CRYPTOCHROME 1a-mediated blue light perception regulates tomato seed germination via changes in hormonal balance and endosperm-degrading hydrolase dynamics.

MAIN CONCLUSION: Blue light exposure delays tomato seed germination by decreasing endosperm-degrading hydrolase activities, a process regulated by CRY1a-dependent signaling and the hormonal balance between ABA and GA. The germination of tomato seeds (Solanum lycopersicum L.) is tightly controlled by an internal hormonal balance, which is also influenced by environmental factors such as light. In this study, we investigated the blue light (BL)-mediated impacts on physiological, biochemical, and molecular processes during the germination of the blue light photoreceptor CRYPTOCHROME 1a loss-of-function mutant (cry1a) and of the hormonal tomato mutants notabilis (not, deficient in ABA) and procera (pro, displaying a GA-constitutive response). Seeds were germinated in a controlled chamber in the dark and under different intensities of continuous BL (ranging from 1 to 25 µmol m-2 s-1). In general, exposure to BL delayed tomato seed germination in a fluency rate-dependent way due to negative impacts on the activities of endosperm-degrading hydrolases, such as endo-ß-mannanase, ß-mannosidase, and α-galactosidase. However, not and pro mutants presented higher germination speed index (GSI) compared to WT despite the BL influence, associated with higher hydrolase activities, especially evident in pro, indicating that the ABA/GA hormonal balance is important to diminish BL inhibition over tomato germination. The cry1a germination percentage was higher than in WT in the dark but its GSI was lower under BL exposure, suggesting that functional CRY1a is required for BL-dependent germination. BL inhibits the expression of GA-biosynthetic genes, and induces GA-deactivating and ABA-biosynthetic genes. The magnitude of the BL influence over the hormone-related transcriptional profile is also dependent upon CRY1a, highlighting the complex interplay between light and hormonal pathways. These results contribute to a better understanding of BL-induced events behind the photoregulation of tomato seed germination.

Silicon mitigates the negative impacts of salt stress in soybean plants.

BACKGROUND: Soybean is widely cultivated around the world, including regions with salinity conditions. Salt stress impairs plant physiology and growth, but recent evidence suggests that silicon (Si) is able to mitigate this stressful condition. Therefore, the purpose of this study was to evaluate how different strategies of Si application impact on salt stress tolerance of an intermediate Si accumulator species (soybean). Therefore, we applied four treatments: Si-untreated plants (Si 0); foliar spraying at 20 mmol L-1 (Si F); nutritive solution addition at 2.0 mol L-1 (Si R), and combined foliar spraying at 20 mmol L-1 plus nutritive solution at 2.0 mmol L-1 (Si F + R). We investigated how Si application modified growth, leaf gas exchange, photosynthetic pigments, chlorophyll fluorescence, relative water content (RWC), nutrient accumulation, and ion homeostasis of soybean plants submitted to different levels of salt stress (50 and 100 mmol L-1 NaCl). RESULTS: Salinity induced an expressive reduction in ion accumulation, plant water status, and growth of soybean, while Si application promoted contrary effects and increased potassium (K+ ) accumulation, water status, photosynthetic pigment content, chlorophyll fluorescence parameters, and gas exchange attributes. Additionally, Si application enhanced Si accumulation associated with decreased Na+ uptake and improved morpho-physiological growth. CONCLUSION: The use of exogenous Si can be an efficient strategy to attenuate the harmful effects of salt stress in soybean plants. The best application strategy was observed with combined foliar spraying with Si included in the nutritive solution (Si F + R). © 2023 Society of Chemical Industry.

Cryptochrome 1a depends on blue light fluence rate to mediate osmotic stress responses in tomato.

The participation of plant cryptochromes in water deficit response mechanisms has been highlighted in several reports. However, the role of tomato (Solanum lycopersicum L.) cryptochrome 1a (cry1a) in the blue light fluence-dependent modulation of the water deficit response remains largely elusive. The tomato cry1a mutant and its wild-type counterpart were grown in water (no stress) or PEG6000 (osmotic stress) treatments under white light (60 µmol m-2 s-1) or from low to high blue light fluence (1, 5, 10, 15 and 25 µmol m-2 s-1). We first demonstrate that under nonstress conditions cry1a regulates seedling growth by mechanisms that involve pigmentation, lipid peroxidation and osmoprotectant accumulation in a blue light-dependent manner. In addition, we further highlighted under osmotic stress conditions that cry1a increased tomato growth by reduced malondialdehyde (MDA) and proline accumulation. Although blue light is an environmental signal that influences osmotic stress responses mediated by tomato cry1a, specific blue light fluence rates are required during these responses. Here, we show that CRY1a manipulation may be a potential biotechnological target to develop a drought-tolerant tomato variety. Nevertheless, the complete understanding of this phenomenon requires further investigation.

Cryptochrome 1a of tomato mediates long-distance signaling of soil water deficit.

