Abstract Introduction Women with Polycystic Ovary Syndrome (PCOS) have a higher prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) than the general population. PCOS and NAFLD have common metabolic risk factors, however, the role of diet in NAFLD development is still uncertain in PCOS women. Objective To evaluate and compare the dietary patterns and nutritional intake in patients with PCOS with and without NAFLD. Method Cross-sectional study that included patients with PCOS diagnosed according to Rotterdam criteria. All participants were submitted to abdominal ultrasound to investigate liver steatosis. Dietary profile was assessed by 24-hour food recall (24hR), and Food Frequency Questionnaire (FFQ). Diet quality was assessed by the Healthy Eating Index (HEI) adapted for the Brazilian population. Physical activity practice was also assessed. Results 87 participants were included (average age 35.2 ± 5.7 years), among whom, 67 (77%) had NAFLD. The group with PCOS and NAFLD presented higher body mass index (BMI) (34.9 ± 4.5 vs. 30.4 ± 4.9 kg/m2; p = 0.001), Waist Circumference (WC) (103 [97‒113] vs. 95 [87.5‒100] cm; p < 0.001) and were considered physically active less frequently than those without NAFLD (34.3% vs. 60%; p = 0.04). Food intake and dietary patterns assessed by 24hR, FFQ and HEI presented no difference between the groups. Conclusions PCOS women with coexistent NAFLD had higher BMI, WC and were less physically active than those without NAFLD. Dietary evaluation showed that PCOS women with NAFLD had no significant difference in macro and micronutrients or food group intake and diet quality in comparison to those without NAFLD.

ABSTRACT Objective: Evaluating the clinical results of bioactive glass S53P4 putty for the treatment of cavitary chronic osteomyelitis. Methods: Retrospective observational study, including patients of any age with clinical and radiological diagnosis of chronic osteomyelitis, who underwent surgical debridement and implantation of bioactive glass S53P4 putty (BonAlive® Putty, Turku, Finland). Patients who underwent any plastic surgery on the soft tissues of the affected site or had segmental bone lesions or septic arthritis were excluded. Statistical analysis was performed using Excel®. Demographic data, as well as data on the lesion, treatment, and follow-up, were collected. Outcomes were classified as “disease-free survival,” “failure,” or “indefinite.” Results: This study included 31 patients, of which 71% were men and had with a mean age of 53.6 years (SD ± 24.2). In total, 84% were followed-up for at least 12 months and 67.7% had comorbidities. We prescribed combination antibiotic therapy for 64.5% of patients. In 47.1%, Staphylococcus aureus was isolated. Finally, we classified 90.3% of cases as “disease-free survival” and 9.7% as “indefinite.” Conclusion: Bioactive glass S53P4 putty is safe and effective to treat cavitary chronic osteomyelitis, including infections by resistant pathogens, such as methicillin-resistant S. aureus. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar a atividade do vidro bioativo S53P4 em pasta no tratamento de osteomielite crônica. Métodos: Estudo observacional retrospectivo, com inclusão de indivíduos de qualquer idade com diagnóstico clínico e radiológico de osteomielite que realizaram tratamento cirúrgico com limpeza e desbridamento, seguido do preenchimento da cavidade com biovidro S53P4 em pasta (BonAlive ® Putty, Turku, Finland). Foram excluídos pacientes submetidos a procedimentos de cirurgia plástica nos tecidos moles do local afetado, com lesões ósseas segmentares e com presença de artrite séptica. A análise estatística foi realizada em Excel ® . Foram coletados dados demográficos, sobre a lesão, o tratamento e o acompanhamento. O desfecho foi classificado em “sobrevida livre de doença”, “falha” ou “indeterminado”. Resultados: Dos 31 pacientes analisados, 71% eram homens, com idade média de 53,6 anos (DP ± 24,26). Do total, 84% foram acompanhados por no mínimo 12 meses, e 67,7% apresentaram comorbidades. A terapia antibiótica combinada foi realizada em 64,5% dos pacientes, sendo o patógeno mais frequente o Staphylococcus aureus (47,1%). Ao final, 90,3% dos pacientes obtiveram “sobrevida livre de doenças” e 9,7% foram considerados “indeterminados”. Conclusão: O vidro bioativo S53P4 em pasta é seguro e eficaz no tratamento da osteomielite cavitária e de infecções por patógenos resistentes, incluindo o S. aureus multirresistente. Nível de Evidência IV, Série de Casos.

