Instituto Dr Jose Frota

Fortaleza, Brazil

Instituto Dr Jose Frota

Fortaleza, Brazil
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De Rezende Pratali R.,Hospital do Servidor Publico Estadual HSPE | Hennemann S.A.,Hospital Mae Of Deus | Amaral R.,Institute Patologia da Coluna IPC | Da Silva L.E.C.T.,Instituto Nacional Of Traumatologia E Ortopedia Into | And 7 more authors.
Coluna/ Columna | Year: 2015

Objective: To develop a consensus for translation of the most relevant terms used in the study of Adult Spinal Deformity, from their original languages into Brazilian Portuguese. Methods: A panel of 12 experts in spine surgery from the five Brazilian regions was constituted. To obtain the standardization of terminology, the Delphi method with an electronic questionnaire was administered to participants about their opinion on the translation of 13 relevant terms chosen by literature review. Each term was considered standard when there was consensus, that is, concordance higher than 80% among participants as to the suggestion to be adopted, and then on the acceptance of the term and its abbreviation in Portuguese. Results: Initially there was consensus (over 80% concordance) on the translation of seven terms in the electronic questionnaire. The other six terms that have not reached consensus were discussed at a meeting among the participants, relying on the opinion of a specialized professional in simultaneous translation of orthopedic terms in Portuguese and other professional majored in Portuguese language. It was decided how these terms should be translated and there was a consensus among all participants regarding their acceptance. Finally, there was consensus among the participants, who agreed with the translation and abbreviation of the 13 propose terms, defining its standardization for Brazilian Portuguese. Conclusion: We present a standard terminology used in the study of Adult Spinal Deformity through consensus among experts, seeking uniformity in the use of these terms in Brazilian Portuguese.


Alves De Souza C.,Instituto Dr Jose Frota | Queiroz Alves De Souza A.,Federal University of Ceará | Queiroz Alves De Souza M.D.S.,Federal University of Ceará | Dias Leite J.A.,Federal University of Ceará | And 2 more authors.
Acta Orthopaedica | Year: 2017

Background and purpose — Treatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma. Patients and methods — 153 patients who fulfilled the inclusion criteria were enrolled from a referral public hospital for trauma. All the patients were followed up daily until hospital discharge and, after this, on an outpatient basis. Patients were treated with prophylactic antimicrobials and surgery according to traumatology service protocol. The IL1RNVNTR and the IL1B-511C > T polymorphisms were determined by PCR and PCR-RFLP, respectively. Results — The IL1RN*2/*2 genotype was associated (OR: 7; p < 0.001) with a higher risk of osteomyelitis and was also significantly associated with Staphylococcus aureus infection. The haplotypes (combination of different markers) *2-C and *2-T were also associated with osteomyelitis development. Interpretation — IL1B-511C > T and IL1RNVNTR polymorphisms were associated with osteomyelitis development, which may have implications for patients with bone traumas. These data may be relevant for new therapeutic strategies for this disease. © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.


Freire de Medeiros C.M.M.,Federal University of Ceará | Arantes E.P.,Federal University of Ceará | Tajra R.D.D.P.,Federal University of Ceará | Santiago H.R.,Federal University of Ceará | And 4 more authors.
Psychology, Health and Medicine | Year: 2016

Resilience and religiosity have received attention as an important process in the experience and management of chronic comorbidities; however, there is no study evaluating resilience in hemodialysis patients and its association with other psychological dimensions or with treatment adherence. This observational prospective study assessed resilience (25 item Wagnild and Young Resilience Scale), religiosity under three dimensions (organizational, non-organizational and intrinsic) using DUREL scale, depressive symptoms (Patient Health Questionnaire-9) and health-related quality of life (Short Form-36 questionnaire). The main outcomes were medication adherence using the Morisky Medication Adherence Scale-8 (MMAR-8) and the missing/shortened dialysis sessions in the following six months. Of 208 patients approached, 202 (97.1%) agreed to participate. One hundred twenty-three patients (60.9%) were males and mean age was 52.8 ± 14.8 years-old. The median time on hemodialysis was 36 months (IQR, 12, 84). 82 (40.6%) patients obtained a MMAS-8 score <6 and were considered as having ‘poor adherence’. Overall, the mean score of medication adherence was low (5.7 ± 2.1). About adherence to hemodialysis sessions, patients missed a total of 234 (1.6%) hemodialysis sessions. Forty-eight patients (23.7%) missed an average of at least three sessions in six months. Regarding adherence to medication, there was no association in the uni- or multivariate analysis between religiosity dimensions and MMAS-8 score. After adjustment, resilience was positively associated with MMAS-8 score (standardized β coefficient .239, p = .016). Organized and intrinsic religiosity were associated with adherence to dialysis sessions (standardized β coefficient .258, p = .004 and .231, p = .026, respectively). Interestingly, opposite to medication adherence, more resilient patients were associated with less adherence to hemodialysis sessions (standardized β coefficient −.296, p = .001). Religiosity was associated with dialysis adherence but not with medication adherence. Resilience was associated with higher medication adherence but lower adherence to dialysis sessions. © 2016 Informa UK Limited, trading as Taylor & Francis Group


Albuquerque P.L.M.M.,Instituto Dr Jose Frota | Albuquerque P.L.M.M.,Federal University of Ceará | Silva Junior G.B.,Federal University of Ceará | Jacinto C.N.,Federal University of Ceará | And 6 more authors.
Nephrology | Year: 2014

Aim Acute kidney injury (AKI) is one of the main causes of morbidity and mortality in cases of envenomation by venomous snakes. The present study was carried out to investigate the clinical and laboratory manifestations in accidents with venomous snakes and the risk factors associated with AKI in these accidents. Methods A retrospective study was carried out with patients victims of snakebite admitted to a reference centre. AKI was defined according to the RIFLE and AKIN criteria. Results A total of 276 patients were included, of which 230 (83.7%) were males. AKI was observed in 42 cases (15.2%). The mean genus involved in the accidents was Bothrops (82.2%). Mean age of patients with AKI was higher than in patients without AKI (43 ± 20 vs. 34 ± 21 years, P = 0.015). The time elapsed between the accident and medical care was higher in the AKI group (25 ± 28 vs. 14 ± 16h, P = 0.034), as well as the time elapsed between the accident and the administration of antivenom (30.7 ± 27 vs. 15 ± 16 h, P = 0.01). Haemodialysis was required in 30% of cases and complete renal function recovery was observed in 54.8% of cases at hospital discharge. There were four deaths, none of which had AKI. Factors associated with AKI were haemorrhagic abnormalities (P = 0.036, OR = 6.718, 95% CI: 1.067-25.661) and longer length of hospital stay (P = 0.004, OR = 1.69, 95% CI 1.165-2.088). Conclusion Acute kidney injury is an important complication of snakebite accidents, showing low mortality, but high morbidity, which can lead to partial renal function recovery. © 2014 Asian Pacific Society of Nephrology.


Jana Neto F.C.,Conjunto Hospitalar Do Mandaqui | Jana Neto F.C.,Nove de Julho University | Canal M.D.P.,Nove de Julho University | Alves B.A.F.,Conjunto Hospitalar Do Mandaqui | And 3 more authors.
Revista Brasileira de Ortopedia | Year: 2016

Objective To analyze the characteristics of patients with Gustilo-Anderson Type III open tibial fractures treated at a tertiary care hospital in São Paulo between January 2013 and August 2014. Methods This was a cross-sectional retrospective study. The following data were gathered from the electronic medical records: age; gender; diagnosis; trauma mechanism; comorbidities; associated fractures; Gustilo and Anderson, Tscherne and AO classifications; treatment (initial and definitive); presence of compartment syndrome; primary and secondary amputations; MESS (Mangled Extremity Severity Score) index; mortality rate; and infection rate. Results 116 patients were included: 81% with fracture type IIIA, 12% IIIB and 7% IIIC; 85% males; mean age 32.3 years; and 57% victims of motorcycle accidents. Tibial shaft fractures were significantly more prevalent (67%). Eight patients were subjected to amputation: one primary case and seven secondary cases. Types IIIC (75%) and IIIB (25%) predominated among the patients subjected to secondary amputation. The MESS index was greater than 7 in 88% of the amputees and in 5% of the limb salvage group. Conclusion The profile of patients with open tibial fracture of Gustilo and Anderson Type III mainly involved young male individuals who were victims of motorcycle accidents. The tibial shaft was the segment most affected. Only 7% of the patients underwent amputation. Given the current controversy in the literature about amputation or salvage of severely injured lower limbs, it becomes necessary to carry out prospective studies to support clinical decisions. © 2015 Sociedade Brasileira de Ortopedia e Traumatologia.


Albuquerque P.L.M.M.,Instituto Dr Jose Frota | Albuquerque P.L.M.M.,Federal University of Ceará | Silva Junior G.B.,Federal University of Ceará | Silva Junior G.B.,University of Fortaleza | And 5 more authors.
Revista do Instituto de Medicina Tropical de Sao Paulo | Year: 2013

The aim of this study was to describe the epidemiological profile of snakebite accidents reported by the toxicological assistance center in Fortaleza, Ceará, Brazil. Database information on snakebite accidents was analyzed regarding the period from January 2003 to December 2011. A total of 1063 cases were found. The accidents occurred during the rainy months (March, April and May), in urban areas (52.3%), affecting individuals younger than 50 years and predominantly among males (70.7%). The lower limbs were the most frequently affected body area (33.7%). Most accidents involved non-venomous snakes (76.1%). The genus Bothrops was the main one involved in venomous accidents (83%). It is expected that this study can be used as the substrate to improve healthcare surveillance and implementing better measures for the treatment of this population.


