Effect of strength, aerobic, and concurrent training on the memory of cognitively preserved older adults: a randomized clinical trial protocol

Objectives: To verify the effect of strength, aerobic, and concurrent training on the memory of cognitively preserved older adults. Methods: A randomized controlled clinical trial will be conducted. Sedentary older adults (aged 60 to 75 years) of both genders will participate. Outcome measures will include blood biomarkers, cognitive tests, depressive symptoms, socioeconomic data, and physical assessments. Participants will be randomized into the following groups: strength training, aerobic training, concurrent training, or control. Interventions will be conducted for 12 weeks, with adherence to training sessions monitored. Pre-training values will be compared between groups using a one-way ANOVA test. Training effects will be evaluated through two-way ANOVA (time × group). The research protocol was registered in The Brazilian Registry of Clinical Trials (ReBEC) (RBR-655vxdd). Expected results: We believe that concurrent training may yield greater efficacy in improving memory outcomes, combining the benefit of both training modalities. Relevance: Considering the increase in population aging and that few studies have evaluated the chronic effect of physical exercise on the memory of cognitively preserved older adults, this is a relevant topic, since much of the literature has focused on investigating older adults with some cognitive decline. Furthermore, our aim is to provide an alternative training option by combining the benefits of aerobic and strength training, thereby optimizing time and enhancing both physical capacity and memory. (AU)

Effects of traditional concurrent training and multicomponent training composed by strength training and dance classes on functional and cognitive capacity of older adults: a study protocol / Efeitos do treinamento combinado tradicional e do treinamento multicomponente composto por treinamento de força e aulas de dança na capacidade funcional e cognitiva de idosos: protocolo de estudo

The combination of strength and aerobic training (concurrent training - TG) has been a widely used intervention for improving health outcomes. Also, dance has been well described as a great aerobic activity and can be an interesting option to compose an alternative multicomponent training pro-gram. Therefore, the aim of the present protocol study is to describe the methods that will be used in a randomized controlled trial (RCT) design to identify and compare the impacts of traditional TG composed by strength and aerobic training and a multicomponent training consisting of strength training combined with dance classes (DG) on functional and cognitive capacity and quality of life of older people. The sample of RCT will consist of men and women aged between 60 and 75 years. Both interventions will occur twice a week for 12 weeks with progressive intensity and volume. Functional capacity will be assessed by gait, balance, sitting and standing and climbing tests. Strength will be assessed through one repetition maximum test (1RM) in knee extension exercise, and handgrip using a hand dynamometer. Muscle thickness will be assessed using quadriceps ultrasound. Muscle power will be assessed in the knee extension exercise at 30 and 70% of 1RM using an encoder. Aerobic capacity will be assessed using the 6-minute walk test. Quality of life and cognitive performance will be assessed by questionnaires. Comparisons between groups over time will be carried out using Generalized Estimating Equations with a significance level of p<0.01. This protocol follows the rec-ommendations of SPIRIT-2013.

A combinação de treinamento de força e aeróbico (treinamento combinado - TC) tem sido uma interven-ção amplamente utilizada para melhorar desfechos de saúde. Além disso, a dança tem sido bem descrita na literatura como uma ótima atividade aeróbica e pode ser uma opção interessante para compor um programa alternativo de treinamento multicomponente. Portanto, o objetivo do presente protocolo de estudo é descrever os métodos que serão utilizados em um ensaio clínico randomizado (ECR) que visa identificar e comparar os impactos do TC tradicional composto por treinamento de força e aeróbico e de um treinamento multi-componente composto por treinamento de força combinado com aulas de dança sobre capacidade funcional, cognitiva e qualidade de vida de idosos. A amostra do ECR será composta por homens e mulheres com idade entre 60 e 75 anos. Ambas as intervenções ocorrerão duas vezes por semana durante 12 semanas com intensidade e volume progressivos. A capacidade funcional será avaliada por meio de testes de marcha, equilíbrio, sentar e levantar e subir escadas. A força será avaliada por meio do teste de uma repetição máxima (1RM) no exercício de extensão de joelhos e por meio do teste de preensão palmar com o dinamômetro manual. A espessura muscular será avaliada por meio de ultrassonografia do quadríceps. A potência muscular será ava-liada no exercício de extensão de joelhos a 30 e 70% de 1RM por meio de um transdutor linear de posição. A capacidade aeróbica será avaliada por meio do teste de caminhada de 6 minutos. A qualidade de vida e o desempenho cognitivo serão avaliados por meio de questionários. As comparações entre os grupos ao longo do tempo serão realizadas por meio de Equações de Estimativas Generalizadas com nível de significância p<0,01. Este protocolo segue as recomendações do SPIRIT-2013.

Chronic Effects of Different Intensities of Power Training on Neuromuscular Parameters in Older People: A Systematic Review with Meta-analysis.

BACKGROUND: Power training (PT) has been shown to be an effective method for improving muscle function, including maximal strength, measured by one-repetition maximum (1RM), and power output in older adults. However, it is not clear how PT intensity, expressed as a percentage of 1RM, affects the magnitude of these changes. The aim of this systematic review (International prospective register of systematic reviews-PROSPERO-registration: CRD42022369874) was to summarize the evidence from randomized clinical trials (RCT) assessing the effects of low-intensity (≤ 49% of 1RM) and moderate-intensity (50-69% of 1RM) versus high-intensity (≥ 70% of 1RM) PT on maximal power output and maximal strength in older adults. METHODS: We included RCTs that examined the effects of different intensities of power training on maximum strength and power output in older people. The search was performed using PubMed, LILACS, Embase, and Scopus. Methodological quality was assessed using the preferred reporting items for systematic reviews and meta-analyses (PRISMA 2020 statement checklist), and the quality of evidence was determined using the PEDro scale. Data were analyzed using standardized mean differences (SMD) with a 95% confidence interval (CI), and random effects models were used for calculations. A significance level of p ≤ 0.05 was accepted. RESULTS: Three RCTs assessing 179 participants, all of high methodological quality, were included. There were no significant differences between different PT intensities in terms of power output gains for leg press [SMD = 0.130 (95% CI - 0.19, 0.45), p = 0.425] and knee extension exercises [SMD: 0.016 (95% CI - 0.362, 0.395), p = 0.932], as well as leg press 1RM increases [SMD: 0.296 (95% CI - 0.03, 0.62); p = 0.072]. However, high-intensity PT (70-80% of 1RM) was significantly more effective than low-intensity PT in increasing 1RM for knee extension exercise [SMD: 0.523 (95% CI 0.14, 1.91), p = 0.008]. CONCLUSIONS: PT performed at low-to-moderate intensities induces similar power gains compared to high-intensity PT (70-80% of 1RM) in older adults. Nonetheless, the influence of PT intensity on lower-limb strength gains seems to be dependent on the assessed exercise. Cautious interpretation is warranted considering the inclusion of only three studies.

Strategy to avoid vascular injuries in revision total hip arthroplasty with intrapelvic implants.

AIMS: Our objective was describing an algorithm to identify and prevent vascular injury in patients with intrapelvic components. METHODS: Patients were defined as at risk to vascular injuries when components or cement migrated 5 mm or more beyond the ilioischial line in any of the pelvic incidences (anteroposterior and Judet view). In those patients, a serial investigation was initiated by a CT angiography, followed by a vascular surgeon evaluation. The investigation proceeded if necessary. The main goal was to assure a safe tissue plane between the hardware and the vessels. RESULTS: In ten at-risk patients undergoing revision hip arthroplasty and submitted to our algorithm, six were recognized as being high risk to vascular injury during surgery. In those six high-risk patients, a preventive preoperative stent was implanted before the orthopaedic procedure. Four patients needed a second reinforcing stent to protect and to maintain the vessel anatomy deformed by the intrapelvic implants. CONCLUSION: The evaluation algorithm was useful to avoid blood vessels injury during revision total hip arthroplasty in high-risk patients.Cite this article: Bone Jt Open 2022;3(11):859-866.

