Treatment of osteochondral injuries with platelet gel

OBJECTIVES: Treatments for injured articular cartilage have not advanced to the point that efficient regeneration is possible. However, there has been an increase in the use of platelet-rich plasma for the treatment of several orthopedic disorders, including chondral injuries. Our hypothesis is that the treatment of chondral injuries with platelet gel results in higher-quality repair tissue after 180 days compared with chondral injuries not treated with gel.METHODS: A controlled experimental laboratory study was performed on 30 male rabbits to evaluate osteochondral injury repair after treatment with or without platelet gel. Osteochondral injuries were surgically induced in both knees of each rabbit at the medial femoral condyle. The left knee injury was filled with the platelet gel, and the right knee was not treated. Microscopic analysis of both knee samples was performed after 180 days using a histological grading scale.RESULTS: The only histological evaluation criterion that was not significantly different between treatments was metachromasia. The group that was treated with platelet gel exhibited superior results in all other criteria (cell morphology, surface regularity, chondral thickness and repair tissue integration) and in the total score.CONCLUSION: The repair tissue was histologically superior after 180 days in the study group treated with platelet gel compared with the group of untreated injuries.

Valores hematológicos em Geochelone carbonária (Jabuti)

Hematology has a great importance in assessing the health of all animals, including reptiles, since it aids in the diagnosis of certain diseases and help to monitor patient's clinical evolution, although studies and articles in this area are rare, even with the increasing number of calls of these animals in veterinary clinics. Moreover, there are a lot of environmental and individual factors, which influence the hematological values of this group, such as age, sex, stress levels, nutrient levels and season which the exam was made, among others. For these reasons studies that aimed to evaluate the reference values of some specie, are essential to increase the knowledge in the field and to assist on the clinical approach. This paper aim’s to study the patterns of Hematology of Tortoise (Geochelone carbonaria) seeking the greater knowledge of clinical pathology of this species and increasing the possibilities for diagnosis, monitoring clinical outcome, and assessment of the general state and treatment

Radioterapia com elétrons

Radiotherapy is a field of medical physics, which has been going through a scientific and technological advancement, it is extreme important the professionals that work in this area continuous their study to improve the quality of service provided. For it, they should know the physical principles related as well their employment in radiotherapy. The electrons have been using in therapy of superficial tumors, because they show rapid decrease of dose in depth, they don’t expose the deeper tissues to radiation. The electron therapy has replaced the surface therapy with x-ray and mold brachytherapy, and nowadays, it represents 10 to 15% of radiotherapy treatments. This study brings the definition of physical parameters used in the dosimetry of electron beam, describes the tests for quality control of linear accelerator with a electrons beam, as well the activities realized in the Radiotherapy Division, of Hospital de Clinicas, in the Universidade Estadual of Campinas, in the Clinac 2100C machine

Colangiohepatite Felina

Cholangiohepatitis is a common hepatic disorder in cats that is second only to hepatic lipidosis in frequency. The cholangitis-cholangiohepatitis complex is known as the diseases that involve the biliar tract inflammation and may extend to the liver. The classification of the cholangiohepatitis is still controversial, in this present study the following classification was used: Acute Cholangiohepatitis, Chronic Cholangiohepatitis, Lymphocitic Cholangitis. The cholangiohepatitis may be associated with pancreatitis and inflammatory bowel disease, this association is known as feline triaditis. The diagnosis is based on the clinical signs, alterations in laboratory exams and ultrasonography alterations, but the definitive diagnosis is only possible through liver biopsy. The treatment for each type of cholangiohepatitis differs, hence the importance of the right diagnosis. This study aimed to do a review over the ethiology, clinical presentation, diagnosis and treatment for this disease

Correlação entre aneuploidia cromossômica em espermatozóides e taxa de implantação embrionária: subtitulo

