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The purpose of this study is to evaluate the effects of photobiomodulation (PBM) therapy in chondrocyte response by in vitro experiments and cartilage repair using an experimental model of osteoarthritis (OA) in the knee of rats. The in vitro experiment was performed with chondrocyte cells, and they were divided into two groups: non-irradiated and irradiated with PBM (808 nm; 0.8 J or 1.4 J). Then, cell proliferation was evaluated after 1, 3, and 5 days. The experimental model of osteoarthritis (OA) was performed in the knee of 64 Wistar rats, and they were assorted into control group (CG), PBM (808 nm; 1.4 J). The results of in vitro showed that PBM 1.4 J increased cell proliferation, on days 1 and 5. However, after 3 days was demonstrated a significant increase in cell proliferation in PBM 0.8 J. The in vivo experiment results demonstrated, on histological analysis, that PBM presented less intense signs of tissue degradation with an initial surface discontinuity at the superficial zone and disorganization of the chondrocytes in the cartilage region when compared to CG, after 4 and 8 weeks. These findings were confirmed by immunohistochemistry and qRT-PCR analysis which showed that PBM increased IL-4, IL-10, COL-2, Aggrecan, and TGF-β which are anabolic factors and acts on extracellular matrix. Also, PBM reduces the IL1-β, an inflammatory marker that operates as a catabolic factor on articular cartilage. In conclusion, these results suggest that PBM may have led to a return to tissue homeostasis, promoting chondroprotective effects and stimulating the components of the articular tissue.

Feocromocitoma é uma neoplasia rara de células cromafins, localizado nas adrenais que apresenta importância por ter a capacidade de incitar crises hipertensivas potencialmente fatais. Os sinais clínicos estão relacionados com a liberação de catecolaminas. A ressecção cirúrgica é o tratamento definitivo, mas o tratamento clínico também mostra-se profícuo. Objetivou-se descrever um caso de feocromocitoma em uma cadela de nove anos, a qual apresentava hematomas cutâneos e perioculares, comportamento apático, anorexia há quatro dias e polidipsia. A paciente foi recebida no Hospital Veterinário da UNIJUÍ, e após consulta clínica e internação, a tutora optou pela eutanásia e necrópsia motivada pela baixa adesão da cadela ao tratamento. O animal foi encaminhado para o laboratório de Patologia Veterinária da mesma instituição que evidenciou a adrenal direita com proliferação de células vacuolizadas focalmente extensa, relativo a feocromocitoma. Diante disso, o médico veterinário deve conhecer e considerar este tipo de neoplasia.

Due to the complexity involved in the healing process of full thickness burns, the literature looks for alternatives to optimize tissue reconstruction. The objective of this study was to explore the action of photobiomodulation therapy associated with MSCs in the healing process of third degree burns. A total of 96 male Wistar rats were used, distributed in four groups with 24 animals each: Control Group, Laser Group, Cell Therapy Group, and Laser Group and Cell Therapy. The burn was performed with aluminum plate (150 °C). We performed analysis of wound contraction, histology, immunohistochemistry, birefringence analysis, and immunoenzymatic assay to evaluate tissue quality. Our results demonstrate that the association of the techniques is able to accelerate the repair process, modulating the inflammatory process, presenting a cutaneous tissue with better quality. Thus, we conclude that the use of photobiomodulation therapy associated with cell therapy is a promising treatment in the repair of total thickness burns.

BACKGROUND: Environmental temperatures in the fresh food industry vary from 0°C to 10°C, and go below -20°C for the frozen food industry, representing risk for the health and safety of workers involved. OBJECTIVE: The aim of this work was to evaluate the cold thermal stress risks for workers working in a frozen food industry. METHODS: A total of 27 acclimatized workers (13 male and 14 female) participated in a study which was conducted during 11 working days. The thermal sensation questionnaire and the cold work health questionnaire (CWHQ) were applied to all participants. Additionally, 4 workers were chosen to be fully monitored with a thermometer telemetry capsule for measuring the intra-abdominal temperature and 8 skin temperature sensors. RESULTS: The lowest recorded hand temperature was 14.09°C, lowest forehead 18.55°C, mean skin temperature had variations of 1.10 to 3.20°C along the working period. Highest and most frequent fluctuations were found in the hand and forehead skin temperatures, small changes were found in mean skin temperature. CONCLUSIONS: Answers to the CWHQ increase concern on clinical forms of “a frigore”, and in two cases the mean body temperature decreased below 35.0°C, which is defined in the current literature as a mild form of hypothermia.

