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Talanta ; 236: 122899, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34635272


A real-time quartz crystal microbalance (QCM) cytosensor was first developed for dynamical and noninvasive monitoring of cell viscoelasticity for evaluation of apoptosis degree. In this work, human breast cancer cells MCF-7 and MDA-MB-231 were employed as cell model and respectively captured on the surface of QCM electrode modified with mercaptosuccinic acid and poly-l-lysine. Cell viscoelasticity was measured dynamically by real-time monitoring energy dissipation with QCM, and the dynamic diagram of the energy dissipation of MDA-MB-231 cells treated with curcumin was first obtained. The results displayed that the changes of energy dissipation in MDA-MB-231 cells and MCF-7 cells were 8.81 × 10-6 and 5.29 × 10-6, particularly due to the difference in cell viscoelasticity. Furthermore, curcumin was used to induce cell apoptosis and suppress energy dissipation of MDA-MB-231 cells. Combining apoptosis assay with QCM measurement, the results revealed good linear relationship between cell viscoelasticity inhibition and apoptosis rate with correlation coefficient R = 0.9908. The QCM cytosensor could rapidly, accurately, dynamically, and noninvasively monitor the changes of cell viscoelasticity for evaluation of apoptosis degree in MDA-MB-231 cells. The study established a new model for cell apoptosis assessment, facilitating understanding of the mechanisms of cell apoptosis on the aspect of mechanical properties.

Técnicas Biossensoriais , Neoplasias da Mama , Curcumina , Apoptose , Neoplasias da Mama/tratamento farmacológico , Curcumina/farmacologia , Feminino , Humanos , Viscosidade
Food Chem ; 367: 130661, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34348197


Cow (CwC) and camel casein (CaC) hydrolysates were generated using Alcalase™ (CwCA and CaCA) and Pronase-E (CwCP and CaCP) each for 3 and 6 h, and investigated for their potential to inhibit key lipid digesting enzymes i.e., pancreatic lipase (PL) and cholesteryl esterase (CE). Results revealed stronger PL and CE inhibition by CaC hydrolysates compared to CwC. Potent hydrolysates (CwCP-3 h and CaCA-6 h) upon simulated gastrointestinal digestion (SGID) showed significant improvement in inhibition of both PL and CE. However, both the SGID hydrolysates showed similar extent of PL and CE inhibition and were further sequenced for peptide identification. Peptides MMML, FDML, HLPGRG from CwC and AAGF, MSNYF, FLWPEYGAL from CaC hydrolysates were predicted to be most active PL inhibitory peptides. Peptide LP found in both CwC and CaC hydrolysates was predicted as active CE inhibitor. Thus, CwC and CaC could be potential source of peptides with promising CE and PL inhibitory properties.

Caseínas , Esterol Esterase , Animais , Camelus , Bovinos , Digestão , Feminino , Hidrólise , Lipase , Peptídeos , Hidrolisados de Proteína , Esterol Esterase/genética
Gene ; 806: 145922, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34454032


Gastric cancer (GC)-derived cell lines were generally used in basic cancer research and drug screening. However, it is always concerned about the difference between cultured cells and primary tumor by oncologists. To address this question, we compared differentially expressed genes (DEGs) in primary cancers, healthy tissues, and cell lines both in vitro and in silico. Seven reported genes with decreased expression in GCs by DNA methylation were analyzed in our cohort studies and experimentally validation. Selected datasets from TCGA (The Cancer Genome Atlas), CCLE (The Broad Institute Cancer Cell Line Encyclopedia), and GTEx (The Genotype-Tissue Expression project) were used to represent GCs, GC-derived cell lines, and healthy tissues respectively in the in silico analysis. Thirty gastric tissues together with six cell lines were used for validations. Unexpectedly, we experimentally found that reported cancer-related downregulated genes were only found in cancer cell lines but not in biopsies. The unchanged gene expressions in primary GCs were generally consistent with our cohort study, using information from cancerous (TCGA) and healthy tissues (GETx). Substantial differences were also found between DEGs of cancer tissues (TGCA)/ healthy tissues (GTEx) pair and cell lines (CCLE)/ healthy tissues (GTEx) pair, which confirmed the significant differences between primary cancer and cancer cell lines. Moreover, elevated expression of YWHAQ (14-3-3 δ) and THBS1 were observed in the GC biopsies, which might be potential biomarkers for GC diagnosis, considering the increased YWHAQ and THBS1 associated with poor survival rates in gastric cancer patients. In sum, it is suggested that cautions should be taken when using GC cell lines to study genes that show great differences between cell lines and tissues.

Proteínas 14-3-3/genética , Regulação Neoplásica da Expressão Gênica , Proteínas de Neoplasias/genética , Neoplasias Gástricas/genética , Trombospondinas/genética , Proteínas 14-3-3/metabolismo , Idoso , Atlas como Assunto , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Linhagem Celular Tumoral , Metilação de DNA , Conjuntos de Dados como Assunto , Epigênese Genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Proteínas de Neoplasias/metabolismo , Cultura Primária de Células , Prognóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Análise de Sobrevida , Trombospondinas/metabolismo , Células Tumorais Cultivadas
Gene ; 806: 145935, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34478821


Soluble molecules of programmed death ligand 1 (sPD-L1) are known to modulate T-cell depletion, an important mechanism of hepatitis B virus (HBV) persistence and liver disease progression. In addition, PD-L1 polymorphisms in the 3'-UTR can influence PD-L1 expression and have been associated with cancer risk, although not definitively. The purpose of this study was to investigate the association of PD-L1 polymorphisms and circulating levels of sPD-L1 in HBV infection and live disease progression. In this study, five hundred fifty-one HBV infected patients of the three clinically well-defined subgroups chronic hepatitis B (CHB, n = 186), liver cirrhosis (LC, n = 142) and hepatocellular carcinoma (HCC, n = 223) and 240 healthy individuals (HC) were enrolled. PD-L1 polymorphisms (rs2297136 and rs4143815) were genotyped by in-house validated ARMS assays. Logistic regression models were applied in order to determine the association of PD-L1 polymorphisms with HBV infection as well as with progression of related liver diseases. Plasma sPD-L1 levels were quantified by ELISA assays. The PD-L1 rs2297136 AA genotype was associated with HBV infection susceptibility (HBV vs. HC: OR = 1.6; 95%CI = 1.1-2.3; p = 0.0087) and disease progression (LC vs. CHB: OR = 1.8; 95%CI = 1.1-2.9; p = 0.018). Whereas, the rs2297136 GG genotype was a protective factor for HCC development. Plasma sPD-L1 levels were significantly high in HBV patients (p < 0.0001) and higher in the LC followed by CHB and HCC groups. High sPD-L1 levels correlated with increased liver enzymes and with advanced liver disease progression (Child-pugh C > B > A, p < 0.0001) and BCLC classification (BCLC D > C > B > A, p = 0.031). We could, for the first time, conclude that PD-L1 rs2297136 polymorphism and plasma sPD-L1 protein levels associate with HBV infection and HBV-related liver disease progression.

Antígeno B7-H1/genética , Carcinoma Hepatocelular/genética , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Polimorfismo Genético , Regiões 3' não Traduzidas , Adulto , Idoso , Antígeno B7-H1/sangue , Biomarcadores/sangue , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/virologia , Estudos de Casos e Controles , Progressão da Doença , Feminino , Expressão Gênica , Predisposição Genética para Doença , Vírus da Hepatite B/crescimento & desenvolvimento , Hepatite B Crônica/complicações , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/virologia , Humanos , Fígado/metabolismo , Fígado/patologia , Fígado/virologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/etiologia , Cirrose Hepática/virologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
Braz. j. oral sci ; 20: e210298, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO | ID: biblio-1252387


Oral squamous cell carcinoma (OSCC) is one of the most well-known malignancies that affect the human population worldwide. The early diagnosis and early intervention of OSCC help improve the survival rate of the patients. The tumour free surgical margins are a positive prognostic factor for recurrence-free survival. The molecular markers can be used to detect the tumour free surgical margins. Aim: The aim of the study is to evaluate the expression of p53 & Cyclin D1 marker in resected surgical apparently clear margins and to correlate the p53 & Cyclin D1 expression with clinicopathological characteristics and patient outcome. Methods: The study population included retrospective cases of OSCC with apparently clear margins (2017-18) n=10 and Clinicopathological variables relevant to survival analysis were recorded. Finally, two margins were selected from each case, a total of 20 margins were included in this study. Paraffin-embedded wax blocks retrieved and tissue sections were made. Expression of cyclin D1 and p 53 was assessed by the immunohistochemical staining procedure Results: Positive expressions Cyclin D1 in 40% of mild dysplasia margins and 60% in clearance adequate margins were present. p53 expression was seen in 16% of mild dysplasia margins and 84% in clearance adequate margins. The expression of p53 and Cyclin D1 molecular markers are noted in the basal & parabasal layer of epithelium. Conclusion: Molecular markers could play a more reliable method for the assessment of dysplasia at the margins

Humanos , Masculino , Feminino , Carcinoma de Células Escamosas , Proteína Supressora de Tumor p53 , Ciclina D1
Braz. j. oral sci ; 20: e210699, jan.-dez. 2021. tab
Artigo em Inglês | LILACS, BBO | ID: biblio-1253172


Aim: To evaluate orthodontists' knowledge and clinical practices regarding the treatment of patients with HIV/AIDS. Methods: Cross-sectional study performed with 655 Brazilian orthodontists based on a previously calculated sample size. Self-administered questionnaires were sent to orthodontists to collect information on knowledge and clinical conduct regarding the care of patients with HIV/AIDS. The study evaluated the awareness of possible risk factors for contamination, oral manifestations of HIV, need for more information on the care of HIV-positive patients, whether orthodontic treatment is indicated in HIV-positive patients, and whether they had knowingly performed orthodontic treatment in HIV-positive patients. Simple regression models were adjusted, and crude Odds Ratios estimated the associations with 95% confidence intervals. The variables with P < 0.20 in the crude analysis were tested in multiple logistic regression models, and those with P ≤ 0.05 were maintained in the final model. Magnitudes were estimated by adjusted Odds Ratios values, with 95% confidence intervals. Results: Orthodontists who were aware of the oral manifestations of HIV/AIDS, those having work experience of more than 20 years, and those who believed that orthodontic treatment could be indicated for these patients were 3.30 (1.79-6.10), 2.74 (1.36-5.52) and 1.92 (1.13-3.24) times more likely to perform orthodontic treatment in HIV-positive patients, respectively. Most orthodontists (92.9%) reported they needed to obtain more information about orthodontic care in patients with HIV/AIDS. Conclusion: Although orthodontists reported feeling able and qualified to provide dental care to patients with HIV/AIDS, gaps in their knowledge need to be addressed with further training