Infertility is directly related to chromosomal abnormalities in germ cells. Among them, the aneuploidies are the most frequent chromosomal abnormalities and responsible for embryo implantation failures, miscarriages, fetal losses and newborns with congenital malformations, mental disability and neuropsychomotor developmental delay. Male patients with normal somatic karyotype may present different rates of aneuploidies in sperm, resulting in abnormal embryos. This study aimed to correlate the frequency of chromosomal aneuploidies in spermatozoa with embryo implantation rate in couples undergoing assisted reproductive techniques. The methodology has included chromosomal analysis by GTG banding and molecular cytogenetic study using Fluorescent In Situ Hybridization technique for evaluation of chromosomes 9, X and Y in germ cells of 22 patients referred to the Human Reproduction Service of the Clinical Hospital FMRP-USP. Embryo implantation rates were determined by hormonal evaluation in maternal peripheral blood and ultrasound confirmation. Two patients presented abnormal karyotype, characterized by polymorphism of the heterochromatic region of the long arm of chromosome 9 and a satellite in the short arm of chromosome 22. Both alterations, usually considered variants of normality, have been related to infertility phenotype and miscarriages. Significant differences were detected between couples who presented pregnancy (group 1) and couples with embryo implantation failure (group 2), with higher frequency of aneusomy and diploidy of chromosome 9, as well as total aneuploidy in sperm of group 2 patients. Our results suggest a correlation between aneuploidy and embryo implantation rates, since the infertile group with reproductive failure has showed higher frequency of aneuploidy. Screening for aneuploidies detection in male germ cells should be included in order to decrease embryo implantation failures, miscarriages and fetuses with chromosomal ...

Acidentes na infância atendidos no pronto socorro de pediatria do Hospital das Clínicas de Botucatu que motivaram internação

Accidents represent a major public health problem as they are frequent, preventable, and account for high morbidity and mortality rates. Children are the most vulnerable to accidents due to their inherent characteristics, and as a result of their physical, sensorial, psychomotor and cognitive limitations, which will only develop with time. Watchfulness and careful attention are of paramount importance, especially as children develop locomotor skills that are accompanied by curiosity about their surroundings. Child accidents, particularly those that could have been avoided, are the accidents most commonly seen in emergency and urgency departments. Urgency and emergency departments are the greatest allies in the attention to pediatric accidents as they offer adequate, immediate and specific high complexity care to patients at risk, viewing their vital stabilization. Investigating the causes and consequences of this insult is essential to establish a diagnosis and to contribute for the adoption of measures of prevention, control, and assistance. To identify the epidemiologic characteristics of the accidents involving children that received care at the pediatric emergency department of Botucatu Medical School Hospital and required hospitalization. This quantitative, retrospective, descriptiveanalytic epidemiologic study included all children aged 0-14 years who had had an accident and were seen at the Pediatric Emergency Department of Botucatu Medical School Hospital of São Paulo State University/UNESP between January 1/2008 and December 31/2009. A total of 227 medical charts were reviewed and 178 (78.4%) patients were included in this study. Of these, 116 (65.1%) were males and 62 (34.8%) were females. Children aged 5 - 9 years (38.9%) were the most affected, followed by those aged 10 - 14 years (37.5%). Fractures occurred in 138 (77.5%) of the cases, followed by foreign bodies... (Complete abstract click electronic access below)

Análise quantitativa dos parâmetros físicos e radiométricos de procedimetnos radioterapicos em tumores de mama

