Osvandré Lech - Academia.edu (original) (raw)
Papers by Osvandré Lech
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Aug 31, 2022
Revista de la Asociación Argentina de Ortopedia y Traumatología
Objetivo: Evaluar los datos demográficos, como edad, sexo, profesión, lado afectado, lesión única... more Objetivo: Evaluar los datos demográficos, como edad, sexo, profesión, lado afectado, lesión única o múltiple, tipo de material utilizado, tiempo de cicatrización ósea y posibles complicaciones de los pacientes con fracturas diafisarias de húmero tratados mediante la técnica MIPO en tres centros hospitalarios de Ecuador, Paraguay y Brasil. Materiales y Métodos: Estudio retrospectivo, longitudinal, observacional de los datos de 133 pacientes recolectados en tres Servicios: de Quito (Ecuador), Asunción (Paraguay) y Passo Fundo (Brasil). Se compararon las distribuciones entre diferentes Servicios mediante la prueba x2 de Pearson. Resultados: La edad de los pacientes varió entre 17 y 76 años, con una media de 36 años. El tiempo promedio hasta la consolidación fue de 11 semanas (126 de 132 pacientes). Predominó el sexo masculino (70,45%), el lado derecho era el más afectado (55,3%), la mayoría de las fracturas eran únicas (85,61%), se logró la consolidación en el 95,45%. Solo el 9,09% tuv...
The authors describe a case of a synovial cyst within Guyon's canal at the left wrist. The patien... more The authors describe a case of a synovial cyst within Guyon's canal at the left wrist. The patient reported constant pain, loss of strength, and paresthesias at the hypothenar region, radiating to left hand fourth and fifth digits. Pain started spontaneously with no previous history of trauma about a year before. She had conservative therapy for a year with no improvement. Radiological imaging was normal. Nerve conduction studies showed a reduction of ulnar nerve conduction speed at wrist topography. Surgical decompression followed, with complete removal of the synovial cyst. The surgery offered pain and paresthesias relief. After a year and a half, the motor deficit remained, with persistence of hand intrinsic muscle atrophy.
Epicondilite lateral do cotovelo/ Lateral elbow epicondylitis Autor(es): Lech, Osvandré; Piluski,... more Epicondilite lateral do cotovelo/ Lateral elbow epicondylitis Autor(es): Lech, Osvandré; Piluski, Paulo César Faiad; Severo, Antônio Lourenço Fonte: Rev. bras. ortop; 38(8): 421-436, ago. 2003. ilus Artigo [LILACS ID: 360823 ] Idioma: Português A epicondilite lateral do cotovelo é afecção controvertida: da correta nomenclatura à verdadeira etiologia, à fisiopatologia e à melhor forma de tratamento. Diversas modalidades terapêuticas conservadoras e variadas técnicas cirúrgicas têm sido empregadas no seu tratamento, com resultados pouco confiáveis ou reprodutíveis. As diversas modalidades fisioterápicas têm resultados discutíveis e, assim como outras formas de tratamento, como a terapia por ondas de choque, parecem não alterar o curso natural da afecção. As infiltrações de corticóide proporcionam alívio fugaz, levando à deterioração do colágeno a longo prazo. Outras modalidades de tratamento apresentadas carecem de estudos que comprovem sua real eficácia. O tratamento cirúrgico aprese...
The sub-scapularis is the largest muscle in the entire rotator cuff and plays a critical role in ... more The sub-scapularis is the largest muscle in the entire rotator cuff and plays a critical role in the stability and function of the shoulder [1,2]. It is known, historically, that their lesions received little attention from the literature and were also under diagnosed [2-7]. The diagnosis is performed with a combination of physical examinations (Lift-off, Belly-Press and Bear-Hug) and imaging and the detection of sub-scapularis in reliable magnetic resonance imaging requires a high level of suspicion 3. With the advent of arthroscopy, more diagnoses of ruptures of this muscle have been made [5,8,9].
