Resultados post operatorios en pacientes con prótesis total de revisión de cadera mas injerto óseo cadavérico de banco de tejidos en el Hospital de Clínicas en el periodo 2017 al 2020 / Postoperative results in patients with total hip revision arthroplasty and cadaveric bone graft of tissue bank at the Hospital de Clínicas in the period 2017 to 2020

Introducción: La artroplastia total de cadera de revisión junto con la utilización de injerto óseo cadavérico de banco de tejidos es una alternativa de tratamiento eficaz ante los procedimientos de reemplazo con déficit óseo femoral o acetabular. El presente estudio, analizó los resultados post operatorios en pacientes intervenidos quirúrgicamente en el Hospital de Clínicas. Materiales y métodos: Estudio descriptivo. Muestreo no probabilístico de casos consecutivos atendidos en la Cátedra de Ortopedia y Traumatología de la Facultad de Ciencias Médicas (U.N.A). Fueron captados pacientes con indicación de artroplastia total de cadera de revisión (ATCR) más injerto óseo cadavérico de banco de tejidos, entre diciembre 2017 - octubre 2020, previo consentimiento informado. Se relevaron datos cuya caracterización fue posible mediante un instrumento establecido previamente, ingresado en base Excel. Resultados: 12 pacientes con déficit óseo femoral y acetabular han sido tratados con artroplastia total de cadera de revisión más injerto óseo cadavérico de banco de tejidos, en donde además de la funcionalidad y a través de seguimientos radiológicos se ha determinado la osteointegración total de los aloinjertos. La relación masculino-femenina fue 1/1, siendo el diagnóstico preoperatorio para la colocación de la prótesis de revisión más injerto óseo cadavérico de banco de tejidos el aflojamiento séptico en un 75%. El motivo de consulta más frecuente fue dolor y la secreción y el tiempo quirúrgico fue en promedio de 116 minutos. Conclusión: La artroplastia total de cadera de revisión más aloinjerto presenta óptimos resultados en relación a la osteointegración total y funcionalidad.

Introduction: Revision total hip arthroplasty with use of cadaveric bone graft is an effective treatment for replacement procedures in patients with bone loss femoral or acetabular. The present study analyzed the postoperative results in patients who underwent surgery at the Hospital de Clínicas. Materials and methods: Descriptive study. Non-probabilistic sampling of consecutive cases treated at the Department of Orthopedics and Traumatology of Hospital de Clínicas. Data of patients with indication for revision total hip arthroplasty plus cadaveric bone graft from a tissue bank with prior informed consent,were analyzed between December 2017 and October 2020. Results: 12 patients with femoral and acetabular bone deficits have been treated with revision total hip arthroplasty plus cadaveric bone graft from a tissue bank. A radiological and functional follow up was made. The male-female ratio was 1/1, with the preoperative diagnosis for placement of the revision prosthesis plus cadaveric bone graft,from the tissue bank,was septic loosening in 75%. The most frequent symptom was pain, all revision total hip arthroplasties were performed through a posterior approach, and the surgical time was an average of 116 minutes,using a later approach in all cases.Two intraoperative fracture was presented, and were resolved. Conclusion: Revision total hip arthroplasty plus allograft presents optimal results in relation to total osseointegration and functionality.

Evaluation of Histological Properties of Human Meniscal Grafts Stored in a Tissue Bank / Avaliação das propriedades histológicas de enxertos meniscais humanos armazenados em banco de tecido

Abstract Objectives The present paper aims to evaluate and compare the histological features of fresh and frozen menisci stored in a tissue bank for 1 month and for 5 years. Methods The meniscal grafts were subjected to a histological study. A total of 10 menisci were evaluated; 2 were frozen for 5 years, 4 were frozen for 1 month, and 4 were fresh, recently harvested specimens. Histological properties were evaluated in sections stained with hematoxylin and eosin and Masson trichrome methods. Results The menisci frozen for 1 month showed partially preserved collagen fiber structure and no significant hydropic tissue degeneration. The menisci frozen for 5 years presented an evident dissociation of collagen fibers and multiple foci of hydropic degeneration. Discussion Degeneration was much more significant in menisci stored for 5 years, indicating that a long freezing period results in substantial progression of tissue deterioration. This may suggest that the 5-year period, considered the maximum time for graft storage before transplant, is too long. Conclusion Grafts stored for 1 month showed a slight degenerative change in collagen fibers, whereas menisci frozen for 5 years presented significant tissue degeneration.

Resumo Objetivos Avaliar e comparar as características histológicas de meniscos frescos e meniscos congelados armazenados em banco de tecidos por 1 mês e por 5 anos. Métodos Foi feito um estudo histológico com enxertos meniscais. Avaliamos 10 meniscos, sendo 2 que ficaram armazenados sob congelamento por 5 anos, 4 armazenados congelados por 1 mês, e 4 frescos, recém captados. Foram feitos cortes histológicos corados com hematoxilina e eosina e Tricrômico de Masson, para avaliação das propriedades histológicas. Resultados Os meniscos congelados por 1 mês apresentaram preservação parcial da estrutura das fibras colágenas, sem degeneração hidrópica significativa do tecido. Nos meniscos congelados por 5 anos, observamos dissociação evidente das fibras colágenas, com presença de múltiplos focos de degeneração hidrópica. Discussão Encontramos degeneração bem mais significativa nos meniscos armazenados por 5 anos, o que indica que o longo período de congelamento leva à progressão significativa da degeneração do tecido. Isto pode sugerir que o período de 5 anos, considerado período máximo que o enxerto pode permanecer armazenado antes de ser transplantado, é um período muito longo. Conclusão Nos enxertos armazenados por 1 mês, existiu apenas discreta alteração degenerativa das fibras colágenas, enquanto que nos meniscos com 5 anos de congelamento foi observada degeneração significativa do tecido. Tibiais