ABSTRACT Objective: Evaluating clinical factors associated with mortality in older patients who underwent surgical correction of hip fractures. Methods: This observational and retrospective study analyzed the medical records of 67 patients (aged older than 60 years), both men and women, who underwent surgical correction of hip fractures from 2019 to 2020 at Hospital São Paulo. The following variables were analyzed: age, sex, presence of comorbidities, affected hip region, and trauma mechanism. Statistical analyses were performed using the SPSS software. Results: The mean age of patients was 78.12 ± 9.80 years and 80.6% of the sample were women. The prevalence of hip fractures on the right side (52.2%), in the transtrochanteric region (53.7%), and due to fall on the same level (88.1%) was higher. Systemic arterial hypertension (77.6%), diabetes mellitus (37.3%), and dementia (16.4%) were frequent comorbidities. The prevalence of death after fracture was 17.9% and it was associated with longer hospital stay after surgery (p = 0.028). Conclusion: The prevalence of mortality of patients with hip fractures who underwent surgery was 17.9%. A longer hospital stay due to pre-existing comorbidities was the main factor related to this outcome. Level of Evidence III, Retrospective Study.

RESUMO Objetivo: Avaliar os fatores clínicos associados à mortalidade em pacientes idosos submetidos ao tratamento cirúrgico para correção de fraturas do quadril. Métodos: Estudo observacional e retrospectivo de análise de prontuários de 67 pacientes (idade superior a 60 anos). Foram incluídos indivíduos de ambos os sexos, submetidos ao tratamento cirúrgico para correção de fraturas do quadril, entre 2019 e 2020, no Hospital São Paulo. Foram analisadas as variáveis: idade, sexo, presença de comorbidades, região do quadril acometido e mecanismo de trauma. As análises estatísticas foram realizadas pelo software SPSS. Resultados: A idade média dos participantes foi de 78,12 ± 9,80 anos, e 80,6% da amostra era constituída por mulheres. Houve maior prevalência de fraturas do quadril no lado direito (52,2%), na região transtrocantérica (53,7%) e causada por queda sem desnível (88,1%). Hipertensão arterial sistêmica (77,6%), diabetes mellitus (37,3%) e demência (16,4%) foram frequentes. A prevalência de óbito após a fratura foi de 17,9%, sendo associada a maior tempo de internação hospitalar após a cirurgia (p = 0,028). Conclusão: A prevalência de mortalidade dos pacientes com fratura do quadril submetidos à cirurgia foi de 17,9%. O tempo prolongando de internação hospitalar por comorbidades pré-existentes foi o principal fator relacionado a este desfecho. Nível de Evidência III, Estudo Retrospectivo.

Abstract The Brazilian Buriti oil presents low extraction costs and relevant antioxidant properties. Thus, this work aimed to analyze Buriti oil biomaterial (BB), within its physicochemical properties, biocompatibility and cellular integration, with the purpose to the use as a growth matrix for Goat Wharton’s jelly mesenchymal stem cells. Biomaterials were produced from Buriti oil polymer (Mauritia flexuosa), for it’s characterization were performed Infrared Region Spectroscopy (FTIR) and Thermogravimetric Analysis (TG and DTG). The biointegration was analyzed by Scanning Electron Microscopy (SEM) and histological techniques. In order to investigate biocompatibility, MTT (3-(4,5-dimetil-2-tiazolil)-2,5-difenil-2H-tetrazólio) test and hemolytic activity tests were performed. The activation capacity of immune system cellswas measured by phagocytic capacity assay and nitric oxide synthesis . The BB presented an amorphous composition, with high thermal stability and high water expansion capacity, a surface with micro and macropores, and good adhesion of Wharton’s jelly mesenchymal stem cells (MSCWJ). We verified the absence of cytotoxicity and hemolytic activity, in addition, BB did not stimulate the activation of macrophages. Proving to be a safe material for direct cultivation and also for manufacturing of compounds used for in vivo applications.

