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1.
Int. j. morphol ; 37(2): 568-575, June 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1002260

RESUMO

The aim of this study was to compare body composition (BC) and morphological symmetry differences among elite athletes (n = 132) in six martial arts (judo, karate, fencing, wrestling, taekwondo, kickboxing). Multivariate analysis of variances (MANOVA) was used to compare the following variables: absolute (FFM) and relative (FFMrel) value of fat free mass, percentage of fat mass (FMp), bone mass, protein mass, basal metabolic rate, absolute (TBW) and percentual (TBWp) value of total body water, segmental proportion of muscle mass, phase angle, and percent-age differences between the upper and lower limbs. MANOVA revealed significant differences in BC among the groups (λ = 0.01, F104, 256 = 10.01, p< 0.01, ηp2 = 0.67). No significant differences were observed for FMp, FFMrel, and TBWp (p>0.05). In all other BC variables, significant differences were detected (p<0.05). The comparison of paired differences between limbs revealed significantly greater fluid volume in the preferred arm compared to the non-preferred arm in karate and fencing athletes. Significant differences (p<0.05) in favour of the preferred leg in all combat athletes were detected. This study revealed morphological differences among practitioners of different martial arts and between paired limbs.


El objetivo de este estudio fue comparar la composición corporal (CC) y las diferencias de simetría morfológica entre atletas de élite (n = 132) en seis artes marciales (judo, karate, esgrima, lucha, taekwondo, kickboxing). Se utilizó el análisis multivariado de varianzas (MANOVA) para comparar las siguientes variables: valor absoluto (FFM) y relativo (FFMrel) de la masa libre de grasa, porcentaje de masa grasa (FMp), masa ósea, masa proteica, tasa metabólica basal, absoluto (TBW) y el valor porcentual (TBWp) de líquido corporal total, la proporción segmentaria de la masa muscular, el ángulo de fase y las diferencias porcentuales entre los miembros superiores e inferiores. MANOVA reveló diferencias significativas en BC entre los grupos (λ = 0,01, F104, 256 = 10,01, p <0,01, ηp2 = 0,67). No se observaron diferencias significativas para FMp, FFMrel y TBWp (p>0,05). En todas las demás variables de BC, se detectaron diferencias significativas (p<0,05). La comparación de las diferencias pareadas entre los miembros reveló un volumen de líquido significativamente mayor en el brazo dominante en comparación con el brazo no dominante en karate y atletas de esgrima. Se detectaron diferencias significativas (p<0,05) a favor de la pierna dominante en todos los atletas de combate. Este estudio reveló diferencias morfológicas entre los practicantes de diferentes artes marciales y entre las miembros emparejadas.


Assuntos
Humanos , Masculino , Composição Corporal , Artes Marciais , Extremidades/anatomia & histologia , Antropometria , Tecido Adiposo , Análise Multivariada
2.
Rev. Asoc. Argent. Ortop. Traumatol ; 83(3): 157-166, set. 2018. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-976766

RESUMO

Introducción: El objetivo de este artículo es comunicar los resultados obtenidos con el uso del colgajo paraescapular para cubrir defectos severos postraumáticos de tejidos blandos en las extremidades. Materiales y Métodos: Estudio retrospectivo, descriptivo, de una serie de 20 pacientes a los que se les realizó un colgajo libre paraescapular para cubrir lesiones masivas combinadas postraumáticas de tejidos blandos en las extremidades, entre 2006 y 2017. La edad de los pacientes promedió 30 años (18 hombres, 2 mujeres). La localización de las lesiones fue: 10 en antebrazo y muñeca, una en la región inguinal, siete en la pierna y dos en tobillo/pie. Resultados: El seguimiento promedio fue de 3.6 años. Se logró la cobertura exitosa en 17 casos. El tamaño de los colgajos promedió 24,8 x 10,7 cm. Seis casos presentaron lesiones vasculonerviosas que necesitaron injerto, seis se asociaron a pérdidas óseas, 11 requirieron injerto de piel y cuatro, reconstrucciones tendinosas. En todos los pacientes, el área donante cerró en forma primaria y sin secuelas funcionales. Dicho colgajo se combinó con el escapular en tres casos y con colgajo de dorsal ancho en tres casos. Dos colgajos fallaron y debió amputarse la extremidad lesionada; un paciente falleció por embolia masiva al séptimo día de la cirugía. Conclusiones: El colgajo paraescapular permitió salvar y reconstruir satisfactoriamente defectos masivos extensos en 17 de 20 extremidades, sin morbilidad para la zona donante del colgajo, pero su uso no está exento de complicaciones, y un abordaje multidisciplinario es necesario para disminuir esta morbilidad. Nivel de Evidencia: IV


Introduction: The aim of this paper is to present the results after the use of parascapular free flaps to cover severe softtissue defects at the extremities. Methods: A retrospective, descriptive study of 20 patients who received parascapular free flaps to cover massive combined soft-tissue lesions at the extremities as a salvage procedure from 2006 to 2017 was performed. Patients' age averaged 30 years (18 men, 2 women). Sites of lesions were: ten at the forearm and wrist, one at the inguinal region, seven at the leg and two at the ankle/foot. Results: Follow-up averaged 3.6 years. Successful coverage was achieved in 17 cases. Flap size averaged 24.8 x 10.7 cm. There were six cases with neurovascular lesions that needed grafting, six cases had associated bone loss, eleven patients needed skin graft and four required tendon reconstructions. Donor area closed primarily without functional limitations in all patients. In three cases the flap was combined with a scapular flap and in three cases with a latissimus dorsi flap. Two flaps failed and the injured limb was amputated; one patient died due to massive embolism seven days after surgery. Conclusions: Parascapular free flaps allowed salvage and reconstruction of 17 out of 20 severely injured limbs, without morbidity for the donor area. But its use is not free of complications, and a multidisciplinary approach is necessary to reduce this morbidity. Level of Evidence: IV