Dance as an Intervention to Reduce Fall Risk in Older Adults: A Systematic Review With a Meta-Analysis.

The purpose of this study was to summarize the evidence from randomized clinical trials on the effects of dance on fall risk in older adults through a systematic review with meta-analysis. Fall risk was assessed through timed up and go, Berg Balance Scale, or one-leg stand tests. Data are presented as mean differences for timed up and go test and standardized mean differences for Berg Balance Scale and one-leg stand tests between treatments with 95% confidence intervals, and calculations were performed using random effects models. Significance was accepted when p < .05. A significant difference was found between dance interventions and the control groups in the general analysis of fall risk assessed by timed up and go (mean differences: -1.446 s; 95% confidence interval [-1.586, -1.306]; p < .001) and Berg Balance Scale and one-leg stand tests (standardized mean differences: 0.737; 95% confidence interval [0.508, 0.966]; p < .001) in favor of the intervention group. Different dance interventions decreased the fall risk in older practitioners.

First assessment of hoary fox (Lycalopex vetulus) seasonal ovarian cyclicity by non-invasive hormonal monitoring technique.

Reproduction is key to species survival, and reproductive physiology represents a high priority investigative area for conservation biology, as it provides a basic understanding of critical life-history traits, information that is helpful for the establishment of management strategies. Here, we generated knowledge about the reproductive endocrinology of the hoary fox (Lycalopex vetulus), a small canid (2.5-4 kg) endemic to open areas of the Brazilian Cerrado and listed in the Brazilian National List of Endangered species. Specifically, we utilized non-invasive hormone monitoring methods to assess oestrogen and progestagen metabolites from eight female hoary foxes housed in five zoological institutions in the state of São Paulo-Brazil. We observed the elevations of oestrogen and progestagen metabolites between July and September in six of the eight females. No significant evidence of ovarian activity was observed during other months. Two females, who shared the same enclosure, did not show a pattern of reproductive cyclicity. Based on these characteristics, we concluded that captive hoary foxes are seasonal monoestric, with the beginning of the oestrus cycle occurring mainly in July followed by 2 months of the luteal phase when conception does not occur. We suggest the dosage of faecal metabolites of estradiol and progesterone could be used to differentiate the reproductive period from a non-reproductive period in Lycalopex vetulus females, providing relevant information about their reproductive biology that may contribute to species conservation and management strategies, such as increased ex situ reproductive success.

Testicular volume and semen characteristics in the endangered southern muriqui (Brachyteles arachnoides).

BACKGROUND: The southern muriqui (Brachyteles arachnoides) is an endangered Neotropical primate. Semen collection and description of its traits, as well as testicular morphometry, have never been reported for this species. METHODS: Testicles from five healthy adult captive southern muriqui were measured, and semen was collected by rectal probe electrostimulation (RPE). RESULTS AND CONCLUSIONS: A solid coagulum was identified in all ejaculates, and none of them liquefied, spontaneously or non-spontaneously. It was possible to collect semen using RPE, and although solids coagula did not liquefy, we managed to describe ejaculates characteristics and also confirmed that southern muriqui have relatively large testes size. Further investigations are needed to improve coagulum handling, to achieve a better spermatozoa recovery aiming its application in assisted reproductive technologies.

Comparison of semen characteristics and sperm cryopreservation in common marmoset (Callithrix jacchus) and black-tufted-ear marmoset (Callithrix penicillata).

BACKGROUND: The common marmoset (Callithrix jacchus) is one of the most studied Neotropical primates regarding reproduction. However, little has been reported on the black-tufted-ear marmoset (Callithrix penicillata), which may produce fertile hybrids with other Callithrix. This is the first study to evaluate sperm freezing from black-tufted-ear marmoset. METHODS: Testicles from all animals were measured, and semen was collected by penile vibrostimulation. Samples were analyzed after collection, after chilling and addition of glycerol, and after thawing. RESULTS AND CONCLUSIONS: Fresh semen from both species was similar in many aspects. Additionally, there is a relationship between total motility, plasma membrane integrity, and acrosome integrity observed in sperm samples from both species. We managed to evaluate fresh and thawed sperm with suitable methods for use under zoo or field conditions. However, TEST egg yolk with glycerol at 4% and 6% concentration was not effective for sperm protection in both species during cryopreservation.

