PurposeTo investigate the behavior of rotator cuff tears treated with conventional repair technique with the aid of autologous bone marrow mononuclear cells (BMMC).MethodsFourteen consecutive patients (9 women, 5 men, mean age of 59.2 years) with complete rotator cuff tears (mean preoperative UCLA score of 12 ± 3.0) were fixed by transosseous stitches through mini-open incision, with subsequent injection of BMMC into the tendon borders, obtained from the iliac crest just prior to surgery. Magnetic resonance images (MRI) were acquired before and after surgery and evaluated by two musculoskeletal radiologists regarding new postoperative findings of patients treated with BMMC.ResultsAfter a minimum 12-month follow-up period, the UCLA score increased from 12 ± 3.0 to 31 ± 3.2. Clinical findings remained unaltered in the following year in all but one patient (13/14). MRI analysis after a 12-month follow-up period demonstrated tendon integrity in all cases (14/14), presence of low-signal intensity areas along the supraspinatus tendon and distal muscle belly in 8 cases (8/14), and high-intensity blooming small round artifact at the bursal and tendon topography in 11 cases (11/14). Six patients (6/14) showed formation of a high-signal intensity zone at the critical zone. Clinical findings remained unaltered in the following year in all but one patient, who relapsed into loss of strength and pain, being considered a bad result.ConclusionImplantation of BMMC in rotator cuff sutures appears to be a safe and promising alternative to other biological approaches currently used to enhance tissue quality in affected tendons.Level of evidenceIV.

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To determine whether the clinical results of radiofrequency microtenotomy for the treatment of chronic insertional tendinopathy are comparable to those of monopolar electrocautery. Sixteen patients with chronic knee and elbow tendon injuries who were refractory to conservative therapy, between January 2006 and July 2007, were selected in the surgical ward of Hospital de Clínicas de Porto Alegre, Brazil. Eight patients underwent microtenotomy with a Topaz probe (Arthrocare) whereas the remaining 8 patients underwent microtenotomy with monopolar electrocautery. The patients were assessed using a Visual Analog Pain Scale and the Mayo Elbow Performance Score. Statistically significant differences with regard to the relief of pain were perceived in both groups on postoperative day 7. Both groups showed remarkable alleviation of pain after the seventh day and their pain scores decreased over time. Most patients (75%) scored 1 or less on the pain scale 3 months after surgery. In contrast, at 6 months, 93.7% of the patients scored 1 or less on the pain scale. The groups did not show any differences in terms of the Mayo Elbow Performance Score. On postoperative day 14, 77% of the patients had a score greater than 75, which is rated as good. After 6 months, all patients had good and excellent outcomes. Radiofrequency microtenotomy, either with a Topaz probe or with conventional electrocautery, yielded good and excellent results, respectively, for the treatment of chronic insertional tendinopathy.

The recent outbreak of the Zika virus (ZIKV) and the discovery that perinatal Zika exposure can lead to the Congenital Zika Syndrome has promoted a call for prevention measures. Due to the increased number of babies born with microcephaly, structural brain abnormalities, and neurological alterations in regions affected by ZIKV, investigations were carried out in order to better understand this process. The maternal immune system directly influences the fetal central nervous system, and complications during pregnancy have been associated with neurodevelopmental disorders. Autism spectrum disorder (ASD), a neurodevelopmental disorder commonly manifested in the first years of life, is a disease with multifactorial etiology and is manifested typically by social and communication impairments, as well as stereotyped behaviors. Brain abnormalities, including both anatomically and functionally, can be observed in this disorder, suggesting delays in neuronal maturation and altered brain connectivity. It is known that some viral congenital infections, such as rubella, and cytomegalovirus can interfere with brain development, being associated with brain calcification, microcephaly, and ASD. Here, we reviewed a range of studies evaluating the aspects concerning brain development, immunological status during pregnancy, and neuroimmunomodulation in congenital viral infections, and we discuss if the fetal brain infection caused by ZIKV could predispose to ASD. Finally, we suggest a mechanism encompassing neurological and immunological pathways that could play a role in the development of ASD in infants after ZIKV infection in pregnancy.

Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5 degrees, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.

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