Assuntos
Adulto , Retalhos Cirúrgicos , Lesões dos Tecidos Moles/cirurgia , Extremidades/cirurgia , Estudos Retrospectivos , Seguimentos , Resultado do Tratamento
3.
Rev. Asoc. Argent. Ortop. Traumatol ; 83(3): 167-178, set. 2018. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-976767

RESUMO

Introducción: El colgajo libre anterolateral de muslo es actualmente una de las opciones reconstructivas más útiles. Su versatilidad se debe a la inclusión de distintos tipos de tejido en diferentes combinaciones, una anatomía local confiable y un pedículo largo con un calibre adecuado. El objetivo de este estudio es revisar nuestra experiencia y evaluar la versatilidad del colgajo en defectos de los miembros superiores e inferiores. Materiales y Métodos: Estudio retrospectivo. Se consideraron pacientes tratados por defectos en las extremidades. Se analizaron variables preoperatorias, intraoperatorias y posoperatorias. Resultados: Se incluyeron 12 pacientes (7 hombres y 5 mujeres) con una edad promedio de 44 años. La causa del defecto fue resección oncológica (9 casos) y trauma (3 casos). La localización fue el miembro superior en cuatro casos y el miembro inferior en ocho pacientes. El tiempo promedio entre el defecto y la cirugía fue de 8 días. La tasa de supervivencia del colgajo fue del 92%, con falla en un caso. El sitio donante no presentó complicaciones, el cierre fue primario en 10 pacientes y con injerto de piel en dos. Conclusiones: El colgajo libre anterolateral de muslo es un recurso válido y de gran utilidad para la cobertura de defectos de diferentes etiologías tanto en los miembros superiores como en los miembros inferiores, ya que su versatilidad permite que se adapte con éxito en defectos de localización y tamaño variados. Nivel de Evidencia: IV


Introduction: The anterolateral thigh free flap is currently one of the most useful reconstructive options. A long pedicle with suitable vessel diameter, reliable anatomy and the availability of different tissues with large amounts of skin make this flap versatile. The purpose of this study was to evaluate the flap versatility in a series of patients with coverage defects in both, the upper and lower limbs. Methods: A retrospective study was performed. Inclusion criteria were patients with defects in the limbs to whom this flap was made as a reconstructive treatment. Preoperative, intraoperative and postoperative variables were analyzed. Results: Twelve patients (7 men and 5 women) with an average age of 44 years were included. Defects were caused by oncological resection (9 patients) and trauma (3 cases). In 4 cases the defect was in the upper limb and in 8 cases in the lower limb. The average time from the defect to the reconstructive surgery was 8 days. The survival rate of the flap was 92%, with only one failure. Donor site presented no complications and primary closure was performed in all cases, except for two requiring closure with skin graft. Conclusions: Anterolateral thigh free flap is a valid and very useful resource to cover defects of different etiologies in the upper and lower limbs since its versatility allows its successful adaptation in defects of varied location and size. Level of Evidence: IV


Assuntos
Adulto , Retalhos Cirúrgicos , Coxa da Perna , Procedimentos Cirúrgicos Reconstrutivos/métodos , Extremidades/cirurgia , Estudos Retrospectivos
5.
Rev. chil. cir ; 70(2): 185-193, 2018. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-959369

RESUMO

Resumen La fasciotomía es el pilar del tratamiento y prevención del síndrome compartimental agudo. Una vez resuelto el cuadro agudo que derivó en la necesidad de ésta, el cierre de la herida resultante genera un importante desafío reconstructivo para el cirujano dado el importante edema residual de los tejidos. El objetivo de este artículo es entregar una actualización respecto a las alternativas de cierre de una fasciotomía de extremidades, para lo cual se realizó una búsqueda de artículos indexados en PubMed, Epistemonikos y Scielo. Se encontraron al menos 6 técnicas disponibles, cada una de ellas con determinadas ventajas y desventajas. Recomendamos que la elección sea de acuerdo a la experiencia del cirujano, los recursos disponibles y el contexto de cada paciente.


Fasciotomy is the mainstay of treatment and prevention of acute compartment syndrome. Given the important deep tissue edema, closure of the resulting wound generates a significant reconstructive challenge for the surgeon. The aim of this article is to provide an update concerning alternatives for closure of fasciotomy of limbs, for which a search of articles indexed in PubMed, Scielo and Epistemonikos databases was performed. At least 6 techniques were found, each of them with specific advantages and disadvantages. We recommend that the choice should be according to the surgeons experience, resources and context of each patient.


