Periprosthetic shoulder infection management: one-stage should be the way: a systematic review and meta-analysis.

BACKGROUND: There is still no consensus among surgeons on whether to perform a 1- or 2-stage surgical revision in infected shoulder arthroplasties. The aim of this systematic review and meta-analysis is to rigorously synthesize published studies evaluating the clinical outcomes, recurrence of infection, and other clinical complications in order to discuss which is the best strategy for treating periprosthetic joint infection after shoulder arthroplasty. METHODS: Upon research using the PubMed, Scopus, and Web of Science databases, in November 2022, studies that presented 1- or 2-stage surgical revision as a treatment for periprosthetic joint infection after shoulder arthroplasty and assessed the reinfection rate on these patients, as well as other clinical outcomes, with a minimum follow-up of 12 months, were included. Study quality was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) score. Reinfection and complication rates were extracted, and pooled estimates were calculated using the random-effect model. RESULTS: After careful screening, 44 studies were included, 5 reporting on 1-stage and 30 on 2-stage revisions and 9 assessing both strategies. A total of 185 shoulders were reported in 1-stage revision studies, whereas 526 shoulders were reported in 2-stage revision studies. The overall pooled random-effects reinfection rate was 6.68% (95% confidence interval [CI]: 3.76-10.13), with low heterogeneity (I2 = 28%, P = .03). One-stage revision showed a reinfection rate of 1.14% (95% CI: 0.00-4.88), whereas 2-stage revision analysis revealed a reinfection rate of 8.81% (95% CI: 4.96-13.33). There were significant statistical differences between 1- and 2-stage reinfection rates (P = .04). The overall pooled rate for other clinical complications was 16.76% (95% CI: 9.49-25.15), with high heterogeneity (I2 = 70%, P < .01). One-stage revision had a complication rate of 6.11% (95% CI: 1.58-12.39), whereas the 2-stage revision complication rate was 21.26% (95% CI: 11.51-32.54). This difference was statistically significant (P = .03). CONCLUSIONS: This is the first systematic review and meta-analysis showing significant statistical differences between 1- and 2-stage surgical revision in infected shoulder arthroplasties. Provided the right conditions exist, 1-stage revision shows better results in infection control, with lower clinical complications and possible better clinical outcomes.

Behavior of diclofenac from contaminated fish after cooking and in vitro digestion.

BACKGROUND: Seafood consumers are widely exposed to diclofenac due to the high contamination levels often present in aquatic organisms. It is a potential risk to public health due its endocrine disruptor properties. Limited information is available about diclofenac behavior after food digestion to enable a more realistic scenario of consumer exposure. This study aimed to evaluate cooking effects on diclofenac levels, and determine diclofenac bioaccessibility by an in vitro digestion assay, using commercial fish species (seabass and white mullet) as models. The production of the main metabolite 4'-hydroxydiclofenac was also investigated. Fish hamburgers were spiked at two levels (150 and 1000 ng g-1) and submitted to three culinary treatments (roasting, steaming and grilling). RESULTS: The loss of water seems to increase the diclofenac levels after cooking, except in seabass with higher levels. The high bioaccessibility of diclofenac (59.1-98.3%) observed in both fish species indicates that consumers' intestines are more susceptible to absorption, which can be worrisome depending on the level of contamination. Contamination levels did not affect the diclofenac bioaccessibility in both species. Seabass, the fattest species, exhibited a higher bioaccessibility of diclofenac compared to white mullet. Overall, cooking decreased diclofenac bioaccessibility by up to 40% in seabass and 25% in white mullet. The main metabolite 4'-hydroxydiclofenac was not detected after cooking or digestion. CONCLUSION: Thus, consumption of cooked fish, preferentially grilled seabass and steamed or baked white mullet are more advisable. This study highlights the importance to consider bioaccessibility and cooking in hazard characterization studies. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Addressing chemical pollution in biodiversity research.