Humanos , Masculino , Feminino , Ortodontia , Inquéritos e Questionários , Síndrome de Imunodeficiência Adquirida , HIV , Síndromes de Imunodeficiência
Braz. j. oral sci ; 20: e211443, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO | ID: biblio-1253787


Aim: The mandible is regarded as a frequently fractured bone in patients who present with maxillofacial trauma accounting for almost 15.5% to 59% of all facial fractures. Managing condylar trauma has remained to be a point of contention amongst experts, regardless of the advances in surgical modalities and methodologies, and the treatment plan is often determined by the preference and the experience of the surgeon. There exist various approaches in the literature, each with its own specific benefits and drawbacks. With this study, we aimed to evaluate the prevalence of post-operative complications in patients who experienced ORIF by means of the retromandibular approach, by comparing the outcomes of one group having undergone transparotid surgery, with another that underwent retroparotid surgery. Methods: An experimental trial was undertaken. Convenience sampling was done from among the cases of condylar neck and base fracture visiting the department of OMFS, Dow University of Health Sciences from January 2017 to December 2019. An overall 26 patients were divided into 2 groups of 13 members each; one was managed using Open Reduction Internal Fixation (ORIF) by means of a retromandibular transparotid approach while the other group was treated with ORIF by means of a retromandibular retroparotid approach. A 6 month follow-up was done to assess range of active motion, occlusion, and complications such as deviation/deflection, neural injury, infections, sialocele, salivary fistulae and Frey's syndrome in both groups. Results: There was no statistically significant difference between the two groups in terms of inter-incisal opening, right and left lateral movements, or protrusion. One patient in the retroparotid group had deviation on mouth opening (7.69%), while one in the transparotid group reported with infection (7.69%), and 2 developed post operative seromas (15.38%). None had persisting facial nerve palsy at 6 months. Conclusion: We find no significant disparity between the 2 approaches at a follow-up of 6 months; therefore, the primary determining factor for selection of either technique is surgeon preference and appropriate case selection

Humanos , Masculino , Feminino , Procedimentos Cirúrgicos Bucais , Côndilo Mandibular , Fraturas Mandibulares
Braz. j. oral sci ; 20: e219912, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO | ID: biblio-1254429


Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections

Humanos , Masculino , Feminino , Diagnóstico por Imagem , Tomografia Computadorizada por Raios X , Inquéritos e Questionários , Imageamento Tridimensional , Fraturas Mandibulares
Braz. j. oral sci ; 20: e211202, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO | ID: biblio-1254523


Aim: To evaluate the prevalence and predisposing factors for hypomineralization of second molars in children in primary dentition. Methods: A questionnaire was applied to parents to analyze predisposing factors and to assist in the diagnosis of hypomineralization in children between 2 and 6 years old, followed by an intraoral examination based on indices of non-fluorotic enamel defects in the primary dentition, according to the "Modified Index DDE" to determine demarcated opacity and HSPM presence / severity index to assess hypomineralization. Children from public and private schools were dived into two groups: if they presented HSPM-Group 1 (G1) and if they did not have HSPM-Control group (CG). Results: The most frequent predisposing factors associated with the child were Illness in the first year of life (X2= 6.49; p=0.01) and antibiotic use in the first year of life (X2= 41.82; p= 0.01). The factors associated with the mother were hypertension (X2= 9.36; p=0.01), infections during pregnancy (X2=14.80; p=0.01) and alcohol consumption during pregnancy (X2=97.33; p=0.01). There was a prevalence of 3.9% of HSPM in 14 children, with statistical difference regarding gender (X2 = 4.57; p <0.05), with boys presenting a higher frequency. In G1 hypomineralization was of the type with demarcated opacity, with more prevalent characteristics the yellowish spot, with moderate post-eruptive fracture and acceptable atypical restorations. All lesions were located in the labial region with 1/3 of extension. Conclusion: The prevalence of HSPM in children between 2 and 6 years old was 3.9%, with a predominance in males, with tooth 65 being the most affected. There was an association between HSPM and infection in the first year of life, as well as the use of antibiotics and sensitivity in the teeth affected by the lesion. There was an association between HSPM and hypertension, infection and mothers' alcohol use during pregnancy

Humanos , Masculino , Feminino , Pré-Escolar , Desmineralização do Dente , Esmalte Dentário , Hipoplasia do Esmalte Dentário/epidemiologia , Amelogênese
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 21-24, set.-dez. 2021. ilus
Artigo em Português | LILACS, BBO | ID: biblio-1284111


Introdução: os cistos radiculares são as lesões císticas mais comuns nos maxilares. Eles surgem dos Restos Epiteliais de Malassez, presos no ligamento periodontal e podem ser ativados por um processo inflamatório na região pulpar. Geralmente são descobertos em exames radiográficos de rotina, apresentando-se como uma imagem radiolúcida, bem delimitada, envolvendo o periápice de um ou mais dentes. Objetivo: apresentar o tratamento de um extenso cisto radicular, em região de maxila, com acompanhamento de 18 meses. Relato do caso: Paciente do sexo feminino, 49 anos, foi encaminhada para avaliação e tratamento na Clínica Odontológica da Faculdade Sete Lagoas (FACSETE), apresentando lesão extensa em região maxilar anterior direita ao exame radiográfico. Ao exame clínico, observou-se leve assimetria facial e ausência de sintomas dolorosos. Tomografia computadorizada, punção aspirativa e biópsia incisional foram utilizadas para se chegar ao diagnóstico compatível com cisto radicular. Optou-se por uma técnica conservadora, em que foi realizada a descompressão da lesão. Após 05 meses de tratamento, um novo procedimento cirúrgico foi realizado para enuclear o restante da patologia. Conclusão: a descompressão, com utilização de cânula, é um tratamento auxiliar fácil, conservador, eficaz e reduz a morbidade causada por diferentes cistos odontogênicos(AU)