Situación actual de los bancos de tejidos en Colombia: tejido cardiovascular / An update on cardiovascular tissue banks in Colombia

Resumen Introducción: ¿Cuál es la situación actual técnica y productiva de los cuatro bancos que están certificados en buenas prácticas para tejido cardiovascular en Colombia si se comparan con estándares internacionales? Objetivo: Caracterizar la capacidad técnica y la actividad de los bancos certificados del país para tejido cardiovascular durante el periodo de tiempo 2014 a 2016. Metodología: Mediante una encuesta realizada por vía teleconferencia a cada banco, se evaluaron ítems de donación, extracción, procesamiento, almacenamiento, distribución y capacidad de producción de los tejidos cardiovasculares. La información referida por las instituciones fue complementada con actas de certificación de buenas prácticas del INVIMA y la suministrada por el INS de las estadísticas reportadas por los mismos bancos durante el periodo 2014 a 2016. Resultados: El tejido cardiovascular procesado por los bancos colombianos procede principalmente de donantes con muerte encefálica y es extraído directamente en el quirófano; la edad de los donantes va desde recién nacidos hasta los 60 años. Cuando se requiere, el antibiótico de elección es la vancomicina. El almacenamiento más usado es la criopreservación y su distribución se hace principalmente a grupos quirúrgicos preestablecidos e intrainstitucionales. Conclusiones: El desarrollo del banqueo de este tipo de tejido está muy rezagado en Colombia respecto a otros países, debido a las dificultades de donación, extracción y utilización por grupos con alta experticia; adicionalmente, la normativa utilizada para evaluar estas instituciones está muy desactualizada.

Abstract Introduction: A study is performed to determine if the current technical and productive situation of the four cardiovascular tissue banks that have Good Practice Certificates in Colombia compare with international standards. Objective: To determine the technical capacity and activity of the banks certified by the country for cardiovascular tissue during the period from 2014 to 2016. Methodology: The items analysed using a questionnaire completed by teleconference to each bank were, donation, extraction, processing, storage, distribution, and production capacity of the cardiovascular tissues. The information provided by the institutions was complemented with the Minutes of Good Practice Certification of the Colombia National Food and Drug Surveillance Institute (INVIMA) as well as the statistics reported by the banks themselves and provided by the National Health Institute (INS) during the period 2014 to 2016. Results: The cardiovascular tissue processed by Colombian tissue banks mainly comes from donors with brain death, and is extracted directly in the operating theatre. The age of the donors go from newborn up to 60 years-old. When used, the antibiotic of choice is vancomycin. The most used storage method is cryopreservation, and is mainly distributed to established and institutional surgical groups. Conclusions: The development of this type of tissue bank is lagging behind in Colombia compared to other countries. This is due to the difficulties in donation, extraction, and use by groups with high expertise. Furthermore, the guidelines used to evaluate these institutions are very out of date.

Comparação dos meios de preparação e preservação de membrana amniótica humana para uso no tratamento de doenças da superfície ocular / Comparison of the preparation and preservation techniques of amniotic membrane used in the treatment of ocular surface diseases

Resumo Atualmente a membra amniótica (MA) tem obtido importância devido à comprovada capacidade de reduzir inflamação, auxiliar a cicatrização e epitelização, possuindo propriedades antimicrobianas e antivirais, além de baixa imunogenicidade. As indicações de seu uso na oftalmologia têm aumentado muito nas duas últimas décadas. Objetivo: Descrever a estrutura básica e as propriedades biológicas da MA em relação aos componentes da sua matriz extracelular e fatores de crescimento, as consequências de diferentes técnicas empregadas na sua preservação e esterilização, métodos para remoção do epitélio e a comparação dos custos dos diferentes meios de conservação atualmente empregados. Métodos: Pesquisa nas bases de dados do Portal da Biblioteca Virtual em Saúde (BVS), Pubmed, Cochrane, Scielo e Lilacs com as palavras-chave: membrana amniótica, transplante, reconstrução da córnea, doenças da conjuntiva. Resultados: A literatura é vasta na descrição dos efeitos de diversos agentes e técnicas na preparação da MA, dentre elas sua preservação, esterilização e desepitelização. A membrana desnuda tem sido a escolha para a reconstrução da superfície ocular, pois facilita a cicatrização. Em relação aos agentes conservantes, o glicerol é o meio mais utilizado mundialmente pelo baixo custo e facilidade de manuseio. Conclusão: A comparação das diversas técnicas nos guia na elaboração de protocolos de preparo da MA para uso oftalmológico. A membrana desnuda facilita a cicatrização em relação a com células epiteliais. O glicerol é o meio de conservação mais utilizado pelo baixo custo e facilidade de manuseio.