Climate change, biodiversity loss, and chemical pollution are planetary-scale emergencies requiring urgent mitigation actions. As these "triple crises" are deeply interlinked, they need to be tackled in an integrative manner. However, while climate change and biodiversity are often studied together, chemical pollution as a global change factor contributing to worldwide biodiversity loss has received much less attention in biodiversity research so far. Here, we review evidence showing that the multifaceted effects of anthropogenic chemicals in the environment are posing a growing threat to biodiversity and ecosystems. Therefore, failure to account for pollution effects may significantly undermine the success of biodiversity protection efforts. We argue that progress in understanding and counteracting the negative impact of chemical pollution on biodiversity requires collective efforts of scientists from different disciplines, including but not limited to ecology, ecotoxicology, and environmental chemistry. Importantly, recent developments in these fields have now enabled comprehensive studies that could efficiently address the manifold interactions between chemicals and ecosystems. Based on their experience with intricate studies of biodiversity, ecologists are well equipped to embrace the additional challenge of chemical complexity through interdisciplinary collaborations. This offers a unique opportunity to jointly advance a seminal frontier in pollution ecology and facilitate the development of innovative solutions for environmental protection.

Modelling and Design of a Dual Depletion PIN Photodiode as Temperature Sensor.

Nowadays, optical systems play an important role in communications. Dual depletion PIN photodiodes are common devices that can operate in different optical bands, depending on the chosen semiconductors. However, since semiconductor properties vary with the surrounding conditions, some optical devices/systems can act as sensors. In this research work, a numerical model is implemented to analyze the frequency response of this kind of structure. It considers both transit time and capacitive effects, and can be applied to compute photodiode frequency response under nonuniform illumination. The InP-In0.53Ga0.47As photodiode is usually used to convert optical into electrical power at wavelengths around 1300 nm (O-band). This model is implemented considering an input frequency variation of up to 100 GHz. The focus of this research work was essentially the determination of the device's bandwidth from the computed spectra. This was performed at three different temperatures: 275 K, 300 K, and 325 K. The aim of this research work was to analyze if a InP-In0.53Ga0.47As photodiode can act as a temperature sensor, to detect temperature variations. Furthermore, the device dimensions were optimized, to obtain a temperature sensor. The optimized device, for a 6 V applied voltage and an active area of 500 µm2, had a total length of 2.536 µm, in which 53.95% corresponded to the absorption region. In these conditions, if the temperature increases 25 K from the room temperature, one should expect a bandwidth increase of 8.374 GHz, and if it decreases 25 K from that reference, the bandwidth should reduce by 3.620 GHz. This temperature sensor could be incorporated in common InP photonic integrated circuits, which are commonly used in telecommunications.

Risk Polymorphisms of FNDC5, BDNF, and NTRK2 and Poor Education Interact and Aggravate Age-Related Cognitive Decline.

Cognitive abilities tend to decline with aging, with variation between individuals, and many studies seek to identify genetic biomarkers that more accurately anticipate risks related to pathological aging. We investigated the influence of BDNF, NTRK2, and FNDC5 single nucleotide polymorphisms (SNPs) on the cognitive performance of young and older adults with contrasting educational backgrounds. We addressed three questions: (1) Is education associated with reduced age-related cognitive decline? (2) Does the presence of SNPs explain the variation in cognitive performance observed late in life? (3) Is education differentially associated with cognition based on the presence of BDNF, NTRK2, or FNDC5 polymorphisms? We measured the cognitive functions of young and older participants, with lower and higher education, using specific and sensitive tests of the Cambridge Automated Neuropsychological Test Assessment Battery. A three-way ANOVA revealed that SNPs were associated with differential performances in executive functions, episodic memory, sustained attention, mental and motor response speed, and visual recognition memory and that higher educational levels improved the affected cognitive functions. The results revealed that distinct SNPs affect cognition late in life differentially, suggesting their utility as potential biomarkers and emphasizing the importance of cognitive stimulation that advanced education early in life provides.

Survey on endocrine-disrupting chemicals in seafood: Occurrence and distribution.

