A prospective, comparative study of the analgesic effect between the WALANT technique and local anesthesia associated with sedation for hand surgery.

PURPOSE: The primary objective of this study was to compare the WALANT (wide awake, local anesthesia, no tourniquet) technique with local anesthesia associated with sedation in relation to pain intensity for minor hand surgical procedures. The secondary objective was to evaluate the need for analgesic complementation. METHODS: A prospective, randomized, comparative, and clinical study was carried out. The sample size in each group was determined after statistical evaluation of the results of a pilot project. The participants were allocated to one of two groups; those in group 1 were submitted to the WALANT technique, and those in group 2, to local anesthesia associated with sedation, for elective surgery. The surgical procedures were carpal tunnel syndrome, De Quervain's tenosynovitis, synovial cyst, finger cyst, and trigger finger. Pain intensity, need for complementation and evolution to complex regional pain syndrome were evaluated. RESULTS: There was no difference between groups in pain intensity after WALANT and need for intraoperative complementation. There was no significant difference in the amount of opioid applied postoperatively between the groups. There was no difference between groups regarding comfort during surgery. There was no difference in adverse effects and complications between the groups. Hematoma was the most frequent adverse event. No severe adverse events were observed. CONCLUSIONS: The WALANT technique promoted an analgesic effect similar to that of local anesthesia associated with sedation, without increasing adverse effects.

Thermal Transport and Rheological Properties of Hybrid Nanofluids Based on Vegetable Lubricants.

Nanofluids based on vegetal oil with different wt.% of carbon nanotubes (CNT), hexagonal boron nitride (h-BN), and its hybrid (h-BN@CNT) were produced to investigate the effects of these nano-additives on the thermal conductivity and rheological properties of nanofluids. Stable suspensions of these oil/nanostructures were produced without the use of stabilizing agents. The dispersed nanostructures were investigated by SEM, EDS, XRD, and XPS, while the thermal conductivity and rheological characteristics were studied by a transient hot-wire method and steady-state flow tests, respectively. Increases in thermal conductivity of up to 39% were observed for fluids produced with 0.5 wt.% of the hybrid nanomaterials. As for the rheological properties, it was verified that both the base fluid and the h-BN suspensions exhibited Newtonian behavior, while the presence of CNT modified this tendency. This change in behavior is attributed to the hydrophobic character of both CNT and the base oil, while h-BN nanostructures have lip-lip "bonds", giving it a partial ionic character. However, the combination of these nanostructures was fundamental for the synergistic effect on the increase of thermal conductivity with respect to their counterparts.

A prospective, comparative study of the analgesic effect between the WALANT technique and local anesthesia associated with sedation for hand surgery

Purpose: The primary objective of this study was to compare the WALANT (wide awake, local anesthesia, no tourniquet) technique with local anesthesia associated with sedation in relation to pain intensity for minor hand surgical procedures. The secondary objective was to evaluate the need for analgesic complementation. Methods: A prospective, randomized, comparative, and clinical study was carried out. The sample size in each group was determined after statistical evaluation of the results of a pilot project. The participants were allocated to one of two groups; those in group 1 were submitted to the WALANT technique, and those in group 2, to local anesthesia associated with sedation, for elective surgery. The surgical procedures were carpal tunnel syndrome, De Quervain's tenosynovitis, synovial cyst, finger cyst, and trigger finger. Pain intensity, need for complementation and evolution to complex regional pain syndrome were evaluated. Results: There was no difference between groups in pain intensity after WALANT and need for intraoperative complementation. There was no significant difference in the amount of opioid applied postoperatively between the groups. There was no difference between groups regarding comfort during surgery. There was no difference in adverse effects and complications between the groups. Hematoma was the most frequent adverse event. No severe adverse events were observed. Conclusions: The WALANT technique promoted an analgesic effect similar to that of local anesthesia associated with sedation, without increasing adverse effects.

Multifunctional Hybrid MoS2-PEGylated/Au Nanostructures with Potential Theranostic Applications in Biomedicine.

In this work, flower-like molybdenum disulfide (MoS2) microspheres were produced with polyethylene glycol (PEG) to form MoS2-PEG. Likewise, gold nanoparticles (AuNPs) were added to form MoS2-PEG/Au to investigate its potential application as a theranostic nanomaterial. These nanomaterials were fully characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), photoelectron X-ray spectroscopy (XPS), Fourier-transformed infrared spectroscopy (FTIR), cyclic voltammetry and impedance spectroscopy. The produced hierarchical MoS2-PEG/Au microstructures showed an average diameter of 400 nm containing distributed gold nanoparticles, with great cellular viability on tumoral and non-tumoral cells. This aspect makes them with multifunctional characteristics with potential application for cancer diagnosis and therapy. Through the complete morphological and physicochemical characterization, it was possible to observe that both MoS2-PEG and MoS2-PEG/Au showed good chemical stability and demonstrated noninterference in the pattern of the cell nucleus, as well. Thus, our results suggest the possible application of these hybrid nanomaterials can be immensely explored for theranostic proposals in biomedicine.

