, Anna Raquel Ribeiro dos

; Serufo, Ângela Vieira

; Figueiredo, Maria Marta

; Godoi, Lara Carvalho

; Vitório, Jéssica Gardone

; Marcelino, Andreza Pain

; Avelar, Daniel Moreira de

; Rodrigues, Fernandes Tenório Gomes

; Machado-Coelho, George Luiz Lins

; Medeiros, Fernanda Alvarenga Cardoso

; Jerônimo, Selma Maria Bezerra

; Oliveira, Edward José de

; Nascimento, Frederico Crepaldi

; Teixeira, Santuza Maria Ribeiro

; Gazzinelli, Ricardo Tostes

; Nagem, Ronaldo Alves Pinto

; Fernandes, Ana Paula

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e180405

Abstract: En | Text: En | PDF: En

BACKGROUND Visceral Leishmaniasis (VL) is an infectious disease that is a significant cause of death among infants aged under 1 year and the elderly in Brazil. Serodiagnosis is a mainstay of VL elimination programs; however, it has significant limitations due to low accuracy. OBJECTIVE This study aimed to evaluate three recombinant Leishmania infantum proteins (rFc, rC9, and rA2) selected from previous proteomics and genomics analyses to develop enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests (ICT) for the serodiagnosis of human VL (HVL) and canine VL (CVL). METHODS A total of 186 human (70 L. infantum-infected symptomatic, 20 other disease-infected, and 96 healthy) and 185 canine (82 L. infantum-infected symptomatic, 27 L. infantum-infected asymptomatic, and 76 healthy) sera samples were used for antibody detection. FINDINGS Of the three proteins, rA2 (91.5% sensitivity and 87% specificity) and rC9 (95.7% sensitivity and 87.5% specificity) displayed the best performance in ELISA-HVL and ELISA-CVL, respectively. ICT-rA2 also displayed the best performance for HVL diagnosis (92.3% sensitivity and 88.0% specificity) and had high concordance with immunofluorescence antibody tests (IFAT), ELISA-rK39, IT-LEISH®, and ELISAEXT. ICT-rFc, ICT-rC9, and ICT-rA2 had sensitivities of 88.6%, 86.5%, and 87.0%, respectively, with specificity values of 84.0%, 92.0%, and 100%, respectively for CVL diagnosis. MAIN CONCLUSIONS The three antigens selected by us are promising candidates for VL diagnosis regardless of the test format, although the antigen combinations and test parameters may warrant further optimisation.

https://doi.org/10.1590/0074-02760180405 1700 downloads

Ortner's Syndrome: Secondary Laryngeal Paralysis Caused by a Great Thoracic Aorta Aneurysm
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Zangirolami, Ana Claudia Alves

; Oliveira, Frederico Vieira de

; Tepedino, Miguel Soares

International Archives of Otorhinolaryngology

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jun 2015, Volume 19 N. 2 Pages 180 - 182

Abstract: En | Text: En | PDF: En

<sec><title>Introduction</title> Recurrent laryngeal nerve injury caused by cardiovascular disease is a rare condition, and often it is the only prominent sign of an imminent break of an aortic artery aneurysm.</sec><sec><title>Objective</title> To report left laryngeal paralysis caused by a great aortic arch aneurysm and to highlight the importance of an otorhinolaryngologic evaluation along with a thoracic radiologic study.</sec><sec><title>Resumed Report</title> A 42-year-old man complained of thickness of his voice and dysphagia for 3 months, but no thoracic pain or other relevant complaints. Video laryngoscopy revealed immobility of his left vocal fold in the paramedian position. Imaging was obtained for investigation, including magnetic resonance imaging of his thorax, which showed a fusiform aneurysm in the aortic arch, leading to recurrent compression of the left laryngeal nerve. The patient was successfully treated with endovascular repair of the aneurysm. At 2-month follow-up, there was still no recovery of the laryngeal mobility.</sec><sec><title>Conclusion</title> An aortic artery aneurysm can suddenly break, requiring emergency heart surgery, and the results can be fatal in many cases. We suggest routine exam of the vocal folds in all patients with a heart condition, and we review the literature and suggest the use of imaging to reduce the number of emergency procedures.</sec>

https://doi.org/10.1055/s-0034-1397331 1358 downloads

Garré's sclerosing osteomyelitis: case report
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Moraes, Frederico Barra de

