Arthroscopic surgical treatment of medial epicondylitis.

BACKGROUND: The study purpose was to evaluate the outcomes of patients who received arthroscopic surgical treatment for medial epicondylitis refractory to conservative treatment. METHODS: This was a retrospective study of 7 patients who underwent arthroscopic surgical débridement of the common flexor tendon for treatment of medial epicondylitis refractory to conservative treatment. The patients were assessed using the Disabilities of the Arm, Shoulder and Hand score; visual analog scale for pain; and Short Form 36 Health Survey. The mean age at the time of surgery was 50 years (range, 36-67 years). The mean duration of symptoms before surgery was approximately 2 years (range, 8 months to 4 years). The mean follow-up duration was 17 months (range, 6-48 months). RESULTS: The average postoperative scores were 17 points on the Disabilities of the Arm, Shoulder and Hand outcome measure; 2 points on the visual analog scale at rest for 6 subjects (86%) with slight pain and 1 (14%) with moderate pain; and 78 on the Short Form 36 Health Survey. No significant complications were observed when the procedure was performed via arthroscopy. CONCLUSION: Arthroscopic surgical treatment for medial epicondylitis of the elbow exhibits good outcomes and is safe and effective.

Changes in bacterial communities induced by integrated production systems and the phenological stages of soybean.

Plant development and productivity depend on interactions with soil microorganisms for nutrient availability, promotion of growth and protection against phytopathogens. Although the influence of the phenological stages of soybean crops and their environmental conditions on the soil bacterial communities have already been reported, no studies have focused on the influence of integrated agrosilvopastoral systems on bacterial consortia. In this study, we evaluated the influence of the phenological stages of soybean cultivated under conventional full sunlight (CFS) and integrated crop-livestock-forestry (ICLF) systems on bacterial communities in the rhizosphere and in bulk soil using high-throughput sequencing techniques. Proteobacteria, Actinobacteriota and Acidobacteriota were the most abundant phyla in both the rhizosphere and the bulk soil at all growth stages. The results support our hypotheses that the richness and diversity of soil bacterial communities are influenced by different cultivation systems, and that the structure of the bacterial communities in the rhizosphere and the bulk soil are modulated by the phenological stages of the soybean crop.

Secretory breast carcinoma in a male child: Case report and literature review.

INTRODUCTION: The secretory breast carcinoma is very rare in children. It represents less than 1% of malignancy cases in childhood and is even less common in males, with 15 cases reported until 2004. Therefore, the aim of this study is to report a male child with breast carcinoma and review literature. PRESENTATION OF CASE: A 14-year-old male patient with a history of a painless slow-growing lump in the left breast and, five years later, onset of yellow discharge from the papilla. Ultrasound scanning demonstrated a well- defined, regular, homogeneous and hypoechoic mass. Nodule excision was initially performed, followed by mastectomy, due to compromised radial margin. Immunohistochemistry revealed weakly positive estrogen and progesterone receptors. Adjuvant therapy was not required. Sixteen months after resection, the patient is well with no complaints or recurrence. DISCUSSION: Due to its rarity, there is no therapeutic guideline. Although the recommended treatment is still surgical excision, there is no consensus as to its extent. Prognosis is usually favorable. Our patient was submitted to mastectomy with sentinel lymph node biopsy due to compromised radial margin. CONCLUSION: Secretory breast carcinoma is a rare form of breast cancer, especially in male children; which hampers standardization of diagnosis, treatment and prognosis establishment.

ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION.

OBJECTIVE: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. METHODS: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). RESULTS: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. CONCLUSION: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.

OBJETIVO: Avaliar os resultados dos pacientes submetidos a tratamento cirúrgico artroscópico da epicondilite lateral (EL) refratária depois da falha no tratamento conservador. MÉTODOS: Estudo retrospectivo que incluiu 104 pacientes submetidos a desbridamento artroscópico do tendão extensor radial curto do carpo (ERCC) para tratamento de EL. Os pacientes foram avaliados pelo escore de DASH, pela classificação visual analógica de dor (EVA) e pelo Short-Form 36 (SF36). A média da idade foi de 46,9 anos (variação de 30 a 69 anos). O tempo de sintomas foi de 2,1 anos (variação de 6 meses a 10 anos). O seguimento médio foi de 34,4 meses (variação de 6 ­ 68 meses). RESULTADOS: A média dos escores pós-operatórios foi de: 20,67 pontos no DASH; 1,8 pontos no EVA de repouso, sendo 48 (46%) sem dor, 40 (38%) com dor leve, 13 casos (13%) com dor moderada e 4 (4%) com dor intensa; 4,7 pontos no EVA em atividade, sendo 21 (20%) sem dor, 21 (20%) com dores leves, 35 (34%) com dores moderadas e 27 (26%) com dores intensas; e SF-36 de 66,8. Dos 23 pacientes em prática constante de esporte ou com maior demanda física nos membros superiores, 17 (74%) conseguiram retornar ao mesmo nível. Não observamos complicações significativas exceto por 3 (2,8%) casos de infecção pós-operatória superficial. CONCLUSÃO: O tratamento artroscópico para EL recalcitrante do cotovelo é eficaz e seguro, apresentando resultados positivos. Nível de Evidencia IV, Série de Casos.

ARTHROSCOPIC LATARJET TECHNIQUE COMBINED WITH ENDOBUTTONS: FUNCTIONAL OUTCOMES IN 26 CASES.

OBJECTIVE: The cause of anterior shoulder instability is not fully understood and surgical management remains controversial. The objective of this study was to evaluate the results of patients undergoing arthroscopic Latarjet procedure with endobuttons. METHODS: A retrospective study of 26 patients undergoing arthroscopic Latarjet procedure with endobuttons to treat anterior shoulder instability. Patients with previous glenohumeral instability, failure of Bankart procedure or Instability Severity Index Score (ISIS) greater than or equal to 6, were included. Patients were assessed by: DASH, UCLA, Rowe, Visual Analog Scale (VAS) of pain and Short-Form 36 (SF36) scores. Correct position and consolidation of the graft were evaluated. RESULTS: Mean age was 31.5 years (16 to 46). Preoperative duration of symptoms was 1.7 years (1 month to 10 years). Mean follow-up was 14.3 (6 to 24) months. Mean postoperative scores were: 10 points in DASH; 1.6 in VAS, where 23 (88%) patients experienced mild pain and 3 (12%) moderate pain; 89 in Rowe; 32 in UCLA and 78 in SF-36. Positioning of the graft was correct in 25 (96%) cases, and was consolidated in 23 (88%). We had two cases of graft fracture (7%) and postoperative migration (7%). CONCLUSION: Surgical treatment using arthroscopic Latarjet with endobuttons is safe and effective, producing good functional outcomes in patients. Level of Evidence IV, Case Series.

OBJETIVO: A causa da instabilidade anterior do ombro não é totalmente esclarecida e o tratamento cirúrgico é controverso. O objetivo deste estudo foi avaliar o resultado dos pacientes submetidos à técnica de Latarjet artroscópica com endobuttons. MÉTODOS: Estudo retrospectivo de 26 pacientes submetidos à técnica de Latarjet artroscópica com endobuttons para tratamento de instabilidade anterior do ombro. Foram incluídos pacientes com instabilidade glenoumeral anterior, falha no procedimento de Bankart ou Instability Severity Index Score (ISIS) maior ou igual a 6. Foram avaliados mediante DASH, UCLA, Rowe, Escala Visual Analógica de dor (EVA) e pelo Short-Form 36 (SF36). Avaliamos também a posição correta e a consolidação do enxerto. RESULTADOS: A média de idade foi de 31,5 anos (16 a 46). Os sintomas antes da cirurgia foram de 1,7 anos (1 mês a 10 anos). Seguimento médio de 14,3 (6 ­ 24) meses. A média dos escores pós-operatórios foi de 10 pontos no DASH; 1,6 pontos na EVA sendo 23 (88%) dores leves e 3 (12%) dores moderadas; Rowe de 89, UCLA de 32; SF-36 de 78. O posicionamento foi correto em 25 (96%) casos e consolidou em 23 (88%). Tivemos 2 casos de fratura (7%) e de migração pós-operatória do enxerto (7%). CONCLUSÃO: A cirurgia de Latarjet artroscópica com endobuttons é eficaz e segura, produzindo bons resultados funcionas. Nível de Evidencia IV, Série de Casos.

Biocompatibility of resin-based dental materials applied as liners in deep cavities prepared in human teeth.

BACKGROUND: Since only a few data have been published concerning the effects of resinous dental materials on the pulp-dentin complex, the aim of this study was to evaluate the biocompatibility of resin-based materials applied as liners in deep cavities prepared in human teeth. METHODS: After preparing class V cavities, the following dental materials were applied on the axial walls: group 1, Vitrebond (VIT; 3M ESPE); group 2, Ultra-Blend Plus (UBP; Untradent); and group 3, Clearfil SE Bond (CSEB; Kuraray). In group 4 (control), the hard-setting calcium hydroxide cement Dycal (CH; Caulk/Dentsply) was used. The teeth extracted at 7 days or between 30 and 85 days after the clinical procedures were processed for histological evaluation. RESULTS: For all the experimental and control groups, most of specimens exhibited no pulpal response or slight inflammatory reaction associated with slight tissue disorganization at 7-day period. Moderate inflammatory pulpal response occurred only in one tooth (RDT = 262 microm) of group 3 in which transdentinal diffusion of resin components was observed. CONCLUSION: The resin-based dental cements VIT and UBP as well as the bonding agent CSEB presented acceptable biocompatibility when applied in deep cavities prepared in sound human teeth.

Origin of mounds in the Pantanal wetlands: An integrated approach between geomorphology, pedogenesis, ecology and soil micromorphology.