Is there a relationship between the neutrophil/lymphocyte ratio and bilaterality in patients with coxarthrosis? / Existe relação entre a razão neutrófilo/linfócito e a bilateralidade para artrose de quadril?

ABSTRACT Objective: The objective of this study was to evaluate the relationship between the neutrophil/lymphocyte ratio and the presence of signs of arthrosis in both hips in patients followed at this medical center. Methods: This was a cross-sectional, retrospective study through the analysis of medical records and database review of patients over 18 years of age with hip arthrosis, followed at the outpatient clinic of this hospital. Results: Regarding the analysis of the Mann-Whitney test to correlate the neutrophil/lymphocyte ratio and laterality, a bi-lateral test result of p = 0.036 was obtained, thus demonstrating a significant difference between the observed groups. When we analyzed the absolute values of neutrophils and lymphocytes, the authors obtained results of p = 0.14 and p = 0.24. Therefore, it was not possible to observe statistically significant differences between the absolute values in the two groups. Conclusion: Considering the interactions between the inflammatory mechanisms in osteoarthritis and the fact that the interaction between neutrophils and lymphocytes has differences in relation to the laterality of the coxarthrosis, it is hypothesized that the inflammatory etiology of unilateral and bilateral osteoarthritis could have different dynamics. However, more in-depth studies with flow cytometry are needed to assess the possible impact of these differences in the inflammatory mechanisms observed in this study.

RESUMO Objetivo: Avaliar a relação entre a razão neutrófilo/linfócito e a presença de sinais de artrose em ambos os quadris em pacientes acompanhados neste serviço. Métodos: Estudo transversal, retrospectivo, que usou análise de prontuários e revisão de banco de dados de pacientes maiores de 18 anos com diagnóstico de artrose de quadril acompanhados no ambulatório deste hospital. Resultado: Com relação à análise do teste de Mann-Whitney para correlacionar a razão neutrófilo/linfócito e a lateralidade, observou-se um resultado de teste bilateral de 0,036, evidenciou desse modo a diferença entre os grupos. Quando os valores absolutos de neutrófilos e linfócitos foram analisados, observaram-se p = 0,14 e p = 0,24, não foi possível observar diferenças estatisticamente significativas entre os valores absolutos nos dois grupos. Conclusões: Considerando-se as interações entre os mecanismos inflamatórios na osteoartrose e o fato de que a interação entre os neutrófilos e os linfócitos tem diferenças com relação à lateralidade da coxartrose, é possível levantar a hipótese de que a etiologia inflamatória da osteoartrose unilateral e da bilateral tem dinâmicas diferentes. Entretanto, são necessários estudos mais aprofundados, com citometria de fluxo, para avaliar o impacto com relação às diferenças nos mecanismos inflamatórios observados nesse estudo.

Avaliação de impacto à saúde da incidência de dengue associada à pluviosidade no município de Ribeirão Preto, São Paulo / Health impact assessment of the incidence of dengue associated with precipitation in the city of Ribeirão Preto, São Paulo

Resumo Introdução A dengue é considerada um problema de saúde pública. O município de Ribeirão Preto possui condições climáticas e geográficas favoráveis à proliferação do Aedes aegypti , sendo reportadas altas taxas de incidência de dengue. Objetivo Avaliar a relação entre a precipitação pluviométrica e a incidência de casos confirmados de dengue. Método Foi utilizado o coeficiente de correlação de Spearman para a análise da relação entre a pluviosidade e a incidência de dengue. Resultados Encontrou-se associação entre a precipitação e os casos de dengue, com p < 0,01, considerando um intervalo de defasagem (time lag ) que ocorre a partir do primeiro mês e se estende até o quinto mês. Conclusão Estudos como este contribuem para o conhecimento sobre a influência de fatores climáticos na incidência e na dinâmica de transmissão da dengue, sendo essenciais para auxiliar os gestores na tomada de decisão para a prevenção e o controle da doença.