Abstract Currently, the amniotic membrane (AM) has obtained importance due to its ability to reduce inflammation, helping in the healing and epithelialization processes, having antimicrobial and antiviral properties and low immunogenicity. Its indications in ophthalmology have increased considerably in the past two decades. Objective: To describe the basic structure and biological properties of the AM, the components of the extracellular matrix and growth factors, the consequences of different techniques used in its preservation, and sterilization methods for the epithelium removal. To compare the costs of the different preservation solutions currently employed. Study design: literature review. Methods: Research in BVS databases, PubMed, Cochrane, Scielo and Lilacs with keywords: amniotic membrane transplantation, corneal reconstruction, conjunctival diseases. Results: The literature is vast in describing the effects of different agents and techniques used in the preparation of MA, including its preservation, sterilization and desepithelization. The naked membrane is the choice to reconstruct the ocular surface, as it facilitates the healing course. Regarding the preservatives, glycerol is the most used worldwide due its low cost and easy handling. Conclusion: Comparing different techniques guides us in developing a MA preparation protocol for ophthalmic use. The naked membrane facilitates the healing process compared with the presence of epithelial cells. The glycerol is the most used preservation method because of its low cost and easy handling.

Situacion actual de los bancos de tejidos en colombia: tejido osteomuscular / Current situation of tissue banks in colombia: musculoskeletal tissue

Introducción El tejido óseo es el segundo tejido más trasplantado en el ser humano. Los Ortopedistas y Odontólogos son los principales profesionales que lo utilizan en sus procedimientos. El objetivo de este trabajo fué caracterizar la actividad de los Bancos certificados del país para Tejido Osteomuscular. Materiales y Métodos Mediante encuesta realizada vía teleconferencia a cada Banco de tejidos, se evalúan ítems de donación, extracción, procesamiento, almacenamiento, distribución y capacidad de producción de los tejidos Osteomusculares. La información es complementada con actas de certificación de Buenas Prácticas del Invima (Instituto Nacional para la Vigilancia de Medicamentos y Alimentos) e información suministrada por el INS (Instituto Nacional de Salud) de las estadísticas reportadas por los bancos mensualmente. Resultados El tejido procesado procede de donantes de medicina legal 77%, IPS (Instituciones Prestadoras de Servicios de Salud) 5% y donantes vivos 17%. La edad de donación es de 45 a 70 años dependiendo de si es tejido estructural, género y condición del donante vivo/muerto. Las tecnologías para el control microbiológico son variadas, encontrando condiciones asépticas de procesamiento, antibióticos y radiación Gamma. Los productos finales ofrecidos son tejido fresco, liofilizado, pulverizado, decalcificado y matriz ósea desmineralizada. El periodo de almacenamiento máximo encontrado es de 5 años. Se estima que por donante real se obtendrían 67 unidades de implantes en Colombia. Discusión El desarrollo Tecnológico de los Bancos Colombianos de tejido Osteomuscular alcanza altos estándares internacionales, pudiéndose cubrir la variada demanda de productos internos necesarios para todas las especialidades, sin embargo se encuentra un rezago en los procesos de aprovechamiento suficiente de los tejidos procedente de los donantes y de la distribución de los mismos. Nivel de Evidencia: IV.

Background The bone is the second most transplanted tissue in humans. Orthopaedists and Dentists are the main professionals that use it in their procedures. The aim of this study was to describe the activity of the certified musculoskeletal tissue banks in Colombia. Methodology The extraction, processing, storage, distribution, and production capacity of musculoskeletal tissues donated to each Tissue Bank were evaluated using a questionnaire completed via teleconference. The information was supplemented with records of management certification of Good Practices, Invima registers, and information provided by the NHI (Colombian National Health Institute) statistics reported by tissue banks each month. Results The processed tissue comes from forensic donors (77%), IPS health care institutions (5%), and 17% from living donors. Donor age was 45 to 70 years, depending on whether it was structural tissue, gender, and condition of live / dead donor. Technologies for microbiological control varied, with aseptic processing, antibiotics, and gamma radiation being found. The final products offered are fresh tissue, lyophilised, pulverised, decalcified, and demineralized bone matrix. The maximum storage period found was 5 years. It is estimated that 67 tissue units could be obtained from each donor in Colombia. Discussion Technological development of Colombian musculoskeletal Tissue Banks is of the highest international standards, being able to meet the varied demand for domestic products necessary for all related medical fields. However, it was identified that there was a lag in the distribution process, as well as in usability and taking advantage of the availability, and use of tissues from donors. Evidence Level: IV

Comparative Study of the Osteointegration of Irradiated and Non-irradiated Bone Grafts Used in Patients with Revision Hip Arthroplasty / Estudo comparativo da osteointegração de enxertos ósseos irradiados e não irradiados utilizados em pacientes com revisão de artroplastia do quadril

Abstract Objective To evaluate and compare the osteointegration of irradiated and nonirradiated frozen bone grafts used in 21 patients undergoing revision hip arthroplasty procedures with the Exeter technique. Methods A retrospective study of 21 patients undergoing revision hip arthroplasty with the Exeter technique using bone tissues treated or not with gamma radiation between 2013 and 2014. The patients were divided into two groups according to the use of grafts treated or not with ionizing radiation (gamma rays); as such, these groups were classified as irradiated or non-irradiated. The osteointegration results determined by radiographic analysis of these grafts were compared in the postoperative period of 6 and 12months. Results Comparing the graft osteointegration in all patients at 6 and 12months postoperatively, we noticed a significant difference in the radiographic evaluations in this period (p = 0.031). Out of the patients studied, 7 were from the irradiated group, and 14 belonged to the non-irradiated group. No statistically significant differences were observed (p = 0.804) regarding osteointegration when we compared the irradiated and non-irradiated groups. Conclusion There was no significant difference in the use of irradiated or nonirradiated grafts in revision hip arthroplasty procedures with the Exeter technique.

