Digestibility and nutritional parameters of maize ethanol coproducts and xylanase for broiler diets.

1. The objective of this study was to determine the nutritional and energy values of four maize distiller's dried grains with solubles (DDGS) and one maize high protein distiller's dried grains (HP-DDG) from ethanol production plants in Brazil; to evaluate the digestibility, performance, nitrogen balance and energy values for broiler chickens fed diets containing these coproducts (Experiment I); and to evaluate the effects of xylanase inclusion in diets containing maize DDGS for broilers on energy availability, digestibility, nitrogen balance and gastrointestinal morphometry (Experiment II).2. For each experiment, 180 broiler chickens aged 17 and 30 days with initial weights of 450 ± 18 g and 1228 ± 33 g, respectively, were used; the chickens were distributed into 36 metabolism cages. The experimental design consisted of complete randomised blocks, with six replications per treatment and five birds per experimental unit. The treatments consisted of a basal diet (BD) and five test diets containing maize ethanol coproducts (Experiment I) one BD and five test diets containing DDGS with inclusions of 0, 8,000, 16,000, 24,000 and 32,000 BXU/kg xylanase (Experiment II). In Experiment I, HP-DDG and DDGS2 presented higher AME and AMEn values (14.1 and 13.9 MJ/kg and 13.4 and 13.3 MJ/kg, respectively), than did the other coproducts (p < 0.05). Compared with DDGS1 and DDGS3, DDGS4 and HP-DDG had higher digestible CP values (p < 0.05). In Experiment II, the inclusion of the enzyme quadratically affected the values of digestible CP and digestible EE (p < 0.05), with the maximum values occurring with the inclusion of 18 750 and 22,170 BXU/kg of xylanase, respectively.3. The digestible NDF and digestible MM values linearly increased with the inclusion of xylanase (p < 0.05). The addition of xylanase had no effect on gastrointestinal morphometry (p > 0.05). It was concluded that the inclusion of between 18,000 and 22,000 BXU/kg of xylanase resulted in better digestible CP and digestible EE values.

Distinctive g-Factor of Moiré-Confined Excitons in van der Waals Heterostructures.

We investigated the valley Zeeman splitting of excitonic peaks in the microphotoluminescence (µPL) spectra of high-quality hBN/WS2/MoSe2/hBN heterostructures under perpendicular magnetic fields up to 20 T. We identify two neutral exciton peaks in the µPL spectra; the lower-energy peak exhibits a reduced g-factor relative to that of the higher energy peak and much lower than the recently reported values for interlayer excitons in other van der Waals (vdW) heterostructures. We provide evidence that such a discernible g-factor stems from the spatial confinement of the exciton in the potential landscape created by the moiré pattern due to lattice mismatch or interlayer twist in heterobilayers. This renders magneto-µPL an important tool to reach a deeper understanding of the effect of moiré patterns on excitonic confinement in vdW heterostructures.

Stroke in systemic lupus erythematosus: epidemiology, mechanism, and long-term outcome.

OBJECTIVE: To determine stroke prevalence, mechanisms, and long-term outcome in a cohort of Hispanic patients with systemic lupus erythematosus (SLE). METHODS: We analyzed demographical data, the timing between SLE diagnosis and stroke onset, stroke type, recurrence, and outcomes from an institutional database of 4451 patients with SLE followed from 1993 to 2018. RESULTS: We observed 139 strokes (3.1%), for an incidence rate of 1.25 per 1000 person-years: 81 (58.3%) acute ischemic stroke (AIS), 19 (13.7%) subarachnoid hemorrhage (SAH), 17 (12.2%) cerebral venous thrombosis, 13 (9.4%) intracerebral hemorrhage (ICH), and 9 (6.5%) transient ischemic attack. Median time from SLE diagnosis to acute stroke was 60 months (interquartile range 12-132 months). AIS had a bimodal presentation with 26% occurring within the first year and 30% >10 years after SLE diagnosis. In contrast, 75% of ICH cases occurred >3 years (and 34% >10 years) after SLE diagnosis. The most important cause of AIS was secondary antiphospholipid syndrome (48%). Hypertension was associated with 69% of ICH cases, while aneurysmal rupture was observed in 78% of SAH cases. Excellent recovery at hospital discharge was observed in 65%. Stroke recurrence was observed in 7%. The long-term all-cause fatality rate was 8%. CONCLUSIONS: The prevalence of stroke in this cohort was 3.1%. Ischemic strokes had a bimodal presentation, occurring either early after SLE diagnosis or after a several-year delay. Half of the hemorrhagic strokes occurred >10 years after the diagnosis of SLE. Clinical outcome was usually good with a relatively low recurrence rate.

Effect of Amide on Semen Cryopreservation of Curimba (Prochilodus lineatus).

BACKGROUND: The low molecular weight and high cellular permeability of amides make them suitable for use as penetrative cryoprotectants for sperm cells. OBJECTIVE: This study aims to evaluate the effect of dimethylformamide (DMF) and dimethylacetamide (DMA) on sperm cryopreservation of Curimba (Prochilodus lineatus). MATERIALS AND METHODS: Semen samples were diluted in media containing cryoprotectants [DMF, DMA and dimethyl sulfoxide (DMSO)]. Parameters of motility, membrane integrity, DNA integrity, mitochondrial functionality, viability and fertility were assessed upon thawing. RESULTS: As compared to the 10% DMSO, DMA at 5% and DMF at 2% obtained the best results for the integrity of membrane, DNA and mitochondria; the motility parameters were best in the 2% and 5% DMF treatments. The best fertilization rates were demonstrated in 2%, 5%, and 8% DMF treatment groups. CONCLUSION: DMF at 2%, 5%, and 8% provided the best results for both in vitro and in vivo assessments, and can efficiently cryopreserve semen of Prochilodus lineatus.

Exogenous ATP in the Cryopreservation of Brycon orbignyanus Spermatozoa.

BACKGROUND: ATP exogenous (ATPe) has been used successfully in improving motility and fertility for many animal species. However this has not yet been tested on Brycon orbignyamus. OBJECTIVE: The objective of this study was to evaluate the use of ATPe for the cryopreservation of sperm from B. orbignyamus. MATERIALS AND METHODS: The ATPe concentrations tested were 1.0 µM, 5.0 µM and 10 µM combined with Beltsville Thawing SolutionTM extender and dimethylformamide at 7.5%. The sperm were frozen in a nitrogen vapour vessel and stored in liquid nitrogen at -196 ºC. The parameters of viability post-thawing were evaluated using CASA, and flow cytometer. RESULTS: The ATPe did not promote improvements in spermatic kinetics, and in the higher concentrations caused a worsening in these parameters. Also there was loss of mitochondrial functionality and greater cellular disruption with the concentration of 10 µM. CONCLUSION: We do not recommend the addition of ATP for cryopreserving B. orbignyamus.

Eosinophilic dermatosis of hematologic malignancy: a case report.

Eosinophilic dermatosis of hematologic malignancy (EDHM) is a dermatosis characterized by tissue eosinophilia that has been previously reported as insect bite-like reaction. It is a rare condition with a wide variety of clinical presentations ranging from papules, nodules, or blisters that simulate arthropod bites, to the formation of plaques of differing sizes. We report a case of eosinophilic dermatosis of hematologic malignancy in a patient with a hematoproliferative disorder.

Intrathecal formation of anticardiolipin antibodies in a patient with SLE-related relapsing longitudinal myelitis: a possible pathogenic connection.

BACKGROUND: Nontraumatic acute transverse myelitis (ATM) can occur in response to infectious, inflammatory and vascular triggers; 1% of patients with systemic lupus erythematosus (SLE) develop ATM, but the mechanism remains unknown. OBJECTIVE: The objective of this case report is to describe a case of intrathecal formation of anticardiolipin antibodies (aCL) during SLE-related ATM. METHODS: A single patient analysis was conducted. RESULTS: A 26-year-old housewife was diagnosed with SLE at age 19. Circulating aCL antibodies were positive at diagnosis. At age 21, she developed an episode of severe sepsis. At 23 years of age she developed an episode of ATM that left her paraplegic with a D10 sensory level, from which she recovered partially. Three years later, she developed a clinical relapse of ATM. During that second episode, serum levels of aCL were within normal limits, while cerebrospinal fluid levels were increased, suggesting intrathecal production of aCL. CONCLUSION: Here, we present a case of a woman who developed relapsing SLE-related longitudinally extensive ATM in whom intrathecal formation of aCL was demonstrated, suggesting that local production and cross-recognition of nervous tissue by those autoantibodies may be myelopathic.

Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality.

Background and objective Acute transverse myelitis (TM) is an infrequent neurological complication of systemic lupus erythematosus (SLE). Short-term outcome varies widely between cohorts. Little is known about the epidemiology and long-term functional outcome of TM associated to SLE. Methods Patients with SLE and acute TM were identified during hospital admission, visits to the Emergency Room or the Neurology Outpatient Clinic. We evaluated ambispectively those patients with SLE presenting with clinical myelopathy and corroborated with spinal MRI. Cases were divided as partial (non-paralyzing) or complete (paralyzing). We determined long-term functional outcome as well as mortality in those patients with follow-up periods of at least five years. Results We identified 35 patients (partial, n = 15; complete, n = 20) in which complete clinical and imaging data were available (26 with follow-up ≥ 5 years). Patients with complete TM were significantly older than those with partial forms. Positive antiphospholipid antibodies were observed in 80% of patients, suggesting a possible mechanistical role. Surprisingly, functional recovery at one year was in general good; however, we observed a five-year mortality of 31% because of sepsis (in 10 cases) or pulmonary embolism (in one case). Conclusions Short-term outcome of SLE-related TM is generally good, and recurrence rate is low. However, we observed a long-term fatality rate of 31% for reasons unrelated to TM, suggesting that TM is a manifestation of severe immune dysregulation and a predictor of severity and mortality in patients with SLE.

A comparative study on karyotypic diversification rate in mammals.

Chromosomal rearrangements have a relevant role in organismic evolution. However, little is known about the mechanisms that lead different phylogenetic clades to have different chromosomal rearrangement rates. Here, we investigate the causes behind the wide karyotypic diversity exhibited by mammals. In particular, we analyzed the role of metabolic, reproductive, biogeographic and genomic characteristics on the rates of macro- and microstructural karyotypic diversification (rKD) using comparative phylogenetic methods. We found evidence that reproductive characteristics such as larger litter size per year and longevity, by allowing a higher number of meioses in absolute time, favor a higher probability of chromosomal change. Furthermore, families with large geographic distributions but containing species with restricted geographic ranges showed a greater probability of fixation of macrostructural chromosomal changes in different geographic areas. Finally, rKD does not evolve by Brownian motion because the mutation rate depends on the concerted evolution of repetitive sequences. The decisive factors of rKD evolution will be natural selection, genetic drift and meiotic drive that will eventually allow or not the fixation of the rearrangements. Our results indicate that mammalian karyotypic diversity is influenced by historical and adaptive mechanisms where reproductive and genomic factors modulate the rate of chromosomal change.

Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial.

Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P=0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9-38.6] and a number needed to treat of 5 (95% CI 3-17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear. Clinical trial registration: NCT01693172.

Evaluation of helper-dependent canine adenovirus vectors in a 3D human CNS model.

Gene therapy is a promising approach with enormous potential for treatment of neurodegenerative disorders. Viral vectors derived from canine adenovirus type 2 (CAV-2) present attractive features for gene delivery strategies in the human brain, by preferentially transducing neurons, are capable of efficient axonal transport to afferent brain structures, have a 30-kb cloning capacity and have low innate and induced immunogenicity in preclinical tests. For clinical translation, in-depth preclinical evaluation of efficacy and safety in a human setting is primordial. Stem cell-derived human neural cells have a great potential as complementary tools by bridging the gap between animal models, which often diverge considerably from human phenotype, and clinical trials. Herein, we explore helper-dependent CAV-2 (hd-CAV-2) efficacy and safety for gene delivery in a human stem cell-derived 3D neural in vitro model. Assessment of hd-CAV-2 vector efficacy was performed at different multiplicities of infection, by evaluating transgene expression and impact on cell viability, ultrastructural cellular organization and neuronal gene expression. Under optimized conditions, hd-CAV-2 transduction led to stable long-term transgene expression with minimal toxicity. hd-CAV-2 preferentially transduced neurons, whereas human adenovirus type 5 (HAdV5) showed increased tropism toward glial cells. This work demonstrates, in a physiologically relevant 3D model, that hd-CAV-2 vectors are efficient tools for gene delivery to human neurons, with stable long-term transgene expression and minimal cytotoxicity.

