Treatment of Extensive Soft Tissue Injury with Polypropylene Prosthesis: A Case Study.

Injuries with exposure of soft tissue are frequent in orthopaedics. Innovative therapies using prosthesis as an auxiliary material to treat this type of injury are under development, aiming to overcome applicability and execution limitations of myocutaneous flap techniques. Figueiredo's technique uses a polypropylene prosthesis extracted from sterile saline to treat trauma at the fingertip. It is an alternative technique with a high success rate, reproducible, low cost and easy to apply. This article reports a case of foot injury with exposure of soft tissue treated with a treatment similar to Figueiredo's technique. The patient was admitted with a large and contaminated skin wound, muscle damage, tendon exposure, cuboid fracture and bone loss. Initially, debridement was performed. After 72 hours, a polypropylene prosthesis extracted from a sterile saline bottle was implanted and subsequently replaced after 60 days. After 76 days, the prosthesis was removed. There was no infection. 8 months later, there was total healing by second intention. The patient's motor and sensory functions were preserved. This case study shows that Figueiredo's technique can also be employed in more extensive injuries, representing an alternative to using myocutaneous flaps. The polypropylene prosthesis is extremely affordable, which enables resolution of cases in a greater number of services. This technique still offers the best aesthetic result and does not compromise other body regions.

Estructura genética poblacional del pez Brycon henni (Characiformes: Characidae) en la región andina de Colombia utilizando marcadores microsatélites

Las especies de peces en Colombia están sujetas a procesos de sobrepesca, introducción de especies exóticas, deterioro de hábitat y fragmentación de ecosistemas, con la consecuente pérdida de conectividad que limita el flujo genético y pudiera llevar a las poblaciones a la extinción. En el presente trabajo se analizó la estructura genética poblacional de Brycon henni, un pez de importancia económica y ecológica, en cuatro cuencas de la región Andina colombiana, mediante el uso de diez marcadores microsatélites en 60 muestras de los ríos Risaralda (RR), Campoalegre (RC), Riofrío (RRf) y Chinchiná (RCh). Se encontró un total de 136 alelos. Con excepción del marcador BoM12, todos fueron altamente informativos y polimórficos y en todos se presentó desviación significativa (P < 0.05) del equilibrio Hardy Weinberg. En RC se observó el mayor número de alelos (81), Número promedio de alelos (8) y alelos privados (34), además una HE de 0.689 ± 0.05. En general, hubo un marcado déficit de heterocigotos con respecto a la población total (FIT = 0.562), dentro de las subpoblaciones (FIS = 0.526) y moderada, pero altamente significativa estructura genética (FST = 0.07). Según la distancia estándar de Nei, la población más divergente fue la del RC con un k = 4, se encontró tendencia a cuatro poblaciones ancestrales. Los resultados sugieren que el flujo genético entre poblaciones naturales de B. henni es limitado, lo cual puede tener efectos negativos sobre su conservación. Los resultados sugieren que las poblaciones pueden estar alcanzando valores críticos de baja densidad, lo cual pone en riesgo su conservación.

Fish species in Colombian Andes are subject to processes of overfishing, exotic species invasions, habitat loss, ecosystems fragmentation and low connectivity that limits the genetic flow and leads populations to loss genetic variability and extinction. Genetic variation of B. henni from four basins of the Colombian Andean region (Risaralda, Campoalegre, Riofrío and Chinchiná) was analyzed using ten microsatellites in 60 samples. A total of 136 alleles were found. Except BoM12, all markers were highly informative and polymorphic and presented a significant deviation (P < 0.05) from Hardy Weinberg Equilibrium. There was a marked deficiency of heterozygotes (FIS = 0.526). In Campoalegre river basin, the largest allele number, average allele number and private alleles were observed (81, eight and 34 alleles, respectively) and HE 0.689 ± 0.05. Moderate and highly significant genetic structure was evidenced (FST = 0.07). According to the standard distance of Nei (1972), population from Campoalegre River basin was the most divergent. This results suggest that genetic variability of the B. henni in the studied basins may be affected by critical low population density, river pollution and overfishing.

Bilateral hydrosalpinx in patients with Hirschsprung's disease.

