Adulteration of Brain Health (Cognitive, Mood, and Sleep Enhancement) Food Supplements by the Addition of Pharmaceutical Drugs: A Comprehensive Review of Analytical Approaches and Trends.

In recent years, the consumption of dietary supplements has grown worldwide, particularly in developed regions. However, this growing market has also become a prime target for adulteration practices, with some manufacturers illegally adding pharmaceuticals into plant-based food supplements (PFS) to enhance their effects. While extensive research has focused on detecting adulterant drugs in PFS tailored for improving sexual performance, weight loss, and muscle building, less attention has been given to supplements intended for mood enhancement, sleep aid, and cognitive function (nootropics). Nonetheless, recent reports indicate an increasing level of adulteration within this group of PFS. Therefore, this review aims at providing a comprehensive overview on the adulteration of PFS tailored for brain health, with a focus on the analytical techniques utilized for detection while also presenting data on consumption patterns and the prevalence of reported adulterants. Considering that the detection of such fraudulent practices primarily relies on chromatographic techniques coupled with mass spectrometry (MS), the developments in this field comprising either targeted or untargeted analysis of pharmaceutical adulterants are discussed.

A conserved transcriptional program for MAIT cells across mammalian evolution.

Mucosal-associated invariant T (MAIT) cells harbor evolutionarily conserved TCRs, suggesting important functions. As human and mouse MAIT functional programs appear distinct, the evolutionarily conserved MAIT functional features remain unidentified. Using species-specific tetramers coupled to single-cell RNA sequencing, we characterized MAIT cell development in six species spanning 110 million years of evolution. Cross-species analyses revealed conserved transcriptional events underlying MAIT cell maturation, marked by ZBTB16 induction in all species. MAIT cells in human, sheep, cattle, and opossum acquired a shared type-1/17 transcriptional program, reflecting ancestral features. This program was also acquired by human iNKT cells, indicating common differentiation for innate-like T cells. Distinct type-1 and type-17 MAIT subsets developed in rodents, including pet mice and genetically diverse mouse strains. However, MAIT cells further matured in mouse intestines to acquire a remarkably conserved program characterized by concomitant expression of type-1, type-17, cytotoxicity, and tissue-repair genes. Altogether, the study provides a unifying view of the transcriptional features of innate-like T cells across evolution.

IL-7 Receptor Drives Early T Lineage Progenitor Expansion.

IL-7 and IL-7R are essential for T lymphocyte differentiation by driving proliferation and survival of specific developmental stages. Although early T lineage progenitors (ETPs), the most immature thymocyte population known, have a history of IL-7R expression, it is unclear whether IL-7R is required at this stage. In this study, we show that mice lacking IL-7 or IL-7R have a marked loss of ETPs that results mostly from a cell-autonomous defect in proliferation and survival, although no changes were detected in Bcl2 protein levels. Furthermore, a fraction of ETPs responded to IL-7 stimulation ex vivo by phosphorylating Stat5, and IL-7R was enriched in the most immature Flt3+Ccr9+ ETPs. Consistently, IL-7 promoted the expansion of Flt3+ but not Flt3- ETPs on OP9-DLL4 cocultures, without affecting differentiation at either stage. Taken together, our data show that IL-7/IL-7R is necessary following thymus seeding by promoting proliferation and survival of the most immature thymocytes.

Odontoma complexo em maxila: relato de caso / Complex odontoma of the maxila: case report

O odontoma é uma alteração definida como um tumor odontogênico benigno e representa cerca de 70% das ocorrências dos tumores odontogênicos. O objetivo desse estudo foi apresentar um caso clínico referente ao diagnóstico e tratamento de um odontoma complexo em região anterior de maxila. Paciente de 27 anos compareceu à clínica buscando avaliação de rotina e, ao exame clínico, foi verificada a ausência dos elementos dentais 13 e 14 e retenção prolongada do 54. Radiograficamente, foi observada a presença de uma lesão radiopaca sugestiva de odontoma complexo, além de impactação dos elementos dentais 13 e 14. A abordagem adotada foi a remoção da lesão, do elemento 54 e tracionamento ortodôntico do elemento 13. A cirurgia foi feita em ambiente ambulatorial, sob anestesia local, iniciando pela exodontia do elemento 54, logo depois foi feita a incisão de Newman, descolamento mucoperiostal e remoção da lesão com broca cirúrgica esférica em alta rotação, sob refrigeração abundante com soro fisiológico estéril. Posteriormente, foi acessado o elemento 13 por vestibular e feito o desgaste ósseo com broca cirúrgica esférica, até a exposição da coroa do dente. Por fim, foi realizada a colagem do dispositivo de tracionamento ortodôntico, botão associado a fio de aço colocado com resina composta e o paciente foi encaminhado ao ortodontista. O diagnóstico e tratamento desse tipo de patologia é de suma importância, evitando implicações estéticas e funcionais ao paciente. Não é comum recorrências, e tem prognóstico excelente... (AU)

Odontoma is an alteration defined as a benign odontogenic tumor and represents about 70% of the oc currences of odontogenic tumors. The aim of this study was to present a clinical case regarding the diag nosis and treatment of a complex odontoma in the anterior region of the maxilla. A 27-year-old patient came to the clinic seeking routine evaluation and, on clinical examination, the absence of dental elements 13 and 14 and prolonged retention of 54 were verified. Radiographically, the presence of a radiopaque lesion suggestive of a complex odontomawas observed, in addition to impaction of dental elements 13 and 14. The approach adopted was the removal of the lesion, element 54 and orthodontic traction of element 13. The surgery was performed in an outpatient setting, under local anesthesia, starting with the extraction of element 54, shortly afterwards Newman's incision, mucoperiosteal detachment and removal of the lesion with a high-speed spherical surgical drill, under abundant refrigeration with sterile saline. Subsequently, element 13 was accessed through the vestibular and bone wear was done with a spherical surgical drill, until the tooth crown was exposed. Finally, the orthodontic traction device was bonded, a button associated with steel wire placed with composite resin and the patient was referred to the ortho dontist. The diagnosis and treatment of this type of pathology is extremely important, avoiding aesthetic and functional implications for the patient. Recurrences are not common and have an excellent prognosis... (AU)

Self-renewal of double-negative 3 early thymocytes enables thymus autonomy but compromises the ß-selection checkpoint.

T lymphocyte differentiation in the steady state is characterized by high cellular turnover whereby thymocytes do not self-renew. However, if deprived of competent progenitors, the thymus can temporarily maintain thymopoiesis autonomously. This bears a heavy cost, because prolongation of thymus autonomy causes leukemia. Here, we show that, at an early stage, thymus autonomy relies on double-negative 3 early (DN3e) thymocytes that acquire stem-cell-like properties. Following competent progenitor deprivation, DN3e thymocytes become long lived, are required for thymus autonomy, differentiate in vivo, and include DNA-label-retaining cells. At the single-cell level, the transcriptional programs of thymopoiesis in autonomy and the steady state are similar. However, a new cell population emerges in autonomy that expresses an aberrant Notch target gene signature and bypasses the ß-selection checkpoint. In summary, DN3e thymocytes have the potential to self-renew and differentiate in vivo if cell competition is impaired, but this generates atypical cells, probably the precursors of leukemia.

Investigation of ethnomedicinal use of Commiphora leptophloeos (Mart.) J. B. Gillett (Burseraceae) in treatment of diarrhea.