de Souza M.D.S.Q.A.,Federal University of Ceará | de Souza M.D.S.Q.A.,Instituto Dr Jose Frota | de Souza C.A.,Instituto Dr Jose Frota | Cunha L.M.P.,Federal University of Ceará | And 3 more authors.
Infection, Genetics and Evolution | Year: 2015

Introduction: CCR5 receptor exerts an important role in the host immune response. Osteomyelitis is an inflammatory process and Staphylococcus aureus is the principal causative agent of this bone injury complication. A deletion of 32. bp (CCR5δ32) in the CCR5 gene seems to protect against HIV-1, S. aureus and other infections. However, the CCR5δ32 allele has been associated with an increased risk for other diseases. Objective: To investigate the function of CCR5 and to gather data about the relationship of the CCR5δ32 mutation and the risk of developing osteomyelitis as a complication in patients with bone traumas. Methods: In a study of 153 patients with bone traumas the presence of the CCRδ32 mutation was determined by PCR. Results: In this study, the CCR5δ32 allele was present only in the heterozygous form. Osteomyelitis was more frequent in the wild type carriers (94.87%; 37/39) and most of the CCR5δ32 carriers (87.5%; 14/16) did not present with osteomyelitis. Conclusion: The CCR5δ32 could be associated with protection against osteomyelitis caused by S. aureus, corroborating the data from Alonzo & Torres study, in which CCR5 receptor is required for S. aureus leukotoxin ED (LukED) cytotoxicity. © 2015 .


Albuquerque P.L.M.M.,Instituto Dr Jose Frota | Albuquerque P.L.M.M.,Federal University of Ceará | Jacinto C.N.,Federal University of Ceará | Silva Junior G.B.,Federal University of Ceará | And 4 more authors.
Revista do Instituto de Medicina Tropical de Sao Paulo | Year: 2013

Ophidic accidents are an important public health problem due to their incidence, morbidity and mortality. An increasing number of cases have been registered in Brazil in the last few years. Several studies point to the importance of knowing the clinical complications and adequate approach in these accidents. However, knowledge about the risk factors is not enough and there are an increasing number of deaths due to these accidents in Brazil. In this context, acute kidney injury (AKI) appears as one of the main causes of death and consequences for these victims, which are mainly young males working in rural areas. Snakes of the Bothrops and Crotalus genera are the main responsible for renal involvement in ophidic accidents in South America. The present study is a literature review of AKI caused by Bothrops and Crotalus snake venom regarding diverse characteristics, emphasizing the most appropriate therapeutic approach for these cases. Recent studies have been carried out searching for complementary therapies for the treatment of ophidic accidents, including the use of lipoic acid, simvastatin and allopurinol. Some plants, such as Apocynaceae, Lamiaceae and Rubiaceae seem to have a beneficial role in the treatment of this type of envenomation. Future studies will certainly find new therapeutic measures for ophidic accidents.


Rodrigues L.P.,Instituto Dr Jose Frota | Melo E.L.A.,Hospital Geral Dr Cesar Cals Hgcc
Radiologia Brasileira | Year: 2012

Madelung's disease is characterized by the presence of symmetric masses of adipose tissue on the neck, shoulders, arms and the upper trunk. Computed tomography demonstrates characteristic imaging findings, and it is considered to be the method of choice for diagnosis, pre-operative staging, and postoperative follow-up. The authors report the case of a man with typical tomographic findings of Madelung's disease. © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem.


PubMed | Conjunto Hospitalar do Mandaqui, Instituto Dr Jose Frota and Nove de Julho University
Type: Journal Article | Journal: Revista brasileira de ortopedia | Year: 2016

To analyze the characteristics of patients with Gustilo-Anderson Type III open tibial fractures treated at a tertiary care hospital in So Paulo between January 2013 and August 2014.This was a cross-sectional retrospective study. The following data were gathered from the electronic medical records: age; gender; diagnosis; trauma mechanism; comorbidities; associated fractures; Gustilo and Anderson, Tscherne and AO classifications; treatment (initial and definitive); presence of compartment syndrome; primary and secondary amputations; MESS (Mangled Extremity Severity Score) index; mortality rate; and infection rate.116 patients were included: 81% with fracture type IIIA, 12% IIIB and 7% IIIC; 85% males; mean age 32.3 years; and 57% victims of motorcycle accidents. Tibial shaft fractures were significantly more prevalent (67%). Eight patients were subjected to amputation: one primary case and seven secondary cases. Types IIIC (75%) and IIIB (25%) predominated among the patients subjected to secondary amputation. The MESS index was greater than 7 in 88% of the amputees and in 5% of the limb salvage group.The profile of patients with open tibial fracture of Gustilo and Anderson Type III mainly involved young male individuals who were victims of motorcycle accidents. The tibial shaft was the segment most affected. Only 7% of the patients underwent amputation. Given the current controversy in the literature about amputation or salvage of severely injured lower limbs, it becomes necessary to carry out prospective studies to support clinical decisions.

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