Ultrasound-Guided Radiofrequency Ablation for Chronic Hip Pain Due to Osteoarthritis.

BACKGROUND AND AIMS: Hip osteoarthritis (OA) has a prevalence of 2.9% in Portugal and is a related cause of pain and disability. A sufficient number of patients report these symptoms even after total hip arthroplasty (THA), while others are contraindicated to such surgery and suffer from uncontrolled pain. Percutaneous denervation of hip nerve branches using radiofrequency ablation (RFA) has emerged as a powerful therapeutic avenue to consider for patients with chronic hip pain. METHODS: Between January 2020 and March 2021, 26 patients with chronic hip pain received ultrasound-guided RFA with a pericapsular nerve group (PENG) block technique adaptation. Patients suffering from chronic hip pain for more than three months with radiographic evidence of osteoarthritis were included. A numeric rating scale (NRS) and pain medication reduction were defined as outcome variables assessed before treatment and at three-, six-, nine-, and 12-month follow-ups. RESULTS: All selected patients underwent the procedure. All the patients had hip osteoarthritis. Twelve-month follow-up data revealed a statistically significant decrease in the numeric rating scale. The mean NRS for pain was 2 after the procedure. Over 75% of patients reported >50% pain relief during the follow-up and 85% reduced pain medication consumption. No side effects were reported. CONCLUSION: Hip sensory articular branch RFA is a treatment option with interesting outcomes for chronic hip pain, as demonstrated by our study.

[Fighting against erasure: a community archive of photos of the São Daniel Profeta Church in Manguinhos]. / Luta contra o apagamento: acervo comunitário de fotografias da igreja São Daniel Profeta, em Manguinhos.

This article describes the construction and development of tangible and intangible ties that link the São Daniel Profeta Church to its community in the territory of Manguinhos by tracing the history of the community's photo archive through a selection of photographs that were digitized as part of the heritage education project carried out by the São Daniel Profeta Church Preservation Committee between 2019 and 2021. These images improved understanding of the affective relationships which were established and the strategy by the Catholic Church and the government to insert themselves into favela communities during the second half of the twentieth century in the city of Rio de Janeiro.

O artigo apresenta a construção e a valorização dos laços tangíveis e intangíveis que unem a igreja São Daniel Profeta e sua comunidade no território de Manguinhos. Traça a história do acervo de fotografias da comunidade a partir de uma seleção de fotografias digitalizadas no projeto de educação patrimonial desenvolvido pela Comissão de Preservação da Igreja de São Daniel Profeta entre 2019 e 2021. Tais registros fotográficos contribuem para a compreensão das relações de afeto estabelecidas e a estratégia da inserção da Igreja católica e do Estado em territórios de favelas na segunda metade do século XX na cidade do Rio de Janeiro.

Suprascapular Nerve Pulsed Radiofrequency as an Effective Pain Relief Strategy in Supraspinatus Muscle Tendon Tears.

INTRODUCTION: The supraspinatus muscle tendon is the most frequently rotator cuff muscle torn. Reliable shoulder pain relief strategies are needed for patients with severe pain, refractory to conservative management, and without surgical indication. MATERIALS AND METHODS: We conducted a retrospective analysis in a Portuguese reference Rehabilitation Centre during the 1st of January 2020 and the 30th of June 2021, including all patients with partial or complete supraspinatus tendon tear, older than 50 years, who presented with severe pain and who were submitted to suprascapular nerve pulsed radiofrequency. RESULTS: We included 32 patients in our retrospective analysis, mainly female (53%) with a mean age of 66.50 years old. Most of the patients reported right shoulder pain (21 patients, 66%). The mean baseline pain, reported on the numeric rating scale, was 8.00 ± 0.88. Compared to baseline, mean pain reduced 4.00 ± 3.19 at three months (p<0.001), 3.59 ± 3.13 at six months (p<0.001) and 2.94 ± 2.78 at 12 months (p<0.001). From the 3rd to the 12th month there was an increase of 1.06 ± 2.77 in mean pain (p=0.038). There was no difference (p>0.05) in average pain at 0, 3, 6, or 12 months between patients who were simultaneously submitted to an intra-articular shoulder injection. DISCUSSION: Our analysis revealed 36% average shoulder pain reduction for, at least, 12 months following suprascapular nerve pulsed radiofrequency, with a peak pain reduction of 50% at three months. Slow fading of pain reduction in the following nine months was seen, however, compared to baseline, pain reduction was always statistically significant. Cortico-anaesthetic intra-articular shoulder injections seem not to add benefit in shoulder pain reduction when performed simultaneously with suprascapular nerve pulsed radiofrequency. CONCLUSION: Suprascapular nerve pulsed radiofrequency seems to be an effective strategy for shoulder pain reduction, in patients with severe pain, refractory to other management modalities. Nonetheless, larger prospective studies, analyzing shoulder functionality and quality of life lost scores, besides pain reduction, should be pursued.