Abstract To analyze the biocompatibility of the scaffold produced from a natural polymer derived from castor oil through hemolytic activity and antimicrobial activity, to enable the clinical application. Three in vitro tests were performed: Hemolytic activity test - Polymer partially dissolved in contact with blood agar; Hemolytic activity test in sheep's blood - Polymer extract with red blood cells solution; Antimicrobial activity test - Solid polymer in direct contact with E. Coli and S. Aureus. For hemolytic tests, none of the samples showed hemolysis. Negative hemolytic activity is a good indicator, as the maintenance of the blood clot in the area of the lesion is essential for the formation of new tissue. For the antimicrobial activity test, no significant activity was observed against the bacteria used. The polymer is not toxic to red blood cells, being viable for clinical application as a matrix for tissue regeneration.

RESUMO Objetivo: Avaliar o entendimento entre ortopedistas e residentes em ortopedia sobre as fraturas por fragilidade, em seus aspectos clínicos, terapêuticos e sociais. Métodos: Estudo transversal, observacional e prospectivo que ocorreu no período de junho de agosto de 2020. Resultados: Foram analisados 540 participantes. A população foi composta por ortopedistas (85,56%; N = 462) e residentes (14,44%; N = 78), com prevalência de idade entre 41 e 50 anos (36,67%; N=198) e oriundos da região Sudeste (57,22%; N = 309). Para 47,04% (N = 254) dos participantes o perfil do paciente em risco para fratura por fragilidade corresponde a: mulher, sedentária, tabagista e acima dos 60 anos de idade. Sendo consenso entre os participantes (97,96%; N = 529) que as fraturas por fragilidade ocorrem em ambientes domiciliares ou próximo a eles. Além disso, 47,59% (N = 257) dos participantes acreditam que a primeira fratura por fragilidade seja o fator de risco preditivo mais importante para novo episódio de fratura e 63,89% (N = 345) dos avaliadores atendem mais de 15 casos por ano. Em relação ao tratamento, 74,44% (N = 402) dedicam-se exclusivamente aos aspectos ortopédicos (68,33%; N = 369). No entanto, 62,41% (N = 337) dos participantes acreditam que paciente devam receber medicamentos e suplementos. Da mesma forma, 70,74% (N = 382) dos avaliadores consideram que medidas de segurança domiciliar e treinamento de familiares sejam importantes e atribuídas a equipe multiprofissional. Conclusão: As fraturas por fragilidade são frequentes na rotina dos ortopedistas brasileiros. No entanto, estes não estão familiarizados com tratamentos adjuvantes nas fraturas consideradas por fragilidade, atuando quase que exclusivamente nos aspectos ortopédicos envolvidos nestas lesões. Nível de Evidência II, Estudo Prospectivo.

ABSTRACT Objective: To evaluate the involvement of orthopedists and orthopedic residents with fragility fractures, in its clinical, therapeutic, and social aspects. Methods: Cross-sectional observational and prospective study that took place in the period from June to August 2020. Results: 540 participants were analyzed. The population consisted of orthopedists (85.56%; N = 462) and residents (14.44%; N = 78), with a greater proportion of individuals from 41 to 50 years of age (36.67%; N = 198) and from the Southeast region (57.22%; N = 309). For 47.04% (N = 254) of the participants, the profile of the patient at risk for fragility fracture corresponds to: woman, sedentary, smoker and over 60 years of age. The consensus among the participants (97.96%; N = 529) is that fragility fractures occur in or near home environments. Moreover, 47.59% (N = 257) believe that the first fragility fracture is the most important predictive risk factor for subsequent occurrences and 63.89% (N = 345) of the participants claim to attend more than 15 cases per year. Regarding treatment, 74.44% (N = 402) are dedicated exclusively to orthopedic aspects (68.33%; N = 369). However, 62.41% (N = 337) of the participants believe that patients with fragility fractures should receive medication and supplements. Likewise, 70.74% (N = 382) of the participants consider that home security measures and training of family members are important, and they attribute the role to the multidisciplinary team. Conclusions: Fragility fractures are frequent in the routine of Brazilian orthopedists. However, they are not familiar with adjuvant treatments for fragility fractures, acting almost exclusively in the orthopedics aspects of these injuries. Level of Evidence II, Prospective Study.