Introduction: root cysts are the most common cystic lesions in the jaw. They arise from the Epithelial Remains of Malassez, trapped in the periodontal ligament and can be activated by an inflammatory process in the pulp region. They are usually discovered in routine radiographic examinations, presenting as a well-defined radiolucent image involving the periapex of one or more teeth. Objective: to present the treatment of an extensive root cyst, in the maxillary region, with a follow-up of 18 months. Case report: A 49-year-old female patient was referred for evaluation and treatment at the Dental Clinic of Faculdade Sete Lagoas (FACSETE), with an extensive lesion in the right anterior maxillary region on radiographic examination. On clinical examination, mild facial asymmetry and absence of painful symptoms were observed. Computed tomography, aspiration puncture and incisional biopsy were used to reach a diagnosis compatible with radicular cyst. We opted for a conservative technique, in which the lesion was decompressed. After 05 months of treatment, a new surgical procedure was performed to enucleate the rest of the pathology. Conclusion: decompression, using a cannula, is an easy, conservative, effective auxiliary treatment and reduces the morbidity caused by different odontogenic cysts.

Humanos , Feminino , Pessoa de Meia-Idade , Cisto Radicular , Descompressão , Ligamento Periodontal , Cistos Odontogênicos , Cisto Radicular/cirurgia , Cisto Radicular/diagnóstico , Cisto Radicular/terapia , Cisto Radicular/diagnóstico por imagem
Infectio ; 25(4): 284-288, oct.-dic. 2021. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286723


Resumen Objetivo: Determinar los factores de riesgo a la infección en cavidad residual post quistectomía hepática en los pacientes del hospital Ramiro Prialé Prialé - EsSalud -Huancayo. Materiales y Métodos: Se realizó una cohorte retrospectiva, entre enero del 2014 y enero del 2018. Se utilizó una ficha de recolección de datos. Se obtuvieron los riesgos relativos (RR) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 83 pacientes. El 41,2% de las mujeres presentaron infección en la cavidad postquistectomía y la mediana de edad de los pacientes infecta dos fue de 33 años. Los antecedentes patológicos que se relacionaron con la infección fueron obesidad o sobrepeso (62,5%), neoplasia previa (100%) y enferme dad inmunológica previa (31%). La infección en cavidad residual postquistectomía estuvo relacionada a la presencia de obesidad o sobrepeso, diabetes mellitus, neoplasia previa , cirugía previa y al uso de antibióticos posteriores a la cirugía. Conclusiones: La obesidad o sobrepeso, diabetes mellitus, haber padecido alguna neoplasia o cirugía previa y el uso de antibióticos luego de la cirugía; son factores de riesgo para la infección en cavidad residual postquistectomía hepática en los pacientes del Hospital Nacional Ramiro Prialé Prialé EsSalud de Huancayo, Perú.

Abstract Objective: To determine the risk factors with the infection in the residual cavity after hepatic cystectomy in the patients of the Ramiro Prialé Prialé hospital - EsSalud -Huancayo. Materials and Methods: A retrospective cohort was conducted, between January 2014 and January 2018. A data collection sheet was used. Crude and adjusted relative risks (RR) were obtained, with 95% confidence intervals. Results: 83 patients participated. 41.2% of women infected in the post-cystectomy cavity and the median age of infected patients was 33 years. The pathological antecedents that were related to the infection were obesity or overweight (62.5%), previous neoplasia (100%) and previous immune disease (31%). Post-cystectomy residual cavity infection was affected by the presence of obesity or overweight (aRR: 1.56; 95% CI: 1.15-2.13; p value = 0.005), diabetes mellitus (aRR: 2.67; 95% CI : 2.09-3.41; p value <0.001), previous neoplasia (aRR: 2.49; 95% CI: 1.94-3.20; p value <0.001), previous surgery (aRR: 1.49; 95% CI: 1.36-1.64; p value <0.001) and the use of post-surgery antibiotics (aRR: 2.14; 95% CI: 1.30-3.51; p value = 0.003) Conclusions: Obesity or overweight, diabetes mellitus, having suffered some neoplasia or previous surgery and the use of antibiotics after surgery; they are factors associated with infection in the residual post-cystectomy liver cavity in patients of the Ramiro Prialé Prialé EsSalud National Hospital in Huancayo, Peru.

Humanos , Feminino , Adulto , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Fatores de Risco , Infecções , Peru , Ranunculaceae , Diabetes Mellitus , Equinococose Hepática , Hospitais , Doenças do Sistema Imunitário , Neoplasias
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 45-49, set.-dez. 2021. ilus
Artigo em Português | LILACS, BBO | ID: biblio-1291672


