A feasible in vitro method to evaluate bacterial infiltration in three implant-abutment connection systems / Método in vitro factible para evaluar la infiltración bacteriana en tres sistemas de conexión implante-pilar

Introduction: Microorganism infiltration through the im-plant-abutment interface causes oral health problems such as periimplantitis, leading to implant loss. Materials and Methods: A feasible new method to quantify the Streptococcus mutans (S. mutans) infiltration through the implant-abutment interface gap is introduced in the present work. Internal hexagon (IH; n = 10), external hexagon (EH; n = 10), Morse taper (MT; n = 10), and a control for each group (n = 1) were tested. Bacteria suspension was prepared at 1.5x108 CFU/mL (CFU: colony forming units), and the implants were individually submerged up to the connection level, allowing the bacteria to contact it. The abutment was removed, and bacteria count was performed. Results: The implant sets were tested under normal bacterial growth and early and late biofilm growth conditions. Colony-forming units per mL were obtained, and the results were compared among groups. Differences in bacterial count between the MT and EH (p<0.001) and the MT and IH (p<0.001) groups were significantly higher in the MT-type implant. There was a significant increment of bacterial infiltration in the MTs submitted to late biofilm growth conditions. EH and IH connections are more effective in preventing bacterial infiltration independent of the growth condition. Conclusions: The proposed methodology is feasible to evaluate the infiltration of microorganisms through the implant-abutment interface.

Introducción: La infiltración de microorganismos a través de la interfaz implante-pilar provoca problemas de salud bucal como la periimplantitis, que conduce a la pérdida del implante. Materiales y Métodos: En el presente trabajo se presenta un nuevo método factible para cuantificar la infiltración de Streptococcus mutans (S. mutans) a través de la brecha de la interfaz implante-pilar. Se probaron el hexágono interno (IH; n = 10), el hexágono externo (EH; n = 10), el cono Morse (MT; n = 10) y un control para cada grupo (n = 1). Se preparó una suspensión de bacterias a 1,5x108 UFC/mL y los implantes se sumergieron individualmente hasta el nivel de conexión, permitiendo que las bacterias entraran en contacto con él. Resultados: Se retiró el pilar y se realizó recuento de bacterias. Los conjuntos de implantes se probaron en condiciones de crecimiento bacteriano normal y de crecimiento temprano y tardío de biopelículas. Se obtuvieron unidades formadoras de colonias por ml y los resultados se compararon entre grupos. Las diferencias en el recuento bacteriano entre los grupos MT y EH (p<0,001) y MT e IH (p<0,001) fueron significativamente mayores en el implante tipo MT. Hubo un incremento significativo de la infiltración bacteriana en los MT sometidos a condiciones tardías de crecimiento de biopelículas. Las conexiones EH e IH son más efectivas para prevenir la infiltración bacteriana independientemente de las condiciones de crecimiento. Conclusión: La metodología propuesta es factible para evaluar la infiltración de microorganismos a través de la interfaz implante-pilar.

Maltodextrin as a Drying Adjuvant in the Lyophilization of Tropical Red Fruit Blend.

Guava, pitanga and acerola are known for their vitamin content and high levels of bioactive compounds. Thus, the preparation of combinations of these fruits comprises a blend with high nutraceutical potential, yielding a strong and attractive pigmentation material. In this study, the influence of different proportions of maltodextrin on the lyophilization of a blend of guava, acerola and pitanga was evaluated considering not only the physicochemical, physical and colorimetric parameters but also the bioactive compounds in the obtained powders. The blend was formulated from the mixture and homogenization of the three pulps in a ratio of 1:1:1 (m/m), then maltodextrin was added to the blend, resulting in four formulations: blend without adjuvant (BL0), and the others containing 10% (BL10), 20% (BL20) and 30% (BL30) maltodextrin. The formulations were lyophilized and disintegrated to obtain powders. The powders were characterized in terms of water content, water activity, pH, total titratable acidity, ash, total and reducing sugars, ascorbic acid, total phenolic content, flavonoids, anthocyanins, carotenoids, lycopene, color parameters, Hausner factor, Carr index, angle of repose, solubility, wettability and porosity. All evaluated powders showed high levels of bioactive compounds and the increase in maltodextrin concentration promoted positive effects, such as reductions in water content, water activity and porosity and improved flow, cohesiveness and solubility characteristics.

Tropical Red Fruit Blend Foam Mat Drying: Effect of Combination of Additives and Drying Temperatures.

Foam mat drying is a widely used technique for liquid products because it has a number of advantages; however, for an efficient process, the choice of additives and temperatures is extremely important. The objective of this study was to evaluate the effect of additives and drying temperatures on the powders obtained from the blend of tropical red fruits, such as acerola, guava, and pitanga. The foam formulations were prepared by mixing the pulps of the three fruits in equal proportions (1:1:1), all added with 6% albumin and 1% stabilizing agent: E1, gum Arabic; E2, guar gum; E3, gelatin. The combinations were subjected to beating, and subsequently, they were dried in an oven with forced air circulation at four temperatures (50 to 80 °C), with a mat thickness of 0.5 cm. The obtained powders showed low levels of water and water activity and high levels of bioactive compounds, colors with a predominance of yellow, intermediate cohesiveness, poor fluidity, and solubility above 50%. The best temperature for obtaining the powders was 60 °C. The formulation that produced the best results for the production of the tropical red fruit blend powder was the combination of albumin and gelatin.

DOES PARTIAL MEDIAL KNEE ARTHROPLATIES HAVE BETTER RESULTS THAN TOTAL ONES?

Objective: Compare the results of medial unicompartmental knee arthroplasty (UKA) using a mobile platform and total knee arthroplasty (TKA) in patients with isolated medial osteoarthritis. Methods: Retrospectivecross-sectional study. Preoperative radiographs of 602 patientswho underwent knee arthroplastybetween February 2017 and February 2020 were evaluated. Isolated medial osteoarthritis was found in 125 patients. Of these, 57 underwent UKA and 68 TKA. With chart analysis and telephone interviews, we compared patients' clinical outcomes and degree of satisfaction. The statistical analysis used a confidence level of 5%. Results: The group of UKA patients obtained 65.8% of favorable results against 79.1% of those undergoing TKA in the function questionnaire (p<0.0001). The complication rate was statistically similar between the groups(p>0.5). Most patients were satisfied or very satisfied in both groups (88.6% of UKA and 91.2% of TKA) (p>0.999). Conclusion: Patients submitted to UKA or TKA have presented the same degree of satisfaction and rate of postoperative complications when comparing patients with isolated medial osteoarthritis. UKA patients had less favorable results onthe clinical functional questionnaire than patients undergoing total arthroplasty. Level Of Evidence III;Retrospective Study.

Objetivo: Comparar os resultados da artroplastia unicompartimental do joelho (UKA) medial com plataforma móvel e artroplastia total do joelho (TKA) em pacientes com osteoartrose medial isolada. Métodos: Estudo transversal retrospectivo. Foram avaliadas radiografias pré-operatórias de 602 pacientes submetidos à artroplastia de joelho entre fevereiro de 2017 e fevereiro de 2020. A osteoartrose medial isolada foi encontrada em 125 pacientes, destes em 57 haviam sido submetidos a UKA e 68 TKA. Com análise de prontuários e entrevistas telefônicas comparamos os resultados clínicos e o grau de satisfação dos pacientes. A análise estatística utilizou nível de confiança de 5%. Resultados: O grupo de pacientes com UKA obteve 65,8% de resultados favoráveis contra 79,1% daqueles submetidos à TKA no questionário de função (p<0,0001). A taxa de complicações foi estatisticamente semelhante entre os grupos (p>0,5). A maioria dos pacientes estava satisfeita ou muito satisfeita em ambos os grupos (88,6% de UKA e 91,2% de TKA) (p>0,999). Conclusão: Pacientes submetidos a UKA ou TKA apresentaram o mesmo grau de satisfação e taxa de complicações pós-operatórias quando comparados pacientes com osteoartrite medial isolada. Os pacientes da UKA apresentaram resultados menos favoráveis ao questionário clínico funcional do que os pacientes submetidos à artroplastia total. Nível de Evidência III; Estudo Retrospectivo.

Physicochemical Aspects, Bioactive Compounds, Phenolic Profile and In Vitro Antioxidant Activity of Tropical Red Fruits and Their Blend.

The combination of fruit pulps from different species, in addition to multiplying the offer of flavors, aromas and textures, favors the nutritional spectrum and the diversity of bioactive principles. The objective was to evaluate and compare the physicochemical characteristics, bioactive compounds, profile of phenolic compounds and in vitro antioxidant activity of pulps of three species of tropical red fruits (acerola, guava and pitanga) and of the blend produced from the combination. The pulps showed significant values of bioactive compounds, with emphasis on acerola, which had the highest levels in all parameters, except for lycopene, with the highest content in pitanga pulp. Nineteen phenolic compounds were identified, being phenolic acids, flavanols, anthocyanin and stilbene; of these, eighteen were quantified in acerola, nine in guava, twelve in pitanga and fourteen in the blend. The blend combined positive characteristics conferred by the individual pulps, with low pH favorable for conservation, high levels of total soluble solids and sugars, greater diversity of phenolic compounds and antioxidant activity close to that of acerola pulp. Pearson's correlation between antioxidant activity and ascorbic acid content, total phenolic compounds, flavonoids, anthocyanins and carotenoids for the samples were positive, indicating their use as a source of bioactive compounds.

Smelling Peppers and Pout Submitted to Convective Drying: Mathematical Modeling, Thermodynamic Properties and Proximal Composition.

