Marcelo Rezende - Academia.edu (original) (raw)

Uploads

Papers by Marcelo Rezende

Ciencia & Saude Coletiva, 2010

The vitamin C and iron ingestion level was evaluated in adolescents during the three phases of th... more The vitamin C and iron ingestion level was evaluated in adolescents during the three phases of the menstrual cycle. The food intake of 30 adolescents was analyzed during the premenstrual, menstrual, and postmenstrual phases, by the registration technique, with the analysis of two registrations per individual, in each phase. The prevalence estimate was done considering six dietary registrations for each adolescent. The patterns used as reference were the Dietary Reference Intakes (DRI) - Estimated Average Requirement (EAR) from Institute of Medicine - IOM (2001), using the probability approaches and the cut - point method for the iron and vitamin C respectively, in addition to the values from the Recommended Dietary Allowances (National Research Council). The adolescents were aged 15.5 ± 1.7; the age of the menarche was 11.8 ± 1,1; and gynecological age 3.6 ± 1.9. The medial consumption of iron was 10.6 mg/day and of vitamin C 77.6 mg/day. It was observed by DRIs-EAR an estimate of inadequacy for iron of 22.6% and for vitamin C of 34% and by National Research Council, 63.3% and 20%, respectively. Despite the divergence among the patterns, both results shows a nutritional risk for the studied population. The accomplishment of wider dietary studies, using DRI-EAR is suggested, favoring nutritional diagnoses with subsequent evaluation of intervention measures.

Revista Brasileira De Reumatologia, 2005

Post-chemotherapy rheumatism is a rare syndrome characterised by polyarthralgia that develops fol... more Post-chemotherapy rheumatism is a rare syndrome characterised by polyarthralgia that develops following a period of 1 to 4 months of various forms of chemotherapy for cancer treatment. There is very little representation of post-chemotherapy rheumatism (PCR) in literature. Here we report the case of a 21 years old girl with Hodgkin lymphoma who was not treated with cyclophosphamide, the drug considered as an etiological factor in PCR. Rather, we suggest the possibility of a transitory dysfunction in immunological tolerance mechanisms.

Computers & Structures, 2000

... References. 1. RJ Baron and L. Higbie. Computer architecture Addison-Wesley Publishing, Readi... more ... References. 1. RJ Baron and L. Higbie. Computer architecture Addison-Wesley Publishing, Reading, MA (1994). 2. L. Chien and CT Sun, Parallel Processing Techniques for Finite Element Analysis of Nonlinear Large Truss Structures. Comput. Struct. 31 (1989), pp. 1023–1029. ...

Objective: The authors analyze the follow-up of results in 62 adult patients who had traumatic am... more Objective: The authors analyze the follow-up of results in 62 adult patients who had traumatic amputations in the upper limb and who underwent successful replantation procedures from 1994 to 2004. Methods: The levels of amputation were in fingers or thumb in 48, hand in 5, wrist in 4, forearm in 2 and arm in 3 patients. All patients were treated in a rehabilitation program of specialized hand therapy. A simplified questionnaire was used to evaluate the return to work activities using the operated limb, either in the formal or informal economy, and the patient's satisfaction rate concerning the surgical procedure. Results: It was noted that 85.5% of patients returned to some work activity using the operated limb and 96.8% of patients are satisfied with the results. Conclusions: Patients submitted to successful replantation present a high rate of satisfaction and return to work activities.

Journal of Orthopaedic Trauma, 2010

This is a clinical study of our experience using pedicle perforator flaps to cover skin defects i... more This is a clinical study of our experience using pedicle perforator flaps to cover skin defects in the middle and distal segment of the leg. Prospective study. University hospital. Twenty-four patients underwent treatment of a skin defect in the middle or distal segment of the leg by means of pedicled flaps based on perforating arteries. The perforating arteries were located before the operation by means of echo-Doppler examination. The flaps were planned in propeller fashion (21 cases) and as advancement (three cases). The results were evaluated according the origin of perforator flap, size of the flap, and donor area and viability of the flap. The success rate of the echo-Doppler to identify the location of perforator vessel was also evaluated. In nine cases, the perforating vessels originated from the fibular artery, in 10 the posterior tibial artery, and in five the anterior tibial artery. The mean size of the flaps was 5 cm in width by 12 cm in length. The success rate using an echo-Doppler was 87%. The flaps were fully viable in 20 cases and partially viable in four cases. On the basis of these results, it is concluded that perforating flaps are a good choice of treatment for skin losses, especially in the distal segment of the leg, and could be an alternative option for the use of free microsurgical flaps.

