Failure rate of isolated medial meniscus repair in the stable knee: Systematic review and meta-analysis.

PURPOSE: The present meta-analysis aims to determine the outcomes and failure rates for medial meniscus repairs in patients with stable knees. METHODS: A literature search was conducted using PubMed and Scopus with the terms '(medial meniscus OR medial meniscal) AND (repair)'. The search strategy was based on the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) protocol and included 93 articles assessed for eligibility. The search criteria were limited to studies reporting outcomes and failure rates. The exclusion criteria included languages other than English, biomechanical studies, letters to editors, non-full text, review articles, meta-analyses and case reports. RESULTS: In total, 10 studies with 595 patients were included. Degenerative tears or studies reporting meniscus repair outcomes on root repairs, revision or primary anterior cruciate ligament reconstruction, discoid menisci or ramp lesions were excluded. All studies included revision surgery and/or clinical symptoms as failure definitions. The overall medial meniscal repair failure rate was 26% with a 95% confidence interval (CI) [15%-37%]. The mean time to failure from isolated medial meniscus repair surgery was 27.7 months with 95% CI [18.5-36.9 months]. The postoperative Lysholm and IKDC scores were reported in three articles. At the final follow-up, the mean postoperative Lysholm and IKDC scores were 92.3 with 95% CI [84.5-100] and 88.6 with 95% CI [83.5-93.8], respectively. CONCLUSION: The current meta-analysis revealed an overall failure rate of 26% in the case of medial meniscus repair in a stable knee. For these reasons, the patient should be aware of the substantial risk of revision surgery (one out of four cases). Medial meniscus repair in a stable knee yielded good clinical results. LEVEL OF EVIDENCE: II.

Three predictive scores compared in a retrospective multicenter study of nonunion tibial shaft fracture.

BACKGROUND: Delayed union, malunion, and nonunion are serious complications in the healing of fractures. Predicting the risk of nonunion before or after surgery is challenging. AIM: To compare the most prevalent predictive scores of nonunion used in clinical practice to determine the most accurate score for predicting nonunion. METHODS: We collected data from patients with tibial shaft fractures undergoing surgery from January 2016 to December 2020 in three different trauma hospitals. In this retrospective multicenter study, we considered only fractures treated with intramedullary nailing. We calculated the tibia FRACTure prediction healING days (FRACTING) score, Nonunion Risk Determination score, and Leeds-Genoa Nonunion Index (LEG-NUI) score at the time of definitive fixation. RESULTS: Of the 130 patients enrolled, 89 (68.4%) healed within 9 months and were classified as union. The remaining patients (n = 41, 31.5%) healed after more than 9 months or underwent other surgical procedures and were classified as nonunion. After calculation of the three scores, LEG-NUI and FRACTING were the most accurate at predicting healing. CONCLUSION: LEG-NUI and FRACTING showed the best performances by accurately predicting union and nonunion.

Assessing the water quality in a World Heritage Site using biomarkers in top fish predators.

The use of biomarkers in fish for biomonitoring is a valuable approach to reveal effects of human impacts on biota health. Top predator fish are effective models for monitoring human activities' impacts on aquatic ecosystems. The Guaraguaçu River is the largest river-system on coastal region of South Brazil and a World Heritage site. The river receives contaminants from disorderly urban growth, including discharges of domestic sewage and small fishery boats, particularly during the tourist season. Our study aimed to assess impact of anthropogenic activities on water quality in the Guaraguaçu River by analyzing environmental contamination biomarkers in the top fish predator Hoplias malabaricus. Fish were collected using a fyke net trap across sectors representing a gradient of anthropic impact: sector 1 - pristine; sector 2 - impacted; and sector 3 - less impacted. Water samples were collected to analyze the presence of trace elements and pesticide. Biomarkers of the antioxidant system, histopathology, genotoxicity, neurotoxicity, and concentration of trace elements were analyzed in fish tissues. In water samples Al, Fe and Mn were detected, but no pesticides were found. In fish muscle, zinc and iron were detected. Brain acetylcholinesterase activity decreased in impacted sectors, indicating neurotoxic effects. The antioxidant system increased activity in gills and liver, and damage from lipoperoxidation was observed, particularly in sector 2 when compared to sector 1, suggesting oxidative stress. Histopathological biomarkers revealed lesions in the liver and gills of fish in impacted sectors. Micronuclei, a genotoxicity biomarker, were observed in organisms from all sectors. Our results demonstrate detrimental effects of poor water quality on biota health, even when contaminants are not detected in water.

Evaluation of organo-vermiculites as sorbent phases for solid-phase extraction of ibuprofen from water.