Resumo Objetivo Avaliar e comparar a osteointegração dos enxertos ósseos congelados irradiados e não irradiados utilizados em 21 pacientes submetidos a revisão de prótese do quadril pela técnica Exeter. Métodos Foi realizado estudo retrospectivo de 21 pacientes submetidos a revisão de artroplastia do quadril pela técnica Exeter comutilização de tecidos ósseos tratados ou não com radiação gama no período entre 2013 e 2014. Dividimos os pacientes em dois grupos, de acordo com o uso do enxerto tratado ou não com radiação ionizante (raios gama), que foram, portanto, classificados como: grupo irradiado e não irradiado. Os resultados da osteointegração por análise radiográfica destes enxertos foram comparados no pós-cirúrgico de 6 e 12 meses. Resultados Quando comparamos a osteointegração dos enxertos no pós-cirúrgico de 6 e 12 meses de todos os pacientes, notamos que houve diferença significativa entre as avaliações radiográficas neste período (p= 0,031). Dos pacientes estudados, 7 pertenciam ao grupo irradiado, e 14, ao grupo não irradiado. Não foram observadas diferenças estatisticamente significativas (p= 0,804) quando a osteointegração entre os grupos irradiados e não irradiados foi comparada. Conclusão Não houve diferença significativa no uso de enxerto irradiado e não irradiado nas revisões de artroplastias do quadril pela técnica Exeter.

The Expression of Androgen Receptor and Its Variants in Human Prostate Cancer Tissue according to Disease Status, and Its Prognostic Significance

PURPOSE: To evaluate changes in the expression of androgen receptor (AR) and its variants (ARVs) in human prostate cancer (PCa) tissues according to disease status, and its prognostic significance following radical prostatectomy (RP). MATERIALS AND METHODS: A total of 282 PCa cases were evaluated, which included 252 localized PCa, 8 metastatic castration resistant prostate cancer (CRPC), and 22 benign prostatic hyperplasia (BPH) cases. Samples were collected from patients who underwent RP or transurethral resection and were stored in ethically approved tissue banks. Quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry were performed for AR and ARVs. Each tissue was confirmed as cancerous (greater than 80%) using hematoxylin and eosin staining. AR and ARVs expression was compared according to disease status. The biochemical recurrence free survival (BCRFS) rates in men with localized PCa was analyzed according to AR and ARV7 expression using the Kaplan-Meier curve. RESULTS: Only 58 of the 252 localized PCa were included in the analysis because of insufficient cancer tissue. AR and ARV7 mRNA expression was higher in the CRPC tissue than in the localized PCa tissue (p=0.025, p=0.002, respectively). In localized PCa tissue, high AR mRNA and protein level was associated with a low BCRFS rate (log-ranked, p=0.019, p < 0.001, respectively). CONCLUSIONS: Overall AR and ARV7 mRNA expression levels were increased in CRPC tissues compared to localized PCa and BPH tissues. High AR protein and mRNA expression in the tumor tissue may be considered a predictive factor of BCRFS following RP.

Cenário da doação de órgãos em uma macrorregional de Pernambuco / Escenario de la donación de órganos en una central de Pernambuco / Organ donation scenario in a transplantation center of Pernambuco

Objetivo conhecer o cenário da doação de órgãos e tecidos de uma macrorregional de transplantes situada em Pernambuco. Método estudo quantitativo, descritivo, retrospectivo e exploratório. Resultados suspeita de morte encefálica identificada em 524 prontuários de pacientes internados entre janeiro de 2013 e dezembro de 2017. A maioria dos potenciais doadores era do sexo masculino (63,6%), faixa etária entre 21 e 60 anos (55,9%); principais causas de morte encefálica foram acidente vascular encefálico (27,9%) e trauma cranioencefálico (19,5%). Maioria de internamentos (96,2%) em instituições públicas. Protocolos de morte encefálica totalizaram 86,8%. Predominou aceitação familiar (53,5%) para doação. Conclusão doação de órgãos e tecidos em uma macrorregional de transplantes era feita majoritariamente por indivíduos do sexo masculino, adultos jovens, atendidos em hospitais públicos e tendo como principal causa de morte o traumatismo crânio encefálico. Quanto ao aceite para doação, as entrevistas familiares foram positivas e, em grande parte, favoráveis à doação.

Objetivo conocer el escenario de donación de órganos y tejidos de un centro de trasplantes ubicado en Pernambuco. Método estudio cuantitativo, descriptivo, retrospectivo y exploratorio. Resultados sospecha de muerte cerebral identificada en 524 registros médicos de pacientes hospitalizados entre enero de 2013 y diciembre de 2017. La mayoría de los donantes potenciales eran varones (63,6%), de edad entre 21 y 60 años (55,9%); las principales causas de muerte cerebral fueron accidente cerebrovascular (27,9%) y traumatismo craneoencefálico (19,5%). La mayoría de las hospitalizaciones (96,2%) en instituciones públicas. Los protocolos de muerte cerebral totalizaron el 86,8%. Predominó la aceptación familiar (53,5%) para la donación. Conclusión la donación de órganos y tejidos en un centro de trasplante fue realizada principalmente por individuos masculinos, adultos jóvenes, tratados en hospitales públicos y con traumatismo craneoencefálico como la principal causa de muerte. En cuanto a la aceptación de la donación, las entrevistas familiares fueron positivas y, en gran parte, favorables a la donación.