ETHNOPHARMACOLOGICAL RELEVANCE: Commiphora leptophloeos (Mart.) J.B. Gillett, popularly known as "imburana", "imburana-de-cheiro" or "imburana-de-espinho", has been used in folk medicine for the treatment of gastrointestinal diseases, such as diarrhea. The indian tribes "Kairir-Shokó and shokó use the bark to treat diarrhea. However, there is no scientific evidence to justify the therapeutic use of this species. AIM OF THE STUDY: To investigate the ethnomedicinal use of Commiphora leptophloeos, with respect to the antimicrobial, antisecretory, antimotility and antispasmodic activities of the crude ethanolic extract obtained from its leaves (CL-EtOHL) and the mechanism underlying this action in rodents. MATERIAL AND METHODS: In the evaluation of antibacterial and antifungal activities was determined the minimum inhibitory concentration (MIC) of the extract, against different strains of bacteria and fungi. All experimental protocols were approved by the Animal Ethics Committee of the Federal University of Paraíba (045/2016). In addition, behavioral screening and acute toxicity assessment of CL-EtOHL were performed in female mice (n = 6). In the investigation of antidiarrheal activity (n = 6), frequency of defecation and number of liquid stools, were classified during 4 h, and intestinal fluid and transit were measured. In addition, the antispasmodic effect on rat ileum (n = 5) was also investigated. RESULTS: The ethanolic extract is rich in flavonoids and the main were identified as C-glycosylated flavonoids (isoorientin, orientin, and vitexin). In the evaluation of antimicrobial and antifungal activity, the extract showed moderate efficacy only against the tested strains of Candida krusei ATCC-6258, Candida parapsilosis ATCC-22019 and Candida glabrata ATCC-90030. The extract had no toxic effect until 2000 mg/kg. In castor oil-induced diarrhea, CL-EtOHL inhibited, in a dose-dependent manner, both total defecation frequency (ED50 = 380.4 ± 145.4 mg/kg) and the number of watery stools (ED50 = 151.2 ± 76.3 mg/kg). The extract showed no effect on fluid accumulation or normal intestinal transit. On the other hand, when the animals were pretreated with castor oil, the extract decreased the distance traveled by the activated charcoal (ED50 = 177.0 ± 50.3 mg/kg). In the investigation of antispasmodic effect, CL-EtOHL antagonized the contractions induced by KCl 30 mM (IC50 = 208.2 ± 25.9 µg/mL) and CCh 10-6 M (IC50 = 95. ± 22.0 µg/mL). To verify the participation of muscarinic receptors in this effect, cumulative carbachol curves were performed in the absence and presence of the extract, and a non-competitive pseudo-irreversible antagonism of these receptors was observed. CONCLUSION: The data indicate that ethanol extract obtained from the leaves of Commiphora leptophloeos has an antidiarrheal effect due to inhibition of the intestinal motility and antispasmodic effect, through the antagonism of muscarinic receptors. In addition, we suggest that flavonoids isolated from CL-EtOHL may be responsible for antidiarrheal activity of this extract. This explains its ethnomedicinal use in the treatment of diarrhea.

New approaches to diagnose and target reproductive failure in cattle.

Reproductive failure and pregnancy loss in cattle are some of the largest economic burdens to cattle producers and one of most perplexing factors influencing management decisions. Pregnancy loss may occur at any point during gestation with the largest percentage of loss occurring in the first 30 days and, subsequently, decreasing as the pregnancy progresses. Losses may be attributed to numerous factors, predisposed issues or environmental conditions such as nutritional stressors or disease. From a research perspective, determining the exact causes of pregnancy loss or embryonic mortality in cattle have been difficult, due to limitations of accurately determining early gestation pregnancy status. Until methods that precisely determine embryo success early in gestation are available, our understanding of in vivo pregnancy loss will lack clarity necessary to develop management strategies to decrease such loss. In this review, we will briefly discuss the pivotal periods of pregnancy loss affecting beef and dairy cattle, methods and technologies to determine pregnancy status and embryo viability and potential opportunities to decrease reproductive failure.

Technical Note: Using enzyme-linked immunosorbent assays to evaluate humoral responses to vaccination against respiratory viruses in beef cattle.

This experiment evaluated humoral responses in beef calves vaccinated against parainfluenza-3 virus (PI3), bovine respiratory syncytial virus (BRSV), and bovine herpesvirus-1 (BHV-1) using serum neutralization (SN) tests or enzyme-linked immunosorbent assays (ELISA). Blood samples were collected from 50 overtly healthy Angus-influenced steers (183 ± 3 kg of body weight, 212 ± 2 d of age) on days 0, 21, 35, and 49 of the experiment. Steers were vaccinated against respiratory viruses on days 0 and 21. Blood was processed for serum collection and frozen in duplicates. One of the duplicates was analyzed for antibodies against BRSV, PI3, and BHV-1 using commercially available ELISA (IDEXX Switzerland AG, Liebefeld-Bern, Switzerland), and results reported as sample:positive control (S/P, %) ratio. The other duplicate was analyzed for antibodies against the same vaccine antigens via SN. This method reports results as titers, the greatest dilution that provides complete protection of the cells, which were transformed with base 2 log for statistical analyses. Samples were classified as positive for the presence of antibodies by SN if log-transformed titer ≥ 2 for all viruses, and by ELISA if S/P ratio ≥ 50% for BHV-1 or ≥ 20% for PI3 and BRSV. Day effects were detected (P < 0.01) for SN and ELISA across all vaccine antigens, as antibody levels increased after vaccine administration. Linear fits were detected (P < 0.01) across all vaccine antigens when regressing the SN and ELISA results; as SN titer increased, the ELISA S/P ratio linearly increased (P < 0.01). Kendall (τ) and Spearman's rank (ρ) correlations were also detected (P < 0.01) between SN and ELISA results across all vaccine antigens. The SN and ELISA were very strongly correlated (ρ ≥ 0.83) for BHV-1 and PI3 and strongly correlated (ρ = 0.66) for BRSV. Cohen's kappa coefficient for diagnosis agreement between methods was strong for BHV-1 and PI3 (κ ≥ 0.88), but weak (κ = 0.47) for BRSV. The sensitivity of the ELISA in yielding true positive results approached 100% across all antigens. The specificity of the ELISA in yielding negative results was satisfactory for BHV-1 and PI3 assays (84.0% and 88.5%, respectively) but not for BRSV (34.4%). Despite limitations in detecting true BRSV negatives, results from this experiment indicate that the commercial ELISAs tested herein can be used as surrogate for SN tests in quantifying humoral responses to vaccination against BHV-1, PI3, and BRSV in beef cattle.