Pepper (Capsicum spp.) is among the oldest and most cultivated crops on the planet. Its fruits are widely used as natural condiments in the food industry for their color, flavor, and pungency properties. Peppers have abundant production; on the other hand, their fruits are perishable, deteriorating within a few days after harvesting. Therefore, they need adequate conservation methods to increase their useful life. This study aimed to mathematically model the drying kinetics of smelling peppers (Capsicum chinense) and pout peppers (Capsicum chinense Jacq.) to obtain the thermodynamic properties involved in the process and to determine the influence of drying on the proximal composition of these peppers. Whole peppers, containing the seeds, were dried in an oven with forced air circulation, at temperatures of 50, 60, 70, and 80 °C, with an air speed of 1.0 m/s. Ten models were adjusted to the experimental data, but the Midilli model was the one that provided the best values of coefficient of determination and lowest values of the mean squared deviation and chi-square value in most of the temperatures under study. The effective diffusivities were well represented by an Arrhenius equation, appearing in the order of 10-10 m2·s-1 for both materials under study, since the activation energy of the smelling pepper was 31.01 kJ·mol-1 and was 30.11 kJ·mol-1 in the pout pepper, respectively. Thermodynamic properties in both processes of drying the peppers pointed to a non-spontaneous process, with positive values of enthalpy and Gibbs free energy and negative values of entropy. Regarding the influence of drying on the proximal composition, it was observed that, with the increase in temperature, there was a decrease in the water content and the concentration of macronutrients (lipids, proteins, and carbohydrates), providing an increase in the energy value. The powders obtained in the study were presented as an alternative for the technological and industrial use of peppers, favoring obtaining a new condiment, rich in bioactives, providing the market with a new option of powdered product that can be consumed directly and even adopted by the industry as a raw material in the preparation of mixed seasonings and in the formulation of various food products.

Use of Inverse Method to Determine Thermophysical Properties of Minimally Processed Carrots during Chilling under Natural Convection.

The aim of this study was to determine the thermophysical properties and process parameters of cylindrical carrot pieces during their chilling. For this, the temperature of the central point of the product, initially at 19.9 °C, was recorded during chilling under natural convection, with the refrigerator air temperature maintained at 3.5 °C. A solver was created for the two-dimensional analytical solution of the heat conduction equation in cylindrical coordinates. This solver and the experimental data set were coupled to the LS Optimizer (V. 7.2) optimization software to simultaneously determine not only the values of thermal diffusivity (α) and heat transfer coefficient (hH), but also the uncertainties of these values. These values were consistent with those reported in the literature for carrots; in this study, the precision of these values and the confidence level of the results (95.4%) were also presented. Furthermore, the Biot numbers were greater than 0.1 and less than 40, indicating that the mathematical model presented in this study can be used to simultaneously estimate α and hH. A simulation of the chilling kinetics using the values obtained for α and hH showed good agreement with the experimental results, with a root mean square error RMSE = 9.651 × 10-3 and a chi-square χ2 = 4.378 × 10-3.

Optimization of Extraction Method of Anthocyanins from Red Cabbage.

Among the vegetables that stand out for their high concentration of anthocyanins, red cabbage appears as one of the most-used sources of these pigments in food production and it is considered a suitable raw material for the extraction of natural dye. Therefore, the objective was to carry out the production of natural extracts from red cabbage, under different conditions, varying the solvent, type of pre-treatment, pH range, and processing temperature during the concentration of the extracts. The anthocyanins were extracted from red cabbage using the following solvents: distilled water, 25% ethyl alcohol, and 70% ethyl alcohol. The raw material was divided into two groups, the first was subjected to a drying pre-treatment at 70 °C for 1 h and for the second group, the extraction was performed with the raw material in natura. Two pH ranges of 4.0 and 6.0 and extraction temperatures of 25 °C and 75 °C were used in the extracts, resulting in 24 formulations. The extracts obtained were analyzed for colorimetric parameters and anthocyanins. The results of anthocyanins show that the methodology that uses 25% alcohol, pH 4.0, and processing temperature of 25 °C produces a reddish extract and better results in the extraction, presenting average values of 191.37 mg/100 g of anthocyanins, being 74% higher compared to the highest values obtained in the other extracts where the same raw material was used and the solvents differed.

Influence of Dehydration Temperature on Obtaining Chia and Okra Powder Mucilage.

Gum and mucilage from seeds and fruits are objects of study because they have characteristics of high viscosity at low concentrations and gelling properties, which are useful characteristics for modifying the texture and stabilizing products in the food industry. Chia and okra have high concentrations of polysaccharide gums in their composition, which makes them an interesting target for use in the composition of foods that require the use of texture enhancers and stabilizers. The present study investigated the influence of dehydration temperature on the characteristics of chia and okra powder mucilage obtained at different temperatures. The mucilages were extracted using an aqueous process and dehydrated in an air circulation oven at 50, 60, and 70 °C until hydroscopic equilibrium. Then, the powdered chia mucilage (CM) and okra mucilage (OM) were analyzed for chemical and physicochemical characteristics, bioactive compounds, antioxidant activity, and physical properties. It was found that powdered mucilage had low water content and water activity, with CM standing out in terms of ash, pectin, and starch content and OM, along with higher averages of proteins, sugars, total phenolic compounds, anthocyanins, flavonoids, and antioxidant activity. As for the physical parameters, CM stood out in relation to greater solubility and lower hygroscopicity, whereas OM presented higher wettability rates. Both powdered mucilages were classified as having good fluidity and cohesiveness from low to intermediate. In relation to the dehydration temperature, the best mucilage properties were verified at 70 °C. The study revealed that mucilages have good functional properties offering great potential as raw material for industry.