The paper presents the radiometric parameters determined by the medical physicist during routine radiotherapy planning service in cases of breast cancer . The contours of the breast volume in patients undergoing radiation breast tumors at the Hospital das Clinicas, Faculty of Medicine , UNESP, Botucatu ( HCFMB ) during the year 2012 were analyzed . In order to analyze the influence of physical and radiometric parameters for the determination of the dose distribution of irradiated breast volume , four measurements of isodose curves were prepared in four different heights breast , and compared with the isodose curves plotted computationally . In the routine of planning , the medical physicist must determine the isodose curve that gives the best dose distribution homogeneity in the irradiated volume . The choice of the treatment plan can be done by dedicated computer systems , which require significantly costly investments available services having better financial support . In the Service of Medical Physics , Department of Radiotherapy , HC FMB , we use a two-dimensional software for determination of isodose curves , however , this software is out of date and frequently becomes inoperable due to the lack of maintenance and it is a closed system without feasibility of interference from computer professionals . This fact requires manual preparation of isodose curves , which are subject to uncertainties due to the subjectivity in the clinical interpretation of medical radiation oncologist and medical physicist responsible for planning , plus dispendiar significant calculation time . The choice of the optimal isodose curve depends on the energy of the radiation beam , the geometry and dimensions of the irradiated area . The contours of the breast studied in this work evaluations showed that , for a given energy input , such as the energy of 1.25 MeV of gamma radiation Unit Telecobaltoterapia , the determination of the percentage depth dose ( PDP ) ...

Análise das microdeformações geradas ao redor de implantes de hexágono externo sob a aplicação de cargas verticais em pilares microunit retos e angulados

Pós-graduação em Odontologia Restauradora - ICT

Avaliação do pH na amostra isolada e na urina de 24h de pacientes litiásicos em uso de citrato de potássio

Pós-graduação em Bases Gerais da Cirurgia - FMB

Próteses parciais removíveis associadas a encaixes: implicações clínicas e laboratoriais

Nowadays, the fixed partial dentures and/or dental implants is the most requested treatmentby the majority of partially edentulous patients. However, depending on the periodontal condition of the remaining teeth, as well as the bone condition of the prosthetic space, the oral rehabilitation with these treatments may be limited or even contraindicated. In such cases, the use of removable partial dentures associated to attachments becomes an important alternative for aesthetic and functional rehabilitation. Attachments are mechanical devices consisted of two parts (patrix-matrix), one placed inside another, which act as direct retainer, providing retention, support and stability to the dentures. These devices can be classified as intra or extracoronal attachments, considering their position in relation to the abutment tooth. However, regardless the type of attachment, the association between fixed and removable partial dentures should be performed respecting the biomechanical principles of both. Therefore, the purpose of this study was to review and discuss the literature about the clinical and laboratory implications of the association between fixed and removable partial dentures by means of attachments.

Estudio descriptivo in vitro de dos agentes blanqueadores de distinta concentración sobre la micromorfología del esmalte bovino

Dental tooth bleaching is a conservative option for the treatment of tooth stains. It is based on the use of hydrogen peroxide as an active agent. Despite its effectiveness to lighten tooth colour, there is concern regarding its use due to the effects it could have over enamel surface. There is scarce evidence on the subject and contradictions exist between different authors. The aim of this study was to compare enamel surface micromorphology after bleaching teeth with different concentrations of hydrogen peroxide solutions. Method: 50 healthy bovine incisors sectioned horizontally at the cemento-enamel junction were prepared. Contents of pulp chamber and tooth surfaces were cleaned. The buccal surface of each tooth was divided vertically, assigning one half to the control group (CG) and the other randomly to: Group 1: 25 samples treated with 15% hydrogen peroxide with nitrogen doped titanium dioxide. Group 2: 25 samples treated with 35% hydrogen peroxide. Square samples (2x2 mm.) were obtained and observed by SEM (magnification of 5.000x and 10.000x). Results: All treated groups showed longitudinal depressions on the surface and increased surface roughness. Conclusions: Tooth bleaching with hydrogen peroxide produces subclinical alterations over bovine enamel surface. 15% hydrogen peroxide bleaching agent produced less micromorphology alteration over bovine enamel surface than the 35% hydrogen peroxide agent.

