http://repositorio.ufc.br/handle/riufc/427 2026-04-04T20:09:21Z http://repositorio.ufc.br/handle/riufc/84911 Título: Talipes equinovarus congênito e tálus vertical congênito decorrente de doença do corno anterior da medula espinhal: lições da síndrome congênita associada a infecção pelo vírus Zika Autor(es): Colares, Paulo Giordano Baima Abstract: ABSTRACT Idiopathic congenital talipes equinovarus (iCTEV) and congenital vertical talus (CVT) are structural foot deformities whose etiologies remain incompletely understood. Clinical and histopathological findings described in classic cases have long raised the possibility of neurogenic mechanisms involving the anterior horn of the spinal cord. Similarly, neurogenic arthrogryposis multiplex congenita (AMC) is characterized by congenital joint contractures and muscular and medullary patterns compatible with early motor neuron impairment. Congenital Zika Syndrome (CZS), in turn, represents a contemporary model of congenital viral injury to the central and peripheral nervous systems, including selective neural depletion and calcification of the anterior horn of the spinal cord, frequently associated with foot deformities. Given these convergences, this study aimed to describe and analyze congenital foot deformities in patients with CZS, with clinical, etiological, and pathophysiological emphasis, to support the hypothesis of anterior horn injury as an etiological factor in orthopedic deformities. Secondarily, it illustrates clinical, anatomopathological, and histopathological findings from two pre-Zika stillborns diagnosed with iCTEV and CVT, compares these findings with those observed in CZS and neurogenic AMC, and describes additional foot deformities identified in this case series. Thus, an observational, descriptive, prospective, uncontrolled study was conducted, composed of two complementary subgroups. Subgroup 1 included a coorte of children with CZS followed between December 2016 and June 2019 in a multidisciplinary clinic in Fortaleza, Ceará, with 30-month follow-up and semiannual clinical and radiographic evaluations. Subgroup 2 consisted of an illustrative retrospective analysis of two pre-2015 stillborns with bilateral iCTEV and CVT who underwent autopsy. The evaluation included macroscopic examination of the lumbar spine, histologic analysis of the lumbar spinal cord and lower-limb muscles, and documentation of “ghost fascicles” as well as neural depletion and calcification of the anterior horn. Orthopedic clinical assessments were performed by a team of three pediatric orthopedic surgeons. Among 130 patients with CZS, 11 (8.46%) presented isolated rigid iCTEV, isolated CVT, or both deformities; four (3.08%) met diagnostic criteria for AMC. The pre-Zika iCTEV case showed neural depletion and spinal cord calcification, while both pre-Zika cases exhibited muscular patterns with “ghost fascicles”, characteristic of neurogenic atrophy, similar to those observed in neurogenic AMC and CZS. The foot deformities identified demonstrate a clinical and pathophysiological pattern consistent with motor neuron injury of the anterior horn. The analysis of pre-Zika cases reinforces etiological similarities among iCTEV/CVT, neurogenic AMC, and CZS. The diversity of deformities observed in CZS suggests focal spinal cord involvement capable of producing multiple orthopedic phenotypes. These findings support the hypothesis of a neurogenic etiology for iCTEV and CVT—or at least for a subset of cases—and indicate new directions for etiological, diagnostic, and preventive investigation. Tipo: Tese 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/83521 Título: Matriz descelularizada (Scaffold) de pele de tilápia (Oreochromis niloticus) como substituto da túnica albugínea para cirurgias penianas reconstrutivas em ratos Wistar (Rattus norvegicus) Autor(es): Mesquita, Francisco José Cabral Abstract: The repair of tunica albuginea severe conditions, such as Peyronie's disease (PD), often requires reconstructive techniques, including the use of tissue substitutes. Despite advances, the ideal graft is still being sought. This study aimed to evaluate the biocompatibility and inflammatory process of a decellularized tilapia (Oreochromis niloticus) skin scaffold as a substitute for the tunica albuginea in penile reconstructive surgery in Wistar rats (Rattus norvegicus). The scaffold’s effects were assessed through histological evaluation and quantification of vascular density via CD31 immunoexpression.. A surgical incision was made in the tunica albuginea layer of the penile shaft in 36 rats. , They were separated into three groups: Negative Control - Sham: a fragment of the tunica albuginea itself sutured in the original location; Positive Control: reconstruction with a bovine pericardial membrane (Biopatch®); Test Group: Reconstruction with decellularized tilapia skin scaffold. After 15 days, the animals were euthanized and the penile tissue was harvested for analysis. Histopathological analysis demonstrated that the Sham Group exhibited preserved anatomical architecture of the tunica albuginea layer and corpora cavernosa tissue; the Positive Control Group showed an intense inflammatory response, with mixed leukocyte infiltration, multinucleated giant cells, and areas of necrosis, in addition to areas of rupture suggesting pronounced inflammatory response to the material; and Test Group showed maintaince of vascular spaces in the corpora cavernosa along with its lack of significant inflammation. In immunohistochemical analysis, the Positive Group showed greater vascular density (angiogenesis) compared to the other groups (p<0.001), indicating a more intense inflammatory response. The analysis of the results disclose that the decellularized tilapia skin matrix has promising potential as a substitute for the tunica albuginea in penile reconstructive surgeries. The biocompatibility of the tilapia scaffold, the absence of marked inflammation, and the preservation of vascular spaces suggest that the biomaterial can promote tissue regeneration and the restoration of penile function, proving to be a promising alternative to bovine pericardium. Tipo: Tese 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/82427 Título: Efeito de soluções de preservação na modulação da síntese de sulfeto de hidrogênio no endotélio da veia safena magna na cirurgia de revascularização do miocárdio Autor(es): Pimentel, Matheus Duarte Abstract: The great saphenous vein (GSV) remains widely utilized in coronary artery bypass grafting (CABG), yet venous grafts exhibit limited long-term patency despite recent advances. Endothelial preservation is critical for improving graft outcomes. During CABG, vascular conduits are stored in preservation solutions, which influence endothelial integrity and the expression of functional molecules. Hydrogen sulfide (H2S), a multifaceted gasotransmitter with vasodilatory, anti-inflammatory, and antithrombotic effects, has an underexplored role in GSV grafts. This study aimed to evaluate the effect of different preservation solutions on the expression of H2S-producing enzymes and GSV endothelial integrity. GSV segments from twenty CABG patients were divided into five groups: Control (immediate fixation post-excision), normal saline (NS), autologous heparinized blood (AHB), histidine-tryptophan-ketoglutarate solution (HTK), and no solution (Damage). Post-fixation, segments were analyzed by light microscopy (LM) to assess graft integrity and endothelial coverage percentage, and by immunofluorescence (IF) to quantify CD31, endothelial nitric oxide synthase (eNOS), and H2S-synthesizing enzymes: cystathionine γ-lyase (CSE), cystathionine β-synthase (CBS), and 3-mercaptopyruvate sulfurtransferase (3-MPST). LM analysis showed that AHB and HTK better preserved endothelial structure and coverage compared to NS and Damage groups (p < 0.001). IF analysis revealed that surgical handling attenuated enzyme expression, with preservation solutions showing a protective effect, which was significantly less pronounced with NS. All three H2S-synthesizing enzymes were detected in GSV endothelium, with CSE being the most expressed. Preservation solutions influenced enzyme expression, with AHB and HTK exhibiting a protective effect, maintaining higher CSE, CBS, and 3-MPST levels compared to NS. This study confirms the presence of H2S-producing enzymes in GSV endothelium and demonstrates that preservation solutions used during CABG affect their expression and endothelial integrity and functionality, with NS being deleterious to the endothelium. Tipo: Tese 2025-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/81432 Título: Desenvolvimento e avaliação de usabilidade de aplicação web de planejamento em artroplastias totais do joelho Autor(es): Sales, João Bosco Nogueira Abstract: Preoperative planning for total knee arthroplasty (TKA) enables the anticipation of intraoperative challenges, increases the likelihood of surgical success, and reduces complications. A structured planning methodology implemented through a web-based application, eliminating the need for printed radiographic films or photographing examinations, and capable of directly utilizing DICOM-format Imaging, may streamline the planning process and contribute to improved outcomes in TKA.The objectives of this study were: to develop a web application for preoperative planning in TKA; to implement, within this application, the preoperative planning protocol previously developed and incorporated by the author into the ATJ® mobile application; to evaluate its usability by comparing it to the ATJ® mobile application; to measure and compare the time required for planning between the developed web application and the ATJ® mobile application; and to compare the accuracy of the web application in measuring the angle between the anatomical and mechanical axes of the femur (AAMF) relative to the ATJ® application.The application was developed using the React® framework, the JSXGraph® library, the pydicom library, the SQLite® database, and the CloudflareR2® service, with communication between the interface and server established via HTTPS protocol and SSL/TLS encryption. Following development, the application underwent usability testing, evaluated by 24 volunteers: 8 orthopedic surgeons affiliated with the Brazilian Society of Knee Surgery (SBCJ), 8 orthopedic surgeons not affiliated with the SBCJ, and 8 orthopedic surgery residents.Using the System Usability Scale (SUS) questionnaire, a SUS score of 90.3 was obtained, corresponding to grade A in the Bangor classification and A+ on the Sauro and Lewis scale. Compared to the ATJ® application, the new web application reduced the time required for planning by 41%. It enabled preoperative TKA planning through direct use of DICOM-format radiographic exams, implementing a guided planning protocol previously adopted in the ATJ® mobile application. The web application demonstrated excellent usability, proved accurate in AAMF measurement, and significantly reduced average planning time compared to the mobile version, positioning itself as a technological alternative to conventional planning approaches. Tipo: Tese 2025-01-01T00:00:00Z