Although the blue light photoreceptors cryptochromes mediate the expression of genes related to reactive oxygen species, whether cryptochrome 1a (cry1a) regulates local and long-distance signaling of water deficit in tomato (Solanum lycopersicum L.) is unknown. Thus the cry1a tomato mutant and its wild-type (WT) were reciprocally grafted (WT/WT; cry1a/cry1a; WT/cry1a; cry1a/WT; as scion/rootstock) or grown on their own roots (WT and cry1a) under irrigated and water deficit conditions. Plant growth, pigmentation, oxidative stress, water relations, stomatal characteristics and leaf gas exchange were measured. WT and cry1a plants grew similarly under irrigated conditions, whereas cry1a plants had less root biomass and length and higher tissue malondialdehyde concentrations under water deficit. Despite greater oxidative stress, cry1a maintained chlorophyll and carotenoid concentrations in drying soil. Lower stomatal density of cry1a likely increased its leaf relative water content (RWC). In grafted plants, scion genotype largely determined shoot and root biomass accumulation irrespective of water deficit. In chimeric plants grown in drying soil, cry1a rootstocks increased RWC while WT rootstocks maintained photosynthesis of cry1a scions. Manipulating tomato CRY1a may enhance plant drought tolerance by altering leaf pigmentation and gas exchange during soil drying via local and long-distance effects.

Evapotranspiration and crop coefficients of Italian zucchini cultivated with recycled paper as mulch.

Recycled paper has the potential to be used as a mulch for vegetable production and can be adopted for the cultivation of Italian zucchini. However, there have been no studies about the water savings or crop coefficient values used in irrigation management in this system; therefore, there is a need for more research. In view of the above, this study aimed to evaluate the effects of recycled paper mulch on evaporation and evapotranspiration in Italian zucchini and to determine the crop coefficients in its developmental stages. The study was carried out in two cultivation cycles conducted at the Lysimetric Station in Viçosa, MG, Brazil. The experiments were installed in a randomized block design with four replicates. Four lysimeter cultivation treatments were applied: without mulch (C); with recycled paper as mulch (CP); with only recycled paper (P); and with Bahia grass (G). Irrigation and drainage measurements were performed daily to calculate the crop and reference evapotranspiration, and thus the crop coefficient (Kc) values. The following characteristics were evaluated: fruit yield, NDVI and water productivity. For the cultivation of Italian zucchini using paper as mulch, Kc values of 0.54, 0.77 and 0.44 and Kcb values of 0.15, 0.45 and 0.18 are recommended for the initial, intermediate and final stages, respectively. NDVI can be used to estimate the Kc values for Italian zucchini. The use of recycled paper as mulch reduces the water consumption of Italian zucchini.

Mechanisms of cadmium-stress avoidance by selenium in tomato plants.

Cadmium (Cd) is probably the most damaging metal to plant species; with a long biological half-life, it can be taken up by plants, disrupting the cell homeostasis and triggering several metabolic pathways. Selenium (Se) improves plant defence systems against stressful conditions, but the biochemical antioxidant responses to Cd stress in tomato plants is poorly understood. To further address the relationship of Cd-stress responses with Se mineral uptake, Cd and Se concentration, proline content, MDA and H2O2 production, and the activity of SOD, APX, CAT and GR enzymes were analyzed in Micro-Tom (MT) plants submitted to 0.5 mM Cd. The results revealed different responses according to Se combination and Cd application. For instance, roots and leaves of MT plants treated with Se exhibited an increase in dry mass and nutritional status, exhibited lower proline content and higher APX and GR activities when compared with plants with no Se application. Plants submitted to 0.5 mM Cd, irrespective of Se exposure, exhibited lower proline, MDA and H2O2 content and higher SOD, CAT and GR activities. Selenium may improve tolerance against Cd, which allowed MT plants exhibited less oxidative damage to the cell, even under elevated Cd accumulation in their tissues. The results suggest that Se application is an efficient management technique to alleviate the deleterious effects of Cd-stress, enhancing the nutritional value and activity of ROS-scavenging enzymes in tomato plants.

Impacts of warming and water deficit on antioxidant responses in Panicum maximum Jacq.

Agricultural activities are affected by many biotic and abiotic stresses associated with global climate change. Predicting the response of plants to abiotic stress under future climate scenarios requires an understanding of plant biochemical performance in simulated stress conditions. In this study, the antioxidant response of Panicum maximum Jacq. cv. Mombaça exposed to warming (+2°C above ambient temperature) (eT), water deficit (wS) and the combination eT + wS was analysed under field conditions using a temperature free-air-controlled enhancement facility. Warming was applied during the entire growth period. Data were collected at 13, 19 and 37 days after the start of the water deficit treatment (DAT) and at two sampling times (6:00 and 12:00 h). A significant decrease in chlorophyll was observed under the wS treatment, but an increment in total chlorophyll was observed in eT + wS, particularly at 19 DAT. Significant increase in H2 O2 content, malondialdehyde and protein oxidation was observed in the wS treatment at noon of the third sampling. In the combined wS + eT stress treatment, the activity of the enzymatic antioxidant system increased, particularly of superoxide dismutase (SOD; EC 1.15.1.1) and ascorbate peroxidase (APX; EC 1.11.1.11). The chlorophyll fluorescence images showed that the photochemical performance was not significantly affected by the treatments. In conclusion, under simulated future warming and water stress conditions, the photosystem II (PSII) activity of P. maximum acclimated to moderate warming and a water-stressed environment associated with a relatively favourable antioxidant response, particularly in the activity of APX and SOD.

Exposure to low concentration of fluoxetine affects development, behaviour and acetylcholinesterase activity of zebrafish embryos.

Fluoxetine (FLX) is a selective serotonin reuptake inhibitor (SSRI) antidepressant widely used in clinics and very often found in environmental samples of urban aquatic ecosystems in concentrations ranging from ng/L to µg/L. Fish populations might be especially susceptible to FLX due to the presence of conserved cellular receptors of serotonin. Neurotoxic effects on fish biota of polluted water bodies may be expected, but there are no sufficient studies in the current literature to elucidate this hypothesis. Batteries of embryo larval assays with zebrafish were performed to evaluate the potential effects of FLX exposure, including environmentally relevant concentrations. Evaluated parameters included survival, development, behaviour and neuronal biochemical markers. Regarding acute toxicity, a 168 h-LC50 value of 1.18 mg/L was obtained. Moreover, hatching delay and loss of equilibrium were observed, but at a concentration level much higher than FLX measured environmental concentrations (>100 µg/L). On the other hand, effects on locomotor and acetylcholinesterase activity (≥0.88 and 6 µg/L, respectively) were found at levels close to the maximum reported FLX concentration in surface waters. Altogether, these results suggest that FLX is neurotoxic to early life stages of zebrafish, in a short period of time causing changes in important ecological attributes which can probably be linked from molecular to population level.

Tomographic analysis of subaxial cervical vertebrae in children between 0 and 12 years / Análise tomográfica das vértebras cervicais subaxiais em crianças de 0 a 12 anos / Análisis tomográfica de vertebras cervicales subaxiales en niños de 0 a 12 años

ABSTRACT Objective: Tomographic and anatomic analysis of cervical vertebrae in children from 0 to 12 years of age to verify the possibility of utilization of lateral mass screws. Methods: Twenty-five cervical spine tomographies of children between 0 and 12 years of age, admitted to the emergency room of Hospital das Clínicas of São Paulo were retrospectively analyzed. The following distances were measured: width and length of the lateral masses in the axial section; width and height in the coronal section; height, length and diagonal diameter in the sagittal section. The variables studied were correlated with age and sex and submitted to statistical analysis. Results: The analysis of tomographic measurements of 20 patients showed a correlation between age and dimensions of the lateral mass, which were higher after 6 years of age. In relation to sex, greater measures were observed in males in all axes. With regard to the passage of the screws, we only had 22 masses (11%) that prevented their use. However, when stratified by age, we noticed that no patients had restrictions on the use of the lateral mass screw after the age of 6. Conclusion: This study analyzed the measurements of 200 lateral masses, making it possible to infer that there is an increase of dimensions with age and in males. Through the data, it was possible to affirm that in this sample, considering the implants available in the market, the lateral mass screws could be used in 89% of the lateral masses.

RESUMO Objetivo: Análise tomográfica e anatômica das vértebras cervicais em crianças de zero a doze anos de idade para verificar a possibilidade de passagem de parafuso de massa lateral. Métodos: Foram analisadas retrospectivamente 25 tomografias de coluna cervical de crianças entre 0 e 12 anos de idade, admitidas no pronto socorro do Hospital das Clínicas de São Paulo. Foram aferidas as seguintes medidas: largura e comprimento das massas laterais no corte axial; largura e altura no corte coronal; altura, comprimento e diâmetro diagonal no corte sagital. As variáveis estudadas foram correlacionadas com a idade e o sexo dos indivíduos e submetidas a análise estatística. Resultados: Por meio da análise de medidas tomográficas de 20 pacientes, foi verificada a correlação entre idade e dimensões das massas laterais, sendo estas maiores a partir dos 6 anos. Já em relação ao sexo, foram verificadas medidas maiores no sexo masculino em todos os eixos. Com relação à passagem dos parafusos, tivemos apenas 22 massas (11%) com impossibilidade de uso. Porém, quando estratificados pela idade, notamos não haver pacientes com impedimento para uso do parafuso de massa lateral após os 6 anos. Conclusão: O estudo analisou as medidas de 200 massas laterais, possibilitando inferir que existe aumento das suas dimensões com a idade e no sexo masculino. Através dos dados, foi possível afirmar que nesta amostra, considerando-se os implantes disponíveis no mercado, o parafuso de massa lateral poderia ser utilizado em 89% das massas laterais.

RESUMEN Objetivo: Análisis tomográfico y anatómico de las vértebras cervicales en niños de hasta doce años de edad, para comprobar la posibilidad de pasaje de tornillos de masa lateral. Métodos: Se analizaron retrospectivamente 25 tomografías computarizadas de la columna cervical de niños entre 0 y 12 años de edad, ingresados en el servicio de urgencias del Hospital das Clínicas de São Paulo. Se tomaron las siguientes medidas: anchura y longitud de las masas laterales en corte axial; anchura y altura del corte coronal; altura, longitud y diámetro diagonal en el corte sagital. Las variables se correlacionaron con la edad y el sexo de los individuos y se sometieron a análisis estadístico. Resultados: Mediante el análisis de las mediciones tomográficas de 20 pacientes, se observó la correlación entre la edad y las dimensiones de las masas laterales, que son más grandes a partir de los 6 años de edad. En relación con el sexo, se observaron medidas más altas en los hombres en todos los ejes. En cuanto al paso de los tornillos, encontramos sólo 22 masas (11%) que impidieron su uso. Sin embargo, cuando se estratificó por edad, observamos que no había ningún impedimento para el uso de tornillo de masa lateral después de 6 años de edad. Conclusión: El estudio examinó las medidas de 200 masas laterales, por lo que es posible inferir que hay un aumento de tamaño con la edad y en el sexo masculino. De estos datos, fue posible afirmar que en esta muestra, teniendo en cuenta los implantes disponibles en el mercado, el tornillo de masa lateral podría ser utilizado en el 89% de las masas laterales.

Computed tomography morphometric analysis of the vertebrae C7 and T1 / Análise morfométrica por tomografia computadorizada das vértebras C7 e T1 / Análisis morfométrico mediante tomografía computarizada de las vértebras C7 y T1

ABSTRACT Objective: The anatomical study of the vertebrae C7 and T1 of the cervicothoracic junction aimed to evaluate quantitatively, by axial computerized tomography (CT), the linear and angular dimensions of the anatomical laminae of the vertebrae of the cervicothoracic junction C7 and T1 in adults over 18 years. Methods: We retrospectively analyzed 49 CT of the cervical and thoracic spine (C7 and T1) of individuals over 18 years, of both sexes. We also evaluated the length and thickness of the laminae, as well as spinolaminar angle in axial sections of C7 and T1 at the point of least thickness between the inner cortical layers. The variables were correlated with age groups and sex of the individuals. Statistical analysis was performed using the t test and the results were considered significant when p<0.05. Results: After analyzing tomographic measurements of 49 patients, it was found that men had greater laminae thickness than women, both in C7 and T1, with 71% of C7 laminae and 92% of T1 laminae thicker than 5mm, and 97% of C7 laminae and 100% of T1 thicker than 4mm. The mean spinolaminar angle was 56.40 degrees in C7 and 57.31 degrees in T1. Conclusion: This study brings important anatomical information about the cervicothoracic junction C7 and T1 in the Brazilian population, showing that fixation of C7 and T1 with intralaminar screws is anatomically possible.

RESUMO Objetivo: O estudo anatômico das vértebras da transição cervicotorácica C7 e T1 teve como objetivo avaliar quantitativamente, por tomografia computadorizada axial (TC), as dimensões anatômicas lineares e angulares de lâminas das vértebras da transição cervicotorácica C7 e T1 em indivíduos adultos maiores de 18 anos. Métodos: Foram analisadas retrospectivamente 49 TC da coluna cervical e torácica (C7 e T1) de indivíduos maiores de 18 anos, de ambos os sexos. Avaliaram-se o comprimento e a espessura das lâminas, bem como o ângulo espinolaminar, em cortes axiais de C7 e T1, no ponto de menor espessura entre as camadas corticais internas. As variáveis estudadas foram correlacionadas com os grupos etários e o sexo dos indivíduos. A análise estatística foi feita pelo teste t e os resultados foram considerados significativos quando p < 0,05. Resultados: Após análise de medidas tomográficas de 49 pacientes, foi verificado que os homens apresentaram espessura de lâmina maior que as mulheres tanto em C7, quanto em T1, sendo que 71% das lâminas de C7 e 92% das lâminas de T1 apresentavam espessura maior que 5 mm e 97% das lâminas de C7 e 100% de T1, espessura maior que 4 mm. O ângulo espinolaminar apresentou média de 56,40 graus em C7 e 57,31 graus em T1. Conclusão: O estudo traz informações anatômicas importantes sobre a região da transição cervicotorácica C7 e T1 na população brasileira, mostrando ser possível anatomicamente, fixação de C7 e T1 com parafuso intralaminar.

RESUMEN Objetivo: El estudio anatómico de las vértebras de la unión cervicotorácica C7 y T1 tuvo el objetivo de evaluar cuantitativamente mediante tomografía axial computarizada (TAC), las dimensiones anatómicas lineales y angulares de láminas de las vértebras de la unión cervicotorácica C7 y T1 en adultos mayores de 18 años. Métodos: Se analizaron retrospectivamente 49 TAC de la columna cervical y torácica (C7 y T1) de pacientes mayores de 18 años de ambos sexos. Se evaluaron la longitud y el espesor de las láminas, así como el ángulo espinolaminar en secciones axiales de C7 y T1 en el punto de menor espesor entre las capas corticales internas. Las variables se correlacionaron con los grupos de edad y sexo de los individuos. El análisis estadístico se realizó mediante la prueba t y los resultados se consideraron significativos cuando p < 0,05. Resultados: Después del análisis de las mediciones tomográficas de 49 pacientes, se encontró que los hombres tenían espesor de la lámina mayor que las mujeres, tanto en C7, como en T1, con el 71% de las láminas C7 y el 92% de las láminas T1 con espesor mayor que 5 mm, 97% de C7 y 100% de T1, mayor que 4 mm de espesor. El ángulo espinolaminar promedio fue 56,40 grados en C7 y 57,31 grados en T1. Conclusión: Este estudio contiene información anatómica importante sobre la región de la unión cervicotorácica C7 y T1 en la población brasileña, mostrando que es anatómicamente posible la fijación de C7 y T1 con tornillos intralaminares.

Aspectos mediadores e desencadeadores da síndrome de burnout nos enfermeiros / Aspectos de mediadores y factores desencadenantes del síndrome de burnout en enfermeras / Mediators and triggers aspects of burnout syndrome in nurses

Introdução: Síndrome de Burnout, ou do esgotamento profissional, é um distúrbio psíquico caracterizado por estado de tensão emocional eestresse crônico. O enfermeiro hospitalar é suscetível ao Burnout. Objetivo: Abordar a gênese dos aspectos mediadores e desencadeadoresda síndrome de Burnout em enfermeiros. Material e Método: Estudo de revisão, qualitativo, baseado em dados da literatura científicapublicados no período de 1999 a 2011. Resultado: O conceito de Burnout envolve o desgaste emocional ou exaustão, a despersonalizaçãoou cinismo e diminuição da realização pessoal no trabalho. Dados científicos revelam que as características pessoais, de trabalho e asorganizacionais influenciam no desenvolvimento da síndrome. A personalidade, estratégias de coping e características do trabalho comoclima organizacional, têm-se demonstrado como mediadoras ou desencadeadoras para o surgimento desse distúrbio em enfermeiros. Ocoping centrado no problema e a personalidade hardiness são características pessoais mediadoras de Burnout nos enfermeiros, enquantoque o baixo clima organizacional desencadeia o processo. Conclusão: A síndrome de Burnout...

