Peripheral Nerve Block Practice in Portugal: A National Survey.

Regional anesthesia (RA) has several benefits and its use has increased with the advent of ultrasound-guided techniques. Opioid-sparing anesthesia and reduced use of general anesthesia are some of the mainstay advantages of RA. Although anesthetic practices differ deeply between countries, RA has assumed a crucial role in the daily practice of anesthesiologists, particularly during the COVID-19 pandemic period. This cross-sectional study provides an overview of peripheral nerve block (PNB) techniques performed in Portuguese hospitals. An online survey was reviewed by members of Clube de Anestesia Regional (CAR/ESRA Portugal) and then sent to a national mailing list of anesthesiologists. The survey focused on specific topics related to RA techniques such as the importance of training and experience, and the relevance of logistical limitations during the execution of RA. All data were collected anonymously and included in a Microsoft Excel (Microsoft Corp., Redmond, WA, USA) database, for further analysis. A total of 335 valid answers were obtained. All participants considered RA as a key competence in their daily practice. Half of those inquired performed PNB techniques once to twice per week. The main limitations identified for performing RA in Portuguese hospitals were the absence of block rooms and insufficiently trained personnel for the appropriate and safe execution of these techniques. This survey provides a comprehensive overview of RA in the Portuguese setting and could serve as a baseline for further studies.

Tecnologias educacionais sobre saúde mental na área da saúde: protocolo de scoping review / Education technologies for mental health in healthcare: scoping review protocol

OBJETIVO: Identificar e mapear as tecnologias educacionais sobre saúde mental utilizadas no ensino da saúde. MÉTODO: Será conduzida uma scoping review, seguindo o referencial do Joanna Briggs Institute, com o objetivo de responder à questão: "Quais são as tecnologias educacionais sobre saúde mental que têm sido utilizadas na área da saúde?". Para a identificação dos estudos, serão utilizadas bases de dados eletrônicas multidisciplinares em ciências da saúde, bem como repositórios de dissertações e teses. A identificação e o mapeamento da evidência disponível por meio deste estudo revelarão aspectos relevantes acerca das tecnologias educacionais existentes, seus impactos e desafios neste campo, o que é considerado relevante para subsidiar a melhoria da qualidade do ensino, seja na educação permanente, educação em saúde ou formação acadêmica. Espera-se que a scoping review contribua para a análise crítica das tecnologias educacionais sobre saúde mental na área da saúde, dada a potencialidade de impacto no desenvolvimento das competências educacionais.

OBJECTIVE: To identify and map educational technologies related to mental health in healthcare. METHOD: A scoping review will follow the Joanna Briggs Institute guidelines to answer the question: "What educational technologies related to mental health have been used in healthcare?". Multidisciplinary electronic databases in the health sciences and dissertation or thesis repositories will be used. The review aims to identify and map available evidence regarding educational technologies, their impact, and challenges in the field. This information is essential to improve teaching quality in continuing education, health education, or academic training. The scoping review is anticipated to contribute to a critical analysis of educational technologies focused on mental health in the health sector, given their potential impact on the development of educational competencies.

Fitness cost and reversion of resistance Leucoptera coffeella (Lepidoptera: Lyonetiidae) to chlorpyrifos.

A better understanding of fitness costs and insecticide resistance reversion has practical applications for improving resistance management approaches. The coffee leaf miner, Leucoptera coffeella, is one of the most important coffee pests worldwide. Chlorpyrifos is still used to control L. coffeella despite studies showing resistance in this pest. The current study investigated the fitness costs and reversion of resistance to chlorpyrifos in L. coffeella populations in coffee. The control failure of this insecticide was evaluated in 15 field populations. Selection of resistant and susceptible L. coffeella (G1-G10), with and without chlorpyrifos exposure, was evaluated. The following parameters were investigated: consumed leaf area, adult longevity, number of eggs per female, and egg viability. The present study showed control failures of chlorpyrifos and low (< 31-folds) to high levels (> 80-folds) of resistance in all field populations tested. The resistant population showed less fitness than the susceptible population. The fitness of the resistant population decreased significantly after 10 generations of chlorpyrifos selection. Specifically, the number of eggs per female, larvae hatched, and adult longevity were reduced by factors of 5, 2.3 and 3, respectively. Furthermore, the chlorpyrifos-resistant L. coffeella population consumed more than the susceptible population. Therefore, we concluded that non-exposing L. coffeella populations to chlorpyrifos insecticide leads to rapid reversion of resistance and susceptibility. In addition, resistant populations show reduced reproductive fitness and longevity, while consuming more, probably to meet greater metabolic demands.

