Lesiones degenerativas del menisco / Lésions méniscales dégénératives / Degenerative lesions of meniscus

Introducción: La enfermedad degenerativa articular afecta a todas las estructuras intrarticulares entre las que se encuentran el menisco y el cartílago. Las lesiones del menisco están asociadas a otras enfermedades que provocan dolor. Objetivo: Describir el comportamiento de las lesiones degenerativas del menisco en un grupo de pacientes. Métodos: Se realizó un estudio observacional analítico, con 230 pacientes que presentan diagnóstico clínico, imaginológico y artroscópico de lesiones degenerativas del menisco, atendidos en el Hospital Universitario Manuel Ascunce Domenech, del 9 octubre de 2012 al 22 de enero de 2018. Las variables del estudio fueron: edad, sexo, rodilla derecha e izquierda, menisco medial-lateral, las cinco variantes de la clasificación artroscópica de Boyer T, síntomas y signos, lesiones intrarticulares asociadas, lesión de cartílagos y procedimientos artroscópicos. Se empleó la distribución de frecuencias absoluta y relativa en el análisis de las variables cualitativas y la media aritmética para la variable cuantitativa edad. Para la relación entre variables cualitativas independientes se utilizó la prueba de chi-cuadrado. Resultados: El promedio de edades de los pacientes estudiados fue de 54,5 años. La proporción por sexo fue 2,5 mujeres por 1 hombre afectado. Según la clasificación artroscópica de Boyer T, hubo mayor incidencia del tipo I en los enfermos (47 por ciento). Predominó el dolor difuso de la articulación. La lesión asociada con mayor incidencia fue la de cartílagos grados III/IV. Los procedimientos artroscópicos más empleados fueron: el lavado articular, desbridamiento y la meniscectomía parcial. Conclusiones: Las lesiones degenerativas del menisco son frecuentes en pacientes con la enfermedad degenerativa articular. Se asocian a otras enfermedades articulares que provocan dolor, de ahí que sus síntomas y signos sean similares. El grado de afección del menisco no es simétrico al del cartílago. El tratamiento artroscópico es el de elección, por sus múltiples ventajas. Son necesarios varios procedimientos en un mismo enfermo(AU)

Introduction: The articular degenerative disease affects all intra-articular structures, including meniscus and cartilage. Meniscus injuries are associated with other diseases that cause pain. Objective: To describe the behavior of meniscal degenerative lesions in a group of patients. Methods: An analytical observational study was carried out in 230 patients presenting a clinical, imaging and arthroscopic diagnosis of meniscus degenerative lesions; they were treated at Manuel Ascunce Domenech University Hospital, from October 9, 2012 to January 22, 2018. The variables of the study were age, sex, right and left knee, medial-lateral meniscus, Boyer's T five variants of arthroscopic classification, symptoms and signs associated intra-articular injuries, cartilage injury and arthroscopic procedures. The distribution of absolute and relative frequencies was used in the analysis of the qualitative variables and the arithmetic mean for the quantitative age variable. The chi-square test was used to assess the relationship between independent qualitative variables. Results: The average age of the patients studied was 54.5 years. The proportion by sex was 2.5 women per one affected man. According to Boyer T arthroscopic classification, there was higher incidence of type I in these patients (47 percent). The joint diffuse pain predominated. The highest incidence lesion associated was cartilages grades III / IV. Joint washing, debridement and partial meniscectomy were the most arthroscopic procedures used. Conclusions: Degenerative lesions of the meniscus are frequent in patients with degenerative joint disease. They are associated with other joint diseases that cause pain; hence, their symptoms and signs are similar. The degree of affection of the meniscus is not symmetrical to that of the cartilage. The treatment of choice is arthroscopic, due to its multiple advantages. Several procedures are necessary in the same patient(AU)

