Femoral shaft fracture: reproducibility of AO-ASIF and Winquist classifications

OBJECTIVE: To evaluate inter-observer reproducibility of AO / ASIF and Winquist-Hansen classifications for shaft fractures of the femur in adults. METHODS: 50 anterior-posterior and profilelateral radiographs were randomly selected, of adult patients awith diaphyseal fracture of the femur. The radiographs were analyzed by 5 observers-a member of the Brazilian Society of Orthopedic Trauma, a radiologist and 3 residents. To assess the concordance between these classifications, we used the statistical index Kappa (K). RESULTS: In all analyses, we observed a statistically significant correlation coefficient between observers (p <0.05) and according to the criteria of Landis and Koch, they were ranked them as good (values of 0.61 to 0.80) or very good (values above 0.80). CONCLUSION: The AO rating and Winquist present a high rate of concordance between observers for shaft fractures of the femur in adults.OBJETIVO: Avaliar a reprodutibilidade interobservadores das classificações AO/ASIF e de Winquist para as fraturas diafisárias do fêmur no adulto. MÉTODOS: foram selecionadas aleatoriamente 50 radiografias de pacientes adultos portadores de fratura diafisária do fêmur nas incidências em antero-posterior e perfil. As radiografias foram analisadas por 5 observadores, sendo um membro da Sociedade Brasileira de Trauma Ortopédico, um radiologista, um residente do terceiro ano de Ortopedia e Traumatologia, um do segundo e um do primeiro. Para avaliar a concordância interobservadores destas classificações, foi utilizado o índice estatístico Kappa (K). RESULTADOS: Em todas as análises, observou-se um coeficiente de concordância entre observadores estatisticamente significativo (valor p < 0,05) e classificado como bom (valores de 0,61 a 0,80) ou muito bom (valores acima de 0,80), segundo os critérios de Landis e Koch. CONCLUSÃO: As classificações AO e Winquist apresentam alto índice de concordância interobservadores para as fraturas diafisárias do fêmur no adulto.Universidade Federal de Minas Gerais Hospitais Felício Rocho e da Baleia Departamento do Aparelho LocomotorUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaHospital Felício Rocho Serviço de Ortopedia e TraumatologiaUniversidade Federal de Minas Gerais Departamento do Aparelho LocomotorUNIFESP, EPMSciEL

Bilateral stress fracture of femoral neck in non-athlete – case report

AbstractBilateral stress fracture of femoral neck in healthy young patients is an extremely rare entity, whose diagnostic and treatment represent a major challenge. Patients with history of hip pain, even non-athletes or military recruits, should be analyzed to achieve an early diagnosis and prevent possible complications from the surgical treatment. This report describes a 43-year-old male patient, non-athlete, without previous diseases, who developed bilateral stress fracture of femoral neck without displacement. He had a late diagnosis; bilateral osteosynthesis was made using cannulated screws. Although the diagnosis was delayed in this case, the study highlights the importance of the diagnosis of stress fracture, regardless of the activity level of the patients, for the success of the treatment