The present study aimed to evaluate the effects of mesenchymal stromal cell (MSC) transplantation on motor function and collagen organization in the muscles of rats with type 1 diabetes mellitus. Male Wistar rats were randomly assigned to three groups: control (C), diabetic (DM) and diabetic treated with MSCs (DM‐MSCs). Diabetes was induced by streptozotocin (50 µg/kg). Bone marrow cells were isolated from the tibia and femur. After 10 weeks of DM induction, the DM‐MSC rats received four i.p. injections of MSCs (1 × 106). Ten weeks after MSC transplantation, motor performance was evaluated by the rotarod test and the anterior tibial (TA) muscles were collected for morphometric and quantification of collagen birefringence by polarizing microscopy analysis. Motor performance of the DM group was significantly reduced when compared to the C group and increased significantly in the DM + MSC group. The TA muscle mass was significantly reduced in the DM and DM + MSC groups compared to the C group. The connective tissue increased in the DM group compared to the C group and decreased in the DM + MSC group. The percentage collagen birefringence decreased significantly in the DM group when compared to the C group and increased in the DM + MSC group. Motor performance was positively correlated with collagen birefringence and negatively correlated with percentage of connective tissue. The results indicate that MSC transplantation improves both motor function and the collagen macromolecular organization in type 1 DM.

Introdução: A doença metabólica óssea da prematuridade consiste numa diminuição da matriz óssea, relativamente ao nível esperado para a idade gestacional. O rastreio baseia-se no doseamento sérico da fosfatase alcalina e fósforo. O objetivo deste estudo é avaliar a prevalência da doença metabólica óssea da prematuridade, analisar os aspetos associados a maior risco para esta doença e descrever o crescimento estaturo-ponderal dos recém-nascidos com peso ao nascer inferior a 1500 g, com doença metabólica óssea da prematuridade.Material e Métodos: Estudo multicêntrico, retrospetivo, observacional e descritivo em três unidades de apoio perinatal diferenciado, entre 1 de maio de 2016 e 30 de abril de 2017; foi obtida uma amostra de conveniência de recém-nascidos com muito baixo peso ao nascer. Descrevem-se as variáveis demográficas, clínicas e laboratoriais dos recém-nascidos com e sem doença metabólica óssea da prematuridade.Resultados: Neste estudo foram incluídos 53 recém-nascidos: 30 do sexo masculino, 16 com idade gestacional ≤ 28 semanas. Foram diagnosticados cinco casos de doença metabólica óssea da prematuridade. Neste grupo, a maioria dos doentes era do sexo masculino e apresentavam idade gestacional e peso ao nascer inferior aos do grupo sem doença metabólica óssea da prematuridade. A duração média de nutrição parentérica foi superior nos recém-nascidos com doença metabólica óssea da prematuridade e a relação cálcio/fósforo utilizada foi inferior às recomendações nacionais. A evolução estaturo-ponderal foi semelhante nos recém-nascidos com e sem doença. Nenhum doente com doença metabólica óssea da prematuridade teve intervenção por medicina física e reabilitação.Discussão: A prevalência de doença metabólica óssea da prematuridade foi de 9,43%, valor inferior ao descrito na literatura. Contudo, apenas 50% dos recém-nascidos cumpriram o rastreio de acordo com as recomendações. Os principais fatores de risco identificados estão de acordo com a literatura.Conclusão: A doença metabólica óssea da prematuridade é uma comorbilidade frequente nos recém-nascidos de muito baixo peso, mas encontra-se subdiagnosticada. É fundamental rastrear os recém-nascidos em risco para esta patologia, utilizando marcadores bioquímicos, assim como estruturar intervenções nutricionais e estimulação física para evitar as consequências da doença a curto e longo prazo.