Introduction: Burnout syndrome, or professional burnout, is a psychic disorder characterized by a condition of emotional tension andchronic stress. The hospital nurse is susceptible to burnout. Objective: To approach the genesis of mediators and triggers aspects ofburnout syndrome in nurses. Methods: It is a review qualitative study, based on data from scientific literature published from 1999 to2011. Result: The concept of Burnout involves emotional stress or exhaustion, depersonalization or cynicism and personal accomplishmentreduction at work. Scientific data show that the personal, working and organizational characteristics influence the development of thesyndrome. Personality, coping strategies and job characteristics like organizational climate, have been shown to mediate or to triggerthe onset of this disorder in nurses. The coping focused on the problem and the hardiness personality are individual characteristics thatmediate burnout in nurses at the same time that bad organizational climate triggers the process. Conclusion: The Burnout syndrome isrelated to work environment...

Introducción: Burnout o síndrome de desgaste, es um trastorno mental que se caracteriza por el estado de estrés emocional y elestrés crónico. La enfermeira del hospital es susceptible al desgaste. Objetivo: Conocer la génesis de mediadores aspectos y factoresdesencadenantes del síndrome de Burnout en enfermeras. Métodos: Um estudio de revisión, cualitativa, basado en datos de literaturacientífica publicada entre 1999 a 2011. Resultado: El concepto de Burnout implica estrés emocional o agotamiento, despersonalizacióno cinismo y baja realización personal en el trabajo. Los datos científicos muestran que las características personales, del trabajo yde la influencia de la organización desarrollan el síndrome. La personalidad, las estrategias y las características del trabajo y el climaorganizacional de afrontamiento, se ha demostrado mediar o desencadenar la aparición de este transtorno en las enfermeras. El copingcentrado en el problema y la personalidad hardiness son características personales mediadoras de burnout en enfermeras, asi como elbajo clima organizacional desencadena el proceso. Conclusión...

Tomographic analysis of T-1 vertebra to insert laminar screws in children from 0 to 12 years / Análise tomográfica da vértebra T-1 para passagem de parafusos laminares em crianças de 0 a 12 anos / Análisis tomográfico de la vértebra T-1 para pasar tornillos laminares en niños de 0 a 12 años

Objective : Tomographic analysis of the T1 vertebra in children from 0 to 12 years of age, in order to obtain anatomical parameters that assist intralaminar fixation in this pediatric population. Methods : Retrospectively analysis of the spine with CT (cervical and thoracic) of individuals aged between 0 and 12 years old, of both sexes, without anatomical deformities. The CT scans were evaluated separately, on each side, for length and thickness of the laminas as well as spinolaminar angle. The morphometric analysis was performed with iSite PACS Philips Healthcare Informatics(r) program and the values were expressed in millimeters (mm). The variables were correlated with age groups and sex of individuals. Statistical analysis was performed using t test and the results were considered significant when p<0.05. Results : By means of tomographic analysis of 24 patients it was found that age has no correlation with the angle of attack for intralaminar screws T1. However, the length and thickness of the T1 lamina increase proportionally with age. The total average length of the laminas was 28.62 ± 4.42 mm. The total average thickness was 4.75 ± 0.95 mm (3.2 to 6.5). Conclusion : This study shows relevant data on the use of Tran laminar screws currently commercially available with a minimum thickness of 3.5 mm. It is thus possible to say in this sample, they can be used in 87.5% of all laminas, being applicable in all lamina in patients older than 44 months of age.

Objetivo : Análise tomográfica da vértebra T1 em crianças de zero a doze anos de idade, obtendo parâmetros anatômicos que auxiliarão a fixação intralaminar nessa população infantil. Métodos : Análise retrospectiva da coluna por TC (cervical e torácica) de indivíduos entre 0 e 12 anos de idade, de ambos os sexos, sem deformidades anatômicas. Foram avaliados, separadamente, em cada lado, o comprimento e a espessura das lâminas, bem como o ângulo espino-laminar. A análise morfométrica foi realizada com o programa iSite PACS Philips Healthcare Informatics(r) e os valores obtidos foram expressos em milímetros (mm). As variáveis estudadas foram correlacionadas com os grupos etários e o sexo dos indivíduos. A análise estatística foi feita pelo teste t e os resultados foram considerados significativos quando p < 0,05. Resultados : Por meio de análises tomográficas de 24 pacientes, verificou-se que a idade não tem correlação com o ângulo de ataque para parafusos intralaminares de T1. Já o comprimento e a espessura da lâmina de T1 aumentam proporcionalmente com a idade. O comprimento médio total das lâminas foi de 28,62 ± 4,42 mm. A média total da espessura 4,75 ± 0,95 mm (3,2 a 6,5). Conclusão : O presente estudo mostra dados relevantes sobre a utilização de parafusos translaminares, que atualmente são disponíveis comercialmente com espessura mínima de 3,5 mm. É possível, assim, afirmar que, nesta amostra, pode ser utilizado em 87,5% do total de lâminas, sendo aplicável em todas as lâminas nos pacientes acima de 44 meses de idade.

Objetivo : Análisis tomográfico de la vértebra T1 en niños de cero a doce años de edad, para obtener parámetros anatómicos que ayudarán la fijación con tornillos intralaminares en esta población infantil. Métodos : Análisis retrospectivo de la columna por TAC (cervical y torácica) de individuos entre 0 y 12 años de edad, de ambos sexos, sin deformidades anatómicas. Se evaluaron por separado, en cada lado, la longitud y el grosor de las láminas, así como el ángulo espinolaminar. El análisis morfométrico se realizó con el programa iSite PACS Philips Healthcare Informatics(r) y los valores se expresaron en milímetros (mm). Las variables se correlacionaron con los grupos de edad y sexo de los individuos. Se realizó un análisis estadístico mediante la prueba t y los resultados se consideraron significativos cuando p < 0,05. Resultados : Por medio de análisis tomográficos de 24 pacientes, se encontró que la edad no se correlaciona con el ángulo de ataque para tornillos intralaminares T1. Sin embargo, la longitud y el grosor de la lámina T1 aumentan proporcionalmente con la edad. La longitud promedio total de las láminas fue 28,62 ± 4,42 mm. El espesor promedio total fue 4,75 ± 0,95 mm (3,2 a 6,5). Conclusión : Este estudio muestra datos relevantes sobre el uso de tornillos translaminares que actualmente están disponibles en el mercado con un espesor mínimo de 3,5 mm. Por tanto, es posible afirmar que, en esta muestra, se puede utilizarlos en el 87,5% de todas las láminas siendo aplicable en todas las láminas de pacientes mayores de 44 meses de edad.

Subaxial cervical fracture: application and correlation of ao and SLIC / Fratura cervical subaxial: aplicação e correlação das classificações ao e SLIC / Fractura subaxial cervical: aplicación y correlación de las clasificaciones ao y SLIC

OBJECTIVE: To evaluate the AO/Magerl classification and the SLIC (Subaxial Cervical Spine Injury Classification), used in the cervical spine fractures and assess whether they are correlated to the neurological severity of patients, the choice of approach to be used, de duration of surgery an between themselves. METHOD: Retrospective analysis of medical records and radiological image files of 77 patients surgically treated of subaxial cervical fracture or dislocation from August 2010 to September 2012. RESULTS: The SLIC classification showed a strong correlation with neurological deficit and Pearson correlation value of -0.600. The AO classification was not correlated with the Frankel scale and the value of Pearson was 0.06 with a statistical significance of 0.682 (p<0.05), that is, unable to determine or suggest the severity of the deficit. When compared to each other the two classifications showed statistical correlation and the value of Pearson was 0.282 with a significance value of 0.022 (p<0.05). CONCLUSION: Among the most used classifications, the SLIC has been able to statistically define the need for surgical treatment and the severity of the neurological status, but was unable to predict the approach or the time of the surgery; the classification AO failed to predict the severity of neurological injury, surgical time, and did not help to choose the approach, just being a morphological classification.

OBJETIVO: Avaliar as classificações AO-Magerl e SLIC (Subaxial Cervical Spine Injury Classification) utilizadas em fraturas da coluna cervical e avaliar se elas apresentam correlações com a gravidade neurológica dos pacientes, com a escolha da via de acesso, a duração do ato cirúrgico e entre si mesmas. MÉTODOS: Análise retrospectiva do prontuário e acervo de imagens radiológicas dos 77 pacientes submetidos à cirurgia de fratura e ou luxação da coluna cervical subaxial, no período de agosto de 2010 a setembro de 2012. RESULTADOS: A classificação SLIC apresentou forte correlação com déficit neurológico, com valor de correlação de Pearson de -0,600. Já a classificação AO não apresentou correlação com a escala de Frankel, e o valor de Pearson foi de 0,06 com significância estatística de 0,682 (p < 0,05), ou seja, incapaz de determinar ou sugerir a gravidade do déficit. Quando comparadas entre si as duas classificações apresentaram correlação estatística e o valor de Pearson foi de 0,282 com valor de significância de 0,022 (p < 0,05). CONCLUSÃO: Entre as classificações mais utilizadas, a classificação SLIC foi estatisticamente capaz de definir necessidade de tratamento cirúrgico e a gravidade do estado neurológico, porém foi incapaz de predizer a via de acesso ou o tempo de duração da cirurgia; a classificação AO falhou em predizer a gravidade da lesão neurológica, o tempo cirúrgico e em auxiliar a escolha da via de acesso, sendo apenas uma classificação morfológica.

OBJETIVO: Evaluar las clasificaciones AO/Magerl y SLIC (Subaxial Cervical Spine Injury Classification) utilizadas en las fracturas de la columna cervical y evaluar si tienen correlación con la gravedad neurológica de los pacientes, la elección de la vía de acceso, la duración de la cirugía y si están correlacionados entre sí. MÉTODO: Análisis retrospectivo de registros médicos y colección de imágenes radiológicas de 77 pacientes tratados quirúrgicamente de fractura o dislocación de la columna cervical subaxial, desde agosto 2010 a septiembre 2012. RESULTADOS: La clasificación SLIC mostró una fuerte correlación con déficit neurológico y el valor de correlación de Pearson de -0,600. La clasificación AO no se correlacionó con la escala de Frankel y el valor de Pearson fue 0,06, con una significación estadística de 0,682 (p < 0,05), es decir, incapaz de determinar o sugerir la gravedad del déficit. Cuando se compararon entre sí, las dos clasificaciones mostraron correlación estadística y el valor de Pearson fue de 0,282, con valor de significación de 0,022 (p < 0,05). CONCLUSIÓN: Entre las clasificaciones más utilizadas, la calificación SLIC ha sido capaz de definir estadísticamente la necesidad de tratamiento quirúrgico y la gravedad del estado neurológico, pero fue incapaz de predecir la vía de acceso o la duración de la cirugía; la clasificación AO no logró predecir la gravedad de la lesión neurológica, el tiempo quirúrgico ni auxilió a elegir la vía de acceso, siendo sólo una clasificación morfológica.

Controlled medial branch anesthetic block in the diagnosis of chronic lumbar facet joint pain: the value of a three-month follow-up.

OBJECTIVES: To verify the incidence of facetary and low back pain after a controlled medial branch anesthetic block in a three-month follow-up and to verify the correlation between the positive results and the demographic variables. METHODS: Patients with chronic lumbar pain underwent a sham blockade (with a saline injection) and then a controlled medial branch block. Their symptoms were evaluated before and after the sham injection and after the real controlled medial branch block; the symptoms were reevaluated after one day and one week, as well as after one, two and three months using the visual analog scale. We searched for an association between the positive results and the demographic characteristics of the patients. RESULTS: A total of 104 controlled medial branch blocks were performed and 54 patients (52%) demonstrated >50% improvements in pain after the blockade. After three months, lumbar pain returned in only 18 individuals, with visual analogue scale scores >4. Therefore, these patients were diagnosed with chronic facet low back pain. The three-months of follow-up after the controlled medial branch block excluded 36 patients (67%) with false positive results. The results of the controlled medial branch block were not correlated to sex, age, pain duration or work disability but were correlated with patient age (p<0.05). CONCLUSION: Patient diagnosis with a controlled medial branch block proved to be effective but was not associated with any demographic variables. A three-month follow-up is required to avoid a high number of false positives.

Controlled medial branch anesthetic block in the diagnosis of chronic lumbar facet joint pain: the value of a three-month follow-up

OBJECTIVES: To verify the incidence of facetary and low back pain after a controlled medial branch anesthetic block in a three-month follow-up and to verify the correlation between the positive results and the demographic variables. METHODS: Patients with chronic lumbar pain underwent a sham blockade (with a saline injection) and then a controlled medial branch block. Their symptoms were evaluated before and after the sham injection and after the real controlled medial branch block; the symptoms were reevaluated after one day and one week, as well as after one, two and three months using the visual analog scale. We searched for an association between the positive results and the demographic characteristics of the patients. RESULTS: A total of 104 controlled medial branch blocks were performed and 54 patients (52%) demonstrated >50% improvements in pain after the blockade. After three months, lumbar pain returned in only 18 individuals, with visual analogue scale scores >4. Therefore, these patients were diagnosed with chronic facet low back pain. The three-months of follow-up after the controlled medial branch block excluded 36 patients (67%) with false positive results. The results of the controlled medial branch block were not correlated to sex, age, pain duration or work disability but were correlated with patient age (p<0.05). CONCLUSION: Patient diagnosis with a controlled medial branch block proved to be effective but was not associated with any demographic variables. A three-month follow-up is required to avoid a high number of false positives. .

Functional assessment of patients with cervical myelopathy who underwent surgical treatment / Avaliação funcional de pacientes com mielopatia cervical submetidos a tratamento cirúrgico / Evaluación funcional de los pacientes con mielopatía cervical sometidos a tratamiento quirúrgico

OBJECTIVE: Evaluate and correlate the functional response of patients with cervical myelopathy with the current clinical scores in patients who underwent surgical treatment. METHODS: We analyzed medical records of 34 patients with cervical myelopathy who underwent four different types of surgery. All patients were evaluated preoperatively and postoperatively with the application of the JOA and Nurick questionnaires. RESULTS: Functional clinical improvement was statistically significant. The mean preoperative JOA was 8.5 ± 3.06 and 10.7 ± 3.9 in the postoperative; Nurick was 3.2 ± 1.1 preoperatively and 2.8 ± 1.3 postoperatively. CONCLUSION: There is benefit with the surgical procedure in patients with cervical myelopathy. The neurological function after surgery depends on the previous function (the higher the duration of the previous symptoms, the greater the progression of the disease and, therefore, worse the neurological function) and the age is not a relevant factor of improvement, as already shown in other series. The clinical functional improvement of patients is visible with surgical treatment, regardless of surgical technique. .

OBJETIVO: Avaliar e correlacionar a resposta funcional dos pacientes com mielopatia cervical com os escores clínicos já existentes, em pacientes que foram submetidos ao tratamento cirúrgico. MÉTODOS: Trabalho retrospectivo com análise de 34 prontuários de pacientes portadores de mielopatia cervical que foram submetidos a quatro diferentes tipos de cirurgia. Todos os pacientes foram avaliados no pré e pós-operatório com a aplicação dos questionários de JOA e Nurick. RESULTADOS: A melhora clínica funcional foi estatisticamente relevante. O JOA pré-operatório médio foi de 8,5 ± 3,06 para 10,7 ± 3,9, no pós-operatório e o Nurick foi 3,2 ± 1,1 no pré-operatório e de 2,8 ± 1,3 no pós-operatório. CONCLUSÃO: Há benefício com a realização do tratamento cirúrgico em pacientes com mielopatia cervical, a função neurológica pós-operatória depende da função prévia (quanto maior o tempo de sintomas, maior progressão e, com isso pior a função neurológica) e a idade dos pacientes não é fator relevante de melhora, como já mostrado em outras séries. A melhora funcional clínica dos pacientes, é visível com o tratamento cirúrgico, independente da técnica cirúrgica aplicada. .