Lasalocid Poisoning in Buffalo Calves in the State of Pará, Brazil

Background: Ionophore antibiotics are food additives with coccidiostatic or antimicrobial action; they are also used as growth promoters, ruminal pH regulators, volatile fatty acid molar modifiers, and methanogenesis reducers. However, these compounds have the potential to cause microbial resistance, in addition to the risk of intoxication. Ionophore poisoning may be caused by excessive intake, sensitivity of certain animal species, and concomitant use with other drugs. In Brazil, cases of ionophore poisoning in buffalos are rare. This study aims to describe the epidemiological, clinical, and pathological findings of lasalocid poisoning in buffalo calves.Case: A visit was made to a farm in the municipality of Mojú, Pará state to care for Murrah buffalo calves. After weaning, the buffalos were grazed in paddocks with Panicum spp., and received a supplement of mineral, protein, and vitamin. This supplement contained, per kg, 250 g PB, 50 g Ca, 20 g P, 8 g S, 39 g Na, 20 mg Co, 557 mg Cu, 200 mg Fe, 12.4 mg Se, 2040 mg Zn, 0.19 mg biotin, 26750 IU of vitamin A, 4175 IU of vitamin D, 155 IU of vitamin E and 300 mg/kg of lasalocid. The product was made available to all calves, at 1-2 g/kg body weight (BW), according to the manufacturer's recommendations. Older calves were raised together with those less than 30 days old; as a result, the older calves tended to eat more, which could lead to a supplementation consumption of more than 1 kg body weight per animal per day. It was reported that between 40 and 60 days after the introduction of this supplement, 16 calves fell ill and died due to apathy, motor instability, tremors, and distended neck. The herd had a mortality rate of 33.3%. Two calves underwent a necroscopic examination at the Pathology Section of the Veterinary Institute of the Federal University of Pará. Macroscopic examination revealed extensive pale areas in the skeletal muscles, myocardium, and tongue. Fragments of these muscles and various organs were collected, fixed in 10% buffered formalin, processed according to the routine histological technique, and stained with hematoxylin-eosin and Masson's trichrome stain. Microscopic examination of the histologic samples revealed foci of muscle atrophy and necrosis characterized by an increase in cytoplasmic eosinophilia associated with the loss of stretch marks, and hyperchromatic nuclei that were displaced to the periphery. The necrosis of the muscle fibers was highlighted by Masson's trichrome staining.Discussion: The diagnosis of lasalocid poisoning in buffalo calves was based on epidemiological data, clinical findings, results of macroscopic and histopathological examination, and based on the estimated ionophore intake, obtained directly from the supplement label and by the calf's handler. Based on the absence of stratification of the calves by similarity of age and because the buffalo calves older than 30 days could eat more than 1 kg of the supplement (containing 300 mg/kg of lasalocid), it was possible to estimate the intake of lasalocid per kg CP (body weight). Therefore, the intake of lasalocid by a 70-kg buffalo calf in approximately 90 days and daily supplement consumption between 1 and 1.5 kg would be between 4.2 and 6.4 mg/kg of body weight. This report reinforces that notion that buffalo calves should never ingest ionophores; however, if necessary, strict protocols must be followed to avoid poisoning in these animals. This study highlighted the fact that stratification of buffaloes by different age groups during feeding became a risk factor that allowed greater consumption by older animals; this led to the estimated consumption of 4.2-6.4 mg/kg of lasalocid.Keywords: ionophores, ruminants, buffalo calves, muscle necrosis.Descritores: ionóforos, ruminantes, bezerros búfalos, necrose muscular.Título:  Intoxicação por lasalocida em bezerros búfalos no Estado do Pará, Brasil 

Potential biosurfactant producing endophytic and epiphytic fungi, isolated from macrophytes in the Negro River in Manaus, Amazonas, Brazil

Endophytic and epiphytic fungi isolated from Eichhornia crassipes (Mart.) Solms and Cyperus ligularis L., macrophytes collected from oil-contaminated waters, were studied to assess their potential for producing biosurfactants; the most promising ones were identified by means of the rDNA region sequencing. In the selection, in the hydrocarbonate biodegradation activity, 2.6-indophenol (DCPIP) in oil-added Bushnell-Haas (BH) medium was the indicator used. The following tests were performed to ascertain the biosurfactant, bioemulsifier activity: emulsification measurement, drop-collapse, surface tension and production slope. Of the twenty fungi isolated, six promoted DCPIP discoloration. The isolate (S31) Phoma sp. showed emulsification of diesel (1.5 cm or 52%) and reduction of the surface tension of 51.03 mN/m water identified as Phoma sp. The other five fungi were identified as Rhizopus oryzae (S24), Fusarium sp. (S32, S33, S42, S46), presenting potential for biodegradation of hydrocarbons, as well. New studies on Phoma sp. (S31), including its cultivation in different carbon sources will be necessary to improve the production of secondary compounds involved in surface tension bioemulsification and reduction.Keywords: Bioremediation, bioemulsifiers, Eichhornia, Cyperus, oil, diese