The Temperature Influence on Drying Kinetics and Physico-Chemical Properties of Pomegranate Peels and Seeds.

Pomegranate is a fruit desirable for its nutritional and medicinal properties which has a great industrial potential that is yet under-explored. Notable for its integral use, the peels are used in medicinal infusions and the seeds consumed without restrictions. In this sense, the objective of this work is to determine the drying kinetics of pomegranate peels and seeds in a hot air circulation oven, at temperatures of 50, 60, and 70 °C, adjust mathematical models to experimental data, determine the effective diffusivities and thermodynamic properties of the process and the physicochemical characteristics of peels and seeds of fresh pomegranates and in their flours. Twelve models were used to adjust the drying kinetics, obtaining better results with the Diffusion Approximation model, Verma, and modified Henderson and Pabis. The effective diffusivities were well represented by an Arrhenius equation, with activation energies of 31.39 kJ/mol for seeds and 10.60 kJ/mol for peels. In the drying process, the seeds showed higher values of enthalpy, entropy, and Gibbs free energy concerning peels. Pomegranate peel and seed flours have proximal composition and distinct physicochemical characteristics, with high fiber, carbohydrate, and energy content. In addition, peel flours stand out for their mineral content, and seed flours do for their lipid and protein content.

Does partial medial knee arthroplaties have better results than total ones? / Artroplastias parciais mediais do joelho têm resultados melhores do que as totais?

ABSTRACT Objective Compare the results of medial unicompartmental knee arthroplasty (UKA) using a mobile platform and total knee arthroplasty (TKA) in patients with isolated medial osteoarthritis. Methods Retrospectivecross-sectional study. Preoperative radiographs of 602 patientswho underwent knee arthroplastybetween February 2017 and February 2020 were evaluated. Isolated medial osteoarthritis was found in 125 patients. Of these, 57 underwent UKA and 68 TKA. With chart analysis and telephone interviews, we compared patients' clinical outcomes and degree of satisfaction. The statistical analysis used a confidence level of 5%. Results The group of UKA patients obtained 65.8% of favorable results against 79.1% of those undergoing TKA in the function questionnaire (p<0.0001). The complication rate was statistically similar between the groups(p>0.5). Most patients were satisfied or very satisfied in both groups (88.6% of UKA and 91.2% of TKA) (p>0.999). Conclusion Patients submitted to UKA or TKA have presented the same degree of satisfaction and rate of postoperative complications when comparing patients with isolated medial osteoarthritis. UKA patients had less favorable results onthe clinical functional questionnaire than patients undergoing total arthroplasty. Level Of Evidence III;Retrospective Study.

RESUMO Objetivo Comparar os resultados da artroplastia unicompartimental do joelho (UKA) medial com plataforma móvel e artroplastia total do joelho (TKA) em pacientes com osteoartrose medial isolada. Métodos Estudo transversal retrospectivo. Foram avaliadas radiografias pré-operatórias de 602 pacientes submetidos à artroplastia de joelho entre fevereiro de 2017 e fevereiro de 2020. A osteoartrose medial isolada foi encontrada em 125 pacientes, destes em 57 haviam sido submetidos a UKA e 68 TKA. Com análise de prontuários e entrevistas telefônicas comparamos os resultados clínicos e o grau de satisfação dos pacientes. A análise estatística utilizou nível de confiança de 5%. Resultados O grupo de pacientes com UKA obteve 65,8% de resultados favoráveis contra 79,1% daqueles submetidos à TKA no questionário de função (p<0,0001). A taxa de complicações foi estatisticamente semelhante entre os grupos (p>0,5). A maioria dos pacientes estava satisfeita ou muito satisfeita em ambos os grupos (88,6% de UKA e 91,2% de TKA) (p>0,999). Conclusão Pacientes submetidos a UKA ou TKA apresentaram o mesmo grau de satisfação e taxa de complicações pós-operatórias quando comparados pacientes com osteoartrite medial isolada. Os pacientes da UKA apresentaram resultados menos favoráveis ao questionário clínico funcional do que os pacientes submetidos à artroplastia total. Nível de Evidência III; Estudo Retrospectivo.

Arbuscular mycorrhizal fungi community in soils under desertification and restoration in the Brazilian semiarid.

