Avaliação da lipocalina associada à gelatinase de neutrófilos (NGAL) em idosos após osteossíntese de fêmur

Pós-graduação em Anestesiologia - FMB

Vitamin D serum levels are associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture

Objectives: The aim of this study was to evaluate the association between serum levels of 25(OH) vitamin D-3 with midupper arm muscle circumference (MUAMC), handgrip strength and length of hospital stay (LOS) after hip fracture.Methods: In total, 102 consecutive patients with hip fracture over the age of 65 were admitted to the orthopedic unit and prospectively evaluated. All of the patients were treated according to specific protocols depending on the type of fracture. Anthropometric measurements and handgrip strength were performed, and blood samples were taken for serum biochemistry and 25(OH) vitamin D-3 analysis within the first 72 h of admission. All of the patients were followed during their hospital stay, and the length of stay was recorded.Results: Of the patients, two were excluded because of pathologic fractures. In total, 100 patients with a mean age of 80 +/- 7 y were included in the analysis. Among these patients, 73% were female, and 37% had vitamin D deficiency. The median LOS was 7 (5-11) d. Patients with vitamin D deficiency had lower handgrip strength in univariate analysis. In the multiple linear regression analysis with robust standard error, serum vitamin D levels adjusted by age and sex were associated with handgrip strength but not with MUAMC and LOS after hip fracture.Conclusions: In conclusion, vitamin D serum levels were associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. (C) 2015 Elsevier Inc. All rights reserved.

Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block. Comparison with interscalene block

Shoulder arthroscopic surgeries evolve with intense postoperative pain. Several analgesic techniques have been advocated. The aim of this study was to compare suprascapular and axillary nerve blocks in shoulder arthroscopy using the interscalene approach to brachial plexus blockade. According to the technique used, sixty-eight patients were allocated into two groups: interscalene group (IG, n=34) and selective group (SG, n=34), with neurostimulation approach used for both techniques. After appropriate motor response, IG received 30 mL of 0.33% levobupivacaine in 50% enantiomeric excess with adrenalin 1:200,000. After motor response of suprascapular and axillary nerves, SG received 15 mL of the same substance on each nerve. General anesthesia was then administered. Variables assessed were time to perform the blocks, analgesia, opioid consumption, motor block, cardiovascular stability, patient satisfaction and acceptability. Time for interscalene blockade was significantly shorter than for selective blockade. Analgesia was significantly higher in the immediate postoperative period in IG and in the late postoperative period in SG. Morphine consumption was significantly higher in the first hour in SG. Motor block was significantly lower in SG. There was no difference between groups regarding cardiocirculatory stability and patient satisfaction and acceptability. Failure occurred in IG (1) and SG (2). Both techniques are safe, effective, and with the same degree of satisfaction and acceptability. The selective blockade of both nerves showed satisfactory analgesia, with the advantage of providing motor block restricted to the shoulder.

Noninvasive and multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta: a pediatric case report

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

O papel de enfermeiros na equipe multidisciplinar frente ao sobrepeso/obesidade em ambiente de trabalho

Overweight and obesity are pandemics and have been widely discussed in Public Health and Health at Work. Comorbidities such as metabolic syndrome, hypertension, diabetes mellitus type 2, orthopedic disorders and coronary diseases can induce to absenteeism, reduced work performance, disability and death. The aim of this review is to discuss the role of the nurse in control and prevention of these illnesses in the workplace. We concluded that occupational health nurses work should act proactively with a multidisciplinary team aimed at individual and collective monitoring of actions designed to control and prevent overweight and obesity. Furthermore, this professional should follow up the health of individual workers with a high body mass index in order to warn and prevent comorbidities related to these conditions.

Aspectos oclusais na etiologia das desordenstemporomandibulares

Since the occlusion area is presented in almost all specialties of Dentistry, its relationship with the health of the patient has been shown. The etiology of temporomandibular disorders is multifactorial and the occlusion is considered an etiologic factor. This study aimed to discuss the functional occlusion aspects and the presence of temporomandibular disorders. Literature Review: The loss of orthopedic balance can induce temporomandibular disorder. Therefore, both the physiological and functional occlusions have been analyzed as a dental relation. Several functional occlusal factors have been linked to the temporomandibular disorders such as deviations of centric relation to maximum intercuspation, occlusal interferences, absence of posterior teeth, changes on the occlusion vertical dimension, malocclusion, orthodontic treatment and parafunction. Conclusion: The most common occlusal factors related to temporomandibular disorders are quite frequent; however, the diagnosis and treatment of such disorders should be considered individually

Tratamento compensatorio da má oclusnao de classe lll: revisão de literatura

Class III malocclusion is less common occlusal relationship, covering less than 5% of the population. There are various forms of treatment in Class III malocclusion. Depending on how the form is expressed Class III and age of the patient, the therapy may be orthopedic and orthodontic surgical orthodontics. The objective was to review the literature of the last 10 years about ways to compensatory treatment of Class III malocclusion. Several articles were published between 04/2003 and 04/2013 in the Pubmed database from the keyword "Class III malocclusion". However, only 19 articles that addressed the compensatory treatment of Class III were selected. Based on the selected items it was concluded that the treatment of Class III malocclusions in children before the peak of pubertal growth has better prognosis with greater effects orthopedic and orthodontic minor effects. The ideal treatment option for this condition is the Rapid maxillary expansion associated with maxillary protraction of the same. The treatment of Class III malocclusion in young people after the peak of pubertal growth is doubtful prognosis. You can opt to treat rapid maxillary expansion and maxillary protraction of the same or fixed appliance, however, orthopedic effects can be the same or smaller than the orthodontic effects, depending on the age of the patient. Depending on the degree of Class III malocclusion in adults, the treatment will consist of dental compensations or orthognathic surgery.