Cell Competition, the Kinetics of Thymopoiesis, and Thymus Cellularity Are Regulated by Double-Negative 2 to 3 Early Thymocytes.

Cell competition in the thymus is a homeostatic process that drives turnover. If the process is impaired, thymopoiesis can be autonomously maintained for several weeks, but this causes leukemia. We aimed to understand the effect of cell competition on thymopoiesis, identify the cells involved, and determine how the process is regulated. Using thymus transplantation experiments, we found that cell competition occurs within the double-negative 2 (DN2) and 3 early (DN3e) thymocytes and inhibits thymus autonomy. Furthermore, the expansion of DN2b is regulated by a negative feedback loop that is imposed by double-positive thymocytes and determines the kinetics of thymopoiesis. This feedback loop affects the cell cycle duration of DN2b, in a response controlled by interleukin 7 availability. Altogether, we show that thymocytes do not merely follow a pre-determined path if provided with the correct signals. Instead, thymopoiesis dynamically integrates cell-autonomous and non-cell-autonomous aspects that fine-tune normal thymus function.

T Cell Acute Lymphoblastic Leukemia as a Consequence of Thymus Autonomy.

Thymus autonomy is the capacity of the thymus to maintain T lymphocyte development and export independently of bone marrow contribution. Prolonging thymus autonomy was shown to be permissive to the development of T cell acute lymphoblastic leukemia (T-ALL), similar to the human disease. In this study, performing thymus transplantation experiments in mice, we report that thymus autonomy can occur in several experimental conditions, and all are permissive to T-ALL. We show that wild type thymi maintain their function of T lymphocyte production upon transplantation into recipients with several genotypes (and corresponding phenotypic differences), i.e., Rag2 - / - γc - / -, γc - / -, Rag2 - / - IL-7rα - / -, and IL-7rα - / - We found that the cellularity of the thymus grafts is influenced exclusively by the genotype of the host, i.e., IL-7rα-/- versus γc -/- Nonetheless, the difference in cellularity detected in thymus autonomy bore no impact on onset, incidence, immunophenotype, or pathologic condition of T-ALL. In all tested conditions, T-ALL reached an incidence of 80%, demonstrating that thymus autonomy bears a high risk of leukemia. We also analyzed the microbiota composition of the recipients and their genetic background, but none of the differences found influenced the development of T-ALL. Taken together, our data support that IL-7 drives cellular turnover non-cell autonomously, which is required for prevention of T-ALL. We found no influence for T-ALL in the specific combination of the genotypic mutations tested (including the developmental block caused by Rag deficiency), in microbiota composition, or minor differences in the genetic background of the strains.

Ischaemia alters the effects of cardiomyocyte-derived extracellular vesicles on macrophage activation.