Cytocompatibility of HEMA-free resin-based luting cements according to application protocols on dentine surfaces.

AIM: To evaluate the transdentinal cytotoxicity of resin-based luting cements (RBLCs), with no HEMA in their composition, to odontoblast-like cells. METHODOLOGY: Human dentine discs 0.3 mm thick were adapted to artificial pulp chambers (APCs) and placed in wells of 24-well plates containing 1 mL of culture medium (DMEM). Two categories of HEMA-free RBLCs were evaluated: group 1, self-adhesive Rely X Unicem (RU; 3M ESPE), applied directly to the dentine substrate; and group 2, Rely X ARC (RARC; 3M ESPE), applied to dentine previously acid-etched and treated with a bonding agent. In group 3 (control), considered as representing 100% cell metabolic activity, no treatment was performed on dentine. The APC/disc sets were incubated for 24 h or 7 days at 37 °C and 5% CO2 . Then, the extracts (DMEM + dental materials components that diffused through dentine) were applied to cultured odontoblast-like MDPC-23 cells for 24 h. After that, the cell viability (MTT assay), cell morphology (SEM), total protein production (TP) and alkaline phosphatase (ALP) activity were assessed. Data from MTT assay and TP production were analysed by Kruskal-Wallis and Mann-Whitney tests (α = 5%). Data from ALP activity were analysed by one-way anova and Tukey's test (α = 5%). RESULTS: In group 1, a slight reduction in cell viability (11.6% and 16.8% for 24-h and 7-day periods, respectively) and ALP activity (13.5% and 17.9% for 24-h and 7-day periods, respectively) was observed, with no significant difference from group 3 (control) (P > 0.05). In group 2, a significant reduction in cell viability, TP production and ALP activity compared with group 3 (control) occurred (P < 0.05), regardless of incubation time. Alteration in MDPC-23 cell morphology was observed only in group 2. CONCLUSIONS: HEMA-free Rely X ARC cement caused greater toxicity to odontoblast-like MDPC-23 cells than did Rely X Unicem cement when both resin-based luting materials were applied to dentine as recommended by the manufacturer.

Daily oscillations of skin temperature in military personnel using thermography.

INTRODUCTION: The human body makes many physiological adjustments throughout the day, including adjustments to body temperature. The purpose of this study was to determine oscillations in the skin temperature (Tsk-1-Tsk-25) at 25 body regions of interest (ROIs) over 1 day using infrared thermography. METHODS: Tsk values of 31 male (age 22.9±3.0 years) Brazilian Air Force members were evaluated from five thermograms collected at 7, 11, 15, 19 and 23 h (Tsk7,11,15,19,23) by a Fluke imager. We applied one-way analysis of variance for repeated measures for the different times of the day and Tukey's post hoc test to determine significant Tsk differences between ROIs (α=0.05), and the cosinor analysis was used to determine the midline estimating statistic of rhythm, amplitude and acrophase of Tsk during the 24 h period. RESULTS: The anterior hands showed the greatest Tsk variations throughout the day. In the lower limbs, scapula, abdomen, chest and lower back, Tsk-11, Tsk-15, Tsk-19 and Tsk-23 were significantly different (p<0.05) from Tsk-7. The lowest Tsk values were obtained in the early morning, with increases in the afternoon and levelling after 15:00. CONCLUSIONS: The Tsk at all ROIs and the averaged Tsk showed oscillations throughout the day, with the lowest values in the early morning (07:00). Temperature fluctuations depended on the specific ROI, with thermal stabilisation in some regions in the afternoon and a central upward trend throughout the day in the hands.

Study of the diversity and short-chain fatty acids production by the bacterial community in overweight and obese Mexican children.

Obesity and overweight are health problems of multifactorial etiology, which may include changes in the microbiome. In Mexico, more than 30 % of the child population between 5 and 11 years of age suffer from being overweight or are obese, which makes it a public health issue in progress. The purpose of this work was to measure the short-chain fatty acid concentration by high-performance liquid chromatography (HPLC), and to characterize the bacterial diversity by ion torrent semiconductor sequencing, of 16S rDNA libraries prepared from stools collected from a sample of well-characterized Mexican children for normal weight, overweight, and obese conditions by anthropometric and biochemical criteria. We found that triglyceride levels are increased in overweight and obese children, who presented altered propionic and butyric acid concentrations in feces. In addition, although the colon microbiota did not show a clear bacterial dysbiosis among the three conditions, the abundance of some particular bacteria was changed with respect to normal controls. We conclude from our results that the imbalance in the abundance of at least nine different bacteria as well as altered short-chain fatty acid concentration in feces is associated to the overweight and obese conditions of Mexican children.