Soil desertification has a significant social, economic, and environmental impact worldwide. Mycorrhizal diversity remains poorly understood in semiarid regions impacted by desertification, especially in Brazilian drylands. More importantly, positive impacts of grazing exclusion on mycorrhizal communities are still incipient. Here, we hypothesized that overgrazing changes the structure of Arbuscular Mycorrhizal Fungi (AMF) community compared to native areas and, grazing exclusion is effective to restore the AMF community. Thus, we analyzed the status of AMF community in soils under desertification (overgrazing) and restoration (twenty-years of grazing exclusion) in the Brazilian semiarid. AMF-spores were extracted via humid decantation methodology, morphologically classified, and alpha diversity metrics were calculated. Soil samples were chemically, and physically characterized and multivariate statistical analyses were applied to verify the impact of soil degradation and restoration on AMF-community. Briefly, native, and restored areas presented higher contents of organic matter, phosphorus, microbial carbon, and ß-glucosidase activity. However, degraded soil showed higher Al3+, Na+, and bulk soil density values. The abundance of AMF spores was higher in restored soil, followed by degraded and native vegetation, and Shannon's diversity index was significantly higher in restored soils, followed by native vegetation. AMF-spores were classified into four families (Gigasporaceae > Acaulosporaceae > Glomeraceae > Ambisporaceae). Ambisporaceae was closed correlated with degraded soil, mainly with Al3+, Na+, and bulk soil density properties. On the other hand, Acaulosporaceae and Glomeraceae were positively correlated with native vegetation and restored soil, respectively, thereby improving Shannon index, richness, enzyme activity, and soil respiration. Thus, grazing exclusion, in long term, can be a good strategy to restore AMF-diversity in soils in the Brazilian semiarid.

Assessing the carbon stock of cultivated pastures in Rondônia, southwestern Brazilian Amazon.

Cattle ranching is the primary land-use of deforested areas in the Brazilian Amazon. Deforestation precedes pasture establishment, implying tremendous amounts of greenhouse gas emissions caused by carbon stock losses. Despite several studies addressing carbon storage in forests, there is a lack of data regarding cultivated pastures. Hence, the estimation of greenhouse gas emissions associated with land-use change becomes uncertain. In this study, we assessed the carbon stock of cultivated pastures located in Rondônia, southwestern Brazilian Amazon. A total of 50 squared plots of 1 m² were randomly allocated in cattle ranching farms covered by Oxisols (Dystrophic Yellow and Dystrophic Red-Yellow Latosols). Carbon fraction ranged from 0.36 for belowground biomass to 0.45 gC.g-1 d.m. for aboveground biomass. The average total carbon stock was 5.17 MgC.ha-1, with non-significant differences when stratifying data by soil types. Considering data from the III Brazilian Inventory of Anthropogenic Emissions and Removals of Greenhouse Gases, our results suggested that land-use change from primary forests to cultivated pastures resulted in a loss of 192.54 MgC.ha-1, which corresponds to a net emission of 705.98 MgCO2eq.ha-1 to the atmosphere. This study provides valuable information to improve the Brazilian Inventory of Anthropogenic Emissions and Removals of Greenhouse Gases.

Mathematical Models to Describe the Foam Mat Drying Process of Cumbeba Pulp (Tacinga inamoena) and Product Quality.

The present study investigated the mathematical modeling foam-mat drying kinetics of cumbeba pulp and the effect of drying conditions on the color and contents of ascorbic acid, flavonoids, and phenolic compounds of the powder pulps obtained. Foam-mat drying was carried out in a forced air circulation oven at temperatures of 50, 60, and 70 °C, testing foam-mat thicknesses of 0.5, 1.0, and 1.5 cm. The increase in the water removal rate is a result of the increase in air temperature and the decrease in the thickness of the foam layer. Among the empirical and semi-empirical mathematical models, the Midilli model was the one that best represented the drying curves in all conditions evaluated. Effective water diffusivity ranged from 1.037 × 10-9 to 6.103 × 10-9 m2 s-1, with activation energy of 25.212, 33.397, and 36.609 kJ mol-1 for foam thicknesses of 0.5, 1.0, and 1.5 cm, respectively. Cumbeba powders showed light orangish colors and, as the drying temperature increased from 50 to 70 °C, for all thicknesses, the lightness value (L*) decreased and the values of redness (+a*) and yellowness (+b*) increased. Foam-mat drying at higher temperatures (60 and 70 °C) improved the retention of ascorbic acid and flavonoids, but reduced the content of phenolic compounds, while the increase in thickness, especially for flavonoids and phenolic compounds, caused reduction in their contents. The foam-mat drying method allowed obtaining a good-quality cumbeba pulp powder.

CLINICAL RESULTS OF MEDIAL PATELLOFEMORAL LIGAMENT RECONSTRUCTION.