OBJETIVO: Evaluar y correlacionar la respuesta funcional de los pacientes con mielopatía cervical con las puntuaciones clínicas vigentes en pacientes sometidos a tratamiento quirúrgico. MÉTODOS: Se analizaron los registros médicos de 34 pacientes con mielopatía cervical que se sometieron a cuatro diferentes tipos de cirugía. Todos los pacientes fueron evaluados antes y después de la cirugía con la aplicación de los cuestionarios JOA y Nurick. RESULTADOS: La mejoría clínica funcional fue estadísticamente significativa. El JOA preoperatorio promedio fue de 8,5 ± 3,06 y 10,7 ± 3,9 en el postoperatorio. El Nurick antes de la operación fue 3,2 ± 1,1 y 2,8 ± 1,3 después de la operación. CONCLUSIÓN: Existe beneficio con el tratamiento quirúrgico en pacientes con mielopatía cervical. La función neurológica después de la cirugía depende de la función previa (cuanto mayor sea la duración de los síntomas anteriores, mayor será la progresión de la enfermedad y, por lo tanto, peor es la función neurológica) y la edad no es un factor relevante de la mejora, como ya se ha demostrado en otras series. La mejora clínica funcional de los pacientes es visible con el tratamiento quirúrgico, independientemente de la técnica quirúrgica y esto está directamente relacionado con su condición antes de la cirugía. .

Fractures of the cervical spine.

OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

Fractures of the cervical spine

OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. .

Correlação tomográfica da técnica de magerl para artrodese C1-C2 na artrite reumatoide / Tomographic correlation of the magerl technique for C1-C2 arthrodesis in rheumatoid arthritis

Objetivo: Utilizar a análise tomográfica das vértebras C1 e C2 para avaliar a possibilidade do emprego da técnica de Magerl nestes pacientes. Outros objetivos foram obter dados anatômicos para a escolha da técnica cirúrgica de modo geral, estabelecer parâmetros de segurança e obter dados epidemiológicos da população em questão. Métodos: Foram analisados, retrospectivamente, tomografias de 20 pacientes com artrite reumatoide do ambulatório do Grupo de Coluna do IOT-HCFMUSP. Os dados foram analisados estatisticamente para obtenção dos valores médios e da variação de cada medida: do comprimento do pedículo de C2 até a massa lateral de C1, da espessura do pedículo e do ângulo de ataque do parafuso no istmo de C2 com a horizontal. Resultados: Os valores médios encontrados foram respectivamente: lado direito 23,08 mm e esquerdo 23,16 mm; direito 6,46 mm e esquerdo 6,50 mm; direito 44,50O e esquerdo 44,95O. Discussão: os principais fabricantes de parafusos dispõe de implantes compatíveis com as medidas anatômicas encontradas neste trabalho. Considerando a ampla difusão e domínio da técnica de Magerl em nosso meio e no mundo todo, esta é uma opção cirúrgica segura e mecanicamente estável. Conclusão: A técnica de Magerl, segundo análise tomográfica, pode ser empregada nos pacientes com artrite reumatoide. Nível de Evidência IV. Série de Casos.

Objective: To use the tomographic analysis of C1 and C2 vertebrae to assess the possibility of using Magerl’s technique in patients with rheumatoid arthritis. Other objectives were to obtain anatomical data for the choice of the surgical technique in general, to establish safety parameters and obtain epidemiological data of the population in question. Methods: We retrospectively reviewed the CT scans of 20 patients with rheumatoid arthritis of the Outpatient Spine Group, IOT-HCFMUSP. Data were analyzed statistically to obtain the mean values and the variance of each measurement: the length of the C2 pedicle to the C1 lateral mass, the thickness of the pedicle and the angle of attack of the screw in the isthmus of C2 to the horizontal. Results: The mean values were, respectively: right 23.08 mm and left 23.16 mm, right 6.46 mm and left 6.50 mm, right 44.50O and left 44.95O. Discussion: The leading screw’s manufacturers have implants compatible with the anatomical measurements found in this work. Considering the wide diffusion and mastery of Magerl’s technique in our country and around the world, this is a safe surgical option that provides mechanical stability. Conclusion: Magerl’s technique, according to tomographic analysis, can be used in patients with rheumatoid arthritis. Levels of Evidence IV,Case Series.

Tomographic correlation of the Magerl technique for C1-C2 arthrodesis in rheumatoid arthritis.

OBJECTIVE: To use the tomographic analysis of C1 and C2 vertebrae to assess the possibility of using Magerl's technique in patients with rheumatoid arthritis. Other objectives were to obtain anatomical data for the choice of the surgical technique in general, to establish safety parameters and obtain epidemiological data of the population in question. METHODS: We retrospectively reviewed the CT scans of 20 patients with rheumatoid arthritis of the Outpatient Spine Group, IOT-HCFMUSP. Data were analyzed statistically to obtain the mean values and the variance of each measurement: the length of the C2 pedicle to the C1 lateral mass, the thickness of the pedicle and the angle of attack of the screw in the isthmus of C2 to the horizontal. RESULTS: THE MEAN VALUES WERE, RESPECTIVELY: right 23.08 mm and left 23.16 mm, right 6.46 mm and left 6.50 mm, right 44.50(o) and left 44.95(o). DISCUSSION: The leading screw's manufacturers have implants compatible with the anatomical measurements found in this work. Considering the wide diffusion and mastery of Magerl's technique in our country and around the world, this is a safe surgical option that provides mechanical stability. CONCLUSION: Magerl's technique, according to tomographic analysis, can be used in patients with rheumatoid arthritis. Levels of Evidence IV,Case Series.