Myocardial ischaemia is associated with an exacerbated inflammatory response, as well as with a deregulation of intercellular communication systems. Macrophages have been implicated in the maintenance of heart homeostasis and in the progression and resolution of the ischaemic injury. Nevertheless, the mechanisms underlying the crosstalk between cardiomyocytes and macrophages remain largely underexplored. Extracellular vesicles (EVs) have emerged as key players of cell-cell communication in cardiac health and disease. Hence, the main objective of this study was to characterize the impact of cardiomyocyte-derived EVs upon macrophage activation. Results obtained demonstrate that EVs released by H9c2 cells induced a pro-inflammatory profile in macrophages, via p38MAPK activation and increased expression of iNOS, IL-1ß and IL-6, being these effects less pronounced with ischaemic EVs. EVs derived from neonatal cardiomyocytes, maintained either in control or ischaemia, induced a similar pattern of p38MAPK activation, expression of iNOS, IL-1ß, IL-6, IL-10 and TNFα. Importantly, adhesion of macrophages to fibronectin was enhanced by EVs released by cardiomyocytes under ischaemia, whereas phagocytic capacity and adhesion to cardiomyocytes were higher in macrophages incubated with control EVs. Additionally, serum-circulating EVs isolated from human controls or acute myocardial infarction patients induce macrophage activation. According to our model, in basal conditions, cardiomyocyte-derived EVs maintain a macrophage profile that ensure heart homeostasis, whereas during ischaemia, this crosstalk is affected, likely impacting healing and post-infarction remodelling.

Thymus autonomy as a prelude to leukemia.

Cell competition in the thymus promotes turnover and functions as a tumor suppressor by inhibiting leukemia. Using thymus transplantation experiments, we have shown that the presence of T lymphocyte precursors, recently seeding the thymus, promotes the clearance of precursors with a longer time of thymus residency. If cell competition is impaired and no cells seed the thymus, the organ is capable of sustaining T lymphocyte production, a state termed thymus autonomy. However, we observed consistently that prolonged autonomy is permissive to the emergence of T cell acute lymphoblastic leukemia (T-ALL). This resembled the onset of T-ALL in patients treated by gene therapy for X-linked severe combined immunodeficiency (SCID-X1). Following treatment, thymus activity was established, with T lymphocyte production, although no bone marrow contribution was detected. However, some patients developed T-ALL. The favored explanation for malignant transformation was considered to be genotoxicity due to integration of the retroviral vector next to oncogenes, thereby activating them ectopically. Although plausible, we consider an alternative, mutually nonexclusive explanation: that any condition enabling prolonged thymus autonomy will promote leukemogenesis. In support of this view, two independent studies have recently shown that the efficacy of reconstitution of the bone marrow in the context of SCID-X1 dramatically influences the outcome of treatment, and that lymphoid malignancies emerge following transplantation of a small number of healthy progenitors. Here, we discuss the most recent data in light of our own studies in thymopoiesis and the conditions that trigger malignant transformation of thymocytes in various experimental and clinical settings.

Microbial Food-Web Drivers in Tropical Reservoirs.

Element cycling in aquatic systems is driven chiefly by planktonic processes, and the structure of the planktonic food web determines the efficiency of carbon transfer through trophic levels. However, few studies have comprehensively evaluated all planktonic food-web components in tropical regions. The aim of this study was to unravel the top-down controls (metazooplankton community structure), bottom-up controls (resource availability), and hydrologic (water residence time) and physical (temperature) variables that affect different components of the microbial food web (MFW) carbon stock in tropical reservoirs, through structural equation models (SEM). We conducted a field study in four deep Brazilian reservoirs (Balbina, Tucuruí, Três Marias, and Funil) with different trophic states (oligo-, meso-, and eutrophic). We found evidence of a high contribution of the MFW (up to 50% of total planktonic carbon), especially in the less-eutrophic reservoirs (Balbina and Tucuruí). Bottom-up and top-down effects assessed through SEM indicated negative interactions between soluble reactive phosphorus and phototrophic picoplankton (PPP), dissolved inorganic nitrogen, and heterotrophic nanoflagellates (HNF). Copepods positively affected ciliates, and cladocerans positively affected heterotrophic bacteria (HB) and PPP. Higher copepod/cladoceran ratios and an indirect positive effect of copepods on HB might strengthen HB-HNF coupling. We also found low values for the degree of uncoupling (D) and a low HNF/HB ratio compared with literature data (mostly from temperate regions). This study demonstrates the importance of evaluating the whole size spectrum (including microbial compartments) of the different planktonic compartments, in order to capture the complex carbon dynamics of tropical aquatic ecosystems.

