Wrist Arthrodesis: Clinical and Ultrasonographic Trial

INTRODUCTION: The wrist arthrodesis has become a well-established procedure on the treatment of various diseases that affect the radiocarpal joint with the objective of pain relief and restoration of joint stability, allowing a recovery of gripping function and lifestyle. OBJECTIVES: Evaluate the functional outcomes of wrist arthrodesis in patients with advanced symptomatic inflammatory or degenerative arthritis and evaluate the residual synovitis by ultrasonography. METHODS: Review the patients who underwent a total wrist arthrodesis in our Hospital between 1999 and 2009, by a comparative and functional study. The study population was divided into two groups: Inflammatory Rheumatic Disease (IRD group) and another that included the remaining cases (RC group). For functional evaluation we used the Buck-Gramcko&Lohman (BGL) Evaluation for Total Wrist Function and the Disabilities of the Arm, Shoulder and Hand (DASH) Score. Pain levels were measured pre- and postoperatively according to the Visual Analogue Scale (VAS). A General Electric P5 Power Doppler Ultrasound with a high-resolution linear 7-12 MHz array was used to identify local synovitis. Mann-Whitney, Wilcoxon and Chi-Square tests were applied for statistical evaluation. p <0.05 was considered statistically significant. RESULTS: According to the study criteria we selected 38 patients. From these, 7 were treated bilaterally, with a total of 45 total wrist arthrodesis evaluated (IRD group n=25 vs RC group n=20). The predominant gender was the female (78.4%), the average age at the time of surgery was 50.0 ±14.2 years and the mean postoperative follow-up was 4.8 ± 2.6 years. Regarding to the most common surgical indication, on the RC group we had 40% of post-traumatic arthritis and on the IRD group, 96% had rheumatoid arthritis.The most frequent surgical technique used on the IRD group was Mannerfelt (52%) vs AO/ASIF plate osteosynthesis (95%) on the RC group, Darrach procedure was associated in 37.8% of all cases. IRD group presented a greater time for bone union (3.6 vs 2.9, p=0.228), fewer postoperative complications (12.0% vs 35.0%, p=0.069) and fewer cases of material extraction (20.0% vs 25.0%, p = 0.481).There was a lower deficit of pronosupination on the RC group (76% vs 60%, p=0.204), and this group also presented a better assessment on the DASH score (13.0 vs. 22.4, p=0.153). 75.0% of the RC group had a BGL score with excellent to good results vs 32.0% on the IRD group, p = 0.005.All patients improved their VAS between pre-and postoperatively (8.0 vs 2.0 on the IRD group and 6.5 vs 1.5 on the RC group, p = 0.000). After surgery, most patients maintained the previous profession (90% on the RC vs 56% on the IRD group, p = 0.013).The ultrasonographic wrist evaluation of the IRD group revealed local synovitis in 2 cases as also as extensor tenosynovitis of the fingers in other 2 cases. All of these 4 cases were of low intensity and without inflammatory activity identified by power-Doppler signal. CONCLUSION: Although being a retrospective study it allows us to evaluate the effectiveness of wrist arthrodesis, on its various indications, with encouraging functional outcomes and pain relief levels on patients with and without inflammatory rheumatic disease

Characterization of Sirtuin Inhibitors in Nematodes Expressing a Muscular Dystrophy Protein Reveals Muscle Cell and Behavioral Protection by Specific Sirtinol Analogues

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Tissemouminites: A new group of primitive achondrites spanning the transition between acapulcoites and winonaites

The Northwest Africa (NWA) 090 meteorite, initially classified as an acapulcoite, presents petrological, chemical, and isotopic characteristics comparable to a group of seven primitive winonaites: Dhofar 1222, NWA 725, NWA 1052, NWA 1054, NWA 1058, NWA 1463, and NWA 8614. Five of these samples were previously classified as acapulcoites or ungrouped achondrites before being reclassified as winonaites based on their oxygen isotopic compositions. These misclassifications are indicative of the particular compositional nature of these primitive achondrites. All contain relict chondrules and a lower closure temperature of metamorphism of 820 ± 20 °C compared to other typical winonaites, as well as mineral elemental compositions similar to those of acapulcoites. The oxygen isotopic signature of these samples, δ17O of 1.18 ± 0.17‰, δ18O of 3.18 ± 0.30‰, and Δ17O of −0.47 ± 0.02, is in fact resolvable from both acapulcoites and winonaites. We investigate the relationship between these eight primitive achondrites, typical winonaites, and acapulcoites, to redefine petrological, mineralogical, and geochemical criteria of primitive achondrite classification. Distinguishing between winonaites, acapulcoites, and this group of eight primitive achondrites can be unambiguously done using a combination of several mineralogical and chemical criteria. A combination of olivine fayalite content and FeO/MnO ratio, as well as plagioclase potassium content allow us to separate these three groups without the absolute necessity of oxygen isotope analyses. NWA 090 as well as the other seven primitive achondrites, although related to winonaites, are most likely derived from a parent body distinct from winonaites and acapulcoites–lodranites, and define a new group of primitive achondrites that can be referred to as tissemouminites

Análise clínica e laboratorial para a identificação da Talassemia Alfa

14214

Wheezing in infants: frequency, clinical characteristics and treatment

OBJECTIVE: To estimate the frequency and describe the clinical characteristics and respective treatments of previous history of wheezing. METHODS: Infants aged 6-23 months with upper respiratory tract complaints and reporting previous wheezing were followed-up retrospectively. Data were registered on a validated standardized form. RESULTS: Out of 451 infants, 164 (36.4%; 95%CI: 31.9-41.0) had a report of prior history of wheezing, 148 (32.8%; 95%CI: 28.5-37.4) during the first year of life. The mean age at the first episode of wheezing was 5.3±3.9 months. Among those who had had their first episode before 12 months of age, 38.5% reported 3 to 6 episodes and 14.2% > 6 episodes. Mean age at first episode was lower for those with > 3 episodes in comparison with those with seis episódios. A média da idade no primeiro episódio foi menor para os que apresentaram > três episódios em comparação aos que apresentaram até dois episódios (3,2±2,7 versus 5,7±2,5 meses, p < 0,001). CONCLUSÃO: Um terço dos lactentes apresentou chiado no primeiro ano de vida. Quanto mais cedo ocorre o primeiro episódio, mais frequente é a recorrência do chiado.Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal da Bahia Faculdade de Medicina da Bahia Programa de Pós-Graduação em Ciências da SaúdeUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PediatriaUniversidade de São Paulo Faculdade de Saúde Pública Departamento de EpidemiologiaEscola Bahiana de Medicina e Saúde PúblicaUFBAUFBA Faculdade de Medicina da Bahia Departamento de Anatomia Patológica e Medicina LegalUFBA Faculdade de Medicina da Bahia Departamento de PediatriaUNIFESP, EPM, Depto. de PediatriaSciEL

Inbreeding levels in Northeast Brazil: Strategies for the prospecting of new genetic disorders

A new autosomal recessive genetic condition, the SPOAN syndrome (an acronym for spastic paraplegia, optic atrophy and neuropathy syndrome), was recently discovered in an isolated region of the State of Rio Grande do Norte in Northeast Brazil, in a population that was identified by the IBGE (Brazilian Institute of Geography and Statistics) as belonging to the Brazilian communities with the highest rates of “deficiencies” (Neri, 2003), a term used to describe diseases, malformations, and handicaps in general. This prompted us to conduct a study of consanguinity levels in five of its municipal districts by directly interviewing their inhabitants. Information on 7,639 couples (corresponding to about 40% of the whole population of the studied districts) was obtained. The research disclosed the existence of very high frequencies of consanguineous marriages, which varied from about 9% to 32%, suggesting the presence of a direct association between genetic diseases such as the SPOAN syndrome, genetic drift and inbreeding levels. This fact calls for the introduction of educational programs for the local populations, as well as for further studies aiming to identify and characterize other genetic conditions. Epidemiological strategies developed to collect inbreeding data, with the collaboration of health systems available in the region, might be very successful in the prospecting of genetic disorders

The understanding of information about oral chemotherapy treatment among outpatients at a University Hospital in Ceará, Brazil

This study assessed the understanding of information about oral chemotherapy treatment, among patients attending the hematology outpatients' ward of a University hospital. A questionnaire with patient data and details of the treatment was applied to 147 outpatients. The analysis of variables and classification of the level of understanding about the treatment followed methods established in the literature with some adjustments. The study found a significant association between the level of understanding about treatment with the level of education and the occupation of the respondents. Regarding the correct acquisition and administration of the medicine-its name, dose and frequency of administration-there was agreement between the medical prescriptions and the responses for 90.7, 88.0 and 99.3 % of patients, respectively. Patients had less knowledge about the duration and side-effects of the treatment. The level of treatment understanding was classified as good for 74.1 % of those interviewed, suggesting a rational use of oral chemotherapy by the majority of patients.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Laboratórios Remotos no Ensino de Engenharia

O presente capítulo contém uma seleção de artigos que foram apresentados na Sessão Dirigida: Laboratórios remotos no ensino da engenharia, realizada durante o XLIV Congresso Brasileiro de Educação em Engenharia (COBENGE), de 27 a 30 de setembro de 2016, em Natal, Rio Grande do Norte. Essa Sessão Dirigida propôs mostrar trabalhos que viessem a apresentar experiências baseadas em laboratórios remotos no ensino de engenharia, a fim de discutir e demonstrar as práticas ou técnicas propostas pelos grupos em diferentes realidades. Buscou, assim, expor pontos positivos e negativos para potenciais disseminações de projetos com semelhantes contextos. Portanto, o objetivo da Sessão Dirigida foi proporcionar um ambiente para discussão e reflexão referente à integração dos laboratórios remotos no ensino de engenharia. Os cinco artigos apresentados neste capítulo foram selecionados entre aqueles que receberam a qualificação a partir da apresentação oral na Sessão Dirigida ou como convidados. O primeiro, escrito por Thiago Schaedler Uhlmann e Luciano Antonio Mendes, da Pontifícia Universidade Católica do Paraná (PUC-PR), é intitulado “Jogos remotos: perspectivas de aplicação conjunta de aprendizagem baseada em jogos e experimentação remota no ensino de engenharia”. Tem como objetivo geral identificar possibilidades acerca do emprego da Aprendizagem Baseada em Jogos, associada a recursos de experimentação remota, no ensino de engenharia. O segundo artigo selecionado foi escrito por Ana M. B. Pavani; Delberis A. Lima; Guilherme P Temporão; Vanessa A. P. Lima, vinculados à Pontifícia Universidade Católica do Rio de Janeiro (PUC-RIO). O documento, intitulado “Implantação de um laboratório remoto: um projeto de múltiplas facetas”, busca descrever a experiência de iniciar a implantação de um laboratório remoto nessa instituição, no âmbito do Projeto VISIR+. O terceiro artigo, “Projetos de experimentos remotos como estratégia for- mativa para estudantes de engenharia”, foi escrito por Eduardo Kojy Takahashi; Rubens Gedraite; Hermes Gustavo Fernandes Neri; Dayane Carvalho Cardoso e Rener Martins de Moura, da Universidade Federal de Uberlândia (UFU). Os autores buscam apresentar uma possibilidade metodológica de formação básica de estudantes de engenharia, a partir do desenvolvimento colaborativo de projetos envolvendo experimentação remota e com o engajamento de professores-pesquisadores, estudantes de engenharia e estudantes do ensino médio que apresentem um potencial para a carreira de engenharia. O quarto artigo, intitulado “Percepções acerca de experimentos remotos no contexto de um curso de especialização em Educação em Engenharia e Ciências Exatas”, foi escrito por Luciano Andreatta Carvalho da Costa, da Universidade Estadual do Rio Grande do Sul (UERGS). No documento, o autor busca apresentar as percepções dos estudantes de um curso de especialização em Educação em Engenharia e em Ciências Exatas na UERGS, no âmbito da utilização de laboratórios remotos, a partir de uma disciplina ministrada no curso que trata do tema dos experimentos online e seus impactos para a formação na área tecnológica. O quinto artigo, “Programa de cooperação interinstitucional para experimentação remota nos processos de ensino e de aprendizagem de engenharia”, é de autoria de Gabriela Rocha Roque (Faculdade SATC); Josiel Pereira e Simone Meister Sommer Bilessimo, da Universidade Federal de Santa Catarina (UFSC). O documento descreve a uma iniciativa de cooperação entre duas instituições de ensino superior, a UFSC e a Faculdade SATC. Cooperação esta motivada pela integração de tecnologia no ensino de engenharia, através da utilização e do compartilhamento dos recursos de laboratórios de experimentação remota.info:eu-repo/semantics/publishedVersio