PURPOSE: Hirschsprung's disease (HD) is uncommon in females. There are very few reports on the patients' obstetric and gynecological outcome. Hydrosalpinx causes pain and infertility. It is rare in nonsexually active teenagers. It may be because of an intrinsic disease of the fallopian tubes or secondary to surgery. AIM: to describe the relationship between hydrosalpinx and HD or its surgical approach; to report the impact of bilateral hydrosalpinx on fertility in HD. METHODS: The records of all females with HD since 1980 were reviewed. Only patients who reached menarche were included. Prevalence of hydrosalpinx and hydrosalpinx-free survival were compared after abdominoperineal (A) or transanal (T) surgery. Treatment for hydrosalpinx was reviewed. RESULTS: Seventeen out of 27 patients had reached menarche (Group A: 13 patients; Group T: 4 patients). Five patients in group A and none in group T presented bilateral hydrosalpinx (p=0.261). There were no statistical differences in hydrosalpinx-free survival between groups (p=0.344). Hydrosalpinx treatment: two bilateral and one unilateral salpingectomy, one pyosalpinx evacuation and one untreated. Three patients had conception desire: one has children; two are on IVF program. CONCLUSION: An association between hydrosalpinx and HD was observed. The development of hydrosalpinx was not associated with surgical approach in our study. Females with HD should have a gynecological follow-up for the development of hydrosalpinx, which can impair fertility. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Vertebrate road kill survey on a highway in southern Brazil / Levantamento de vertebrados atropelados em rodovias do sul do Brasil

Highways are a major factor acting in the decline of several wildlife populations. Impact occurs due to the continuous flow of motor vehicles over tracks and collision with animals using the same area. This study aimed to list road killed wild vertebrates found in highways in the Pampa Biome, state of Rio Grande do Sul, over an entire year. The taxa found (amphibians, reptiles, birds and mammals) were identified to species level and their frequency of occurrence was seasonally registered. Along 2,160 km, we found 318 road killed individuals, totaling 65 species. This number represents an average of 0.147 road killed specimens by kilometer (that is, 1 individual each 7 km). Of these, seven species are under threat of extinction in the state of Rio Grande do Sul. We also found a seasonal pattern among road kills, in which the highest number of road killed animals was registered in the summer and spring months. These results contribute to increase knowledge about which species are most impacted by road kill on highways of the Pampa Biome. Such data can be used as an indicator for the implementation of measures by competent bodies to mitigate impacts of highways in the state of Rio Grande do Sul.

As rodovias são um fator provocador de declínio populacional de diversas espécies da fauna silvestre. O impacto ocorre devido ao contínuo fluxo de veículos automotores sobre as pistas e a colisão dos mesmos com animais que também utilizam essa área. O presente estudo teve por finalidade listar os vertebrados silvestres encontrados atropelados em rodovias no bioma Pampa, no Estado do Rio Grande do Sul, ao longo de um ano. Os táxons encontrados (anfíbios, répteis, aves e mamíferos) foram identificados em nível específico e a sua frequência de ocorrência foi registrada de forma sazonal. Em 2.160 km de estrada percorridos, foram encontrados 318 indivíduos atropelados, totalizando 65 espécies. Essa quantia representa uma média de 0,147 espécimes atropelados por quilômetro (ou seja, 01 indivíduo atropelado a cada 07 Km). Destas, sete espécies estão sob ameaça de extinção no Estado do Rio Grande do Sul. Foram observados padrões sazonais nos atropelamentos, sendo que os meses de verão e da primavera apresentaram o maior número de animais atropelados. Os resultados do estudo contribuem para o conhecimento de quais espécies da fauna silvestre são mais impactadas por atropelamentos no bioma Pampa. Estes dados poderão ser utilizados como orientação na implantação de medidas por órgãos competentes, afim de mitigar o impacto de rodovias no Estado do Rio Grande do Sul.

