RESUMO
INTRODUCTION: Posterior tibial tendon dysfunction is a common cause of adult flat foot deformity, and its etiology is unknown. PURPOSE: In this study, we characterized the morphologic pattern and distribution of types I, III and V collagen in posterior tibial tendon dysfunction. METHOD: Tendon samples from patients with and without posterior tibial tendon dysfunction were stained by immunofluorescence using antibodies against types I, III and V collagen. RESULTS: Control samples showed that type V deposited near the vessels only, while surgically obtained specimens displayed type V collagen surrounding other types of collagen fibers in thicker adventitial layers. Type III collagen levels were also increased in pathological specimens. On the other hand, amounts of collagen type I, which represents 95% of the total collagen amount in normal tendon, were decreased in pathological specimens. CONCLUSION: Fibrillogenesis in posterior tibial tendon dysfunction is altered due to higher expression of types III and V collagen and a decreased amount of collagen type I, which renders the originating fibrils structurally less resistant to mechanical forces.
Assuntos
Colágeno Tipo III/metabolismo , Colágeno Tipo I/metabolismo , Colágeno Tipo V/metabolismo , Disfunção do Tendão Tibial Posterior/metabolismo , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Imunofluorescência , Humanos , Pessoa de Meia-Idade , Disfunção do Tendão Tibial Posterior/patologiaRESUMO
INTRODUCTION: Posterior tibial tendon dysfunction is a common cause of adult flat foot deformity, and its etiology is unknown. PURPOSE: In this study, we characterized the morphologic pattern and distribution of types I, III and V collagen in posterior tibial tendon dysfunction. METHOD: Tendon samples from patients with and without posterior tibial tendon dysfunction were stained by immunofluorescence using antibodies against types I, III and V collagen. RESULTS: Control samples showed that type V deposited near the vessels only, while surgically obtained specimens displayed type V collagen surrounding other types of collagen fibers in thicker adventitial layers. Type III collagen levels were also increased in pathological specimens. On the other hand, amounts of collagen type I, which represents 95 percent of the total collagen amount in normal tendon, were decreased in pathological specimens. CONCLUSION: Fibrillogenesis in posterior tibial tendon dysfunction is altered due to higher expression of types III and V collagen and a decreased amount of collagen type I, which renders the originating fibrils structurally less resistant to mechanical forces.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Colágeno Tipo V/metabolismo , Disfunção do Tendão Tibial Posterior/metabolismo , Estudos de Casos e Controles , Imunofluorescência , Disfunção do Tendão Tibial Posterior/patologiaRESUMO
Despite appropriate laws to protect workers, the health conditions of Brazilian workers reflect the social and economic reality in Brazil. A statistical analysis of health actions in Brazil shows serious distortions caused by the immense discrepancy between the poverty of the Northern and Northeastern states and the richness, although concentrated, of the great Southern and Southeastern cities of the country. Valid quantitative measures of health care problems of workers are confounded by the presence of a large mass of informal workers within the country, which may not be included in standard statistical analysis. Despite the existence of norms and laws related to the health of workers, their application is precarious and selective. The development of educational and preventive actions is already a reality in Brazil with unquestionable statistical repercussions, notwithstanding their doubtful comprehensiveness. The diseased worker or victim of a work-related accident in Brazil has no access to adequate medical assistance, and survival depends on benefits that are often insufficient to enable them to support themselves.
Assuntos
Acidentes de Trabalho/economia , Acessibilidade aos Serviços de Saúde/economia , Saúde Ocupacional , Reabilitação Vocacional/economia , Indenização aos Trabalhadores , Acidentes de Trabalho/legislação & jurisprudência , Brasil , Atenção à Saúde/economia , Humanos , Cobertura do Seguro , Seguro de Acidentes/legislação & jurisprudência , Saúde Ocupacional/legislação & jurisprudência , Pobreza , Fatores Socioeconômicos , Indenização aos Trabalhadores/estatística & dados numéricosRESUMO
Os autores trataram as lesoes ligamentares agudas do tornozelo por dois métodos em universo de pacientes diferentes. Os 20 pacientes tiveram lesao ligamentar completa (tipo III). O primeiro grupo de 14 pacientes - considerados atletas recreativos, pois participavam de atividades esportivas como lazer - recebeu tratamento ortopédico com imobilizaçao com aparelho gessado suropodálico por seis semanas. O segundo grupo de seis pacientes - todos esportistas de elite, isto é, participavam de atividades esportivas como profissionais - recebeu tratamento cirúrgico, ou seja, reparaçao cirúrgica dos ligamentos rotos e sutura da cápsula articular do tornozelo. Dois pacientes apresentaram avulsao óssea, nao suspeitada antecipadamente. Seguimento máximo de 115 meses e mínimo de três meses nao resultou em nenhuma instabilidade do tornozelo ou dor e todos os atletas retornaram às atividades exercidas antes do trauma.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Traumatismos do Tornozelo/terapia , Traumatismos em Atletas/terapia , Traumatismos do Tornozelo/cirurgiaRESUMO
Os autores estudaram 36 pacientes com lesöes tendineas do pé e tornozelo em esportistas, sendo a maioria de tratamento cirúrgicos, com retorno às às atividades esportivas em média após três a seis meses do início do tratamento. Obtivemos maior incidência de lesäo no tendäo de Aquiles (roturas agudas), em seguida de disfunçäo do tibial posterior e fibular curto
