Peripheral nerve regeneration in rats using nerve graft in a vein conduit pre-filled with platelet-rich fibrin (PRF).

Treatment of peripheral nerve injury is not always satisfactory. To improve results, specific adjuvant methods have been used, such as platelet-rich fibrin (PRF) and vein conduits. The goal of this study was to assess whether use of PRF and vein conduits after nerve suture improves nerve regeneration as measured by a functional score and histomorphometry analysis. Ten isogenic spontaneously hypertensive rats were randomly assigned to 4 experimental procedures: 1) Sham group (n = 10); 2) Nerve graft (NG) group (n = 10); 3) Nerve graft covered with a vein conduit (NGVC) (n = 10); and 4) Nerve graft covered with a vein conduit pre-filled with PRF (NGVCP) (n = 10). Nerve repair results were evaluated on: sciatic functional index (SFI) at 0, 30, 60 and 90 days; morphometric and morphologic analysis of the distal nerve; and histological analysis of Fluoro-Gold® stained motor neurons in the anterior horn of the spinal cord. Compared to the Sham control group, the NGVC and NGVCP groups exhibited lower SFI on all measures. The NGVC group showed improvement in SFI at day 90, which was significant compared to the NG group. Fiber and axon diameters were comparable in the NGVC and NGVCP groups, which were both significantly lower than in the Sham and NG groups. Significant improvement was expected with PRF, but in fact the release of factors from this substance was not as effective as hoped.

Outcome of carpal tunnel release surgery in patients with and without Linburg-Comstock anomaly.

Anatomical variations may entail increased volume within the carpal tunnel and consequently the development of carpal tunnel syndrome (CTS) symptoms. The clinical importance of anomalous connection between the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) tendons was described by Linburg and Comstock. The objective of the present study was to compare postoperative outcomes of carpal tunnel release surgery in patients with and without Linburg-Comstock anomaly (LCA). Hands of CTS patients with and without LCA were evaluated for finger sensitivity, grip, tip, key and tripod pinch strength, pain intensity and Boston Carpal Tunnel Questionnaire score. Patients were evaluated preoperatively and 1, 3 and 6 months after surgery. Forty-six hands in 36 CTS patients with LCA and 50 hands in 38 patients without LCA were included. On all study parameters, no significant difference was found between CTS patients with versus without LCA. As outcomes are similar in both cases, LCA resection is not useful in patients with LCA and CTS. Preoperative diagnosis is unnecessary and screening for LCA is non-contributive for CTS evaluation.

Linburg-Comstock anomaly: A comparison of the prevalence in women with and without clinical carpal tunnel syndrome.

We aimed to compare the prevalence of the Linburg-Comstock anomaly in women with and without a clinical diagnosis of carpal tunnel syndrome. The prevalence of the Linburg-Comstock anomaly was evaluated in 400 hands from 200 women over 40 years of age who were diagnosed clinically with carpal tunnel syndrome (CTS), designated as the CTS group. The volunteer group consisted of 400 hands from 200 healthy women over 40 years of age. The women from both groups were asked to carry out the clinical flexion and pain tests described by Linburg and Comstock (1979) as a basis for the clinical diagnosis. CTS patient ages ranged from 40 to 90 (mean 55.8) years, while volunteer group ages ranged from 40 to 93 (mean 55) years. The flexion test was positive in 305 (76%) hands in the CTS group and 242 (60%) hands in the volunteer group. The pain test was positive in 261 (65%) hands in the CTS group and 108 (27%) hands in the volunteer group. Both tests were positive in 244 (61%) hands in the CTS group and 98 (24%) hands in the volunteer group. All these differences were statistically significant. Based on clinical examination using the flexion and pain tests, the prevalence of Linburg-Comstock anomaly was statistically higher in the group of women with carpal tunnel syndrome than in healthy volunteers.

Genetic divergence of common bean cultivars.