Abstract To analyze the surface topography and mechanical properties of a polyurethane derived from castor oil reinforced with hydroxyapatite (PU–HA) for bone fixation. The surface analysis was performed by Scanning Electron Microscopy (SEM) and the mechanical properties by Vickers microhardness and tensile tests. The SEM images showed that the PU surface presented important characteristics for materials intended for bone fixation, such as an irregular and porous surface. The analysis showed a surface with alternating areas with depressions and elevations of approximately 80±100 µm, presence of pores of 12 µm in size. The microhardness analysis showed values of 0.42±1.01 HV for PU–HA plates, lower in relation to the poly lactic-co-glycolic acid (PLGA) plate (control group). The elastic modulus and ultimate tensile strength of 317.4 MPa, and 35.57 MPa for PLGA sample, 1.187 MPa, and 0.29 MPa for PU–HA sample. The PU produced showed good surface properties, however demands better mechanical properties.

RESUMO Objetivo: Comparar a estrutura da córnea e as alterações morfológicas endoteliais após cirurgia de catarata por facoemulsificação sem intercorrências entre pacientes com diabetes mellitus tipo 2 e não diabéticos; e determinar quais fatores pré e intra-operatórios relacionados com a maior redução da densidade celular endotelial. Métodos: Quarenta e cinco diabéticos (45 olhos) e 43 (43 olhos) controlos com catarata relacionada à idade foram incluídos neste estudo observacional prospectivo. Os parâmetros da córnea (espessura e volume) e do segmento anterior foram medidos pela tomografia Scheimpflug; a densidade e morfologia celular endotelial (coeficiente de variação do tamanho das células, células hexagonais) foram registrados usando microscopia especular não contato. Os pacientes foram avaliados no pré-operatório, 1 e 6 meses após a cirurgia. Foi realizada uma análise de regressão linear uni e multivariada para avaliar a relação entre os parâmetros demográficos, clínicos, oculares e intra-operatórios com a redução da densidade celular endotelial aos 6 meses. Resultados: Nos dois grupos houve uma perda significativa de células endoteliais ao 1º mês pós-operatório (p<0,001), que permaneceu estável até ao 6º mês; sem diferenças estatisticas entre os grupos diabetes mellitus e não diabetes mellitus em qualquer avaliação. A espessura média da córnea no pós-operatório central aos 1 e 6 meses não mudou significativamente em relação ao valor médio pré-operatório nos dois grupos (p>0.05). A análise de regressão multivariada linear mostrou que a idade avançada (p=0.042) e os graus mais elevados de catarata (p=0.001) foram significativamente associados à maior redução densidade celular endotelial aos 6 meses de seguimento. Conclusão: Este estudo mostrou que a idade avançada e as cataratas mais densas podem predispor a uma maior redução densidade celular endotelial após a cirurgia de catarata. Outros fatores, como diabetes mellitus e parâmetros pré-operatórios do segmento anterior, não influenciaram significativamente as alterações pós-operatórias da densidade celular endotelial.

ABSTRACT Purpose: The aim of this study was to compare corneal structure and endothelial morphological changes after uneventful phacoemulsification cataract surgery between type 2 diabetic and nondiabetic patients and to determine the preoperative and intraoperative factors that may predict greater endothelial cell density loss. Methods: Forty-five diabetic patients (45 eyes) and 43 controls (43 eyes) with age-related cataract were enrolled in this prospective observational study. Corneal (thickness and volume) and anterior segment parameters were measured by Scheimpflug tomography; endothelial cell density and morphology (coefficient of variation of cell size, hexagonal cells) were recorded using noncontact specular microscopy. Patients were evaluated preoperatively and at one and six months after surgery. Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographic, clinical, ocular, and intraoperative parameters and postoperative endothelial cell density changes at six months. Results: Significant postoperative endothelial cell loss occurred one month after surgery in both groups (p<0.001), which remained stable until month 6; there were no differences between patients with and without diabetes mellitus at any time point. The mean postoperative central corneal thickness at one and six months did not change significantly from the mean preoperative value in either group (p>0.05). Multivariate linear regression analysis showed that older age (p=0.042) and higher cataract grades (p=0.001) were significantly associated with greater endothelial cell density reduction at six-month follow-up. Conclusion: This study showed that older age and denser cataracts might be associated with greater endothelial cell density reduction after cataract surgery. Other factors, such as diabetes mellitus and preoperative anterior segment parameters, did not influence postoperative changes in endothelial cell density.

