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ABSTRACT Introduction To evaluate the relationship between the genetic polymorphism of matrix metalloproteinases 1 and 13 and posttraumatic elbow stiffness, as well as the association of other risk factors with this condition. Materials and methods We evaluated 20 patients with posttraumatic elbow stiffness and 12 controls with traumatic elbow disorders without contracture. Deoxyribonucleic acid (DNA) was obtained from buccal mucosa epithelial cells of the volunteers. The MMP-1 and MMP-13 genotypes were determined using PCR-restriction fragment length polymorphism assays. Results We did not find any significant differences in the frequency of genotypes and alleles between the test and control groups for the polymorphism of metalloproteinases 1 and 13. We observed that genotypes 1G/2G and 2G/2G of MMP-1 were present in 65% (13/20) of patients with articular stiffness and 50% (6/12) of controls (p = 0.599). Genotypes A/A and A/G of MMP-13 were obtained in 95% (19/20) of patients and 91.6% (11/12) of controls (p = 0.491). Among the prognostic factors for elbow stiffness, only immobilization time correlated positively. The mean immobilization time for cases and controls were 16 ± 10 days and 7 ± 7 days, respectively (p = 0.017). Conclusion The genetic polymorphism of MMP-1 at position -1607 and MMP-13 at position -77 was not associated with post-traumatic elbow stiffness. Level of Evidence III; Prognosis Study; Case-Control Study.
RESUMO Introdução Avaliar a relação entre o polimorfismo genético das metaloproteinases 1 e 13 da matriz e a rigidez pós-traumática do cotovelo, assim como a associação de outros fatores de risco com essa condição. Material e método Foram avaliados 20 pacientes com rigidez pós-traumática do cotovelo e 12 controles com distúrbios traumáticos do cotovelo sem contratura. O ácido desoxirribonucleico (DNA) de voluntários foi obtido a partir de células epiteliais da mucosa bucal. Os genótipos MMP-1 e MMP-13 foram determinados usando ensaios de polimorfismo de comprimento de fragmento de restrição de PCR. Resultados Não encontramos diferença significativa na frequência de genótipos e alelos entre os grupos teste e controle para o polimorfismo das metaloproteinases 1 e 13. Observamos que os genótipos 1G/2G e 2G/2G de MMP-1 estavam presentes em 65% (13/20) dos pacientes com rigidez articular e 50% (6/12) dos controles (p = 0,599). Os genótipos A/A e A/G da MMP-13 foram obtidos em 95% (19/20) dos pacientes e 91,6% (11/12) dos controles (p = 0,491). Dentre os fatores prognósticos para rigidez de cotovelo, apenas o tempo de imobilização se correlacionou positivamente. O tempo médio de imobilização para casos e controles foi de 16 ± 10 dias e 7 ± 7 dias, respectivamente (p = 0,017). Conclusões O polimorfismo genético de MMP-1 na posição -1607 e MMP-13 na posição -77 não foi associado à rigidez pós-traumática do cotovelo. Nível de Evidência III; Estudos Prognósticos; Estudo de Caso-Controle.
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Background@#In 716 Mongolian patients who had breast augmentation surgery at Perfect Clinic during 18 years. The purpose of this study evaluates Mongolians predictors of early and late outcome after primary breast augmentation surgery.@*Aims of study@#In this study, we aimed to clarify predictors of early and late outcome after breast augmentation surgery.@*Methods@#We selected patients who underwent breast augmentation implant surgery between 1999 and 2017. Development of hematoma was chosen for measure of early outcome and capsule contracture was chosen for measure of late outcome. Multivariable Cox proportional hazard regression and Kaplan-Meier estimations were used to clarify independent relationship between possible predictors and outcomes.@*Results@#A total of 716 patients were chosen and mean age was 32±7 years old. Hematoma was occurred in 43 patients (6%) and median time to hematoma was 3 days (IQR 1; 7).). According to the univariable analysis, every 1 year experience was associated with 9% decreased risk of hematoma development. (HR=0.91, 95% CI 0.84-0.99, p<0.05). Finally, Kaplan-Meier estimation was showed that hematoma free survival is higher in more experienced years and patients who had subpectoral muscle.(log rank p<0.01 and p<0.001, respectively). Capsule contracture was occurred in 38 patients (5.3%) and median time to capsule contracture was 10 months (IQR 3; 27). According to the univariable analysis, every 1 year increase of surgical experience is related to 9% decreased risk of capsule contracture (HR=0.81, 95% CI 0.75-0.88, p<0.001), and more textured implant type is associated with less capsule contracture (HR=0.47, 95% CI 0.34-0.66, p<0.001). </br> Multivariable hazard regression was revealed that implant type (HR=0.55, 95% 0.33-0.90, p<0.05) and surgical time (HR=1.00, 95% CI 1.00-1.01, p<0.001) were independently associated with capsule contracture after breast augmentation surgery (Table 4). Kaplan-Meier estimation was determined that capsule contracture free survival is higher in more experienced years and patients who had more textured implant and subpectoral muscle implant (log rank p<0.001, p<0.001 and p<0.001, respectively).@*Conclusions@#For breast augmentation surgery, implant type is independent predictor of capsule contracture and surgical experience is predictor for both hematoma and capsule contracture. Therefore, above mentioned predictors should be considered to prevent complications related to breast augmentation implant surgery.