In general, bone fractures are able of healing by itself. However, in critical situations such as large bone defects, poor blood supply or even infections, the biological capacity of repair can be impaired, resulting in a delay of the consolidation process or even in non-union fractures. Thus, technologies able of improving the process of bone regeneration are of high demand. In this context, ceramic biomaterials-based bone substitutes and photobiomodulation (PBM) have been emerging as promising alternatives. Thus, the present study performed a systematic review targeting to analyze studies in the literature which investigated the effects of the association of ceramic based bone substitutes and PBM in the process of bone healing using animal models of bone defects. The search was conducted from March and April of 2019 in PubMed, Web of Science and Scopus databases. After the eligibility analyses, 16 studies were included in this review. The results showed that the most common material used was hydroxyapatite (HA) followed by Biosilicate associated with infrared PBM. Furthermore, 75% of the studies demonstrated positive effects to stimulate bone regeneration from association of ceramic biomaterials and PBM. All studies used low-level laser therapy (LLLT) device and the most studies used LLLT infrared. The evidence synthesis was moderate for all experimental studies for the variable histological analysis demonstrating the efficacy of techniques on the process of bone repair stimulation. In conclusion, this review demonstrates that the association of ceramic biomaterials and PBM presented positive effects for bone repair in experimental models of bone defects.

IntroductionAutomated systems for ventilator management to date have been either fully heuristic rule-based systems or based on a combination of simple physiological models and rules. These have been shown to reduce the duration of mechanical ventilation in simple to wean patients. At present, there are no published studies that evaluate the effect of systems that use detailed physiological descriptions of the individual patient.The BEACON Caresystem is a model-based decision support system that uses mathematical models of patients’ physiology in combination with models of clinical preferences to provide advice on appropriate ventilator settings. An individual physiological description may be particularly advantageous in selecting the appropriate therapy for a complex, heterogeneous, intensive care unit (ICU) patient population.Methods and analysisIntenive Care weaning (iCareWean) is a single-blinded, multicentre, prospective randomised control trial evaluating management of mechanical ventilation as directed by the BEACON Caresystem compared with that of current care, in the general intensive care setting. The trial will enrol 274 participants across multiple London National Health Service ICUs. The trial will use a primary outcome of duration of mechanical ventilation until successful extubation.Ethics and disseminationSafety oversight will be under the direction of an independent committee of the study sponsor. Study approval was obtained from the regional ethics committee of the Health Research Authority (HRA), (Research Ethic Committee (REC) reference: 17/LO/0887. Integrated Research Application System (IRAS) reference: 226610. Results will be disseminated through international critical care conference/symposium and publication in peer-reviewed journal.Trial registration numberClinicalTrials.gov under NCT03249623. This research is registered with the National Institute for Health Research under CPMS ID: 34831.

Skin Flap is used in reconstructive plastic surgery. However, complications such as ischemia followed by local necrosis may occur, requiring a new surgical procedure. It is well known that photobiomodulation therapy (PBMT) is an effective technique for improving microcirculation and neoangiogenesis, which contributes positively to the blood supply in the pre and post surgical period. Thus, the objective of the present study was to investigate the effects of preemptive treatment with laser PBMT with different energies on the viability in skin flaps in rats. Sixty-three Wistar rats, male, were randomized into five groups: Control Group (CG) (n = 15): PBMT simulation; Preemptive group 1.1 J laser (GP1) (n = 15): preemptive laser PBMT with 1.1 J of energy per point; Preemptive group 4 J laser (GP4) (n = 15): preemptive PBMT with 4 J of energy per point; Laser group 11 J (G1) (n = 9): PBMT immediately after surgery with 1.1 J of energy per point; Laser group 4 J (G4) (n = 9): TFMB immediately after surgery with 4 J of energy per point. The CG, GP1 and GP4 groups started treatment 72 h prior to surgery and were subdivided into two experimental periods, one of them on the day of the flap and the other along with the other groups on the seventh postoperative day. Three days after the randomization, the animals underwent random skin flap surgery. PBMT was performed with a 660 nm laser at three points. In the first experimental period, a greater number of vessels were found, as well as mast cells in GP1 compared to the CG and greater expression of fibroblast growth factor and vascular endothelial growth factor in the GP1 and GP4 groups compared to the CG. In the second experimental period, GP1 presented a lower percentage of necrotic tissue, a higher number of vessels and a percentage of cells labeled with both VEGF and hypoxia indicible factor alpha (HIF-1α) compared to the CG, FGF in GP1, GP4 and G4 when compared to the CG. Thus, it was concluded that preemptive treatment with PBMT with the application of 1.1 J of energy per point is effective in improving the viability of the skin flap.

Introduction Injuries and/or dysfunctions in the somatosensory system can lead to neuropathic pain. Transient receptor potential vanilloid sub‑type 1 (TRPV1) play an important role in the development of allodynia and hyperalgesia following injury and the ensuing inflammatory conditions. Resiniferatoxin (RTX) is an ultrapotent synthetic TRPV1 agonist and many different administration routes are available for different mechanisms and different effects. RTX is used intraperitonially as a model of neuropathic pain or epidurally and topically to produce prolonged analgesic effects. However, the use of RTX is controversial because its neurotoxicity and margin of safety have not been addressed adequately. The present study evaluates the effect of intrathecal RTX on the induction and allodynia behavior of animals submitted to neuropathic pain by chronic constriction injury (CCI). Methods 160 Swiss mice were randomly distributed into two groups: intrathecal pre‑treatment group (PRE) aiming the effect in induction of allodynia and late intrathecal treatment group (POST) to evaluate the antiallodynic effect of the RTX on mechanical nociceptive threshold evaluated by the Von Frey hair filaments. Additionally, we evaluated the expression of TRPV1 in dorsal root ganglia (DRG) by western blotting after PRE‑ and POST‑treatment with RTX. Results Our results showed that the CCI mice developed prolonged mechanical allodynia‑like behavior in ipsilateral paw after surgery up to 24 hours. The PRE‑ and POST‑treatment groups presented significant antiallodynic effects in ipsilateral paw for 24 hours. Only the POST‑treatment group showed a significant reduction of expression of the TRPV1 receptor after CCI. Conclusion The presented data demonstrated that both PRE‑ and POST‑treatment with RTX given intrathecally produced potent antiallodynic activities in CCI mice and that POST‑treatment can reduce TRPV1 expression in DRG, suggesting that POST‑treatment RTX can revert central sensitization and its associated allodynia.

Wound healing is a complex biological process with specific phases. Photobiomodulation (PBM) decreases the inflammatory infiltrate, stimulating fibroblast proliferation and angiogenesis, and therefore, is indicated for wound healing. Vitamin A is used to reverse the inhibitory effects on wound healing and accelerate the healthy granulation tissue. The study aimed to evaluate the effect of topical vitamin A and PBM (GaAlAs) in inflammatory phase of cutaneous wounds. Forty Wistar male rats were separated into four groups: (1) control (CG); (2) laser group (LG) GaAlAs, 670 nm, 30 mW, energy per point of 0.9 J, radiating by 1 point in 30 s; (3) vitamin A group (VitAG); and (4) laser group plus vitamin A (LG + VitAG). Wounds were surgically made by a punch biopsy with 10 mm of diameter on the back of the animals and all treatments were started according to the experiment. The treatments were administered for four consecutive days and biopsy was performed on day 4. We performed both H&E and immunohistochemistry analysis. The results were compared between groups by one-way analysis of variance ANOVA test with post hoc Tukey (p

RESUMO A terapia a laser de baixa intensidade (LLLT) vem sendo amplamente discutida na literatura como forma alternativa de tratamento para diversos tipos de dor, com destaque para a neuropática. Essa terapia sobressai pelo fato de não ser invasiva, raramente causar efeitos colaterais e ser de baixo custo. Em contrapartida, para sua eficácia, é necessário o detalhamento dos parâmetros, que ainda são muito discrepantes na literatura. Assim, este trabalho tem como objetivo investigar o efeito da LLLT, na faixa do infravermelho, com fluência de 30J/cm², no controle da dor neuropática em modelo animal. Foram utilizados 24 camundongos da cepa suíço albino, machos, pesando 2530 gramas, divididos em três grupos: Grupo Placebo (GP), Grupo Laser (GL30) e Grupo Sham (GS). A indução da neuropatia foi feita através do modelo de constrição crônica do nervo isquiático (CCI), e o tratamento da LLLT realizou-se da seguinte maneira: GP com o laser com fluência de 0J/cm2, GL30 tratado com fluência de 30J/cm2, e GS com simulação de cirurgia sem intervenção. Executaram-se as irradiações 3 vezes por semana, durante 90 dias, no ponto de compressão do nervo, utilizando-se a técnica de contato. A fins de avaliação, foram utilizados o teste da placa quente, para hiperalgesia térmica, e o Teste de Randall-Selitto para hiperalgesia mecânica. Nos resultados do GP, observamos que não houve melhora significativa nos dias após a cirurgia em nenhum dos testes realizados e, no GL30, observou-se uma melhora expressiva em ambos os testes a partir do 30º dia de tratamento para o teste de Placa Quente e a partir do 45º para o Randall-Selitto, em que os camundongos apresentaram restauração total da sensibilidade. Concluímos, pois, que a utilização de LLLT com fluência de 30J/cm2 no tratamento da dor neuropática em modelo animal é eficaz. RESUMEN La terapia láser de baja potencia (LLLT) ha sido ampliamente discutida en la literatura como forma alternativa de tratamiento para muchos tipos de dolor, especialmente para el neuropático. Esa terapia se destaca por el hecho de no ser invasiva, raramente causar efectos secundarios y ser de bajo costo. En cambio, para su eficacia, es necesario que se presenten los detalles de los parámetros, que todavía son muy discordantes en la literatura. Así, este trabajo tiene como objetivo investigar el efecto de la LLLT, en el rango del infrarrojo, con fluidez de 30 J/cm², en el control del dolor neuropático en modelos animales. Se utilizaron 24 ratones de la cepa suizo-albino, machos, con peso de 2530 gramos, divididos en tres grupos: Grupo Placebo (GP), Grupo Láser (GL30) y Grupo Sham (GS). Se llevó a cabo la inducción de la neuropatía por medio del modelo de constricción crónica del nervio isquiático y se realizó el tratamiento de la LLLT como sigue: GP con el láser con fluidez de 0 J/cm2, GL30 con fluidez de 30 J/cm2, y GS con simulación de cirugía sin intervención. Se realizaron las irradiaciones tres veces por semana, durante 90 días, en el punto de compresión del nervio, utilizándose la técnica de contacto. A efectos de evaluación, se utilizaron la prueba de placa caliente para hiperalgesia térmica y la prueba de Randall y Selitto para hiperalgesia mecánica. En los resultados del GP, observamos que no hubo mejora significativa en los días después de la cirugía en ninguna de las pruebas realizadas y, en el GP30, se verificó mejora significativa en ambas pruebas: desde el 30.º día de tratamiento para la prueba de placa caliente y desde el 45.º día para la prueba de Randall y Selitto, en que los ratones presentaron restauración total de la sensibilidad. Concluimos, por lo tanto, que el uso de la LLLT con fluidez de 30 J/cm2 en el tratamiento del dolor neuropático en modelos animales es efectivo. ABSTRACT Low-level laser therapy (LLLT) has been widely discussed in the literature as an alternative form of treatment for several types of pain, especially neuropathic pain. This kind of therapy stands out for not being invasive, rarely causing side effects and being cost effective. However, for its effectiveness, it is necessary more detailed parameters, which are still very discrepant in the literature. Thus, this study aims to investigate the effect of LLLT, in the infrared range, with 30J/cm² fluency, on the control of neuropathic pain in animal models. A total of 24 male Swiss albino mice, weighing 25.30 grams, were divided into three groups: the Control Group (CG), the Laser Group (L30G) and the Sham Group (SG). The induction of neuropathy was held through the model of chronic constriction of the sciatic nerve (CCI), and the LLLT treatment was conducted as follows: The CG was treated with 0 J/cm2 fluency, whereas the L30G was treated with 30 J/cm2 fluency, and the SG with simulation of surgery without intervention. The irradiations were performed 3 times a week, for 90 days, at the nerve’s point of compression, using the contact technique. For the evaluation, the Hot Plate Test was used for thermal hyperalgesia, and the Randall-Selitto test was used for mechanical hyperalgesia. In the CG’s results, we observed no significant improvement in the days after surgery in any of the tests conducted, and, in the GL30, a significant improvement in both tests was observed: from the 30th day of treatment for the Hot Plate Test, and from the 45th for the Randall-Selitto Test, in which the mice showed total restoration of sensitivity. We thus conclude that the use of LLLT with 30 J/cm2 fluency in the treatment of neuropathic pain in animal models is effective.

A fraqueza da musculatura respiratória é a principal respon¬sável por insuficiência respiratória na Distrofia Muscular de Duchenne (DMD). Objetivo. Avaliar os efeitos do treinamento muscular inspi­ratório na força respiratória de pacientes com DMD. Método. Série de casos com cinco crianças portadoras da DMD, idade de 11,4±2,6 anos, avaliados pela Manovacuometria e Pico de Fluxo Expiratório (PFE) nos momentos inicial (basal), quinta e décima sessão. Realizou­-se treino muscular inspiratório, com 30% da PImáx em dispositivo de carga linear (Threshold®), com cinco séries de 10 repetições, totali­zando 10 sessões, três vezes por semana. Resultados. Valores médios inicial, quinta e décima sessão, respectivamente: PImax (cmH2O): -64, -69,8 e -86,8 (p=0,006) melhora de 29% inicial para 10 sessões; PEmax (cmH2O): 64, 67 e 73,6 (p=0,003) melhora de 25% inicial para 10 sessões e PFE (L/min): 210, 218 e 232 (p=0,012) melhora de 9% inicial para 10 sessões. Conclusão. O programa de treinamento muscular inspiratório proposto mostrou-se eficaz tanto no ganho de força inspiratória quanto expiratória, proporcionando também o au­mento do pico de fluxo expiratório.

In response to innumerable global challenges in a world ever more complex and interconnected, including a number of public health challenges, the United Nations launched the 2030 Agenda for Sustainable Development; a guideline intended to deal with these issues. Foreseeing their huge complexity, the UNLEASH initiative was created with a vision to gather, on a yearly basis until 2030, 1.000 young talents from all over the world to co-create disruptive solutions for the 17 Sustainable Development Goals (SDGs). The School of Public Health of the University of São Paulo was selected as the only educational institution partner in South America and was invited to select and send students to the launching event in Denmark in August 2017. The aim of this study is to address and reflect on the seven SDGs (health, food, water, energy, urban sustainability, sustainable consumption and production and education) that were explored in this first event and relate the students’ experiences of this global innovation lab. Resumo Em resposta a problemas cada vez mais complexos e interconectados, entre os quais figuram diversos desafios de saúde pública, as Nações Unidas lançaram a Agenda 2030 de Desenvolvimento Sustentável que pretende servir como guia para lidar com essas questões. Visando abordar a complexidade destes desafios, foi proposta a iniciativa UNLEASH, um evento que reúne 1.000 jovens talentos de todo o mundo anualmente até 2030 para encontrar soluções inovadoras aos 17 Objetivos do Desenvolvimento Sustentável (ODS) propostos na Agenda 2030. A Faculdade de Saúde Pública da Universidade de São Paulo foi a única instituição de ensino latino-americana selecionada para enviar estudantes na primeira edição do evento, realizado na Dinamarca em 2017. O presente artigo tem como objetivo abordar os sete ODS (saúde, comida, água, energia, sustentabilidade urbana, consumo sustentável e educação) que foram trabalhados neste primeiro encontro, refletir sobre os mesmos e relatar a experiência dos pós-graduandos no evento global e inovador da UNLEASH. Resumen Como respuesta a los innumerables desafíos globales en un mundo cada vez más complejo e interconectado, las Naciones Unidas lanzó la Agenda 2030 para el Desarrollo Sostenible; como un guía para tratar con estos problemas. Previendo las grandes complejidades de estos, la iniciativa UNLEASH, fue creada con la visión de reunir anualmente 1000 jóvenes talentos de todo el mundo hasta 2030 para encontrar soluciones disruptivas para los 17 Objetivos de Desarrollo Sostenible (ODS). La Facultad de Salud Pública de la Universidad de São Paulo ha sido elegida como la única institución colaboradora en América del Sur, y fue invitada a seleccionar y enviar estudiantes para el primer evento en agosto del 2017 en Dinamarca. El objetivo de este estudio es abordar y reflexionar sobre los siete ODS (salud, alimentación, agua, energía, sostenibilidad urbana, producción y consumo responsables, y educación) que fueron explorados en este primer evento, y relatar las experiencias de los estudiantes sobre este laboratorio de innovación global.