Objective to know the scenario of organ and tissue donation of a transplantation center located in Pernambuco. Method quantitative, descriptive, retrospective and exploratory study. Results suspected brain death identified in 524 medical records of patients hospitalized between January 2013 and December 2017. Most potential donors were male (63.6%), age group between 21 and 60 years old (55.9%); main causes of brain death were stroke (27.9%) and head trauma (19.5%). Most of hospitalizations (96.2%) in public institutions. Total of brain death protocols 86.8%. Family acceptance (53.5%) for donation predominated. Conclusion mostly male individuals, young adults, treated in public hospitals and having traumatic brain injury as the main cause of death, were organ and tissue donors in a transplant center. As for donation acceptance, family interviews were positive and, in large part, in favor of donation.

Regulatory challenges relating to tissue banks in South Africa: Impediments to accessing healthcare

The demand for human tissue in the medical context has increased rapidly since the early 1980s, when the use of human bone in allografts in orthopaedic surgery became the norm. During the 1990s, the demand for human tissue turned towards tissue-engineered products in the field of regenerative medicine. Tissue engineering, as an established and growing interdisciplinary field comprising different specialties, such as medicine, materials science, cell biology, genomics and chemical engineering, aims to develop biological substitutes to restore, maintain or improve tissue function, thus offering patients the chance to regain normal functionality in their bodies. The purpose of this article is to explore some of the gaps that exist in the current regulatory framework that governs tissue banks in South Africa (SA), and to make certain recommendations aimed at closing these gaps. The discrepancies and gaps cause confusion and may lead to undesired and unforeseen consequences regarding the use of human tissue, as well as prejudice the welfare of patients in SA

Brain Banking for Research into Neurodegenerative Disorders and Ageing / 神经科学通报·英文版

Advances in cellular and molecular biology underpin most current therapeutic advances in medicine. Such advances for neurological and neurodegenerative diseases are hindered by the lack of similar specimens. It is becoming increasingly evident that greater access to human brain tissue is necessary to understand both the cellular biology of these diseases and their variation. Research in these areas is vital to the development of viable therapeutic options for these currently untreatable diseases. The development and coordination of human brain specimen collection through brain banks is evolving. This perspective article from the Sydney Brain Bank reviews data concerning the best ways to collect and store material for different research purposes.

Biobancos: os meus, os seus, os nossos / Biobanks: mine, yours, ours

O presente artigo tem como objetivo discutir aspectos conceituais, éticos e legais e também científicos e cooperativos dos acervos de materiais biológicos utilizados para pesquisa conhecidos como biobancos ou biorrepositórios humanos. Inicialmente são apresentados conceitos fundamentais sobre o tema, amplamente discutido internacional e nacionalmente e também aberta discussão sobre a presença destes acervos na Odontologia e nas Ciências Forenses, bem como sua situação em território nacional. O texto prossegue em três maiores blocos: O primeiro visa introduzir o leitor aos aspectos legais que cercam a temática dos biobancos e biorrepositórios, apresentando-o aos principais dispositivos que regulamentam o tema no Brasil. O segundo bloco aborda a importância do aspecto cooperativo e institucional que exercem os biobancos e biorrepositórios, expondo problemática existente acerca desse tema, mas evidenciando notoriamente os benefícios provenientes de uma postura receptiva dessas infraestruturas a pessoas externas. O terceiro e último bloco conecta o que foi anteriormente dito ao que é atualmente enfrentado cientificamente dentro da Odontologia Legal, referente à necessidade de uma maior variabilidade e número de amostras disponíveis ao pesquisador, que torne possível a este acompanhar e criar o dinamismo da evolução científica. Como conclusão, o artigo evidencia as vantagens e defende uma conduta receptiva a ser adotada pelos diferentes e variados centros e instituições de pesquisa que possuam biobancos ou biorrepositórios a pesquisadores como forma de elevar o nível científico produzido pela Odontologia Legal nacional.

The purpose of this article is to discuss conceptual, ethical and legal aspects, as well as scientific and cooperative aspects of the collections of biological materials used for research known as biobanks or human bio-repositories. Initially, fundamental concepts are presented on the subject, widely discussed internationally and nationally, and opens discussion about the presence of these collections within Dentistry and of Forensic Sciences, as well as their situation in national territory. The text aims to introduce the reader to the legal aspects that surround the biobanks and bio-repositories, presenting it to the main documents that regulate the subject in Brazil. The second section addresses the importance of the cooperative and institutional aspect of biobanks and bio-repositories, exposing existing problems on this topic, but highlighting the benefits of a receptive posture of these infrastructures to external people. The third and last section connects what was previously exposed to what is currently scientifically faced within Forensic Dentistry, referring to the need for a greater variability and number of samples available to the researcher, which makes it possible to follow up and create the dynamism of the scientific evolution. As a conclusion, the article highlights the advantages and advocates a receptive behavior to be adopted by different and varied research centers and institutions that have biobanks or bio-repositories to other researchers to raise the scientific level produced by national Forensic Dentistry.

Elaboração de um protocolo para implementação e funcionamento do primeiro banco de pele animal do Brasil: Relato de experiência / Preparation of a protocol for the implementation and functioning of the first animal skin bank of Brazil: Experience report / Elaboración de un protocolo para implementación y funcionamiento del primer banco de piel animal de Brasil: Relato de experiencia

Objetivo: Elaborar um protocolo para implementação e funcionamento do primeiro banco de pele animal do Brasil. Resultados: Para a construção do protocolo, até o presente momento, foram realizadas as seguintes etapas: visita técnica ao Banco de Pele Animal de Recife, onde foi traçado o levantamento das necessidades de insumos, controle de esterilização e organização do ambiente; identificação e descrição de todas as etapas do processamento da pele de tilápia; elaboração de planilhas de relação de materiais necessários para o processamento da pele de tilápia; e controle do gasto de material utilizado. Conclusão: Frente à incontestável importância e ineditismo da concepção do primeiro Banco de Pele Animal do Brasil e o primeiro para pele de animal aquática no mundo, o papel do enfermeiro é fundamental para a elaboração e implantação de um protocolo que, por meio de um gerenciamento adequado, assegure o estabelecimento de regras, uniformização dos procedimentos e rotinas de processo. Este trabalho permitirá a criação de manuais e controles que irão nortear os processos e garantir a qualidade de todas as etapas do processamento da pele da tilápia do primeiro Banco de Pele Animal do Brasil.