Objective: To assess clinical results of patients who underwent medial patellofemoral ligament (MPFL) reconstruction after a minimum of two years of follow-up. Methods: Patients' medical records were assessed for residual instability, patient satisfaction, and post-operative functional outcomes. Results: Fifty-one patients were analyzed, out of which 56.87% were women. Patients' mean age was 30.8 years (16 to 57 years). The mean follow-up time was 68.7 months (37 to 120 months). Length between first dislocation and surgery was less than 1 year for 58.82% of patients, between 1 and 5 years for 37.25%, and over 5 years for 3.93%. Patients showed a high degree of satisfaction (96.08% would undergo surgery again), with recurrence rate of 11.76%. Twenty-two patients reported knee symptoms, including pain from movements (72.72%), weakness (18.18%), constant pain (13.63%), and crepitus (4.54%). Considering dissatisfied patients, patients with dislocation recurrence, and patients with symptoms, five cannot practice physical activity, out of which only three blame their knee. Conclusion: MPFL reconstruction showed a recurrence rate of 11.7%, with high patient satisfaction, good functional results, and high rate of return to sports, after a minimum of two years of follow-up. Level of Evidence IV, Case Series.

Objetivo: Avaliar o resultado clínico de pacientes submetidos à reconstrução do ligamento patelofemoral medial (LPFM), acompanhados por mínimo de dois anos. Métodos: Avaliação de prontuários para informações sobre instabilidade residual, satisfação do paciente e resultado funcional pós-operatório. Resultados: Foram analisados 51 pacientes. 56,87% do sexo feminino e média etária 30,8 anos (16 a 57). Tempo médio de acompanhamento de 68,7 meses (37 a 120). Intervalo entre primeira luxação e cirurgia foi menos de 1 ano em 58,82%, entre 1 e 5 anos em 37,25% e mais de 5 anos para 3,93%. Os pacientes apresentaram alto grau de satisfação (96,08% fariam a cirurgia novamente), com 11,76% de recidiva. Houve persistência de sintomas em 22 pacientes, sendo dor ao movimento o principal (72,72%), seguido de fraqueza (18,18%), dor constante (13,63%) e crepitações (4,54%). Somando os pacientes insatisfeitos aos que tiveram recidiva da instabilidade e os sintomáticos, 5 não conseguem praticar atividade física, mas apenas 3 por causa do joelho. Conclusão: A reconstrução isolada do LPFM demonstrou índice de recidiva de 11,7%, com alto nível de satisfação dos pacientes, ótimos resultados funcionais e alta taxa de retorno ao esporte, em acompanhamento mínimo de 2 anos. Nível de Evidência IV, Série de Casos.

THE RESULTS OF A COMPARISON OF A BRAZILIAN AND AN IMPORTED KNEE PROSTHESIS - 5 YEARS OF FOLLOW-UP.

Introduction: To compare the functional results, satisfaction rates, and revisions of total knee arthroplasties performed by the same surgical team using either Brazilian or imported implants, with a minimum follow-up of 5 years after surgery. Materials and Methods: A retrospective cohort study analyzing the medical records and interviews of patients who underwent total knee arthroplasty with Brazilian or imported implants with a minimum of 5 years after surgery. Results: One hundred and fifty patients were evaluated (164 knees). In the functional questionnaire, 71% of patients had favorable answers in the group of patients who underwent surgery using the Brazilian prosthesis and 74.8% in the group with imported implants (p=0.634). There was no statistical difference in satisfaction between the groups, with 78.4% of patients satisfied or very satisfied in the Brazilian implant group and 90.7% in the imported implant group (p=0.053). Loosening of the implants was reported in 5.3% versus 4.7% (p>0.999). Conclusion: The total knee arthroplasties performed by the same surgical team with a minimum follow-up period of 5 years showed similar levels of satisfaction, function, and complications with both the Brazilian and imported implants. Level of Evidence III, cohort study.

Introdução: Comparar resultados funcionais, índices de satisfação e revisões de artroplastias totais de joelho realizadas pela mesma equipe cirúrgica usando implantes brasileiros ou importados, com acompanhamento mínimo de cinco anos após a cirurgia. Material e Método: Estudo de coorte retrospectivo com análise de prontuários e entrevistas de pacientes submetidos à artroplastia total do joelho com implantes brasileiros e importados com no mínimo cinco anos de pós-operatório. Resultados: Foram avaliados 150 pacientes (164 joelhos). No questionário funcional, encontramos 71% dos pacientes com respostas favoráveis no grupo de pacientes submetidos à cirurgia com uso de próteses brasileiras e 74,8% no grupo com implantes importados (p = 0,634). Em relação à satisfação, não houve diferença estatística entre os grupos com 78,4% dos pacientes satisfeitos ou muito satisfeitos no grupo com implante brasileiro e 90,7% no grupo com implante importado (p = 0,053). A ocorrência de soltura dos implantes foi relatada em 5,3% versus 4,7% (p > 0,999). Conclusões: As artroplastias totais de joelho realizadas pela mesma equipe cirúrgica com acompanhamento mínimo de cinco anos apresentaram níveis semelhantes de satisfação, função e complicações com os implantes brasileiros e importados. Nível de evidência III, estudo de coorte.

