Lumbar estrecho: experiencia de 10 años en la fundación santa fé de Bogotá

El canal lumbar estrecho de tipo degenerativo, es una enfermedad que se presenta en pacientes entre la quinta y la sexta década de vida; es la causa más común de cirugía lumbar después de los 65 años. Este trabajo busca determinar cuáles son los factores asociados a la presentación de eventos adversos o re-intervención en cirugía de canal lumbar estrecho en la Fundación Santa Fe de Bogotá en los años comprendidos entre 2003 y 2013. Métodos: se realizó un estudio de prevalencia de tipo analítico, en donde se analizaron 249 pacientes sometidos a intervención quirúrgica por cirugía de canal lumbar estrecho.

Osteomielitis esternal: utilidad de las pruebas de diagnóstico por imágenes con enfoque en medicina nuclear

Introducción: El diagnóstico de osteomielitis esternal post-esternotomía resulta difícil empleando síntomas clínicos o de laboratorio y las imágenes morfológicas orientan a sospecha más que al diagnóstico. Un diagnóstico precoz ofrece calidad de vida y el mejor tratamiento para reducir una mortalidad que oscila entre 14% y 47%. La gammagrafía con leucocitos marcados ofrece el mejor rendimiento diagnóstico para infecciones y se destaca como el patrón de oro diagnóstico. Objetivo: Identificar el desempeño y utilidad de la gammagrafía con leucocitos autólogos marcados con 99mTc-HMPAO en los estudios realizados para la evaluación de osteomielitis esternal. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo de prueba diagnóstica en la Fundación Cardioinfantil de Bogotá entre enero/2010 y mayo/2015 evaluando gammagrafías con leucocitos marcados ante la sospecha de osteomielitis posterior a esternotomía. Resultados: Se evaluaron 52 pacientes, en los que la gammagrafía con leucocitos mostró 23 pacientes (44,2%) con osteomielitis esternal, logrando una sensibilidad y especificidad del 88,46% y 100% respectivamente. El valor predictivo positivo fue de 100%, y el valor predictivo negativo fue de 89,66%. El impacto de una prueba negativa no modificó el manejo médico inicial en el 93% de los casos mientras que una prueba positiva lo modificó en el 83%. Conclusiones: La gammagrafía con leucocitos autólogos radiomarcados con 99mTc-HMPAO continúa siendo el patrón de oro de referencia no invasiva para el diagnóstico de osteomielitis, y en el caso de osteomielitis esternal se convierte en la prueba de elección pertinente en la selección de pacientes que ameritan una re-intervención quirúrgica.

Incidência de lesões locomotoras no cavalo, diagnosticadas por raio-x

Na medicina equina, os problemas locomotores estão na origem da maioria das consultas veterinárias, provocando uma enorme preocupação para os proprietários e equitadores e exigindo um grande conhecimento por parte do veterinário. Assim, não são demais os estudos realizados nesta área, que permitem auxiliar os médicos veterinários sempre que se deparam com este tipo de problemas. Uma das ferramentas fundamentais para o diagnóstico das lesões ósseas e articulares nos membros é o raio-X. Desde que este foi tornado portátil, passou a ser um enorme aliado do veterinário, permitindo diagnósticos mais facilitados e imediatos no terreno. O objectivo da presente dissertação, para além de rever a bibliografia descrita acerca da incidência de lesões locomotoras, é também contribuir para a caracterização das lesões mais frequentes na medicina equina na população estudada que envolvam as estruturas óssea e articular dos membros do cavalo. As lesões locomotoras descritas no estudo, foram determinadas após uma observação rigorosa aos diferentes raios-X de 95 cavalos e os dados recolhidos foram tratados através de uma análise estatística utilizando o programa «SPSS®». Existe uma maior incidência de lesões nos membros anteriores quando comparado com os membros posteriores. Tanto o membro anterior direito, como o membro posterior direito são igualmente mais afectados do que os membros esquerdos, havendo também uma elevada distribuição das lesões em ambos os membros anteriores em simultâneo. No membro anterior, a lesão mais frequentemente diagnosticada é a osteoartrite, sendo a luxação uma das lesões menos encontradas. Para o membro posterior, é o esparvão que mais se diagnostica, contrastando com o síndrome podotroclear, que tem uma prevalência baixa. No membro anterior, a 3ª falange é uma das regiões mais afectadas, sendo a ulna uma das regiões menos afectadas. No membro posterior, é a região do curvilhão que representa um dos locais mais propícios a lesão, enquanto a 2ª falange é uma das regiões onde menos frequentemente se diagnosticam lesões no cavalo. Os resultados encontrados estão de acordo com a bibliografia descrita e sugerem a importância da continuidade deste tipo de estudos, nomeadamente abrangendo outras variáveis como a raça, a idade e o tipo de utilização do cavalo e, ainda, a utilização de outros métodos imagiológicos.

New radiocarbon accelerator dates on artefacts from the early Mesolithic site of Star Carr, North Yorkshire

For the well-known early Mesolithic site of Star Carr, dating of organic artefacts by accelerator mass spectrometry (AMS) has been hampered by treatment of bone and antler recovered during the original excavations with preservatives. Some, untreated, artefacts were, however, collected after Clark's excavation in 1950. Four of these artefacts were AMS dated in 1995, but two of the dates were significantly younger than the others, and were questionable due to their low collagen yields. These suspect samples have now been re-analysed, demonstrating that all four artefacts are of similar date. The significance of these dates for the chronology of Star Carr is discussed.

In Vivo Comparison of Hard Tissue Regeneration with Human Mesenchymal Stem Cells Processed with Either the FICOLL Method or the BMAC Method

Objective: To compare new bone formation in maxillary sinus augmentation procedures using biomaterial associated with mesenchymal stem cells (MSCs) separated by two different isolation methods. Background: In regenerative medicine open cell concentration systems are only allowed for clinical application under good manufacturing practice conditions. Methods: Mononuclear cells, including MSCs, were concentrated with either the synthetic poylsaccharid (FICOLL) method (classic open system-control group, n = 6 sinus) or the bone marrow aspirate concentrate (BMAC) method (closed system-test group, n = 12 sinus) and transplanted in combination with biomaterial. A sample of the cells was characterized by their ability to differentiate. After 4.1 months (SD +/- 1.0) bone biopsies were obtained and analyzed. Results: The new bone formation in the BMAC group was 19.9% (90% confidence interval [CI], 10.9-29), and in the FICOLL group was 15.5% (90% CI, 8.6-22.4). The 4.4% difference was not significant (90% CI, -4.6-13.5; p = 0.39). MSCs could be differentiated into osteogenic, chondrogenic, and adipogenic lineages. Conclusion: MSCs harvested from bone marrow aspirate in combination with bovine bone matrix particles can form lamellar bone and provide a reliable base for dental implants. The closed BMAC system is suited to substitute the open FICOLL system in bone regeneration procedures.

Outcome analysis of immediately placed, immediately restored implants in the esthetic area: The clinical relevance of different interimplant distances

Background: The purpose of this study was to compare and evaluate bone and soft tissue levels between immediately placed, immediately restored implants positioned in the esthetic anterior region with different interimplant distances (IID). Methods: Forty-nine patients requiring multiple implant restorations in the anterior regions received 152 implants, which were restored immediately. Periapical radiographs and digital images of 99 interimplant sites were taken at the regular follow-up examinations at 0, 6, 12, and 24 months after surgery. They were digitally recorded and analyzed. The presence of the interproximal papilla was assessed and compared to the distances between the bone crest and the contact point between the natural teeth and the restoration crowns. Results: Implants with an IID <2 mm seemed to lose less bone laterally. When the IID was <2 mm, vertical crestal bone loss was significantly greater than in the group with IID >4 mm. The percentage of the interproximal papilla presence decreased when the distance between the bone crest and the contact point between the two restoration crowns was >6 mm and when two implants were placed at a distance >= 4 mm. Conclusions: To guarantee a better esthetic result in immediately placed, immediately restored implants, the contact point between the two prosthetic crowns should be placed at 3 to 4 mm, and never >6 mm, from the bone peak. Two adjacent implants should be placed at a distance >2 and <4 mm.

Histomorphologic evaluation of Ti-13Nb-13Zr alloys processed via powder metallurgy. A study in rabbits

This study presents the in-vivo evaluation of Ti-13Nb-13Zr alloy implants obtained by the hydride route via powder metallurgy. The cylindrical implants were processed at different sintering and holding times. The implants` were characterized for density, microstructure (SEM), crystalline phases (XRD), and bulk (EDS) and surface composition (XPS). The implants were then sterilized and surgically placed in the central region of the rabbit`s tibiae. Two double fluorescent markers were applied at 2 and 3 weeks, and 6 and 7 weeks after implantation. After an 8-week healing period, the implants were retrieved, non-decalcified section processed, and evaluated by electron, UV light (fluorescent labeling), and light microscopy (toluidine blue). BSE-SEM showed close contact between bone and implants. Fluorescent labeling assessment showed high bone activity levels at regions close to the implant surface. Toluidine blue staining revealed regions comprising osteoblasts at regions of newly forming/formed bone close to the implant surface. The results obtained in this study support biocompatible and osseoconductive properties of Ti-13Nb-13Zr processed through the hydride powder route. (c) 2007 Published by Elsevier B.V.

Biodistribution of the Radiopharmaceutical Sodium Pertechnetate after Biliopancreatic Bypass with a Duodenal Switch

Study with the purpose to examine the effects of duodenal switch (DS), regularly performed in morbidly obese patients, on biodistribution of sodium pertechnetate in several organs of rats. There was no early or late mortality in either rats groups. The values of percent radioactivity per gram of tissue (%ATI/g), showed no significant difference in liver, stomach, small bowel, duodenum, kidney, heart, bladder, bone and brain, when compared the DS rats with sham and controls rats. A postoperative significant increase (p<0.05) in mean %ATI/g levels was observed in spleen, pancreas and muscle in group DS rats, as compared to group S and C rats. In the lung there was an increase and in thyroid a decrease in mean %ATI/g of DS rats, when compared to sham rats (p<0.05). In conclusion, the biliopancreatic diversion with duodenal switch in rats modified the biodistribution of sodium pertechnetate in thyroid, lung, pancreas, spleen and muscle

Biodistribuição do pertecnetato de sódio após cirurgia do Switch Duodenal

The biliopancretic diversion with duodenal switch is one of the mixing techniques used in the treatment of morbid obesity. The duodenal switch reduces the stomach capacity and leaves only 50-100 cm of small intestine for nutrition and absorption. The surgery produces hormonal, structural and biochemical changes, which can influence on the result of scintigraphic examinations in operated patients. With the objective of evaluate the postoperative biodistribution of sodium pertechnetate (Na99mTcO4) in brain, thyroid, heart, lung, liver, spleen, kidney, stomach, duodenum, pancreas, small intestine, bladder, muscle and bone of Wistar rats. The rats were randomly allocated into 3 groups of 7 rats each: the duodenal switch group (DS), the control group (C) and the sham group (S). They were operated under anesthesia and aseptic technique. In the tenth postoperative day, 0.1mL of sodium pertechnetate was injected via orbital plexus. After 30 min the animals were killed with overdose of anesthetic and samples of liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, bone and brain were harvested, washed with saline and weighed. The detention of radioactivity was made using the automatic Gamma Counter Wizard, PerkinElmer and the percentage of activity per gram of tissue (%ATI/g) was calculated. There was no early or late mortality in either rats groups. The values of percent radioactivity per gram of tissue (%ATI/g), showed no significant difference in liver, stomach, small bowel, duodenum, kidney, heart, bladder, bone and brain, when compared the DS rats with sham and controls rats. A postoperative significant increase in mean %ATI/g levels was observed in spleen, pancreas and muscle in group DS rats, as compared to group S and C rats (p<0.05). In the lung there was an increase and in thyroid a decrease in mean %ATI/g of DS rats, when compared to sham rats (p>0.05). In conclusion, the biliopancreatic diversion with duodenal switch in rats modified the biodistribution of sodium pertechnetate in thyroid, lung, pancreas, spleen and muscle. The study had the participation of the departments and laboratories researches, as Nucleus of Experimental Surgery, Department of Surgery, Laboratory of Radiobiology, Department of Pathology and Service of Nuclear Medicine, certifying the character of a multidisciplinary research

The use of stable isotopes for authentication of gadoid fish species

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da presença de osteopatia decorremte do diabetes tipo 1 em criança e adolecentes do Rio Grande do Norte

Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure

Construction of an alkaline phosphatase-liposome system: a tool for biomineralization study

Alkaline phosphatase is required for the mineralization of bone and cartilage. This enzyme is localized in the matrix vesicle, which plays a role key in calcifying cartilage. In this paper. we standardize a method for construction an alkaline phosphatase liposome system to mimic matrix vesicles and examine a some kinetic behavior of the incorporated enzyme. Polidocanol-solubilized alkaline phosphatase, free of detergent, was incorporated into liposomes constituted from dimyristoylphosphatidylcholine (DMPC), dilaurilphosphatidylcholine (DLPC) or dipalmitoylphosphatidylcholine (DPPC). This process was time-dependent and >95% of the enzyme was incorporated into the liposome after 4 h of incubation at 25 degreesC. Although, incorporation was more rapid when vesicles constituted from DPPC were used, the incorporation was more efficient using vesicles constituted from DMPC. The 395 nm diameter of the alkaline phosphatase-liposome system was relatively homogeneous and more stable when stored at 4 degreesC.Alkaline phosphatase was completely released from liposome system only using purified phosphatidylinositol-specific phospholipase C (PIPLC). These experiments confirm that the interaction between alkaline phosphatase and lipid bilayer of liposome is via GPI anchor of the enzyme, alone. An important point shown is that an enzyme bound to liposome does not lose the ability to hydrolyze ATP, pyrophosphate and p-nitrophenyl phosphate (PNPP), but a liposome environment affects its kinetic properties, specifically for pyrophosphate.The standardization of such system allows the study of the effect of phospholipids and the enzyme in in vitro and in vivo mineralization, since it reproduces many essential features of the matrix vesicle. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Mananoligossacarídeos em dietas para frangos de corte

Objetivou-se avaliar dietas contendo mananoligossacarídeos (MOS) como aditivo alternativo aos promotores de crescimento por meio do estudo da morfometria do intestino e do desempenho de frangos de corte. Para tanto, 1280 pintos de corte foram distribuídos em delineamento inteiramente casualizado com quatro tratamentos (controle negativo, CN: dieta isenta de antibiótico; controle positivo, CP: dieta contendo antibiótico e duas dietas, MOS 1 e MOS 2, nas quais foram adicionadas ao CN duas fontes distintas de MOS) e oito repetições, sendo a unidade experimental composta por 40 aves. Para submeter as aves ao desafio sanitário, foi formulada uma dieta basal com milho, farelo de soja e farinha de carne e ossos. Adotou-se cama reutilizada, limpeza dos bebedouros duas vezes por semana e oferta semanal de água contaminada com cama. Foram avaliadas altura de vilo e profundidade de cripta do duodeno, jejuno e íleo, consumo da dieta, peso médio, ganho de peso e conversão alimentar das aves. Houve melhora na profundidade de cripta no jejuno e na altura de vilo no íleo das aves alimentadas com dietas contendo MOS. A adição de MOS, independente da fonte, resultou em melhor conversão alimentar em relação às aves do CN, sendo similares às aves do CP. Os mananoligossacarídeos podem ser utilizados como aditivo alternativo aos promotores de crescimento em dietas para frangos de corte, porém, dependendo da fonte, esta pode acarretar em pequenas diferenças no desempenho das aves.

Características quantitativas da carcaça de cordeiros deslanados Morada Nova em função da relação volumoso:concentrado na dieta

Com o objetivo de avaliar a influência da relação volumoso:concentrado sobre a composição tecidual e os rendimentos de carcaça e de cortes comerciais de cordeiros Morada Nova em confinamento, utilizaram-se 18 cordeiros com peso vivo (PV) inicial de 15 kg, distribuídos em seis grupos de três animais (um em cada dieta), de acordo com a relação volumoso(V):concentrado(C): 40:60, 55:45 e 70:30. Foram avaliados os pesos de corpo vazio (PCV), de carcaça quente (PCQ) e de carcaça fria (PCF), a partir dos quais foram calculados os rendimentos biológico (RB), de carcaça quente (RCQ) e de carcaça fria (RCF) e a perda de peso por resfriamento (PPR). A carcaça foi dividida em cinco cortes cárneos (perna, lombo, costelas, paleta e pescoço), os quais foram pesados para cálculo de seus rendimentos em relação ao peso da meia-carcaça. A perna foi dissecada em músculo, osso e gordura e os pesos desses tecidos foram expressos em peso absoluto e em porcentagem da perna. Calcularam-se as relações músculo:osso e músculo:gordura, o índice de musculosidade da perna (IMP) e a área de olho-de-lombo (AOL). O aumento de 30 para 60% de concentrado na dieta elevou os rendimentos de carcaça quente e carcaça fria, assim como o rendimento biológico. Os crescentes teores de concentrado na dieta não afetaram a porcentagem de músculo na perna, mas proporcionaram maior deposição de gordura e maior área de olho-de-lombo.

Estudo da detecção preventiva da osteoporose pela aplicação da variação da permissividade elétrica a partir da sondagem eletromagnética

This paper proposes a method based on the theory of electromagnetic waves reflected to evaluate the behavior of these waves and the level of attenuation caused in bone tissue. For this, it was proposed the construction of two antennas in microstrip structure with resonance frequency at 2.44 GHz The problem becomes relevant because of the diseases osteometabolic reach a large portion of the population, men and women. With this method, the signal is classified into two groups: tissue mass with bony tissues with normal or low bone mass. For this, techniques of feature extraction (Wavelet Transform) and pattern recognition (KNN and ANN) were used. The tests were performed on bovine bone and tissue with chemicals, the methodology and results are described in the work