PERSPECTIVA MULTIDIMENSIONAL DO IMPACTO DO AVC NA QUALIDADE DE VIDA: UMA REVISÃO BIBLIOGRÁFICA

Introdução: O AVC seja isquêmico ou hemorrágico, não apenas ameaça a vida imediatamente, mas também deixa um legado de sequelas físicas e mentais que podem persistir por toda a vida. Os sobreviventes muitas vezes enfrentam um longo caminho de recuperação, com consequências que afetam quase todos os aspectos de suas existências. Metodologia: A pesquisa foi realizada nas seguintes bases de dados: PubMed, Scopus e Web of Science. A busca foi restrita a estudos publicados em inglês ou português publicados de 2013 a 2023.  Resultados e Discussão: O impacto do AVC não se restringe apenas às consequências físicas e sociais; ele também tem um profundo impacto nos aspectos psicológicos da vida dos sobreviventes. Os desafios psicológicos após o AVC são muitas vezes complexos e podem variar de pessoa para pessoal. A abordagem multidimensional é fundamental para capturar a complexidade do impacto do AVC na qualidade de vida dos sobreviventes. Esta perspectiva não se limita à avaliação de sintomas físicos, mas busca uma compreensão mais profunda dos desafios enfrentados pelos pacientes, bem como das estratégias de adaptação e apoio necessárias para melhorar sua qualidade de vida. Conclusão: Para melhorar a qualidade de vida após o AVC, é essencial adotar uma abordagem holística que inclua reabilitação física e psicológica, apoio social, educação e intervenções de saúde mental.Introduction: Stroke, whether ischemic or hemorrhagic, not only threatens life immediately, but also leaves a legacy of physical and mental sequelae that can persist for a lifetime. Survivors often face a long road to recovery, with consequences that affect nearly every aspect of their existence. Methodology: The search was carried out in the following databases: PubMed, Scopus and Web of Science. The search was restricted to studies published in English or Portuguese published from 2013 to 2023. Results and Discussion: The impact of stroke is not limited to physical and social consequences; it also has a profound impact on the psychological aspects of survivors' lives. The psychological challenges after stroke are often complex and can vary from person to person. The multidimensional approach is essential to capture the complexity of the impact of stroke on survivors' quality of life. This perspective is not limited to the assessment of physical symptoms, but seeks a deeper understanding of the challenges faced by patients, as well as the adaptation and support strategies needed to improve their quality of life.  Conclusion:To improve quality of life after stroke, it is essential to adopt a holistic approach that includes physical and psychological rehabilitation, social support, education and mental health interventions. Introducción: El accidente cerebrovascular, ya sea isquémico o hemorrágico, no sólo amenaza la vida de manera inmediata, sino que también deja un legado de secuelas físicas y mentales que pueden persistir durante toda la vida. Los supervivientes suelen afrontar un largo camino hacia la recuperación, con consecuencias que afectan a casi todos los aspectos de su existencia.. Metodología: La búsqueda se realizó en las siguientes bases de datos: PubMed, Scopus y Web of Science. La búsqueda se restringió a estudios publicados en inglés o portugués publicados entre 2013 y 2023. Resultados y Discusión: El impacto del accidente cerebrovascular no se limita a las consecuencias físicas y sociales; también tiene un profundo impacto en los aspectos psicológicos de la vida de los sobrevivientes. Los desafíos psicológicos después de un accidente cerebrovascular suelen ser complejos y pueden variar de persona a persona. El enfoque multidimensional es esencial para captar la complejidad del impacto del accidente cerebrovascular en la calidad de vida de los supervivientes. Esta perspectiva no se limita a la evaluación de los síntomas físicos, sino que busca una comprensión más profunda de los desafíos que enfrentan los pacientes, así como de las estrategias de adaptación y apoyo necesarias para mejorar su calidad de vida. Conclusión: Para mejorar la calidad de vida después de un accidente cerebrovascular, es esencial adoptar un enfoque holístico que incluya rehabilitación física y psicológica, apoyo social, educación e intervenciones de salud mental.Introdução: O AVC seja isquêmico ou hemorrágico, não apenas ameaça a vida imediatamente, mas também deixa um legado de sequelas físicas e mentais que podem persistir por toda a vida. Os sobreviventes muitas vezes enfrentam um longo caminho de recuperação, com consequências que afetam quase todos os aspectos de suas existências. Metodologia: A pesquisa foi realizada nas seguintes bases de dados: PubMed, Scopus e Web of Science. A busca foi restrita a estudos publicados em inglês ou português publicados de 2013 a 2023.  Resultados e Discussão: O impacto do AVC não se restringe apenas às consequências físicas e sociais; ele também tem um profundo impacto nos aspectos psicológicos da vida dos sobreviventes. Os desafios psicológicos após o AVC são muitas vezes complexos e podem variar de pessoa para pessoal. A abordagem multidimensional é fundamental para capturar a complexidade do impacto do AVC na qualidade de vida dos sobreviventes. Esta perspectiva não se limita à avaliação de sintomas físicos, mas busca uma compreensão mais profunda dos desafios enfrentados pelos pacientes, bem como das estratégias de adaptação e apoio necessárias para melhorar sua qualidade de vida. Conclusão: Para melhorar a qualidade de vida após o AVC, é essencial adotar uma abordagem holística que inclua reabilitação física e psicológica, apoio social, educação e intervenções de saúde mental