Lifetime prevalence and underdiagnosis of migraine in a population sample of Mexican women.

OBJECTIVE: The objective of this report is to evaluate migraine, migraine characteristics, and underdiagnosis of migraine in a large population sample of Mexican women. METHODS: Participants are part of a prospective cohort of Mexican teachers. Between 2011 and 2013, 77,855 participants completed a detailed questionnaire on headache characteristics. Migraine was defined according to criteria of the International Classification of Headache Disorders (ICDH-II). RESULTS: We found lifetime migraine prevalence was 19%, prevalence peaked at 40-44 years (20.4%) and only 45.1% participants with migraine had a previous diagnosis of the disease. CONCLUSION: Estimated lifetime prevalence of migraine was higher than previous reports in Latin America. Migraine may be underdiagnosed and undertreated in Mexico despite its considerable burden.

Evaluation of multiplex PCR in first episodes of febrile neutropenia as a tool to improve early yeast diagnosis in leukemic/preleukemic patients.

In febrile neutropenic onco-hematological patients, delayed microbiological diagnosis leads to an increase in morbidity and mortality. Identification of the microorganism changes antibiotic therapy in more than half of cases; however, in only 20-30 % of such cases pathogen isolation is achieved. This study evaluates the frequency of fungus infection and its etiology in onco-hematological patients with febrile neutropenia utilizing blood cultures and non-commercial multiplex polymerase chain reaction (MT-PCR) primers. Fifty-three febrile neutropenia episodes in 35 onco-hematological patients were observed, and the results for the first unique 30 episodes are presented. Blood cultures were positive for Candida tropicalis (one case), gram-positive bacteria (two cases), and gram-negative bacteria (four cases), showing a 23.3 % microbiological isolation rate. Multiplex-PCR pan-fungal sequence was positive in 18 cases (60 %), and further sequencing identified fugal pathogens in 11 cases (Candida glabrata and Candida parapsilosis being the most common). MT-PCR pan-fungal sequence amplification was detected in 13 of 16 patients that later received antifungal treatment for clinical reasons only, while positivity was found in 5 out of 14 patients that did not receive antifungal treatment (p = 0.02). These results show that performing in-house non-commercial MT-PCR is feasible and may provide additional information about fungal infection without the need to wait for culture results. Further research is necessary to incorporate this technology into the decision-making process.

Hospital arrival time and functional outcome after acute ischaemic stroke: results from the PREMIER study.

INTRODUCTION: Information regarding hospital arrival times after acute ischaemic stroke (AIS) has mainly been gathered from countries with specialised stroke units. Little data from emerging nations is available. We aim to identify factors associated with achieving hospital arrival times of less than 1, 3, and 6 hours, and analyse how arrival times are related to functional outcomes after AIS. METHODS: We analysed data from patients with AIS included in the PREMIER study (Primer Registro Mexicano de Isquemia Cerebral) which defined time from symptom onset to hospital arrival. The functional prognosis at 30 days and at 3, 6, and 12 months was evaluated using the modified Rankin Scale. RESULTS: Among 1096 patients with AIS, 61 (6%) arrived in <1 hour, 250 (23%) in <3 hours, and 464 (42%) in <6 hours. The factors associated with very early (<1 hour) arrival were family history of ischemic heart disease and personal history of migraines; in <3 hours: age 40-69 years, family history of hypertension, personal history of dyslipidaemia and ischaemic heart disease, and care in a private hospital; in <6 hours: migraine, previous stroke, ischaemic heart disease, care in a private hospital, and family history of hypertension. Delayed hospital arrival was associated with lacunar stroke and alcoholism. Only 2.4% of patients underwent thrombolysis. Regardless of whether or not thrombolysis was performed, arrival time in <3 hours was associated with lower mortality at 3 and 6 months, and with fewer in-hospital complications. CONCLUSIONS: A high percentage of patients had short hospital arrival times; however, less than 3% underwent thrombolysis. Although many factors were associated with early hospital arrival, it is a priority to identify in-hospital barriers to performing thrombolysis.

