Ankle function after reconstruction of post-traumatic soft tissue defects with soleus and/or gastrocnemius local muscle flaps.

Local muscle flaps are especially advantageous when treating soft tissue defects, but one disadvantage is the potential functional deficits associated with the muscle transfer. In this study, we evaluated ankle function among patients (cases) who underwent reconstruction of soft tissue defects in the leg using local flaps of the gastrocnemius and/or soleus muscle. Function was compared between the affected and contralateral non-affected limb and against patients (controls) with open tibial fractures who required no soft tissue reconstruction. In a retrospective cohort study, ankle function was accessed as range of motion (ROM) and plantar flexion strength, and using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot summation and subscale scores. Among 31 patients who underwent soft-tissue reconstruction, 19 were available for functional evaluation. Controls were 23 patients with open tibial fractures not requiring flaps. Among cases, reconstruction was performed with a soleus flap in nine patients, a medial gastrocnemius flap in seven, a lateral gastrocnemius in one, and with both gastrocnemius and soleus flaps in one patient each. One patient developed partial flap necrosis. In cases, ankle dorsiflexion and plantar flexion were significantly decreased on the affected versus normal side. However, no deficit in plantar flexion strength was detected; nor any significant difference in AOFAS ankle-hindfoot scores in cases versus controls. Local muscle flaps are useful for reconstructing post-traumatic soft tissue defects in the leg. Some loss of ankle ROM should be expected, but likely no clinically-measurable deficit in overall ankle strength and function.

Evaluation of oxidative stress in an experimental model of Crohn's disease treated with hyperbaric oxygen therapy.

INTRODUCTION: Treatments of Inflammatory Bowel Disease (IBD) are able to control symptoms in most cases, however, a fraction of patients do not improve or have a loss of response to treatments, making it important to explore new therapeutic strategies. Hyperbaric oxygen therapy (HBO) may represent one of them. The aim of this study was to evaluate the effects of HBO therapy in an experimental model of IBD. METHODS: Sixty male BALBc mice were divided into six groups. Group 1 was colitis-induced with trinitrobenzene sulfonic acid (TNBS) + ethanol, group 2 received TNBS + ethanol plus HBO, group 3 received only ethanol, group 4 received ethanol plus HBO, group 5 received saline solution, and group 6 received saline solution plus HBO. HBO was performed for four days, subsequently, the mice were evaluated daily. At the end of the study, samples from the intestine were collected for histological analysis as well as for measurement of antioxidant enzymes and cytokine levels. RESULTS: HBO significantly improved the clinical and histological status of the animals. Treatment with HBO increased the activity of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) in all of the groups; moreover, the difference was only significant between the TNBS and TNBS + HBO groups and treatments promoted a reduction in the proinflammatory cytokines IFN-γ, IL-12, IL-17 and TNF-α and increased the anti-inflammatory cytokines IL-4 and IL-10, with no changes in IL-13. CONCLUSION: HBO effectively treats TNBS-induced colitis by increasing the activity of antioxidant enzymes and modulating cytokine profiles.

Evaluation of oxidative stress in an experimental model of Crohn's disease treated with hyperbaric oxygen therapy

Abstract Introduction: Treatments of Inflammatory Bowel Disease (IBD) are able to control symptoms in most cases, however, a fraction of patients do not improve or have a loss of response to treatments, making it important to explore new therapeutic strategies. Hyperbaric oxygen therapy (HBO) may represent one of them. The aim of this study was to evaluate the effects of HBO therapy in an experimental model of IBD. Methods: Sixty male BALBc mice were divided into six groups. Group 1 was colitis-induced with trinitrobenzene sulfonic acid (TNBS) + ethanol, group 2 received TNBS + ethanol plus HBO, group 3 received only ethanol, group 4 received ethanol plus HBO, group 5 received saline solution, and group 6 received saline solution plus HBO. HBO was performed for four days, subsequently, the mice were evaluated daily. At the end of the study, samples from the intestine were collected for histological analysis as well as for measurement of antioxidant enzymes and cytokine levels. Results: HBO significantly improved the clinical and histological status of the animals. Treatment with HBO increased the activity of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) in all of the groups; moreover, the difference was only significant between the TNBS and TNBS + HBO groups and treatments promoted a reduction in the proinflammatory cytokines IFN-γ, IL-12, IL-17 and TNF-α and increased the anti-inflammatory cytokines IL-4 and IL-10, with no changes in IL-13. Conclusion: HBO effectively treats TNBS-induced colitis by increasing the activity of antioxidant enzymes and modulating cytokine profiles.

Factors Associated with the Development of Early Complications after Total Knee Arthroplasty.

Objective To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty Methods The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention. Results Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications. Conclusions Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Factors Associated with the Development of Early Complications after Total Knee Arthroplasty / Fatores associados ao desenvolvimento de complicações precoces após artroplastia total do joelho

Abstract Objective To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty Methods The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention. Results Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications. Conclusions Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Resumo Objetivo Identificar fatores de risco para o desenvolvimento de complicações pós-operatórias locais ou clínicas ocorridas até 30 dias após a cirurgia em pacientes submetidos a artroplastia total do joelho. Métodos Todos os pacientes submetidos a artroplastia de joelho realizada neste hospital no período do estudo foram incluídos na análise, baseada em dados dos prontuários dos pacientes, para investigar os fatores associados à ocorrência de complicações locais ou clínicas durante o internamento até 30 dias após o procedimento que necessitaram de alguma intervenção. Resultados Dos 157 pacientes incluídos no estudo, 17,1% cursaram com alguma complicação. As mais prevalentes foram artrofibrose (6,4%), infecção profunda (4,4%) e infecção superficial (2,5%), dentre outras. A maior idade e maior número de comorbidades prévias foram relacionadas com maior risco de complicações pós-operatórias. Conclusões A maior idade e maior número de comorbidades foram relacionados a um risco aumentado de complicações pós-operatórias. O escore Sociedade Americana de Anestesiologistas (ASA, na sigla em inglês) se mostrou insuficiente para avaliar a ocorrência de complicações pós artroplastia de joelho e novas ferramentas devem ser empregadas para este fim.

Impact of the COVID-19 Pandemic in the Prevalence of Burnout among Residents in Orthopedics.

Objective The primary objective of the present study is to assess the impact of the COVID-19 pandemic on the prevalence of burnout syndrome among residents in orthopedic surgery. As a secondary objective, characteristics associated with the risk of developing the severe form of the syndrome were assessed. Method In the present cross-sectional study, graduating orthopedic residents were evaluated before and during the COVID-19 pandemic. Medical students formed a control group. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory, and the Brazilian validated version of the 36-item short-form health survey questionnaire (SF-36). Fifty-two residents were appraised before the pandemic and 19 during the pandemic. Results Forty-four (84.6%) residents fulfilled the criteria for burnout syndrome, and the severe form of the syndrome was present in 16 (30.7%). There was no significant change in the evaluated scores after the beginning of the COVID-19 pandemic. There was also no increase in the prevalence of burnout syndrome or of the severe form of the syndrome. A negative correlation was observed between SF-36 items and the development of the severe form of burnout syndrome. Conclusion The prevalence of burnout syndrome and of the severe form of the disease was very high among residents in orthopedic surgery. The COVID-19 outbreak does not increase burnout in the residents.

Impact of the COVID-19 Pandemic in the Prevalence of Burnout among Residents in Orthopedics / Impacto da pandemia COVID-19 na prevalência de burnout entre residentes em ortopedia

Abstract Objective The primary objective of the present study is to assess the impact of the COVID-19 pandemic on the prevalence of burnout syndrome among residents in orthopedic surgery. As a secondary objective, characteristics associated with the risk of developing the severe form of the syndrome were assessed. Method In the present cross-sectional study, graduating orthopedic residents were evaluated before and during the COVID-19 pandemic. Medical students formed a control group. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory, and the Brazilian validated version of the 36-item short-form health survey questionnaire (SF-36). Fifty-two residents were appraised before the pandemic and 19 during the pandemic. Results Forty-four (84.6%) residents fulfilled the criteria for burnout syndrome, and the severe form of the syndrome was present in 16 (30.7%). There was no significant change in the evaluated scores after the beginning of the COVID-19 pandemic. There was also no increase in the prevalence of burnout syndrome or of the severe form of the syndrome. A negative correlation was observed between SF-36 items and the development of the severe form of burnout syndrome. Conclusion The prevalence of burnout syndrome and of the severe form of the disease was very high among residents in orthopedic surgery. The COVID-19 outbreak does not increase burnout in the residents.

Resumo Objetivo O objetivo principal do presente estudo é avaliar o impacto da pandemia de COVID-19 na prevalência da síndrome de burnout entre residentes de ortopedia Como objetivo secundário, foram avaliadas características associadas ao risco de desenvolver a forma grave da síndrome. MétodoNo presente estudo transversal, foram avaliados residentes antes e durante a pandemia de COVID-19. Estudantes de medicina formaram um grupo de controle. Os participantes responderam a um questionário sociodemográfico, ao Inventário Maslach Burnout, e à versão validada brasileira do Short Form Health Survey 36 (SF-36). Cinquenta e dois residentes foram avaliados antes da pandemia e 19 durante a pandemia. Resultados Quarenta e quatro (84,6%) residentes tinham critérios para síndrome de burnout, e a forma grave da síndrome estava presente em 16 (30,7%). Não houve alteração significativa nos escores avaliados após o início da pandemia de COVID-19. Também não houve aumento na prevalência da síndrome de burnout ou da forma grave da síndrome. Observou-se correlação negativa entre os itens SF-36 e o desenvolvimento da forma grave da síndrome de burnout. Conclusão A prevalência da síndrome de burnout e da forma grave da doença foi muito alta entre os residentes em cirurgia ortopédica. A pandemia de COVID-19 não aumentou o burnout nos residentes.

Development of Triazoles and Triazolium Salts Based on AZT and Their Anti-Viral Activity against HIV-1.

We report herein a set of 3'-azido-3'-deoxythymidine (AZT) derivatives based on triazoles and triazolium salts for HIV-1 infection. The compounds were synthesized via click chemistry with Cu(I) and Ru(II) catalysts. Triazolium salts were synthesized by reaction with methyl iodide or methyl triflate in good yields. The antiviral activity of the compounds was tested using two methodologies: In method one the activity was measured on infected cells; in method two a pre-exposure prophylaxis experimental model was employed. For method one the activity of the compounds was moderate, and in general the triazolium salts showed a decreased activity in relation to their triazole precursors. With method two the antiviral activity was higher. All compounds were able to decrease the infection, with two compounds able to clear almost all the infection, while a lower antiviral activity was noted for the triazolium salts. These results suggest that these drugs could play an important role in the development of pre-exposure prophylaxis therapies.

Benefits of intraoperative music on orthopedic surgeries under spinal anesthesia: A randomized clinical trial.

OBJECTIVE: To determine whether instrumental music influences the anxiety status and intraoperative sedative requirements of a patient DESIGN: A single center, prospective, randomized controlled trial SETTING: Patients between 18 and 65 years, physical status of American Society of Anesthesiologists (ASA I or II) who underwent lower limb orthopedic surgery under spinal anesthesia. INTERVENTIONS: Patients were assigned to one of two groups: (1) Music Group: patients hearing instrumental music through a headset during the entire procedure or (2) No Music Group: patients wearing headphones without music MAIN OUTCOME MEASURES: Before and after the procedure, the anxiety status of the patient was assessed using the State-Trait Anxiety Inventory, and intraoperative sedative drug consumption was quantified. RESULTS: A total of 107 patients were analyzed. A significant reduction in anxiety in the Music Group patients after surgery (p = 0.023) was found. Patients in this group also required less additional medication for intraoperative sedation (p = 0.004), and 88.9% of Music Group patients self-reported that music helped them remain calm during the procedure. Most patients in both groups agreed that music should be used during surgical procedures (98.2% and 94.3% in Music and No Music Groups, respectively) CONCLUSIONS: This study showed that listening to instrumental music during lower limb orthopedic surgery caused a reduction in anxiety and sedative requirements. Patients also self-reported a positive music-related experience.

Functional outcomes of the anterior subcutaneous internal pelvic fixator (INFIX) technique for pelvic ring injuries: A case series.

INTRODUCTION: Anterior external fixation is a well-established technique for treating pelvic ring injuries, but many complications are associated with it. The subcutaneous anterior internal fixator (INFIX) technique is associated with reduced complication rates and is less uncomfortable for patients. OBJECTIVE: This study evaluated functional outcomes among patients with pelvic ring injuries treated using the INFIX method. PATIENTS AND METHODS: In this retrospective case series, patients treated using the INFIX technique were reviewed for functional outcomes, using the Iowa Pelvic Score (IPS). Thirty-four patients, of mean age 39.2 years, were evaluated after a mean follow-up of 1.2 years. RESULTS: Twenty-three of the 34 patients experienced reduction classified as excellent, and eleven as good, with no instances of moderate or poor reduction. One patient developed implant exposure and infection during follow-up. Twenty-six ultimately experienced an excellent or good functional result. The average final IPS was 79.4 (range: 48-100). CONCLUSION: Our results reinforce prior evidence that the INFIX method is safe for fixating pelvic ring lesions. Most of our patients also experienced excellent or good functional recovery, suggesting that this technique is a viable option for treating certain pelvic ring injuries.

Ethanolic Extract of the Red Algae Meristiella echinocarpa (Areschoug) Confers Neuroprotection in Mice / Extrato Etanólico da Alga Vermelha Meristiella echinocarpa (Areschoug) Confere Neuroproteção em Camundongos

Objectives: This study aimed to investigate the neuroprotective effects of the ethanolic extract obtained from red algae marine Meristiella echinocarpa (Areschougiaceae) ­ EEMe. Methods: EEMe was used in doses ranging from 10 to 40 mg/kg, administered intraperitoneally in mice. Behavioral tests were performed to assess locomotor activity (open field), anxiety (elevated plus maze), depression (tail suspension), and motor coordination (rota-rod). The anticonvulsant effect of the algae extract was evaluated in two models of seizures induced by strychnine and pentylenetetrazol. The level of oxidative stress was also evaluated in the following brain areas: the prefrontal cortex, hippocampus, and striatum. Statistical analysis was performed applying ANOVA followed by the Bonferroni test. Results: EEMe reduced significantly the number of crossing (36%) and rearing (54%) in the open field test and increased 1.3x the immobility time in the tail suspension test. In brain areas EEMe also reduced significantly malondialdehyde levels (striatum: 45%, hippocampus: 38%, prefrontal cortex: 37%) and nitrite levels (striatum: 72%, hippocampus: 79%, prefrontal cortex: 63%), and increased the reduced-glutathione levels (striatum: 72%, hippocampus: 73%, prefrontal cortex: 42%). In addition, the extract significantly prolonged the latency of seizures induced by strychnine (38%) or pentylenetetrazol (57%), and the latency of death induced by pentylenetetrazol (6.1x). Conclusion: EEMe exhibits antioxidant and anticonvulsant effects, probably involving GABAergic and glycinergic pathways.

Objetivos: este estudo teve como objetivo investigar os efeitos neuroprotetores do extrato etanólico da alga marinha vermelha Meristiella echinocarpa (Areschougiaceae) - EEMe. Métodos: EEMe foi utilizado em doses que variaram de 10 a 40 mg/kg, administrados via intraperitoneal em camundongos. Foram realizados testes comportamentais que avaliaram a atividade locomotora (campo aberto), a ansiedade (labirinto em cruz elevado), a depressão (suspensão em cauda) e a coordenação motora (rota-rod). O efeito anticonvulsivante do extrato da alga foi avaliado em dois modelos de convulsões por estricnina e pentilenotetrazol. Foi também realizada a avaliação do nível de estresse oxidativo nas seguintes áreas cerebrais: córtex pré-frontal, hipocampo e corpo estriado. A análise estatística foi realizada, aplicando a ANOVA seguida do teste de Bonferroni. Resultados: o EEMe reduziu, significativamente, o número de cruzamentos (36%) e o número de rearing (54%) no teste de campo aberto e aumentou, em 1,3x, o tempo de imobilidade no teste de suspensão pela cauda. Nas áreas cerebrais, o EEMe também reduziu, significativamente, os níveis de malondialdeído (estriado: 45%, hipocampo: 38%, córtex pré-frontal: 37%) e os níveis de nitrito (estriado: 72%, hipocampo: 79%, córtex pré-frontal: 63%) e aumentou a glutationa reduzida (estriado: 72%, hipocampo: 73%, córtex pré-frontal: 42%). Além disso, o EEMe prolongou, significativamente, a latência das convulsões induzidas por estricnina (38%) ou pentilenotetrazol (57%), e a latência da morte induzida por pentilenetetrazol (6,1x). Conclusão: o EEMe apresenta efeitos antioxidantes e anticonvulsivantes, provavelmente envolvendo as vias GABAérgica e glicinérgica.

Case report: treatment of Fournier's gangrene of the shoulder girdle / Relato de caso: tratamento da gangrena de Fournier na cintura escapular

ABSTRACT Fournier's gangrene is a rare, high-mortality infection that affects the subcutaneous tissue with rapidly progressive necrosis. The objective is to report a case of Fournier's gangrene involving the region of the shoulder girdle after closed fracture of the clavicle, and to discuss this unusual evolution. The patient underwent a series of surgical procedures and was followed up on an outpatient basis for 12 months, at which point she was discharged. Fournier's gangrene is an aggressive lesion and requires early diagnosis (clinical-laboratory correlation) with the appropriate adequate surgical approach and clinical stabilization.

RESUMO A gangrena de Fournier é uma infecção rara e com alta mortalidade que acomete o tecido subcutâneo, com necrose rapidamente progressiva. O objetivo é relatar um caso de gangrena de Fournier que envolveu a região da cintura escapular após fratura fechada da clavícula e discutir essa incomum evolução. A paciente foi submetida a procedimentos cirúrgicos seriados e acompanhada ambulatorialmente por 12 meses, quando obteve alta. A gangrena de Fournier é uma lesão agressiva e necessita de diagnóstico precoce (correlação clínico-laboratorial) com adequada abordagem cirúrgica e estabilização clínica.

FACTORS ASSOCIATED WITH THE DEVELOPMENT OF EARLY INFECTION AFTER SURGICAL TREATMENT OF FRACTURES.

OBJECTIVE: Infection after the internal fixation of fractures is a major complication. Early infection is particularly challenging, because it occurs when the fracture is not yet united. The objective of this study is to identify possible factors related to the development of early infection in patients treated with internal fixation for fractures. METHOD: This retrospective observational study analyzed 24 patients with long bone fractures who underwent internal fixation and developed infections in the post-operatory period. The infections were classified as early (diagnosis in the first two weeks after surgery) or late (diagnosis after 2 weeks). RESULTS: Of the 24 patients studied, 11 (46%) developed early infections and 13 (54%) were diagnosed with late infections. The early infection group was significantly younger (37.8 versus 53.1 [p = 0.05]) and underwent more surgeries prior to internal fixation (1.2 versus 0.2 [p < 0.00]). CONCLUSION: Risk factors for the development of early infection in the postoperative period should be considered when treating patients with internal fracture fixation in order to diagnose this condition as early as possible. Level of Evidence IV; Case series.

OBJETIVO: A infecção após a fixação interna das fraturas é uma complicação grave, sendo a infecção precoce particularmente desafiadora, pois acontece quando a fratura ainda não está consolidada. O objetivo deste estudo é identificar fatores relacionados com o desenvolvimento de infecção precoce em pacientes submetidos à fixação interna de fraturas. MÉTODO: Estudo retrospectivo que envolveu 24 pacientes com fraturas de ossos longos submetidos à fixação interna, que evoluíram com infecção no pós-operatório. A infecção foi classificada como precoce (diagnóstico nas primeiras duas semanas após a fixação interna) e tardia (diagnóstico após 2 semanas da realização da fixação). RESULTADOS: Dos 24 pacientes estudados, 11 (46%) desenvolveram infecção precoce e 13 (54%) tiveram infecção tardia. Os pacientes portadores de infecção precoce eram mais jovens (37,8 anos versus 53,1 anos [p = 0,05]) e foram submetidos a um maior número de cirurgias antes da fixação interna (1,2 versus 0,2 [p < 0,00]). CONCLUSÃO: É recomendável levar em consideração os fatores de risco de desenvolvimento de infecção no pós-operatório em pacientes submetidos à fixação interna de fraturas visando realizar o diagnóstico o mais breve possível. Nível de Evidência IV; Série de casos.

Case report: treatment of Fournier's gangrene of the shoulder girdle.

Fournier's gangrene is a rare, high-mortality infection that affects the subcutaneous tissue with rapidly progressive necrosis. The objective is to report a case of Fournier's gangrene involving the region of the shoulder girdle after closed fracture of the clavicle, and to discuss this unusual evolution. The patient underwent a series of surgical procedures and was followed up on an outpatient basis for 12 months, at which point she was discharged. Fournier's gangrene is an aggressive lesion and requires early diagnosis (clinical-laboratory correlation) with the appropriate adequate surgical approach and clinical stabilization.

A gangrena de Fournier é uma infecção rara e com alta mortalidade que acomete o tecido subcutâneo, com necrose rapidamente progressiva. O objetivo é relatar um caso de gangrena de Fournier que envolveu a região da cintura escapular após fratura fechada da clavícula e discutir essa incomum evolução. A paciente foi submetida a procedimentos cirúrgicos seriados e acompanhada ambulatorialmente por 12 meses, quando obteve alta. A gangrena de Fournier é uma lesão agressiva e necessita de diagnóstico precoce (correlação clínico-laboratorial) com adequada abordagem cirúrgica e estabilização clínica.

Fatty acid composition from the marine red algae Pterocladiella capillacea (S. G. Gmelin) Santelices & Hommersand 1997 and Osmundaria obtusiloba (C. Agardh) R. E. Norris 1991 and its antioxidant activity

ABSTRACT This study evaluated the chemical composition and antioxidant activity of fatty acids from the marine red algae Pterocladiella capillacea (S. G. Gmelin) Santelices & Hommersand 1997 and Osmundaria obtusiloba (C. Agardh) R. E. Norris 1991. The gas chromatography mass spectrometry (GC-MS) identified nine fatty acids in the two species. The major fatty acids of P. capillacea and O. obtusiloba were palmitic acid, oleic acid, arachidonic acid and eicosapentaenoic acid. The DPPH radical scavenging capacity of fatty acids was moderate ranging from 25.90% to 29.97%. Fatty acids from P. capillacea (31.18%) had a moderate ferrous ions chelating activity (FIC), while in O. obtusiloba (17.17%), was weak. The ferric reducing antioxidant power (FRAP) of fatty acids from P. capillacea and O. obtusiloba was low. As for β-carotene bleaching (BCB), P. capillacea and O. obtusiloba showed a good activity. This is the first report of the antioxidant activities of fatty acids from the marine red algae P. capillacea and O. obtusiloba.

Fatty acid composition from the marine red algae Pterocladiella capillacea (S. G. Gmelin) Santelices & Hommersand 1997 and Osmundaria obtusiloba (C. Agardh) R. E. Norris 1991 and its antioxidant activity.

This study evaluated the chemical composition and antioxidant activity of fatty acids from the marine red algae Pterocladiella capillacea (S. G. Gmelin) Santelices & Hommersand 1997 and Osmundaria obtusiloba (C. Agardh) R. E. Norris 1991. The gas chromatography mass spectrometry (GC-MS) identified nine fatty acids in the two species. The major fatty acids of P. capillacea and O. obtusiloba were palmitic acid, oleic acid, arachidonic acid and eicosapentaenoic acid. The DPPH radical scavenging capacity of fatty acids was moderate ranging from 25.90% to 29.97%. Fatty acids from P. capillacea (31.18%) had a moderate ferrous ions chelating activity (FIC), while in O. obtusiloba (17.17%), was weak. The ferric reducing antioxidant power (FRAP) of fatty acids from P. capillacea and O. obtusiloba was low. As for ß-carotene bleaching (BCB), P. capillacea and O. obtusiloba showed a good activity. This is the first report of the antioxidant activities of fatty acids from the marine red algae P. capillacea and O. obtusiloba.

Factors associated with the development of early infection after surgical treatment of fractures / Fatores associados ao desenvolvimento de infecção precoce após tratamento cirúrgico das fraturas

ABSTRACT Objective: Infection after the internal fixation of fractures is a major complication. Early infection is particularly challenging, because it occurs when the fracture is not yet united. The objective of this study is to identify possible factors related to the development of early infection in patients treated with internal fixation for fractures. Method: This retrospective observational study analyzed 24 patients with long bone fractures who underwent internal fixation and developed infections in the post-operatory period. The infections were classified as early (diagnosis in the first two weeks after surgery) or late (diagnosis after 2 weeks). Results: Of the 24 patients studied, 11 (46%) developed early infections and 13 (54%) were diagnosed with late infections. The early infection group was significantly younger (37.8 versus 53.1 [p = 0.05]) and underwent more surgeries prior to internal fixation (1.2 versus 0.2 [p < 0.00]). Conclusion: Risk factors for the development of early infection in the postoperative period should be considered when treating patients with internal fracture fixation in order to diagnose this condition as early as possible. Level of Evidence IV; Case series.

RESUMO Objetivo: A infecção após a fixação interna das fraturas é uma complicação grave, sendo a infecção precoce particularmente desafiadora, pois acontece quando a fratura ainda não está consolidada. O objetivo deste estudo é identificar fatores relacionados com o desenvolvimento de infecção precoce em pacientes submetidos à fixação interna de fraturas. Método: Estudo retrospectivo que envolveu 24 pacientes com fraturas de ossos longos submetidos à fixação interna, que evoluíram com infecção no pós-operatório. A infecção foi classificada como precoce (diagnóstico nas primeiras duas semanas após a fixação interna) e tardia (diagnóstico após 2 semanas da realização da fixação). Resultados: Dos 24 pacientes estudados, 11 (46%) desenvolveram infecção precoce e 13 (54%) tiveram infecção tardia. Os pacientes portadores de infecção precoce eram mais jovens (37,8 anos versus 53,1 anos [p = 0,05]) e foram submetidos a um maior número de cirurgias antes da fixação interna (1,2 versus 0,2 [p < 0,00]). Conclusão: É recomendável levar em consideração os fatores de risco de desenvolvimento de infecção no pós-operatório em pacientes submetidos à fixação interna de fraturas visando realizar o diagnóstico o mais breve possível. Nível de Evidência IV; Série de casos.

Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty / Eficácia do tratamento adjuvante da dor pós-artroplastia total do joelho utilizando emplastros com lidocaína

BACKGROUND: Effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical outcomes. The current trend is to use multimodal treatment, in which the use of patches with lidocaine as adjuvant therapy has an increasingly relevant role. OBJECTIVE: To investigate the potential benefits of lidocaine patch association with the basic analgesia regimen for pain relief during the postoperative period of total knee arthroplasty. METHOD: A retrospective cohort study was performed , with a total of 24 patients in each group, who underwent total knee arthroplasty. Pain levels using a visual analogue scale and opioid intake were controlled from the immediate postoperative to the end of a 28-day interval. RESULTS: During the postoperative period, pain was less intense in patients who used lidocaine patches. In these same patients, the doses of opioids needed to control pain were lower in 15 of the 28 days analyzed. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Patients older than 70 years and females predominated. CONCLUSION: Adjuvant treatment after total knee arthroplasty using lidocaine patches was effective in reducing pain and decreasing the use of opioids in the period analyzed, and represents a good addition to multimodal analgesic therapy.

OBJETIVO: A terapia analgésica eficaz no pós-operatório de artroplastia total do joelho é imprescindível para bons resultados cirúrgicos. A tendência atual é a de se utilizar o tratamento multimodal, no qual a utilização de emplastros com lidocaína como terapia adjuvante tem papel crescente e relevante. Investigar os potenciais benefícios da associação do emplastro com lidocaína ao esquema terapêutico básico de analgesia para o alívio da dor durante o período pós-operatório de artroplastia total de joelho. MÉTODO: Foi realizado um estudo de coorte retrospectivo cuja população foi a de pacientes submetidos a artroplastia total do joelho, divididos em dois grupos com 24 integrantes em cada, acompanhados por um período de 28 dias. RESULTADOS: Durante o pós-operatório analisado a dor foi menos intensa nos pacientes que utilizaram os emplastros com lidocaína. Nesses mesmos pacientes, as doses de opióides necessárias para controlar a dor foram menores em 15 dos 28 dias analisados. A frequência relativa de náuseas foi maior no grupo que não utilizou a terapia adjuvante. Predominaram os pacientes com mais de 70 anos e o gênero feminino. CONCLUSÃO: O tratamento adjuvante após a artroplastia total do joelho utilizando emplastros com lidocaína mostrou ser eficaz na redução da dor e diminuição do uso de opióides no período analisado, constituindo um bom incremento para a terapia analgésica multimodal.

Protective effects of ethanolic extract from the red algae Amansia multifida on experimental inflammation, nociception and seizure experimental models / Efeito protetor do extrato etanólico da alga marinha vermelha Amansia multifida em modelos experimentais de inflamação, nocicepção e convulsão

This study aimed to investigate the EEAm effect in mice models of nociception, inflammation and in behavioral tests evaluating the central nervous system. EEAm had inhibitory effects in the following tests: acetic acid-induced writhing (78%); formalin (62% - inflammatory phase); open field (46%). EEAm increased the nociceptive latency (56%) in tail flick test and increased the death-latency by 36% in the pentylenetetrazole-induced seizure model. Moreover, EEAm inhibited paw edema (82%) and peritonitis (45%) induced by carrageenan. In conclusion, EEAm presents antinociceptive, anti-inflammatory and anticonvulsant effects involving peripheral and central-acting mechanisms in mice.

Neste estudo objetivou-se investigar o efeito do EEAm em modelos de nocicepção e inflamação, e em testes comportamentais que avaliam o sistema nervoso central em camundongos. EEAm exibiu efeitos inibitórios nos testes comportamentais de contorções abdominais induzidas por ácido acético (78%); formalina (62% - fase inflamatória) e campo aberto (46%). EEAm aumentou a latência de nocicepção no teste de retirada da cauda (56%) e a latência de morte 36% no modelo de convulsões induzidas por pentilenetetrazol. Além disso, EEAm inibiu o edema de pata (82%) e a peritonite (45%) induzidos por carragenana. Como conclusão, EEAm apresenta efeitos antinociceptivo, anti-inflamatório e anticonvulsivante em camundongos por mecanismos periféricos e centrais.

Bioactive extracts of red seaweeds Pterocladiella capillacea and Osmundaria obtusiloba (Floridophyceae: Rhodophyta) with antioxidant and bacterial agglutination potential.

OBJECTIVE: To evaluate the antioxidant, antibacterial and bacterial cell agglutination activities of the hexane (Hex) and 70% ethanol (70% EtOH) extracts of two species of red seaweeds Pterocladiella capillacea (P. capillacea) and Osmundaria obtusiloba. METHODS: In vitro antioxidant activity was determined by DPPH radical scavenging assay, ferric-reducing antioxidant power assay, ferrous ion chelating assay, ß-carotene bleaching assay and total phenolic content quantification. Antimicrobial activity was tested using the method of disc diffusion on Mueller-Hinton medium. The ability of algal extracts to agglutinate bacterial cells was also tested. RESULTS: The 70% EtOH extract of the two algae showed the highest values of total phenolic content compared to the Hex extract. The results of DPPH for both extracts (Hex, 70% EtOH) of Osmundaria obtusiloba (43.46% and 99.47%) were higher than those of P. capillacea (33.04% and 40.81%) at a concentration of 1000 µg/mL. As for the ferrous ion chelating, there was an opposite behavior, extracts of P. capillacea had a higher activity. The extracts showed a low ferric-reducing antioxidant power, with optical density ranging from 0.054 to 0.180. Antioxidant activities of all extracts evaluated for ß-carotene bleaching were above 40%. There was no antibacterial activity against bacterial strains tested. However, the extracts of both species were able to agglutinate bacterial Gram positive cells of Staphylococcus aureus and Gram negative cells of Escherichia coli, multidrug-resistant Salmonella and Vibrio harveyi. CONCLUSIONS: This is the first report of the interaction between these algal extracts, rich in natural compounds with antioxidant potential, and Gram positive and Gram negative bacterial cells.