Currently, the presence of endocrine disrupting chemicals (EDCs) in the marine environment pose а potential risk to both wildlife and human health. The occurrence of EDCs in seafood depends of several factors such as source and amounts of EDCs that reach the aquatic environment, physicochemical features of EDCs, and its accumulation in trophic chain. This review highlights the occurrence and distribution of EDCs along the seafood in the last 6 years. The following EDCs were included in this review: brominated flame retardants (PBDEs, PBBs, HBCDDs, TBBPA, and novel flame retardants); pharmaceuticals (paracetamol, ibuprofen, diclofenac, carbamazepine), bisphenols, hormones, personal care products (Musk and UV Filters), and pesticides (organochlorides, organophosphates, and pyrethroids). Some of them were found above the threshold that may cause negative effects on human, animal, and environmental health. More control in some countries, as well as new legislation and inspection over the purchase, sale, use, and production of these compounds, are urgently needed. This review provides data to support risk assessment and raises critical gaps to stimulate and improve future research.

Perfluoroalkylated compounds in the eggs and feathers of resident and migratory seabirds from the Antarctic Peninsula.

In this study, we investigated factors that influence the differences in exposure of perfluoroalkyl acids (PFAAs) from eight species of Antarctic seabirds, including Pygoscelis penguins, Stercorarius maccormicki, and Macronectes giganteus. We analyzed the relationship between foraging ecology (based on δ13C, δ15N, and δ34S values) and PFAAs accumulated in eggs and breast feathers. Ten out of 15 targeted PFAAs were detected in eggs compared to eight in feathers. Mean ∑PFAA concentrations in feathers ranged from 0.47 in P. antarcticus to 17.4 ng/g dry weight (dw) in S. maccormicki. In eggs, ∑PFAA concentrations ranged from 3.51 in P. adeliae to 117 ng/g dw in S. maccormicki. The highest concentrations of most PFAAs were found in trans-equatorial migrators such as S. maccormicki, probably due their high trophic position and higher concentrations of PFAAs in the Northern Hemisphere compared to the Southern Hemisphere. Based on stable isotopes correlations, our results suggest that the trophic position (δ15N) and the foraging area (δ13C and δ34S) influence PFAAs concentrations in Antarctic seabirds. Our results point to the possibility that long-distance migratory birds may have as bio-vectors in the transport of pollutants, including PFCAs, in Antarctic environments, although this must be further confirmed in future studies using a mass balanced approach, such as extractable organofluorine (EOF).

PAHs impacts on aquatic organisms: contamination and risk assessment of seafood following an oil spill accident.

Oil spills, intrinsically related to the petroleum production chain, represent a risk to the marine environment and a potential threat to humans through seafood consumption. We revised the NE Brazil oil spill and other accidents along the Brazilian coast, with a focus on seafood contamination, covering topics such as bioaccumulation, bioaccessibility, and risk analysis. Comprehensive knowledge of the impacts of spills helps in the interpretation of the dynamics of hydrocarbons released into the sea, contributing to actions to control their negative impacts. Currently, no legal limits have been established permanently in Brazil for PAHs in seafood edible tissues.

Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project).

PURPOSE: To compare the outcomes of PN to those of RN in very elderly patients treated for clinically localized renal tumor. PATIENTS AND METHODS: A purpose-built multi-institutional international database (RESURGE project) was used for this retrospective analysis. Patients over 75 years old and surgically treated for a suspicious of localized renal with either PN or RN were included in this database. Surgical, renal function and oncological outcomes were analyzed. Propensity scores for the predicted probability to receive PN in each patient were estimated by logistic regression models. Cox proportional hazard models were estimated to determine the relative change in hazard associated with PN vs RN on overall mortality (OM), cancer-specific mortality (CSM) and other-cause mortality (OCM). RESULTS: A total of 613 patients who underwent RN were successfully matched with 613 controls who underwent PN. Higher overall complication rate was recorded in the PN group (33% vs 25%; p = 0.01). Median follow-up for the entire cohort was 35 months (interquartile range [IQR] 13-63 months). There was a significant difference between RN and PN in median decline of eGFR (39% vs 17%; p < 0.01). PN was not correlated with OM (HR = 0.71; p = 0.56), OCM (HR = 0.74; p = 0.5), and showed a protective trend for CSM (HR = 0.19; p = 0.05). PN was found to be a protective factor for surgical CKD (HR = 0.28; p < 0.01) and worsening of eGFR in patients with baseline CKD. Retrospective design represents a limitation of this analysis. CONCLUSIONS: Adoption of PN in very elderly patients with localized renal tumor does not compromise oncological outcomes, and it allows better functional preservation at mid-term (3-year) follow-up, relative to RN. Whether this functional benefit translates into a survival benefit remains to be determined.