Piper tectoniifolium Kunth: A New Natural Source of the Bioactive Neolignan (-)-Grandisin.

The Piper species are a recognized botanical source of a broad structural diversity of lignans and its derivatives. For the first time, Piper tectoniifolium Kunth is presented as a promising natural source of the bioactive (-)-grandisin. Phytochemical analyses of extracts from its leaves, branches and inflorescences showed the presence of the target compound in large amounts, with leaf extracts found to contain up to 52.78% in its composition. A new HPLC-DAD-UV method was developed and validated to be selective for the identification of (-)-grandisin being sensitive, linear, precise, exact, robust and with a recovery above 90%. The absolute configuration of the molecule was determined by X-ray diffraction. Despite the identification of several enantiomers in plant extracts, the major isolated substance was characterized to be the (-)-grandisin enantiomer. In vascular reactivity tests, it was shown that the grandisin purified from botanical extracts presented an endothelium-dependent vasorelaxant effect with an IC50 of 9.8 ± 1.22 µM and around 80% relaxation at 30 µM. These results suggest that P. tectoniifolium has the potential to serve as a renewable source of grandisin on a large scale and the potential to serve as template for development of new drugs for vascular diseases with emphasis on disorders related to endothelial disfunction.

Clinical results of medial patellofemoral ligament reconstruction / Resultados clínicos da reconstrução do ligamento patelofemoral medial

ABSTRACT Objective: To assess clinical results of patients who underwent medial patellofemoral ligament (MPFL) reconstruction after a minimum of two years of follow-up. Methods: Patients' medical records were assessed for residual instability, patient satisfaction, and post-operative functional outcomes. Results: Fifty-one patients were analyzed, out of which 56.87% were women. Patients' mean age was 30.8 years (16 to 57 years). The mean follow-up time was 68.7 months (37 to 120 months). Length between first dislocation and surgery was less than 1 year for 58.82% of patients, between 1 and 5 years for 37.25%, and over 5 years for 3.93%. Patients showed a high degree of satisfaction (96.08% would undergo surgery again), with recurrence rate of 11.76%. Twenty-two patients reported knee symptoms, including pain from movements (72.72%), weakness (18.18%), constant pain (13.63%), and crepitus (4.54%). Considering dissatisfied patients, patients with dislocation recurrence, and patients with symptoms, five cannot practice physical activity, out of which only three blame their knee. Conclusion: MPFL reconstruction showed a recurrence rate of 11.7%, with high patient satisfaction, good functional results, and high rate of return to sports, after a minimum of two years of follow-up. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar o resultado clínico de pacientes submetidos à reconstrução do ligamento patelofemoral medial (LPFM), acompanhados por mínimo de dois anos. Métodos: Avaliação de prontuários para informações sobre instabilidade residual, satisfação do paciente e resultado funcional pós-operatório. Resultados: Foram analisados 51 pacientes. 56,87% do sexo feminino e média etária 30,8 anos (16 a 57). Tempo médio de acompanhamento de 68,7 meses (37 a 120). Intervalo entre primeira luxação e cirurgia foi menos de 1 ano em 58,82%, entre 1 e 5 anos em 37,25% e mais de 5 anos para 3,93%. Os pacientes apresentaram alto grau de satisfação (96,08% fariam a cirurgia novamente), com 11,76% de recidiva. Houve persistência de sintomas em 22 pacientes, sendo dor ao movimento o principal (72,72%), seguido de fraqueza (18,18%), dor constante (13,63%) e crepitações (4,54%). Somando os pacientes insatisfeitos aos que tiveram recidiva da instabilidade e os sintomáticos, 5 não conseguem praticar atividade física, mas apenas 3 por causa do joelho. Conclusão: A reconstrução isolada do LPFM demonstrou índice de recidiva de 11,7%, com alto nível de satisfação dos pacientes, ótimos resultados funcionais e alta taxa de retorno ao esporte, em acompanhamento mínimo de 2 anos. Nível de Evidência IV, Série de Casos.

The results of a comparison of a brazilian and an imported knee prosthesis - 5 years of follow-up / Os resultados de uma comparação de uma prótese de joelho brasileira e uma importada - cinco anos de acompanhamento

ABSTRACT Introduction To compare the functional results, satisfaction rates, and revisions of total knee arthroplasties performed by the same surgical team using either Brazilian or imported implants, with a minimum follow-up of 5 years after surgery. Materials and Methods A retrospective cohort study analyzing the medical records and interviews of patients who underwent total knee arthroplasty with Brazilian or imported implants with a minimum of 5 years after surgery. Results One hundred and fifty patients were evaluated (164 knees). In the functional questionnaire, 71% of patients had favorable answers in the group of patients who underwent surgery using the Brazilian prosthesis and 74.8% in the group with imported implants (p=0.634). There was no statistical difference in satisfaction between the groups, with 78.4% of patients satisfied or very satisfied in the Brazilian implant group and 90.7% in the imported implant group (p=0.053). Loosening of the implants was reported in 5.3% versus 4.7% (p>0.999). Conclusion The total knee arthroplasties performed by the same surgical team with a minimum follow-up period of 5 years showed similar levels of satisfaction, function, and complications with both the Brazilian and imported implants. Level of Evidence III, cohort study.

