SOME - Artigos publicados em revistas indexadas na Medline
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- Giant cell tumours of the small bones of the hands and feet: long-term results of 30 patients and a systematic literature reviewPublication . Oliveira, V.; van der Heijden, L.; van der Geest, I.; Campanacci, D.; Gibbons, C.; van de Sande, M.; Dijkstra, P.Giant cell tumours (GCTs) of the small bones of the hands and feet are rare. Small case series have been published but there is no consensus about ideal treatment. We performed a systematic review, initially screening 775 titles, and included 12 papers comprising 91 patients with GCT of the small bones of the hands and feet. The rate of recurrence across these publications was found to be 72% (18 of 25) in those treated with isolated curettage, 13% (2 of 15) in those treated with curettage plus adjuvants, 15% (6 of 41) in those treated by resection and 10% (1 of 10) in those treated by amputation. We then retrospectively analysed 30 patients treated for GCT of the small bones of the hands and feet between 1987 and 2010 in five specialised centres. The primary treatment was curettage in six, curettage with adjuvants (phenol or liquid nitrogen with or without polymethylmethacrylate (PMMA)) in 18 and resection in six. We evaluated the rate of complications and recurrence as well as the factors that influenced their functional outcome. At a mean follow-up of 7.9 years (2 to 26) the rate of recurrence was 50% (n = 3) in those patients treated with isolated curettage, 22% (n = 4) in those treated with curettage plus adjuvants and 17% (n = 1) in those treated with resection (p = 0.404). The only complication was pain in one patient, which resolved after surgical removal of remnants of PMMA. We could not identify any individual factors associated with a higher rate of complications or recurrence. The mean post-operative Musculoskeletal Tumor Society scores were slightly higher after intra-lesional treatment including isolated curettage and curettage plus adjuvants (29 (20 to 30)) compared with resection (25 (15 to 30)) (p = 0.091). Repeated curettage with adjuvants eventually resulted in the cure for all patients and is therefore a reasonable treatment for both primary and recurrent GCT of the small bones of the hands and feet.
- Identification of novel nucleus pulposus markers: Interspecies variations and implications for cell-based therapiesfor intervertebral disc degenerationPublication . Rodrigues-Pinto, R.; Richardson, S.; Hoyland, J.Mesenchymal stem-cell based therapies have been proposed as novel treatments for intervertebral disc degeneration, a prevalent and disabling condition associated with back pain. The development of these treatment strategies, however, has been hindered by the incomplete understanding of the human nucleus pulposus phenotype and by an inaccurate interpretation and translation of animal to human research. This review summarises recent work characterising the nucleus pulposus phenotype in different animal models and in humans and integrates their findings with the anatomical and physiological differences between these species. Understanding this phenotype is paramount to guarantee that implanted cells restore the native functions of the intervertebral disc.
- [Physical exercise in the treatment of Ankylosing Spondylitis: a systematic Review]Publication . Ribeiro, F.; Leite, M.; Silva, F.; Sousa, O.O exercício físico é um componente regular no tratamento de várias patologias, entre as quais a espondilite anquilosante (EA). A EA é uma patologia reumática, crónica e sistémica, sem cura conhecida e na qual o exercício físico se tem revelado como terapia essencial no controlo e prevenção de deformidades associadas. No sentido de promover uma prática de acordo com a evidência e de ajudar na tomada de decisões acerca dos cuidados de saúde em pacientes com EA, foi efectuada uma revisão de estudos randomizados controlados tendo por objectivo examinar o papel do exercício físico no tratamento de pacientes com EA. Uma pesquisa computorizada nas bases de dados Cochrane Central,Pubmed/ Medline e PEDro permitiu identificar 13 estudos envolvendo 1.056 pacientes, com classificação metodológica de 5,62 na escala de PEDro. Dos estudos incluídos, 3 avaliaram o efeito aditivo do exercício físico à medicação, 3 compararam os benefícios da prática regular de exercício supervisionado em grupo com os benefícios do exercício físico não supervisionado no domicílio, 5 avaliaram programas de exercício alternativo (hidroterapia e reeducação postural global) ao programa tradicionalmente usado em pacientes do EA e 2 centraram-se sobre o rácio custo/efectividade da terapia. Os estudos incluídos nesta revisão sugerem que o exercício físico é uma terapia benéfica no tratamento de pacientes com EA; este exercício deve ser efectuado em grupo com supervisão de fisioterapeuta. Novas modalidades de exercício, hidroterapia ou exercício baseado na reeducação postural global, parecem oferecer igualmente uma terapia alternativa válida e promissora para pacientes com EA.
- A Strange GaitPublication . Nascimento, J.; Almeida, E.
- Subjective outcome of reconstruction of the adult acquired neurological equinovarus foot.Publication . Lemos, R.; Pereira, A.Abstract A retrospective study was done of the subjective outcome of surgical correction of a spastic equinovarus foot deformity in 27 adult patients with acquired spastic hemiplegia. The mean age of the patients was 49 years and the mean follow-up period was 29 months. The patients were submitted to individualized soft-tissue surgery intended to correct their deformities and rebalance the affected joints, and subsequently subjected to a standard rehabilitation protocol. The assessment was based on the clinical records and on a questionnaire sent to the patients about relevant aspects of their gait, lifestyle and untoward effects and complications. The results have shown that patients experience frank improvement in terms of gait, orthostatic posture, self-esteem and quality of life. Transient or permanent adverse effects occurred in 11 of the 27 patients. The changes induced by surgery to reduce the imbalance and deformity of the foot have a considerable impact on independence and quality of life of these patients despite the high rate of complications.