Polymorphisms of the Dopamine beta-hidroxylase gene and its association with bovine temperament / Polimorfismos del gen Dopamina beta hidroxilasa y su asociación con temperamento bovino / Polimorfismos no gene dopamina beta hidroxilase e sua associação com temperamento bovino

Temperament in bovines is defined as behavior in response to human handling and is influenced by the sympatheticadrenal system. The bovine Dopamine beta-hidroxylase (DBH) gene is located on chromosome 11 and codes for the Dopamine beta hidroxylase enzyme, essential por the synthesis of this neurotransmitter. Simple nucleotide polymorphisms (SNP) have been identified on exon 12, possibly associated with changes in bovine temperament. The aim of this study was to find polymorphisms in this region and associate them with temperament traits in BON (Blanco Orejinegro - Bos taurus taurus), fighting bulls (Bos taurus taurus) and Brahman (Bos taurus indicus) cattle breeds. A total of 80 individuals were used to evaluate chute behavior (CB) and flight speed (VS), and in 52 of them a 702bp fragment in exon 12 of the gene was sequenced, identifying 22 haplotypes. The mínimum number of haplotypes (4), the lowest nucleotide diversity (0,0012±0,0011) and the highest fixed loci number were found on fighting bulls. Moderate differentiation between the populations was observed with the lowest genetic distance (FST=0.03309) between Bos taurus taurus breeds. Differences in VS were observed (p<0.05) being lower in BON males than in Brahman (1.45±0.61 and 2.02±0.74 respectively) and in Brahman females than in Fighting bull females (1.05±0.58 y 2.23±0.80 respectively). Even though no association with the genetic plymorphisms was found, a posible influence of selection in exon 12 is suggested which may influence in other behavioral characteristics.

El temperamento en bovinos se define como el comportamiento en respuesta a la manipulación humana y está influenciado por el sistema simpático adrenal. El gen DBH (Dopamina beta hidroxilasa) bovino está ubicado en el cromosoma 11 y codifica para la Dopamina beta hidroxilasa (DBH), enzima indispensable para la síntesis de este neurotransmisor. Se han identificado polimorfismos de nucleótido simple en el exón 12, posiblemente asociados a cambios en el temperamento en bovinos. El objetivo de este estudio fue encontrar polimorfismos en dicha región y asociarlos con rasgos de temperamento en las razas Blanco orejinegro (BON - Bos taurus taurus), de lidia (Bos taurus taurus) y brahman (Bos taurus indicus). Se utilizaron 80 individuos para evaluar comportamiento en brete (CB) y velocidad de salida (VS), y en 52 de ellos se secuenció un fragmento de 702 pb en el exón 12 del gen identificando 22 haplotipos. El menor número de haplotipos (4), la menor diversidad nucleotídica (0,0012±0,0011) y el mayor número de loci fijos se presentaron en bovinos de Lidia. Hubo moderada diferenciación entre las poblaciones con la menor distancia genética (FST=0,03309) presente entre las razas Bos taurus. Se presentaron diferencias (p <0,05) en VS, siendo ésta menor en machos BON que en Brahman (1,45±0,61 y 2,02±0,74 respectivamente) y en hembras Brahman que en hembras de Lidia (1,05±0,58 y 2,23±0,80 respectivamente). Aunque no se presentó asociación con los polimorfismos genéticos encontrados, se sugiere una posible influencia de fuerzas de selección en el exón 12 que podría influir en otras características comportamentales.

O temperamento em bovinos se define como o comportamento em resposta a manipulação humana e está influenciado pelo sistema simpático adrenal. O gene DBH bovino está localizado no cromossomo 11 e codifica para a dopamina beta hidroxilase (DBH), enzima indispensável para a síntese de este neurotransmissor. Tem se identificado polimorfismos de nucleotídeo simples no éxon 12, possivelmente associados a mudanças no temperamento em bovinos. O objetivo de este estudo foi buscar possíveis polimorfismos no éxon 12 do gene DBH e avaliar sua associação com características de temperamento nas raças Blanco Orejinegro (BON - Bos taurus taurus), de Lídia (Bos taurus taurus e zebu Brahman (Bos taurus indicus). Se utilizaram 80 indivíduos para avaliar o comportamento no curral (CB) e velocidade de saída (VS). Em 52 deles sequenciou-se um fragmento de 702 pb no éxon 12 do gene DBH identificando 22 haplotipos. O menor número de haplótipo (4), a menor diversidade nucleotídica (0,0012±0,0011) e o maior número de loci fixos apresentaram-se em bovinos de Lídia. Houve moderada diferenciação entre as populações com a menor distancia genética (FST=0,03309) presente entre as raças Bos Taurus. Apresentaram-se diferenças (p <0,05) em VS, sendo esta menor em machos BON que em Brahman (1,45±0,61 e 2,02±0,74 respectivamente) e em fêmeas Brahman que de Lídia (1,05±0,58 y 2,23±0,80 respectivamente). Ainda que não se apresentou associação com os polimorfismos genéticos encontrados, sugere-se uma possível influência de forças de seleção no éxon 12 que poderia influenciar em outras características comportamentais..

