OBJECTIVE: This study aims to evaluate emotional factors such as anxiety and depression, and the Quality of Life of individuals with chronic persistent pain after amputation in order to identify the interindividual variation in response to pain. METHODS: This was a descriptive, exploratory and cross-sectional study with quantitative approach. Twenty seven patients were interviewed. The instruments have rated the sociodemographic, clinical and economic profile (semistructured interview) and the Quality of Life (generic Quality of Life questionnaire SF-12) and emotional factors (HAD scale) of the interviewed patients. RESULTS: It was identified that the most frequent amputations occur in males aged 18-38 years and are related to occupational accidents. The Quality of Life was compromised in both components of physical and mental health. Furthermore, anxiety levels were more prevalent in the range from aged 18 to 38 years old, while the levels of depression were most prevalent among the elderly (60 to 80 years old). CONCLUSION: The impairment of Quality of Life and change in the perception of body image has a major impact on adherence to the rehabilitation program and the functional prognosis. Therapeutic orientation is, therefore, critical after this type of surgery. Level of Evidence II, Descriptive and Exploratory Study.

This audit aimed to determine the usefulness of microscopy to detect presumptive rectal gonorrhoea (GC) infection in asymptomatic men. We retrospectively audited more than 400 male patients attending a London genitourinary medicine clinic from January 2005 to March 2007 who tested rectal culture positive for Neisseria gonorrhoeae and compared this with the microscopy detection rate. In total, 123/423 (29%) of culture positive samples were microscopy positive. Of those that tested microscopy negative (300/423), 64 (21%) were symptomatic and 236 (79%) asymptomatic. In addition, a time and motion study examined 81 rectal slides over a two-week period to identify microscopy reading time required to make a presumptive diagnosis of GC. Three slides were positive, resulting in six hours and 45 minutes to detect one positive sample. Given the low sensitivity for rectal microscopy coupled with the length of time required to obtain a presumptive positive rectal GC result, we believe rectal microscopy is no longer a cost-effective tool screening for asymptomatic men, and this report supports the BASHH guideline that it is not recommended in the management of asymptomatic rectal infection.

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Schatzker types IV to VI tibial plane fractures compromise the two tibial plateaus. Most cases involve joint deviation and require anatomic reduction and rigid fixation. Dual access and prolonged surgical time are factors that exert an influence on the occurrence of infection of the surgical wound and, consequently, the clinical outcome. The reason why these fractures have a greater incidence of infection compared to others remains unclear. The aim of the present study was to investigate risk factors for infection in patients undergoing osteosynthesis for tibial plateau fracture considering demographic, clinical, and operative factors. A retrospective study was conducted with data on patients with Schatzker types IV, V, and VI tibial plateau fracture submitted to surgical treatment at a tertiary university hospital affiliated with the public healthcare system. The following data were extracted from the patient files: age; type of fracture; mechanisms of trauma; exposure of fracture; use of external fixator prior to osteosynthesis considering the time of fixator use, distance between Schanz screws, and location of the fracture; presence of compartment syndrome; number of surgical accesses; surgical time; number of participants in surgery and smoking; and comparing groups with and without infection at the surgical site in the immediate postoperative period (up to three weeks). Among the 44 patients studied, mean age was 48.5±15.1 years, 72.7% patients were male, 11.4% were diabetic, 56.8% had Schatzker type V tibial fracture, 88.6% had fractures caused by high-impact trauma, 95.5% of the fractures were closed, 100% used an external fixator prior to definitive osteosynthesis, 54.5% had a single lateral surgical access, and infection at the surgical site occurred in 25% of patients. In the comparison of patients with and without infection, a significant difference was found regarding the distance between the Schanz screws and location of the fracture (p=0.0286), which was shorter in patients with infection at the surgical site. The analysis of potential risk factors for infection revealed that open fracture was the only risk factor in patients with proximal tibial fracture, with a 1.22-fold increase in the likelihood of infection (odds ratios {OR}: 1.22; 95% confidence intervals {CI}: 0.93-1.62; p=0.012). In conclusion, open fracture, greater proximity between the Schanz screws of the external fixator, and the location of the fracture were considered risk factors for infection at the surgical site in patients undergoing osteosynthesis for tibial plateau fracture.