Tenodese bicipital "a rocambole": técnica e resultados

OBJETIVO: Apresentar nova técnica de tenodese bicipital e seus resultados, realizada parcialmente por via artroscópica e fundamentada em conceitos da anatomia normal e patológica do tendão da cabeça longa do bíceps. O fundamento é a predisposição deste tendão em fixar-se, após rotura ou tenotomia, no sulco intertubercular (autotenodese). MÉTODO: Avaliados, 63 pacientes (63 ombros); idade, 32 a 77 anos (média 55); femininos, 32 (51%); e masculinos, 31 (49%). Com idade acima de 60 anos, 35 pacientes (55,6%); abaixo de 60 anos, 28 pacientes (44,4%); desportistas, 18 (28,6%); com lesão associada do subescapular, 14 pacientes (22,2%). O seguimento mínimo foi de 12 meses, máximo de 74 e médio de 43 meses. O ombro direito correspondeu a 48 casos (76,2%), um dos quais era sinistro e 47 destros. O ombro esquerdo representou 15 (23,8%), com dois sinistros e 13 destros. Não houve ocorrência bilateral. Análise estatística de acordo com o programa SPSS, versão 18. Teste do Qui-quadrado de Pearson, correção de continuidade, adotado para testar a significância estatística da associação entre as variáveis. Consideradas associações estatisticamente significativas quando p inferior a 0,05. RESULTADOS: A deformidade residual de Popeye foi observada por sete pacientes (11,1%), observada apenas pelo examinador em 15 (23,8%) e não observada pelo examinador ou pelo paciente em 41 casos (65%). Não houve influência estatisticamente válida entre idade, prática de esportes de contato ou arremesso, lesão associada do tendão subescapular e a ocorrência de deformidade de Popeye. Satisfeitos, 58 (92,06%) pacientes; insatisfeitos, dois (3,17%); e indiferentes, três (4,76%). CONCLUSÕES: A técnica apresenta altos percentuais de satisfação por parte dos pacientes (92,06%); deformidade residual é percebida por 11,1% dos pacientes. Seu aparecimento não tem correlação estatisticamente válida com a faixa etária acima ou abaixo de 60 anos (p = 0,883), com a prática esportiva (p = 0,195) ou com a lesão associada do subescapular (p = 0,958)

Videoarthroscopic treatment of glenohumeral osteoarthritis Tratamento Videoartroscópico da Osteoartrite Glenoumeral

OBJECTIVE: To evaluate possible benefits obtained through the use of surgical videoarthroscopy in the management of glenohumeral osteoarthritis. METHODS: We evaluated 37 patients (38 shoulders) who underwent through surgical videoarthroscopy in the period between November 1999 and May 2009 (minimum follow-up of two years). Twenty five patients attend for revaluation and thirteen were interviewed by telephonic contact. Functional assessments were performed (UCLA, Constant, and measurement of range of motion -ROM-), as well as pre and post surgical radiographics. We evaluated the influence of the following factors in the final results: the presence of chondral lesions, joint space narrowing, osteophyte presence, associated injuries (rotator cuff torn or instability), and follow-up. Among those patients interviewed by phone we evaluated the satisfaction level and if they would submit themselves again to the surgical procedure. RESULTS: It was observed significant gain towards to the function (UCLA) and the internal rotation, as well as the association between dissatisfaction and pre surgical joint space reduced. Among the operated patients, 84% were satisfied with the results and 86.6% would repeat the procedure. CONCLUSION: Surgical videoarthroscopy presents a relevant role in management of the glenohumeral osteoarthritis, providing improvement of functional results and high levels of satisfaction.<br> OBJETIVO: Avaliar poss&#237;veis benef&#237;cios obtidos mediante o uso da videoartroscopia cir&#250;rgica no tratamento da osteoartrite glenoumeral. M&#201;TODOS: Avaliamos 37 pacientes (38 ombros) submetidos &#224; v&#237;deoartroscopia cir&#250;rgica no per&#237;odo compreendido entre novembro de 1999 e maio de 2009 (seguimento m&#237;nimo de dois anos). Compareceram para reavalia&#231;&#227;o 25 pacientes e 13 foram entrevistados por contato telef&#244;nico. Foram feitas avalia&#231;&#245;es funcionais (UCLA, Constant, e aferi&#231;&#227;o da Amplitude de Movimento *[ADM]), assim como estudo radiogr&#225;fico pr&#233; e p&#243;s-operat&#243;rios. Avaliamos a influ&#234;ncia dos seguintes fatores no resultado final dos pacientes: presen&#231;a de les&#227;o condral, redu&#231;&#227;o do espa&#231;o articular, presen&#231;a de oste&#243;fito, presen&#231;a de les&#245;es associadas (rotura do manguito rotador ou instabilidade) e tempo de seguimento. Nos pacientes entrevistados por telefone avaliamos o n&#237;vel de satisfa&#231;&#227;o e se fariam novamente o procedimento cir&#250;rgico. RESULTADOS: Observamos ganhos significativos em rela&#231;&#227;o &#224; fun&#231;&#227;o (UCLA) e rota&#231;&#227;o medial, assim como a associa&#231;&#227;o entre insatisfa&#231;&#227;o e presen&#231;a de espa&#231;o articular pr&#233;-operat&#243;rio reduzido. Nos pacientes operados, 84% se mostraram satisfeitos com os resultados obtidos e 86,6% repetiriam o procedimento. CONCLUS&#195;O: A videoartroscopia apresenta papel relevante na abordagem da osteoartrite glenoumeral, proporcionando melhora dos resultados funcionais e n&#237;veis de satisfa&#231;&#227;o elevados