Home-Based Rehabilitation Following Subtalar Dislocation: A Case Report.

The demand for physical medicine and rehabilitation services has risen significantly. Immediate rehabilitation is not always readily available which may compromise patients' functional recovery. Here, we describe a rare subtalar dislocation case and how an unsupervised home-based rehabilitation program allowed functional recovery. A 49-year-old male presented to the emergency department with an injury to the right ankle which resulted from a 3-meter height fall with his foot in plantar flexion and inversion. Clinical and imaging findings confirmed a diagnosis of a rare case of subtalar dislocation. The post-injury AOFAS Ankle-Hindfoot Scale score was 24/100 points. After six weeks of immobilization, a patient-tailored home-based rehabilitation program was prescribed. Adherence to our home-based rehabilitation program was critical to allow a range-of-motion improvement and functional recovery. Delaying rehabilitation may lead to long-term functional impairments. Thus, acknowledging the post-acute period as critical to initiate rehabilitation is mandatory. When outpatient rehabilitation settings are not readily available due to high demand, comprehensive patient education, and home-based rehabilitation programs may constitute effective alternative interventions. We demonstrate the significant improvement obtained with an early patient-tailored home-based rehabilitation program in range-of-motion and functional outcomes in a case of medial subtalar dislocation.

Luta contra o apagamento: acervo comunitário de fotografias da igreja São Daniel Profeta, em Manguinhos / Fighting against erasure: a community archive of photos of the São Daniel Profeta Church in Manguinhos

Resumo O artigo apresenta a construção e a valorização dos laços tangíveis e intangíveis que unem a igreja São Daniel Profeta e sua comunidade no território de Manguinhos. Traça a história do acervo de fotografias da comunidade a partir de uma seleção de fotografias digitalizadas no projeto de educação patrimonial desenvolvido pela Comissão de Preservação da Igreja de São Daniel Profeta entre 2019 e 2021. Tais registros fotográficos contribuem para a compreensão das relações de afeto estabelecidas e a estratégia da inserção da Igreja católica e do Estado em territórios de favelas na segunda metade do século XX na cidade do Rio de Janeiro.

Abstract This article describes the construction and development of tangible and intangible ties that link the São Daniel Profeta Church to its community in the territory of Manguinhos by tracing the history of the community's photo archive through a selection of photographs that were digitized as part of the heritage education project carried out by the São Daniel Profeta Church Preservation Committee between 2019 and 2021. These images improved understanding of the affective relationships which were established and the strategy by the Catholic Church and the government to insert themselves into favela communities during the second half of the twentieth century in the city of Rio de Janeiro.

The Burden of Post-Thrombotic Syndrome in a Long-Term Retrospective Cohort in Northern Portugal.

INTRODUCTION: Post-thrombotic syndrome is a frequent and disabling complication of deep venous thrombosis. Its incidence is not described in the Portuguese population. The objective of this study is to report the incidence and severity of post-thrombotic syndrome after the initial episode of deep venous thrombosis. MATERIAL AND METHODS: This is an observational, unicentric, retrospective cohort of patients who had a first episode of deep venous thrombosis in the lower limb, documented with duplex ultrasound (n = 101). The modified Villalta score was applied by phone interview for the diagnosis and staging of post-thrombotic syndrome. The quality of life of patients was measured with the modified CIVIQ 14 classification. RESULTS: Median follow-up time was six years (interquartile range 1). Severe post-thrombotic syndrome was present in 27% of patients and moderate in 33%. Performing physical activity at the time of the interview was associated with lower incidence of post-thrombotic syndrome (relative risk 0.489; 95% confidence interval = 0.320 - 0.748). Body weight gain after deep venous thrombosis (relative risk 2.188; 95% confidence interval 1.137 - 4.210) and lower education levels (relative risk 2.005; 95% confidence interval 1.297 - 3.098) were associated positively with post-thrombotic syndrome. Quality of life was 90 ± 17 vs 64 ± 18 vs 43 ± 15 in patients without postthrombotic syndrome, with moderate post-thrombotic syndrome and with severe post-thrombotic syndrome, respectively (p < 0.001). DISCUSSION: The long-term incidence of post-thrombotic syndrome in a cohort of patients from Northern Portugal is higher than in other studies and correlates with worse adjusted CIVIQ-14 scores. CONCLUSION: Large studies of prospective nature could provide more definitive evidence.

Introdução: A síndrome pós-trombótica é uma complicação frequente da trombose venosa profunda, contudo a incidência em Portugal é desconhecida. O principal objetivo é determinar a incidência e gravidade da síndrome pós-trombótica após primeiro episódio de trombose venosa profunda. Material e Métodos: Estudo de coorte observacional, unicêntrico e retrospetivo de doentes com primeiro episódio de trombose venosa profunda do membro inferior documentado por eco-doppler (n = 101). O score Villalta modificado foi aplicado por entrevista telefónica para diagnóstico e categorização da síndrome pós-trombótica. A qualidade de vida dos pacientes foi avaliada pela classificação CIVIQ -14 ajustada. Resultados: A mediana do tempo de seguimento foi de seis anos. A síndrome pós-trombótica grave esteve presente em 27% e moderada em 33%. A prática de atividade física no momento da entrevista esteve associada a uma menor incidência de síndrome pós-trombótica (risco relativo = 0,489; intervalo de confiança de 95% = 0,320 - 0,748). O aumento de peso após trombose venosa profunda (risco relativo = 2,188; intervalo de confiança de 95% = 1,137 - 4,210) e menores habilitações literárias (risco relativo = 2,005; intervalo de confiança de 95% = 1,297 - 3,098) revelaram associação positiva com síndrome pós-trombótica. A qualidade de vida correlacionou-se com a síndrome pós-trombótica, sendo 90 ± 17, 64 ± 18 e 43 ± 15 em doentes sem síndrome pós-trombótica, com síndrome pós-trombótica moderada e com síndrome pós-trombótica severa, respetivamente (p < 0,001). Discussão: Nesta coorte de doentes no Norte de Portugal, a incidência a longo prazo da síndrome pós-trombótica é superior a outros estudos e correlaciona-se com piores resultados na classificação CIVIQ-14 ajustada. Conclusão: Estudos prospetivos são necessários para maior evidência.

The Moorish Pavilion in the context of eclecticism in Rio de Janeiro. / Pavilhão Mourisco no contexto do ecletismo carioca.

The article tells the history of the design of the Moorish Pavilion, headquarters of Fundação Oswaldo Cruz (Fiocruz), completed in 1918. The year 2021 marks the fortieth anniversary since its listing by the Brazilian heritage protection agency, Instituto do Patrimônio Histórico Nacional, as one of the most representative examples of eclectic architecture in Brazil. Designed by the Portuguese architect Luiz Moraes Jr., its aesthetic, formal, spatial, and functional features derive from multiple influences, which consolidated its recognition as Brazilian cultural heritage. The urban setting in which it was built, in Rio de Janeiro, is also analyzed, and the revision of the historiography of Brazilian architecture, instrumental in the recognition of its cultural and scientific value, is appraised.

[Cristina Mello and her role in the preservation of the historical buildings of Fiocruz at Manguinhos]. / Cristina Mello e seu papel na preservação do Núcleo Arquitetônico Histórico de Manguinhos-Fiocruz.

Interview with the architect and professor Maria Cristina Fernandes de Mello, who, among other architectural heritage conservation and restoration activities, played an important role in the events that led to the creation of the Department of Historical Heritage at Casa de Oswaldo Cruz. A broader analysis of her professional trajectory could help draw links between theory and practice in the safeguarding of cultural assets in Brazil, especially in the 1980s.

Edifícios da saúde no Rio de Janeiro oitocentos / Health buildings in Rio de Janeiro eight hundred

Neste capítulo pretende-se investigar como a linguagem arquitetônica neoclássica foi adotada em hospitais no Rio de Janeiro no contexto do século XIX. Como polo cultural do período imperial, esta cidade receberia uma intensa migração de artistas ao longo do século, tendo sediado a primeira academia para ensino das artes - a Academia Imperial de Belas artes. Assim, comenta sobre a saúde urbana e os hospitais do período imperial, a Santa Casa de Misericórdia, a Beneficência Portuguesa, o Hospício Pedro II, o Hospital Bom Jesus do Calvário, o Hospital da Ordem Terceira do Carmo. Como legado formal, trata sobre a Santa Casa de Misericórdia da Fafe e a Faculdade de Medicina do Rio de Janeiro