The study of ibuprofen (IBU) preconcentration was carried out making use of a homemade column for solid-phase extraction (SPE), using vermiculite (VT) or organo-vermiculites (OVTs) as sorbent phases. Aqueous samples (50.0 mL) percolated the column and IBU was sorbed onto the VT or OVT and then desorbed using acetonitrile. Employing this SPE system and OVT, calibration curves were generated for IBU, by spectrophotometric quantification using the α-naphthylamine method. R2 values higher than 0.9950 and LOD between 12 and 18 µg L-1 were observed, for real enrichment factors of 21 and 31, by using OVTs. The analytical protocol was applied to three water samples, which were spiked with IBU solutions to evaluate the precision and accuracy of the method. Recoveries between 77 and 110% at three different IBU concentrations and RSD lower than 18% were observed, even by using the spectrophotometric method. The protocol developed in this study demonstrated that the OVT was appropriate to work as a preconcentration phase for IBU determination in water samples.

Ripening stage impacts nutritional components, antiglycemic potential, digestibility and antioxidant properties of grumixama (Eugenia brasiliensis Lam.) fruit.

This study aimed to determine the nutritional components (macronutrients ans minerals) and α-amylase inhibition capacity of freeze-dried grumixama (Eugenia brasiliensis Lam) seeds (S) and pulp/peel (P) portions, at ripe and mid-ripe stages. In vitro digestion was also performed on S and P from grumixama to assess the bioaccessibility of total phenolic compound (TPC), flavonoids (TFC), and anthocyanins (TAC), as well as to examine their impact on antioxidant activity (DPPH, ABTS, FRAP). The ripening process impacts the bioactive compounds and individual phenolics of S and P portions. The ripe S was source of myricetin and exhibited higher antioxidant activity, while mid-ripe S was high in flavonoids and cinnamic acid with higher antiglycemic potential. Ripe P showed higher soluble fiber, carbohydrate, TAC, and caffeic acid content, whereas mid-ripe P had increased mineral content (calcium, potassium, manganese), catechin, and TPC. After in vitro digestion, the P portion showed a bioaccessibility of total phenolic content (TPC) and total flavonoid content (TFC) exceeding 40% at intestinal phase. In contrast, the S portions had better release of TPC and TFC and antioxidant activity at gastric phase. Considering the outstanding nutritional and biological properties of grumixama fruit, freeze-dried S and P portions from both ripening stages possess could be explored as valuable sources of nutrients and antioxidant compounds.

Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center.

BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery. METHODS: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2-3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale. RESULTS: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications. CONCLUSIONS: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up.

Lichens as bio-monitors of polycyclic aromatic hydrocarbons: Measuring the impact of features and traffic patterns.

The role of road characteristics, including gradient and speed control devices, in influencing emission dynamics remains to be fully elucidated. Most studies have focused on fuel consumption as an indirect indicator of sector emissions instead of directly quantifying specific pollutants, like polycyclic aromatic hydrocarbons (PAHs). This research approach is often due to the complexities involved in capturing these pollutants and their subsequent analysis. Bio-monitors, such as lichens, offer an economically viable method. Their wide distribution across various habitats enables the comparison of PAH levels in diverse environments. Against this background, The present work analyses the ability of tropical lichens to indicate the effect that traffic patterns and geometric design features of roads (traffic activity, road gradient, traffic control devices, and vehicular speed) have on the emission of PAH concentration. Results showed that PAHs in lichens strongly correlated with the road gradient (Spearman correlation, p<0.005 with R=0.98). Each 1% increase in road gradient implies a rise of 24 ngPAH/gLichen in National Road. Additionally, a trend coherent of PAH concentration with the vehicle speed profile was observed on Panamericana Road. Speed control devices were associated with higher concentrations of PAHs due to acceleration and braking actions that increment fuel consumption. Finally, the results evidenced that lichens helped determine the source of aromatics and their carcinogenic potential using the diagnostic ratio of PAHs and the carcinogenic equivalence sum, respectively.

Osmoregulatory responses in the neotropical fish species Astyanax lacustris, exposed to single and combined microplastics, polycyclic aromatic hydrocarbons, and their mixture.