Os ferimentos por arma de fogo (FAF) são um grande problema de saúde pública. Na face, a mandíbula é o local de maior incidência, sendo a região de corpo mandibular a mais atingida e as lesões aos tecidos moles frequentemente a ela associadas. Em alguns casos, tais ferimentos apresentam-se de difícil resolução, sobretudo, em casos de fraturas cominutivas e lesões de tecidos moles com alta complexidade. Isso torna o atendimento desses pacientes um desafio para cirurgiões buco-maxilo-faciais. Desta forma, o objetivo deste artigo é relatar um caso de FAF em terço inferior da face, com comprometimento de tecidos moles e mandíbula, pela equipe de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Geral do Estado - Bahia. Paciente de 28 anos de idade, sexo feminino, vítima de FAF em terço inferior da face, por disparo acidental de espingarda. Ao exame clínico, pode-se observar ferimento perfuro-contuso em região de mandíbula e fratura cominutiva de corpo e ângulo mandibular à direita. A paciente foi submetida à cirurgia para remoção de fragmentos ósseos/corpos estranhos, fixação dos cotos com placa de reconstrução 2.4mm e sutura dos planos, em mesmo tempo cirúrgico, reestabelecendo a função da mandíbula. Portanto, devido à fisiopatologia variável dos FAF na mandíbula, não se indica um único padrão de tratamento para as fraturas cominutivas. Além disso, é indispensável o emprego de protocolos de limpeza cirúrgica imediata e antibioticoterapia nos casos com alto grau de cominuição, bem como, sugere-se realizar o tratamento definitivo o mais breve possível(AU)

Firearm injuries (FIs) are a major public health problem. On the face, the mandible is the place with the highest incidence of this trauma, with the mandibular body region being the most affected and the lesions to the soft tissues frequently associated with it. In some cases, such injuries are difficult to resolve, especially in cases of comminuted fractures and soft tissue injuries with high complexity. This makes the care of these patients a challenge for oral and maxillofacial surgeons. Thus, the objective of this article is to report a case of care for a FAF victim in the lower third of the face, with soft tissue and mandible involvement, by the Maxillofacial Surgery and Traumatology team at the Hospital Geral do Estado - Bahia. 28-year-old female patient, victim of FAF in the lower third of the face, due to acidental shotgun firing. On clinical examination, a perforated-blunt wound can be seen in the mandible region and comminuted fracture of the body and angle of the mandible on the right. The patient underwent surgery to remove bone fragments / foreign bodies, fix the stumps with a 2.4 mm reconstruction plate and suture the planes, at the same surgical time, reestablishing the function of the mandible. Therefore, due to the variable pathophysiology of FAF in the mandible, a single treatment pattern is not indicated for comminuted fractures. In addition, it is essential to use immediate surgical cleaning protocols and antibiotic therapy in cases with a high degree of comminution, as well as, it is suggested to carry out the definitive treatment as soon as possible(AU)

Humanos , Feminino , Adulto , Ferimentos por Arma de Fogo , Lesões dos Tecidos Moles , Fraturas Cominutivas , Cirurgiões Bucomaxilofaciais , Fraturas Ósseas , Fraturas Maxilomandibulares , Mandíbula , Antibacterianos
Infectio ; 25(4): 276-283, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286722


Resumen Objetivo: Describir la supervivencia a siete años y los principales factores asociados a esta, en las personas con VIH que fueron atendidas en el sistema de salud colombiano entre 2011 a 2018. Métodos: Análisis de supervivencia de una cohorte de 64 039 personas diagnosticadas con VIH en Colombia. Se aplicó el método de Kaplan-Meier para estimar la probabilidad de supervivencia a partir de la fecha del diagnóstico. Se ajustó un modelo de supervivencia paramétrico flexible de Royston Parmar. Resultados: La estimación de la supervivencia global a 7 años fue de 94,8% (IC 95%: 94,5-95,2). El mayor riesgo de muerte se presentó en los hombres (HR: 1,2; IC 95%: 1,1-1,4; p: 0,010); en personas ≥50 años de edad (HR: 3,1; IC 95%: 1,6-6,3; p: 0,002); en el régimen subsidiado (HR: 2,2; IC 95%: 1,9-2,5; p: <0,001); en la etapa sida (HR: 2,8; IC 95%: 2,1-3,7; p: <0,001); en quienes presentaron la última carga viral detectable (HR: 7,1; IC 95%: 6,0-8,3; p: <0,001); y en quienes mostraron conteo de linfocitos T CD4+ <350 células/μL (HR: 1,9; IC 95%: 1,4-2,4; p: <0,001). Conclusión: La probabilidad de la supervivencia de las personas que viven con VIH aumenta al ser diagnosticados en edades jóvenes, en quienes presenten un recuento de linfocitos T CD4+ ≥350 células/μL, una carga viral indetectable (< 50 copias/mL) y no se encuentren en etapa sida.

Summary Objective: to describe the seven-year survival and predictors of mortality among people with HIV who were treated in the Colombian health system between 2011 and 2018. Methods: 64 039 people diagnosed with HIV in Colombia were included. Kaplan-Meier analysis estimated the probability of survival from the date of diagnosis. A Royston Parmar flexible parametric survival model was fitted. Results: The overall survival at 7 years was 94.8% (95% CI: 94.5-95.2). Survival was related to sex (men, HR: 1.2; 95% CI: 1.1-1.4; p: 0.010); people ≥50 years of age (HR: 3.1; 95% CI: 1.6-6.3; p: 0.002); subsidized regime (HR: 2.2; 95% CI: 1.9-2.5; p: <0.001); AIDS stage (HR: 2.8; 95% CI: 2.1-3.7; p: <0.001); a detectable viral load (HR: 7.1; 95% CI: 6.0-8.3; p: <0.001); and a CD4+ Lymphocyte count <350 cells/μL (HR: 1.9; 95% CI: 1.4-2.4; p: <0.001). Conclusion: The probability of survival of people living with HIV increases when they are diagnosed at a young age, in those with a CD4+ T Lymphocyte count ≥350 cells/μL, an undetectable viral load (<50 copies/mL) and are not in the AIDS stage.

Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Análise de Sobrevida , Síndrome de Imunodeficiência Adquirida , Sexo , Linfócitos T , Probabilidade , HIV , Colômbia , Contagem de Linfócitos , Carga Viral , Sobrevivência
Infectio ; 25(4): 270-275, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286721


Resumen Objetivo: Comparar la expresión de mRNA y proteínas de SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 y HAND1 en pacientes con lesión intra-epitelial cervical de bajo y alto grado, con posterior progresión o regresión. Material y Método: Se realizó análisis de expresión de genes mediante RT-PCR y análisis de expresión de proteínas por inmunohistoquímica. El análisis estadís tico fue realizado con las pruebas: Wilcoxon, coeficiente de correlación de Spearman e índice de concordancia. Las muestras fueron pareadas en momento 1 y momento 2. Resultados: SFRP1 mostró tendencia de mayor expresión de mRNA en lesión intra-epitelial de bajo grado (momento 2) Vs. alto grado (momento 1). La expresión de proteínas por inmunohistoquímica de SFRP1 en casos de progresión (83,3 %) mostró disminución en su graduación (p = 0,0313*); los demás genes en estudio no tuvieron cambios estadísticamente significativos. Discusión: SFRP1 mostró comportamiento ajustado a resultados de estudios previos donde se encontró hipermetilado en lesiones intra-epiteliales de alto grado; su subexpresión por hipermetilación se reportó en otros canceres, proceso que colabora con su silenciamiento y transición epitelial-mesenquimatosa del cáncer de cuello uterino. Conclusiones. SFRP1 es potencial biomarcador en lesiones preneoplásicas del cuello uterino asociadas al virus de papiloma humano.

Abstract Objective. The aim of this work was to compare the expression of mRNA and proteins of SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 and HAND1 in patients with low and high grade cervical intraepithelial lesion, with subsequent progression or regression. Material and Methods: Gene expression analysis was conducted through RT-PCR and protein expression analysis was performed by immunohistochemistry. The statistics analysis were Wilcoxon test, Spearman's correlation coefficient and concordance index. The samples were paired during moment 1 (initial patient diag nosis) and moment 2 (follow-up histological diagnosis). Results: SFRP1 showed a trend of higher mRNA expression in low-grade intra-epithelial lesions (moment 2) Vs. high-grade (moment 1). The expression of proteins by immunohistochemistry of SFRP1 in progression cases (83.3%) showed a decrease in its graduation (p = 0.0313*); the other genes under study had no statistically significant. Discussion: SFRP1 showed a biological behavior adjusted to the results of previous studies where hypermethylation was found in high-grade intra-epithelial lesions; its subexpression by hypermethylation has been reported in other cancers, a process that collaborates with its silencing and epithelial-mesenchymal tran sition of cervical. Conclusions. SFRP1 is a potential biomarker in preneoplastic lesions of the cervix associated with human papillomavirus.

Humanos , Feminino , Adulto , Papiloma , Sondas de DNA de HPV , Vírus , Proteínas , Neoplasias do Colo do Útero , Progressão da Doença , Alphapapillomavirus
Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286720


Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.

Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Biomarcadores , COVID-19 , Pacientes , Tabagismo , Comorbidade , Risco , Fatores de Risco , Mortalidade , Colômbia , Sobrepeso , Cursos , Infecções , Obesidade
Infectio ; 25(4): 207-211, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286715


Resumen Objetivo: Describir la proporción, características clínicas, demográficas y programáticas de casos fatales de coinfección TB/VIH de Cali-Colombia, en 2017. Material y Método: Estudio de corte transversal, con información de las bases de datos del programa de tuberculosis, las historias clínicas y unidades de análisis de mortalidad disponibles. Resultados: Se depuraron 257 casos fatales por TB, el 24,5% (63/257) falleció con coinfección TB/VIH. La mediana de edad fue 43 años (Rango Intercuartílico: 30-52), 73% (46/63) eran hombres, 76,2% (48/63) no pertenecían al régimen contributivo, 28,6% eran habitantes de calle. 81,2% (39/48) eran casos nuevos de TB, 76,6% (37/47), inició tratamiento; al 74,6% (47/63) se les realizó unidad de análisis de mortalidad. La presentación pulmonar fue frecuente (75,9%-44/58), en 60% de los registros se observó desnutrición (Índice de Masa Corporal <20), en 39,7% (25/63) dependencia al alcohol, tabaco o farmacodependencia. Conclusiones: La mortalidad asociada a TB/VIH es prevenible, pero en 2017 representó la cuarta parte de la mortalidad por TB en Cali. Hombres adultos con condiciones de vulnerabilidad social, diagnosticados en estados avanzados de enfermedad, fueron blanco de fatalidad. Mejorar los sistemas de información e integrar los programas de TB/VIH, deben ser estrategias prioritarias para la salud pública en Colombia.

