Agreement of olecranon fractures before and after the exposure to four classification systems.

BACKGROUND: Although classification systems of olecranon fractures are important to help choose the best treatment and to predict prognosis, their degree of observer agreement is poorly investigated. The objective of this study was to investigate the intraobserver and interobserver reliability of currently used classification systems for olecranon fractures. Our hypothesis is that the Colton classification presents an acceptable agreement because it is simpler to use; on the other hand, considering the AO classification's complexity, we expect it to reach a lower level of agreement. METHODS: Radiographic images of elbow joint fractures were classified according to Colton, AO, Mayo, and Schatzker classification systems. The raters were 8 orthopedic surgeons split into 2 groups with 4 participants each, one with specialists in upper extremity surgery and the other with orthopedic surgeons without a specific focus on upper extremity surgery. This first procedure was the pretest training, aimed at calibrating participants' judgment. Image classification was conducted after all training was completed. After 30 days from the initial rating session, the test was conducted once again following the exact same procedures. RESULTS: The Colton classification has substantial intraobserver and interobserver agreement for specialists and nonspecialists. The Schatzker classification revealed a fair agreement for both specialists and nonspecialists. A fair concordance was also found for the Mayo classification. The AO classification demonstrated a moderate rate of agreement for specialists, whereas nonspecialists presented slight intraobserver agreement. CONCLUSION: No classification system is widely accepted because it can be affected by interobserver variability, which can raise questions about its use in a research as well as in a clinical context.

Protective effect of gastrin-releasing peptide receptor antagonist in carrageenan-induced pleural inflammation in rats.

OBJECTIVE: We report the effects of the gastrin-releasing peptide (GRP) receptor antagonist RC-3095 in an acute inflammation model induced by carrageenan. METHODS: Male Wistar rats received saline or saline containing 2% lambda-carrageenan into the pleural cavity, with some also receiving RC-3095 3 mg/kg subcutaneously, immediately after surgery. Four hours later, the rats were killed and pleural exudate was obtained for evaluation of total cell count, lactate dehydrogenase activity, total protein, cytokines analysis and nitrite/nitrate concentrations; myeloperoxidase (MPO) activity and oxidative stress were evaluated in the lung. RESULTS: RC-3095 exhibited pronounced anti-inflammatory actions by inhibition of leukocyte influx and blockade of MPO, nitrite/nitrate and cytokine levels. Moreover, the results showed that RC-3095 elicits action against oxidative damage in lipids and proteins, as well as increasing cell viability. CONCLUSION: The present findings suggest that GRP plays a role in acute inflammation that can be related with the reduction of oxidative damage and that it could be effective in therapeutic applications.

Oxidative stress and metabolism in animal model of colitis induced by dextran sulfate sodium.

BACKGROUND AND AIM: Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal tract. Its etiology remains unclear, but it appears to result from a dysregulated immune response, with infiltration of phagocytic leukocytes into the mucosal interstitium. The production and release of reactive oxygen species by immune cells seems to play a crucial role in physiopathology of colitis. The aim of this work was to evaluate the effects of N-acetylcysteine (NAC) and deferoxamine (DFX) in the treatment of colitis induced by dextran sulfate sodium (DSS). METHODS: The effects of NAC and DRX on rats with DSS-induced colitis were determined by measuring intestinal parameters of oxidative stress and mitochondrial function, inflammatory response and bowel histopathological alterations. RESULTS: DSS increased white blood cells count and NAC and DFX did not prevent this effect. However, DSS increased mitochondrial respiratory chain complex IV in colon of rats and NAC and DFX prevented this alteration. In addition, thiobarbituric acid reactive substances were increased in colon of DSS-treated rats. NAC and DFX, when taken together, prevented this effect. Complex II and succinate dehydrogenase were not affected by DSS, as protein carbonyl content. CONCLUSIONS: It is speculated that NAC and DFX might be useful for treatment of colitis, but further research is necessary to clarify these effects.