The aim of this study was to evaluate genetic divergence in the 'Carioca' (beige with brown stripes) common bean cultivar used by different institutions and in 16 other common bean cultivars used in the Rede Cooperativa de Pesquisa de Feijão (Cooperative Network of Common Bean Research), by using simple sequence repeats associated with agronomic traits that are highly distributed in the common bean genome. We evaluated 22 polymorphic loci using bulks containing DNA from 30 plants. There was genetic divergence among the Carioca cultivar provided by the institutions. Nevertheless, there was lower divergence among them than among the other cultivars. The cultivar used by Instituto Agronômico do Paraná was the most divergent in relation to the Carioca samples. The least divergence was observed among the samples used by Universidade Federal de Lavras and by Embrapa Arroz e Feijão. Of all the cultivars, 'CNFP 10104' and 'BRSMG Realce' showed the greatest dissimilarity. The cultivars were separated in two groups of greatest similarity using the Structure software. Genetic variation among cultivars was greater than the variation within or between the groups formed. This fact, together with the high estimate of heterozygosity observed and the genetic divergence of the samples of the Carioca cultivar in relation to the original provided by Instituto Agronômico de Campinas, indicates a mixture of cultivars. The high divergence among cultivars provides potential for the utilization of this genetic variability in plant breeding.

Brachial plexus injuries: diagnosis performance and reliability of everyday tools.

PURPOSE: Determining the patterns of brachial plexus injuries is challenging. Diagnostic methods have been used to facilitate diagnosis, but there is no consensus regarding which tool best complements physical examination (PE). Magnetic resonance imaging (MRI) and nerve conduction studies (NCSs) are instruments with widespread use and feasibility for everyday assessment. In this study, we evaluated the diagnostic performance of these diagnostic instruments and PE. We also assessed the agreement in the PE and diagnostic instrument findings of two experienced and certified hand surgeons. METHODS: We reviewed data gathered from medical records and compared these data with the results of operative findings. We divided data according to the site of injury and the root injury patterns for all three diagnostic instruments (PE, MRI, and NCSs). RESULTS: We considered 102 assessments. We found poor inter-observer agreement for the PE assessments and poor agreement among the PE, NCS, and MRI assessments. Diagnostic performance was higher for PE: sensitivity = 97.8 [95% confidence interval (C.I.) = 92.1-99.7]; specificity = 30.8 [95% C.I. = 9.1-61.4], and NCSs (sensitivity = 98.9 [95% C.I. = 93.9-100]; specificity = 23.1 [95% C.I. = 5-53.8]. MRI had inferior performance for all measurements. Separate analysis using pre- and post-ganglionic injuries revealed that PE had the lowest sensitivity, 46.7 (95% C.I. = 21.3-73.4) despite having the highest specificity, 81.6 (95% C.I. = 71.9-89.1). DISCUSSION: Low agreement among the findings using different diagnostic instruments demonstrated that PE is the most specific tool, despite its low sensitivity. Detailed PE is cornerstone for evaluating brachial plexus injuries and NCSs are better than MRI for scrutinizing injuries not found in PE. CLINICAL RELEVANCE: In our study, NCSs exhibited superior performance to MRI, and should be considered a more reliable supporting tool after detailed PE.

Follow-up of patients with low-risk papillary thyroid carcinoma and undetectable basal serum thyroglobulin after ablation measured with a sensitive assay: a prospective study.

The importance of thyroglobulin (Tg) stimulation after ablation in patients with papillary thyroid carcinoma (PTC) and undetectable basal Tg measured with sensitive assays has been questioned. However, there is a need for prospective studies that evaluate the evolution of these patients when stimulated Tg is omitted and this was the objective of the present investigation. One hundred twenty-two consecutive patients with PTC with the following characteristics were evaluated: submitted to total thyroidectomy and remnant ablation; low risk for recurrence; undetectable basal Tg (functional sensitivity of 0.1 ng/ml) 6 months after initial therapy; anti-Tg antibodies (TgAb) negative, and neck ultrasound (US) showing no abnormalities. These patients were not submitted to Tg stimulation. After follow-up for 24-78 months, only one patient (0.8%) presented apparent disease (lymph node metastases). TgAb were detected at low titers and without progression in 1 patient (0.8%). Tg became detectable and continued to be detectable in 3 patients (2.4%), but at concentrations ≤0.3 ng/ml in the absence of further increases, with stimulated Tg < 1.4 ng/ml. A total of 117 patients (96%) coursed with no apparent disease throughout follow-up and had undetectable Tg at the end of the study. Of these, 111 showed undetectable Tg in all measurements and 6 showed detectable Tg in some of them, although Tg later returned spontaneously to an undetectable range. After ablation, the risk of recurrence is very low in patients with low-risk PTC who show undetectable basal Tg measured with a sensitive assay, negative TgAb and negative US.

Does an ulnar styloid fracture interfere with the results of a distal radius fracture?