Vegetated mounds are an important geomorphological feature of the Pantanal, where the influence of floods dictates not only hydropedological processes, but also the distribution and ecology of the flora and fauna. This work aimed to identify factors and processes that influence the formation and spatial distribution of the mounds, which are commonly associated with termite activity. In order to characterize pedological processes, macro and micro morphological descriptions, satellite image interpretation, dating of the sandy sedimentary material using OSL and carbon dating using 14C AMS were carried out. This dating of the materials indicates that the sediments in which the soils were formed were deposited during the Pleistocene, while the carbonates are from the Holocene. The basin-like format of the laminar structures suggests that part of the more clayey material was deposited in lacustrine environments. The more humid climate in the Holocene intensified argilluviation, which at an advanced stage, led to a more pronounced textural gradient, reducing drainage and leading to ferrolysis and thickening of the E horizon. Besides pedogenic processes, more erosive flooding during the Holocene began reducing and rounding the landscape's more elevated structures (paleolevees). In the final stage, these structures were occupied by termites to shelter from flooding. Thereafter, the bio-cementation action of the termite nests has increased the resistance of the vegetated mounds to processes of erosion.

Response of human pulps following acid conditioning and application of a bonding agent in deep cavities.

OBJECTIVES: The aim of this in vivo study was to evaluate the human dental pulp response when a one-bottle adhesive system was applied on etched or unetched deep dentine. METHODS: Eighteen class V deep cavity preparations were divided in three groups: group 1-total etching + two coats of single bond (SB) + composite resin (Z-100); group 2-enamel etching + two coats of SB + Z-100; group 3-cavity floor lined with a calcium hydroxide liner (Dycal) + acid-etching of enamel and lateral walls + two coats of SB + Z-100. Two teeth were used as intact control group. After 30 days the teeth were extracted and processed through H and E, Masson's trichrome and Brown and Brenn staining techniques. RESULTS: Moderate inflammatory response, disorganization of pulp tissue, as well as, deposition of thin layer of reactionary dentin were observed in group 1 teeth in which the remaining dentin thickness (RDT) was less than 300 microm. These histological findings appear to be related to long resin tags formation and bonding agent diffusion through dentinal tubules. In group 2, slight inflammatory response was observed only in one tooth in which the RDT was 162 microm. In group 3, all the teeth showed normal histological characteristics which were similar to the intact control group. Presence of bacteria was not correlated with the intensity of pulpal response. The patients reported no symptoms during the experiment. Radiographic evaluation showed no periapical pathology for any of the teeth. SIGNIFICANCE AND CONCLUSIONS: Acid-etched deep dentin (RDT less than 300 microm) lined with SB causes more intense pulpal response than unetched deep dentin. Based on the results observed in the present study and the conditions in which it was carried out, we recommend the application of a biocompatible liner before etching deep dentin and applying SB.

Short-term evaluation of the pulpo-dentin complex response to a resin-modified glass-ionomer cement and a bonding agent applied in deep cavities.

OBJECTIVES: To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth. METHODS: Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group 1 the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome and Brown and Brenn techniques. RESULTS: In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization. CONCLUSIONS: Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal.

Caracterização química e citotoxicidade do óleo essencial do cravo-da-índia (Syzygium aromaticum) / Chemical characterization and cytotoxicity of clove essential oil (Syzygium aromaticum)

RESUMO Este trabalho avalia as propriedades-físico químicas do óleo essencial dos botões florais seco do cravo-da-índia (Syzygium aromaticum) que são encontradas no Municipio de São Luís, Maranhão. Extraiu-se quantitativamente o óleo essencial por hidrodestilação. Determinaram-se as propriedades físico-químicas do óleo essencial (densidade, índice de refração, solubilidade, cor e aparência) e atividade citotóxica frente às larvas da Artemia salina. Caracterizou-se analiticamente o óleo por cromatografia gasosa acoplada a espectrómetro de massas (CG-EM). Os resul tados mostram que o melhor tempo e o rendimento do óleo foram correspondente mente 4 horas e 4,33 % de massa por volume. A partir disso foi possível identificar 5 componentes, sendo a presença majoritária do eugenol que logo foi confirmada pelas técnicas espectroscópica. Na identificação do componente majoritário e dos demais componentes, bem como suas quantificações, as técnicas foram precisas e os métodos eficientes, proporcionando um bom desempenho analítico nas determinações.

Summary This work evaluates the physical-chemical properties of the essential oil of the dry floral buds of clove (Syzygium aromaticum) that are found in the Municipality of Saint Louis, Maranhão. The essential oil was quantitatively extracted by hydrodistil lation. The physicochemical properties of the essential oil (density, refractive index, solubility, color and appearance) and cytotoxic activity against larvae of Artemia salina were determined. The oil was analytically characterized by gas chromatog raphy coupled to mass spectrometer (GC-MS). The results show that the best time and yield of the oil were correspondingly 4 hours and 4.33% mass per volume. From this, it was possible to identify five components, being the major presence of eugenol that soon was confirmed by the spectroscopic techniques. In the identification of the major component and the other components, as well as their quantifications, the techniques were precise and the methods efficient, providing a good analytical performance in the determinations.