Potential Production of Theranostic Boron Nitride Nanotubes (64Cu-BNNTs) Radiolabeled by Neutron Capture.

In this work, the radioisotope 64Cu was obtained from copper (II) chloride dihydrate in a nuclear research reactor by neutron capture, (63Cu(n,γ)64Cu), and incorporated into boron nitride nanotubes (BNNTs) using a solvothermal process. The produced 64Cu-BNNTs were analyzed by TEM, MEV, FTIR, XDR, XPS and gamma spectrometry, with which it was possible to observe the formation of64Cu nanoparticles, with sizes of up to 16 nm, distributed through nanotubes. The synthesized of 64Cu nanostructures showed a pure photoemission peak of 511 keV, which is characteristic of gamma radiation. This type of emission is desirable for Photon Emission Tomography (PET scan) image acquisition, as well as its use in several cancer treatments. Thus, 64Cu-BNNTs present an excellent alternative as theranostic nanomaterials that can be used in diagnosis and therapy by different techniques used in nuclear medicine.

Micro Scalable Graphene Oxide Productions Using Controlled Parameters in Bench Reactor.

The detailed study of graphene oxide (GO) synthesis by changing the graphite/oxidizing reagents mass ratios (mG/mROxi), provided GO nanosheets production with good yield, structural quality, and process savings. Three initial samples containing different amounts of graphite (3.0 g, 4.5 g, and 6.0 g) were produced using a bench reactor under strictly controlled conditions to guarantee the process reproducibility. The produced samples were analyzed by Raman spectroscopy, atomic force microscopy (AFM), x-ray diffraction (XDR), X-ray photoelectron spectroscopy (XPS), Fourier-transform infrared spectroscopy (FTIR) and thermogravimetry (TGA) techniques. The results showed that the major GO product comprised of nanosheets containing between 1-5 layers, with lateral size up to 1.8 µm. Therefore, it was possible to produce different batches of graphene oxide with desirable physicochemical characteristics, keeping the amount of oxidizing reagent unchanged. The use of different proportions (mG/mROxi) is an important strategy that provides to produce GO nanostructures with high structural quality and scale-up, which can be well adapted in medium-sized bench reactor.

Thermal Conductivity Performance of 2D hBN/MoS2/Hybrid Nanostructures Used on Natural and Synthetic Esters.

In this paper, the thermal conductivity behavior of synthetic and natural esters reinforced with 2D nanostructures-single hexagonal boron nitride (h-BN), single molybdenum disulfide (MoS2), and hybrid h-BN/MOS2-were studied and compared to each other. As a basis for the synthesis of nanofluids, three biodegradable insulating lubricants were used: FR3TM and VG-100 were used as natural esters and MIDEL 7131 as a synthetic ester. Two-dimensional nanosheets of h-BN, MoS2, and their hybrid nanofillers (50/50 ratio percent) were incorporated into matrix lubricants without surfactants or additives. Nanofluids were prepared at 0.01, 0.05, 0.10, 0.15, and 0.25 weight percent of filler fraction. The experimental results revealed improvements in thermal conductivity in the range of 20-32% at 323 K with the addition of 2D nanostructures, and a synergistic behavior was observed for the hybrid h-BN/MoS2 nanostructures.

DISTAL HUMERAL FRACTURE: AN EPIDEMIOLOGICAL ANALYSIS OF ORTHOPEDIC PATIENTS FOR CHILDREN.

OBJECTIVE: To analyze the epidemiological profiles of children with orthopedic distal humerus fractures. METHODS: An analytical descriptive study was conducted with a retrospective approach using medical records of 665 orthopedic children who attended the Jesser Amarante Faria Children's Hospital, a reference hospital in the city of Joinville, Santa Catarina, between June 2012 and December 2016. RESULTS: The results showed a predominance of male patients (64.2%), with a mean age of 7 years, and the age group of 6-10 years being the most frequent with 319 patients (48%). The main mechanism of trauma was fall of height in 59.7% of patients, Gartland type 1 fracture in 57.1%, and absence of vascular injury in 99.7%. Conservative management was implemented in 64.7% (95%) of patients. Absence of neurological lesion (95.6%) and closed lesion (99.4%) were the main epidemiological characteristics of patients in the study. A low complication rate was observed, with reduction losses in 1.7% of patients, followed by infections in 1.1%. CONCLUSION: We can conclude that the cases studied presented epidemiological characteristics similar to those described in the literature. Level of evidence IV, Description of a case series, with analysis of results, without a comparative study.