A ruptura fechada das polias digitais, sem lesao dos tendoes flexores associada, constitui-se em ... more A ruptura fechada das polias digitais, sem lesao dos tendoes flexores associada, constitui-se em quadro de dificil diagnostico clinico. Na revisao bibliografica efetuada, nao encontramos descricao de patologia identica. O mecanismo envolvido nos dois casos descritos e o de forca intensa de flexao do dedo que encontra um obstaculo (forca de extensao) em sentido contrario. O quadro clinico constitui-se de edema, dor, hiperplasia e aumento do diâmetro ântero-posterior (fenomeno de arco-de-corda) na fase aguda e limite de flexoextensao e rigidez articular na fase cronica. A tecnica de Kleinert-Bennett (emprego do tendao do palmar longo, em disposicao ziguezague) foi utilziada para a reconstrucao do sistema de polias. O follow-up de seis anos mostrou funcao normal dos dedos envolvidos
Arthroscopy: The Journal of Arthroscopic & Related Surgery, Oct 1, 2017
Management of significant glenoid bone loss in patients undergoing a Reverse Shoulder Arthroplast... more Management of significant glenoid bone loss in patients undergoing a Reverse Shoulder Arthroplasty (RSA) poses a significant treatment challenge. The long-term outcome of single stage RSA with glenoid bone grafting is unknown. This study assesses the indications, technique and outcome of RSA with glenoid bone grafting. Materials and Methods: Between 2001 and 2010, 1074 RSA were performed at our institution. Out of this cohort 94 patients had significant glenoid bone loss. These patients underwent a single or two-stage RSA with glenoid bone grafting. Intra operatively each patient was subcategorized on the basis of the size of the glenoid defect and managed in accordance with a standardized treatment protocol. The defects were sub classified as centric or eccentric and graded from 1-4 based upon their size. A retrospective analysis of the pre and post-operative clinical and radiological outcome was carried out. The mean follow up was 2.4 years, (0.52 years e 10.7 years). Results: Indication for RSA were as follows: 1) 29.3% Cuff tear arthropathy, 2) 27.2% failed prior arthroplasty, 3) 21% chronic dislocation, 4) 17.4% post traumatic cases. During the operation 17 % had a centric defect and 83 % of patients had an eccentric glenoid defect; the bone loss being anterior in the majority (51.1%). Composite glenoid grafts were required in 10 patients and 9 patients required a revision specific glenoid base plate. 92.5% (87/94) of the patients could be managed as
Revista brasileira de ortopedia
Advances in the studies with adult mesenchymal stem cells (MSCs) have turned tissue regenerative ... more Advances in the studies with adult mesenchymal stem cells (MSCs) have turned tissue regenerative therapy into a promising tool in many areas of medicine. In orthopedics, one of the main challenges has been the regeneration of cartilage tissue, mainly in diarthroses. In the induction of the MSCs, in addition to cytodifferentiation, the microenvironmental context of the tissue to be regenerated and an appropriate spatial arrangement are extremely important factors. Furthermore, it is known that MSC differentiation is fundamentally determined by mechanisms such as cell proliferation (mitosis), biochemical-molecular interactions, movement, cell adhesion, and apoptosis. Although the use of MSCs for cartilage regeneration remains at a research level, there are important questions to be resolved in order to make this therapy efficient and safe. It is known, for instance, that the expansion of chondrocytes in cultivation, needed to increase the number of cells, could end up producing fibroc...