Introduction: La maladie articulaire dégénérative touche toutes les structures intra-articulaires, telles que le ménisque et le cartilage. Les lésions méniscales sont associées à d'autres affections qui provoquent la douleur. Objectif: Le but de cet article est de décrire le comportement des lésions méniscales dégénératives dans un groupe de patients. Méthodes: Une étude observationnelle et analytique de 230 patients diagnostiqués de lésions méniscales dégénératives par examen clinique, IRM et arthroscopie, et traités à l'hôpital universitaire Manuel Ascunce Domenech, du 9 octobre 2012 au 22 janvier 2018, a été réalisée. Les variables utilisées dans cette étude ont compris l'âge, le sexe, le genou affecté (gauche et droit), le ménisque médial-latéral, les cinq variables de la classification arthroscopique de Boyer, les symptômes et signes, les lésions intra-articulaires associées, la lésion de cartilages, et les méthodes arthroscopiques. On a employé la distribution des fréquences absolues et relatives pour l'analyse des variables qualitatives, et la moyenne arithmétique pour la variable quantitative de l'âge. Pour la relation entre les variables qualitatives indépendantes, on a utilisé le test du chi carré (χ2). Résultats: L'âge moyen des patients dans cette étude a été 54.5 ans. Le sex-ratio a été de 2,5 femmes contre 1 homme. Selon la classification arthroscopique de Boyer, les lésions de type I ont été les plus fréquentes chez les malades (47 %). La douleur diffuse de l'articulation a été en prédominance. La lésion intra-articulaire associée de plus haute incidence a été celle de cartilages grades III/IV. Parmi les procédés arthroscopiques les plus souvent utilisés, on peut trouver le lavage articulaire, le débridement et la méniscectomie partielle. Conclusions: Les lésions méniscales dégénératives sont fréquentes chez les patients atteints de maladie articulaire dégénérative. Elles sont associées à d'autres affections articulaires provoquant la douleur, c'est pourquoi leurs symptômes et signes sont similaires. Le grade d'atteinte du ménisque est différent à celui du cartilage. Étant donné ses multiples bénéfices, le procédé arthroscopique est le traitement de choix. Il faut utiliser plusieurs procédés chez un même malade(AU)

Identification of poxvirus under transmission electron microscopy during outbreak period in wild birds, in São Paulo, Brazil / Identificación de poxvirus por microscopía electrónica de transmisión durante período de brote en aves silvestres en São Paulo, Brasil

Avianpox is a highly contagious disease infecting both commercial and wild birds, causing great damages to breeders and breeding. Caused by DNA viruses of the family Poxviridae, genus Avipoxvirus, if manifest through 3 forms, cutaneous, diphtheric and septicemic. In June 2003, during illegal commercialization of Brazilian birds, 800 wild birds (Paroaria dominicana, Sporophila caerulescens and Sporophila albogularis) were apprehended and being forwarded to the CRAS (Wild Animals Recovery Center), Tietê Ecological Park. After one month, birds presented cutaneous lesions in the beak and feet and anorexia, emaciation, locomotion difficulties, diarrhea, dehydration and death. Among the 800 birds, 500 died and 40 these (15 Paroaria dominicana, 15 Sporophila caerulescens and 10 Sporophila albogularis) were sent to the Electron Microscopy Laboratory of the Biology Institute of São Paulo, SP, to investigate viral agents. Scabs and fragments of skin lesions collected of theses birds were processed for transmission electron microscopy utilizing negative staining (rapid preparation), resin embedding and immunocitochemistry techniques. Under the transmission electron microscopy in all the analyzed samples it was visualized two types of poxvirus particles, M form, with regular spaced thread-like ridges comprising the exposed surface, measuring 280 x 230 nm; C form or stain-penetrated particle showing the dumbbell-shaped core surrounded by the outer envelope, measuring 360 x 330 nm. In the ultrathin sections obtained, three types of intracytoplasmic inclusion bodies were encountered: type A or Bollinger body, outlined by membrane, containing in its interior a great number of mature particles, measuring 200 x 300 nm, revealing the inner dumbbell-shaped core, two lateral bodies and an external envelope. In the type B electron dense inclusions bodies, viral particles budding of dense amorphous material were observed. Fibrillar inclusions constituted by ...

Avianpox es una enfermedad altamente contagiosa que infecta tanto aves comerciales como aves silvestres, causando grandes daños a lo ganadería y a la crianza. Causados por los virus de ADN de la familia Poxviridae, género Avipoxvirus, se manifiestan a través de 3 formas, cutánea, diftérica y septicémica. En junio del 2003, durante la comercialización ilegal de aves brasileñas, 800 aves silvestres (Paroaria dominicana; Sporophila caerulescens; Sporophila albogularis) fueron capturadas y remitidas al CRAS (Centro de Recuperación de Animales Silvestres), Parque Ecológico de Tietê. Después de un mes, las aves presentaron lesiones cutáneas en el pico y las patas, anorexia, adelgazamiento, dificultades de locomoción, diarrea, deshidratación y muerte. 500 de las 800 aves murieron, 40 de éstas (15 Paroaria dominicana, 15 Sporophila caerulescens y 10 Sporophila albogularis) fueron enviadas al Laboratorio de Microscopía Electrónica del Instituto de Biología de São Paulo, SP, para investigar agentes virales. Costras y fragmentos de lesiones en la piel de estas aves fueron recolectadas y se procesaron para microscopía electrónica de transmisión utilizando tinción negativa (preparación rápida), incrustación de resina y técnica inmunocitoquímica. Bajo la microscopía electrónica de transmisión en todas las muestras analizadas se encontraron dos tipos de partículas de poxvirus, Forma M, con espacios regulares como hilo que abarcan toda la superficie expuesta, midiendo 280 x 230 nm; Forma C o partícula teñida por penetración mostrando núcleo en forma de pesa rodeado por una envoltura externa, que medía 360 x 330 nm. Se encontraron en secciones ultrafinas, tres tipos de cuerpos de inclusión intracitoplásmica: el tipo A o cuerpo de Bollinger, esbozado por la membrana, que contiene en su interior un gran número de partículas maduras, que miden 200 x 300 nm, revelando núcleo interno en forma de pesa, dos cuerpos laterales y una envoltura externa. En el tipo ...

Tracheal cartilage fracture with the percutaneous dilatational tracheostomy, Ciaglia method

Surgical tracheostomy was first introduced by an ENT surgeon [Chevalier Jackson] in 1900. In 1955, Seldinger, a Swedish radiologist, introduced a way of insertion of a tube with the aid of a guidewire into the hollow spaces of body, such as blood vessels. In 1985 Pasquale Ciaglia performed percutaneous dilatational tracheostomy [PDA] with the Seldinger method. Tracheostomy nowadays is usually performed as PDT in the ICUs[1]. Most of the PDT methods are performed with the Seldinger method. The basic difference between the various PDT methods, however, is in both the way of dilation and the way of dilator entrance [antegrade vs retrograde]. In the Ciaglia method, several dilator tubes are used for tracheal dilation[2]

Imobilização articular prolongada e remobilização / Prolonged articular immobilization and remobilization

Foram avaliados os aspectos clínicos e morfofisiológicos da articulação do joelho de ratos após imobilização prolongada e remobilização com atividade livre e natação. Trinta e quatro ratos adultos machos (Wistar) foram alocados aleatoriamente em um dos quatro grupos: sem imobilização (G1, n = 4, grupo controle), com imobilização (G2, n = 10), imobilização e remobilização com atividade livre (G3, n = 10), imobilização e remobilização com atividade livre e natação (G4, n = 10). A imobilização degenerou as células sinoviais, em relação ao controle, indicando diminuição da produção de fluido sinovial e redução do suprimento nutricional à cartilagem e, tanto a atividade livre na gaiola quanto sua associação com a natação influenciaram positivamente o retorno das condições morfológicas da cápsula, anteriores à imobilização.

The aim of this study was to evaluate the clinical and morphophysiological aspects of the rat knee articulation after immobilization and remobilization with free activity and swimming. Thirty four adult male rats (Wistar) were randomly allocated into one of four groups: without immobilization, (G1, n = 4, control group), with immobilization (G2, n = 10), immobilization and remobilization with free activity (G3, n = 10), and immobilization and remobilization with free activity and swimming (G4, n = 10). Synovial cells were degenerated by immobilization indicating decreased synovial fluid production and reduced nutritional supplying to the cartilage and both free cage activity and its association with swimming influenced positively the return of the capsule morphologic conditions to those before immobilization.

Fixação interna de fragmento osteocondral originado de osteocondrite dissecante do joelho / Internal fixation of osteochondral fragment originated fro dissecting knee osteochondritis

O tratamento da osteocondrite dissecante do joelho com lesão tipo cratera associada a corpo livre intra-articular pode ser realizado pela fixação do fragmento osteocondral no seu local de origem. No entanto, existem controvérsias quanto à indicação e eficácia deste procedimento, principalmente quando o corpo livre está solto por tempo prolongado, já que existem relatos na literatura demonstrando deterioração do revestimento condral do mesmo diretamente relacionado com o intervalo decorrente de sua soltura. Relatamos um caso em que, apesar do fragmento osteocondral estar livre na articulação por aproximadamente cinco semanas, a sua fixação não trouxe complicações e resultou em cicatrização completa da lesão. Nós concluímos que, principalmente nos casos onde a lesão osteocondral no côndilo femoral envolve a superfície de carga, quando então o descarte do fragmento geralmente resultaria em mau prognóstico, as possíveis complicações da fixação tardia são compensadas pelos benefícios obtidos pela redução do fragmento osteocondral no local de origem, resultando na recuperação da congruência articular e possivelmente evitando um processo degenerativo articular precoce.

The treatment of dissecting knee osteochondritis with crater-like lesion associated to intra-articular loose body can be provided by fixating the osteochondral fragment on its original site. However, there is some concern about the efficacy of this approach, since some reports have shown that the cartilage layer in osteochondral loose bodies that have been detached for a long time becomes deteriorated. We report a case where while the osteochondral loose body was detached for as long as five weeks, the fixation to the osteochondral defect was uneventful and resulted in a completely healed lesion. We concluded that, especially in cases in which the lesion involves a weight-bearing area of the knee with a detached osteochondral fragment, when the prognosis is usually worse if the fragment is discarded, potential complications of the fixation are offset by the benefits achieved by reducing the osteochondral fragment at the crater-like lesion, resulting in better joint congruence, and potentially avoiding an early joint degeneration process.

Cultura de condrócitos humanos para tratamento de lesões cartilaginosas / Human chondrocytes culture to treatment of cartilaginous injuries

Este trabalho apresenta como objetivo testar o cultivo de condrócitos por um método não enzimático. Para isto, foram isolados condrócitos de cartilagem costal humana pelo método de explante primário, em que as células migraram da cartilagem e se aderiram ao fundo do frasco de cultura. posteriormente, pelo método de imunofluorescência indireta dosou-se a capacidade de produção de colágeno tipo II pelos condrócitos isolados a fim de / This work presents as objective to test culture of chondrocytes for a not enzymatic method of primary explante, where the cells migrate of the cartilage and if they had adhered to the deep one in the bottle of culture. Later, for the method of indirect immunofluorescence it was dosed capacity of production of collagen type II for the isolated chondrocytes in order to evaluate the capacity of the cells to produce extracellular matrix to demonstrate the maintenance of the physiological capacities of the isolated cells in culture...

Perfuraçöes X abrasäo do osso subcondral no tratamento das lesöes condrais do joelho por via artroscópica / Perforations X abrasion of subchondral bone in the treatment of chondral lesions of the knee by arthroscopic way

Estudo prospectivo e comparativo entre as técnicas de perfuraçäo do osso subcondral e artroplastia por abrasäo das lesöes condrais do joelho foi realizado de forma aleatória em dois grupos de dez pacientes cada um. Ambas as técnicas foram realizadas por via videoartroscópica, sendo que em sete pacientes o resultado do tratamento inicial foi reavaliado aos seis meses de pós-operatório através de uma segunda artroscopia. O resultado comparativo baseou-se na resposta clínica ao tratamento estabelecido, sendo que o número de resultados insatisfatórios foi igual em ambos os grupos, sem que se pudesse verificar a supremacia de uma técnica sobre a outra

Tratamento das lesöes da fibrocartilagem triangular por via artroscópica / Treatment of the triangular fibrocartilage lesion with wrist arthroscopy

Os autores demonstram a importância da artroscopia de punho no tratamento das lesöes da fibrocartilagem triangular. Eles salientam a técnica e resultados no emprego em 21 pacientes com sintomatologia e exames radiológicos complementares (artrografia e ressonância magnética) característicos. Discutem suas vantagens em comparaçäo com o método tradicional da artrotomia.