Videoarthroscopic treatment of glenohumeral osteoarthritis

OBJECTIVE: To evaluate possible benefits obtained through the use of surgical videoarthroscopy in the management of glenohumeral osteoarthritis. METHODS: We evaluated 37 patients (38 shoulders) who underwent through surgical videoarthroscopy in the period between November 1999 and May 2009 (minimum follow-up of two years). Twenty five patients attend for revaluation and thirteen were interviewed by telephonic contact. Functional assessments were performed (UCLA, Constant, and measurement of range of motion -ROM-), as well as pre and post surgical radiographics. We evaluated the influence of the following factors in the final results: the presence of chondral lesions, joint space narrowing, osteophyte presence, associated injuries (rotator cuff torn or instability), and follow-up. Among those patients interviewed by phone we evaluated the satisfaction level and if they would submit themselves again to the surgical procedure. RESULTS: It was observed significant gain towards to the function (UCLA) and the internal rotation, as well as the association between dissatisfaction and pre surgical joint space reduced. Among the operated patients, 84% were satisfied with the results and 86.6% would repeat the procedure. CONCLUSION: Surgical videoarthroscopy presents a relevant role in management of the glenohumeral osteoarthritis, providing improvement of functional results and high levels of satisfaction

Validity of pre and post-term birth rates based on the date of last menstrual period compared to early obstetric ultrasonography

The aim of this study was to assess the validity of the last menstrual period (LMP) estimate in determining pre and post-term birth rates, in a prenatal cohort from two Brazilian cities, S&#227;o Lu&#237;s and Ribeir&#227;o Preto. Pregnant women with a single fetus and less than 20 weeks' gestation by obstetric ultrasonography who received prenatal care in 2010 and 2011 were included. The LMP was obtained on two occasions (at 22-25 weeks gestation and after birth). The sensitivity of LMP obtained prenatally to estimate the preterm birth rate was 65.6% in S&#227;o Lu&#237;s and 78.7% in Ribeir&#227;o Preto and the positive predictive value was 57.3% in S&#227;o Lu&#237;s and 73.3% in Ribeir&#227;o Preto. LMP errors in identifying preterm birth were lower in the more developed city, Ribeir&#227;o Preto. The sensitivity and positive predictive value of LMP for the estimate of the post-term birth rate was very low and tended to overestimate it. LMP can be used with some errors to identify the preterm birth rate when obstetric ultrasonography is not available, but is not suitable for predicting post-term birth

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora