Trajano Sardenberg

Análise dos aspectos éticos da pesquisa em seres humanos contidos nas Instruções aos Autores de 139 revistas científicas brasileiras

The concern with ethical standards during research in human subjects has been improving in Brazil during the last decade. Analysis of the ethical recommendations in instructions to authors may contribute to understand Brazilian Scientific Journals policies. OBJECTIVE: to evaluate the recommendations related to the ethics of investigation in human subjects in instructions to authors of Brazilian Scientific Journals. MATERIAL AND METHODS: instructions to authors of 139 Brazilian Scientific Journals in medicine, biomedicine, nursery, odontology and general sciences were analysed. RESULTS: ln one hundred ten (79.1%) of the 139 journals no recommendations related to ethics were found; 17 (12.2%) required previous approval by the institutional committee; 3 (2,1 %) the procedures should be in accordance with the Declaration of Helsinki; 1 (0.7%) recommends the aplication of the informed consent; 5 (3.5%) recommend the use of Uniform requeriments for manuscripts submitted to biomedical journals and 3 (2.1%) follow no specified rules. Twenty nine journals ask for references in ethics standards: in 15 (51.7%) the information must be included in the text; in 2 (6,8%) the authors must send a letter informing how the ethics standards were followed; in 1 (3.4%) a copy of the approval by the institutional committee must be included; in 1 (3,4%) believed the authors followed the standards and in 10 (34.4%) no specific reference was made. CONCLUSION: these results indicated that the majority of Brazilian Scientific Journals have little concern related to ethical aspects of research in human subjects included in instructions to authors. Even journals that make references to the ethical aspects the recommendations are quite different.UNLABELLED The concern with ethical standards during research in human subjects has been improving in Brazil during the last decade. Analysis of the ethical recommendations in instructions to authors may contribute to understand Brazilian Scientific Journals policies. OBJECTIVE To evaluate the recommendations related to the ethics of investigation in human subjects in instructions to authors of Brazilian Scientific Journals. MATERIAL AND METHODS Instructions to authors of 139 Brazilian Scientific Journals in medicine, biomedicine, nursery, odontology and general sciences were analysed. RESULTS In one hundred ten (79.1%) of the 139 journals no recommendations related to ethics were found; 17 (12.2%) required previous approval by the institutional committee; 3 (2.1%) the procedures should be in accordance with the Declaration of Helsinki; 1 (0.7%) recommends the application of the informed consent; 5 (3.5%) recommend the use of Uniform requirements for manuscripts submitted to biomedical journals and 3 (2.1%) follow no specified rules. Twenty nine journals ask for references in ethics standards: in 15 (51.7%) the information must be included in the text; in 2 (6.8%) the authors must send a letter informing how the ethics standards were followed; in 1 (3.4%) a copy of the approval by the institutional committee must be included; in 1 (3.4%) believed the authors followed the standards and in 10 (34.4%) no specific reference was made. CONCLUSION These results indicated that the majority of Brazilian Scientific Journals have little concern related to ethical aspects of research in human subjects included in instructions to authors. Even journals that make references to the ethical aspects the recommendations are quite different.

Estudo epidemiológico, clínico e microbiológico prospectivo de pacientes portadores de fraturas expostas atendidos em hospital universitário

Epidemiological, clinical and microbiological prospective study of patients with open fractures assisted at university Hospital. We studied 117 patients with open fractures during a period of two years, submitted to a protocol to identify the patient and the kind of trauma, interned for surgical treatment. The culture was collected in 45 patients for microbiological evaluation, before the surgery. The Gram-positive bacteria were the most observed type. All patients used prophylactic antibiotic therapy, but the choice of drug could have a better pattern. Most patients had the following profile: male, white, married, age group 21-30 years, industrial worker with Elementary School complete, victim of car or Motorcycle accidents. The fractures were grouped according to the Gustilo classification, and most of them were of Type III. The infection levels were related to the degree of the classification, being more frequent in Type III. Compared with the literature, the present study showed a higher infection rate in Type II. On the average, the exposure time was of five hours and thirty-nine minutes. Most fractures were managed with an external fixator. It was also evaluated the presence of other injuries, that was low. The Average time spent at the Hospital was of 9.14 days, with almost eight visits to the ambulatory for patient assistance. The most observed complications were infection and pseudoarthrosis, and the more implicated bone was the tibia. Most patients were discharged by the end of this study.

Análise clínica e biomecânica do efeito do diclofenaco sódico na consolidação da fratura da tíbia no rato

The antinflammatories are agents utilized on clinical practice that interfere on inflammatory process by synthesis inhibition of prostaglandin and tromboxanes. Some experimental studies investigated their action on the fractures consolidation process, through clinical and histological studies, as the biomechanical analyses are scarce. In this study, 20 (twenty) Wistar pedigree rats were used, aleatory divided into two groups: A group (control) and B group (treated with diclofenac). In both groups open fractures were made through perforation on right tibia. The drug administration was done intramuscularly in a single daily dose, during 28 (twenty-eight) days. The animals were weekly weighed. After the sacrifice the tibias were dissected, weighed and submitted to a biomechanical analysis of flexion and the maximum load, deformation and rigidity coefficient were measured. It was remarkable that the treated group with antinflammatory did not present body weight gain after the second week and the broken tibias were heavier. In this group the osseous callous supported less maximum load, presenting larger deformation and smaller rigidity coefficient. In the treated group, the non-fractured bone was also less rigid. Concluding, at this studied conditions, the diclofenac can interfere on the consolidation process and on the osseous metabolism, promoting a delay on the callous maturation and a smaller rigidity of the intact bone, respectively.

Análise dos aspectos éticos da pesquisa em seres humanos contidos nas instruções aos autores de 38 revistas de ortopedia e traumatologia

O objetivo do estudo foi analisar as normas relativas a etica da pesquisa em seres humanos contidas nas Instrucoes aos Autores de revistas de ortopedia e traumatologia. Trinta e oito revistas foram estudadas observando-se que 52,6% nao fazem referencia a aspectos eticos, 28,9% exigem aprovacao por Comite de Etica da Instituicao, 15,7% seguem orientacao dos Requisitos Uniformes para Manuscritos Submetidos a Revistas Biomedicas e 2,6% solicitam o consentimento do paciente. Aspectos relacionados a privacidade dos pacientes sao citados em 36,8% das revistas estudadas. Os resultados indicam que a maioria das revistas de ortopedia e traumatologia apresenta pouca preocupacao com os aspectos eticos de pesquisa em seres humanos nas Instrucoes aos Autores.

Detecting Early Biomechanical Effects of Zoledronic Acid on Femurs of Osteoporotic Female Rats

Aim. To investigate the biomechanical effects of zoledronic acid (ZA) on femurs of female osteoporotic rats after follow-up periods of 9 and 12 months. Methods. Eighty female Wistar rats were prospectively assessed. At 60 days of age, the animals were randomly divided into two groups: bilateral oophorectomy (O) (n = 40) and sham surgery (S) (n = 40). At 90 days of age, groups O and S were randomly subdivided into four groups, according to whether 0.1 mg/kg of ZA or distilled water (DW) was intraperitoneally administered: OZA (n = 20), ODW (n = 20), SZA (n = 20), and SDW (n = 20). The animals were sacrificed at 9 and 12 months after the administration of the substances, and then their right femurs were removed and analyzed biomechanically. Axial compression tests that focused on determining the maximum load (N), yield point (N), and stiffness coefficient (N/mm) of the proximal femur were performed in the biomechanical study. Results. ZA significantly increased the maximum load and yield point, reducing the stiffness coefficient concerning the oophorectomy status and follow-up period. Conclusion. Zoledronic acid, at a dose of 0.1 mg/kg, significantly increased the maximum loads and yield points and reduced the stiffness coefficients in the femurs of female rats with osteoporosis caused by bilateral oophorectomy.

Análise comparativa das propriedades mecânicas do ligamento da patela e do tendão calcâneo

Traction tests were performed in specimens obtained from 25 human cadavers, with the purpose of comparing the mechanical properties of the patellar ligament and the calcaneus tendon. Age range of donors was 58 ± 14 years (33-85). There were 19 (76%) males and 6 (24%) females; 23 whites (92%) and 2 blacks (8%). The 10-mm central portion of the specimens was tested at a load application rate level of 30 mm/min. The cross-sectional area of the specimens was obtained so that their structural and material properties could be studied. The following variables were studied: ultimate load (N), stress (MPa), elasticity modulus (Mpa), energy (Nm), absolute (mm) and specific strain (%), yield point (N), yield point stress (MPa). Statistical analysis revealed that both the patellar ligament and the calcaneus tendon, the ultimate load, proportionality limits and ultimate stress, were similar (p>0.05). The other variables showed significant differences (p<0.05). Energy and strain values were higher in the calcaneus tendon. The elasticity modulus, significantly higher in the patellar ligament (p< 0.05) was the variable that best characterized the mechanical behavior of both materials.

Evolution of representation of the hands in plastic arts

The interaction between art and science was high during the Renaissance and it declined later to return significantly in the 20th century, mainly with the use of identification techniques, dating of art works and the development of new materials. The relationship between plastic arts and hand surgery is intense and artistic reproductions of hands are frequent in the illustration of scientific texts. With the objective of understanding the role of the hand in plastic arts, reproductions of works of art (sculptures and paintings) representative of several periods or styles in the history of art were analyzed emphasizing the study of the hands. Anatomical details, relationship with other structures of the human body, role in the composition and symbolic aspects of the hands were studied in historical and artistic contexts of art works in the Paleolithic period (pre-history) until the 20th century. The representation of the hands in plastic arts is directly related to the style or period of the work and to the individual ability of interpretation and execution by the artist.

Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries

Universidade Estadual Paulista Julio de Mesquita Filho Departamento de Cirurgia e Ortopedia Faculdade de Medicina de Botucatu

Fibular Nerve Injury After Small Saphenous Vein Surgery

Superficial nerve injuries are very common during varicose vein surgery. In contrast, deep nerve injuries are rare and reported especially when surgery involves the small saphenous vein (SSV). The deep motor nerves most commonly injured are the tibial nerve and the peroneal nerve, which are directly or indirectly affected by extrinsic compression, stretching, or healing process involvement. In this report, two cases of common fibular nerve injury after SSV stripping are described, including treatment used and patient outcomes. Nerve damage mechanisms, anatomy, and prevention strategies are also discussed. In conclusion, fibular nerve damage may occur during SSV stripping. Preventive measures include careful preoperative ultrasonographic investigation of the anatomy of the vein, determining location of the saphenopopliteal joint, and careful dissection far from fibular nerve and restricted to the popliteal fossa.

Efeito tardio e imediato da sutura em tendão extrassinovial íntegro: estudo biomecânico em ratos

OBJETIVO: O objetivo do estudo foi avaliar o efeito, nas propriedades mecânicas, do arranjo de reparo com material de sutura, no tendao calcâneo de rato, na ausencia de processo de cicatrizacao. METODO: Foram utilizados 12 ratos machos da linhagem Wistar. Os animais foram submetidos a colocacao de ponto de sutura tipo Kessler modificado no tendao calcâneo. Os sacrificios foram realizados nos periodos imediato e com seis semanas de pos-operatorio. As propriedades mecânicas estudadas foram: carga maxima, tensao na carga maxima e modulo de elasticidade. O tendao contralateral foi usado como controle. RESULTADOS: A analise estatistica indicou que, em relacao aos periodos estudados, os valores das propriedades mecânicas nao apresentaram diferencas significativas. Em relacao ao controle, isto e, tendao contralateral sem sutura, os resultados demonstram que, com seis semanas de pos-operatorio, houve queda dos valores do modulo de elasticidade, enquanto a carga maxima e a tensao na carga maxima nao apresentaram variacoes significativas. CONCLUSAO: A colocacao de material de sutura em tendao extrassinovial nao lesado provocou queda do modulo de elasticidade, porem nao interferiu na carga maxima e na tensao na carga maxima apos seis semanas de pos-operatorio.