Abstract Background Dengue is considered a public health problem. The municipality of Ribeirão Preto has climatic and geographical conditions conducive to the proliferation of Aedes aegypti and high rates of dengue incidence are reported. Objective To evaluate the relationship between rainfall and the incidence of confirmed cases of dengue. Method The Spearman Correlation Coefficient was used to analyze the relationship between rainfall and the dengue incidence. Results An association between precipitation and dengue cases was found, with p < 0.01, considering a time lag, which occurs from the first month until the fifth month. Conclusion Studies such as this contribute to the knowledge about the influence of climatic factors on the incidence and transmission dynamics of dengue fever, being essential to guide managers in decision making for disease prevention and control.

Is there a relationship between the neutrophil/lymphocyte ratio and bilaterality in patients with coxarthrosis?

OBJECTIVE: The objective of this study was to evaluate the relationship between the neutrophil/lymphocyte ratio and the presence of signs of arthrosis in both hips in patients followed at this medical center. METHODS: This was a cross-sectional, retrospective study through the analysis of medical records and database review of patients over 18 years of age with hip arthrosis, followed at the outpatient clinic of this hospital. RESULTS: Regarding the analysis of the Mann-Whitney test to correlate the neutrophil/lymphocyte ratio and laterality, a bi-lateral test result of p = 0.036 was obtained, thus demonstrating a significant difference between the observed groups. When we analyzed the absolute values of neutrophils and lymphocytes, the authors obtained results of p = 0.14 and p = 0.24. Therefore, it was not possible to observe statistically significant differences between the absolute values in the two groups. CONCLUSION: Considering the interactions between the inflammatory mechanisms in osteoarthritis and the fact that the interaction between neutrophils and lymphocytes has differences in relation to the laterality of the coxarthrosis, it is hypothesized that the inflammatory etiology of unilateral and bilateral osteoarthritis could have different dynamics. However, more in-depth studies with flow cytometry are needed to assess the possible impact of these differences in the inflammatory mechanisms observed in this study.

OBJETIVO: Avaliar a relação entre a razão neutrófilo/linfócito e a presença de sinais de artrose em ambos os quadris em pacientes acompanhados neste serviço. MÉTODOS: Estudo transversal, retrospectivo, que usou análise de prontuários e revisão de banco de dados de pacientes maiores de 18 anos com diagnóstico de artrose de quadril acompanhados no ambulatório deste hospital. RESULTADO: Com relação à análise do teste de Mann-Whitney para correlacionar a razão neutrófilo/linfócito e a lateralidade, observou-se um resultado de teste bilateral de 0,036, evidenciou desse modo a diferença entre os grupos. Quando os valores absolutos de neutrófilos e linfócitos foram analisados, observaram-se p = 0,14 e p = 0,24, não foi possível observar diferenças estatisticamente significativas entre os valores absolutos nos dois grupos. CONCLUSÕES: Considerando-se as interações entre os mecanismos inflamatórios na osteoartrose e o fato de que a interação entre os neutrófilos e os linfócitos tem diferenças com relação à lateralidade da coxartrose, é possível levantar a hipótese de que a etiologia inflamatória da osteoartrose unilateral e da bilateral tem dinâmicas diferentes. Entretanto, são necessários estudos mais aprofundados, com citometria de fluxo, para avaliar o impacto com relação às diferenças nos mecanismos inflamatórios observados nesse estudo.

Seroprevalence and risk factors for Neospora caninum infection in cattle from the eastern Antioquia, Colombia.

Bovine neosporosis is a parasitic disease with worldwide distribution that causes important economic losses. Because of the limited information on the occurrence of Neospora caninum infection in Colombia, this study aimed to determine the seroprevalence and identify the risk factors associated with this infection in cattle in Antioquia, which is the largest milk-producing state in the country. We collected 1,038 blood samples from Holstein, Jersey and crossbred cows from 31 farms. An epidemiologic questionnaire was given to all the owners. A commercial ELISA kit was used as the diagnostic technique. The occurrence of anti-N. caninum antibodies was determined to be 28.3% (294/1038), and 100% of the screened farms were positive, indicating that all the properties had at least one positive animal. The seropositivity within each farm ranged from 5.5% to 50%. A multivariable logistic regression model identified the following as significant risk factors: history of abortion (OR = 5.33, p < 0.001), replacement with cattle purchased outside the farm (OR = 1.54, p < 0.05), age (OR = 1.7, p < 0.01) and poor hygienic practices associated with manual milking (OR = 1.69, p < 0.01). The latter two factors suggest that horizontal transmission is an important route of infection. This study is the first to report the seroprevalence of and risk factors for N. caninum infection in Antioquia and allows us to conclude that N. caninum is widely distributed in this region.

Total hip arthroplasty: a still evolving technique.

It has been advocated that total hip arthroplasty (THA) is probably the most successful surgical intervention performed in Medicine. In the 1960s, Sir John Charnley not only introduced, but also modified and improved the technique of cemented arthroplasties. The concepts on biological fixation established by Pillar and Galante served as the foundation for the development of uncemented implants that are now used worldwide. Currently, THA is a worldwide widespread surgery performed on millions of people. However, keeping abreast of the large number of information available on these procedures, especially on implant fixation, designs, different tribological pairings, and the long-term results can be challenging at times. This article is a brief update on the main aspects of THA.

A artroplastia total do quadril (ATQ) é uma das cirurgias de maior sucesso na história da medicina. Nos anos 1960, Sir John Charnley introduziu e aperfeiçoou as artroplastias cimentadas. Pillar e Galante estabeleceram os conceitos da fixação biológica, base para o desenvolvimento das artroplastias não cimentadas. Atualmente, a ATQ é uma cirurgia mundialmente difundida e feita em milhões de pessoas. No entanto, o grande número de informações disponíveis sobre as artroplastias, especialmente quanto à forma de fixação do implante ao osso, aos diferentes designs das hastes e dos acetábulos, aos diferentes pares tribológicos e aos resultados no longo prazo por vezes dificulta a tomada de decisão. Este artigo é uma breve atualização sobre os principais aspectos da ATQ.

Acetabular revision in total hip arthroplasty with tantalum augmentation and lyophilized bovine xenograft.

OBJECTIVE: To evaluate a mixed technique of acetabular reconstruction, which uses trabecular metal in the form of tantalum augments associated with lyophilized bovine xenograft. METHODS: Fifteen patients were evaluated prospectively, who underwent acetabular reconstruction with impacted lyophilized bovine xenograft associated with the use of tantalum augments. The main outcome was the failure of the tantalum-bone interface. RESULTS: The population had a mean age of 58.33 years ± 14.27; the majority was female, 80%. Of the total subjects, 66.7% were operated for failure in primary arthroplasty. The mean follow-up time was 45.2 months ± 11.39. The failure rate of the method in the period and population studied was 6.7%. CONCLUSION: An extremely high index (93.3%) of success was observed in an average time of 45.2 months of follow-up. Data were comparable to current literature, demonstrating that the technique employed and proposed is adequate for hip reconstruction in young patients.

OBJETIVO: Avaliar uma técnica mista de reconstrução acetabular que usa metal trabecular na forma de cunhas de tântalo associadas com enxerto ósseo bovino liofilizado. MÉTODOS: Foram avaliados prospectivamente 15 pacientes submetidos à reconstrução acetabular com enxerto bovino liofilizado impactado associado ao uso de cunhas de tântalo. O principal desfecho avaliado foi a falha da interface tântalo-osso. RESULTADOS: A população apresentou idade média de 58,33 anos ± 14,27, a maioria do sexo feminino 80%. Do total, 66,7% foram operados por falha da artroplastia primária. O tempo médio de seguimento foi de 45,2 meses ± 11,39 meses. A taxa de falha do método no período e na população estudada foi de 6,7%. CONCLUSÃO: Observou-se um índice extremamente elevado (93,3%) de sucesso em um tempo médio de 45,2 meses de seguimento. Os dados são comparáveis à literatura corrente, o que demonstra que a técnica empregada e proposta é adequada para reconstrução de quadril em pacientes jovens.

Physical education Professionals and their role in Primary Care in Curitiba / O profissional de Educação Física e sua atuação na Atenção Primária à Saúde de Curitiba

The aim of this study was to describe the inclusion of the Physical Education professor, relating historical aspects and outlining the role of these professionals in Primary Care in Curitiba, Brazil. Inclusion occurred in 2009 with the hiring of 29 professionals, 26 of whom were still employed in early 2016. Activities performed include exercise groups; individual care; clinical support; continuing education; health education; as well as participation in social control, by representing the profession at the Municipal Health Council of Curitiba and Teaching-Service integration via a Multidisciplinary Residency preceptorship. The historical background reveals advances, achievements and much more to accomplish, in a permanent and ongoing process.

O objetivo desse texto foi descrever a inserção do profissional de Educação Física, resgatando aspectos históricos e descrevendo a atuação desses profissionais na Atenção Primária à Saúde de Curitiba-PR. A inserção aconteceu em 2009, com a contratação de 29 profissionais, dos quais 26 permanecem em atuação até início de 2016. As ações desenvolvidas pautam-se em grupos de exercício físico; atendimento individual; apoio matricial; educação permanente; educação em saúde; além da participação no Controle Social, por meio da representação da classe no Conselho Municipal de Saúde de Curitiba e da aproximação Ensino-Serviço, com a preceptoria da Residência Multiprofissional. O percurso histórico revela avanços, conquistas e um longo caminho a ser percorrido, que está em permanente construção.

Total hip arthroplasty: a still evolving technique / Atualização em artroplastia total de quadril: uma técnica ainda em desenvolvimento

ABSTRACT It has been advocated that total hip arthroplasty (THA) is probably the most successful surgical intervention performed in Medicine. In the 1960s, Sir John Charnley not only introduced, but also modified and improved the technique of cemented arthroplasties. The concepts on biological , fixation established by Pillar and Galante served as the foundation for the development of uncemented implants that are now used worldwide. Currently, THA is a worldwide widespread surgery performed on millions of people. However, keeping abreast of the large number of information available on these procedures, especially on implant fixation, designs, different tribological pairings, and the long-term results can be challenging at times. This article is a brief update on the main aspects of THA.

RESUMO A artroplastia total do quadril (ATQ) é uma das cirurgias de maior sucesso na história da medicina. Nos anos 1960,SirJohn Charnley introduziu e aperfeiçoou as artroplastias cimentadas. Pillar e Galante estabeleceram os conceitos da fixação biológica, base para o desenvolvimento das artroplastias não cimentadas. Atualmente, a ATQ é uma cirurgia mundialmente difundida e feita em milhões de pessoas. No entanto, o grande número de informações disponíveis sobre as artroplastias, especialmente quanto à forma de fixação do implante ao osso, aos diferentesdesignsdas hastes e dos acetábulos, aos diferentes pares tribológicos e aos resultados no longo prazo por vezes dificulta a tomada de decisão. Este artigo é uma breve atualização sobre os principais aspectos da ATQ.

Acetabular revision in total hip arthroplasty with tantalum augmentation and lyophilized bovine xenograft / Revisão acetabular em artroplastia total de quadril com cunhas de tântalo associadas a enxerto ósseo bovino liofilizado

Abstract Objective To evaluate a mixed technique of acetabular reconstruction, which uses trabecular metal in the form of tantalum augments associated with lyophilized bovine xenograft. Methods Fifteen patients were evaluated prospectively, who underwent acetabular reconstruction with impacted lyophilized bovine xenograft associated with the use of tantalum augments. The main outcome was the failure of the tantalum-bone interface. Results The population had a mean age of 58.33 years ± 14.27; the majority was female, 80%. Of the total subjects, 66.7% were operated for failure in primary arthroplasty. The mean follow-up time was 45.2 months ± 11.39. The failure rate of the method in the period and population studied was 6.7%. Conclusion An extremely high index (93.3%) of success was observed in an average time of 45.2 months of follow-up. Data were comparable to current literature, demonstrating that the technique employed and proposed is adequate for hip reconstruction in young patients.

Resumo Objetivo Avaliar uma técnica mista de reconstrução acetabular que usa metal trabecular na forma de cunhas de tântalo associadas com enxerto ósseo bovino liofilizado. Métodos Foram avaliados prospectivamente 15 pacientes submetidos à reconstrução acetabular com enxerto bovino liofilizado impactado associado ao uso de cunhas de tântalo. O principal desfecho avaliado foi a falha da interface tântalo-osso. Resultados A população apresentou idade média de 58,33 anos ± 14,27, a maioria do sexo feminino 80%. Do total, 66,7% foram operados por falha da artroplastia primária. O tempo médio de seguimento foi de 45,2 meses ± 11,39 meses. A taxa de falha do método no período e na população estudada foi de 6,7%. Conclusão Observou-se um índice extremamente elevado (93,3%) de sucesso em um tempo médio de 45,2 meses de seguimento. Os dados são comparáveis à literatura corrente, o que demonstra que a técnica empregada e proposta é adequada para reconstrução de quadril em pacientes jovens.

Interactive Universal Design Kiosks: Explanations About Social Inclusion Features in Architectural Design.

This paper details a set of self-supporting and illuminated panels that work together but independently in order to emphasize the explanation of building features and activities that are based on Universal Design guidelines. The exhibition is based on two structures that are arranged in semi-circles (A and B). They are integrated to form a carpeted path where the visitor will be gradually exposed to the concepts related to the principles of Universal Design. Following the sequence of three-dimensional objects and swivelling box elements that support the tactile information on the subject, it is expected that visitors become familiar with each of the principles being demonstrated. Operated by a control system consisting of keys with colour signage, textures and high relief, the panel on the control table allows the user to choose information about paired relationships between some of seven principles contained in printed images about the architectural design on the set of panels. The effectiveness of the composition can be verified by the time people remain enough to hear, see and touch the kiosks for all the information, or by successive visits users make to the setting.

Universal Design Criteria in Standards and Codes About Accessibility of Built Environments in Brazil.

This paper includes some criticism in analysis of the development and implementation of the national standards for accessibility of the built environment in Brazil, i.e., the NBR9050. Currently, the 2015 version of it resembles an encyclopaedia including a variety of exotic contributions gathered historically from different sources; however, that characteristic makes it work like a puzzle that keeps alive prejudices about users' needs and disabilities. Besides, there are conflicts between recommended ideas and previous requirements from older versions. The definition of Universal Design has been published since 2004, but there is still no indication of how to make the principles work in practice. Therefore, it is very hard for city officials to assess quality of environments, and professionals have serious constraints to explore their skills further while addressing users' diversified needs. Certainly, the current NBR9050 requires further editorial work. Nevertheless, an important decision is necessary: it is important to organize information so that readers may identify in each topic whether Universal Design application can be achieved or whether the proposed technical solution may lead to construction of limited spatial adaptation and reach only some poor accommodation of users with uncommon needs. Presenting some examples in context of socially inclusive environments, the newer revised version of NBR9050 is necessary to explain about pitfalls of bad design of accessibility for discriminated disabled users. Readers should be able to establish conceptual links between the best ideas so that Universal Design could be easily understood.

The Joyful Aging Club: An Example of Universal Design Practice on Architectural and Urban Settings.

Universal Design is a very simple idea that is based on complex decisions and it involves user satisfaction during performance of activities and socially inclusive interaction. Generally, the design guidelines for application in architecture requires that both students and professionals explore their imagination about the situations in which the design of a certain building becomes more pleasant and inviting than simply accessible to the needs of people with permanent and temporary disabilities. In this paper, the aim is to discuss peculiar aspects in the design of a three storey building that make it special. The result of technical solutions create environments that are not restricted to the boundaries of a site. It also encompasses the street, the crossing, the corner square and traffic signals and marks beside some accessible parking areas. The building design is an academic exploration of potential usage to an actual site. It belongs to an institution for social network of people aging above sixty-five year old.