RESUMO Objetivo: Avaliar a conduta adotada por ortopedistas brasileiros em relação ao tratamento adjuvante após a cirurgia de fraturas de fragilidade. Métodos: Foi aplicado um questionário aos ortopedistas brasileiros. A estatística foi realizada no programa SPSS 16.0. Resultados: Foram analisados 257 participantes. A maioria dos participantes 90,7% (n = 233) relataram atender os pacientes com fraturas e 62,3% (n = 160) relataram tratar. Os tratamentos mais indicados foram a suplementação de vitamina D (22,6%; n = 134) e de cálcio (21,4%; n = 127). De acordo com a comparação médicos experientes (n = 184) versus médicos residentes (n = 73), a rotina de fraturas de fragilidade foi mais observada por médicos residentes (98,6%; n = 72) que por médicos experientes (87,5%; n = 161), p = 0,0115. Enquanto a conduta de tratamento foi mais relatada por médicos experientes (63,6%; n = 117) versus médicos residentes (58,9%; n = 43), p = 0,004. A maior proporção de médicos experientes (21,4%; n = 97) indicaram o tratamento com bifosfatos versus médicos residentes (14,2%; n = 20), p = 0,0266. Conclusão: Apesar da maioria dos profissionais prescreverem um tratamento após a cirurgia de fraturas de fragilidade, cerca de 40% dos profissionais ainda não tratam, sendo observadas diferenças em relação à experiência. Neste contexto, reforçamos a importância da prevenção secundária na conduta de fraturas de fragilidade. Nível de Evidência II, Estudo prospectivo comparativo.

ABSTRACT Objective: To evaluate the conduct of Brazilian orthopedists regarding preventive treatment after fragility fracture surgery. Methods: A questionnaire was applied to Brazilian orthopedists. Statistical analyses were performed using the SPSS 16.0 program. Results: 257 participants were analyzed. Most participants, 90.7% (n = 233), reported that they cared for patients with fractures and 62.3% (n = 160) treated them. The most indicated treatments were vitamin D (22.6%; n = 134) and calcium supplementation (21.4%; n = 127). According to the experience of the physicians - experienced (n = 184) and residents (n = 73) - fragility fractures were more common in the routine of residents (98.6%; n = 72) than experienced physicians (87.5%; n = 161), p = 0.0115. While treatment conduction was more reported by experienced physicians (63.6%; n = 117) than residents (58.9%; n = 43), p = 0.004. More experienced orthopedists (21.4%; n = 97) indicated treatment with bisphosphates than residents (14.2%; n = 20), p = 0.0266. Conclusion: Although most professionals prescribe treatment after fragility fracture surgery, about 40% of professionals still do not treat it, with differences in relation to experience. In this sense, we reinforce the importance of secondary prevention in the management of fragility fractures. Level of Evidence II, Prospective comparative study.

Resumo Introdução Cirurgias ortopédicas apresentam a possibilidade de perfuração das luvas, que pode chegar a 56,8%, relacionada principalmente à manipulação de instrumentos cortantes. O tratamento de fraturas e cirurgias de trauma apresenta risco adicional pelo contato com espiculas ósseas. Objetivo Análise da prevalência de perda de integridade das luvas cirÚrgicas em procedimentos ortopédicos de trauma, principalmente fraturas, avaliando a exposição do cirurgião e o contato com secreções provenientes do paciente. Métodos Inspeção macroscópica das luvas de dois cirurgiões especializados em trauma, durante um período de 4 meses. Ambos usaram duas luvas para todos os procedimentos e, ao término da cirurgia, analisaram a presença ou ausência de manchas de sangue nas luvas internas e/ou nos dedos. Os procedimentos foram categorizados quanto ao tempo e tipo de cirurgia. A intercorrência investigada foi a perfuração de uma ou duas luvas; se a perfuração foi percebida imediatamente ou apenas ao final da cirurgia, e qual o local e o motivo do rasgo, se identificado. Resultados Foram incluídas 210 cirurgias, das quais 87 apresentaram perfurações, sendo 17 casos em ambas as luvas e 70 apenas na luva externa. Um total de 27,5% dos danos foram descobertos apenas no final da cirurgia; os rasgos se concentraram no indicador esquerdo em 62,5% dos casos. Por Último, houve uma relação mais significativa com cirurgias de foco aberto e com duração superior a 60 minutos. Conclusão O nosso resultado sugere que em cirurgias prolongadas e com foco aberto, é necessário maior cuidado e inspeção à procura de danos nas luvas.

Abstract Introduction The possibility of perforation of gloves during orthopedic surgeries can reach 56.8%, and it mainly related to the manipulation of blunt instruments. Surgeries for the treatment of fractures and trauma present additional risk due to contact with bone spires. Objective Analysis of the prevalence of loss of integrity of surgical gloves in orthopedic trauma procedures, especially fractures, and evaluation of the surgeon's exposure and contact with secretions from the patient. Methods Macroscopic inspection of the gloves of two surgeons specialized in trauma, over a period of 4 months. Both used two gloves for all procedures and, at the end of the surgery, analyzed the presence or absence of blood stains on the internal gloves and/or fingers. The procedures were categorized according to the time and type of surgery. The intercurrence investigated was the perforation of one or two gloves; if the tear was perceived immediately or only at the end of the surgery, and the location of and reason for the tear, if identified. Results A total of 210 surgeries were included, 87 of which presented perforations, with 17 cases occurring in both gloves and 70 only in the outer glove. Finally, there was a more significant relationship with open focus surgeries and duration > 60 minutes. Conclusion Our results suggest that greater care and inspection of gloves to look for damage are needed in prolonged surgeries with an open focus.

RESUMO Objetivo: Comparar a estrutura da córnea e as alterações morfológicas endoteliais após cirurgia de catarata por facoemulsificação sem intercorrências entre pacientes com diabetes mellitus tipo 2 e não diabéticos; e determinar quais fatores pré e intra-operatórios relacionados com a maior redução da densidade celular endotelial. Métodos: Quarenta e cinco diabéticos (45 olhos) e 43 (43 olhos) controlos com catarata relacionada à idade foram incluídos neste estudo observacional prospectivo. Os parâmetros da córnea (espessura e volume) e do segmento anterior foram medidos pela tomografia Scheimpflug; a densidade e morfologia celular endotelial (coeficiente de variação do tamanho das células, células hexagonais) foram registrados usando microscopia especular não contato. Os pacientes foram avaliados no pré-operatório, 1 e 6 meses após a cirurgia. Foi realizada uma análise de regressão linear uni e multivariada para avaliar a relação entre os parâmetros demográficos, clínicos, oculares e intra-operatórios com a redução da densidade celular endotelial aos 6 meses. Resultados: Nos dois grupos houve uma perda significativa de células endoteliais ao 1º mês pós-operatório (p<0,001), que permaneceu estável até ao 6º mês; sem diferenças estatisticas entre os grupos diabetes mellitus e não diabetes mellitus em qualquer avaliação. A espessura média da córnea no pós-operatório central aos 1 e 6 meses não mudou significativamente em relação ao valor médio pré-operatório nos dois grupos (p>0.05). A análise de regressão multivariada linear mostrou que a idade avançada (p=0.042) e os graus mais elevados de catarata (p=0.001) foram significativamente associados à maior redução densidade celular endotelial aos 6 meses de seguimento. Conclusão: Este estudo mostrou que a idade avançada e as cataratas mais densas podem predispor a uma maior redução densidade celular endotelial após a cirurgia de catarata. Outros fatores, como diabetes mellitus e parâmetros pré-operatórios do segmento anterior, não influenciaram significativamente as alterações pós-operatórias da densidade celular endotelial.

ABSTRACT Purpose: The aim of this study was to compare corneal structure and endothelial morphological changes after uneventful phacoemulsification cataract surgery between type 2 diabetic and nondiabetic patients and to determine the preoperative and intraoperative factors that may predict greater endothelial cell density loss. Methods: Forty-five diabetic patients (45 eyes) and 43 controls (43 eyes) with age-related cataract were enrolled in this prospective observational study. Corneal (thickness and volume) and anterior segment parameters were measured by Scheimpflug tomography; endothelial cell density and morphology (coefficient of variation of cell size, hexagonal cells) were recorded using noncontact specular microscopy. Patients were evaluated preoperatively and at one and six months after surgery. Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographic, clinical, ocular, and intraoperative parameters and postoperative endothelial cell density changes at six months. Results: Significant postoperative endothelial cell loss occurred one month after surgery in both groups (p<0.001), which remained stable until month 6; there were no differences between patients with and without diabetes mellitus at any time point. The mean postoperative central corneal thickness at one and six months did not change significantly from the mean preoperative value in either group (p>0.05). Multivariate linear regression analysis showed that older age (p=0.042) and higher cataract grades (p=0.001) were significantly associated with greater endothelial cell density reduction at six-month follow-up. Conclusion: This study showed that older age and denser cataracts might be associated with greater endothelial cell density reduction after cataract surgery. Other factors, such as diabetes mellitus and preoperative anterior segment parameters, did not influence postoperative changes in endothelial cell density.

SUMMARY OBJECTIVE: To conduct a review of articles which have evaluated the relationship between vitamin D and cardioprotection in adult. METHODS: A literature search was performed in the Pubmed and Scielo databases. The results were extracted from primary and secondary sources and will be presented in the form of a bibliographic review. RESULTS: Twenty-three articles were identified from the electronic search that reported on physiological mechanisms relating the vitamin D axis and the cardiovascular system through receptors. Of the ten studies that evaluated the therapeutic effect of vitamin D in cardiovascular diseases, none reported significant results. CONCLUSION: The articles assessed in this review did not demonstrate a cardioprotective effect of vitamin D, despite the epidemiological correlation of vitamin D deficiency with a higher prevalence of cardiovascular diseases.

RESUMO INTRODUÇÃO: Anemias microcíticas são muito comuns na prática clínica, sendo a anemia ferropriva (AF) e a talassemia menor (TM) as mais prevalentes. A confirmação diagnóstica dessas entidades clínicas requer testes que envolvem o perfil do metabolismo do ferro, eletroforese de hemoglobinas e análises moleculares. Nesse contexto, vários índices discriminantes têm sido propostos para simplificação do diagnóstico diferencial entre AF e TM. OBJETIVO: O objetivo deste artigo foi demonstrar a relevância clínica da utilização de índices discriminantes em indivíduos com anemia microcítica, para simplificação do diagnóstico diferencial entre anemia ferropriva e talassemia menor. MÉTODOS: Foi realizada uma pesquisa bibliográfica e transversal nas bases de dados PubMed, SciELO e Lilacs, utilizando-se os seguintes descritores: anemia ferropriva, talassemia menor e diagnóstico diferencial. RESULTADOS: Mais de 40 índices matemáticos baseados em parâmetros eritrocitários foram propostos na literatura hematológica em indivíduos com microcitose. Os índices de Green & King (IGK), o índice de Ehsani e a contagem de eritrócitos (RBC) obtiveram excelentes desempenhos, especialmente quando sua eficácia foi observada em adultos e crianças. CONCLUSÕES: Testes confirmatórios para o diagnóstico diferencial entre AF e TM demandam métodos que consomem bastante tempo e alto custo. Apesar dos excelentes desempenhos do IGK, do índice de Ehsani e do RBC, nenhum deles possui sensibilidade e especificidade suficientes para firmar diagnóstico. No entanto, podem fornecer uma poderosa ferramenta adicional para simplificação diagnóstica entre AF e TM.

SUMMARY INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.