Comparison of the different protocols of the Hen's Egg Test-Chorioallantoic Membrane (HET-CAM) by evaluating the eye irritation potential of surfactants.

The Hen's Egg Test - Chorioallantoic Membrane (HET-CAM) is a valid alternative method used to assess the potential for eye irritation from chemicals. This method is the only one that mimics the conjunctivae of the eye and aims to semi-quantitatively evaluate the irritant potential of a chemical on the chorioallantoic membrane surrounding the chicken embryo in egg by observing the irritation effects on the membrane immediately after the pure or diluted chemical is applied. The purpose of this study was to compare the different protocols of the HET-CAM, the French and German protocols, by evaluating the eye irritation potential of surfactants. The comparison led to the optimization of the French protocol, generating an adapted one, to reduce subjectivity in the test evaluation, ensuring more accurate results and greater quality control. The comparison showed that there are no significant differences between the results obtained in the French and German protocols. HET-CAM is known to overestimate the results and to be able to accurately identify non-irritant products and it is a great candidate to be part of a Bottom-up test strategy. It also can be used in a battery of tests to completely replace rabbits.

Comparative Effect between Infiltration of Platelet-rich Plasma and the Use of Corticosteroids in the Treatment of Knee Osteoarthritis: A Prospective and Randomized Clinical Trial.

Objectives This study aimed to analyze the efficacy of platelet-rich plasma obtained from the peripheral, autologous blood of the patients in pain complaints reduction and functional improvement of knee osteoarthritis compared with the standard treatment with injectable corticosteroid, such as triamcinolone. Methods The patients were followed-up clinically at the preinfiltrative visit, with quantitative evaluation using the Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Kellgren and Lawrence scales. In addition, they were reevaluated with the same scales after 1 month and 6 months of intervention with 2.5 mL of triamcinolone acetate or 5 mL of platelet-rich plasma. The study was performed on 50 patients with knee osteoarthritis treated at the Medical Specialty Center and randomly divided into equivalent samples for each therapy. Results The present study verified the reduction of pain scores, such as the WOMAC score, and elevations of functional scales, such as the KSS, evidenced in 180 days when using platelet-rich plasma, a therapy that uses the autologous blood of the patient and has fewer side effects. Conclusion Although both platelet-rich plasma and corticosteroid therapies have been shown to be effective in the reduction pain complaints and functional recovery, there was a statistically significant difference between them at 180 days. According to the results obtained, platelet-rich plasma presented longer-lasting effects within 180 days in the treatment of knee osteoarthritis.

Comparative Effect between Infiltration of Platelet-rich Plasma and the Use of Corticosteroids in the Treatment of Knee Osteoarthritis: A Prospective and Randomized Clinical Trial / Efeito comparativo entre a infiltração de plasma rico em plaquetas e o uso de corticosteroides no tratamento de osteoartrite do joelho: Estudo clínico prospectivo e randomizado