Arthroscopic fibroarthrolysis and mobilization under anesthesia is a simple, reproducible, and satisfactory method for the treatment of patients with severe post-traumatic arthrofibrosis of the knee.

OBJECTIVE: To evaluate the range of motion (ROM) of the knee in patients with severe post-traumatic knee arthrofibrosis after being treated with arthroscopic fibroarthrolysis (AFA) and manipulation under anesthesia (MUA). METHODS: Case series of patients with severe post-traumatic knee arthrofibrosis who underwent AFL+MUA in a national referral center. The primary outcome to be assessed was ROM before and after surgery and then at 3-month intervals until a minimum follow-up of one year was completed. RESULTS: 51 patients were included. The main injuries preceding the stiffness were tibial plateau fracture (37.3%), distal femur fracture (27.5%), and femoral shaft fracture (15.7%). Forty-five patients had severe flexion deficits with a median preoperative flexion of 70°. Intraoperative flexion significantly improved to 110°. Significant loss of flexion was observed at 3 and 6 months, however, patients regained ROM in the 9 and 12-month follow-ups. At discharge, 80% of the patients achieved flexion of 90° or more. There were 4 intraoperative complications and 3 reinterventions were performed. CONCLUSION: AFA+MUA can help patients with severe post-traumatic knee arthrofibrosis to recover ROM in most cases. However, this procedure is not without risks and complications, therefore, careful consideration should be given to its indication and execution.

Estimation of predation rate and handling time of boll weevil larvae by Marava arachidis (Dermaptera: Labiidae) using different mathematical methods.

Anthonomus grandis grandis (Coleoptera: Curculionidae) is a pest with a large potential for destruction in cotton crops, causing damage to the cotton reproductive structures. The earwig Marava arachidis (Dermaptera: Labiidae), is an important reference as a predator in several crops and being easy to rear in the laboratory. To analyze the potential biocontrol of M. arachidis of A. grandis grandis larvae, a study of predatory capacity was conducted using a functional response model. A. grandis grandis larvae were exposed to the predator at densities 1, 2, 4, 6, and 8 larvae (= prey/predator / Petri dish), with 30 replications at each density. Contact between the predator and the prey occurred for 24 hours; after this period, the level of predation of M. arachidis was assessed based on the proportion of preyed larvae. The linear logistic regression coefficient was used with a beta-binomial generalized linear model to determine the functional response. The negative signal of the linear coefficient and the goodness-of-fit tests revealed a quadratic or type II functional response, with the number of prey varying from 1.00 larva (density of 1 larva/predator) to 6.50 larvae (density of 8 larvae/predator). Therefore, the results of the present study demonstrate a high predatory capacity of M. arachidis on A. grandis grandis larvae.

[Translated article] The use of arthroscopy does not increase the incidence of complications in the management of Schatzker IV-VI tibial plateau fractures.

BACKGROUND AND OBJECTIVE: The use of arthroscopy for tibial plateau fractures type I, II and III according to Schatzker classification has increased, yet its employment for tibial plateau fractures Schatzker IV, V and VI is controversial due to the potential risk of compartment syndrome, deep vein thrombosis and infection. We aimed to compare the rate of operative and postoperative complications among patients with these types of tibial plateau fractures treated with and without arthroscopy at the time of definitive reduction and osteosynthesis. METHODS: Retrospective cohort study. Patients with diagnosis of tibial plateau fracture Schatzker IV, V or VI who underwent reduction and definitive osteosynthesis with or without the use of arthroscopy were included. The development of compartment syndrome, deep vein thrombosis, and fracture-related infection was evaluated up to 12 months after the definitive surgery. RESULTS: Two hundred eighty-eight patients were included: 86 with arthroscopic assistance and 202 without it. The overall complication rate in the group with and without arthroscopic assistance was 18.60% and 26.73%, respectively (p=.141). No statistical association was found between the use of arthroscopic assistance and the development of the analysed complications. DISCUSSION AND CONCLUSION: The use of arthroscopy to support reduction or addressing concomitant intra-articular injuries did not increase the risk of complications in patients with high-energy tibial plateau fractures at 12 months of follow up.