Acta Ortopedica Brasileira, 2008

Os retalhos de vasos perfurantes representam um avanço no tratamento das perdas cutâneas. No terç... more Os retalhos de vasos perfurantes representam um avanço no tratamento das perdas cutâneas. No terço distal da perna as opções para a cobertura cutânea são poucas e muitas vezes devemos recorrer a microcirurgia. Neste trabalho realizou-se uma avaliação prospectiva de 20 pacientes submetidos ao tratamento de áreas cruentas no terço distal da perna através de retalhos pediculados em artéria perfurante. A localização das artéria perfurantes foi feita , no pré-operatório , através do exame de eco-doppler. Os retalhos foram planejados de forma a permitir sua rotação junto à área cruenta em até 180 graus. Em 6 casos os vasos perfurantes tinham como origem a artéria fibular, em 10 a artéria tibial posterior e 4 a artéria tibial anterior. O índice de acerto do eco-doppler foi de 88,2%. Em pacientes jovens com lesões traumáticas houve 15,4% de falha do procedimento e 33,3% em pacientes com morbidades associadas. Baseado em nossos resultados concluímos ser o retalho de perfurante uma boa opção de tratamento das perdas cutâneas no segmento distal da perna.

Historically, the dorsal arterial system of the hand received less attention than the palmar syst... more Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries. METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distal-based U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS: The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation. CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.

Revista Brasileira De Ortopedia, 2009

OBJECTIVE: Flexor tendon tenolysis on zone 2 is a difficult and really challenging for hand surge... more OBJECTIVE: Flexor tendon tenolysis on zone 2 is a difficult and really challenging for hand surgery. With the objective of comparing the results obtained between tenolyses with intraoperative awakening, performed with locoregional anesthesia (group 1), from those obtained with traditional tenolysis performed under general anesthesia or total blockage of the brachial plexus (group 2), the authors conducted a prospective and controlled study. METHODS: 22 patients with 39 fingers with flexor tendon injuries on zone 2 evolving to adherences were assessed. All patients were operated after three months and before one year of the primary tendinous suture. All patients showed limited active motion not improved by rehabilitation. Groups 1 and 2 showed to be homogenous concerning patients' age and gender, preoperative compromising, and absence of associated injuries or pathologies. All patients were assessed according to active motion (TAMs) both preoperatively and at 6 months postoperatively. RESULTS: The statistical analysis of data obtained for groups 1 and 2 shows that the tenolysis performed with both techniques produce good results. By comparing the results for total active motion after six months of the tenolysis, group 1 patients (treated by the intraoperative awakening technique) were found to present better outcomes. CONCLUSIONS: Flexor tenolysis on zone 2 provide good results in terms of joint range of motion. The intraoperative awakening technique with locoregional anesthesia provides improved outcomes when compared to the traditional technique.

Ciencia & Saude Coletiva, 2010

The vitamin C and iron ingestion level was evaluated in adolescents during the three phases of th... more The vitamin C and iron ingestion level was evaluated in adolescents during the three phases of the menstrual cycle. The food intake of 30 adolescents was analyzed during the premenstrual, menstrual, and postmenstrual phases, by the registration technique, with the analysis of two registrations per individual, in each phase. The prevalence estimate was done considering six dietary registrations for each adolescent. The patterns used as reference were the Dietary Reference Intakes (DRI) - Estimated Average Requirement (EAR) from Institute of Medicine - IOM (2001), using the probability approaches and the cut - point method for the iron and vitamin C respectively, in addition to the values from the Recommended Dietary Allowances (National Research Council). The adolescents were aged 15.5 ± 1.7; the age of the menarche was 11.8 ± 1,1; and gynecological age 3.6 ± 1.9. The medial consumption of iron was 10.6 mg/day and of vitamin C 77.6 mg/day. It was observed by DRIs-EAR an estimate of inadequacy for iron of 22.6% and for vitamin C of 34% and by National Research Council, 63.3% and 20%, respectively. Despite the divergence among the patterns, both results shows a nutritional risk for the studied population. The accomplishment of wider dietary studies, using DRI-EAR is suggested, favoring nutritional diagnoses with subsequent evaluation of intervention measures.

Revista Brasileira De Reumatologia, 2005

Post-chemotherapy rheumatism is a rare syndrome characterised by polyarthralgia that develops fol... more Post-chemotherapy rheumatism is a rare syndrome characterised by polyarthralgia that develops following a period of 1 to 4 months of various forms of chemotherapy for cancer treatment. There is very little representation of post-chemotherapy rheumatism (PCR) in literature. Here we report the case of a 21 years old girl with Hodgkin lymphoma who was not treated with cyclophosphamide, the drug considered as an etiological factor in PCR. Rather, we suggest the possibility of a transitory dysfunction in immunological tolerance mechanisms.

Computers & Structures, 2000

... References. 1. RJ Baron and L. Higbie. Computer architecture Addison-Wesley Publishing, Readi... more ... References. 1. RJ Baron and L. Higbie. Computer architecture Addison-Wesley Publishing, Reading, MA (1994). 2. L. Chien and CT Sun, Parallel Processing Techniques for Finite Element Analysis of Nonlinear Large Truss Structures. Comput. Struct. 31 (1989), pp. 1023–1029. ...