Revista Brasileira de Ortopedia (English Edition), 2010
The figure behind the first volume of the RBO was called ACHILLES DE ARAÚJO. This mythical founde... more The figure behind the first volume of the RBO was called ACHILLES DE ARAÚJO. This mythical founder, who was a native of Rio de Janeiro and the second president of SBOT (in 1937-38), understood the need to establish a scientific basis for the new orthopedic society. With the collaboration of a few authors, he was able to edit the first volume as early as 1939. In the final paragraph of the Presentation, Achilles de Araújo defines the philosophical basis of the new publication, which even today continues to inspire us: "The Revista Brasileira de Orthopedia e Traumatologia appears as a logical consequence of these affirmations and it is certain that by bringing together and divulging the technical-scientific production of the cultivators of this specialty in Brazil and, as desired, making it into an efficient platform for studying the many complex medical-social problems that Orthopedics and Traumatology still present, useful and patriotic work will, we repeat, certainly be done". Below is the letter in which he explains to his colleague Renato da Costa Bonfim the intense period of professional activity that he was experiencing. Rio, July 15, 1939 My dear Renato My best greetings I am writing to you with all haste to make the most of Zezito Marcondes de Souza's willingness to convey to you these lines. I am swamped with work: the Surgical Congress, clinical practice and especially the Revista Brasileira de Ortopedia e Traumatologia, without mentioning the S.B.O.T. Regarding the S.B.O.T., there is still no positive news concerning the modifications to the statute. Nevertheless, I think that our point of view is practically accepted. We await notification of the date of the meeting for us to leave for São Paulo. I think that only 10 or 12 of us will go. I am working steadily for the Journal and in this respect, I ask you urgently for a "note" about the next competitive examination with the titles of the theses etc. etc. and one or more studies with absolute urgency. To avoid annoyance and misunderstandings, I have decided to take sole responsibility for the Journal, and to avoid inviting or creating editorial or collaborative boards, etc. Only in this way will I satisfy everyone. I will be the director in charge, and the Journal will have collaboration from among the most respected orthopedists and traumatologists in this country and abroad. I count particularly on my trusted friends, like you, Define, Orlando and our other friends from the Department, and on a good group from Rio and abroad. If all goes as I wish over the next month, it will be issued and we will have succeeded. I will write soon about this matter. Please pass on my best wishes and sincere friendship to Dona Odilla. Achilles (de Araújo) P.S. Zezito will give you an update on certain things in person.
Revista Brasileira de Ortopedia, 2014
Revista Brasileira de Ortopedia, 2021
Resumo Objetivo Observar o perfil de autocitações da Revista Brasileira de Ortopedia (Rev Bras Or... more Resumo Objetivo Observar o perfil de autocitações da Revista Brasileira de Ortopedia (Rev Bras Ortop) e de citações deste periódico em outras revistas médicas de ortopedia de conteúdo geral ou específico de uma determinada área de conhecimento da especialidade. Métodos Trata-se de estudo observacional transversal da frequência de autocitações e citações da Rev Bras Ortop em outros cinco periódicos médicos de ortopedia de diferentes países, todas publicadas em língua inglesa. Foram analisados os 15 últimos artigos publicados em 2020 em cada uma das seis revistas estudadas. As referências usadas em cada um delas foi avaliada para identificação do periódico em que foram publicadas originalmente. A distribuição de frequência dos quatro principais periódicos citados, sua posição e o percentual relativo ao total de citações foram observados e registrados em cada uma das seis revistas. O número de vezes em que a Rev Bras Ortop foi citada em cada um dos periódicos estrangeiros selecionados ...
Revista Brasileira de Ortopedia, 2021
Bone Grafts [Working Title], 2020
The scaphoid fractures are the most common of the carpal bones, corresponding to 60; 10% of these... more The scaphoid fractures are the most common of the carpal bones, corresponding to 60; 10% of these progress to nonconsolidation, moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized (VBG) and nonvascularised bone grafts (NVBG). To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a systematic review of the literature using the following databases: PubMed and Bireme/Lilacs, where 13 case series were selected (10 with use of VBG and 3 of NVBG), according to inclusion and exclusion criteria. In most cases the vascularized bone grafts were used, especially those based on intercompartmental supraretinacular artery 1 and 2 due to greater reproducibility in performing the surgical technique.
Revista Brasileira de Ortopedia, 2018
Esse relato e revisão na literatura tem como objetivo reconhecer a enucleação total além do estág... more Esse relato e revisão na literatura tem como objetivo reconhecer a enucleação total além do estágio IV da classificação proposta por Mayfield. Propõe-se a adição de uma quinta categoria, para lesões ligamentares completas que levam a uma circulação inexistente do ligamento radiolunar, impedem a reconstrução cirúrgica e influenciam, assim, o tratamento cirúrgico.
Pain management, Jan 18, 2018
Pain is highly prevalent among the adult Latin American population. However, many patients with m... more Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries.
Revista Brasileira de Ortopedia, 2010
Pain Management, 2017
Aim: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNO... more Aim: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Methods: Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. Results: The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Conclusion: Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients’ quality of life by increasing access to these effective agents.
Revista Brasileira de Ortopedia, 2017
Os avanços nos estudos com células-tronco mesenquimais (CTMs) adultas tornou a terapia regenerati... more Os avanços nos estudos com células-tronco mesenquimais (CTMs) adultas tornou a terapia regenerativa tecidual uma ferramenta promissora em diversas áreas da medicina. Na ortopedia, um dos principais desafios tem sido a regeneração do tecido cartilaginoso, sobretudo em diartroses. Na indução de CTMs, além da citodiferenciação, o contexto microambiental do tecido a ser regenerado, bem como uma disposição espacial adequada, são fatores de extrema importância. Além disso, sabe-se que a diferenciação das CTMs é basicamente determinada por mecanismos como proliferação celular (mitose), interaç ões bioquímico-moleculares, movimento, adesão celular e apoptose. Apesar de o uso de CTMs para a regeneração da cartilagem estar ainda em âmbito de pesquisa, existem questões importantes a serem resolvidas para tornar essa terapêutica eficaz e segura. Sabe-se, por exemplo, que a expansão de condrócitos em cultura, necessária para aumentar o número de células, pode produzir fibrocartilagem, e não cartilagem hialina. No entanto, os últimos resultados são promissores. Em 2014, foi publicado o primeiro ensaio clínico fase I/II para avaliar a eficácia e a segurança da injeção intra-articular de CTMs na regeneração de cartilagem femorotibial e houve uma diminuição das áreas lesadas. Uma questão a ser explorada é o quanto modificaç ões no próprio ambiente inflamatório articular poderiam induzir a diferenciação de CTMs já alocadas naquela região. Tal incógnita parte do princípio de estudos que sugerem que a supressão da inflamação articular aumentaria, potencialmente, a eficiência da regeneração tecidual. Considerando a complexidade dos eventos relacionados à condrogênese e ao reparo da cartilagem, conclui-se que o caminho ainda é longo, são necessárias pesquisas complementares.
Revista de la Asociación Argentina de Ortopedia y Traumatologia, Aug 31, 2022
Revista de la Asociación Argentina de Ortopedia y Traumatología
Objetivo: Evaluar los datos demográficos, como edad, sexo, profesión, lado afectado, lesión única... more Objetivo: Evaluar los datos demográficos, como edad, sexo, profesión, lado afectado, lesión única o múltiple, tipo de material utilizado, tiempo de cicatrización ósea y posibles complicaciones de los pacientes con fracturas diafisarias de húmero tratados mediante la técnica MIPO en tres centros hospitalarios de Ecuador, Paraguay y Brasil. Materiales y Métodos: Estudio retrospectivo, longitudinal, observacional de los datos de 133 pacientes recolectados en tres Servicios: de Quito (Ecuador), Asunción (Paraguay) y Passo Fundo (Brasil). Se compararon las distribuciones entre diferentes Servicios mediante la prueba x2 de Pearson. Resultados: La edad de los pacientes varió entre 17 y 76 años, con una media de 36 años. El tiempo promedio hasta la consolidación fue de 11 semanas (126 de 132 pacientes). Predominó el sexo masculino (70,45%), el lado derecho era el más afectado (55,3%), la mayoría de las fracturas eran únicas (85,61%), se logró la consolidación en el 95,45%. Solo el 9,09% tuv...
The authors describe a case of a synovial cyst within Guyon's canal at the left wrist. The patien... more The authors describe a case of a synovial cyst within Guyon's canal at the left wrist. The patient reported constant pain, loss of strength, and paresthesias at the hypothenar region, radiating to left hand fourth and fifth digits. Pain started spontaneously with no previous history of trauma about a year before. She had conservative therapy for a year with no improvement. Radiological imaging was normal. Nerve conduction studies showed a reduction of ulnar nerve conduction speed at wrist topography. Surgical decompression followed, with complete removal of the synovial cyst. The surgery offered pain and paresthesias relief. After a year and a half, the motor deficit remained, with persistence of hand intrinsic muscle atrophy.
Epicondilite lateral do cotovelo/ Lateral elbow epicondylitis Autor(es): Lech, Osvandré; Piluski,... more Epicondilite lateral do cotovelo/ Lateral elbow epicondylitis Autor(es): Lech, Osvandré; Piluski, Paulo César Faiad; Severo, Antônio Lourenço Fonte: Rev. bras. ortop; 38(8): 421-436, ago. 2003. ilus Artigo [LILACS ID: 360823 ] Idioma: Português A epicondilite lateral do cotovelo é afecção controvertida: da correta nomenclatura à verdadeira etiologia, à fisiopatologia e à melhor forma de tratamento. Diversas modalidades terapêuticas conservadoras e variadas técnicas cirúrgicas têm sido empregadas no seu tratamento, com resultados pouco confiáveis ou reprodutíveis. As diversas modalidades fisioterápicas têm resultados discutíveis e, assim como outras formas de tratamento, como a terapia por ondas de choque, parecem não alterar o curso natural da afecção. As infiltrações de corticóide proporcionam alívio fugaz, levando à deterioração do colágeno a longo prazo. Outras modalidades de tratamento apresentadas carecem de estudos que comprovem sua real eficácia. O tratamento cirúrgico aprese...
The sub-scapularis is the largest muscle in the entire rotator cuff and plays a critical role in ... more The sub-scapularis is the largest muscle in the entire rotator cuff and plays a critical role in the stability and function of the shoulder [1,2]. It is known, historically, that their lesions received little attention from the literature and were also under diagnosed [2-7]. The diagnosis is performed with a combination of physical examinations (Lift-off, Belly-Press and Bear-Hug) and imaging and the detection of sub-scapularis in reliable magnetic resonance imaging requires a high level of suspicion 3. With the advent of arthroscopy, more diagnoses of ruptures of this muscle have been made [5,8,9].
A ruptura fechada das polias digitais, sem lesao dos tendoes flexores associada, constitui-se em ... more A ruptura fechada das polias digitais, sem lesao dos tendoes flexores associada, constitui-se em quadro de dificil diagnostico clinico. Na revisao bibliografica efetuada, nao encontramos descricao de patologia identica. O mecanismo envolvido nos dois casos descritos e o de forca intensa de flexao do dedo que encontra um obstaculo (forca de extensao) em sentido contrario. O quadro clinico constitui-se de edema, dor, hiperplasia e aumento do diâmetro ântero-posterior (fenomeno de arco-de-corda) na fase aguda e limite de flexoextensao e rigidez articular na fase cronica. A tecnica de Kleinert-Bennett (emprego do tendao do palmar longo, em disposicao ziguezague) foi utilziada para a reconstrucao do sistema de polias. O follow-up de seis anos mostrou funcao normal dos dedos envolvidos
Arthroscopy: The Journal of Arthroscopic & Related Surgery, Oct 1, 2017
Management of significant glenoid bone loss in patients undergoing a Reverse Shoulder Arthroplast... more Management of significant glenoid bone loss in patients undergoing a Reverse Shoulder Arthroplasty (RSA) poses a significant treatment challenge. The long-term outcome of single stage RSA with glenoid bone grafting is unknown. This study assesses the indications, technique and outcome of RSA with glenoid bone grafting. Materials and Methods: Between 2001 and 2010, 1074 RSA were performed at our institution. Out of this cohort 94 patients had significant glenoid bone loss. These patients underwent a single or two-stage RSA with glenoid bone grafting. Intra operatively each patient was subcategorized on the basis of the size of the glenoid defect and managed in accordance with a standardized treatment protocol. The defects were sub classified as centric or eccentric and graded from 1-4 based upon their size. A retrospective analysis of the pre and post-operative clinical and radiological outcome was carried out. The mean follow up was 2.4 years, (0.52 years e 10.7 years). Results: Indication for RSA were as follows: 1) 29.3% Cuff tear arthropathy, 2) 27.2% failed prior arthroplasty, 3) 21% chronic dislocation, 4) 17.4% post traumatic cases. During the operation 17 % had a centric defect and 83 % of patients had an eccentric glenoid defect; the bone loss being anterior in the majority (51.1%). Composite glenoid grafts were required in 10 patients and 9 patients required a revision specific glenoid base plate. 92.5% (87/94) of the patients could be managed as
Revista brasileira de ortopedia
Advances in the studies with adult mesenchymal stem cells (MSCs) have turned tissue regenerative ... more Advances in the studies with adult mesenchymal stem cells (MSCs) have turned tissue regenerative therapy into a promising tool in many areas of medicine. In orthopedics, one of the main challenges has been the regeneration of cartilage tissue, mainly in diarthroses. In the induction of the MSCs, in addition to cytodifferentiation, the microenvironmental context of the tissue to be regenerated and an appropriate spatial arrangement are extremely important factors. Furthermore, it is known that MSC differentiation is fundamentally determined by mechanisms such as cell proliferation (mitosis), biochemical-molecular interactions, movement, cell adhesion, and apoptosis. Although the use of MSCs for cartilage regeneration remains at a research level, there are important questions to be resolved in order to make this therapy efficient and safe. It is known, for instance, that the expansion of chondrocytes in cultivation, needed to increase the number of cells, could end up producing fibroc...
Revista Brasileira de Ortopedia (English Edition), 2010
The figure behind the first volume of the RBO was called ACHILLES DE ARAÚJO. This mythical founde... more The figure behind the first volume of the RBO was called ACHILLES DE ARAÚJO. This mythical founder, who was a native of Rio de Janeiro and the second president of SBOT (in 1937-38), understood the need to establish a scientific basis for the new orthopedic society. With the collaboration of a few authors, he was able to edit the first volume as early as 1939. In the final paragraph of the Presentation, Achilles de Araújo defines the philosophical basis of the new publication, which even today continues to inspire us: "The Revista Brasileira de Orthopedia e Traumatologia appears as a logical consequence of these affirmations and it is certain that by bringing together and divulging the technical-scientific production of the cultivators of this specialty in Brazil and, as desired, making it into an efficient platform for studying the many complex medical-social problems that Orthopedics and Traumatology still present, useful and patriotic work will, we repeat, certainly be done". Below is the letter in which he explains to his colleague Renato da Costa Bonfim the intense period of professional activity that he was experiencing. Rio, July 15, 1939 My dear Renato My best greetings I am writing to you with all haste to make the most of Zezito Marcondes de Souza's willingness to convey to you these lines. I am swamped with work: the Surgical Congress, clinical practice and especially the Revista Brasileira de Ortopedia e Traumatologia, without mentioning the S.B.O.T. Regarding the S.B.O.T., there is still no positive news concerning the modifications to the statute. Nevertheless, I think that our point of view is practically accepted. We await notification of the date of the meeting for us to leave for São Paulo. I think that only 10 or 12 of us will go. I am working steadily for the Journal and in this respect, I ask you urgently for a "note" about the next competitive examination with the titles of the theses etc. etc. and one or more studies with absolute urgency. To avoid annoyance and misunderstandings, I have decided to take sole responsibility for the Journal, and to avoid inviting or creating editorial or collaborative boards, etc. Only in this way will I satisfy everyone. I will be the director in charge, and the Journal will have collaboration from among the most respected orthopedists and traumatologists in this country and abroad. I count particularly on my trusted friends, like you, Define, Orlando and our other friends from the Department, and on a good group from Rio and abroad. If all goes as I wish over the next month, it will be issued and we will have succeeded. I will write soon about this matter. Please pass on my best wishes and sincere friendship to Dona Odilla. Achilles (de Araújo) P.S. Zezito will give you an update on certain things in person.
Revista Brasileira de Ortopedia, 2014
Revista Brasileira de Ortopedia, 2021
Resumo Objetivo Observar o perfil de autocitações da Revista Brasileira de Ortopedia (Rev Bras Or... more Resumo Objetivo Observar o perfil de autocitações da Revista Brasileira de Ortopedia (Rev Bras Ortop) e de citações deste periódico em outras revistas médicas de ortopedia de conteúdo geral ou específico de uma determinada área de conhecimento da especialidade. Métodos Trata-se de estudo observacional transversal da frequência de autocitações e citações da Rev Bras Ortop em outros cinco periódicos médicos de ortopedia de diferentes países, todas publicadas em língua inglesa. Foram analisados os 15 últimos artigos publicados em 2020 em cada uma das seis revistas estudadas. As referências usadas em cada um delas foi avaliada para identificação do periódico em que foram publicadas originalmente. A distribuição de frequência dos quatro principais periódicos citados, sua posição e o percentual relativo ao total de citações foram observados e registrados em cada uma das seis revistas. O número de vezes em que a Rev Bras Ortop foi citada em cada um dos periódicos estrangeiros selecionados ...