Microplastic (MP) pollution poses a significant environmental threat. These MPs can adsorb toxic compounds such as polycyclic aromatic hydrocarbons (PAH), which are highly lipophilic and carcinogenic. To assess the potential effects of virgin MP, PAH, and MP+PAH in association with osmoregulation and energetic substrate, we conducted experiments with the tetra cardinal Astyanax lacustris. The environmentally relevant concentration of MP (10 mg L-1) and 20 % of the LC50-96 h of crude oil for A. lacustris (2.28 µg L-1) were used during the 96-h exposure. Fish were exposed to virgin MP, PAH, MPC (MP loaded with PAH), PAH+MP (PAH and MP in association), and the control without (CT) and with handling (CH). After 96 h, blood was collected for osmoregulatory parameters (plasma osmolality; Na+, K+, Cl-, Mg2+; glycose and lactate); gills for osmoregulatory enzyme activities (Na+, K+ ATPase, H+ ATPase, and carbonic anhydrase); and white muscle samples were used to determine glycogen as an energetic substrate. The low molecular weight PAH was not detected in PAH-loaded MP (MPC) and PAH in combination with MP (PAH+MP). The PAH concentration of the MPC and PAH+MP was similar and low compared to other works. Virgin MP, PAH, MPC, and PAH+MP were able to cause muscle glycogen depletion. The activity of v-type H+ ATPase and plasma Na+ concentrations were lower in PAH with MP (MPC). However, the hydromineral balance (K+, Mg2+, Cl-, and osmolality) was not affected by any treatment. In this sense, we can conclude that the MPC caused osmoregulatory disturbances not seen in the MP associated with PAH (MP+PAH). However, this seems unrelated to the PAH leaking from the MPC or the PAH absorption to the virgin MP once the PAH concentrations from the MPC and PAH+MP were similar.

Exploratory evaluation of iron and its speciation in surface waters of Admiralty Bay, King George Island, Antarctica.

The determination of dissolved iron concentrations and speciation was conducted for the first time in surface seawater coastline samples collected during the austral summer of 2020 in Admiralty Bay, King George Island, Antarctica. The technique of competitive ligand exchange/adsorptive cathodic stripping voltammetry with 2,3-dihydroxynaphthalene as the competing ligand was evaluated, showing a sensitivity between 14.25 and 21.05 nA nmol L-1 min-1, with an LOD of 14 pmol L-1 and a mean blank contribution of 0.248 nmol L-1. Physicochemical parameters such as pH (7.85 ± 0.2), salinity (32.7 ± 0.8) and dissolved oxygen (51.3 ± 26.6%) were compatible with those of the literature; however, the average temperature (4.2 ± 0.8 °C) was higher, possibly as a reflection of global warming. The dissolved iron mean value was 18.9 ± 6.1 nmol L-1, with a total ligand concentration of 23.6 ± 12.2 nmol L-1 and a conditional stability complex constant of 12.2 ± 0.2, indicating humic substances as possible ligands. On average, the calculated free iron concentrations were 0.7 ± 0.3 pmol L-1. Relatively high concentrations of iron indicate a possible local source of Fe, likely predominantly from upwelling sediments and secondarily from ice-melting waters, which does not limit the growth of the phytoplankton.

How natural and anthropogenic factors should drive microplastic behavior and fate: The scenario of Brazilian urban freshwater.

Brazil maintains its position at the top of the global ranking of plastic producers, yet recycling efforts have been incipient. Recent data reveals an annual production of approximately 14 million tons of plastic waste, not accounting for the surge in the usage of plastic masks and related materials due to the COVID-19 pandemic. However, what remains largely unreported is that over half of post-consumer plastic packaging in Brazil is managed without any monitoring, and it remains unclear how this will contribute to the occurrence of plastic waste and microplastics in Brazilian freshwaters. This scenario requires the consideration of several other crucial factors. Studies have been carried out mainly in marine and estuarine waters, while data on freshwaters are lacking. Brazil has continental dimensions and the highest water availability on the planet, yet the demand for water is greatest in regions with medium to low supply. Many densely populated Brazilian urban areas face chronic flood problems, possess inadequate levels of wastewater treatment, and display inadequate solid waste management practices. Consequently, urban freshwater with tropical characteristics in Brazil presents an intriguing scenario and is complementary to the most commonly studied marine environments. In this study, we explore the nuances of pollution in Brazilian urban freshwater and discuss how various parameters, such as organic matter, suspended solids, temperature, and pH, among others, influence the behavior of microplastics and their interactions with organic and inorganic contaminants. Furthermore, we address how microplastic conditions, such as biofouling, the type of plastic, or degradation level, may impact their behavior. By analyzing how these conditions change, we propose priority themes for investigating the occurrence of microplastics in Brazilian urban freshwater systems under different degrees of human impact. Ultimately, this study aims to establish a network dedicated to standardized monitoring of microplastic pollution in Brazilian urban freshwaters.