Fifteen years of experience in the treatment of anorectal malformations.

AIM: To analyze our experience in the treatment of anorectal malformations (ARM) with the posterior sagittal anorectoplasty (PSARP), and our modifications through the last few years and the outcomes. MATERIALS AND METHODS: We reviewed 107 cases divided into two groups: Former (F: 1994-2003) and Recent (R: 2004-2008). Type of ARM, associated anomalies, management and complications were noted. A telephone questionnaire regarding continence outcome was addressed to the 74 cases older than 3 years. RESULTS: According to the type of ARM, there were 53 perineal fistulas, 2 anal stenoses, 11 no fistulas, 12 rectourethral fistulas (5 rectobulbar and 7 rectoprostatic fistulas), 22 vestibular fistulas, 1 rectovesical fistulas and 6 cloacas. A total of 47 patients presented with 73 associated malformations. As much as 45 colostomies were performed, including 5 perineal fístulas, with 6 of 7 vestibular fístulas in group F and only 8 of 15 in group R. We had 19 complications of PSARP. The most frequent one was rectal mucosa prolapse in 14 (12F and 2R) and 2 wound infections (F). Continence was good in 62, poor in 3 and fair in 5. Seven out of eight children with poor or fair continence had associated malformations. CONCLUSIONS: All perineal fístulas can be managed without colostomy. Vestibular fístulas can be safely treated without colostomy in otherwise healthy patients without severe malformations. Overall, continence is good, and fair/poor results are related to associated malformations. Cumulative experience helps avoid colostomies and reduce complication and reoperation rates.

Prenatal covering of the spinal cord decreases neurologic sequelae in a myelomeningocele model.

BACKGROUND/PURPOSE: Recent experience in fetal surgery to correct myelomeningocele in humans reports an early reversion of hydrocephalus and decreased need of ventricular shunting in the first months of life; however, it has not been possible to demonstrate benefit in lower extremity function. In the present work, we have tried to ascertain the impact of cord exposure on hind limb function. METHODS: Fetal rabbits with myelomeningocele (group M), treated myelomeningocele (group T), and control animals (group C) were compared at birth regarding physical examination, somatosensory-evoked potentials of the hind limbs, ventricular morphometry, and spine histology. RESULTS: No major difference was found between groups M and T in the physical examination. Somatosensory-evoked potentials of the hind limbs were absent in group M and present in group T, although showing a longer latency period and decreased amplitude than controls. The area of the third ventricle was significantly larger in group M than in group C; in group T, it was also somewhat larger but not significantly so. Cord histology had evident changes in group M and minor changes in group T, which resembled normal group C cord. CONCLUSIONS: Prenatal covering of the spinal cord prevents central and peripheral neurologic deterioration in this animal model of myelomeningocele.

Morphology and mucosal biochemistry of gastroschisis intestine in urine-free amniotic fluid.

BACKGROUND/PURPOSE: The aim of this study was to determine the role of urine exposure in gastroschisis on the pathologic and biochemical aspects. METHODS: The intestines of fetal rabbits with gastroschisis (group G), gastroschisis and urethral ligation (group GL), and normal controls (group C) were studied by measuring weigh and length, intestinal diameter and wall thickness, and thickness of each intestinal layer. Number and length of villi and villi edema were evaluated. Total protein and DNA were measured in intestinal homogenate. Lactase activity and alkaline phosphatase activity were analyzed in isolated microvilli membranes. RESULTS: Intestinal length, diameter, and wall thickness were significantly different in groups G and GL compared with C but not between groups G and GL. The same was true for the thickness of the internal muscular and serosa, villi length, and villi edema. Serosal reaction was milder in group GL than in group G, and absent in C. Total protein, lactase activity, and alkaline phosphatase activity were also significantly different in G and GL compared with C but not between G and GL. CONCLUSIONS: Urine in amniotic fluid causes an increased serosal reaction but does not account for the mucosal enzyme dysfunction.