Plano inclinado no tratamento da mordida cruzada anterior: relato de caso clínico / Treatment with inclined plane for anterior crossbite: clinical case report

O diagnóstico e a intervenção ortodôntica precoce fei-ta pela odontopediatra nos casos de má oclusão tanto na dentadura decídua quanto na mista determinam o sucesso do tratamento para cada caso. Objetivo: o pre-sente artigo expõe um caso de mordida cruzada ante-rior de origem dental na dentadura decídua envolvendo os elementos 51 e 52 em paciente de gênero feminino com quatro anos de idade. Relato de caso: Para o trata-mento, realizou-se a confecção de aparelho tipo plano, inclinado em 45° em resina acrílica autopolimerizável de forma a permitir uma guia para o descruzamento dessa mordida. A manutenção do aparelho foi feita semanalmente para realizar checagem da oclusão e ajustes necessários. Após duas semanas, o aparelho foi removido e encontrado um resultado satisfatório, com o descruzamento alcançado e o dente em posição de oclusão ideal. Considerações finais: podendo-se, assim, concluir que a utilização do plano inclinado é uma op-ção eficaz e rápida no tratamento da mordida cruzada anterior na dentadura decídua

Ituglanis agreste, a new catfish from the rio de contas basin, northeastern Brazil (siluriformes: trichomycteridae)

Ituglanis agreste, a new species of catfish, is described from a tributary stream of the rio Gongogi drainage, rio de Contas basin, Bahia State, northeastern Brazil, from a transition area between the Atlantic Rain Forest and the semi-arid Caatinga savanna. This species is distinguished from its congeners by the following characters: elongate interopercle plate with high number of odontodes (26-30), high number of ribs (5-6), fewer vertebrae (36), number of branchiostegal rays (7), number of pectoral-fin rays (i,6) and absence of s1 pore. Comparisons with other Ituglanis species and putative plesiomorphic characters are presented. Some comments about conservation of Ituglanis species from northeastern Brazil are also made.

Ituglanis agreste, espécie nova, é descrita de um tributário da drenagem do rio Gongogi, bacia do rio de Contas, Bahia, nordeste do Brasil, de uma área de transição entre dois biomas, a Caatinga e a Mata Atlântica. Esta espécie distingue-se de todas as demais espécies do gênero pelas seguintes características: placa interopercular alongada com elevado número de odontódeos (26-30), número elevado de costelas (5-6), número reduzido de vértebras (36), número de raios branquiostégios (7), número de raios da nadadeira peitoral (i,6), e ausência do poro s1. Comparações com outras espécies de Ituglanis e a presença de supostos caracteres plesiomórficos são apresentados. Alguns comentários sobre conservação das espécies de Ituglanis do nordeste do Brasil também são feitos.

Profilaxis antimicrobiana en cirugía ortopédica: cefazolina vs cefadroxilo IV / Antimicrobial prophylaxis in orthopedic surgery: cefazolina vs cefadroxilo IV

Toda intervención quirúrgica está expuesta a infectarse. La necesidad de profilaxis antimicrobiana en cirugía ortopédica para casos quirúrgicos agudos o electivas de cirugías limpias ha sido establecida como procedimiento de rutina. En Cirugía Ortopédica y Traumatología cuando se requiere el uso de implantes metálicos con el fin de realizar osteosíntesis o sustitución de las superficies articulares, aumenta el riesgo de infección, por tratarse de materiales extraños que son introducidos en el organismo. En estos casos la antibióticoterapia preventiva es de primordial importancia. Se realizó un estudio de profilaxis antimicrobiana, multicéntrico, aleatorizado, prospectivo, doble ciego, comparativo de grupos paralelos, con el fin de evaluar la eficacia de Cefadroxilo I.V. Vs. Cefazolina I.V. como antibióticos profilácticos mediante la determinación del número de pacientes infectados en cirugía de fracturas cerradas en la cuales se colocó material de síntesis. Se completaron 58 pacientes, 34 en el grupo de cefadroxilo y 24 en el grupo de cefazolina, al inicio los grupos fueron similares en cuanto a edad, sexo, tipo de fractura, tiempo de intervención, tiempo entre la fractura y la intervención.Más pacientes en el grupo de cefadroxilo tenían el tiempo máximo autorizado entre la fractura y la intervención (p: 0,07). Se presentó en el grupo de cefadroxilo una infección de la herida operatoria y un caso de eritema leve que cedió con tratamiento oral con cefadroxilo, sin diferencias entre los grupos.Hubo tres casos de eventos adversos, reacción anafiláctica a las 48 horas en el grupo de cefazolina que ameritó finalización de protocolo y hematoma en miembro inferior derecho y, en el grupo de cefadroxilo, una elevación discreta de enzimas hepáticas. La respuesta terapéutica de profilaxis antimicrobianano mostró diferencia entre los grupos. El cefadroxilo es tan eficaz como la cefazolina para la profilaxis antimicrobiana en pacientes con fracturas...