Assuntos
Humanos , Síndromes Compartimentais/cirurgia , Técnicas de Fechamento de Ferimentos , Fasciotomia/métodos , Síndromes Compartimentais/prevenção & controle , Extremidades
6.
Int. j. morphol ; 35(3): 907-912, Sept. 2017. ilus
Artigo em Inglês | LILACS | ID: biblio-893072

RESUMO

An anthropometric analysis was conducted on 64 competitive young male road cyclists of different age categories (U17; U19; & U23 years of age). The purpose of the study is to find asymmetries between the left and right side of upper and lower limbs with the NX-16 (TC2) 3D body scanner, which includes measurement of left and right upper arm girth, elbow girth, forearm girth, wrist girth, thigh girth, knee girth, thigh length, calf girth, and shin length. Body composition was measured by the bioelectrical impedance machine InBody 720 (Biospace Ltd.). Results of body composition measurements of male road cyclists showed that U17 and U19 youth road cyclist differed statistically in five (from 11) paired variables, and the U23 age group differed statistically in six (from 11) paired variables. All of the age groups differed statistically in elbow, forearm, and calf girth. The main finding of study was that as the age of a cyclist increases, there is a tendency to increase asymmetries between the left and right side of several body segments.


Se realizó un análisis antropométrico de 64 ciclistas hombres, competidores de carretera, de diferentes categorías de edad (M17 y M23 años). El objetivo del estudio fue encontrar asimetrías entre el lado izquierdo y el lado derecho de los miembros superiores e inferiores con escáner corporal NX-16 (TC2) 3D, que incluyó la medición de las circunferencias izquierda y derecha de la parte superior del brazo, circunferencia del codo, circunferencia del antebrazo, y de la muñeca, circunferencia del muslo, de la cintura y de la rodilla; se midió el largo del muslo, circunferencia de la pantorrilla y el largo de la tibia. La composición corporal se midió mediante la máquina de impedancia bioeléctrica InBody 720 (Biospace Ltd.). Los resultados de las mediciones de la composición corporal de los ciclistas de carretera mostraron que los ciclistas juveniles de las categorías M17 y M19 difirían estadísticamente en cinco (de 11) variables pareadas, y el grupo de edad de los 23 años difirió estadísticamente en seis variables. Todos los grupos etarios difirieron estadísticamente en el codo, el antebrazo y en la circunferencia de la pantorrilla. El principal hallazgo del estudio indicó que al aumentar de edad un ciclista, se observa un aumento de la asimetría entre los lados izquierdo y derecho de varios segmentos corporales.


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Antropometria , Ciclismo , Extremidades/anatomia & histologia , Distribuição por Idade , Composição Corporal
7.
Rev. méd. Minas Gerais ; 27: [1-11], jan.-dez. 2017.
Artigo em Português | LILACS | ID: biblio-979672

RESUMO

Introdução: Nos países industrializados, o trauma é a terceira causa de mortalidade, sendo a principal entre menores de 45 anos de idade. Em Belo Horizonte (BH), no ano de 2015, quase metade das hospitalizações relacionadas a causas externas se deveu por trauma nos membros. Entretanto, a epidemiologia do trauma fatal de extremidades em nosso meio é ainda pouco conhecida. Objetivos: Avaliar os óbitos decorrentes de trauma nos membros ocorridos em BH e região metropolitana para se estabelecer o perfil das vítimas e dos subtipos deste trauma. Métodos: Estudo transversal dos casos necropsiados no Instituto Médico Legal de BH no período de 2006 a 2011 cuja causa do óbito tenha sido trauma nos membros. Resultados: Foram recuperados 128 casos. Quanto aosmecanismos de trauma, a maioria se deveu a ação contundente, seguida pela ação pérfurocontundente. O ano de 2007, o mês de outubro e o domingo apresentaram maior proporção de necropsias. A maioria dos necropsiados era homem, possuía menos de 49 anos, era solteira, feoderma e ativa do ponto de vista ocupacional. Em quase metade dos casos havia suspeita de homicídio e a maioria das vítimas foi encaminhada de uma unidade de saúde. Conclusões: A caracterização mais detalhada dos óbitos decorrentes de trauma nos membros ocorridos em BH pode fornecer informações de saúde pública importantes para o direcionamento de recursos e delineamento de prioridades para redução das fatalidades. (AU)


Introduction: In industrialized countries, trauma is the third leading cause of mortality, with the highest rate in the young. In Belo Horizonte, nearly half of hospitalizations related to external causes were due to limb trauma. However, the epidemiology of fatal trauma caused by trauma in extremities in our setting is still poorly understood. Objectives: To evaluate the limb trauma related deaths occurred in BH and metropolitan area in order to establish the profile of the victims and the subtypes of this trauma. Methods: Cross-sectional study of the necropsy reports performed at IML/BH from 2006 to 2011, caused by limb trauma. Results: 128 reports of fatal limb trauma victims were recovered during the study period. Concerning the mechanisms of trauma, the majority was due to blunt trauma, followed by gunshot wounds. The year 2007, October and Sunday had a higher proportion of necropsies. Most victims were male, younger than 49 years old, were single, feoderm and active from an occupational point of view. In almost half of the cases, homicide was suspected. Most of the cases had trauma in the lower limbs and were referred from a health unit. Conclusions: The more detailed characterization of limb trauma related deaths in BH can provide important public health information for resource allocation and delineation of priorities for fatalities reduction. (AU)


Assuntos
Humanos , Masculino , Feminino , Ferimentos e Lesões , Mortalidade , Medicina Legal , Autopsia , Brasil , Causas Externas , Extremidades
8.
Acta cir. bras ; 31(1): 15-21, Jan. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-771850

RESUMO

PURPOSE: To investigate the effect of remote ischemic post-conditioning (RIPoC) against ischemia-reperfusion (I/R) injury on flaps of rats. METHODS: Sprague-Dawley rats were randomized into the Sham, Control, RIPoC1 and RIPoC2 groups. All the animals were submitted to a 5×4 cm superficial inferior epigastric artery flap. Eight hours of flap ischemia was induced and two protocols of limb RIPoC were applied. Tissue MDA level and SOD activity in 24-h reperfusion were assessed. Flap survival was assessed 7 days postoperatively. RESULTS: Compared to the Control group, the RIPoC1 group showed statistically decreased MDA level at 6-, 12-, and 24-h reperfusion (P = 0.01, P < 0.01 and P < 0.01, respectively), and statistically increased SOD activity at 12- and 24-h reperfusion (P < 0.05 and P < 0.01, respectively). Flap survival rate on the 7th day was significantly higher in the RIPoC1 group than the control group (47.9 ± 6.4 vs . 29.4 ± 7.1 %, P < 0.01). CONCLUSION: Three cycles of 5-min Limb remote ischemic post-conditioning rather than a single cycle of 15-min limb RIPoC has protective effect on flaps against ischemia-reperfusion injury by attenuating oxidative stress.