Coracoid morphology and humeral version as risk factors for subscapularis tears.

BACKGROUND: The pathophysiology of subscapularis (SS) lesions is still relatively unknown despite recent interest in predictive factors for SS tears. Our goal was to determine the influence of the coracoid morphology and humeral version on SS tears. METHODS: This was a retrospective, controlled, single-blinded study. We analyzed 232 shoulders with SS lesions confirmed by magnetic resonance imaging. The coracoid proximal length, coracoid distal length (CLD), and coracoid total length were measured. The coracoid length ratio, coracoid angle (CA), and humeral version were also evaluated. RESULTS: We found that greater humeral retroversion was progressively related to more serious SS injuries, with values of -28.6° ± 19.5° and -51.0° ± 11.1° in the normal SS group and tear group, respectively (P < .001). The same tendency was shown for the CA, with values of 123.8° ± 11.1° in the control group vs. 97.4° ± 10.1° in the tear group (P < .001). Greater CLD, coracoid total length, and coracoid length ratio were also associated with an increased risk of SS tears (P < .001). The CA and CLD represented the best predictors of SS tears, presenting areas under the receiver operating characteristic curve of 90.0% and 89.0%, respectively. CONCLUSIONS: This article is the first to study the influence of different parameters of the coracoid process morphology and humeral version on SS tears. We proved that humeral version and coracoid morphology were important risk factors for SS pathology and could accurately predict these lesions. Finally, our study was the first to create a classification system to divide coracoids according to their morphology and relative risk of associated SS tears.

Fluoroquinolones and trace elements in poultry litter: estimation of environmental load based on nitrogen requirement for crops.

Poultry litter soil application contributes to sustainability of agricultural systems and is in accordance with the United Nations Sustainable Development Goals (UN-SDG). Poultry litter recommended rates are based on crop nitrogen (N) needs, however, their application can be a potential source of antibiotics and trace elements overload. The aim of the study was to estimate the role of poultry litter application on soil contamination by fluoroquinolones [enrofloxacin (ENR) and ciprofloxacin (CIP)] and trace elements, based on N requirements for crops. Analytical and sampling techniques were used to estimate the loads from poultry litter application. Only CIP was found in poultry litter samples (283 ± 124 µg kg-1) and its load was estimated to be of 9.89 ± 4.33 g ha-1, for the poultry litter application (35 t ha-1). The estimated loads (g ha-1) of trace elements were: Cr 9.19 ± 3.26, Ni 12.3 ± 4.93, Pb 22.0 ± 8.26, Cu 229 ± 85.6, Mn 691 ± 259 and Zn 1,011 ± 378. These estimates were 900% higher than those recommended by the technical guidance, while N exceeded 600% the recommended application. In order to achieve UN-SDGs, local policies to disseminate knowledge and technologies are required for consolidating sustainable agricultural practices.

Residues of legacy organochlorine pesticides and DDT metabolites in highly consumed fish from the polluted Guanabara Bay, Brazil: distribution and assessment of human health risk.

