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Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

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open journal of orthopedics 2024年第1期14卷 41-52页

作者： Walter Hugo Brandão Nascimento Paulo Renan Matos Sucupira Cunha joão Pedro Pimentel Abreu Lethycia Pereira Rosa Kamilly Iêda Silva Veigas Rodrigo martins Silva Caetano orthopedic and Trauma Surgeon Brazilian Army Rio de Janeiro Brazil orthopedic and Trauma Surgeon S&atildeo Luís Brazil Scholarship Holder National Council for Scientific and Technological Development (CNPq) S&atildeo Luís Brazil School of Medicine Federal University of Maranh&atildeo (UFMA) S&atildeo Luís Brazil orthopedic and Trauma Surgeon Shoulder and Elbow Surgery Specialist University Hospital of the Federal University of Maranh&atildeo (HUUFMA/EBSERH) S&atildeo Luís Brazil

Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium

关键词： Acromioclavicular joint Shoulder Dislocation Surgical Procedure Postoperative Complications Postoperative Care

Antioxidants Enzymes Activities and No Levels in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis—A Comparative Study

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journal of Biosciences and Medicines 2024年第2期12卷 50-59页

作者： Natalia Cristina Aparecida Ribeiro e Ribeiro Anderson martins Tavares Jaslana Hainfellner da Silva joão Paulo Lima Daher Salim Kanaan Luciene de Carvalho Cardoso-Weide Laboratory of Neuroplasticity Neurobiology Department Biology Institute Federal Fluminense University Rio de Janeiro Brazil Postgraduate Program in Medical Sciences School of Medicine Federal Fluminense University Rio de Janeiro Brazil School of Biology UNIVERSO—Salgado de Oliveira University Rio de Janeiro Brazil Department of Pathology Faculty of Medicine Federal Fluminense University Rio de Janeiro Brazil

It consists of a retrospective study with twenty-two individuals diagnosed with DRC: fourteen HD and eight CAPD, followed up in the dialysis center of Antonio Pedro University Hospital (HUAP) of Fluminense Federal University (UFF), between 2015 and 2017. Fifteen healthy control (HC) subjects were included, without diagnosed CKD. Patients with HIV positive, hepatitis A, B, and C, pregnant, cancer, smokers, alcoholics and those exposed to X-rays in the last 3 months, were excluded. objectives: As oxidative stress and endothelial dysfunction may be linked to the higher prevalence of CVD in CKD patients, we measured the activities of the antioxidants enzymes: SoD and GPx and total No levels in the plasma and serum of end-stage CKD patients undergoing dialysis therapy, comparing with the HC group. Methods: Quantification of No levels was performed by fluorometric kit, while activities of SoD and GPx were determined using kinetic methods. Results: We found higher plasma SoD activity in HD (8.58 U/ml) and CAPD (10.14 U/ml), compared to C (3.73 U/ml) group, while GPx activity was decreased in HD (115.38 nmol/h/ml) and CAPD (122.76 nmol/h/ml) groups compared to HC group (275.83 nmol/h/ml). Total serum No concentration was decreased in HD (14.09 pmol/μl) and CAPD (10.26 pmol/μl), compared to non-CKD patients (49.65 pmol/μl). Conclusion: Decreased total serum No and GPx activities may lead to endothelial dysfunction and consequently a higher prevalence of CVD in CKD patients.

关键词： Hemodialysis CAPD SoD GPx No

NDRank: optimised parallel search for weather analogues

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Big Earth Data 2023年第2期7卷 276-297页

作者： David martins Miguel Ferreira joão Nuno Silva Instituto Superior Técnico Universidade de LisboaLisboaPortugal Caravela Energy Partners DarienConnecticutUSA Distributed Parallel and Secure Systems GroupINESC-ID LisboaLisboaPortugal

Global meteorology data are now widely used in various areas, but one of its applications, weather analogues, still require exhaustive searches on the whole historical data. We present two optimisations for the state-of-the-art weather analogue search algorithms: a parallelization and a heuristic search. The heuristic search (NDRank) limits of the final number of results and does initial searches on a lower resolution dataset to find candidates that, in the second phase, are locally validated. These optimisations were deployed in the Cloud and evaluated with ERA5 data from ECMWF. The proposed parallelization attained speedups close to optimal, and NDRank attains speedups higher than 4. NDRank can be applied to any parallel search, adding similar speedups. A substantial number of executions returned a set of analogues similar to the existing exhaustive search and most of the remaining results presented a numerical value difference lower than 0.1%. The results demonstrate that it is now possible to search for weather analogues in a faster way (even compared with parallel searches) with results with little to no error. Furthermore, NDRank can be applied to existing exhaustive searches, providing faster results with small reduction of the precision of the results.

