Percutaneous Transseptal Bioprosthetic Implantation in Failed Prosthetic Surgical Mitral Valve - Brazilian Multicenter Experience.

Background: Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment.

Objectives: To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV).

Methods: Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included.

How do Orthopedic Surgeons Manage Displaced Femoral Neck Fracture in the Middle-Aged Patient? Brazilian Survey of 78 Orthopaedic Surgeons.

 The aim of the present study was to evaluate the practices and preferences of Brazilian orthopedic surgeons for the treatment of femoral neck fractures in middle-aged patients.  A survey containing 10 images of femoral neck fractures was sent to a group of 100 orthopedic surgeons, all of them members of the Brazilian Society of Orthopedics and Traumatology. The questionnaire asked the treatment option for cases of nondisplaced and displaced fractures of the femoral neck in middle-aged patients, that is, those between 50 and 69 years old.

The role of the medial plate for Pauwels type III femoral neck fracture: a comparative mechanical study using two fixations with cannulated screws.

Background: The biomechanical behavior of Pauwels type III fractures should be taken into consideration when performing internal fixation, since this repair should resist the shear force inherent in the vertical fracture line to the greatest extent possible. Recently, the use of a small fragment plate on the medial face of the femoral neck has been proposed by some authors, with satisfactory initial results. In the current study we analyze the mechanical role a medial plate used as a buttress plate for Pauwels type III femoral neck fractures, comparing the resistance of two fixation configurations using three cannulated screws.

Asymptomatic Dysplasia Epiphysealis Hemimelica of the Shoulder in a Skeletally Mature Patient with Normal Function.

Dysplasia epiphysealis hemimelica is a rare osteocartilaginous overgrowth syndrome of bone epiphysis, mostly encountered in the lower limbs of immature skeleton patients. We report a case of proximal humerus presentation in an adult male, with neither articular involvement nor clinical dysfunction. This case highlights the importance of stratification into intra- and extra-articular lesions, as this distinction ultimately influences both symptoms and treatment outcome.

Metastatic tumor of the hand of unknown primary origin.

Acral metastases in the hand are exceedingly rare. We present the unusual case of a metastatic tumor of the hand of unknown primary site in a 77-year-old man with no known cancer history. The patient presented with pain and swelling in the tip of the left ring finger, which had previously been diagnosed as gout at another clinic.

General principles for treatment of femoral head fractures.

Femoral head fractures occur almost exclusively as a result of a traumatic hip dislocation. Treatment is typically an emergency and includes the reduction of the dislocated hip under anesthesia. As a rule, the earlier the reduction, the better the outcome.

Stability of L-shaped and inverted triangle fixation assemblies in treating Pauwels type II femoral neck fracture: a comparative mechanical study.

Purpose: The aim of our study is to compare the mechanical resistance of two screw configurations in fixating type II Pauwels femoral neck fractures.

Methods: Fifteen synthetic models of femur bones in young adults were divided into three equal groups: intact (G1), models with fixation of a 5.0-mm failure zone created in the posterior cortex of the femoral neck using an L-shaped screw arrangement (G2, n = 5), and models with an identical failure zone fixated using an inverted triangle assembly (G3, n = 5).

Three physiotherapy protocols: effects on pulmonary volumes after cardiac surgery.

Objective: To evaluate inspiratory volume in patients undergoing cardiac surgery and to determine the effects that incentive spirometry (IS) and the breath stacking (BS) technique have on the recovery of FVC in such patients.

Methods: A prospective, controlled, randomized clinical trial involving 35 patients undergoing cardiac surgery at the Hospital de Força Aérea do Galeão (HFAG, Galeão Air Force Hospital), in the city of Rio de Janeiro, Brazil. The patients, all of whom performed mobilization and cough procedures, were randomly divided into three groups: exercise control (EC), performing only the abovementioned procedures; IS, performing the abovementioned procedures and instructed to take long breaths using an incentive spirometer; and BS, performing the abovementioned procedures, together with successive inspiratory efforts using a facial mask coupled to a unidirectional valve.

Tuberculum sellae meningiomas: surgical considerations.

We report our experience on the treatment of tuberculum sellae meningiomas (TSMs) regarding the involvement of the optic canal and clinical outcomes. We reviewed 23 patients who were operated on between January 1997 and December 2008. The surgical approach was unilateral subfrontal supraorbital osteotomy in one piece.

Monostotic fibrous dysplasia of the clivus: image-guided endoscopic endonasal transsphenoidal surgery.

Introduction: Fibrous dysplasia is a non-heritable, congenital disease involving the bones. Its diagnosis relies on image examination and pathology. Treatment is usually conservative, but in cases of cranial nerve impingement or extension to the condyles, surgery should be considered.

Myocardial revascularization in anomalous origin of the right coronary artery: case report.

A 21-year-old man with angina-like chest pain and syncope related to ischemic ECG changes due to an anomalous origin of the right coronary artery. The patient was submitted to surgical correction with myocardial revascularization with internal thoracic artery. A literature review of this rare congenital heart disease is presented.

Endovascular treatment of carotid-cavernous fistulas: review of 12 cases.

Carotid-cavernous fistulas (CCFs) are an uncommon pathology in current neurosurgical practice. Furthermore, they generally present a challenge to the neurosurgeon because of both their deep location and the major neurovascular structures that surround them. CCFs consist of a vascular anomaly in which blood flows from meningeal branches of the internal and external carotid arteries, or directly from the internal carotid artery, into the venous circulation around and in the cavernous sinus.

Functional Outcome after Operative Treatment of Displaced Fractures of the Acetabulum: A 12-month to 5-year Follow-up Investigation.

Purpose: To review our experience with 82 surgically treated displaced acetabular fractures over a 4-year period.

Patients And Methods: Ninety-three consecutive displaced acetabular fractures were consecutively operated on at Level I Trauma Center from January 1, 2000 through December 31, 2003, and 82 were available for review with a minimum of 12-month follow-up. Clinical (Merle D'Aubigné modified by Matta et al.

Clonal spread of methicillin-resistant Staphylococcus aureus in a large geographic area of the United States.

Methicillin resistance in Staphylococcus aureus has rapidly increased over the last two decades. This increase is paralleled by the emergence of unique multi-resistant MRSA clones. In Brazil, Argentina, Uruguay, Portugal and Czech Republic a specific MRSA clone is widely spread, the so-called Brazilian epidemic clone.

[Sphenoidotomy approach to the sellar tumors: technical note].

Dissection of mucosa from the nasal septum during transphenoidal approach can lead to significant morbidity. We report our experience with sphenoidotomy approach to the sella. This procedure obviates this dissection and its complication as septal perfurations, anosmy and epistaxis.

[Subfrontal approach in sellar and suprasellar lesions].

A variety of mass lesions are placed in and around of the sella turcica. Although their common location these lesions have distinguishing features and different approaches can be selected. There are conventional transcranial and sophisticated skull base approaches.