; Motta, Tainá Melo Vieira

; Severin, Alessandra Assis

; Faria, Deniel de Alencar

; César, Fernanda de Oliveira

; Carneiro, Siderlei de Souza

Revista Brasileira de Ortopedia

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aug 2014, Volume 49 N. 4 Pages 401 - 404

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Relatar um caso raro de osteomielite esclerosante de Garrè. Paciente feminino, 54 anos, com história de tratamento de lúpus com corticoide havia 20 anos e osteoporose, em uso de alendronato havia cinco anos. Apresentava edema e limitação do joelho esquerdo havia um ano, derrame leve, dor à palpação metafisária, afebril, bom estado geral, sem secreção local. Imagens do joelho evidenciaram osteólise trabecular da metáfise distal do fêmur e reação periosteal nas duas tíbias proximais e nos dois fêmures distais, compatíveis com osteomielite crônica, de baixa virulência e progressão lenta. Hipersinal em T2 no fêmur e tíbia à ressonância. Curetagem do fêmur distal esquerdo, com saída de secreção, mas cultura negativa. Biópsia evidenciou infecção e inflamação crônica, fibrose, reação xantogranulomatosa e focos de supuração. Feita antibioticoterapia por seis meses. Etiologia não esclarecida, suspeita de infecção bacteriana, mas geralmente a cultura é negativa, processo crônico mantido por infecção de baixa virulência ou mesmo após o tratamento. Diagnósticos diferenciais: displasia fibrosa, sífilis, pustulose palmoplantar, retocolite, Crohn, Sapho (sinovite, acne, pustulose, hiperostose, osteíte) e Paget. Unifocais: osteoma osteoide, Ewing, osteossarcoma e granuloma eosinofílico.

The aim of this study was to report on a rare case of Garré's sclerosing osteomyelitis. The patient was a 54-year-old woman with a history of treatment for lupus using corticoids for 20 years, and for osteoporosis using alendronate for five years. She presented edema and developed a limitation of left knee movement one year earlier, with mild effusion and pain on metaphyseal palpation, but without fever. She was in a good general state, without local secretion. Images of her knee showed trabecular osteolysis of the distal metaphysis of the femur and a periosteal reaction in both proximal tibias and both distal femurs, compatible with chronic osteomyelitis of low virulence and slow progression. Magnetic resonance imaging showed T2 hypersignal in the femur and tibia. Curettage was performed on the left distal femur, with release of secretion, but this was negative on culturing. A biopsy showed chronic infection and inflammation, fibrosis, xanthogranulomatous reaction and foci of suppuration. Antibiotic therapy was administered for six months. The etiology was not clarified: bacterial infection was suspected, but culturing was generally negative. The chronic process was maintained by low-virulence infection or even after treatment. The differential diagnoses were fibrous dysplasia, syphilis, pustulosis palmoplantaris, rectocolitis, Crohn's disease, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) and Paget's disease. The unifocal diseases were osteoid osteoma, Ewing's disease, osteosarcoma and eosinophilic granuloma.

https://doi.org/10.1016/j.rboe.2014.04.010 8433 downloads

10.

Artrodese tibiotalocalcaneana com haste intramedular retrógrada: avaliação clínica e funcional de 29 pacientes
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Caixeta, Thiago Barbosa

; Calábria Júnior, Márcio Oliveira

; Castro, Régis Vieira de

; Martins, Jefferson Soares

; Costa, Edegmar Nunes

; Albieri, Alexandre Daher

; Moraes, Frederico Barra de

Revista Brasileira de Ortopedia

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jan 2014, Volume 49 N. 1 Pages 56 - 61

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo: avaliar clínica e funcionalmente o pós-operatório de pacientes submetidos à artrodese tibiotalocalcaneana para o tratamento das artropatias traumáticas e neurológicas do tornozelo. Métodos: estudo retrospectivo de 29 pacientes submetidos à artrodese do tornozelo com haste intramedular retrógrada. Todos os pacientes foram avaliados em relação ao tempo de consolidação, escores Aofas e EVA e grau de satisfação, além de complicações do ato cirúrgico. O tempo de seguimento médio foi de 36 meses (variação de 6-60). Resultados: a taxa de união foi de 82% e o tempo médio de consolidação foi de 16 semanas (10-24). O critério Aofas melhorou no pós-operatório em 65,5% (média de 57,7 nos casos neurológicos e de 75,7 nos pós-traumáticos) e a EVA melhorou 94,1% (média de 2,3 nos casos neurológicos e de 4,2 nos pós-traumáticos) e 86% dos pacientes mostraram-se satisfeitos com o procedimento feito. As complicações ocorreram em 11 pacientes (38%), entre elas pseudartrose (17,24%), infecção (17,24%), falha do material (13,8%) e fratura (13,8%). Conclusão: a artrodese tibiotalocalcaneana com haste intramedular retrógrada mostrou ser uma boa opção para o salvamento da articulação do tornozelo, com melhoria dos critérios clínicos e funcionais (Aofas = 65,5% e EVA = 94,1%).

Objective: To evaluate clinically and functionally the pos-operative results of patients submitted to tibiotalocalcaneal arthrodesis for the treatment of traumatic arthropathy and neuropathy. Methods: Retrospective study of 29 patients undergoing ankle arthrodesis with intramedullary retrograde nail. All patients were evaluated for fusion time, AOFAS and VAS scores, satisfaction, and complications of surgery. The mean follow-up was 36 months (range 6-60 months). Results: The union rate was 82%, and the consolidation occurred on average at 16 weeks (10-24 weeks). The pos-operative AOFAS score improved in 65.5% (average of 57.7 on neurological cases and 75.7 on cases pos-traumatic) and VAS score improved 94.1% (average of 2.3 on neurological cases and 4,2 on post-traumatic cases), and 86% of patients were satisfied with the procedure performed. Complications occurred in 11 patients (38%), including pseudoarthrosis (17.24%), infection (17.24%), material failure (13.8%) and fracture (13.8%). Conclusion: Tibiotalocalcaneal arthrodesis with retrograde intramedullary nail proved to be a good option for saving the ankle joint, with improvement of clinical and functional scores (AOFAS = 65.5% and VAS = 94.1%).

https://doi.org/10.1016/j.rbo.2013.11.002 6241 downloads

11.

Relationship between the Porcine Stress Syndrome gene and carcass and performance traits in F2 pigs resulting from divergent crosses
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Band, Guilherme de Oliveira

; Guimarães, Simone Eliza Facioni

; Lopes, Paulo Sávio

; Peixoto, Jane de Oliveira

; Faria, Danielle Assis

; Pires, Aldrin Vieira

; Figueiredo, Frederico de Castro

; Nascimento, Carlos Souza do

; Gomide, Lúcio Alberto de Miranda

Genetics and Molecular Biology

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mar 2005, Volume 28 N. 1 Pages 92 - 96

Abstract: En | Text: En | PDF: En

The PSS genotypes of 596 F2 pigs produced by initial mating of Brazilian native boars commercial sows and were characterized by PCR-RFLP and their carcass and performance traits were evaluated. Among the 596 animals analyzed, 493 (82.72%) were characterized as NN and 103 (17.28%) as Nn. With respect to carcass traits, Nn animals presented higher (p < 0.05) right half carcass weight, left half carcass weight, loin depth and loin eye area, and lower shoulder backfat thickness, backfat thickness between last and next to last but one lumbar vertebrae and backfat thickness after last rib at 6.5 cm from the midline compared to NN animals. Nn animals also showed (p < 0.05) higher values for most of the cut yields, indicating higher cutting yields for animals carrying the n allele and lower values for bacon depth, confirming lower fat deposition in carcass. In addition, Nn animals presented (p < 0.05) lower values for the performance trait weight at 105 days of age. These results indicate that animals carrying the PSS gene generate leaner carcasses, higher cut yields, and that the effects of the gene can be observed even in divergent crosses.

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