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Mycophenolate-Induced Colitis: An uncommon Side-effect.
We have evaluated the proposed system as a gaze-controlled interface in real-time for a 9-block pointing and selection task and compared it with Webgazer.js and OpenFace 2.0. We have conducted a user study with 16 participants, and our proposed system reduces selection time and the number of missed selections statistically significantly compared to other two systems.Lesions to the shoulder rotator cuff may have several configurations, and are divided and classified according to the size of the lesion, the tendon involved, its combinations and whether there is possibility of repair. Irreparable subscapular lesions, as well as irreparable anterosuperior lesions, may generate shoulder dysfunction due to loss of humeral head depressants, causing pain and functional limitation. Myotendinous transfers are among the therapeutic alternatives, and the most studied and widespread in recent decades is the transfer of the pectoralis major to the minor tuberosity. However, some anatomical studies suggest that the latissimus dorsi is a more appropriate alternative for the treatment of these lesions because it presents force vectors more similar to those of the subscapularis, besides presenting promising results in the clinical evaluations with short follow-up. The present work aims to describe the surgical technique developed for transfer of the latissimus dorsi in cases of irreparable subscapular and anterossuperior lesions to the rotator cuff.Objective  To evaluate the prevalence of developmental dysplasia of the hip (DDH), that is, hips classified as Graf type-IIc or higher, among a sample of the population of newborns aged from 0 to 3 days of life, and to correlate the findings with the main risk factors described in the literature. Methods  An observational, cross-sectional, prospective study on a sample of newborns at a Maternity Hospital School in the city of São Paulo, Brazil, to assess the prevalence of DDH diagnosed by the Graf method and verify its correlation with the risk factors. Hexamethonium Dibromide mouse Results  A total of 678 newborns underwent hip ultrasound (1,356 hips). The prevalence of DDH was of 5.46%. The logistic regression analysis showed odds ratios (ORs) with statistical significance for the following parameters white ethnicity (OR = 2.561; 95% confidence interval [95%CI] 1.07 to 6.11); multiparity (OR = 3.50; 95%CI 1.62 to 7.38), female gender (OR = 4.95; 95%CI 1.86 to 13.13); and breech presentation (OR = 2.03; 95%CI 1,01 to 4.11). Conclusion  The prevalence of DDH in the sample was of 5.45% using ultrasound as a diagnostic method. This result is different from that of studies that assessed prevalence exclusively through physical examination (Ortolani maneuver). The main risk factors associated with a higher risk of developing DDH were newborns of the female gender, with breech presentation, firstborns, and of white ethnicity.Objective  Clinical and functional evaluation of the surgical treatment for chronic injury of the distal biceps brachii applying a surgical technique with grafting of the distal triceps brachii tendon. Methods  A study based on a review of the medical records and clinical evaluation of the patients submitted to surgical treatment for chronic injury to the distal insertion of the biceps brachii between February 2015 and February 2017. In a 12-month-minimum postoperative follow-up, 7 patients were evaluated regarding the range of motion of the operated and non-operated elbows, flexion, upper-limb extension and supination with a digital dynamometer, the hook test, the satisfaction index, and the Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Elbow Performance Score (MEPS) intruments. Results  During the postoperative functional evaluation, no patient reported dissatisfaction with the esthetic outcome of the incisions, and all of them were satisfied/very satisfied with the range of motion and strength of the operated limb. No neurovascular complications, surgical site infection or tendon rupture were observed. On the MEPS and DASH scales, all patients scored 100 and 0 respectively. The mean flexion was of 133.5° on the operated side, versus 139.2° on the non-operated side. The mean extension was of 5° on the operated side versus 0° on the non-operated side. The supination was of 86.5° versus 90°, and the pronation, 80° versus 80°, when comparing the operated and non-operated sides respectively. The mean flexion, extension and supination corresponded respectively to 92.5%, 96.4% and 86.8% of those of the non-operated limb. Conclusion  Recosntruction of the distal biceps brachii with triceps grafting seems to be an effective and safe option for the treatment of chronic distal biceps injuries.Objective  The present paper aims to identify the profile of compliance to thromboembolism drug prophylaxis in patients undergoing knee or hip arthroplasty at a public hospital. Methods  This is a prospective cohort study, carried out from August 2017 to September 2018, with adult patients who were followed-up from admission until the postoperative period. The Morisky Medication Adherence Scale, consisting of eight items, was applied. Compliance was quantified according to the sum of all correct answers as high (8 points), medium (6 to  less then  8 points), and low compliance ( less then 6 points). For the present study, subjects with high compliance were referred as highly compliant, whereas those with medium to low compliance were referred as partially compliant. Results  The compliance analysis showed that 73.0% of the patients were highly compliant and 27.0% were partially compliant to thromboprophylaxis. The anticoagulant prescribed at hospital discharge was rivaroxaban, a direct factor Xa inhibitor. Compliance was greater in patients who did not require reinforcement in prophylaxis guidance during follow-up; these subjects reported good and excellent acceptance of prophylaxis, although they were on multiple medications at discharge. Conclusion  The data analysis allowed us to conclude that the factors that most influenced compliance were the levels of understanding and acceptance of prophylaxis by the patients, the amount of medication used per day by the subject, the cost of the anticoagulant agent, and its potential to cause adverse reactions.Objective  The present study aimed to compare the clinical and functional outcomes of hyaluronic acid (HA) or platelet-rich plasma (PRP) applications to treat young patients with knee chondral lesions with no arthrosis. Methods  Prospective clinical and functional evaluation of 30 young adult patients with knee chondral lesions submitted to conservative treatment with HA or PRP for a minimum follow-up time of 12 months. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analog scale (VAS) were used for the evaluation. link2 Results  According to the WOMAC score, the PRP group showed significant improvement in all evaluated points, whereas the HA group presented no score improvement. In the VAS, the PRP group showed improvement in all evaluated points, and the HA group presented improvement at 6 and 12 months. Compared to the HA group, the PRP group presented better WOMAC scores at all evaluated points and better VAS scores up to 6 months after treatment. Conclusion  Platelet-rich plasma application resulted in better clinical and functional outcomes at both the WOMAC and VAS scores when applied to knees from young patients with chondral lesions, but no arthrosis. These outcomes were sustained for up to 12 months. Level of evidence  Randomized clinical trial (Type 2B).Objective  Radiographic evaluate if there are signs of early loosening of the cementless total knee arthroplasties Amplitude-Score® (Amplitude Surgical SAS, Valence, France), checking with a follow-up time ranging from 2 to 5.75 years (mean of 3.75 years). Methods  Descriptive longitudinal investigation of observational nature, non-comparative, through a static radiographic study of annual control, of a case series, in a single center, all operated on by the same surgeon (S.M.). All cementless arthroplasties that met the inclusion and exclusion criteria performed from March 2012 to October 2014 were included. Results  Among the 46 cementless knee arthroplasties evaluated in 40 patients, no radiographic signs of early loosening were verified. Conclusion  Cementless arthroplasty promotes optimal osteointegration, with no early release, and it is essential that the surgical technique is perfectly respected.Objective  The present prospective, randomized and controlled study was conducted with 286 patients submitted to primary total knee arthroplasty (TKA) with the objective of evaluating the efficacy of the addition of antibiotics to bone cement as a way to prevent post arthroplasty infection (PAI). Methods  The patients were randomized into two groups bone cement without antibiotic (No ATB, n  = 158) or cement with antibiotic (ATB, n  = 128), in which 2 g of vancomycin was added to 40 g of cement. The patients were followed up for 24 months after surgery. Results  Regarding preoperative demographic data, the distribution of patients between groups was homogeneous ( p   less then  0.05). In the 24-month period, the overall infection rate was of 2.09% (6/286), with no difference (odds ratio [OR] = 1.636; 95% confidence interval [CI] 0.294-9.080; p  = 0.694) between the ATB group (1.56%; 2/128) and the No ATB group (2.53%; 4/158). In the No ATB group, the infection was caused by methicillin-resistant Staphylococcus aureus (MRSA) ( n  = 2), methicillin-sensitive S. aureus (MSSA) ( n  = 1) and Eschirichia coli ( n  = 1). Proteus mirabilis and MSSA were isolated from patients in the ATB group. Among the comorbidities, all patients with PAI were hypertensive and nondiabetic. Two rheumatoid arthritis patients who developed PAI were from the ATB group. link3 Conclusion  The use of cement with ATB reduced the absolute number of infections, but without statistical difference between the groups; thus, routine use should not be encouraged.Objectives  To identify the main risk factors related to poor outcomes after the treatment for periprosthetic infection. Materials and Methods  Medical records from 109 patients who underwent non-conventional endoprosthesis surgeries (primary and revision procedures) from January 1, 2007, to December 31, 2018, were retrospectively evaluated. In total, 15 patients diagnosed with periprosthetic infection were eligible to participate in the study. Variables including gender, age at diagnosis, affected bone, surgery duration, white blood cell (WBC) count before endoprosthesis placement, urinary tract infection during the first postoperative year, and time elapsed from endoprosthesis placement to infection diagnosis were related to outcomes using the Fisher exact test (for the bicategorical variables) or analysis of variance (ANOVA, for the tricategorical variables). The mean times from diagnosis to final outcome were compared using the Student t -test. Results  These risk factors did not show a statistically significant correlation with the outcomes. The data revealed a trend towards a difference between the mean time for the onset of infection and the final outcome. Due to the limited sample, we believe that studies with larger cohorts can prove this trend. Conclusion  We identified that the time from endoprosthesis placement to the onset of the symptoms of infection tends to be related to the outcome and evolution of the patient evolution during the treatment for periprosthetic infection. Although apparently correlated, other associated factors were not statistically linked to poor treatment outcomes.
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