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BACKGROUND: Medial malleolar fractures are frequent, and their treatment is familiar to the orthopedic surgeon. Lag screw fixation using partially threaded screws remains the standard treatment method for medial malleolar fractures. However, the literature lacks a defined method for selecting lag screw length, relying more so on the empiric choice of the surgeon. AIM: The aim of this study is to help define the ideal lag screw length for medial melleolar fracture fixation. MATERIALS AND METHODS: One hundred and sixteen anatomic specimens were included in the study. A transverse cut was performed in the distal third of the tibia, roughly 1 and a half times the distal tibial plafond width from the ankle joint. A coronal cut was then performed using the center of the medial malleolus. Three observers measured the distance between the medial malleolus tip and beginning of the medullary canal in all anatomic specimens. Differences in measurements were statistically compared, level of (P ≤ 0.05). Interclass correlation coefficient (ICC) significance level was set at P < 0.05. RESULTS: Measurement average was 55 mm between the medial malleolus tip and the medullary canal, with a standard deviation of 10 mm. High concordance (ICC: 0.819) was achieved among all pairs of observers (P < 0.01). The systematic difference among measurements was absent, and random distribution around general measurements was observed. CONCLUSION: The authors recommend a screw length of no more than 45 mm to optimize the location of the screw threads in the best cancellous bone in an effort to obtain the most compression.

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In the present investigation 28 serologically positive HIV-1 patients, 16 patients with AIDS (< 200/mm3 CD4+ T lymphocytes) and 12 with HIV-1 (200 to 500/mm3 CD4+ T lymphocytes) were studied. The Control Group consisted of 11 healthy individuals. The occurrence of alterations in the anthropometric parameters were higher in AIDS patients, compared to HIV-1 and controls patients, indicating a greater level of malnutrition. All individuals in present study showed normal plasma vitamin A levels. Contrasting, urinary excretion of vitamin A were higher in the AIDS Group (0.23 +/- 0.20 mumol/l) than in the HIV Group (0.19 +/- 0.12 mumol/l) and considerably higher than in the Control Group (0.06 +/- 0.05 mumol/l). Urinary excretion of TBARS also were higher in AIDS Group (3.34 +/- 2.65 mumol/l) compared to HIV (1.71 +/- 0.74 mumol/l) and Control Group (1.70 +/- 0.75 mumol/l). These results demonstrate a greater level of malnutrition and elevate excretion of vitamin A and SRATB in urine of AIDS patients. Therefore, monitoring of nutritional status, especially in relation to vitamin A is recommended for patients with HIV and AIDS.

Assuntos

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Vitamin A deficiency is one of the major nutritional problems in the world, most common in developing countries. Food fortification is a recognised approach to supply vitamins and minerals to needed populations. Vegetable cooking oils were previously suggested by us as a carrier for vitamin A fortification. Fortification of cooking oil with beta-carotene could also be a strategy to prevent vitamin A deficiency. The objective of this article is to start studies on the use of cooking soya oil as a vehicle for synthetic carotene, to evaluate its stability to heat treatment, and to test its bioavailability and bioconversion to vitamin A in rats. Batches of carotene-fortified soybean oil were prepared, containing 2, 4 and 8 RE/g of diet. Some of them were heated to test its stability. At 100 degrees C there was no loss of carotene, at higher temperature carotene retention was 65%. The bioavailability and bioconversion of beta-carotene added to soybean oil was measured through feeding nursing rats and their pups method. Weight gain was good and plasma vitamin A increased significantly in all groups. Liver vitamin A values of rats fed diets with fortified soybean oil heated at 100 degrees C was similar to the 4 RE non-heated fortified oil group (0.72 +/- 0.06 and 0.64 +/- 0.08 mumol/g, respectively). Heated at 170 degrees C the liver total vitamin A value was reduced (0.45 +/- 0.04 mumol/g), but kept bioavailable vitamin A equivalent to 2 RE (0.47 +/- 0.09 mumol/g). Bioconversion of beta-carotene to vitamin A was validated by the plasma and liver findings. beta-carotene added to soybean oil showed good stability to heat and its bioconversion to vitamin A was shown in rat assays. beta-carotene mixed well with edible soybean oil and the fortified cooking oil showed potential as a carrier to be used for the prevention of vitamin A deficiency.

Assuntos

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With the purpose of studying the immunological components of granulomatous hypersensitivity in patients infected with Paracoccidioides brasiliensis, we used the model of in vitro granuloma formation developed for schistosomiasis studies, that correlates with in vivo granulomatous reactivity occurring around eggs trapped in organs of infected donors. In this case, granuloma formation can be determined examining cellular reactivity manifested as multiple cell layers surrounding antigen-conjugated polyacrilamide beads. Our results showed that peripheral blood mononuclear cells (PBMC) obtained from acute treated and chronic paracoccidioidomycosis patients proliferate and generate in vitro granulomas in response to P. brasiliensis antigens (PbAg). In contrast, no proliferation or granuloma formation were observed when PBMC from acute non-treated patients were used. These studies demonstrate the feasibility of investigating granulomatous hypersensitivity in P. brasiliensis-infected patients by using an in vitro granuloma model.

Assuntos