Organochlorine (OCP) pesticides were determined in samples of sardine (Sardinella brasiliensis), whitemouth croaker (Micropogonias furnieri), and mullet (Mugil liza) from Guanabara Bay (state of Rio de Janeiro, Brazil). OCP concentrations and fish consumption were linked with acceptable daily intake values in order to assess the human health risk for the Brazilian population. The total concentrations of OCPs (Σ OCP) was 6.6 ng/g f.w., 7.5 ng/g f.w., and 2.8 ng/g f.w. for sardines, corvina, and mullet, respectively. There was a significant difference (P < 0.05) among the species related to o,p'-DDD and o,p'-DDT concentrations. Both DDT-related compounds were 5 and 76 times more abundant in sardines than in whitemouth croaker and mullet. Newly discovered DDT metabolite, o-Cl-DDMU, was frequently detected in the fish. None of the samples exceeded the maximum limits for acceptable levels of OCP residues. According to the data of average intake of Brazilian population, none of three species exceeded toxicological parameter. The investigated fishes are considered as safe for human consumption in regard to exposure of the studied OCPs. However, fish may be a intake source of OCP metabolites such as o-Cl-DDMU whose toxicity is still unknown.

Genes on the edge: A framework to detect genetic diversity imperiled by climate change.

Ongoing global warming is disrupting several ecological and evolutionary processes, spanning different levels of biological organization. Species are expected to shift their ranges as a response to climate change, with relevant implications to peripheral populations at the trailing and leading edges. Several studies have analyzed the exposure of species to climate change but few have explored exposure at the intraspecific level. We introduce a framework to forecast exposure to climate change at the intraspecific level. We build on existing methods by combining correlative species distribution models, a model of species range dynamics, and a model of phylogeographic interpolation. We demonstrate the framework by applying it to 20 Iberian amphibian and reptile species. Our aims were to: (a) identify which species and intraspecific lineages will be most exposed to future climate change; (b) test if nucleotide diversity at the edges of species ranges are significantly higher or lower than on the overall range; and (c) analyze if areas of higher species gain, loss, and turnover coincide with those predicted for lineages richness and nucleotide diversity. We found that about 80% of the studied species are predicted to contract their range. Within each species, some lineages were predicted to contract their range, while others were predicted to maintain or expand it. Therefore, estimating the impacts of climate change at the species level only can underestimate losses at the intraspecific level. Some species had significant high amount of nucleotide at the trailing or leading edge, or both, but we did not find a consistent pattern across species. Spatial patterns of species richness, gain, loss, and turnover were fairly concurrent with lineages richness and nucleotide diversity. Our results support the need for increased attention to intraspecific diversity regarding monitoring and conservation strategies under climate change.

Coracohumeral distance and coracoid overlap as predictors of subscapularis and long head of the biceps injuries.

BACKGROUND: Subscapularis (SS) lesions are often underdiagnosed because of an incomplete understanding of contributing factors but also because of a greater difficulty in SS tear diagnosis with magnetic resonance imaging or physical examination. In this setting, predicting factors can be useful tools in these injuries' management. The goal of this study was to determine the influence of the coracohumeral distance (CHD) and coracoid overlap (CO) in anterior rotator cuff lesions, as well as to determine the CHD and CO values that can accurately predict SS and long head of the biceps (LHB) injuries. METHODS: We performed a retrospective, controlled, single-blinded study. We analyzed 301 patients with rotator cuff pathology and magnetic resonance imaging studies; patients with SS lesions represented the study group. The CHD and CO were measured. RESULTS: We found that lower CHD and higher CO values were progressively related to more serious injuries of the SS and LHB. The CHD was a very strong predictor of SS injury and tear and a good predictor of LHB injuries. A CHD of 7.6 mm had a sensitivity of 84.4% and specificity of 88.6% for SS tears. The CO was also a very strong predictor of SS tears and a good predictor of LHB injury, with a CO of 16.6 mm reaching a sensitivity of 77.8% and specificity of 68.3% for SS tears. CONCLUSIONS: The CHD is an excellent predictor of SS tears and a good predictor of LHB lesions, with the CO also being a very strong predictor of SS tears and a good model for LHB injuries.

Effects of aeration on the suspended matter from a tropical and eutrophic estuary.

A comprehensive understanding of the complex biogeochemical interactions between organic matter and persistent contaminants in the suspended matter is vital for eco-efficient estuary recovery. However, little is known regarding aeration effects in suspended particulate aggregates. Therefore, this study aimed to investigate the effects of aeration on the suspended matter from a Tropical and Eutrophic estuarine environment. Anoxic water with 60 g/L of suspended particulate matter (SPM) was collected from Guanabara Bay, Rio de Janeiro, Brazil, transferred to experimental boxes and aerated for 61 days. SPM aggregates monitoring included abiotic variables measurements and, determination of total organic matter (TOM), biopolymers composition, bacterial activity, trace metals, and polycyclic aromatic hydrocarbons (PAHs) concentrations. The aeration enhanced dissolved oxygen (DO) concentration and the redox potential (Eh). However, from days 0 to 61 the predominant bacterial activities were denitrification and fermentation. Electron transport system activity increased after day 10, and aerobic activity was detected after day 19. In summary, aeration increased aerobic bacterial activity, lipids (LIP) and trace metal concentrations, although diminished protein/carbohydrate ratio and PAH concentration. Trace metals concentration (Ni, Pb, Cu, Cr, Mn, and Fe) were the highest on day 19 when the pH was 5.9. Copper presented toxic values (Cu > 20.0 µg/g). The pH showed a strong negative correlation with Eh (r = -0.94; p < 0.001). Acidic environment (pH ≤ 5.9) in marine ecosystems with high loads of toxic trace metals is unsafe for biota. Therefore, managers must be aware of the environmental and biological risks of introducing the aeration technique into a eutrophic marine environment.

Multi-temporal accumulation and risk assessment of available heavy metals in poultry litter fertilized soils from Rio de Janeiro upland region.

Poultry litter is widely used as fertilizer in soils and can be a relevant source of heavy metals for agricultural environments. In this study, poultry litter fertilization of long-term (< 1-30 years) was evaluated in tropical soils. Our main goal was to investigate the occurrence of temporal variation in the available fraction of heavy metals (Cu, Cr, Zn, Pb, Cd, and Mn) in soils, in addition to their environmental loads through new indexes for risk assessment. The highest mean concentrations in poultry litter were the following: 525 mg kg-1 for Mn, 146 mg kg-1 for Zn, and 94.4 mg kg-1 for Cu. For soils, concentrations were higher for the same heavy metals: Mn (906 mg kg-1), Zn (111 mg kg-1), and Cu (26.3 mg kg-1). Significant accumulation (p < 0.05) in fertilized soils was observed for Cu, Cr, and Zn. The high estimates of poultry litter input based on geological background (LIGB) for Cu, Cr, and Zn coincided with the accumulation observed in soils, confirming the effectiveness of the index. The risk of biogeochemical transfer based on fertilized soils (LIFS) decreased for Cu, Cr, and Zn between 10 and 30 years of soil fertilization. For Mn, a very high LIFS was estimated in all long-term fertilized soils. The proposed indices, based on heavy metal concentration, can be used in risk assessments to guide future studies that analyze other environmental matrices possibly impacted by manure and poultry litter fertilization.

Nontargeted Screening of Halogenated Organic Compounds in Bottlenose Dolphins (Tursiops truncatus) from Rio de Janeiro, Brazil.

To catalog the diversity and abundance of halogenated organic compounds (HOCs) accumulating in high trophic marine species from the southwestern Atlantic Ocean, tissue from bottlenose dolphins (Tursiops truncatus) stranded or incidentally captured along the coast of Rio de Janeiro, Brazil, were analyzed by a nontargeted approach based on GC×GC/TOF-MS. A total of 158 individual HOCs from 32 different structural classes were detected in the blubber of 4 adult male T. truncatus. Nearly 90% of the detected compounds are not routinely monitored in the environment. DDT-related and mirex/dechlorane-related compounds were the most abundant classes of anthropogenic origin. Methoxy-brominated diphenyl ethers (MeO-BDEs) and chlorinated methyl- and dimethyl bipyrroles (MBPs and DMBPs) were the most abundant natural products. Reported for the first time in southwestern Atlantic cetaceans and in contrast to North American marine mammals, chlorinated MBPs and DMBPs were more abundant than their brominated and/or mixed halogenated counterparts. HOC profiles in coastal T. truncatus from Brazil and California revealed a distinct difference, with a higher abundance of MeO-BDEs, mirex/dechloranes and chlorinated bipyrroles in the Brazilian dolphins. Thirty-six percent of the detected HOCs had an unknown structure. These results suggest broad geographical differences in the patterns of bioaccumulative chemicals found in the marine environment and indicate the need to develop more complete catalogs of HOCs from various marine environments.

