Avaliação morfo-histológica e morfo-histométrica de feridas cutâneas tratadas com Sphagneticola trilobata (L) Pruski em ratos / [Morphohistological and morphohistometric evaluation of skin wounds treated with Sphagneticola trilobata (L) Pruski in rats]

O objetivo deste trabalho foi avaliar macro e microscopicamente a atividade cicatrizante da Sphagneticola trilobata em feridas cutâneas induzidas em ratos, a partir da aplicação de creme contendo extrato hidroalcoólico bruto de folhas da planta. A análise fitoquímica apresentou terpenos e flavonoides como compostos majoritários. Sessenta ratos foram divididos em três grupos experimentais (n=20): grupo tratado (GT), grupo controle (GC) e grupo controle absoluto (GCA). Quatro feridas excisionais de 0,8cm de diâmetro foram realizadas no dorso dos animais, tratadas diariamente e avaliadas nos tempos três, sete, 14 e 21 dias de pós-operatório (PO) quanto à contração e à avaliação macroscópica, morfo-histológica e morfo-histométrica. Macroscopicamente, não houve diferença estatística na contração das feridas entre os grupos testados. Na avaliação morfológica e na morfométrica, o GT apresentou menor concentração de células inflamatórias, maior e melhor preenchimento do tecido de granulação pelas fibras colágenas e melhor vascularização das feridas. Não houve diferença entre o GC e o GCA. Conclui-se que o creme à base do extrato hidroalcoólico bruto das folhas de Sphagneticola trilobata contribui positivamente para o processo de cicatrização das feridas em pele de ratos.(AU)

The objective of this work was to macro and microscopically evaluate the healing activity of Sphagneticola trilobata in rat-induced skin wounds by applying cream containing crude hydroalcoholic extract from plant leaves. The phytochemical analysis showed terpenes and flavonoids as major compounds. Sixty rats were divided into three experimental groups (n=20): treated group (GT), control group (CG) and absolute control group (GCA). Four 0.8cm diameter excision wounds were performed on the back of the animals, treated daily and evaluated at the three, seven, 14 and 21 postoperative days (PO) for contraction, macroscopic, morphologic and morphologic evaluation. The TG presented smaller scar area at 21 postoperative days (P<0.05). In the morphological and morphometric evaluation, the WG presented lower inflammation, greater and better filling of granulation tissue by collagen fibers and better wound vascularization. There was no difference between GC and GCA. It was concluded that the cream based on the crude hydroalcoholic extract of Sphagneticola trilobata leaves contribute positively to the healing process of the skin wounds of rats.(AU)

Barriers to treatment of hepatitis C in HIV/HCV coinfected adults in Brazil

The objective of this study was to assess the prevalence of barriers to interferon treatment in a population of HIV/HCV coinfected patients. A cross-sectional study was conducted at two AIDS Outpatient Clinics in Brazil. The study included all HIV infected patients followed at these institutions from January 2005 to November 2007. Medical records of 2,024 HIV-infected patients were evaluated. The prevalence of anti-HCV positive patients among them was 16.7 percent. Medical records of HCV/HIV coinfected patients were analyzed. 189 patients with the following characteristics were included in our study: mean age 43 years; male gender 65 percent; former IDUs (52 percent); HCV genotype 1 (66.4 percent); HCV genotype 3 (30.5 percent); median CD4+ T cell count was 340 cells/mm³. Among 189 patients included in the analyses, only 75 (39.6 percent) were considered eligible for HCV treatment. The most frequent reasons for non-treatment were: non-compliance during clinical follow-up (31.4 percent), advanced HIV disease (21.9 percent), excessive alcohol consumption or active drug use (18.7 percent), and psychiatric disorders (10.1 percent). CONCLUSIONS: In Brazil, as in elsewhere, more than half of HIV/HCV coinfected patients (60.4 percent) have been considered not candidates to received anti-HCV treatment. The main reasons may be deemed questionable: non-adherence, drug abuse, and psychiatric disease. Our results highlight the importance of multidisciplinary teams to optimize the access of coinfected patients to HCV treatment.

Fixacao externa das fraturas de tibias. / External fixation of tibial fractures

Os principios basicos da fixacao externa sao conhecidos ha muitos anos. A infeccao e o maior obstaculo no tratamento de fraturas expostas e sua estabilizacao satisfatoria das fraturas na presenca de infeccao, sendo fundamentalmente importante a selecao dos casos, bem como o uso correto da tecnica cirurgica, devendo-se tomar muito cuidado para nao se causarem lesoes vasculares na perna. O fixador externo nao deve ser empregado num tratamento de rotina, seu uso e restrito, alem disso varios principios devem orientar sua utilizacao