Comparison Of Puddu Osteotomy With Or Without Autologous Bone Grafting: A Prospective Clinical Trial

To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients submitted to medial opening-wedge high tibial osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. The primary outcome was Knee Society Score. Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes. Results: There was no difference in KSS scale between the graft group (64.4. ±. 21.8) and the graftless group (61.6. ±. 17.3; p = 0.309). There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft = 184. ±. 4.6 degrees, graftless = 183.4. ±. 5.1 degrees; p = 1.0), indicating that there is no loss of correction due to the lack of the graft. There was significant worsening of osteoarthritis in a greater number of patients in the graft group (p = 0.005). Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study. © 2016 Sociedade Brasileira de Ortopedia e Traumatologia

Acesso Lateral De Keblish Melhora A Inclinação Da Patela Na Artroplastia Do Joelho Valgo

To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. Methods In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analogue scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. Results There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3) in the lateral approach group and 18 degrees (SD ± 10.2) in the medial approach group (p = 0.02). There were no differences regarding the secondary outcomes. Conclusion Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee. © 2016 Sociedade Brasileira de Ortopedia e Traumatologia51668068

Delta sleep instability in children with chronic arthritis

The objective of the present study was to evaluate the expression of a cyclic alternating pattern (CAP) in slow wave sleep (SWS) in children with the well-defined chronic syndrome juvenile idiopathic arthritis (JIA). Twelve patients (9-17 years of age), 7 girls, with JIA were compared to matched controls by age, pubertal stage and gender. After one night of habituation in the sleep laboratory, sleep measurements were obtained by standard polysomnography with conventional sleep scoring and additional CAP analyses. The sleep parameters of the JIA and control groups were similar for sleep efficiency (91.1 ± 6.7 vs 95.8 ± 4.0), sleep stage in minutes: stage 1 (16.8 ± 8.5 vs 17.8 ± 4.0), stage 2 (251.9 ± 41 vs 262.8 ± 38.1), stage 3 (17.0 ± 6.0 vs 15.1 ± 5.7), stage 4 (61.0 ± 21.7 vs 77.1 ± 20.4), and rapid eye movement sleep (82.0 ± 27.6 vs 99.0 ± 23.9), respectively. JIA patients presented nocturnal disrupted sleep, with an increase in short awakenings, but CAP analyses showed that sleep disruption was present even during SWS, showing an increase in the overall CAP rate (P < 0.01). Overall CAP rate during non-rapid eye movement sleep was significantly higher in pediatric patients who were in chronic pain. This is the first study of CAP in pediatric patients with chronic arthritis showing that CAP analyses can be a powerful tool for the investigation of disturbance of SWS in children, based on sleep EEG visual analysis

Association Of Single Nucleotide Polymorphisms In The Gene Encoding Glut1 And Diabetic Nephropathy In Brazilian Patients With Type 1 Diabetes Mellitus

Mesangial cells subject to high extracellular glucose concentrations, as occur in hyperglycaemic states, are unable to down regulate glucose influx, resulting in intracellular activation of deleterious biochemical pathways. A high expression of GLUT1 participates in the development of diabetic glomerulopathy. Variants in the gene encoding GLUT1 (. SLC2A1) have been associated to this diabetic complication. The aim of this study was to test whether polymorphisms in SLC2A1 confer susceptibility to diabetic nephropathy (DN) in Brazilian type 1 diabetes patients. Four polymorphisms (rs3820589, rs1385129, rs841847 and rs841848) were genotyped in a Brazilian cohort comprised of 452 patients. A prospective analysis was performed in 155 patients. Mean duration of follow-up was 5.6. ±. 2.4. years and the incidence of renal events was 18.0%. The rs3820589 presented an inverse association with the prevalence of incipient DN (OR: 0.36, 95% CI: 0.16 - 0.80, p=. 0.01) and with progression to renal events (HR: 0.20; 95% CI: 0.03 - 0.70; p=. 0.009). AGGT and AGAC haplotypes were associated with the prevalence of incipient DN and the AGAC haplotype was also associated with the prevalence of established/advanced DN. In conclusion, rs3820589 in the SLC2A1 gene modulates the risk to DN in Brazilian patients with inadequate type 1 diabetes control.444170175Nishikawa, T., Edelstein, D., Brownlee, M., The missing link: a single unifying mechanism for diabetic complications (2000) Kidney Int Suppl, 77, pp. S26-S30Ayo, S.H., Radnik, R.A., Glass, W.F., Increased extracellular matrix synthesis and mRNA in mesangial cells grown in high-glucose medium (1991) Am J Physiol, 260, pp. F185-F191Sesso Rde, C., Lopes, A.A., Thome, F.S., Lugon, J.R., Watanabe, Y., Santos, D.R., Chronic dialysis in Brazil: report of the Brazilian dialysis census, 2011 (2012) J Bras Nefrol Orgao Oficial Soc Bras Lat Am Nefrol, 34, pp. 272-277Mauer, S.M., Steffes, M.W., Ellis, E.N., Sutherland, D.E., Brown, D.M., Goetz, F.C., Structural-functional relationships in diabetic nephropathy (1984) J Clin Invest, 74, pp. 1143-1155D'Agord Schaan, B., Lacchini, S., Bertoluci, M.C., Irigoyen, M.C., Machado, U.F., Schmid, H., Increased renal GLUT1 abundance and urinary TGF-beta 1 in streptozotocin-induced diabetic rats: implications for the development of nephropathy complicating diabetes (2001) Horm Metab Res Horm Stoffwechselforschung Horm Metab, 33, pp. 664-669Heilig, C.W., Liu, Y., England, R.L., D-glucose stimulates mesangial cell GLUT1 expression and basal and IGF-I-sensitive glucose uptake in rat mesangial cells: implications for diabetic nephropathy (1997) Diabetes, 46, pp. 1030-1039Henry, D.N., Busik, J.V., Brosius, F.C., Heilig, C.W., Glucose transporters control gene expression of aldose reductase, PKCalpha, and GLUT1 in mesangial cells in vitro (1999) Am J Physiol, 277, pp. F97-F104Weigert, C., Brodbeck, K., Brosius, F.C., Evidence for a novel TGF-beta1-independent mechanism of fibronectin production in mesangial cells overexpressing glucose transporters (2003) Diabetes, 52, pp. 527-535Seaquist, E.R., Goetz, F.C., Rich, S., Barbosa, J., Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy (1989) N Engl J Med, 320, pp. 1161-1165Gross, J.L., de Azevedo, M.J., Silveiro, S.P., Canani, L.H., Caramori, M.L., Zelmanovitz, T., Diabetic nephropathy: diagnosis, prevention, and treatment (2005) Diabetes Care, 28, pp. 164-176Zintzaras, E., Stefanidis, I., Association between the GLUT1 gene polymorphism and the risk of diabetic nephropathy: a meta-analysis (2005) J Hum Genet, 50, pp. 84-91Cui, W., Du, B., Zhou, W., Relationship between five GLUT1 gene single nucleotide polymorphisms and diabetic nephropathy: a systematic review and meta-analysis (2012) Mol Biol Rep, 39, pp. 8551-8558Pimenta, J.R., Zuccherato, L.W., Debes, A.A., Color and genomic ancestry in Brazilians: a study with forensic microsatellites (2006) Hum Hered, 62, pp. 190-195Levey, A.S., Stevens, L.A., Schmid, C.H., A new equation to estimate glomerular filtration rate (2009) Ann Intern Med, 150, pp. 604-612Mohammedi, K., Maimaitiming, S., Emery, N., Allelic variations in superoxide dismutase-1 (SOD1) gene are associated with increased risk of diabetic nephropathy in type 1 diabetic subjects (2011) Mol Genet Metab, 104, pp. 654-660Kohner, E.M., The lesions and natural history of diabetic retinopathy (1991) Text Book of Diabetes, pp. 575-588. , editor, Oxford, Scientific BNyholt, D.R., A simple correction for multiple testing for single-nucleotide polymorphisms in linkage disequilibrium with each other (2004) Am J Hum Genet, 74, pp. 765-769Team, R.C., (2013) R: a language and environment for statistical computingTregouet, D.A., Garelle, V., A new JAVA interface implementation of THESIAS: testing haplotype effects in association studies (2007) Bioinformatics, 23, pp. 1038-1039Ng, D.P., Canani, L., Araki, S., Minor effect of GLUT1 polymorphisms on susceptibility to diabetic nephropathy in type 1 diabetes (2002) Diabetes, 51, pp. 2264-2269Murakami, T., Nishiyama, T., Shirotani, T., Identification of two enhancer elements in the gene encoding the type 1 glucose transporter from the mouse which are responsive to serum, growth factor, and oncogenes (1992) J Biol Chem, 267, pp. 9300-9306Heilig, C.W., Brosius, F.C., Cunningham, C., Role for GLUT1 in diabetic glomerulosclerosis (2006) Expert Rev Mol Med, 8, pp. 1-18Zeggini, E., Rayner, W., Morris, A.P., An evaluation of HapMap sample size and tagging SNP performance in large-scale empirical and simulated data sets (2005) Nat Genet, 37, pp. 1320-132

A systematic survey of floral nectaries

The construction of classifications, as well as the understanding of biological diversity, depends upon a careful comparison of attributes of the organisms studied (Stuessy, 1990). It is widely known that data from diverse sources showing differences from taxon to taxon are of systematic significance. Dur-ing the 20th century, systematists have emphasized that their discipline involves a synthesis of all knowledge (Stevens, 1994) or, in other words, the variation of as many relevant characters as possible should be incorporated into the natural system to be constructed. The extent to which particular characters are constant or labile will determine their usefulness to syste-matics. In general, more conservative characters will be valuable in defining families and orders, whereas more labile characters may be useful at the ge-neric and specific levels (Webb, 1984). There is no doubt that floral characters are among the most used in the classification of flowering plants. At the same time, they constitute essential features in diagnostic keys to taxa in both taxonomic treatments and Floras (Cronquist, 1981, 1988).Fil: Bernardello, Gabriel Luis Mario. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentin