Post-Surgical Rehabilitation of Dupuytren's Disease: A Retrospective Study

Introdução: A doença de Dupuytren é uma patologia proliferativa benigna do tecido conjuntivo que envolve a fáscia palmar. A primeira manifestação clínica reportada pelo doente é o espessamento da pele junto à articulação MCF. O 5º dedo é o mais afetado, e a doença de Dupuytren atinge mais frequentemente homens com mais de 40 anos. A diabetes mellitus, a dependência do álcool e do tabaco e o VIH estão associados a um maior risco de desenvolvimento da doença. O tratamento gold standard nos estadios mais avançados é a indicação cirúrgica. A reabilitação pós-operatória deve começar entre 3 a 5 dias após a cirurgia com a colocação de uma ortótese palmar e o início de um programa de reabilitação funcional da mão. O objectivo do estudo foi caracterizar uma população com doença de Dupuytren submetida a intervenção cirúrgica e avaliar os ganhos dos doentes sujeitos a um programa de reabilitação pós-cirúrgico. Método: Estudo retrospetivo e longitudinal com consulta dos arquivos clínicos dos doentes com doença de Dupuytren tratados cirurgicamente, avaliados e seguidos no Serviço de Medicina Física e de Reabilitação de acordo com o programa de terapia ocupacional. Resultados: De um total de 50 doentes com doença de Dupuytren tratados cirurgicamente entre janeiro de 2014 e agosto de 2015, 92% são homens. A média de idades é de 64,22 anos de idade. Os fatores de risco associados foram predominantemente diabetes mellitus (22%), tabagismo (8%) e hábitos etanólicos moderados a acentuados (6%). Dos doentes, 54% foram operados à mão direita, e a maioria dos doentes foi operada ao 5º raio da mão (38%). Dos doentes, 42 (84%) frequentaram o programa de reabilitação duas vezes por semana. Treze doentes abandonaram o tratamento não tendo efetuado consulta de reavaliação. A média dos tratamentos foi de 70,14 dias (DP 42,5). Em comparação com o início e o fim do programa de reabilitação houve uma diferença significativa tanto na extensão como na flexão da MCF (p = 0,00, p = 0,03) e da IFP (p = 0,00, p = 0,01). Não se encontraram outras relações estatisticamente significativas. Conclusão: A cirurgia seguida de um programa de reabilitação estruturado na doença de Dupuytren permitiu nesta população uma melhoria das amplitudes articulares.info:eu-repo/semantics/publishedVersio

Flow Around a Slender Circular Cylinder: A Case Study on Distributed Hopf Bifurcation

This paper presents a short overview of the flow around a slender circular cylinder, the purpose being to place it within the frame of the distributed Hopf bifurcation problems described by the Ginzburg-Landau equation (GLE). In particular, the chaotic behavior superposed to a well tuned harmonic oscillation observed in the range Re > 270, with Re being the Reynolds number, is related to the defect-chaos regime of the GLE. Apparently new results, related to a Kolmogorov like length scale and the rms of the response amplitude, are derived in this defect-chaos regime and further related to the experimental rms of the lift coefficient measured in the range Re > 270

Effect of the domain spanwise periodic length on the flow around a circular cylinder

We assess the effect of the choice of spanwise periodic length on simulations of the flow around a fixed circular cylinder. The Reynolds number is set to 400 because, at this value, both lift coefficient and shedding frequency show significant drop due to three-dimensional flow structures. From the analysis of the three-dimensionalities of the wake and of the integral quantities such as Strouhal number, RMS of lift coefficient and energy contained in the three-dimensional portion of the flow we obtain an estimate of the minimum spanwise length to satisfactorily represent the flow. Furthermore, we observe a distinct wake behavior when the spanwise length is approximately the mode B instability wavelength. (C) 2011 Elsevier Ltd. All rights reserved

Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review

Odontogenic cysts are considered as nonneoplasic benign lesions. Among the cysts, keratocyst odontogenic tumor (KCOT) is an intra‑osseous tumor characterized by parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior, and for the possibility to develop carcinomas in the lesion wall. Thus, the aim of this study was to describe a clinical case of KCOT in a young patient and discuss the treatment alternatives to solve this case. A 15‑year‑old male was referred for treatment of a giant lesion in his left side of the mandible. After the biopsy, a diagnostic of KCOT was made, and the following procedures were planned for KCOT treatment. Marsupialization was performed for lesion decompression and consequent lesion size reduction. Afterward, enucleation for complete KCOT removal was performed followed by third mandibular molar extraction. After 5 years, no signs of recurrence were observed. The treatment proposed was efficient in removing the KCOT with minimal surgical morbidity and optimal healing process, and the first and second mandibular molars were preserved with pulp vitality. In conclusion, this treatment protocol was an effective and conservative approach for the management of the KCOT, enabling the reduction of the initial lesion, the preservation of anatomical structures and teeth, allowing quicker return to function. No signs of recurrence after 5 years were observed

SMALL INTERFERING RNA TARGETING FOCAL ADHESION KINASE PREVENTS CARDIAC DYSFUNCTION IN ENDOTOXEMIA

Sepsis and septic shock are associated with cardiac depression. Cardiovascular instability is a major cause of death in patients with sepsis. Focal adhesion kinase (FAK) is a potential mediator of cardiomyocyte responses to oxidative and mechanical stress. Myocardial collagen deposition can affect cardiac compliance and contractility. The aim of the present study was to determine whether the silencing of FAK is protective against endotoxemia-induced alterations of cardiac structure and function. In male Wistar rats, endotoxemia was induced by intraperitoneal injection of lipopolysaccharide (10 mg/kg). Cardiac morphometry and function were studied in vivo by left ventricular catheterization and histology. Intravenous injection of small interfering RNA targeting FAK was used to silence myocardial expression of the kinase. The hearts of lipopolysaccharide-injected rats showed collagen deposition, increased matrix metalloproteinase 2 activity, and myocyte hypertrophy, as well as reduced 24-h +dP/dt and -dP/dt, together with hypotension, increased left ventricular end-diastolic pressure, and elevated levels of FAK (phosphorylated and unphosphorylated). Focal adhesion kinase silencing reduced the expression and activation of the kinase in cardiac tissue, as well as protecting against the increased collagen deposition, greater matrix metalloproteinase 2 activity, and reduced cardiac contractility that occur during endotoxemia. In conclusion, FAK is activated in endotoxemia, playing a role in cardiac remodeling and in the impairment of cardiac function. This kinase represents a potential therapeutic target for the protection of cardiac function in patients with sepsis.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Sao Paulo Research Foundation)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Sao Paulo Research Foundation) [06/00443-6

SMALL INTERFERING RNA TARGETING FOCAL ADHESION KINASE PREVENTS CARDIAC DYSFUNCTION IN ENDOTOXEMIA

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Sepsis and septic shock are associated with cardiac depression. Cardiovascular instability is a major cause of death in patients with sepsis. Focal adhesion kinase (FAK) is a potential mediator of cardiomyocyte responses to oxidative and mechanical stress. Myocardial collagen deposition can affect cardiac compliance and contractility. The aim of the present study was to determine whether the silencing of FAK is protective against endotoxemia-induced alterations of cardiac structure and function. In male Wistar rats, endotoxemia was induced by intraperitoneal injection of lipopolysaccharide (10 mg/kg). Cardiac morphometry and function were studied in vivo by left ventricular catheterization and histology. Intravenous injection of small interfering RNA targeting FAK was used to silence myocardial expression of the kinase. The hearts of lipopolysaccharide-injected rats showed collagen deposition, increased matrix metalloproteinase 2 activity, and myocyte hypertrophy, as well as reduced 24-h +dP/dt and -dP/dt, together with hypotension, increased left ventricular end-diastolic pressure, and elevated levels of FAK (phosphorylated and unphosphorylated). Focal adhesion kinase silencing reduced the expression and activation of the kinase in cardiac tissue, as well as protecting against the increased collagen deposition, greater matrix metalloproteinase 2 activity, and reduced cardiac contractility that occur during endotoxemia. In conclusion, FAK is activated in endotoxemia, playing a role in cardiac remodeling and in the impairment of cardiac function. This kinase represents a potential therapeutic target for the protection of cardiac function in patients with sepsis.3717784Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP