Abstract Objectives: To compare the efficacy and safety of a new fixed dose combination of glucosamine sulfate and chondroitin sulfate capsules (GS/CS) versus the fixed dose combination of glucosamine hydrochloride and chondroitin sulfate (Cosamin DS®) in capsules in patients with osteoarthritis (OA) of the knee. Methods: Multicenter, randomized, double-blind study. Participants with knee OA Kellgren-Lawrence grades 1 to 3 and VAS of symptoms ≥4 cm were randomized to receive GS/CS or Cosamin DS® over 12 weeks. The primary efficacy endpoint was the evaluation of the analgesic efficacy by the investigator. Secondary efficacy endpoints included: joint pain and swelling, investigator efficacy of the medication, and the use of rescue medication. Adverse events and drug tolerability were analyzed. Results: One hundred patients were randomized, and 50 patients were allocated to each group. The analgesic efficacy evaluated by the investigator in the GS/CS group was 88.9, 95%CI: 75.2, 95.8% and in the Cosamin DS® group was 85.4%; 95%CI: 70.1, 93.4%. The mean reduction in the pain intensity was significant in both groups (p < 0.001), with no difference between them. The primary efficacy analysis demonstrated the non-inferiority of the GS/CS group compared with the Cosamin DS® group; the lower limit of the 90% confidence interval (CI) between the two groups (− 8.39%) was higher than the established margin of non-inferiority of − 10.00%. Improvement in other efficacy outcomes was observed, again without differences between groups. Adverse events were similar between groups and both presented good tolerability. Conclusions: The new fixed-dose formulation of GS/CS is effective in treating knee OA, presenting a good safety and tolerability profile. Trial Registration: (https://clinicaltrials.gov/ct2/show/NCT00955552?term=NCT00955552&rank=1; ClinicalTrials.gov; register number NCT00955552; First randomized patient: 08/17/2010).

OBJETIVO: Avaliar a reprodutibilidade intraobservador e interobservador da classificação proposta pelo grupo AO/ASIF, para as fraturas dos ossos longos em crianças. MÉTODO: Foram analisadas e classificadas por cinco avaliadores, 100 radiografias convencionais digitalizadas de fraturas dos ossos longos em crianças, utilizando a classificação alfanumérica proposta pelo grupo AO/ASIF. A força de concordância intraobservador (realizada com intervalo de 90 dias) e a interobservador foram avaliadas através do coeficiente Kappa. RESULTADOS: O índice Kappa para observação intraobservador foi de 0,69 (grande concordância) e na análise interobservador o índice foi de 0,64 (grande concordância) na primeira avaliação e 0,61 (grande concordância) na segunda análise realizada 90 dias após a classificação inicial. CONCLUSÃO: A classificação proposta pelo grupo AO/ASIF mostrou grande concordância intra e interobservador, sendo útil para utilização nas fraturas dos ossos longos em crianças.

OBJECTIVE: To evaluate the interobserver and intraobserver reproducibility of the classification proposed by the AO/ASIF group for long bone fractures in children. METHODS: One hundred roentgenograms of long bone fractures in children were evaluated and classified according to the alphanumeric AO/ASIF classification by six observers. The strength of theintraobserver(performed with a 90-day interval) and interobserveragreementwere evaluated using the Kappa coefficient. RESULTS: The intraobserver Kappa index was 0.69 (good agreement). The interobserver index was 0.64 (good agreement) in the first evaluation and 0.61 (goodagreement) in the second analysisperformed 90 days after the initial classification. CONCLUSION: The classification proposed by the AO/ASIF group for long bone fractures demonstrated good inter- and intraobserver agreement. This classification is useful for describing fractures of long bones in children.

OBJETIVO: Avaliar uma série de casos de luxação traumática posterior em crianças, o tratamento e os resultados, e revisar os aspectos relacionados à sua epidemiologia, diagnóstico clínico e radiográfico, tratamento, complicações e prognóstico. MÉTODOS: Foram avaliados retrospectivamente cinco pacientes com luxação traumática do quadril com média idade de 4,6 ± 0,9 anos e tempo de seguimento de 19,8 ± 7,0 meses. Foram avaliados o tempo entre a luxação e a redução, o tipo de tratamento, as lesões associadas e as complicações tardias. RESULTADOS: O tratamento inicial foi a redução incruenta com tempo médio de 5,2 ± 3,6 horas após o trauma inicial, sendo que todos foram submetidos à redução sob anestesia. O tratamento complementar incluiu imobilização gessada e tração. Não foi observada necessidade de cirurgias adicionais ou sequelas a longo prazo. CONCLUSÃO: A luxação traumática do quadril deve ser tratada com redução incruenta rápida, controle adequado da redução e observação rigorosa para diagnóstico e tratamento de complicações tardias.

OBJECTIVE: To evaluate a series of cases of traumatic posterior dislocations in children, the treatment and the results, and to revise aspects such as the epidemiology, clinical and radiographic diagnosis, treatment, complications and prognosis. METHODS: Five patients with traumatic hip dislocation, with an average age of 4.6 ± 0.9 years, and an ongoing follow-up period of 19.8 ± 7.0 months, were evaluated retrospectively. The time between dislocation and reduction, the type of treatment, associated injuries, and subsequent complications were also evaluated. RESULTS: The initial treatment was closed reduction, in an average time of 5.2 ± 3.6 hours after the initial trauma, in which the patients were subjected to the reduction under anesthesia. Complementary treatment included immobilization with casts and traction. No needs for additional surgeries or long-term side effects were observed. CONCLUSION: Traumatic dislocation of the hip should be treated by quick closed reduction, with appropriate control of the reduction and careful observation of the patient for diagnosis and treatment of subsequent complications.

OBJETIVO:Avaliar a variação da pressão intra-ocular (PIO) na mudança de posição em pacientes com glaucoma primário de ângulo aberto (GPAA), glaucoma de pressão normal (GPN) e olhos normais (ON), e correlacionar esta variação à gravidade do defeito de campo visual. MÉTODOS: Foram avaliados 32 olhos de 32 pacientes com GPAA, 30 olhos de 30 pacientes com GPN e 20 olhos de 20 ON. A PIO foi aferida às 6h da manhã na posição supina e 5min após com o paciente sentado. Foi avaliada a correlação entre variação da pressão decorrente da mudança de posição e os defeitos de campo visual. Foram utilizados os testes estatísticos não paramétricos de Kruskal-Wallis, Wilcoxon, Mann-Whitney e o teste de correlação linear de Spearman. Foi considerado significativo valor de p menor que 0,05. RESULTADOS: Foi encontrada diferença significativa entre as pressões intra-oculares na posição supina e assentada nos três grupos (p<0,001). Não houve diferença significativa na variação da PIO com a mudança de posição entre os três grupos (p=0,17). Não houve correlação significativa entre a variação da PIO nas duas posições e o índice MD do campo visual nos grupos GPAA (p=0,81) e GPN (p=0,89). CONCLUSÃO:Os resultados sugerem que existe aumento significativo da PIO com a mudança da posição assentada para supina em pacientes com GPAA, GPN e ON, não havendo, porém, diferença significativa desta variação entre os três grupos. Não foi encontrada correlação significativa entre a variação da PIO e a severidade do campo visual.

PURPOSE: To evaluate intraocular pressure variation due to postural changing of supine to sitting position and, to correlate this variation with visual field defects in primary open angle and normal tension glaucoma patients, as well as normal eyes. METHODS: Thirty-two eyes of 32 POAG patients, 30 eyes of 30 NTG patients and 20 eyes of 20 normal patients were evaluated in the study. Intraocular pressure was measured at 6 o'clock in supine position and 5 minutes after in sitting position for further correlation between intraocular pressure behavior after postural changing and visual field defects Kruskal-Wallis, Wilcoxon, Mann-Whitney and Spearman linear correlation non-parametric tests were used for statistical analysis. Inherent to the methods used, p-values below 0,05 were considered to ensure statistical relevance. RESULTS: Relevant results were observed between intraocular pressure measured in supine and sitting position in all groups, disclosing statistical significance (p<0,001).However, this statistical relevance was not seen when compared among the 3 groups studied (p=0,17). Moreover, visual field defects, expressed by MD index, did not point to have statistical correlation to intraocular pressure variation after postural changing in POAG (P=0,81) and NTG (p=0,89). CONCLUSION: The results suggest there is a significant increase in intraocular pressure due to postural changing in primary open angle and normal tension glaucoma patients, as well as in normal eyes. However, the raise in intraocular pressure neither was significant when compared among the 3 groups nor was consistent with visual field defects.