Abstract Objectives This study aimed to analyze the efficacy of platelet-rich plasma obtained from the peripheral, autologous blood of the patients in pain complaints reduction and functional improvement of knee osteoarthritis compared with the standard treatment with injectable corticosteroid, such as triamcinolone. Methods The patients were followed-up clinically at the preinfiltrative visit, with quantitative evaluation using the Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Kellgren and Lawrence scales. In addition, they were reevaluated with the same scales after 1 month and 6 months of intervention with 2.5 mL of triamcinolone acetate or 5 mL of platelet-rich plasma. The study was performed on 50 patients with knee osteoarthritis treated at the Medical Specialty Center and randomly divided into equivalent samples for each therapy. Results The present study verified the reduction of pain scores, such as the WOMAC score, and elevations of functional scales, such as the KSS, evidenced in 180 days when using platelet-rich plasma, a therapy that uses the autologous blood of the patient and has fewer side effects. Conclusion Although both platelet-rich plasma and corticosteroid therapies have been shown to be effective in the reduction pain complaints and functional recovery, there was a statistically significant difference between them at 180 days. According to the results obtained, platelet-rich plasma presented longer-lasting effects within 180 days in the treatment of knee osteoarthritis.

Resumo Objetivo Analisar a eficácia do uso de plasma rico em plaquetas, obtido do sangue periférico e autólogo dos pacientes, na redução das queixas álgicas e melhoria funcional dos pacientes portadores de osteoartrite de joelhos, em comparação com o tratamento padrão com injeção de corticosteroides de depósito, como a triancilonola. Métodos Os pacientes foram acompanhados clinicamente na consulta pré-infiltrativa, com avaliação quantitativa através das escalas Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), e Kellgren and Lawrence. Além disso, os pacientes foram reavaliados com as mesmas escalas após 1 mês e 6 meses de intervenção com 2,5 mL de acetato de triancinolona ou 5 mL de plasma rico em plaquetas. O estudo foi feito em 50 pacientes portadores de osteoartrite de joelhos atendidos no Centro de Especialidades Médicas, divididos em amostras equivalentes randomizadas para cada terapia. Resultados No presente estudo, verificaram-se redução dos valores em escalas álgicas, como a WOMAC, e elevação das pontuações em escalas funcionais, como a KSS, evidenciadas em 180 dias após o uso de plasma rico em plaquetas, uma terapia feita a partir do sangue autólogo do paciente e com menos efeitos colaterais. Conclusão Embora ambas as terapias com plasma rico em plaquetas e corticosteroides tenham se mostrado eficazes na redução das queixas álgicas e na recuperação funcional, houve diferença significativa entre as terapias aos 180 dias. De acordo com os resultados obtidos, no tratamento da osteoartrite do joelho, o plasma rico em plaquetas demonstrou efeitos mais duradouros em 180 dias.

Characterisation of complete high- and low-risk human papillomavirus genomes isolated from cervical specimens in southern Brazil

The classification of human papillomavirus (HPV) intratypic lineages by complete genome sequencing is a determinant in understanding biological differences in association with this disease. In this work, we have characterised complete HPV genomes from southern Brazil. Fifteen cervicovaginal Pap smear negative samples previously categorised as HPV-positive were sequenced using ultradeep sequencing, and 18 complete genomes from 13 different HPV types were assembled. Phylogenetic and genetic distance analyses were performed to classify the HPV genomes into lineages and sublineages. This is the first report describing the distribution of HPV intratype lineages of high and low oncogenic risk in asymptomatic women from southern Brazil.

Characterisation of complete high- and low-risk human papillomavirus genomes isolated from cervical specimens in southern Brazil.

The classification of human papillomavirus (HPV) intratypic lineages by complete genome sequencing is a determinant in understanding biological differences in association with this disease. In this work, we have characterised complete HPV genomes from southern Brazil. Fifteen cervicovaginal Pap smear negative samples previously categorised as HPV-positive were sequenced using ultradeep sequencing, and 18 complete genomes from 13 different HPV types were assembled. Phylogenetic and genetic distance analyses were performed to classify the HPV genomes into lineages and sublineages. This is the first report describing the distribution of HPV intratype lineages of high and low oncogenic risk in asymptomatic women from southern Brazil.

In vitro and in vivo evaluation of efficacy and safety of photoprotective formulations containing antioxidant extracts

ABSTRACT Chronic exposure to solar radiation could contribute to premature skin aging and skin cancer. Skin presents its own antioxidant defense, however when defenses are out of balance, reactive oxygen species could damage biological structures. In the present work, an oil-in-water photoprotective emulsion was developed and Bauhinia microstachya var. massambabensis Vaz, Fabaceae, extracts at 1% (obtained by extraction with different solvents) were added to this emulsion. In vitro and in vivo efficacy and safety of the formulations were evaluated. Spectrophotometric methods and in vivo Colipa test were performed to evaluated efficacy of the formulations, through sun protection factor (SPF) determination and UVA protection factor assessment. To the in vitro safety assessment HET-CAM, CAM-TBS and Red Blood Cell tests were performed. Results showed that both extracts contributed to a higher in vivo photoprotection (SPF 18) when compared to the formulation without extract (SPF 13), this result could be attributed to the antioxidant activity of the plant extracts that act by capturing reactive oxygen species. Concerning safety, all formulations were considered non-irritant according to in vitro tests. Formulations containing extracts could be considered efficient and safe for cosmetic use since they presented higher sun protection factor and passed the toxicity tests.

Phytochemical study and evaluation of cytotoxic and genotoxic properties of extracts from Clusia latipes leaves

Abstract Some species of the Clusia genus have been shown to have important biomedical properties, including the ability to inhibit tumor growth in vitro and the usefulness for skin care. In this study, we examined the cytotoxic effect of hexane, ethyl acetate and methanol extracts from Clusia latipes Planch. & Triana, Clusiaceae, leaves on survival of human prostate cancer cells (PC-3), colon cancer cells (RKO), astrocytoma cells (D-384), and breast cancer cells (MCF-7). The ethyl acetate extract displayed the most substantial cytotoxic effect. However, using a Comet assay, we observed that the hexane extract induced a genotoxic effect (DNA damage) on human lymphocytes in an in vitro model. Chromatographic purification of the C. latipes hexane extract led to the isolation and identification of friedelin, friedolan-3-ol, and hesperidin as active cytotoxic compounds in hexane extract, while β-amyrine was identified as an active cytotoxic compound in the ethyl acetate extract of C. latipes, thereby supporting further studies of the molecular mechanisms underlying the effect of these secondary metabolites on cancer cell survival.

In vivo and in vitro evaluation of octyl methoxycinnamate liposomes.

UNLABELLED: Solar radiation causes damage to human skin, and photoprotection is the main way to prevent these harmful effects. The development of sunscreen formulations containing nanosystems is of great interest in the pharmaceutical and cosmetic industries because of the many potential benefits. This study aimed to develop and evaluate an octyl methoxycinnamate (OMC) liposomal nanosystem (liposome/OMC) to obtain a sunscreen formulation with improved safety and efficacy by retaining OMC for longer on the stratum corneum. METHODS: The liposome/OMC nanostructure obtained was tested for enzymatic hydrolysis with lipase from Rhizomucor miehei and biodistribution with liposomes labeled with technetium-99m. The liposome/OMC formulation was then incorporated in a gel formulation and tested for ocular irritation using the hen's egg test-chorio-allantoic membrane (HET-CAM) assay, in vitro and in vivo sun protection factor, in vitro release profile, skin biometrics, and in vivo tape stripping. RESULTS: The liposome/OMC nanosystem was not hydrolyzed from R. miehei by lipase. In the biodistribution assay, the liposome/OMC formulation labeled with technetium-99m had mainly deposited in the skin, while for OMC the main organ was the liver, showing that the liposome had higher affinity for the skin than OMC. The liposome/OMC formulation was classified as nonirritating in the HET-CAM test, indicating good histocompatibility. The formulation containing liposome/OMC had a higher in vivo solar photoprotection factor, but did not show increased water resistance. Inclusion in liposomes was able to slow down the release of OMC from the formulation, with a lower steady-state flux (3.9 ± 0.33 µg/cm(2)/hour) compared with the conventional formulation (6.3 ± 1.21 µg/cm(2)/hour). The stripping method showed increased uptake of OMC in the stratum corneum, giving an amount of 22.64 ± 7.55 µg/cm(2) of OMC, which was higher than the amount found for the conventional formulation (14.57 ± 2.30 µg/cm(2)). CONCLUSION: These results indicate that liposomes are superior carriers for OMC, and confer greater safety and efficacy to sunscreen formulations.

Antinociceptive activity of Stephanolepis hispidus skin aqueous extract depends partly on opioid system activation.

Stephanolepis hispidus is one of the most common filefish species in Brazil. Its skin is traditionally used as a complementary treatment for inflammatory disorders. However, there are very few studies on chemical and pharmacological properties using the skin of this fish. This study was undertaken in order to investigate the effect of aqueous crude extract of S. hispidus skin (SAE) in different nociception models. Here, we report that intraperitoneal administration of SAE inhibited the abdominal constrictions induced by acetic acid in mice. In addition to the effect seen in the abdominal constriction model, SAE was also able to inhibit the hyperalgesia induced by carrageenan and prostaglandin E2 (PGE2) in mice. This potent antinociceptive effect was observed in the hot plate model too, but not in tail-flick test. Naloxone, an opioid receptor antagonist, was able to block the antinociceptive effect of SAE in the abdominal constriction and hot plate models. In addition, SAE did not present cytotoxic or genotoxic effect in human peripheral blood cells. Our results suggest that aqueous crude extract from S. hispidus skin has antinociceptive activity in close relationship with the partial activation of opioid receptors in the nervous system. Moreover, aqueous crude extract from S. hispidus skin does not present toxicity and is therefore endowed with the potential for pharmacological control of pain.

Characterization and evaluation of poly(epsilon-caprolactone) nanoparticles containing 2-ethylhexyl-p-methoxycinnamate, octocrylene, and benzophenone-3 in anti-solar preparations.

Ultraviolet radiation can bring both harm and benefits to human health. Among those harms are erythemas, photosensitivity, photoaging, and the most worrying, skin cancer. Nanoencapsulation of sunscreen agents (SA) by using a biocompatible and biodegradable polymer such as poly(epsilon-caprolactone) (PCL) is advantageous as it increases the retention of UV absorbers in the skin, avoids systemic absorption, and consequently, improves water resistance and stability of the preparation. The aim of this work is to develop, characterize, and study the encapsulation of 3 different SA: 2-ethylhexyl-p-methoxycinnamate, benzophenone-3, and octocrylene in PCL nanoparticles (Nps). Nps were prepared by the solvent emulsification and evaporation method. The process yield was calculated, and the Nps were characterized in terms of size, polydispersity index (PI), morphology, zeta potential (ZP), encapsulation efficiency (EE) (%), and sunscreen agent content (SAC). The final formulations were submitted to the hen's egg test-chorioallantoic membrane (HET-CAM), chorioallantoic membrane-trypan blue staining (CAM-TBS), red blood cell (RBC), Draize tests, in vitro release, in vitro sun protection factor (SPF), UVA protection factor (PF-UVA), and photostability. All the Nps were in the nanometric scale. PI showed monodisperse systems. ZP became more negative as the Np were lyophilized and were added to the formulations. EE varied from 84 to 90%. The SAC went from 44 to 65 microg of sunscreen agents by milligram of Np. The process yield went from 60 to 76%. Nps were predominantly spherical and elliptical forms. The addition of Np diminished the release of the SA. The SPF increased with Np presence and helped to maintain the PF-UVA after irradiation. The HET-CAM assay evaluated the formulation as slightly irritant, CAM-TBS and RBC tests as non irritant, and the Draize test as moderately irritant.

Ensaios da membrana cório-alantoide (HET-CAM e CAM-TBS): alternativas para a avaliação toxicológica de produtos com baixo potencial de irritação ocular / Chorioallantoic membrane assays (HET-CAM and CAM-TBS): alternative tests for performing toxicological evaluation of productswith low potential for ocular irritation

O presente estudo analisou o potencial preditivo de dois modelos que utilizam a membrana cório-alantoidede ovo embrionado de galinha (i.e. o HET-CAM e sua versão modificada, o CAM-TBS, que quantifica os danos à membrana por meio da absorção do corante azul trypan), como estratégia para a implementação de alternativas aos testes in vivo de avaliação de toxicidade ocular. Vinte colírios foram avaliados in vivo por meio do teste de irritação ocular de Draize e por ensaios in vitro utilizando-se testes HET-CAM eCAM-TBS. Todos os colírios foram classificados como não irritantes pelo teste in vivo. No ensaio HETCAM, foram observados 4 resultados falso-positivos, e o teste apresentou especificidade e precisão de 80%. O CAM-TBS demonstrou melhor desempenho, pois a especificidade e a precisão foram de 100%. O ponto de corte adotado (cut-off = 0,9) no HET-CAM é discutido, uma vez que os resultados falso-positivos observados no presente estudo poderiam ter sido contornados caso a categoria “não irritante” englobasse produtos “não irritantes” e “irritantes leves”, à semelhança do critério preconizado para o CAM-TBS (cutoff= 7,0).

Influência do erro de micropipetas na dosagem espectrofotométrica do ensaio de endotoxina bacteriana (LAL cromogênico) aplicável a produtos sujeitos à Vigilância Sanitária / Effect of micropipette inaccuracy on performance of spectrophotometric assay for bacteria endotoxin dosage (chromogenic LAL) employed in products subjected to sanitary surveillance

Segundo a norma ISO 17.025, os instrumentos usados em experimento devem ser calibrados. No caso de micropipetas não há limite máximo de erro definido, sendo difícil estipular até que ponto uma micropipeta pode continuar a ser usada. O objetivo do trabalho foi o de determinar a porcentagem de erro no volume da micropipeta que não interfira nos resultados das diferentes etapas do ensaio toxicológico Lisado de Amebócitos de Limulus (LAL). Os percentuais de erro foram obtidos do levantamento de 44 certificados de micropipetas. Foram utilizados uma pipeta monocanal calibrada, de volume variável e kit LAL Cromogênio QCL-1000 (Lonza). A curva de endotoxina foi construída com as concentrações de 0,1; 0,25; 0,5 e 1 UE/mL. Os percentuais de erro de ±2%, ±4% e±10% foram comparados com a concentração de referência (0,5 UE/mL), e analisados pelo Student t-test (p<0,05). A análise estatística mostrou que, para a endotoxina padrão e para o substrato do LAL, erro acima de 2% interferenos resultados, cuja correção deve ser feita pelo ajuste do volume na pipeta. Nenhum erro testado causou interferência estatisticamente significativa na reação da cor do substrato. Micropipetas com erro superior a ±2% devem ser corrigidas.

Efeito do Plasma Rico em Plaquetas na apoptose pós-traumática de condrócitos / Effect of Platelet-Rich Plasma on impact-induced chondrocyte apoptosis

OBJETIVO: Avaliar se a injeção intra-articular de Plasma rico em plaquetas (PRP) pode reduzir a apoptose pós-traumática de condrócitos. MÉTODOS: Foi desenvolvido um estudo experimental duplo-cego com quatro joelhos de coelhos adultos. Após a anestesia, os animais foram submetidos à contusão padronizada dos joelhos. Depois foi injetado 1ml de PRP humano nos dois joelhos esquerdos e 1ml de solução fisiológica (SF) nos dois joelhos direitos. Os dois coelhos foram mantidos no mesmo ambiente sob controle de temperatura, de atividades diárias e de alimentação. A eutanásia dos animais ocorreu dez dias após a intervenção e foram realizadas biópsias da cartilagem de cada joelho. As peças foram preparadas para análise em microscopia eletrônica (ME). RESULTADOS: Quatro preparados para ME foram obtidos, cada um correspondendo a um joelho. Os joelhos-PRP apresentaram as taxas de apoptose de 47,62 por cento (50/105) e de 48,36 por cento (59/122), respectivamente. Nos joelhos-SF as taxas de apoptose foram, respectivamente, 56,67 por cento (17/30) e 70,40 por cento (88/125). A diferença do índice de apoptose nos joelhos-PRP (48,02 por cento) e nos joelhos-SF (67,74 por cento) foi significante (p<0,001) e OR=0,439 (IC95 por cento=0.287-0.673). CONCLUSÃO: A injeção intra-articular de PRP imediatamente ao trauma, reduz as taxas de apoptose (pós-traumática) de condrócitos de coelhos.

OBJECTIVE: To evaluate if the injection of intra-articular platelet-rich plasma (PRP) can reduce impact-induced chondrocyte apoptosis. METHODS: A double-blind experimental study was developed in four knees of two adult rabbits. Each knee was injured after anesthesia. Subsequently, 1ml PRP was injected in the right knees and 1ml of normal saline (NS) in the left knees. The animals were euthanized ten days after the intervention. All cartilage was removed from the 4 knees and prepared for analysis in electron microscopy (EM). RESULTS: Four EM samples were obtained. The PRP-injected knees showed apoptosis rates of 47,62 percent (50/105) and 48,36 percent (59/122), respectively. NS-injected knees showed 56.67 percent (17/30) and 70.40 percent (88/125) of apoptosis. PRP-injected knees had statistically significant less apoptosis (48.02 percent) than NS-injected ones, (67.74 percent, p<0,001) and odds ratio of 0.439 (95 percent CI=0.287-0.673). CONCLUSION: Immediately post-traumatic intra-articular injection of PRP reduces impact-induced chondrocyte apoptosis in rabbits.

Avaliação da relação entre parâmetros antropométricos (peso e altura) e a topografia da raiz de L4 no espaço intertransversário L4-L5 através do acesso paramediano à coluna vertebral- Um estudo anatômico em vinte e um cadáveres / Assessment of the correlation between anthropometric parameters (weight and height) and the L4 root topography at the L4-L5 intertransverse space through paramedian access to the spine: an anatomic research on twenty one cadavers

As hérnias discais extremolaterais correspondem a 10 por cento das hérnias discais sintomáticas, mais comumente localizadas nos níveis L3-L4 e L4-L5. Por muitos anos, a abordagem cirúrgica das hérnias lombares foraminais e extraforaminais foi feita através de via de acesso posterior mediana com hemilaminectomia e facetectomia total ou parcial. A abordagem cirúrgica dessa patologia pela via paramediana, entre os músculos multífido e longuíssimo (via de Wiltse), tem a vantagem de poupar o paciente de perdas ósseas e permitir uma visão mais oblíqua do neuro-foramen. Essa abordagem permite, com mínima mobilização da raiz de L4, acesso ao disco L4-L5 e eventuais herniações extra-foraminais do mesmo. Nosso objetivo é avaliar se há relação entre características antropométricas de um indivíduo e a localização da raiz de L4 no espaço intertransversário, acessado pela via de Wiltse, para com isso poder antecipar alguns riscos cirúrgicos. Foram realizadas dissecções em 21 cadáveres (42 lados) e obtidas as respectivas medidas de peso e altura além da distância entre a base do processo transverso de L5 e o ponto onde a raiz de L4 o cruza. A análise dos dados nos permite concluir que não há relação estatisticamente significativa entre as variáveis envolvidas.

Far lateral disc hernias account for ten percent of all symptomatic disc hernias, usually located at L3-L4 and L4-L5 levels. For many years, the surgical approach to foraminal and extraforaminal lumbar disc hernias was provided through the median posterior access way, with total or partial hemilaminectomy and facetectomy. The advantage of the surgical approach for this pathology through the paramedian way, between the multifidus and longissimus muscles (Wiltse's access) is to spare patients from bone losses and to allow a more oblique view of the neuroforamen. Moreover, this approach allows for accessing the L4-L5 disc and its potential extraforaminal herniations with minimum L4 root mobilization. Our objective is to assess the potential correlation between anthropometric parameters and the L4 root topography. Twenty-one cadavers (42 sides) were dissected and some parameters were measured: cadavers' weight and height, width of the L5 transverse process, distance between L5 transverse process base and the point where the L4 root crosses it. The analysis of data allows us to conclude that no statistically significant correlation exists among the involved variables.