Any operation is exposed to infection. The need for antimicrobial prophylaxis in orthopedic surgery for acute or elective surgical cases of clean surgery is established as a routine procedure. Orthopedic Surgery when required the use of metallic implants in order to perform internal fixation or replacement of the articular surfaces, increases the risk of infection because they are foreign materials are introduced into the body. In these cases, preventive antibiotic therapy is very important. We performed a study of antimicrobialprophylaxis multicenter, randomized, prospective, double-blind, parallel group comparison in order to evaluate the effectiveness of Cefadroxil IV vs. Cefazolin I.V. as prophylactic antibiotics by determining the number of infected patients after fracture surgery in which synthetic material was placed. Fifty eigth patients were completed, 34 in the cefadroxil group and 24 in the cefazolin group, at the beginning the groups were similar in age, sex, fracture type, operative time, time between fracture and surgery. More patients in the cefadroxil group had the maximum allo-wable time between the fracture and surgery. (P: 0.07). In the cefadroxil group we found a wound infection and one case of mild erythema which resolved with oral treatment with cefadroxil, without differences between groups. There were three cases of adverse events, anaphylactic reaction to cefazolin at 48 h in the group that required finalization of protocol and hematoma in right leg and in the cefadroxil group, a moderate increase in liver enzymes. The therapeutic response of antimicrobial prophylaxis showed no difference between groups. Cefadroxil is as effective as cefazolin for antimicrobial prophylaxis in patients with fractures that warrant placement of synthetic material

Viscosuplementación como alternativa de tratamiento en osteoartritis de rodilla: resultados a mediano plazo / Viscosupplementation as treatment option for osteoarthritis of the knee: medium term results

La viscosuplementación es una alternativa de eficacia comprobada en el tratamiento de la osteoartristis de rodilla. La administración de ácido hialurónico intraarticular restaura las propiedades elastoviscosas del líquido sinoval. A la serie de 30 casos de osteoartritis de rodilla tratados con viscosuplementación, publicada en 2001, complementamos en este trabajo los resultados en ciento cincuenta y ocho (158) rodillas, pertenecientes a ciento catorce (114) pacientes, tratados con inyección intra-articular de ácido hialurónico (Synvisc®), a razón de una aplicación semanal por tres dosis, durante el periodo abril 2001 a diciembre 2008. Utilizamos la Escala Análoga Visula (EAV) x 100 para valorar el dolor. La función fue evaluada por el nivel de actividad del paciente para valorar la función y la escala de Kellgren-Lawrence fue usada para evaluar el estadio radiológico de la osteoartritis. En un periodo de seguimiento promedio de 4,5 años, 114 rodillas (91,1 por ciento) presentaron evolución satisfactoria por mejoría del dolor y de la función articular. En 14 rodilla (8,9 por ciento) los resultados fueron pobres. La viscosuplementación representa una opción terapéutica valiosa para la osteoartritis de rodilla en estadios iniciales. Se requiere ensayos clínicos a largo plazo que evidencien la utilización del ácido hialurónico para revertir o retrasar la progresión de la lesión del cartílago en osteoartritis de rodilla.

Viscosupplementation is an alternative of proven efficacy for the treatment of osteoarthritis of the knee. Intraarticular administration of hyaluronic acid restores the elastoviscous properties of the synovial fluid. To complement the series of 30 cases of knee osteoarthritis treated with viscosupplementation published in 2001, we present in this paper the results of our series of one hundred and fifty eigth (158) knees, belonging to one hundred and fourteen patients, treated with intra-articular injection of hyaluronic acid (Synvisc®), at the rate of a weekly application by three doses, from april 2001 to december 2008. We used the Visual Analog Scale (VAS) x 100 to value the pain. The function was valuated by the level of activity of the patient and the scale of Kellgren-Lawrence was used to value the radiological stage of the osteoarthritis. In a follow-up period of 4,5 years, the outcome in 114 knees (91,1 percent) was satisfactory, with improvement of pain and knee function. In fourteen knees (8,9 percent) the outcome was poor. Viscosupplementation represents a valuable therapeutical option for patients with knee osteoarthritis in initial stages more long term clinical trials are needed to evidence the utility of hyaluronic acid to revert or delay the progression of the cartilage injury in knee osteoarthritis.