Nível de atividade física no lazer em usuários do Sistema Único de Saúde

Although leisure physical activity has been investigated in general population, there is absence of data in Brazilian Public Health System about this issue. Thus, the purpose of this study was to analyze in patients attended by Public Health System the prevalence of leisure physical activity, as well as, to identify its correlates and associated diseases. Sample was composed by 963 patients (707 female and 256 male) randomly selected at five basic healthcare units. Leisure physical activity was assessed by Baecke’s questionnaire and subjects with ≥180 and ≥240 minutes per week were classified as sufficiently active. General and central obesity were assessed by body mass index and waist circumference, respectively. Diseases of high occurrence were classified according CID-10. There was low rate of physically active subjects in leisure time (14.8%),but high rate of abdominal obesity (70.1%) and orthopedic diseases (72.1%). Physically active subjects in leisure time had lower occurrence of orthopedic diseases (OR= 0.60 [OR95%CI: 0.37 – 0.98]). The same pattern of association was observed for central obesity (OR= 0.35 [OR95%CI: 0.19 – 0.65]). It is low the rate of physically active in leisure time at Brazilian Public Health System, which is associated with orthopedic diseases.

Characterization of the patellofemoral pain syndrome by frequency parameters of EMG signal

Patellofemoral pain syndrome (PFPS) is the most frequent complaint in orthopedic clinics; although, its etiology remains unclear [Bolgla, 2010; Felicio, 2011]. Trying to understand its causes has been used time analysis of electromyography (EMG), but this method shows controversies. The aim of this study was to apply a method of processing the EMG signal in the frequency domain of the vastus lateralis (VL) and vastus medialis (VM) muscles for the characterization of PFPS.

Characterization of biomechanical parameters during stair ascent

Stair climbing is a functional activity often cited as main complaint by patients with orthopedic – as patellofemoral pain syndrome – or neurologic alterations. Moreover, the stair climbing is usually used as therapeutic resource. However, few studies have been conducted to characterize the movement during the ascent or descent of stairs and these studies concluded that the high variability of the data could not confirm the results [Yu, 1997] . In this way, this study aimed to verify which parameters show less variation and so, are more appropriate to characterize the stair climbing.

Diffusion of oxygen in Ti-15Mo-xZr alloys studied by anelastic spectroscopy

Because of their low elasticity modulus, titanium alloys have excellent biocompatibility, and are largely used in orthopedic prostheses. Among the properties that are beneficial for use in orthopedic implants is the elasticity modulus, which is closely connected to the crystal structure of the material. Interstitial elements, such as oxygen, change the mechanical properties of the material. Anelastic spectroscopy measurements are a powerful tool for the study of the interaction of these elements with the metallic matrix and substitutional solutes, providing information on the diffusion and concentration of interstitial elements. In this study, the effect of oxygen on the anelastic properties of alloys in the Ti-15Mo-Zr system was analyzed using anelastic spectroscopy measurements. The diffusion coefficients, pre-exponential factors, and activation energies of these alloys were calculated for oxygen.

Effect of the substitutional elements on the microstructure of the Ti-15Mo-Zr and Ti-15Zr-Mo systems alloys

Titanium alloys have excellent biocompatibility, and combined with their low elastic modulus, become more efficient when applied in orthopedic prostheses. Samples of Ti-15Mo-Zr and Ti-15Zr-Mo system alloys were prepared using an arc-melting furnace with argon atmosphere. The chemical quantitative analysis was performed using an optical emission spectrometer with inductively coupled plasma and thermal conductivity difference. The X-ray diffractograms, allied with optical microscopy, revealed the structure and microstructure of the samples. The mechanical analysis was evaluated by Vickers microhardness measurements. The structure and microstructure of alloys were sensitive to molybdenum and zirconium concentration, presenting α′, α″ and β phases. Molybdenum proved to have greater β-stabilizer action than zirconium. Microhardness was changed with addition of molybdenum and zirconium, having Ti-15Zr-10Mo (436 ± 2 HV) and Ti-15Mo-10Zr (378 ± 4 HV) the highest values in each system.

Obtenção de nanofibras de carbono a partir do processo de eletrofiação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Relação entre a reatividade de pontos de acupuntura e atividade física com afecções ortopédicas determinadas por exames de imagens em equinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do corticosteroide injetado no tendão calcâneo de coelhos: análise histológica, biomecânica e das expressões de metaloproteinases e interleucinas

Pós-graduação em Bases Gerais da Cirurgia - FMB