Objective: Elaboration of a protocol for the implementation and operation of the first animal skin bank in Brazil. Results: For development of the protocol, until now, the following steps were taken: technical visit to Recife Skin Bank and consulting the head nurse, where it was traced the supplies needs assessment, sterilization control and environmental organization; identification and description of all stages of tilapia skin processing; elaboration of spreadsheets regarding a list of materials necessary for the processing of tilapia skin and control of the expenditure of the material employed. Conclusion: Before of the undeniable importance and the conception originality of the first Animal Skin Bank of Brazil and the first for aquatic animal skin in the world, the role of a nurse becomes key piece to design and implement a protocol that, through adequate management, ensure the establishment of rules, standardization of procedures and process routines. This work will allow the creation of manuals and controls that will guide the processes and guarantee the quality of all stages of the skin processing of tilapia of the first Animal Skin Bank of Brazil.

Objetivo: Elaborar un protocolo para la implementación y el funcionamiento del primer banco de piel animal de Brasil. Resultados: Para el desarrollo del protocolo, hasta el presente momento, se realizaron las siguientes etapas: visita técnica al Banco de Piel de Recife y consultoría por la enfermera jefe, donde fue trazado el levantamiento de las necesidades de insumos, control de esterilización y organización del ambiente identificación y descripción de todas las etapas del procesamiento de la piel de tilapia; elaboración de planillas de relación de materiales necesarios para el procesamiento de la piel de tilapia y control del gasto de material utilizado. Conclusión: El papel del enfermero es fundamental, para la elaboración e implantación de un protocolo que, a través de una gestión adecuada, asegure el establecimiento de reglas, uniformidad de los procedimientos y rutinas de proceso. Este trabajo permitirá la creación de manuales y controles para orientar los procesos y garantizar la calidad de todas las etapas del procesamiento de la piel de la tilapia del Primer Banco de Piel Animal de Brasil.

Acetabular Cup Revision Arthroplasty Using Morselized Impaction Allograft / 대한고관절학회지

The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e.g., evidence suggests that it is challenging to achieve satisfactory results in cases of Paprosky type 3 or higher bone defects using conventional techniques). The author of this study performed acetabular revision to manage patients with large areas of defective bones by filling in with morselized impaction allografts. These allografts were irradiated frozen-stored femoral heads acquired from a tissue bank, and were applied to areas of an acetabular bone defect followed by insertion of a cementless cup. When this procedure was insufficient to obtain primary fixation, a tri-cortical or structural allograft using a femoral head was carried out. Structural stability and bone incorporation were confirmed via long-term follow-up. This study aims to review conventional surgical techniques and verify the utility of surgical procedures by analyzing the author's surgical methods and discussing case reports.

Aspectos intervenientes na efetivação da doação do tecido ósseo durante o acolhimento e a entrevista familiar para doação de órgãos e tecidos / Aspects intervening in the effectiveness of bone tissue donation during the reception and the familiar interview to organs and tissues donation

Atualmente existe uma lacuna de conhecimento referente à doação e ao transplante do tecido ósseo, já que muitas publicações concentram-se, principalmente, na temática 'doação e transplante de órgãos sólidos'. O objetivo deste estudo foi compreender os aspectos intervenientes na efetivação da doação do tecido ósseo durante o acolhimento e a entrevista familiar, realizada pelos profissionais da Organização de Procura de Órgãos, na ótica do profissional e do familiar do potencial doador. Método: Este estudo de abordagem qualitativa, apoiado em conceitos do interacionismo simbólico, constituiu-se de familiares de doadores de órgãos e tecidos que autorizaram a doação do tecido ósseo no período de janeiro a dezembro de 2016, iniciando-se a partir de pesquisa nos prontuários da Organização de Procura de Órgãos localizada no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto/SP. Selecionaram-se todos os prontuários dos doadores de tecido ósseo, totalizando doze doadores Ainda, foram convidados a participar do estudo os quatro enfermeiros responsáveis pelo acolhimento e entrevista para solicitação dos órgãos e tecidos pertencentes à Organização de Procura dos Órgãos citada, por meio de uma entrevista gravada e realizada em seu contexto de trabalho. Foram entrevistados nove familiares e quatro enfermeiros mediante roteiro de entrevista contendo dados sociodemográficos e questões sobre a vivência de todo o processo de doação do tecido ósseo. O material foi transcrito e submetido a análise de conteúdo indutiva em três categorias temáticas: contexto onde se dá o processo de solicitação da doação, fatores que facilitaram a decisão pela doação do tecido ósseo e o resultado do processo de doação para o familiar. Observamos que os familiares, ao refletirem sobre o momento de decisão pela doação do tecido ósseo, revelaram que, apesar do desconhecimento desse tipo de doação, os aspectos que contribuíram para o consentimento foram a satisfação com o atendimento hospitalar humanizado, bem como o profissionalismo dos enfermeiros da Organização de Procura de Órgãos ao explicarem quais ossos seriam retirados e como seria reconstituído o corpo do doador; o conhecimento prévio da vontade do ente querido em ser um doador e o pensamento de estar "fazendo o bem". Observamos ainda que os enfermeiros, ao refletirem sobre seu papel na entrevista para solicitação da doação do tecido ósseo, revelaram que, inicialmente, o desconhecimento dos familiares quanto à possibilidade de doação do tecido ósseo, faz com que os mesmos reajam negativamente devido ao medo da deformidade do corpo. Objetivando superar esse momento difícil, os enfermeiros explicam todo o processo de captação do tecido ósseo, até a forma como seria entregue o corpo do familiar para o velório. Sugerem-se capacitações futuras à equipe de enfermeiros contribuindo para a otimização de todo o processo de doação do tecido ósseo para transplante. Acreditamos ser evidente a necessidade de educação voltada à população por meio de ações governamentais, em que futuras campanhas na divulgação da existência da doação do tecido ósseo possam promover um maior entendimento, resultando em uma reação menos traumática das pessoas no momento da solicitação do tecido ósseo

Currently there is a lack of knowledge regarding donation and transplantation of bone tissue, due many publications to focus primarily on donation and transplantation of solid organs. The aim of this study was to understand the intervening aspects on the effectiveness of bone tissue donation during approach and family interview, carried out by professionals of the Organ Procurement Organization, from perspective of professionals and potential donor relatives. Methods: It is a qualitative study, based on symbolic interactionism concepts; the sample was composed for relatives of donors of organs and tissues that authorized the donation of bone tissue in the period from January to December of 2016,.The first part was characterized for a data collection in the medical records from Organ Procurement Organization located in a Brazilian School Hospital. There were twelve donors during the selected period which medical records were selected to analyze. In addition, four nurses belonging to Organ Procurement Organization were invited to participate in study. They were responsible for the approach and interview with relatives to request organs. The data collection strategy was a structured interview which was recorded and performed in their workplace. Nine families and four nurses were interviewed using an interview script containing sociodemographic data and questions about the experience of entire process of donating bone tissue. The interviews were transcribed and submitted to analysis of inductive content in three thematic categories: the context where the donation request process happens, factors that facilitated the decision by the donation of the bone tissue and the donation process result to the relative. Results: It was observed that family members reflected on the moment of decision of bone tissue donation. They revealed that, despite the lack of knowledge about this type of donation, there were some aspects that contributed to the consent satisfaction with humanized hospital care as well as the nurses of the Organ Procurement Organization professionalism. These nurses explained which bones would be removed and how the donor's body would be reconstituted. Another contributed factor was the relatives prior knowledge of the being´s desire to be an organ donor and the "doing good" feeling. Meanwhile, the nurses interviewed revealed that initially there was family members' lack of knowledge about the possibility of donation of the bone tissue, causes them to react negatively due to the fear of deformity of the body. The nurses explained the whole process of bone tissue withdrawal and the way which the deceased´s body would be delivered to the funeral. The aims of this approach were to overcome this difficult moment and family insecurity to make decision. Conclusions: Future nurses team training is suggested to improve all bone tissue donation for transplantation process. It is extremely important a population-oriented education through governmental actions, campaigns about bone tissue donation to promote a better understanding. It could result in less traumatic people reaction at the moment of bone tissue demand

Frequency of brain tissue donation for research after suicide

Objectives: To describe the frequency of brain tissue donation for research purposes by families of individuals that committed suicide. Methods: All requests for brain tissue donation to a brain biorepository made to the families of individuals aged 18-60 years who had committed suicide between March 2014 and February 2016 were included. Cases presenting with brain damage due to acute trauma were excluded. Results: Fifty-six cases of suicide were reported. Of these, 24 fulfilled the exclusion criteria, and 11 others were excluded because no next of kin was found to provide informed consent. Of the 21 remaining cases, brain tissue donation was authorized in nine (tissue fragments in seven and the entire organ in two). Conclusions: Donation of brain tissue from suicide cases for research purposes is feasible. The acceptance rate of 42.8% in our sample is in accordance with international data on such donations, and similar to rates reported for neurodegenerative diseases.

Presence of Cells in Fresh-Frozen Allogeneic Bone Grafts from Different Tissue Banks

Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts.

Resumo Substitutos ósseos têm sido amplamente utilizados para reconstrução de ossos maxilares atróficos. Uma vez que relatos anteriores demonstram a existência de células viáveis em blocos ósseos após processamento pelos bancos de tecidos músculo-esqueléticos para uso ortopédico, o objetivo deste trabalho foi avaliar a presença de células provenientes de três bancos de tecidos músculo-esqueléticos do Brasil. Todas as amostras foram processadas pelos respectivos bancos seguindo as normas da Agência Nacional de Vigilância Sanitária brasileira. Foi realizada a retirada de 3 amostras de cada bloco, que foram destinadas para processamento histológico e subsequente coloração por hematoxilina e eosina e Feugen e análise ultra-estrutural através de microscopia eletrônica de varredura (MEV). As imagens de microscopia de luz de todos os fragmentos de enxertos ósseos mostraram presença de células do tipo osteócito em todos os grupos avaliados, bem como intensa coloração por Feulgen, demonstrando a presença de DNA nos ossos mesmo após o processamento realizado. As análises ultraestruturais evidenciaram a presença de hemácias nas lacunas do tecido ósseo. Conclui-se que mesmo após os processamentos realizados pelos bancos de tecidos músculo-esqueléticos é possível encontrar células nos ossos utilizados para enxertia alógena.

Perfil epidemiológico do doador de pele do Banco de Tecidos do Hospital das Clínicas da Universidade de São Paulo / Epidemiological characteristics of skin donors from São Paulo University Clinical Hospital / El perfil epidemiológico de los donantes de piel del Banco de tejidos del Hospital de las Clínicas de la Universidad São Paulo

OBJETIVO: Identificar o perfil epidemiológico dos doadores de pele do Banco de Tecidos do Hospital das Clínicas da Universidade de São Paulo. MÉTODO: Trata-se de um estudo documental, retrospectivo, transversal, com abordagem quantitativa de análise de prontuários de doadores de pele do Banco de Tecidos do Hospital das Clínicas de São Paulo, no período entre 2000 a 2015, para identificar as principais características epidemiológicas dos doadores de pele sendo analisadas por método estatístico descritivo. Inicialmente, foram encontrados 183 prontuários, porém 15 foram excluídos devido à falta de informações completas dos doadores. Aprovado pela Comissão de Ética para Análise de Projetos de Pesquisa do HCFMUSP (Nº CAAE 42751915.5.0000.0068). RESULTADOS: Entre os doadores pesquisados, houve predomínio do sexo masculino, com média de idade 43,3 anos, sendo a principal causa dos óbitos os acidentes cerebrais vasculares e causas externas. A retirada do tecido ocorre em geral entre 1 e 4 horas (76,1% dos casos) após a parada cardíaca. A maior parte recebeu antibioticoterapia (92,2%) e não apresenta comorbidades (81,54%). CONCLUSÃO: O doador de pele em geral é do sexo masculino, jovem e previamente hígido, sendo fundamental esta caracterização para o fortalecimento dos mecanismos de busca de doadores e aumento da oferta de tecidos no país.(AU)

OBJECTIVE: To identify the skin donors epidemiological profile from Clinical Hospital Tissue Bank. METHODS: This is a retrospective, cross-sectional documentary study with a quantitative approach to analysis medical records of skin donors from Clínicas' Hospital Tissue Bank, between 2000 and 2015, to identify the main epidemiological characteristics of skin donors, being analyzed by descriptive statistical method. Initially, 183 medical records were found, but 15 were excluded due to lack of complete donor information. Approved by the Ethics Committee for Analysis of Research Projects of HCFMUSP (CAAE No. 42751915.5.0000.0068). RESULTS: Among the donors surveyed, there was a predominance of males, with a mean age of 43.3 years, the main cause of death was cerebrovascular accidents and external causes. Tissue withdrawal usually occurs between 1 and 4 hours (76.1% of cases) after cardiac arrest. The majority received antibiotic therapy (92.2%) and was healthy (81.54%). CONCLUSION: The skin donor in general is male, young and previously healthy, and this characterization is fundamental for the strengthening of donor search mechanisms and an increase in the supply of tissues in Brazil.(AU)

Objetivo: Identificar el perfil epidemiológico de los donantes del Banco de Tejidos del Hospital das Clínicas de la Universidad de São Paulo. Método: Se realizó un estudio documental, retrospectivo, transversal, con un enfoque cuantitativo para el análises de las histórias clínicas de los donadores de piel del Banco de tejidos del Hospital das Clínicas de São Paulo, en el periodo de 2000 a 2015, para identificar las principales características epidemiológicas de los donantes de piel, siendo analisados popr método estadístico descriptivo. Inicialmente, se encontraron 183 registros, pero 15 fueron excluidos debido a la falta de información completa de los donantes. Aprobado por el Comité de Ética en Investigación (núm. CAAE 42751915.5.0000.0068). Resultados: Entre los donantes estudiados, hubo un predominio del sexo masculino, una edad media de 43,3 años, es la principal causa de muerte de los accidentes vasculares cerebrales y las causas externas. El tejido extraído es generalmente entre 1 y 4 horas (76,1% de los casos) después de un paro cardíaco. La mayoría recibió antibióticos (92,2%) y muestra comorbilidades (81,54%). Conclusión: La piel del donante es generalmente de sexo masculino, jóvenes y previamente sanos, siendo fundamental la caracterización para fortalecer los mecanimos de bísqueda de donadores y aumento de la oferta de tejidos en el país.(AU)

Evaluación de umbrales mínimos de celularidad en unidades de sangre de cordon umbilical en el Instituto Nacional Materno Perinatal del Perú / Evaluation of minimum thresholds of cellularity in units of umbilical cord blood at Instituto Nacional Materno Perinatal in Peru

RESUMEN Con el objetivo de evaluar criterios mínimos de celularidad de las unidades de sangre de cordón umbilical (USCU) según los estándares NETCORD en el Instituto Nacional Materno Perinatal de Lima, Perú, se realizó un estudio transversal que incluyó 100 USCU; se determinó el volumen, el recuento de células nucleadas totales (CNT) por hematología y el número de células CD34+ totales, así como también la viabilidad celular, por citometría de flujo. Se encontró que el 56% de las USCU no cumplen los umbrales mínimos de celularidad para ser criopreservadas en un banco de sangre de cordón umbilical. Se encontró, además, que las USCU de recién nacidos de mayor peso y de sexo femenino presentan mayor volumen y recuentos de células. En conclusión, es necesario considerar estas variables para optimizar la colecta de las USCU y obtener mayores recuentos de células que permita almacenar unidades de alta calidad en un futuro banco de sangre de cordón umbilical en Perú.

ABSTRACT A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.