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Objective: Mother-to-child transmission of syphilis remains an important global public health problem. Untreated intrauterine infection may result in adverse events for the fetus or newborn (NB). Maternal risk factors, such as prenatal care, early diagnosis, and appropriate treatment, significantly impact the likelihood of vertical transmission of syphilis. The purpose of this review is to evaluate maternal risk factors for congenital syphilis and the characteristics of exposed NB., Methods: A total of 14 studies were evaluated, including 8 cohort studies, 4 cross-sectional and 2 control cases. A total of 12,230 women were included, with confirmed or highly probable congenital syphilis outcome, and 2285 NB. The studies evaluated risk factors for congenital syphilis, which were maternal, demographic, obstetric factors and characteristics of the exposed NB., Results: Included in the risk factors studied, inadequate prenatal care and late onset, as well as inadequate or late treatment of maternal syphilis were significant risk factors for the outcome of congenital syphilis. When the time set of maternal diagnosis was correlated with neonatal infection, there was a tendency to worsen prognosis (more infected NB) in women diagnosed later in pregnancy, as well as in women who underwent few prenatal consultations and inadequate treatment. Women with recent syphilis with high VDRL titres had a higher rate of vertical transmission. The prior history of syphilis with adequate treatment was identified as a protective factor, resulting in lower rates of congenital syphilis. Among the epidemiological and demographic aspects surveyed, it was observed that young age, lower schooling, unemployment, low family income and no fixed residence were associated with higher risk of congenital syphilis., Conclusions: The association of syphilis with adverse socio-economic conditions and inadequate prenatal care suggests that the improvement of the population's living conditions and equitable access to quality health services may have an impact on the reduction of congenital syphilis., (© 2023 John Wiley & Sons Ltd.)

Background: After the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (coronavirus disease 2019 [COVID-19]), the world started reducing the number of elective surgeries to reduce the transmission of the coronavirus. Some priority elective surgeries were performed, and there was no increase in contagion rates due to safety protocols and protection measures. The study aims to present the coronavirus infection rate of elective hand surgeries and microsurgery performed during pandemics., Methods: A retrospective study evaluating 188 patients submitted to elective surgical procedures. The exclusion criteria were patients infected by COVID-19 before the surgery and patients who submitted to trauma surgery. Only 108 patients were eligible for this study. The mean age was 47.8 years (range: 15 days-81 years). There were 63 females and 45 males. They were divided into 2 groups: outpatient (n = 49) and inpatient (n = 59) procedures., Results: The overall COVID infection rate was 6.48%. The outpatient infection rate was 2.08%, whereas the inpatient infection rate was 10.17% (Student t test: P = .089). The main factor correlated with infection in the postoperative period was the number of postoperative outpatient visits (Student t test: P = .089). No statistical differences were observed between the variables studied, but there was a tendency for patients who submitted to inpatient surgery to get infected by COVID-19 ( P = .089). The statistical power was 0.8 (Cohen's d test), showing that large samples are needed to analyze the correlation better., Conclusion: We concluded that the safety of performing elective hand surgery during the pandemic remains unclear, and more studies with larger samples are needed.

Extra-articular base fractures of the thumb are typical in hand surgeon practice. Nonoperative methods (spica) and operative methods are available for its management. There are operative methods described, such as plate and screws, Kirschner wires, and intramedullary screws. However, there is only a retrograde technique described. This study aims to present a new technique of an anterograde intramedullary headless compression screw to manage the extra-articular thumb metacarpal base fracture. This minimally invasive method allows an early range of motion and does not cross the articular surface of the thumb. This alternative fixation method has the advantage of low damage to soft tissues and good functional outcomes., Competing Interests: Conflicts of Interest and Source of Funding: The author report no conflicts of interest and no source of funding., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Isolated compression of the recurrent motor branch of the median nerve is an uncommon condition encontered in the daily life of the hand surgeon. Its early identification and correction can optimize functional outcomes. Among the few causes described, there are only 2 case reports of compression by fascial bands. We present a case of isolated compression of the recurrent motor branch of the median nerve secondary to anomalous fascial bands in a 34-year-old male patient, with significant atrophy of the thenar musculature of the right hand. Electroneuromyography showed isolated involvement of abductor pollicis brevis, with no sensory changes. The patient underwent exploration and decompression, recovering opposition and thumb function in 6 months.

Hirayama disease is a rare condition of cervical myelopathy. Its early identification and correction can optimize functional outcomes. However, late presentation and some more severe cases may be associated with loss of hand function. Among the cases described, there are no reports of nerve transfers for this condition. We presented the first case report of a Hirayama disease of isolated ulnar nerve impairment managed with nerve transfer. Electroneuromyography showed isolated preganglionic involvement of C7, C8, and T1, with no sensory changes. The patient underwent nerve transfer with anterior interosseous nerve to ulnar nerve supercharge end-to-side, recovering hand function in 7 months.

Malunion of metacarpal fractures can result in severe functional and esthetic impairment to the patient, thus requiring surgical correction. Traditionally, the fixation methods most commonly used for these fractures are the Kirschner wires or the plates and screws. However, one of the options for the fixation of metacarpal fractures is intramedullary fixation with a headless screw. This minimally invasive method can also be used for corrective metacarpal osteotomies. It has the advantages of being a minimally invasive technique and allowing the early range of motion. This minimally invasive method can also be used to stabilize the corrective metacarpal osteotomies for malunion. This case report presents a minimally invasive technique for corrective dorsal metacarpal osteotomy and fixation with a headless intramedullary screw. This alternative fixation method has the advantage of low damage to soft tissues and good functional outcomes., Competing Interests: Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Lipids are important targets of the photosensitized oxidation reactions, forming important signaling molecules, disorganizing and permeabilizing membranes, and consequently inducing a variety of biological responses. Although the initial steps of the photosensitized oxidative damage in lipids are known to occur by both Type I and Type II mechanisms, the progression of the peroxidation reaction, which leads to important end-point biological responses, is poorly known. There are many experimental tools used to study the products of lipid oxidation, but neither the methods nor their resulting observations were critically compared. In this article, we will review the tools most frequently used and the key concepts raised by them in order to rationalize a comprehensive model for the initiation and the progression steps of the photoinduced lipid oxidation., (© 2021 American Society for Photobiology.)

Purpose: The literature reports the presence of the intermesenteric artery (IA), an anastomosis connecting the superior mesenteric artery (SMA) to the inferior mesenteric artery (IMA) in 9-18% of human cadaver dissections. This is the first study describing the morphological and demographic characteristics of the IA based on in vivo imaging., Methods: A total of 150 consecutive abdominal computed tomography (CT) angiographies of adult patients identified by sex and age were analyzed. The IA was assessed for its presence, point of origin, pathway, point of insertion, and diameter at its origin. The diameters of the SMA, IMA, and other arteries from which the IA originated and into which it inserted were measured by CT angiography using Radiant™ and Osirix MD™ software., Results: The IA was found in 17 (51.5%) of the females and 60 (51.3%) of the males. The diameters of the SMA and IMA were larger in the males than in the females, but there was no sex difference in the diameter of the IA. The diameter of the SMA was larger than that of the IMA, and the diameter of the IA was smaller than that of the other arteries evaluated. An IA connecting the SMA and IMA trunks was found in 25.9% of the cases, while other connections between the branches of those trunks through an IA occurred less frequently., Conclusions: The intermesenteric artery is more frequently found than the literature refers and in most of cases directly connects the upper and lower arterial mesenteric circulations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Objectives: To identify the prevalence of viral congenital infections in newborns classified as premature, low-birthweight, small for gestational age or intrauterine growth restriction., Methods: The definition considered for selecting papers were: P as newborns younger than 28 days; V as low-birthweight, prematurity and intrauterine growth restriction; O as frequency of congenital infections with Cytomegalovirus, Parvovirus B19, Herpes Simplex, and Zika virus. The research was performed using EMBASE, LILACS, SCOPUS and MEDLINE databases, with no limitations on date and language., Results: Eight studies were included. Manuscripts including Herpes Simplex, Zika virus or Parvovirus B19 did not fulfill the defined criteria. A wide variation in the frequency of CMV congenital infection (0-4.8%) was found, which might be attributed to regional and methodological differences between investigations., Conclusions: Newborn characteristics associated with CMV congenital infections may direct investigations towards these patients with a higher probability of infection. However, as data are controversial, studies concerning screening of infection are important to define recommendations of diagnosis., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

The accumulation of Hg, Zn, and Cu was evaluated in mangrove sediments located between a large, 20-years-old landfill and waters of Guanabara Bay (southeast Brazil). The contamination history of the area provides substantial evidence that metal accumulation in the study site is influenced by past metal emissions from multiple sources (e.g. contaminated rivers and the landfill surrounding the site). At the southern part of the site, metal levels are up to 890 ng g(-1) Hg, 850 microg g(-1) Zn, and 58 microg g(-1) Cu. Enrichment factors and excess (background-deducted) concentration inventories show a high spatial variability of metal contamination and storage in the site, with differences often by a factor higher than two within a sampling station and higher than five between sampling stations. These contrasts are attributable to a coupling between spatial variability of anthropogenic metal input and metal behavior and retention within the sediments. Results indicate that during the last few decades mangrove sediments retained a substantial part of metal emissions to the site, probably reducing the metal transport to Guanabara Bay waters, and suggest the suitability of mangrove ecosystems as physical and biogeochemical barriers to metal contaminant transport.