Objective: The authors analyze the follow-up of results in 62 adult patients who had traumatic am... more Objective: The authors analyze the follow-up of results in 62 adult patients who had traumatic amputations in the upper limb and who underwent successful replantation procedures from 1994 to 2004. Methods: The levels of amputation were in fingers or thumb in 48, hand in 5, wrist in 4, forearm in 2 and arm in 3 patients. All patients were treated in a rehabilitation program of specialized hand therapy. A simplified questionnaire was used to evaluate the return to work activities using the operated limb, either in the formal or informal economy, and the patient's satisfaction rate concerning the surgical procedure. Results: It was noted that 85.5% of patients returned to some work activity using the operated limb and 96.8% of patients are satisfied with the results. Conclusions: Patients submitted to successful replantation present a high rate of satisfaction and return to work activities.

Journal of Orthopaedic Trauma, 2010

This is a clinical study of our experience using pedicle perforator flaps to cover skin defects i... more This is a clinical study of our experience using pedicle perforator flaps to cover skin defects in the middle and distal segment of the leg. Prospective study. University hospital. Twenty-four patients underwent treatment of a skin defect in the middle or distal segment of the leg by means of pedicled flaps based on perforating arteries. The perforating arteries were located before the operation by means of echo-Doppler examination. The flaps were planned in propeller fashion (21 cases) and as advancement (three cases). The results were evaluated according the origin of perforator flap, size of the flap, and donor area and viability of the flap. The success rate of the echo-Doppler to identify the location of perforator vessel was also evaluated. In nine cases, the perforating vessels originated from the fibular artery, in 10 the posterior tibial artery, and in five the anterior tibial artery. The mean size of the flaps was 5 cm in width by 12 cm in length. The success rate using an echo-Doppler was 87%. The flaps were fully viable in 20 cases and partially viable in four cases. On the basis of these results, it is concluded that perforating flaps are a good choice of treatment for skin losses, especially in the distal segment of the leg, and could be an alternative option for the use of free microsurgical flaps.

Acta Ortopedica Brasileira, 2008

Os retalhos de vasos perfurantes representam um avanço no tratamento das perdas cutâneas. No terç... more Os retalhos de vasos perfurantes representam um avanço no tratamento das perdas cutâneas. No terço distal da perna as opções para a cobertura cutânea são poucas e muitas vezes devemos recorrer a microcirurgia. Neste trabalho realizou-se uma avaliação prospectiva de 20 pacientes submetidos ao tratamento de áreas cruentas no terço distal da perna através de retalhos pediculados em artéria perfurante. A localização das artéria perfurantes foi feita , no pré-operatório , através do exame de eco-doppler. Os retalhos foram planejados de forma a permitir sua rotação junto à área cruenta em até 180 graus. Em 6 casos os vasos perfurantes tinham como origem a artéria fibular, em 10 a artéria tibial posterior e 4 a artéria tibial anterior. O índice de acerto do eco-doppler foi de 88,2%. Em pacientes jovens com lesões traumáticas houve 15,4% de falha do procedimento e 33,3% em pacientes com morbidades associadas. Baseado em nossos resultados concluímos ser o retalho de perfurante uma boa opção de tratamento das perdas cutâneas no segmento distal da perna.

Historically, the dorsal arterial system of the hand received less attention than the palmar syst... more Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries. METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distal-based U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS: The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation. CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.

Revista Brasileira De Ortopedia, 2009

OBJECTIVE: Flexor tendon tenolysis on zone 2 is a difficult and really challenging for hand surge... more OBJECTIVE: Flexor tendon tenolysis on zone 2 is a difficult and really challenging for hand surgery. With the objective of comparing the results obtained between tenolyses with intraoperative awakening, performed with locoregional anesthesia (group 1), from those obtained with traditional tenolysis performed under general anesthesia or total blockage of the brachial plexus (group 2), the authors conducted a prospective and controlled study. METHODS: 22 patients with 39 fingers with flexor tendon injuries on zone 2 evolving to adherences were assessed. All patients were operated after three months and before one year of the primary tendinous suture. All patients showed limited active motion not improved by rehabilitation. Groups 1 and 2 showed to be homogenous concerning patients' age and gender, preoperative compromising, and absence of associated injuries or pathologies. All patients were assessed according to active motion (TAMs) both preoperatively and at 6 months postoperatively. RESULTS: The statistical analysis of data obtained for groups 1 and 2 shows that the tenolysis performed with both techniques produce good results. By comparing the results for total active motion after six months of the tenolysis, group 1 patients (treated by the intraoperative awakening technique) were found to present better outcomes. CONCLUSIONS: Flexor tenolysis on zone 2 provide good results in terms of joint range of motion. The intraoperative awakening technique with locoregional anesthesia provides improved outcomes when compared to the traditional technique.