Rompiendo el efecto ''techo de cristal'' en la generación de evidencia clínica de alto nivel en ortopedia y traumatología / Breaking the "glass ceiling" effect in the generation of high-level clinical evidence in orthopedics and traumatology

Introduction: In clinical studies involving common orthopedic problems and traumatic injuries, randomization methods are difficult to orchestrate. The lack of high-level clinical evidence based on prospective, randomized, double-blind studies is often cited as a major reason for rejecting proposed therapeutic advances in orthopedic surgery. Materials and methods: This opinion document summarizes the limitations of clinical trials in surgical subspecialties. A consensus is presented about how the practicing orthopedic surgeon can produce high-quality clinical evidence and thus make changes to their clinical practice protocols. Results: This literature review revealed that level of evidence classifications vary among surgical subspecialties. Research in orthopedics and traumatology is primarily directed toward diagnosis, preferred treatment, and economic decision analysis, while other prognostic classifications are preferred in other areas, such as plastic surgery. In orthopedics, double-blind controlled studies are rare and often impractical or even unethical. Crossover between randomized surgical trials of study groups is more common. Other difficulties in surgical trials range from: lack of organizational and financial support, institutional approval or ethics committee and registration requirements for clinical trials, and to insufficient time outside of an already busy clinical program to dedicate to this laborious task. uncompensated task. Conclusion: Orthopedic surgery is a subspecialty based on experience and skill. Many innovations begin with enterprising surgeons reporting opinion reports or retrospective cohort studies, many of which are biased. Prospective observational cohort studies with consistent results may offer higher grade clinical evidence than poorly executed randomized trials.

First Occurrence and Population Dynamics of Blissus pulchellus (Hemiptera: Blissidae) in Brazil: a new pest of pastures in Roraima

ABSTRACT Cattle production is one of the main economic activities in the state of Roraima, and insect pest attacks in pastures have a negative effect on this sector in the region. Little is known about the species that cause damage to forage fields in the state. This study presents the first report of the occurrence of the chinch bug Blissus pulchellus Montandon (Hemiptera: Blissidae) in Roraima, Brazil and a description of the population dynamics of this pest in pasture areas in this state. Pasture areas were sampled in nine municipalities of Roraima to detect the insect. The population dynamics study was conducted for two years in Alto Alegre municipality, two of which have Brachiaria brizantha cv. Marandu and one of Megathrysus maximus cv. Mombaça (Poaceae) crops. Blissus pulchellus was found in all sampled areas, except in Rorainópolis and São João da Baliza. High densities of this bug were found in in Alto Alegre. This is the first report of B. pulchellus in Brazil. The factors that affect the population dynamics and the damage caused by this insect pest to pastures as well as the risk of dispersal of this pest in Brazil are discussed.

Resultados de biopsia guiada por tomografía axial computarizada en el síndrome de destrucción vertebral, evaluados en dos instituciones distintas / Resultados de biópsia guiada por tomografia computadorizada axial na síndrome de destruição vertebral, avaliados em duas instituições distintas / Results of computerized axial tomography-guided biopsy in the vertebral destruction syndrome, evaluated at two different institutions

OBJETIVO: Comparar resultados de biopsias vertebrales guiadas por tomografía axial computarizada, reportados por dos servicios de Anatomía Patológica distintos en pacientes con síndrome de destrucción vertebral para confirmar confiabilidad y utilidad en el diagnóstico. MÉTODOS: Se obtuvieron muestras de tejido de 21 pacientes en el periodo comprendido del 1 de marzo al 15 de julio del 2011 con el diagnóstico del síndrome de destrucción vertebral y a quienes se les realizó biopsia guiada por tomografía axial computarizada. Las muestras se enviaron en forma cegada a dos servicios de patología distintos. Los resultados fueron analizados con el método de comparación de dos proporciones. RESULTADOS: 14 pacientes fueron del género masculino (67%) y 7 del femenino (23%), edades de 28-82, con afección principalmente lumbar (48%) y torácica (38%); afectados en una vértebra en 62%, en dos en un 33% y en 3 o más niveles en 5%. Las vértebras más afectadas fueron L1, L2 y L3 (12/30 [40%]), T4 (3/30 [10%]) y T9 (3/30 [10%]). Los resultados se agruparon en categorías: 1. Osteomielitis (9/21 [43%]), 2. Tumores (7/21 [33%]), 3. Metástasis (3/21 [14%]), 4. Tejido normal (2/21 [10%]), 5. Inflamación (0/21 [0%]), 6. Muestra inadecuada (0/21 [0%]), 7. Mal de Pott (0/21 [0%]). CONCLUSIONES: De acuerdo a los valores de Z obtenidos mediante la prueba de comparación de dos proporciones no se encontró diferencia significativa entre los resultados reportados por dos los dos servicios de patología en el síndrome estudiado, determinándose que esta parte del proceso es confiable y útil en un 90%.

OBJETIVO: Comparar resultados de biópsias vertebrais guiadas por tomografia axial computadorizada, relatados por dois serviços de Anatomia Patológica distintos em pacientes com síndrome de destruição vertebral para confirmar a confiabilidade e a utilidade no diagnóstico. MÉTODOS: Foram obtidas amostras de tecido de 21 pacientes no período de 1 de março a 15 de julho de 2011, com diagnóstico de síndrome de destruição vertebral, que foram submetidos a biópsia guiada por tomografia axial computadorizada. As amostras foram enviadas de modo cego a dois serviços de patologia distintos. Os resultados foram analisados pelo método de comparação de duas proporções. RESULTADOS: 14 pacientes eram do sexo masculino (67%) e 7 do feminino (23%), com idades entre 28 e 82 e afecção predominantemente lombar (48%) e torácica (38%); 62% tinham comprometimento em uma vértebra, 33% em duas e 5% em três ou mais níveis. As vértebras mais afetadas foram L1, L2 e L3 (12/30 [40%]), T4 (3/30 [10%]) e T9 (3/30 [10%]). Os resultados foram agrupados em categorias: 1. Osteomielite (9/21 [43%]), 2. Tumores (7/21 [33%]), 3. Metástases (3/21 [14%]), 4. Tecido normal (2/21 [10%]), 5. Inflamação (0/21 [0%]), 6. Amostra inadequada (0/21 [0%]), 7. Mal de Pott (0/21 [0%]). CONCLUSÕES: De acordo com os valores de Z obtidos pela prova de comparação de duas proporções, não se encontrou diferença significante entre os resultados relatados pelos dois serviços de patologia na síndrome estudada, ficando determinado que essa parte do processo tem confiabilidade e utilidade de 90%.

OBJECTIVE: To compare results of vertebral biopsy guided by computerized axial tomography scan, reported by two different Departments of Pathology in patients with vertebral destruction syndrome to confirm the reliability and utility in the diagnosis. METHODS: Tissue samples from 21 patients were obtained March 1 to July 15, 2011, with a diagnosis of the vertebral destruction syndrome and who underwent computerized axial tomography-guided biopsy. The samples were blindly sent to two different pathology services. The results were analyzed using the two-proportion z-test. RESULTS: 14 patients were male (67%) and 7 females (23%), aged between 28 and 82, with condition predominantly lumbar (48%) and thoracic (38%); 62% had one vertebra affected, 33% ha two and 5% had three or more levels involved. The most affected vertebrae were L1, L2 and L3 (12/30 [40%]) and T9 (3/30 [10%]). The results were grouped into categories: 1. Osteomyelitis (9/21 [43%]), 2. Tumors (7/21 [33%]), 3. Metastases (3/21 [14%]), 4. Normal tissue (2/21 [10%]), 5. Inflammation (0/21 [0%]), 6. Inadequate sample (0/21 [0%]), 7. Pott's disease (0/21 [0%]). CONCLUSIONS: According to the values obtained by the two-proportion z-test, there was no significant difference between the results reported by the two departments of pathology for the syndrome studied, being determined that this part of the process has reliability and usefulness of 90%.

Meiotic chromosomes and nucleolar behavior in testicular cells of the grassland spittlebugs Deois flavopicta, Mahanarva fimbriolata and Notozulia entreriana (Hemiptera, Auchenorrhyncha)

Spittlebugs annually infest pastures and cause severe damage, representing a serious problem for the tropical American beef cattle industry. Spittlebugs are an important biotic constraint to forage production and there is a lack of cytogenetic data for this group of insects. For these reasons, we conducted this work, in which the spermatogenesis and nucleolar behavior of Deois flavopicta, Mahanarva fimbriolata and Notozulia entreriana were studied. The males possessed testes in the shape of a "bunch of grapes"; a variable number of testicular lobes per individual and polyploid nuclei composed of several heteropycnotic bodies. A heteropycnotic area was located in the periphery of the nucleus (prophase I); the chiasmata were terminal or interstitial; metaphases I were circular or linear and anaphase showed late migration of the sex chromosome. The chromosome complement had 2n = 19, except for N. entreriana (2n = 15); the spermatids were round with heteropycnotic material in the center and elongated with conspicuos chromatin. The analysis of testes after silver nitrate staining showed polyploid nuclei with three large and three smaller nucleolar bodies. Early prophase cells had an intensely stained nucleolar body located close to the chromatin and another less evident body located away from the chromatin. The nucleolar bodies disintegrated during diplotene. Silver staining occurred in two autosomes, in terminal and subterminal locations, the latter probably corresponding to the nucleolus organizer regions (NORs). The spermatids were round with a round nucleolar body and silver staining was observed in the medial and posterior region of the elongated part of the spermatid head.

Ultrastructure and redescription of Notozulia entreriana (Berg) (Hemiptera: Cercopidae) / Ultraestrutura e redescrição de Notozulia entreriana (Berg) (Hemiptera: Cercopidae)

A morfologia ultra-estrutural da cigarrinha Notozulia entreriana (Berg) é apresentada. Resultaram 32 ilustrações, utilizando-se microscópio eletrônico de varredura, bem como uma detalhada descrição da espécie.

The ultrastructure of the spittlebug Notozulia entreriana (Berg) is presented. The study resulted in 32 scanning electron microscope photos, with detailed species description.

Parasitismo de ovos de cigarrinhas-das-pastagens (Homoptera: Cercopidae) pelo microhimenóptero Anagrus urichi pickles (Hymenoptera: Mymaridae) na região de Campo Grande, MS / Parasitism of spittlebug eggs (Homoptera: Cercopidae) by the microhymenopteran Anagrus urichi pickles (Hymenoptera: Mymaridae) in Campo Grande, MS, Brazil

Constatou-se parasitismo em amostras de ovos de cigarrinhas-das-pastagens coletadas em pastagens de Brachiaria decumbens, pelo microhimenóptero Anagrus urichi Pickles, constituindo-se no primeiro registro dessa natureza para o Estado de Mato Grosso do Sul. O índice de parasitismo observado foi de 10,4 por cento, sendo que, em média, emergiram 4,7 parasitóides por ovo. A exposição de 100 ovos da cigarrinha Notozulia entreriana (Berg), obtidos em laboratório, a oito desses parasitóides, resultou em 13 por cento de parasitismo, indicando a possibilidade de multiplicação desse inimigo natural em laboratório.

Egg parasitism by the microhymenopteran Anagrus urichi Pickles was found on samples of spittlebug eggs collected in Brachiaria decumbens pasture. It is the first record of spittlebug egg parasitism for the State of Mato Grosso do Sul, Brazil. The rate of 10.4 percent of parasitism was observed in 1688 spittlebug eggs, comprising seven samples. On average, 4.7 wasps emerged from each parasitized egg. Thirteen percent of parasitism were observed when 100 eggs of the spittlebug Notozulia entreriana (Berg), obtained in the laboratory, were exposed to eight of these parasitoids. It is anticipated the possibility of mass rearing A. urichi.