Assuntos
Animais , Masculino , Procedimentos Cirúrgicos Dermatológicos , Pós-Condicionamento Isquêmico/métodos , Estresse Oxidativo , Traumatismo por Reperfusão/terapia , Retalhos Cirúrgicos/irrigação sanguínea , Procedimentos Cirúrgicos Dermatológicos/métodos , Artérias Epigástricas/cirurgia , Extremidades/lesões , Malondialdeído/análise , Necrose , Distribuição Aleatória , Ratos Sprague-Dawley , Traumatismo por Reperfusão/metabolismo , Superóxido Dismutase/análise , Retalhos Cirúrgicos/patologia , Fatores de Tempo
9.
Rev. AMRIGS ; 59(3): 227-229, jul.-set. 2015.
Artigo em Português | LILACS | ID: biblio-833862

RESUMO

A Síndrome de Guillain-Barré (SGB) é uma polineuropatia autolimitada, na maioria das vezes de mecanismo autoimune pós-infeccioso. Este caso tem por objetivo relatar uma variante rara do espectro da SGB. O método utilizado foi o acompanhamento clínico do paciente e revisão de prontuário. Conclui-se que conhecimento acerca da FCB e alto grau de suspeição são importantes para o diagnóstico diferencial de pacientes que apresentam sintomas bulbares e fraqueza de membros superiores, principalmente pela gama de diagnósticos diferenciais que os sintomas podem sugerir (AU)


Guillain-Barré syndrome (GBS) is a self-limited polyneuropathy, most often by a post-infectious autoimmune mechanism. This case aims at reporting a rare variant of the GBS spectrum. The method used was clinical monitoring of the patient and medical record review. It was concluded that knowledge of the pharyngeal-cervical-brachial variant and high degree of suspicion are important for the differential diagnosis of patients with bulbar symptoms and weakness of the upper limbs, particularly because of the range of differential diagnoses the symptoms may suggest (AU)


Assuntos
Humanos , Masculino , Adolescente , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/terapia , Debilidade Muscular/diagnóstico , Doenças Faríngeas/diagnóstico , Diagnóstico Diferencial , Extremidades , Debilidade Muscular/etiologia , Doenças Faríngeas/etiologia
10.
Medicina (B.Aires) ; 74(6): 474-475, dic. 2014.
Artigo em Espanhol | LILACS | ID: lil-750492

RESUMO

El síndrome de Guillain-Barré es una polineuropatía desmielinizante inflamatoria aguda, existiendo variantes locorregionales poco frecuentes como la faringo-cérvico-braquial. Presentamos el caso de un varón de 63 años de edad que acudió a urgencias por debilidad de extremidades superiores y a nivel cervical, con incapacidad para deglutir y masticar, y una insuficiencia respiratoria aguda rápidamente progresiva por debilidad de músculos respiratorios, todo ello secundario a la variante faringo-cérvico-braquial del síndrome de Guillain-Barré. Esta variante, aunque poco frecuente, presenta un patrón clínico y unos criterios diagnósticos bien definidos, importantes de reconocer para poder así iniciar de forma precoz el tratamiento y mejorar el pronóstico, no siempre favorable, de estos pacientes.


Guillain-Barré syndrome is an acute inflammatory demyelinating polyneuropathy. Infrequent loco-regional variants, like the pharyngeal-cervical-brachial, have been described. We report the case of a 63-year-old male admitted to the emergency department with cervical and upper limb weakness, inability to swallow and chew, he also presented a rapidly progressive acute respiratory failure due to weakness of the respiratory muscles secondary to the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. This variant, although unusual, presents a well-defined clinical pattern and diagnostic criteria, which is important in order to start an early treatment to improve the prognosis, not always favorable, to these patients.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Guillain-Barré/diagnóstico , Debilidade Muscular/diagnóstico , Doenças Faríngeas/diagnóstico , Insuficiência Respiratória/diagnóstico , Diagnóstico Diferencial , Extremidades , Síndrome de Guillain-Barré/complicações , Músculo Esquelético , Debilidade Muscular/etiologia , Orofaringe , Doenças Faríngeas/etiologia , Músculos Respiratórios , Insuficiência Respiratória/etiologia
11.
Arq. bras. endocrinol. metab ; 58(8): 807-811, 11/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-729788

RESUMO

Objective To determine the value of acromegaly screening in adult patients not reporting enlargement of the extremities, but who present arterial hypertension associated with at least one other comorbidity of the disease. Subjects and methods Patients seen by general practitioners at primary health care units were evaluated. Among the patients without extremity enlargement, those with recently diagnosed arterial hypertension associated with at least one other comorbidity were selected. Results A total of 1,209 patients were submitted to laboratory investigation. Elevated IGF‐1 was observed in 22 patients. Eighteen patients had adequate suppression of growth hormone (GH). No GH suppression was observed in four women with confirmed elevated IGF‐1. In the latter, IGF‐1 and nadir GH were only slightly elevated, magnetic resonance showed a normal pituitary, and chest and abdominal computed tomography revealed no tumor, and no intervention was performed. Conclusion In patients with arterial hypertension without known pituitary disease, acromegaly is unlikely in the absence of enlargement of the extremities. .


Objetivo Determinar o valor do rastreamento de acromegalia em pacientes adultos sem aumento de extremidades, mas com hipertensão arterial associada a pelo menos uma outra comorbidade da doença. Sujeitos e métodos Pacientes vistos por clínicos em unidades primárias de saúde foram avaliados. Entre pacientes sem aumento de extremidades, aqueles com hipertensão arterial diagnosticada recentemente e associada a pelo menos uma outra comorbidade foram selecionados. Resultados Um total de 1.209 pacientes foi submetido à investigação laboratorial. IGF‐1 foi elevado em 22 pacientes. Dezoito pacientes apresentavam supressão adequada do hormônio do crescimento (GH). Ausência de supressão do GH foi vista em quatro mulheres com IGF‐1 repetidamente elevado. Nestas, IGF‐1 e nadir do GH foram apenas discretamente aumentados, ressonância magnética revelou hipófise normal, tomografia computadorizada de tórax e abdome não revelaram tumor, e nenhuma intervenção foi realizada. Conclusão Em pacientes com hipertensão arterial sem doença hipofisária conhecida, acromegalia é improvável na ausência de aumento de extremidades. .


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Acromegalia/diagnóstico , Diabetes Mellitus/epidemiologia , Extremidades/anatomia & histologia , Transtornos da Cefaleia/epidemiologia , Hipertensão/diagnóstico , Fator de Crescimento Insulin-Like I/análise , Acromegalia/sangue , Brasil , Biomarcadores/sangue , Comorbidade , Extremidades/fisiologia , Teste de Tolerância a Glucose , Hormônio do Crescimento/sangue , Imagem por Ressonância Magnética , Programas de Rastreamento , Atenção Primária à Saúde , Hipófise/fisiologia , Inquéritos e Questionários
12.
Braz. j. med. biol. res ; 47(10): 886-894, 10/2014. graf
Artigo em Inglês | LILACS | ID: lil-722168

RESUMO

Administration or expression of growth factors, as well as implantation of autologous bone marrow cells, promote in vivo angiogenesis. This study investigated the angiogenic potential of combining both approaches through the allogenic transplantation of bone marrow-derived mesenchymal stem cells (MSCs) expressing human basic fibroblast growth factor (hbFGF). After establishing a hind limb ischemia model in Sprague Dawley rats, the animals were randomly divided into four treatment groups: MSCs expressing green fluorescent protein (GFP-MSC), MSCs expressing hbFGF (hbFGF-MSC), MSC controls, and phosphate-buffered saline (PBS) controls. After 2 weeks, MSC survival and differentiation, hbFGF and vascular endothelial growth factor (VEGF) expression, and microvessel density of ischemic muscles were determined. Stable hbFGF expression was observed in the hbFGF-MSC group after 2 weeks. More hbFGF-MSCs than GFP-MSCs survived and differentiated into vascular endothelial cells (P<0.001); however, their differentiation rates were similar. Moreover, allogenic transplantation of hbFGF-MSCs increased VEGF expression (P=0.008) and microvessel density (P<0.001). Transplantation of hbFGF-expressing MSCs promoted angiogenesis in an in vivo hind limb ischemia model by increasing the survival of transplanted cells that subsequently differentiated into vascular endothelial cells. This study showed the therapeutic potential of combining cell-based therapy with gene therapy to treat ischemic disease.


Assuntos
Animais , Humanos , Masculino , Extremidades/irrigação sanguínea , /metabolismo , Expressão Gênica , Isquemia/fisiopatologia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/metabolismo , Neovascularização Fisiológica/fisiologia , Antígenos de Superfície/análise , Células da Medula Óssea/metabolismo , Diferenciação Celular , Modelos Animais de Doenças , Proteínas de Fluorescência Verde , Isquemia/terapia , Células-Tronco Mesenquimais/citologia , Músculo Esquelético/irrigação sanguínea , Distribuição Aleatória , Ratos Sprague-Dawley , Transplante Homólogo , Fator A de Crescimento do Endotélio Vascular/metabolismo
13.
Rev. chil. cir ; 66(5): 423-428, set. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-724794

RESUMO

Aim: Present and describe the progressive fasciotomy closure technique with vessel loops. Methods: Progressive and multicentric study in the period between June of 2007 and June of 2011. Results: In 2007 we initiated the complementary treatment for fasciotomy closure related to compartment syndrome or acute ischemia cases. Progressive closure with vessel loops, the shoelace technique. In 2010's preliminary report, we published a total of 56 fasciotomies closed by this technique, with an average closure time of 9.5 +/- 3.31 days. Current report is the result of a 4 years prospective study intending to prove that is possible to associate this technique to the initial management of fasciotomies closure. This final report shows a total of 122 fasciotomies cases closed in 7.9 +/- 3.31 days, without skin grafts. Conclusion: The technique is easy to learn, reproducible and not expensive. Results show that this technique is useful in reduce the time for fasciotomy closure.


Objetivos: Presentar y describir la técnica de cierre progresivo de fasciotomías con elásticos. Métodos: Estudio prospectivo multicéntrico realizado en Santiago de Chile entre junio de 2007 y junio de 2011. Resultados: En el año 2007 se inició un protocolo de manejo del cierre de las fasciotomías realizadas a pacientes portadores de síndrome compartimental o isquemia aguda de extremidades. Utilizando una técnica de entrelazado con elásticos vasculares se realizó el cierre de las fasciotomías. En el 2010 se publicó un reporte preliminar, presentando una serie de 56 fasciotomías cerradas con esta técnica, con un promedio de cierre de 9,5 +/- 3,31 días. La serie actual es el resultado de un estudio prospectivo de 4 años de duración que ha buscado demostrar que resulta posible asociar esta técnica con elásticos al manejo inicial del cierre de las fasciotomías. Nuestro reporte final muestra un total de 122 fasciotomías cerradas en un promedio de 7,9 +/- 3,31 días sin requerir de injertos de piel. Conclusiones: Presentamos una técnica quirúrgica fácil de reproducir, de bajo costo y con buenos resultados. El uso de elásticos vasculares muestra beneficios en el tiempo de cierre de las fasciotomías.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Extremidades/cirurgia , Isquemia/cirurgia , Lesões do Sistema Vascular/cirurgia , Síndromes Compartimentais/cirurgia , Técnicas de Fechamento de Ferimentos , Fáscia/cirurgia , Tempo de Internação , Estudos Multicêntricos como Assunto , Duração da Cirurgia , Estudos Prospectivos
14.
Clinics ; 69(9): 579-584, 9/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-725406

RESUMO

OBJECTIVE: Unplanned excision of soft tissue sarcomas is common because benign soft tissue lesions are very frequent. This study evaluated the impact of unplanned resections on overall survival, local recurrence and distant metastasis in patients with soft tissue sarcomas of the extremities. METHODS: In total, 52 patients who were diagnosed with soft tissue sarcomas between May 2001 and March 2011 were analyzed in a retrospective study. Of these patients, 29 (55.8%) had not undergone previous treatment and the remaining 23 (44.2%) patients had undergone prior resection of the tumor without oncological planning. All subsequent surgical procedures were performed at the same cancer referral center. The follow-up ranged from 6 to 122 months, with a mean of 39.89 months. Age, lesion size and depth, histological grade, surgical margins, overall survival, local and distant recurrence and adjuvant therapies were compared. RESULTS: Residual disease was observed in 91.3% of the re-resected specimens in the unplanned excision group, which exhibited greater numbers of superficial lesions, low histological grades and contaminated surgical margins compared with the re-resected specimens in the planned excision group. No differences were observed in local recurrence and 5-year overall survival between the groups, but distant metastases were significantly associated with planned excision after adjustment for the variables. CONCLUSIONS: There was no difference between patients undergoing unplanned excision and planned excision regarding local recurrence and overall survival. The planned excision group had a higher risk of distant metastasis, whereas there was a high rate of residual cancer in the unplanned excision group. .


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Extremidades/cirurgia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Estimativa de Kaplan-Meier , Análise Multivariada , Gradação de Tumores , Fatores de Risco , Sarcoma/mortalidade , Sarcoma/patologia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento , Carga Tumoral
15.
Braz. j. med. biol. res ; 47(9): 738-745, 09/2014. graf
Artigo em Inglês | LILACS | ID: lil-719313

RESUMO

Hypoxia-inducible factor-1α (HIF-1α) is one of the most potent angiogenic growth factors. It improves angiogenesis and tissue perfusion in ischemic skeletal muscle. In the present study, we tested the hypothesis that ischemic postconditioning is effective for salvaging ischemic skeletal muscle resulting from limb ischemia-reperfusion injury, and that the mechanism involves expression of HIF-1α. Wistar rats were randomly divided into three groups (n=36 each): sham-operated (group S), hindlimb ischemia-reperfusion (group IR), and ischemic postconditioning (group IPO). Each group was divided into subgroups (n=6) according to reperfusion time: immediate (0 h, T0), 1 h (T1), 3 h (T3), 6 h (T6), 12 h (T12), and 24 h (T24). In the IPO group, three cycles of 30-s reperfusion and 30-s femoral aortic reocclusion were carried out before reperfusion. At all reperfusion times (T0-T24), serum creatine kinase (CK) and lactate dehydrogenase (LDH) activities, as well as interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α) concentrations, were measured in rats after they were killed. Histological and immunohistochemical methods were used to assess the skeletal muscle damage and HIF-1α expression in skeletal muscle ischemia. In groups IR and IPO, serum LDH and CK activities and TNF-α, IL-6, and IL-10 concentrations were all significantly increased compared to group S, and HIF-1α expression was up-regulated (P<0.05 or P<0.01). In group IPO, serum LDH and CK activities and TNF-α and IL-6 concentrations were significantly decreased, IL-10 concentration was increased, HlF-1α expression was down-regulated (P<0.05 or P<0.01), and the pathological changes were reduced compared to group IR. The present study suggests that ischemic postconditioning can reduce skeletal muscle damage caused by limb ischemia-reperfusion and that its mechanisms may be related to the involvement of HlF-1α in the limb ischemia-reperfusion injury-triggered inflammatory response.


Assuntos
Animais , Masculino , Extremidades/irrigação sanguínea , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Pós-Condicionamento Isquêmico , Músculo Esquelético/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Western Blotting , Creatina Quinase/metabolismo , Modelos Animais de Doenças , Células Endoteliais/patologia , Imuno-Histoquímica , /sangue , /sangue , L-Lactato Desidrogenase/metabolismo , Músculo Esquelético/lesões , Distribuição Aleatória , Ratos Wistar , Fatores de Tempo , Fator de Necrose Tumoral alfa/sangue , Regulação para Cima
16.
Clinics ; 69(8): 559-564, 8/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-718192

RESUMO

OBJECTIVES : To evaluate the neuroprotective effect of epidural hypothermia in rats subjected to experimental spinal cord lesion. METHODS: Wistar rats (n = 30) weighing 320-360 g were randomized to two groups (hypothermia and control) of 15 rats per group. A spinal cord lesion was induced by the standardized drop of a 10-g weight from a height of 2.5 cm, using the New York University Impactor, after laminectomy at the T9-10 level. Rats in the hypothermia group underwent epidural hypothermia for 20 minutes immediately after spinal cord injury. Motor function was assessed for six weeks using the Basso, Beattie and Bresnahan motor scores and the inclined plane test. At the end of the final week, the rats' neurological status was monitored by the motor evoked potential test and the results for the two groups were compared. RESULTS: Analysis of the Basso, Beattie and Bresnahan scores obtained during the six-week period indicated that there were no significant differences between the two groups. There was no significant difference between the groups in the inclined plane test scores during the six-week period. Furthermore, at the end of the study, the latency and amplitude values of the motor evoked potential test were not significantly different between the two groups. CONCLUSION: Hypothermia did not produce a neuroprotective effect when applied at the injury level and in the epidural space immediately after induction of a spinal cord contusion in Wistar rats. .


Assuntos
Animais , Feminino , Humanos , Masculino , Espaço Epidural/fisiopatologia , Hipotermia Induzida/métodos , Traumatismos da Medula Espinal/fisiopatologia , Modelos Animais de Doenças , Potencial Evocado Motor/fisiologia , Extremidades/fisiopatologia , Destreza Motora/fisiologia , Distribuição Aleatória , Ratos Wistar , Recuperação de Função Fisiológica/fisiologia , Estimulação Transcraniana por Corrente Contínua/métodos
17.
Acta cir. bras ; 28(4): 282-287, Apr. 2013. ilus, graf
Artigo em Inglês | LILACS | ID: lil-670254

RESUMO

PURPOSE: To investigate the effect of sildenafil citrate (SC) on skeletal muscle ischemia-reperfusion (IR) injury in rats. METHODS: Adult male Wistar rats were randomized into three groups: vehicle-treated control (CTG), sildenafil citrate-treated (SCG), and sham group (SG). CTG and SCG had femoral artery occluded for 6 hours. Saline or 1 mg/kg of SC was given 5.5 hours after occlusion. SG had a similar procedure without artery occlusion. Soleus muscle samples were acquired 4 or 24h after the reperfusion. Immunohistochemistry caspase-3 analysis was used to estimate apoptosis using the apoptotic ratio (computed as positive/negative cells). Wilcoxon rank-sum or Kruskal-Wallis tests were used to assess differences among groups. RESULTS: Eighteen animals were included in the 4h reperfusion groups and 21 animals in the 24h reperfusion groups. The mean apoptotic ratio was 0.18±0.1 for the total cohort; 0.14±0.06 for the 4h reperfusion groups and 0.19±0.08 for the 24h groups (p<0.05). The SCG had lower caspase-3 ratio compared to the control groups at the 24h reperfusion time point (p<0.05). CONCLUSION: Sildenafil citrate administration after the onset of the ischemic injury reduces IR-induced cellular damage in skeletal muscle in this rat hindlimb ischemia model.


Assuntos
Animais , Masculino , Ratos , Modelos Animais de Doenças , Músculo Esquelético/irrigação sanguínea , /farmacologia , Piperazinas/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Sulfonas/farmacologia , /análise , Extremidades/patologia , Substâncias Protetoras/farmacologia , Purinas/farmacologia , Distribuição Aleatória , Ratos Wistar , Fatores de Tempo
18.
São Paulo; s.n; 2013. 111 p. ilus, tab.
Tese em Português | LILACS | ID: lil-751061

RESUMO

Introdução: Sarcomas de partes moles (SPM) constituem um grupo de neoplasias raras de comportamentos distintos. O tratamento para os tumores de alto grau, não passiveis de ressecção adequada, é feito por cirurgia, radioterapia (RT) e quimioterapia (QT). Apesar disso, 50% dos pacientes com tumores localizados ao diagnóstico morrem da doença metastática. A QT pré-operatória para o tratamento de tumores localizados, apesar de não ser considerada como padrão, é uma opção promissora. A escassez de preditores biológicos de resposta, e achados de que a superexpressão de genes pertencentes à via mediada por TGFβ estaria relacionada à resistência à QT nos levaram à tentativa de estabelecer a relação entre a expressão de FST, SMAD4, TGFβ e Id com resposta patológica. Objetivos: Avaliar por imunoistoquímica (IQ) a expressão das proteínas produzidas a partir dos genes TGFB, FST, Id1 e SMAD4 da via mediada por TGFβ, correlacionando com a resposta patológica; expandir os resultados clínicos do esquema de QT pré-operatória com doxorrubicina e ifosfamida em vigência no Hospital A.C. Camargo; determinar as taxas de toxicidade e avaliar um método de análise patológica que quantifique a percentagem de células tumorais viáveis em peça operatória. Pacientes e Métodos: 42 pacientes com SPM de alto grau localizados em extremidades, tratados com doxorrubicina e ifosfamida pré-operatória, foram observados de forma prospectiva, desde janeiro de 2005 a agosto de 2012. Amostras das biópsias e das peças operatórias foram obtidas e submetidas à pesquisa da expressão das proteínas já referidas por IQ. Resultados: A expressão das proteínas estudadas não teve correlação estatisticamente significativa com a resposta patológica...


Backgraund: Soft Tissue Sarcomas (STS) are rare neoplasms with many histological subtypes, behaviors and response to different treatments. The treatment of these tumors involves surgery, radiation and chemotherapy. Despite that 50% of patients with localized tumors will develop metastatic disease. Preoperative chemotherapy (CT) although not standard is considered a promising therapeutic option. The lack of biological predictors of response, led us to study the relationship between the expression of FST, SMAD4, TGFβ and Id (TGFβ superfamily genes) in patients submitted to preoperative CT. Objectives: To evaluate the protein expression. Produced by genes belonging to the TGFβ pathway by IH and correlate it with pathologic response; expand the preliminary results of a previous phase II trial testing a schedule of preoperative CT with doxorubicin and ifosfamide in Hospital A.C. Camargo; determine the rate of toxicity and evaluate a method of assessing pathological analysis that quantifies the percentage of viable tumor cells in surgical specimens. Patients and Methods: 42 patients with high grade STS located in extremities treated with preoperative doxorubicin and ifosfamide CT were observed prospectively, on a non controlled fashion since January 2005 to august 2012. Biopsies and surgical specimens were obtained to enable the analysis of TGFβ, FST, SMAD4 and Id protein expressional by immunohistochemistry (IH). Results: The expression of the proteins studied had no significant association with pathological response. The objective response rates of the primary tumor were 17.5% for clinical response and 15% for pathologic complete response. Only 7.5% patients had a limb amputated. The rate of surgical contraindication was 4.7%. Grade 3-4 toxicity occurred in 45.2% of cases. Conclusion: The method of pathological response analysis was considered easily applicable. TGFβ-mediated pathway proteins studied did not correlate with pathological response...


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Doxorrubicina/toxicidade , Extremidades , Ifosfamida/toxicidade , Sarcoma/cirurgia , Sarcoma/diagnóstico , Fator de Crescimento Transformador beta , Tratamento Farmacológico
19.
Acta méd. (Porto Alegre) ; 33(1): [5], 21 dez. 2012.
Artigo em Português | LILACS | ID: biblio-879487

RESUMO

Este artigo versará sobre as lesões musculoesqueléticas graves que podem trazer risco à vida, na importância do seu reconhecimento precoce e manejo inicial dessas lesões, que deverão ser realizadas pelo médico no departamento de emergência.


This article discusses the severe musculoskeletal injuries that can bring serious risk to life, the initial evaluation and management of these injuries that must be performed by the physician in the emergency department.


Assuntos
Ferimentos e Lesões , Extremidades/lesões , Hemorragia , Sistema Musculoesquelético/lesões , Mioglobinúria , Pelve/lesões , Rabdomiólise
20.
Dermatol. pediátr. latinoam. (En línea) ; 10(2): 68-71, jul. 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-742331

RESUMO

La paniculitis lipoatrófica (PL) es una enfermedad rara que afecta principalmente a mujeres y niños. Su forma de presentación consiste en múltiples placas eritematosas en las extremidades, que resuelven con atrofia subcutánea. Frecuentemente el cuadro se asocia con fiebre y trastornos autoinmunes. Presentamos una paciente de sexo femenino, de 8 años de edad, con síndrome febril de un mes de evolución asociado a atrofia y pigmentación en el dorso de las manos y piernas, edema semiduro simétrico del dorso de los pies pies y cara posterior del tercio distal de las piernas, nódulos en la cara posterior de las piernas, parestesias y limitación a la deambulación. Estudios complementarios: enzimas hepáticas, eritrosedimentación, proteína C reactiva, fibrinógeno y ferritina elevadas y FAN positivo; en la ecografía de partes blandas (pies, piernas y dorso de manos) presencia de múltiples imágenes pseudonodulares compatibles con focos de fibrosis; en la biopsia de piel (lesión nodular) hallazgos de paniculitis lobular; cariotipo 46XX, con anomalía estructural y deleción del brazo largo del cromosoma 10. Presentamos este caso, por tratarse de una patología infrecuente, con un sólo caso descripto en la literatura asociado a alteraciones del cromosoma 10, y por el desafío diagnóstico que ocasionó al plantel médico.


Lipoatrophic panniculitis is a rare disease affecting mostly women and children. It presents as multiple erythematous plaques on the extremities resolving with subcutaneous atrophy. Affected patients are often febrile and may have associated autoimmune phenomena. We report an 8-year-old girl, with 30-day history of fever, with atrophy and pigmentation on the back of the hand and legs, semi-hard symmetrical edema in the back of feet and distal posterior third of legs, and nodules on the back of the legs, paresthesia, and impaired deambulation. Complementary studies revealed elevated liver enzymes, fibrinogen, ferritin, VSG and CRP; positive ANA; multiple pseudonodular images compatible with focal areas of fibrosis in ultrasound of feet, limbs and back of the hands; skin biopsy (performed on a nodule) showed a lobular panniculitis; the chariotype was 46XX with structural anomaly and deletion of long arm of chromosome 10. We report this case because of its infrequent nature, with only one case reported in medical literature associated to chromosome 10 anomalies, and the diagnostic challenges that it represented to medical staff.


Assuntos
Humanos , Feminino , Criança , Paniculite , Extremidades
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