关键词： Multidimensional arrays weather analogues search parallel computing algorithm optimisation

Evaluation of markers of outcome in realworld treatment of diabetic macular edema

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Eye and Vision 2018年第1期5卷 240-249页

作者： António Campos Elisa J Campos Anália do Carmo Francisco Caramelo joão martins joão P Sousa António Francisco Ambrósio Rufino Silva Coimbra Institute for Clinical and Biomedical Research(iCBR) Faculty of MedicineUniversity of CoimbraAzinhaga de Santa CombaCelas3000-548 CoimbraPortugal CNC.iCBR Consortium University of CoimbraCoimbraPortugal Department of ophthalmology Leiria HospitalLeiriaPortugal Clinical Pathology Department Centro Hospitalar Universitário de Coimbra(CHUC)CoimbraPortugal Laboratory of Biostatistics and Medical Informatics Faculty of MedicineUniversity of CoimbraCoimbraPortugal Medical Sciences Department Faculty of Health SciencesUniversity of Beira InteriorCovilhãPortugal Association for Innovation and Biomedical Research on Light and Image(AIBILI) CoimbraPortugal Department of ophthalmology Centro Hospitalar Universitário de Coimbra(CHUC)CoimbraPortugal

objective:To evaluate short-term markers of outcome in diabetic macular edema(DME).Methods:Prospective interventional case series included 122 eyes of 122 patients with recently diagnosed DME.Eyes were treated with a 3-monthly loading dose of ranibizumab or aflibercept and pro re nata thereafter.Serial enhanced deep imaging SD-oCT high resolution scans were used to measure subfoveal choroidal thickness(SFCT)and central retinal thickness(CRT).Anatomic(10%CRT decrease)and functional responses(best corrected visual acuity,BCVA gain≥5 letters)were assessed at 3 months and 6 months using univariate and multivariate analyses.Parameters tested were gender,duration of diabetes,HbA1c,hypertension,CRT,SFCT,BCVA,ellipsoid zone(EZ)status,subfoveal neuroretinal detachment(SND),anti-VEGF used and laser naivety.A logistic regression model was applied to find independent markers outcome.Results:BCVA increased,CRT and SFCT decreased at 3 months and 6 months.Good metabolic control(p=0.003),intact baseline EZ(p=0.030),EZ re-grading at 3 M(pociated with better functional outcome.The multivariate linear regression model showed that baseline SND and CRT are predictors of anatomic response,while lower baseline BCVA and intact EZ are predictors of functional response.Conclusion:The presence of SND predicts anatomic response only,while an intact EZ is critical to achieve a good functional outcome in DME.

关键词： Diabetic macular edema outcome factors Spectral-domain optical coherence tomography Antivascular endothelial growth factor Laser

Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients

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journal of Sport and Health Science 2024年第4期13卷 548-558,F0003页

作者： Hugo de Luca Correa Lysleine Alves Deus Dahan da Cunha Nascimento Nicholas Rolnick Rodrigo Vanerson Passos Neves Andrea Lucena Reis Thais Branquinho de Araujo Carmen Tzanno-martins Fernanda Silveira Tavares Luiz Sinesio Silva Neto Claudio Avelino Rodrigues Santos Paolo Lucas Rodrigues-Silva Fernando Honorato Souza Vitoria Marra da Motta Vilalva Mestrinho Rafael Lavarini dos Santos Rosangela Vieira Andrade jonato Prestes Thiago dos Santos Rosa Post-graduate Program of Physical Education Catholic University of BrasıliaBrasılia 71966-700Brazil The Human Performance Mechanic Lehman CollegeNew YorkNY 10011USA Clinical Group Home Dialysis Center and RenalClass Sao Paulo 01239-040Brazil Department of Medicine Catholic University of BrasıliaBrasılia 71966-700Brazil Faculty of Medicine Federal University of TocantinsTocantins 77001-090Brazil Embrapa Genetic Resources and Biotechnology Brasılia 70770-917Brazil Graduate Program of Genomic Sciences and Biotechnology Brasılia 71966-700Brazil

Background:Hemodialysis(HD)per se is a risk factor for thrombosis.Considering the growing body of evidence on blood-flow restriction(BFR)exercise in HD patients,identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model.The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise(RE)with BFR on this molecule.Methods:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate ofon consisted of 50%arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s)and were supervised by a strength and conditioning specialist.Results:Several variables were associated with elevated levels of D-dimer,including higher blood glucose,citrate use,recent cardiovascular events,recent intercurrents,higher inflammatory status,catheter as vascular access,older patients(>70 years old),and HD vintage.Furthermore,RE+BFR significantly increases D-dimer after 4 h.Patients with borderline baseline D-dimer levels(400-490 ng/mL)displayed increased risk of elevating D-dimer over the normal range(-500 ng/mL).Conclusion:These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE+BFR.D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE+BFR.

关键词： Blood-flow restriction Chronic kidney disease Coagulation Hemodialysis Vascular occlusion exercises

Response to Commentary by Dr. Matthew J. Clarkson on "Concerns on the application of blood-flow restriction resistance exercise and thrombosis risk in hemodialysis patients"

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journal of Sport and Health Science 2024年第5期13卷 670-671页

作者： Hugo de Luca Corrêa Lysleine Alves Deus Dahan da Cunha Nascimento Nicholas Rolnick Rodrigo Vanerson Passos Neves Andrea Lucena Reis Thais Branquinho de Araújo Carmen Tzanno-martins Fernanda Silveira Tavares Luiz Sinésio Silva Neto Cláudio Avelino Rodrigues Santos Paolo Lucas Rodrigues-Silva Fernando Honorato Souza Vitória Marra da Motta Vilalva Mestrinho Rafael Lavarini dos Santos Rosangela Vieira Andrade jonato Prestes Thiago dos Santos Rosa Post-graduate Program of Physical Education Catholic University of BrasıliaBrasılia 71966-700Brazil The Human Performance Mechanic Lehman CollegeNew YorkNY 10011USA Clinical Group Home Dialysis Center and RenalClass Sao Paulo 01239-040Brazil Department of Medicine Catholic University of BrasıliaBrasılia 71966-700Brazil Faculty of Medicine Federal University of TocantinsTocantins 77001-090Brazil Embrapa Genetic Resources and Biotechnology Brasılia 70770-917Brazil g Graduate Program of Genomic Sciences and Biotechnology Brasılia 71966-700Brazil

Dear editor:We sincerely thank Matthew J.Clarkson for his insightful commentary1 on our recent publication in the journal of Sport and Health Science.2 Clarkson's pioneering work in the development and application of blood flow restriction (BFR) exercise protocols has undeniably laid the groundwork for subsequent investigations in this field,including our own.(3-6)His commentary not only highlights the relevance and timeliness of our study but also offers valuable perspectives on refining safety considerations for intradialytic BFR exercise among hemodialysis patients.

关键词： patients application flow

Hepatic“pregnancy”:hepatocellular carcinoma with extensive extrahepatic growth

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 641-642页

作者： Ana Rita Ferreira Bárbara Castro jose Daniel martins joão Varanda Alexandre Costa Bela Pereira Manuel oliveira General Surgery Centro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal

A female in her 50s,no previous personal history,presented to the Emergency Department with a 7 months history of progressively worsening abdominal diffuse pain associated with increasing abdominal volume.on physical ... 详细信息

关键词： pregnancy Hepatic Figure

Dexamethasone intravitreal implant(ozurdex) in diabetic macular edema: real-world data versus clinical trials outcomes

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International journal of ophthalmology(English edition) 2021年第10期14卷 1571-1580页

作者： Pedro Neves Mário ornelas Inês Matias joão Rodrigues Margarida Santos Marco DutraMedeiros David martins Department of ophthalmology Centro Hospitalar de SetúbalSetúbal 2910-549Portugal Department of ophthalmology Hospital BeatrizÂngeloLoures 2674-514Portugal Department of ophthalmology Hospital da Luz SetúbalSetúbal 2900-722Portugal Department of ophthalmology Centro Hospitalar Lisboa CentralFaculdade de Ciências MédicasNOVA University of LisbonLisbon 1990-237Portugal

AIM: To investigate the safety and efficacy of intravitreal dexamethasone implants(ozurdex?/DEX) in patients with diabetic macular edema(DME) either na?ve or nonna?ve to anti-VEGF therapies who switched to DEX implant independent of response to anti-vascular endothelial growth factors(anti-VEGFs).METHoDS: This was an audit retrospective review of medical records of patients with DME who switched to the DEX intravitreal implant. Patients were divided into 2 groups: patients na?ve to antiangiogenic therapy and patients who were previously treated with anti-VEGFs. Data regarding demographics, changes in mean best-corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IoP) was collected over 6 mo. The demographic data mean changes in BCVA, CMT, and IoP were compared. Six-month follow-up data of 47 patients(57 eyes), who either switched to DEX implant irrespective of response to previous treatments or were treatment na?ve before receiving DEX implant, was collected.RESULTS: Improvement in mean BCVA was observed from 1-4 mo after injection with a decreased effect at month 6 as expected, with better outcomes in na?ve compared to non-na?ve patients. A statistically relevant decrease in mean CMT was observed during the follow-up period. An increase in mean IoP was observed in the first 2 mo after DEX therapy. The mean number of injections of the overall population during the 6 mo was 1.3. A subgroup analysis showed no relevant difference between phakic versus pseudophakic patients relative to measured outcomes. There was no cataract progression during the follow-up period and no adverse events reported.CoNCLUSIoN: This real-life setting study shows that intravitreal DEX implant is effective and safe. The timings of greater therapeutic impact are concordant with previous studies and suggest that earlier treatment with corticosteroids may have an additional benefit in na?ve patients.

关键词： anti-VEGF therapy diabetic macular edema dexamethasone intravitreal implant na?ve eyes steroids

Curcumin in inflammatory bowel diseases:Cellular targets and molecular mechanisms

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BIoCELL 2023年第11期47卷 2547-2566页

作者： AMYLLY SANUELLY DA PAZ martins MARLA DE CERQUEIRA ALVES oRLANDo RoBERTo PIMENTEL DE ARAÚjo FABIANA oLIVEIRA DoS SANToS CAMATARI MARÍLIA oLIVEIRA FoNSECA GoULART FABIANA ANDRÉA MoURA Rede Nordeste de Biotecnologia(RENoRBIo) Instituto de química e BiotecnologiaUniversidade Federal de Alagoas(UFAL)Maceió57072-900Brasil Programa de Pós-graduação em Nutrição(PPGNUT) Faculdade de Nutrição(FANUT)Universidade Federal de Alagoas(UFAL)Maceió57072-900Brasil Programa de Pós-Graduação em Química e Biotecnologia(PPGQB) Instituto de química e BiotecnologiaUniversidade Federal de Alagoas(UFAL)Maceió57072-900Brasil Colegiado de Nutrição Universidade de Pernambuco(UPE)Campus PetrolinaPernambuco56328-900Brasil Programa de Pós-Graduação em Ciências da Saúde(PPGCS) Instituto de Ciências da SaúdeUniversidade Federal de Alagoas(UFAL)Maceió57072-900Brasil Programa de Pós-graduação em Ciências Médicas(PPGCM) Faculdade de MedicinaUniversidade Federal de Alagoas(UFAL)Maceió57072-900Brasil

Curcumin,a natural product,has exhibited promising effects in both animal models and clinical trials,interacting with a multitude of factors linked to Inflammatory Bowel Disease(IBD).These factors encompass cytokines,oxidative stress-associated enzymes,and modulation of the intestinal microbiota.Notably,curcumin has demonstrated therapeutic potential in animal models of colitis,wherein it exerts a negative regulatory influence on pivotal signaling pathways such as PI3/Akt,JAK/STAT,andβ-catenin.Moreover,it inhibits the expression of proinflammatory enzymes and co-stimulatory molecules(including RANKL,ICAM-1,CD205,CD256,TLR4,among others),while curbing immune cell chemotaxis,thereby attenuating the characteristic neutrophil infiltration observed in IBD.Another facet of curcumin’s action involves its modulation of the intestinal microbiota.Notably,the microbiota itself contributes to beneficial biotrans formations of curcumin,thereby enhancing its effectiveness in IBD treatment.on a clinical front,curcumin has demonstrated the ability to induce clinical and/or endoscopic remission without any reported toxic effects.Hence,curcumin warrants consideration as an adjunctive therapy in IBD management.Subsequent clinical investigations should concentrate on meticulously evaluating curcumin’s impact on these precise therapeutic targets.

关键词： Curcuminoids Polyphenols CDAI scores Ulcerative colitis Antioxidant