OBJETIVO: Analisar o perfil epidemiológico de pacientes ortopédicos infantis com fratura de úmero distal. MÉTODO: Estudo analítico-descritivo, com abordagem retrospectiva dos prontuários médicos de 665 pacientes ortopédicos infantis, atendidos no Hospital Infantil Dr. Jeser Amarante Faria, referência no município de Joinville (SC), do período de junho de 2012 a dezembro de 2016. RESULTADOS: Os resultados mostraram um predomínio de pacientes do sexo masculino (64,2%), com idade média de 7 anos, sendo a faixa etária de 6 a 10 anos a mais frequente, com 319 (48%) pacientes. O principal mecanismo do trauma foi por queda da própria altura (59,7%), com Gartland 1 em 57,1% dos casos e ausência de lesão vascular (99,7%). A conduta conservadora foi observada em 64,7% dos pacientes, além de ausência de complicações imediatas (97,1%), complicações tardias (95,3%) e lesão neurológica (95,6%). Lesão fechada (99,4%) foi a principal característica epidemiológica dos pacientes estudados. Uma baixa frequência de complicações foi observada, sendo mais prevalentes as perdas de reduções (1,7%), seguidas de infecções, em 1,1% dos casos. CONCLUSÕES: Os casos estudados apresentaram características epidemiológicas semelhantes àquelas descritas na literatura. Nível de evidência IV, Descrição de série de casos, com análise de resultados, sem estudo comparativo.

Distal humeral fracture: an epidemiological analysis of orthopedic patients for children / Fratura de úmero distal: uma análise epidemiológica de pacientes ortopédicos infantis

ABSTRACT Objective: To analyze the epidemiological profiles of children with orthopedic distal humerus fractures. Methods: An analytical descriptive study was conducted with a retrospective approach using medical records of 665 orthopedic children who attended the Jesser Amarante Faria Children's Hospital, a reference hospital in the city of Joinville, Santa Catarina, between June 2012 and December 2016. Results: The results showed a predominance of male patients (64.2%), with a mean age of 7 years, and the age group of 6-10 years being the most frequent with 319 patients (48%). The main mechanism of trauma was fall of height in 59.7% of patients, Gartland type 1 fracture in 57.1%, and absence of vascular injury in 99.7%. Conservative management was implemented in 64.7% (95%) of patients. Absence of neurological lesion (95.6%) and closed lesion (99.4%) were the main epidemiological characteristics of patients in the study. A low complication rate was observed, with reduction losses in 1.7% of patients, followed by infections in 1.1%. Conclusion: We can conclude that the cases studied presented epidemiological characteristics similar to those described in the literature. Level of evidence IV, Description of a case series, with analysis of results, without a comparative study.

RESUMO Objetivo: Analisar o perfil epidemiológico de pacientes ortopédicos infantis com fratura de úmero distal. Método: Estudo analítico-descritivo, com abordagem retrospectiva dos prontuários médicos de 665 pacientes ortopédicos infantis, atendidos no Hospital Infantil Dr. Jeser Amarante Faria, referência no município de Joinville (SC), do período de junho de 2012 a dezembro de 2016. Resultados: Os resultados mostraram um predomínio de pacientes do sexo masculino (64,2%), com idade média de 7 anos, sendo a faixa etária de 6 a 10 anos a mais frequente, com 319 (48%) pacientes. O principal mecanismo do trauma foi por queda da própria altura (59,7%), com Gartland 1 em 57,1% dos casos e ausência de lesão vascular (99,7%). A conduta conservadora foi observada em 64,7% dos pacientes, além de ausência de complicações imediatas (97,1%), complicações tardias (95,3%) e lesão neurológica (95,6%). Lesão fechada (99,4%) foi a principal característica epidemiológica dos pacientes estudados. Uma baixa frequência de complicações foi observada, sendo mais prevalentes as perdas de reduções (1,7%), seguidas de infecções, em 1,1% dos casos. Conclusões: Os casos estudados apresentaram características epidemiológicas semelhantes àquelas descritas na literatura. Nível de evidência IV, Descrição de série de casos, com análise de resultados, sem estudo comparativo.

Hybrid MoS2/h-BN Nanofillers As Synergic Heat Dissipation and Reinforcement Additives in Epoxy Nanocomposites.

Two-dimensional (2D) nanomaterials as molybdenum disulfide (MoS2), hexagonal boron nitride (h-BN), and their hybrid (MoS2/h-BN) were employed as fillers to improve the physical properties of epoxy composites. Nanocomposites were produced in different concentrations and studied in their microstructure, mechanical and thermal properties. The hybrid 2D mixture imparted efficient reinforcement to the epoxy leading to increases of up to 95% in tensile strength, 60% in ultimate strain, and 58% in Young's modulus. Moreover, an enhancement of 203% in thermal conductivity was achieved for the hybrid composite as compared to the pure polymer. The incorporation of MoS2/h-BN mixture nanofillers in epoxy resulted in nanocomposites with multifunctional characteristics for applications that require high mechanical and thermal performance.