BACKGROUND: The ulnar styloid is a supportive structure for the capsular ligament complex of the distal radioulnar joint. The relation between fractures of the ulna and distal radius is not clear, especially in regard to whether ulnar fractures predict worse outcomes for distal radius fractures. The objective of this study was to analyze the influence of ulnar styloid fractures in patients with reducible and unstable distal radius fractures. METHODS: A total of 100 patients with unstable and reducible distal radius fractures, with or without an ulnar styloid fracture, were randomly assigned to treatment with transarticular bridging external fixation or transulnar percutaneous pinning. Follow-up was obtained for 91 patients. For the secondary data analysis, three patient cohorts were created: a no ulnar styloid fracture group with the radius fracture treated by pinning or external fixation (n = 30); an ulnar styloid fracture with radius fracture group treated by external fixation (n = 31); and an ulnar styloid fracture with radius fracture treated by pinning (n = 30). Functional and radiological outcomes were measured at 6 and 24 months. Functional outcome measures included wrist pain (visual analogue scale) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. RESULTS: At 24 months, patients with both fractures had worse wrist pain and worse scores on the DASH questionnaire than the patients with an isolated distal radius fracture; and those treated by pinning had less wrist pain and showed better scores on the DASH questionnaire than the patients treated by fixation. CONCLUSIONS: Ulnar styloid fracture may be a predictive factor of worse functional outcome for distal radius fracture. Pinning and above-the-elbow casting, used to treat ulnar styloid fractures, led to better function than fixation.

[Epidemiology and ecology of dermatophytoses in the City of Fortaleza: Trichophyton tonsurans as important emerging pathogen of Tinea capitis]. / Epidemiologia e ecologia das dermatofitoses na cidade de Fortaleza: o Trichophyton tonsurans como importante patogeno emergente da Tinea capitis.

Dermatophytosis is the most common skin infectious disturbance in the world. In this research 2,297 patients were evaluated with suspected clinical lesions of dermatophytosis. It was observed that, 534 (23.2%) patients tested positive for dermatophytes. T. rubrum was the most prevalent specie (49.6%; p < or = 0.05), followed by T. tonsurans (34.4%), M. canis (7%) and T. mentagrophytes (6.2%). When the species isolated was correlated with the respective anatomical localization, it was observed that T. tonsurans was the most frequent isolated in scalp lesions (73.9%; p < or = 0.01). On the other hand, T. rubrum was the main specie involved in body lesions (72.8%; p < or = 0.05). Therefore, in scalp infections it was observed that, there was an absolute prevalence of T. tonsurans. This evidence is different from the statistical data collected in the southeast and south of Brazil, as well as from other areas of the world, which still show M. canis as the most frequent microorganism isolated in Tinea capitis.

Comparison of RAPD and RFLP genetic markers in determining genetic similarity among Brassica oleracea L. genotypes.

Genetic similarity among 45 Brassica Oleracea genotypes was compared using two molecular markers, random amplified polymorphic DNA (RAPD) and restriction fragment length polymorphisms (RFLPs). The genotypes included 37 broccolis (var. italica), five cauliflowers (var. botrytis) and three cabbages (var. capitata) which represented a wide range of commercially-available germplasm, and included open-pollinated cultivars, commercial hybrids, and inbred parents of hybrid cultivars. Fifty-six polymorphic RFLP bands and 181 polymorphic RAPD bands were generated using 15 random cDNA probes and 62 10-mer primers, respectively. The objectives were to compare RFLP and RAPD markers with regard to their (1) sampling variance, (2) rank correlations of genetic distance among sub-samples, and (3) inheritance. A bootstrap procedure was used to generate 200 random samples of size n (n=2,3,5,... 55) independently from the RAPD and RFLP data sets. The coefficient of variance (CV) was estimated for each sample. Pooled regressions of the coefficient of variance on bootstrap sample size indicated that the rate of decrease in CV with increasing sample size was the same for RFLPs and RAPDs. The rank correlation between the Nei-Li genetic similarity values for all pairs of genotypes (990) based on RFLP and RAPD data was 0.745. Differences were observed between the RFLP and RAPD dendrograms of the 45 genotypes. Overlap in the distributions of rank correlations between independent sub-samples from the RAPD data set, compared to correlations between RFLP and RAPD sub-samples, suggest that observed differences in estimation of genetic similarity between RAPDs and RFLPs is largely due to sampling error rather than due to DNA-based differences in how RAPDs and RFLPs reveal polymorphisms. A crossing algorithm was used to generate hypothetical banding patterns of hybrids based on the genotypes of the parents. The results of this study indicate that RAPDs provide a level of resolution equivalent to RFLPs for detemination of the genetic relationships among genotypes.