Experiencia a mediano plazo con el uso de anillos de reforzamiento acetabular / Medium-term experience with the use of acetabular reinforcement rings

Los defectos óseos acetabulares son frecuentes en revisión de artroplastia total de cadera. Pueden requerirse aloinjertos masivos y anillos de reconstrucción para restituir el acetábulo. Entre 1997 y 2003 colocamos dieciocho anillos de reconstrucción acetabular con injerto óseo en diecisiete pacientes con edad promedio de 60,67 años. Se hizo seguimiento a trece pacientes (catorce caderas) por 2.36 años en promedio. Usamos dos mallas, dos anillos tipo Müller, siete cajas tipo Ganz y tres tipo Burch-Schneider. No observamos aflojamiento de los anillos ni copas acetabulares utilizados. El injerto óseo se integró en once casos. Los pacientes mejoraron en una media de 23.23 puntos en la escala de Harris y 31.57 puntos en la escala de WOMAC. Diez de trece pacientes (76.92 por ciento) estuvieron satisfechos con la cirugía Nuestros resultados nos permiten concluir que los anillos de reforzamiento acetabular con injerto óseo producen resultados satisfactorios en el manejo de defectos óseos acetabulares.

Experiencia a mediano plazo con el uso de los anillos de reforzamiento acetabular / Medium-term experience with the use of acetabular reinforcement ring

Los defectos óseos acetabulares son frecuentes en revisión de antroplastia total de cadera. Pueden requerirse aloinjertos masivos y anillos de recontrucción para restituir el acetábulo. entre 1997 y 2003 colocamos dieciocho anillos de reconstrucción acetabular con injerto óseo en diecisiete pacientes con edad promedio de 60,67 años. Se hizo seguimiento a trece pacientes (catorce caderas) por 2,36 años en promedio. Usamos dos mallas, dos anillos tipo Müller, siete cajas tipo Ganz y tres tipo Burch-Schneider. No observamos aflojamiento de los anillos y copas acetabulares utilizados. El injerto óseo se integró en once casos. Los pacientes mejoraron en una media de 23,23 puntos en la escala de Harris y 31,57 puntos en la escala de WOMAC. Diez de trece pacientes (76,92) estuvieron satisfechos con la cirugía. Nuestros resultados nos permiten concluir que los anillos de reforzamiento acetabular con injerto óseo producen resultados satisfactorios en el manejo de defectos óseos acetabulares.

Artroplastia de revisión de cadera: revisando los acetábulos con pérdida ósea: correr, llorar o referir / Artroplastia of hip review: revising the acetabulum with bony loss to run, to cry or to refer

El aflojamiento de los componentes cementados o no en artroplastia primaria de cadera siempre va acompañado de pérdida de la reserva ósea del paciente. Hay muchas opciones para la reconstrucción de los defectos acetabulares y femorales. Presentamos nuestros primeros resultados en reconstrucción acetabular de 31 pacientes con 33 caderas dolorosas secuela de cirugía anterior que ingreseron a nuestra Unidad de Cirugía de Artritis entre Febrero 1997 y Mayo 2002. En el promedio de edad fue de 56.8 (26-92) años. El sexo predominante fue el masculino 1,3:1 femenino. La cadera más afecta fue la derecha. La etiología más frecuente fue el Aflojamiento Aséptico de Artroplastia total de Cadera Cementada 45.45 por ciento (15). Los defectos acetabulares no contenidos menor del 50 por ciento del acetábulo, 39.40 por ciento (13). El procedimiento quirúrgico más empleado para la reconstrucción acetabular fue la Mega copa 30.30 por ciento (10) y el Techo de Reconstrucción 27.28 por ciento (9). Utilizamos el injerto morselizado compactado en todos los casos y necesitamos de aloinjerto estructural en el 6.06 por ciento (2) casos. Tuvimos 23.33 por ciento (7) de complicaciones post quirúrgicas. El seguimiento fue en promedio de 24.5 (1.5-63) meses. El alivio del dolor se obtuvo en el 93.54 por ciento (29) casos. Hasta los momentos no hemos tenido tasa de reoperación por causa de falla acetabular.