Revista Brasileira de Ortopedia, 2021
Bone Grafts [Working Title], 2020
The scaphoid fractures are the most common of the carpal bones, corresponding to 60; 10% of these... more The scaphoid fractures are the most common of the carpal bones, corresponding to 60; 10% of these progress to nonconsolidation, moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized (VBG) and nonvascularised bone grafts (NVBG). To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a systematic review of the literature using the following databases: PubMed and Bireme/Lilacs, where 13 case series were selected (10 with use of VBG and 3 of NVBG), according to inclusion and exclusion criteria. In most cases the vascularized bone grafts were used, especially those based on intercompartmental supraretinacular artery 1 and 2 due to greater reproducibility in performing the surgical technique.
Revista Brasileira de Ortopedia, 2018
Esse relato e revisão na literatura tem como objetivo reconhecer a enucleação total além do estág... more Esse relato e revisão na literatura tem como objetivo reconhecer a enucleação total além do estágio IV da classificação proposta por Mayfield. Propõe-se a adição de uma quinta categoria, para lesões ligamentares completas que levam a uma circulação inexistente do ligamento radiolunar, impedem a reconstrução cirúrgica e influenciam, assim, o tratamento cirúrgico.
Pain management, Jan 18, 2018
Pain is highly prevalent among the adult Latin American population. However, many patients with m... more Pain is highly prevalent among the adult Latin American population. However, many patients with moderate to severe pain do not have access to effective pain management with opioids due to limited access to healthcare, overuse of nonopioid analgesics, regulatory barriers and lack of appropriate information about opioids. There is scarce training on use of opioids among physicians and other healthcare providers, which leads to misconceptions, mainly related to a fear of prescribing opioids. Although opioids are safe and effective drugs for the treatment of moderate to severe chronic pain, the use of opioids in Latin American nations is clearly below standards compared with developed countries.
Revista Brasileira de Ortopedia, 2010
Pain Management, 2017
Aim: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNO... more Aim: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Methods: Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. Results: The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Conclusion: Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients’ quality of life by increasing access to these effective agents.
Revista Brasileira de Ortopedia, 2017
Os avanços nos estudos com células-tronco mesenquimais (CTMs) adultas tornou a terapia regenerati... more Os avanços nos estudos com células-tronco mesenquimais (CTMs) adultas tornou a terapia regenerativa tecidual uma ferramenta promissora em diversas áreas da medicina. Na ortopedia, um dos principais desafios tem sido a regeneração do tecido cartilaginoso, sobretudo em diartroses. Na indução de CTMs, além da citodiferenciação, o contexto microambiental do tecido a ser regenerado, bem como uma disposição espacial adequada, são fatores de extrema importância. Além disso, sabe-se que a diferenciação das CTMs é basicamente determinada por mecanismos como proliferação celular (mitose), interaç ões bioquímico-moleculares, movimento, adesão celular e apoptose. Apesar de o uso de CTMs para a regeneração da cartilagem estar ainda em âmbito de pesquisa, existem questões importantes a serem resolvidas para tornar essa terapêutica eficaz e segura. Sabe-se, por exemplo, que a expansão de condrócitos em cultura, necessária para aumentar o número de células, pode produzir fibrocartilagem, e não cartilagem hialina. No entanto, os últimos resultados são promissores. Em 2014, foi publicado o primeiro ensaio clínico fase I/II para avaliar a eficácia e a segurança da injeção intra-articular de CTMs na regeneração de cartilagem femorotibial e houve uma diminuição das áreas lesadas. Uma questão a ser explorada é o quanto modificaç ões no próprio ambiente inflamatório articular poderiam induzir a diferenciação de CTMs já alocadas naquela região. Tal incógnita parte do princípio de estudos que sugerem que a supressão da inflamação articular aumentaria, potencialmente, a eficiência da regeneração tecidual. Considerando a complexidade dos eventos relacionados à condrogênese e ao reparo da cartilagem, conclui-se que o caminho ainda é longo, são necessárias pesquisas complementares.