Radiographic and functional evaluation of the iliac bone graft in the treatment of adolescent idiopathic scoliosis.

This study aimed to assess the impact of the use of an additional iliac bone graft on functional and radiographic results after thoracic spine arthrodesis with pedicle screws in patients with adolescent idiopathic scoliosis. Participants were divided into two groups: a control group that received only local bone (n=19) and a second group that, in addition to this procedure, received an iliac graft (n=22). The evaluations were performed on preoperative, immediate postoperative, and last follow-up (mean 29.7 months; minimum 12 months). Radiographic evaluations included the loss of correction and the presence of nonunion. The functional outcome was evaluated using the Scoliosis Research Society-30 questionnaire. Surgical complications and the presence of iliac donor site pain were also described. There were no significant differences between groups in the pseudoarthrosis rate, loss of correction over time, and quality of life. We concluded that the addition of bone graft from the iliac yielded no benefit in terms of the fusion rate and functional outcomes. The appropriate facetectomy, bed preparation, and filling with a local bone graft must be adequate to achieve an adequate fusion on surgical treatment of adolescent idiopathic scoliosis.

Functional aerobic exercise capacity limitation in adolescent idiopathic scoliosis.

BACKGROUND CONTEXT: Exercise limitation has been described in patients with adolescent idiopathic scoliosis (AIS); however, whether the walking performance is impaired in these patients should be elucidated. PURPOSE: Thus, we aimed to evaluate the physiologic responses to the incremental shuttle walk test (ISWT) in patients with AIS. STUDY DESIGN/SETTING: Cross-sectional study. PATIENT SAMPLE: Twenty-nine patients with AIS and 20 healthy adolescents aged between 11 and 18 years old. OUTCOME MEASURES: Oxygen uptake (VO2), incremental shuttle walk distance (ISWD), ΔVO2/Δwalking velocity, ΔHR/ΔVO2, ΔVE/ΔVCO2, and linearized Δtidal volume (VT)/ΔlnVE, forced expiratory volume in the first second of expiration (FEV1), and forced vital capacity (FVC). METHODS: We performed two ISWTs, and the data used were acquired in the second test. We also evaluated the lung function and respiratory muscle strength through spirometry test and manovacuometry, respectively. All authors confirm that there are no conflicts of interest. To compare the means or medians of variables between patients and healthy subjects, we used the unpaired t test or Mann-Whitney U test, respectively. The correlations were assessed by Pearson or Spearman coefficients according to the distribution of the studied variables. The probability of alpha error was set at 5% for all analyses. RESULTS: Adolescent idiopathic scoliosis patients showed significant lower values of ISWD, VO2, and ventilation at the end of the ISWT, as well as lower FEV1 and FVC; they also presented significantly shallower slope of ΔVT/ΔlnVE, whereas VO2 related significantly with ISWD (r=0.80), FVC (r=0.78), FEV1 (r=0.73), and ΔVT/ΔlnVE (r=0.58). CONCLUSIONS: Adolescent idiopathic scoliosis correlated to walking limitation and was associated to reduced pulmonary function and worse breathing pattern during exercise. Our results suggest that walking-based aerobic exercises should be encouraged in these patients.

Estudo comparativo entre dois grupos apresentando hipertensäo arterial / A comparative study between two groups with hypertension

Considerando que a Hipertensäo Arterial (HA) aumenta de prevalência conforme o aumento da idade da populaçäo e que uma das formas näo farmacológicas de tratamento seria a prática de atividade física e a diminuiçäo do stress, os alunos do GIM 12 durante a identificaçäo dos problemas da UBS do Conjunto Maria Cecília, notaram que uma das queixas relativamente alta era a HA em um grupo de senhoras que se reuniam semanalmente para trabalhos manuais. A partir deste fato, foram estudados este grupo (G.C) com n=32 e um grupo controle(G.CT) com n=70, com média de idade de 59 a 62 anos respectivamente, com o objetivo de verificar e comparar o perfil dos hipertensos e as variáveis que influem no processo da doença. 59 por cento do G.C e 69 por cento do G.CT foram identificados como hipertensos e näo houve estatisticamente diferenças entre os grupos em relaçäo as outras variáveis, porém, os resultados obtidos revelam existir uma grande preocupaçäo das pessoas em obter informaçöes sobre a HA e uma necessidade urgente de se organizar programas educativos para a populaçäo que freuqnta as UBS do municpio