Guia prático de medicina baseada em evidências

Neste livro são expostos, para uso de profissionais da área, os princípios básicos e conceitos fundamentais, além dos procedimentos necessários para a prática da Medicina Baseada em Evidências (MBE). A MBE é uma prática relativamente nova, criada em 1992, pelo cientista epidemiologista Gordon Guyatt, na canadense McMaster University. Trata-se da utilização e do desenvolvimento de métodos rigorosos que respondam a questões clinicas sobre efetividade, eficiência e segurança de determinado tratamento e prevenção, bem como sobre a sensibilidade e especificidade de testes diagnósticos de certa doença na área de saúde. A MBE propõe realizar pesquisas de boa qualidade metodológica e livres de vieses e conflitos de interesse, de forma que as respostas sejam adequadas para auxiliar na tomada de decisão clínica. Segundo a MBE, a melhor forma de saber se uma medicação específica é eficaz no tratamento de determinada doença é a revisão sistemática de ensaios clínicos randomizados, que mapeiam os estudos publicados e não publicados realizados mundialmente sobre o assunto. Tal revisão deve ainda contar com metodologia rigorosa que busque, por exemplo, explicar resultados contraditórios sobre a mesma questão e comparar estudos com diferentes amostras para detectar possível diferença estatística. De forma didática e detalhada, mas mantendo todo o rigor científico, esta obra tem caráter de manual. Ao longo dos capítulos, seus autores explicam conceitos e apresentam o passo a passo da utilização da MBE para os profissionais de saúde.

Avaliação da resistência à fratura de próteses fixas temporárias reforçadas por uma malha experimental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of resistance training in older women with knee osteoarthritis and total knee arthroplasty

OBJECTIVES: This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program.METHODS: Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had their functional performance, lower-limb loading distribution and balance compared before and after 13 weeks of a twice-weekly progressive resistance training program.RESULTS: At baseline, the OKG showed lower functional performance and unilateral balance, and impaired lower-limb loading distribution compared to the OG and the YG (p<0.05). After resistance training, the OKG showed improvements in functional performance (similar to 13% in sit-to-stand and rising from the floor, similar to 16% in stair-climbing and similar to 23% in 6-minute walking (6 MW)), unilateral balance (similar to 72% and,78% in TKA and OA leg, respectively) and lower-limb loading distribution, which were greater than those observed in the OG and the YG. The OKG showed post-training 6 MW performance similar to that of the OG at baseline. Sit-to-stand performance and unilateral stand balance were further restored to post-training levels of the OG and to baseline levels of the YG.CONCLUSIONS: Resistance training partially restored functional, balance and lower-limb loading deficits in older women with TKA and OA in the contralateral knee. These results suggest that resistance training may be an important tool to counteract mobility impairments commonly found in this population.

Preoperative therapy restores ventilatory parameters and reduces length of stay in patients undergoing myocardial revascularization

Introduction: The frequency of surgical procedures has increased steadily in recent decades, including the myocardial revascularization.Objectives: To demonstrate the importance of physiotherapy in the preoperative period of cardiac surgery in relation to the reduction of hospital stay, changes in lung volumes and respiratory muscle strength.Methods: We conducted a prospective study with patients undergoing myocardial revascularization, the Hospital das Clinicas da Universidade Estadual Paulista (UNESP)/Botucatu - SP. We evaluated 70 patients of both genders, aged between 40 and 75 years, subdivided into two groups: group I - 35 patients of both genders, who received a written protocol guidance, breathing exercises and respiratory muscle training in the preoperative period and group II - 35 patients of both genders, who received only orientation of the ward on the day of surgery. This study was approved by the Ethics Committee of UNESP /Botucatu - SP.Results: Maximal inspiratory pressure in third postoperative day and fifth postoperative day and significant difference between groups, being better for the intervention group. Expiratory pressure was significant in fifth postoperative day in the intervention group compared to controls. The difference of length of hospital stay in the postoperative was found between the groups with shorter hospital stay in the group receiving preoperative therapy.Conclusion: Physical therapy plays an important role in the preoperative period, so that individuals in the intervention group more readily restored the parameters evaluated before surgery, in addition, there was a decrease in the time of the postoperative hospital stay. Thus, it is thought the cost-effectiveness of a program of preoperative physiotherapy.