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Purpose: To describe, in controls and in a population with patellar instability, magnetic resonance imaging values of measurements representing major associated factors for patellar instability (patellar height, trochlear dysplasia, and extensor mechanism alignment), as well as their cutoff values., Methods: In total, 323 knee magnetic resonance imaging scans, 142 with patellar instability and 181 controls without patellofemoral complaints (anterior cruciate, medial collateral ligament, meniscus ruptures or normal) were evaluated. Means, normality values in the control population, ideal cutoff values through receiver operating characteristic curves analysis, and interobserver reliability (intraclass correlation coefficient) were described for a series of measurements., Results: All measurements were statistically different in control and instability patients, except for the patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance. The interobserver intraclass correlation coefficient was good or excellent (above 0.75) only for the patellotrochlear index, patellar tendon-trochlear groove (PTTG) angle, and patellar tilt. The optimal cutoff value for each measurement was: PTTG angle ≥25.3 o with sensitivity (S) of 70% and specificity (E) of 89%, patellar tilt ≥16 o (S: 69% and E: 84%), trochlear sulcus angle ≥153 o (S: 75% and E: 76%), Carrillon ≤12.8 o (S: 62% and E: 87%), PTTG distance ≥11mm (S: 71% and E: 78%), Caton-Deschamps index ≥1.23 (S: 72% and E: 76%) and trochlear bump ≥3.95 mm (S: 76% and E: 65%)., Conclusions: Caton-Deschamps index (≥1.23), trochlear sulcus angle (≥153 o ), ventral prominence of the trochlea (≥3.95 mm), PTTG distance (≥11 mm), PTTG angle (≥25.3 o ), Carrillon angle (≤12.8 o ), and patellar tilt (≥16 o ) presented better diagnostic performance for patellar instability. Patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance were not related to patellar instability. The interobserver reliability of the factors related to patellar instability was excellent only for the PTTG angle and lateral patellar tilt., Level of Evidence: Level III, retrospective case-control study., (Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Osteochondral fracture after acute patellar dislocation in teenagers is relatively common (up to 60% of cases of patellar dislocation), but poorly diagnosed. There are several treatments proposed for this type of injury, but none well defined in the literature. A male patient, 13 years old, with a diagnosis of osteochondral fracture of the lateral femoral condyle after acute dislocation of the right patella. He underwent surgical treatment of the chondral injury, which consisted of suturing of the chondral fragment to the cartilage defect and, in a second approach, reconstruction of the medial patellotibial ligament and medial patellofemoral ligament with autologous flexor graft. Currently, the patient has been followed up for 16 months postoperatively for the suture of the chondral fragment and for 8 months for the ligament reconstruction. He has been evaluated through functional scores and T2 weighted magnetic resonance imaging. Acute fixation through direct bone suturing of a purely chondral fragment can be considered in special situations.

Objective: To present the indications, technical aspects, and initial results of the first cases using Endo-Model™ implants in Brazil., Methods: A prospective study was conducted. It included nine patients submitted to a total knee arthroplasty, of which six were primary and three were revisions, using exclusively the Endo-Model™ implant. These patients were followed for an average of 12 months and evaluated with functional scores, such as the Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), and visual analog pain scale (VAS)., Results: There were statistically significant improvements in all scores evaluated in every patient. Only one complication occurred postoperatively (apraxia of the peroneal nerve) and did not require surgery revision., Conclusion: The use of a rotating-hinge implant for knee arthroplasty is a new option for complex cases with severe instability in Brazil; the initial results are satisfactory.

Purpose: In recent years, considerable concern has been expressed about the deleterious effects of reactive oxygen species (ROS) on sperm function, because ROS at high levels is potentially detrimental to sperm function and quality. Nitric oxide (NO) is a powerful anti-oxidant present in seminal plasma. The aim of the study was to analyze the distribution of the of endothelial nitric oxide synthase (eNOS) gene (T-786C, G894T, e 4a/b) polymorphisms in idiopathic infertile Brazilian men and evaluate the possible role of these polymorphisms in sperm count., Methods: A case-control study was performed comprising 208 infertile men [n=74 with non-obstructive azoospermia and n=134 with severe oligozoospermia] and 201 fertile men as controls. Genotyping of eNOS polymorphisms was performed by real time (T-786C and G894T) and conventional PCR (4a/b). The results were analyzed statistically and a p-value<0.05 was considered significant., Results: According to the sperm count, relatively similar eNOS polymorphism genotypes and allele frequencies were found among the groups. Combined genotypes of the eNOS polymorphisms did not identify a haplotype associated with idiopathic infertility, even when the patients were separated in non-obstructive azoospermia or severe oligozoospermia., Conclusion: In conclusion, the findings demonstrate that, in Brazilian population studied, genetic variations, T-786C, G894T, and e 4a/b, of the eNOS gene are not associated with male infertility., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: Obesity has been associated with the severity of psoriasis, but this relationship is not completely understood., Objectives: This study aimed to evaluate associations between the severity of psoriasis and weight excess as determined using a variety of parameters., Methods: A cross-sectional study was performed in 296 psoriasis patients. Their body mass index (BMI), waist circumference (WC), and waist : hip ratio (WHR) values were compared with results on a psoriasis area severity index (PASI)., Results: The frequency of severe psoriasis was higher in men (P < 0.05). Direct correlations were established between PASI scores and each of BMI (R = 0.0154, P = 0.01), WC (R = 0.207, P = 0.001), and WHR (R = 0.164, P = 0.007)., Conclusions: This study extends previous reports of an association between psoriasis and obesity and shows a direct correlation between obesity as measured according to different parameters and psoriasis severity., (© 2012 The International Society of Dermatology.)

Aims: The aim of this study was to evaluate urokinase-type plasminogen activator gene (uPA) and thrombin-activatable fibrinolysis inhibitor gene (TAFI) genotypes in a group of infertile women with and/or without endometriosis and controls., Methods: A case-control study comprising 180 infertile women with endometriosis, 68 women with idiopathic infertility, and 152 fertile women as controls was carried out. Detection of uPA (C422T/rs2227564) and TAFI (G438A/rs2146881) polymorphisms was performed by TaqMan polymerase chain reaction. The results were statistically analyzed and a p-value of <0.05 was considered significant., Results: We found no association among both uPA or TAFI polymorphisms and endometriosis-related infertility (p=0.920 and p=0.356, respectively) or idiopathic infertility (p=0.502 and p=0.392, respectively) comparing to controls, even considering minimal/mild and moderate/severe endometriosis separately. Both uPA and TAFI polymorphisms were in Hardy-Weinberg equilibrium for all studied groups. The combinatory analysis of both uPA and TAFI polymorphisms to endometriosis-related infertility, idiopathic infertility, and control group showed no statistical difference to any combination., Conclusion: The data suggest that, in the Brazilian population, genetic variations in both uPA and TAFI were not relevant to endometriosis and/or infertility.

Many theories have been proposed to explain the development of endometriosis, and recently, autoimmune aetiology has been suggested. Besides, it is well known that endometriosis, especially the advanced disease, may impair fertility. B lymphocyte stimulator (BLyS) is a cytokine produced by macrophages and is necessary for normal B cell development. One of the most studied polymorphisms is the -817C/T in the promoter region of the gene. We aimed to assess the association between endometriosis-related infertility and idiopathic infertility and the BLyS -817C/T polymorphism in a Brazilian population. We performed a case-control study comprising 165 infertile women with endometriosis, 83 with idiopathic infertility and 145 fertile and assessed the association with BLys -817C/T polymorphism. BLyS -817C/T polymorphism was detected using TaqMan PCR. The results were analysed statistically, and a P-value < 0.05 was considered significant. The results disclosed similar genotype and allelic frequencies between endometriosis-related infertility (P = 0.225) and control group, regardless of the disease stage (P = 0.213 and P = 0.462, respectively). However, a statistically significant difference was observed regarding idiopathic infertile group (P = 0.048) compared with controls. Considering the dominant and recessive inheritance models, no significant differences in both endometriosis and idiopathic infertility group were found. The genotype frequencies were in Hardy-Weinberg equilibrium in all studied groups. The results point to a possible association between BLyS -817C/T polymorphism and idiopathic infertility in Brazilian population., (© 2011 The Authors. Scandinavian Journal of Immunology © 2011 Blackwell Publishing Ltd.)

Recent studies have found a relationship between obesity and chronic inflammation, confirmed by the association of high levels of tumor necrosis factor (TNF-&#95;), interleukin six (IL-6,) and reactive C-protein with an increase in body mass index (BMI). In obese individuals, this inflammatory condition could contribute to the development or aggravation of psoriasis. Analogous phenomena have already been described in other inflammatory chronic diseases, such as rheumatoid arthritis and Crohn's disease. Epidemiological studies have identified a high prevalence of cardiovascular comorbidities, secondary to the metabolic alterations associated with psoriasis and obesity. A few aspects of this association remain unclear, such as the impact of obesity in the clinical forms of dermatoses, in the response to treatment, and its relationship with comorbidities.