The cessation of the long-term exposure to low doses of mercury ameliorates the increase in systolic blood pressure and vascular damage in rats.

This study aimed to verify whether a prolonged exposure to low-level mercury promotes haemodynamic disorders and studied the reversibility of this vascular damage. Rats were divided into seven groups: three control groups received saline solution (im) for 30, 60 or 90 days; two groups received HgCl2 (im, first dose, 4.6µg/kg, subsequent doses 0.07µg/kg/day) for 30 or 60 days; two groups received HgCl2 for 30 or 60 days (im, same doses) followed by a 30-day washout period. Systolic blood pressure (SBP) was measured, along with analysis of vascular response to acetylcholine (ACh) and phenylephrine (Phe) in the absence and presence of endothelium, a nitric oxide (NO) synthase inhibitor, an NADPH oxidase inhibitor, superoxide dismutase, a non-selective cyclooxygenase (COX) inhibitor and an AT1 receptor blocker. Reactive oxygen species (ROS) levels and antioxidant power were measured in plasma. HgCl2 exposure for 30 and 60 days: a) reduced the endothelium-dependent relaxation; b) increased the Phe-induced contraction and the contribution of ROS, COX-derived vasoconstrictor prostanoids and angiotensin II acting on AT1 receptors to this response while the NO participation was reduced; c) increased the oxidative stress in plasma; d) increased the SBP only after 60 days of exposure. After the cessation of HgCl2 exposure, SBP, endothelium-dependent relaxation, Phe-induced contraction and the oxidative stress were normalised, despite the persistence of the increased COX-derived prostanoids. These results demonstrated that long-term HgCl2 exposure increases SBP as a consequence of vascular dysfunction; however, after HgCl2 removal from the environment the vascular function ameliorates.

Patellar Height After Total Knee Arthroplasty: Comparison of 3 Methods.

BACKGROUND: Total knee arthroplasty (TKA) is the gold standard procedure for knee osteoarthritis. However, there have been conflicting reports concerning whether TKA is associated with modifications in patellar height. This controversy might be partially explained by the diversity of methods used to measure patellar height. Therefore, we aimed at assessing the reproducibility of 3 radiological indices commonly used to evaluate patellar height-Insall-Salvati (IS), Blackburne-Peel (BP), and Caton-Deschamps (CD) ratios. Additionally, we aimed at evaluating the short-term differences between preoperative and postoperative patellar heights as measured by those 3 methods. METHODS: Patellar heights were blindly measured by 2 researchers using IS, BP, and CD ratios in 203 knees. Interobserver agreement was evaluated by determination of intraclass correlation coefficients (ICC) and Bland-Altman plots. Preoperative and postoperative patellar heights were compared with Wilcoxon test. The association between postoperative pain and modifications in patellar height was assessed using Mann-Whitney U test. RESULTS: High interobserver agreement was found for IS (preoperative and postoperative ICC = 0.93), BP (preoperative ICC = 0.89; postoperative ICC = 0.91), and CD (preoperative ICC = 0.89; postoperative ICC = 0.90) ratios. Preoperative and postoperative patellar heights were not significantly different whatever the method used. Postoperative pain was reported after 23% procedures and was significantly associated with wider patellar height variations as measured by the BP ratio (P = .018). CONCLUSION: The methods evaluated appear to be reproducible. Although patellar height tended to be lower when measured postoperatively, this difference was not significant for any of the methods studied.