RESUMO Introdução Comparar resultados funcionais, índices de satisfação e revisões de artroplastias totais de joelho realizadas pela mesma equipe cirúrgica usando implantes brasileiros ou importados, com acompanhamento mínimo de cinco anos após a cirurgia. Material e Método Estudo de coorte retrospectivo com análise de prontuários e entrevistas de pacientes submetidos à artroplastia total do joelho com implantes brasileiros e importados com no mínimo cinco anos de pós-operatório. Resultados Foram avaliados 150 pacientes (164 joelhos). No questionário funcional, encontramos 71% dos pacientes com respostas favoráveis no grupo de pacientes submetidos à cirurgia com uso de próteses brasileiras e 74,8% no grupo com implantes importados (p = 0,634). Em relação à satisfação, não houve diferença estatística entre os grupos com 78,4% dos pacientes satisfeitos ou muito satisfeitos no grupo com implante brasileiro e 90,7% no grupo com implante importado (p = 0,053). A ocorrência de soltura dos implantes foi relatada em 5,3% versus 4,7% (p > 0,999). Conclusões As artroplastias totais de joelho realizadas pela mesma equipe cirúrgica com acompanhamento mínimo de cinco anos apresentaram níveis semelhantes de satisfação, função e complicações com os implantes brasileiros e importados. Nível de evidência III, estudo de coorte.

INTRAARTICULAR EPSILON AMINOCAPROIC ACID VERSUS TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY.

OBJECTIVE: To examine and compare the clinical efficacy of intraarticular epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) in total knee arthroplasty (TKA). METHODS: This study was a prospective, single-center, double-blinded randomized controlled trial, including sixty patients with osteoarthritis of the knee divided into two groups of 30 patients. In the TXA group, 1 g of TXA (0.05 g/ml) was applied intraarticularly, and in the EACA group, 4 g of EACA (0.2 g/ml) was applied intraarticularly. Serum hemoglobin (Hgb) and hematocrit (Htb) were measured during the preoperatively and 24 and 48 hours postoperatively. The range of motion and pain were evaluated by clinical examination. To evaluate knee function before and 2 months after surgery, the Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used. RESULTS: In total, 56 (93.3%) patients were evaluated up to the second postoperative month. No significant difference between the groups (p > 0.05) was found in the decrease in Hgb or Htb at 24 or 48 hours. Regarding assessment of the pain, WOMAC score and gain in knee flexion, no significant advantages up to 60 days after surgery (p > 0.05) were found. CONCLUSIONS: The decrease in Hgb and Htb during the first 48 hours postoperatively and the risk of transfusion were similar with the intraarticular use of 1 g of TXA and 4 g of EACA in TKA. The possible benefits regarding knee pain, gain in flexion and function were also similar for the two drugs. Level of Evidence II, Randomized, Double-Blinded, Single-Centre, Prospective Clinical Trial.

OBJETIVO: Avaliar e comparar a eficácia clinica do uso intra-articular do ácido épsilon aminocaproico (AEAC) versus o ácido tranexâmico (ATX) na prótese total do joelho. MÉTODOS: Estudo clínico prospectivo, centro-único, duplo-cego e randomizado. Sessenta pacientes com osteoartrose de joelho foram incluídos. Os participantes foram divididos em dois grupos de 30 pacientes. No grupo ATX, foi aplicado 1 g de ATX (0.05 g/ml) intra-articular e, no grupo AEAC, foram aplicados 4 g de AEAC (0.2 g/ml) intra-articular. Valores séricos da hemoglobina (Hb) e hemtatócrito (Ht) foram dosados no pré-operatório e com 24 e 48 horas após a cirurgia. A amplitude de movimento e a dor também foram avaliadas no exame clínico. O índice WOMAC foi utilizado para avaliar a função do joelho antes e após dois meses da cirurgia. RESULTADOS: Foram avaliados 56 (93.3%) pacientes até o segundo mês pós-operatório. Depois da cirurgia, não houve diferenças entre os grupos (p > 0.05) na queda do valor de Hb e Ht com 24 ou 48 horas. Com relação à avaliação da dor, WOMAC e ganho de flexão do joelho, não houve vantagem significativa para nenhum dos grupos até os 60 dias depois da cirurgia(p > 0.05). CONCLUSÃO: A queda do valor da Hb e do Ht durante as primeiras 48 horas pós-operatórias e o risco de transfusão foram similares com o uso intra-articular de 1 g de ATX e 4 g de AEAC na artroplastia total do joelho. Os possíveis benefícios com relação ao controle da dor, ganho de flexão e função foram similares entre as duas drogas. Nível de Evidência II, Ensaio-Clínico Prospectivo, Randomizado, Duplo Cego, Centro-Único.