Abstract Objective: To describe the proportion, clinical, demographic and programmatic characteristics of fatal cases of TB/HIV coinfection from Cali-Colombia, in 2017. Material and Method: Cross-sectional study, with information from the TB program databases, clinical records and mortality analysis units available. Results: 257 TB fatal cases were cleared in Cali in 2017, 24.5% (63/257) of these died with TB/HIV coinfection. The median age was 43 years (Interquartile Range: 30-52), 73% (46/63) were men, 76.2% (48/63) did not belong to the contributory health regimen, 28.6% were homeless. 81.2% (39/48) were new TB cases, 76.6% (37/47) started treatment; 74.6% (47/63) had mortality analysis register. Pulmonary presentation was frequent (75.9% -44 / 58), in 60% of the registries malnutrition was observed (Body Mass Index <20), in 39.7% (25/63), dependence on alcohol, tobacco or drug dependence was registered. Conclusions: Mortality associated with TB/HIV is preventable, but in 2017 it represented a quarter of the TB mortality in Cali. Adult men with conditions of social vulnerability, diagnosed in advanced stages of disease, were fatally targeted. Improving information systems and integrating TB/HIV programs should be priority strategies for public health in Colombia.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tuberculose , HIV , Índice de Massa Corporal , Infecções por HIV , Saúde Pública , Estudos Transversais , Mortalidade , Estratégias de Saúde , Colômbia , Vulnerabilidade Social , Desnutrição
Rev. enferm. UERJ ; 29: e51932, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224598


Objetivo: analisar a produção do conhecimento sobre a experiência da família acerca dos cuidados paliativos da criança com câncer hospitalizada na unidade de terapia intensiva e discutir o papel da enfermagem no atendimento à família da criança com câncer frente aos cuidados paliativos. Método: revisão integrativa realizada na PUBMED, LILACS, SCOPUS, SCIELO e CINAHL entre janeiro e março de 2020. Resultados: a amostra foi composta por 13 artigos, originando duas categorias: O impacto do cuidado paliativo da criança com câncer na dinâmica familiar e o cuidado multiprofissional, em especial dos enfermeiros, à família da criança com câncer. Conclusão: os estudos revelaram o panorama nacional e internacional dos cuidados paliativos à criança com câncer e a desestruturação da dinâmica familiar nos aspectos físicos, sociais, psicológicos, e financeiros, caracterizando o período como estressante e doloroso. Os enfermeiros estabelecem condutas terapêuticas objetivando promover qualidade de vida para crianças em cuidados paliativos e seus familiares.

Objective: to examine production of knowledge on families' experience of palliative care for children with cancer hospitalized in an intensive care center and discuss the role of nursing in assisting the family of the child in palliative cancer care. Method: this integrative review was conducted on PubMed, LILACS, Scopus, SciELO and CINAHL between January and March 2020. Results: from the sample of 13 articles, two categories originated: The impact of palliative cancer care for children on family dynamics and multiprofessional care, especially by nurses, for the family of the child with cancer. Conclusion: the studies revealed the national and international panorama of palliative care for children with cancer and the breakdown of physical, social, psychological, and financial family dynamics, characterizing the period as stressful and painful. Nurses establish therapeutic approaches aimed at promoting quality of life for children in palliative care and their families.

Objetivo: analizar la producción de conocimiento sobre la experiencia familiar en los cuidados paliativos de niños con cáncer, hospitalizados en la unidad de cuidados intensivos, y discutir el papel de la enfermería en la asistencia a la familia del niño con cáncer frente a los cuidados paliativos. Método: Revisión integradora realizada en PUBMED, LILACS, SCOPUS, SCIELO y CINAHL entre enero y marzo de 2020. Resultados: La muestra estuvo conformada por 13 artículos, originando dos categorías: El impacto de los cuidados paliativos para niños con cáncer en la dinámica familiar y los cuidados multiprofesionales, especialmente de las enfermeras, a la familia del niño con cáncer. Conclusión: Los estudios revelaron el panorama nacional e internacional de los cuidados paliativos para niños con cáncer y la ruptura de la dinámica familiar en aspectos físicos, sociales, psicológicos y económicos, caracterizándolo como un período estresante y doloroso. Las enfermeras establecen enfoques terapéuticos dirigidos a promover la calidad de vida de los niños en cuidados paliativos y sus familias.

Humanos , Masculino , Feminino , Criança , Cuidados Paliativos , Família/psicologia , Criança Hospitalizada , Conhecimentos, Atitudes e Prática em Saúde , Unidades de Terapia Intensiva , Neoplasias/terapia , Papel do Profissional de Enfermagem , Neoplasias/enfermagem , Relações Enfermeiro-Paciente
Rev. enferm. UERJ ; 29: e52717, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224536


Objetivo: compreender a construção dos significados da morte pelos profissionais de saúde frente ao cuidado à pessoa com câncer. Método: estudo qualitativo realizado em ambiente online, com a participação de 34 profissionais de saúde. Foram realizadas entrevistas semiestruturadas, interpretadas segundo análise temática. Resultados: duas categorias analíticas emergiram dos dados, indicando que os significados atribuídos à morte pelos participantes foram: como um processo inerente ao ciclo da vida humana, passagem para a outra vida, e fim do sofrimento tanto do paciente quanto dos profissionais de saúde. As dificuldades que apontaram em lidar com a morte se referem à falta de suporte psicológico, escassez de conhecimento sobre morte, cuidados paliativos e comunicação de más notícias. Conclusão: os profissionais construíram diferentes significados à morte de seus pacientes, tais como um processo natural da vida, vontade de um ser superior, passagem para uma nova existência e término do sofrimento dessas pessoas.

Objective: to understand the construction of meanings of death by healthcare professionals caring for people with cancer. Method: this qualitative study was carried out in an online environment through semi-structured interviews of 34 health professionals, which were interpreted using thematic analysis. Results: two analytical categories emerged from the data, indicating that the meanings attributed to death by the participants were: a process inherent in the human life cycle, a transition to the next life, and an end to the suffering of both patient and health professionals. The difficulties they pointed to in dealing with death related to lack of psychological support, lack of knowledge about death, palliative care, and communicating bad news. Conclusion: the professionals constructed different meanings to their patients' deaths: a natural process of life, the will of a higher being, a transition to a new existence, and an end to these people's suffering.

Objetivo: comprender la construcción de los significados de la muerte desde el punto de vista de los profesionales de la salud ante el cuidado a la persona con cáncer. Metodología: estudio cualitativo realizado en un entorno online, con la participación de 34 profesionales de la salud. Se realizaron entrevistas semiestructuradas, interpretadas según análisis temático. Resultados: de los datos surgieron dos categorías analíticas que indicaron que los significados atribuidos a la muerte por los participantes fueron: como u proceso inherente al ciclo de vida humano, transición a otra vida y fin al sufrimiento tanto del paciente como de los profesionales de la salud. Las dificultades que señalaron para afrontar la muerte se refieren a la falta de apoyo psicológico, escasez de conocimiento sobre la muerte, cuidados paliativos y comunicación de malas noticias. Conclusión: los profesionales han construido diferentes significados para la muerte de sus pacientes: un proceso natural de la vida, la voluntad de un ser superior, un paso a una nueva existencia y el fin del sufrimiento de estas personas.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Prática Profissional , Atitude Frente a Morte , Pessoal de Saúde , Morte , Oncologistas , Neoplasias , Cuidados Paliativos , Pessoal de Saúde/psicologia , Pesquisa Qualitativa , Oncologistas/psicologia , Hospitais , Neoplasias/psicologia
Rev. enferm. UERJ ; 29: e56924, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224444


Objetivo: descrever a incidência de complicações em feridas operatórias de mastectomia e identificar fatores associados. Método: estudo retrospectivo desenvolvido em uma coorte hospitalar de 545 mulheres mastectomizadas por câncer de mama no ano 2018 em um centro de assistência de alta complexidade em oncologia da cidade do Rio de Janeiro, Brasil, após aprovação por Comitê de Ética em Pesquisa. Os dados foram coletados a partir dos prontuários, permitindo cálculos da taxa de incidência e da razão da taxa de incidência para cada complicação. Resultados: a complicação que apresentou maior taxa de incidência foi o sangramento (57,14/100 mastectomias-dia), tendo como fatores associados a raça/cor da pele não branca (Razão da Taxa de Incidência: 3,11) e a diabetes mellitus (Razão da Taxa de Incidência: 0,48). Conclusão: os fatores associados ao sangramento da ferida operatória apontam para a necessidade de novas práticas no cuidado ao pós-operatório de mulheres mastectomizadas.

Objective: to describe the incidence of complications in mastectomy surgical wounds and to identify associated factors. Method: this retrospective study was conducted in a hospital cohort of 545 women mastectomized for breast cancer in 2018 at a high-complexity cancer care center Rio de Janeiro City, Brazil, after approval by the research ethics committee. Data were collected from medical records, allowing incidence rate and incidence rate ratio to be calculated for each complication. Results: the complication with the highest incidence rate was bleeding (57.14/100 mastectomies-day), associated factors being non-white race/skin color (incidence rate ratio 3.11) and diabetes mellitus (incidence rate ratio 0.48). Conclusion: the factors associated with bleeding from the surgical wound point to the need for new practices in post-operative care for women with mastectomies.

Objetivo: describir la incidencia de complicaciones en heridas quirúrgicas de mastectomía e identificar factores asociados. Método: estudio retrospectivo desarrollado en una cohorte hospitalaria de 545 mujeres mastectomizadas por cáncer de mama en 2018 en un centro de atención de alta complejidad en oncología de la ciudad de Río de Janeiro, Brasil, previa aprobación del Comité de Ética en Investigación. Los datos se obtuvieron de las historias clínicas, lo que permitió calcular la tasa de incidencia y el cociente de la tasa de incidencia para cada complicación. Resultados: la complicación que presentó mayor tasa de incidencia fue el sangrado (57,14 / 100 mastectomías-día), con factores asociados a la raza / color de piel no blanca (índice de tasa de incidencia: 3,11) y diabetes mellitus (índice de tasa de incidencia: 0,48). Conclusión: los factores asociados al sangrado de la herida quirúrgica apuntan a la necesidad de nuevas prácticas en el cuidado al postoperatorio de las mujeres con mastectomía.

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Complicações Pós-Operatórias/epidemiologia , Ferida Cirúrgica/complicações , Mastectomia/efeitos adversos , Brasil/epidemiologia , Neoplasias da Mama/cirurgia , Incidência , Estudos Retrospectivos , Fatores de Risco , Hemorragia Pós-Operatória/epidemiologia
BMJ Case Rep ; 14(9)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593545


We present the case of a fifteen-year-old achondroplastic (ACH) woman who requested to have her femurs lengthened by intramedullary nails. She had undergone bilateral tibial lengthening at the age of eleven and presented with a varus deformity of the right lower limb, lateral thrust of the right knee and valgus deformity of the left lower limb. We performed deformity analyses based on mechanical axis measurements, and we came with a staged surgical plan. In ACH adolescences, correction of bony deformity needs to encounter continuous fibula growth dynamics. Lateral knee thrust was corrected by gradual distal translation of the fibula head via an Ilizarov frame and the amount of translation we decided clinically. Tibial lengthening and valgus osteotomy of the distal femur accentuate lateral collateral ligament (LCL) complex laxity. In patients with ACH, tibial lengthening and valgus osteotomy of the distal femur-if needed-should precede LCL complex tightening, and femoral lengthening should follow.

Alongamento Ósseo , Adolescente , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteotomia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia