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α-Lipoic acid (LA) is an antioxidant of endogenous production, also obtained exogenously. Oxidative stress is closely associated with hypertension, which causes kidney injury and endothelial dysfunction. Here, we evaluated the cardiovascular and renal effects of LA in the two-kidney-one-clip (2K1C) hypertension model. The rats were divided into four groups: Sham surgery (Sham), the two-kidneys-one-clip (2K1C) group, and groups treated with LA for 14 days (Sham-LA and 2K1C-LA). No changes were observed in the pattern of food, water intake, and urinary volume. The left/right kidney weight LKw/RKw ratio was significantly higher in 2K1C animals. LA treatment did not reverse the increase in cardiac mass. In relation to vascular reactivity, there was an increase in the potency of phenylephrine (PHE) curve in the hypertensive animals treated with LA compared to the 2K1C group and also compared to the Sham group. Vasorelaxation induced by acetylcholine (Ach) and sodium nitroprusside (SNP) were not improved by treatment with LA. Urea and creatinine levels were not altered by the LA treatment. In conclusion, the morphological changes in the aorta and heart were not reversed; however, the treatment with LA mitigated the contraction increase induced by the 2K1C hypertension.

Local muscle flaps are especially advantageous when treating soft tissue defects, but one disadvantage is the potential functional deficits associated with the muscle transfer. In this study, we evaluated ankle function among patients (cases) who underwent reconstruction of soft tissue defects in the leg using local flaps of the gastrocnemius and/or soleus muscle. Function was compared between the affected and contralateral non-affected limb and against patients (controls) with open tibial fractures who required no soft tissue reconstruction. In a retrospective cohort study, ankle function was accessed as range of motion (ROM) and plantar flexion strength, and using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot summation and subscale scores. Among 31 patients who underwent soft-tissue reconstruction, 19 were available for functional evaluation. Controls were 23 patients with open tibial fractures not requiring flaps. Among cases, reconstruction was performed with a soleus flap in nine patients, a medial gastrocnemius flap in seven, a lateral gastrocnemius in one, and with both gastrocnemius and soleus flaps in one patient each. One patient developed partial flap necrosis. In cases, ankle dorsiflexion and plantar flexion were significantly decreased on the affected versus normal side. However, no deficit in plantar flexion strength was detected; nor any significant difference in AOFAS ankle-hindfoot scores in cases versus controls. Local muscle flaps are useful for reconstructing post-traumatic soft tissue defects in the leg. Some loss of ankle ROM should be expected, but likely no clinically-measurable deficit in overall ankle strength and function., Competing Interests: Declaration of Competing Interest None of the authors has received any financial support from any commercial company or institution directly or indirectly related to the subject of this article. This study was partially supported by the AO Trauma Latin America. Support was provided directly through AO Trauma Latin America office. AO Foundation is an independent medically guided not-for-profit organization., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To determine whether instrumental music influences the anxiety status and intraoperative sedative requirements of a patient DESIGN: A single center, prospective, randomized controlled trial SETTING: Patients between 18 and 65 years, physical status of American Society of Anesthesiologists (ASA I or II) who underwent lower limb orthopedic surgery under spinal anesthesia., Interventions: Patients were assigned to one of two groups: (1) Music Group: patients hearing instrumental music through a headset during the entire procedure or (2) No Music Group: patients wearing headphones without music MAIN OUTCOME MEASURES: Before and after the procedure, the anxiety status of the patient was assessed using the State-Trait Anxiety Inventory, and intraoperative sedative drug consumption was quantified., Results: A total of 107 patients were analyzed. A significant reduction in anxiety in the Music Group patients after surgery (p = 0.023) was found. Patients in this group also required less additional medication for intraoperative sedation (p = 0.004), and 88.9% of Music Group patients self-reported that music helped them remain calm during the procedure. Most patients in both groups agreed that music should be used during surgical procedures (98.2% and 94.3% in Music and No Music Groups, respectively) CONCLUSIONS: This study showed that listening to instrumental music during lower limb orthopedic surgery caused a reduction in anxiety and sedative requirements. Patients also self-reported a positive music-related experience., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Anterior external fixation is a well-established technique for treating pelvic ring injuries, but many complications are associated with it. The subcutaneous anterior internal fixator (INFIX) technique is associated with reduced complication rates and is less uncomfortable for patients., Objective: This study evaluated functional outcomes among patients with pelvic ring injuries treated using the INFIX method., Patients and Methods: In this retrospective case series, patients treated using the INFIX technique were reviewed for functional outcomes, using the Iowa Pelvic Score (IPS). Thirty-four patients, of mean age 39.2 years, were evaluated after a mean follow-up of 1.2 years., Results: Twenty-three of the 34 patients experienced reduction classified as excellent, and eleven as good, with no instances of moderate or poor reduction. One patient developed implant exposure and infection during follow-up. Twenty-six ultimately experienced an excellent or good functional result. The average final IPS was 79.4 (range: 48-100)., Conclusion: Our results reinforce prior evidence that the INFIX method is safe for fixating pelvic ring lesions. Most of our patients also experienced excellent or good functional recovery, suggesting that this technique is a viable option for treating certain pelvic ring injuries., Competing Interests: Declaration of Competing Interest Each author certifies that he has no commercial associations that might pose a conflict of interest regarding the submitted article. AO Trauma Latin America supported this study through a research grant for the first author., (Copyright © 2021. Published by Elsevier Ltd.)

Objective: Infection after the internal fixation of fractures is a major complication. Early infection is particularly challenging, because it occurs when the fracture is not yet united. The objective of this study is to identify possible factors related to the development of early infection in patients treated with internal fixation for fractures., Method: This retrospective observational study analyzed 24 patients with long bone fractures who underwent internal fixation and developed infections in the post-operatory period. The infections were classified as early (diagnosis in the first two weeks after surgery) or late (diagnosis after 2 weeks)., Results: Of the 24 patients studied, 11 (46%) developed early infections and 13 (54%) were diagnosed with late infections. The early infection group was significantly younger (37.8 versus 53.1 [p = 0.05]) and underwent more surgeries prior to internal fixation (1.2 versus 0.2 [p < 0.00])., Conclusion: Risk factors for the development of early infection in the postoperative period should be considered when treating patients with internal fracture fixation in order to diagnose this condition as early as possible. Level of Evidence IV; Case series., Competing Interests: All authors declare no potential conflict of interest related to this article.