Introduction: The EASYCare is a multidimensional assessment tool for older people, which corresponds to the concerns and priorities of older people in relation to their needs, health, and quality of life. The EASYCare instrument has been used in many countries worldwide. Lack of reliability evidence has recently been raised by researchers. This study aimed to test the validity and reliability of the EASYCare-2010 instrument in community-dwelling Portuguese older people attended in Primary Health Care centres. Methods: The sample for this transversal study (N = 244) was collected from Portuguese Primary Health Care Centers. Categorical Principal Component Analysis was used to assess the underlying dimensions of EASYCare-2010. Construct validity was evaluated through correlation with the World Health Organization Quality of Life Assessment Instrument-Short Form. Results: A two-factor model (labelled âmobility and activities of daily lifeâ, and âgeneral well-being and safetyâ) was found. The EASYCare-2010 instrument showed acceptable levels for internal consistency (â¥0.70). The EASYCare-2010 factors were correlated with measures of quality of life. Results showed that in most polytomous items, some of the more extreme categories were not considered at all or only by a residual number of participants. Conclusion: EASY Care -2010 version is a valid and reliable instrument for holistic assessment of the older people attended in Primary Health Care centres in Portugal. Resumen: Introducción: El EASYCare es una herramienta de evaluación multidimensional para las personas mayores, que corresponde a las preocupaciones y prioridades de las personas mayores en relación con sus necesidades, salud y calidad de vida. El instrumento EASYCare se ha utilizado en muchos países del mundo. La falta de pruebas de fiabilidad ha sido planteada recientemente por los investigadores. Este estudio tuvo como objetivo probar la validez y fiabilidad del instrumento EASYCare-2010 en personas mayores portuguesas residentes en la comunidad, atendidos en centros de Atención Primaria de la Salud. Métodos: La muestra para este estudio transversal (N = 244) se recogió en Centros de Atención Primaria de Portugal. Se utilizó el Análisis de Componentes Principales Categórico para evaluar las dimensiones subyacentes de EASYCare-2010. La validez del constructo se evaluó mediante la correlación con el instrumento de evaluación de la calidad de vida de la Organización Mundial de la Salud, instrumento en su forma corta. Resultados: Se encontró un modelo de dos factores (denominado «movilidad y actividades de la vida diaria» y «bienestar general y seguridad»). El instrumento EASYCare-2010 mostró niveles aceptables de consistencia interna (⥠0.70). Los factores EASYCare-2010 se correlacionaron con medidas de calidad de vida. Los resultados mostraron que en la mayoría de ítems politómicos en algunas categorías extremas no se consideraron o solo por un número residual de participantes. Conclusión: La versión EASY Care-2010 es un instrumento válido y fiable para la evaluación holística de las personas mayores atendidas en centros de Atención Primaria de Salud en Portugal. Keywords: Geriatric assessment, Primary health care, Reliability and validity, Palabras clave: Evaluación geriátrica, Atención primaria de salud, Confiabilidad y validez

Purpose: To present an alternative experimental model of third degree burn of easy reproducibility. Methods: Eighteen male Wister rats were randomly divided into three groups, 6 of which were allocated to each group. A soldering iron coupled to an aluminum plate was used to produce burn, at a temperature of 150ºC, with different exposure times per group. Group 5 (G5) animals were burned at 150°C with exposure time of 5 seconds; Group 10 (G10) the animals were burned at 150°C with exposure time of 10 seconds and group 15 (G15) the animals were burned at 150°C with exposure time of 15 seconds. Results: Histopathological analyzes showed that all three groups had similar morphological characteristics, with total thickness involvement. Conclusion: The technique is effective to reproduce a third degree burn and suggests the temperature of 150ºC with 5 seconds of exposure in order to minimize the risks to the animals.

Burn is defined as a traumatic injury of thermal origin, which affects the organic tissue. Low-level laser therapy (LLLT) has gained great prominence as a treatment in this type of injury; however, the application parameters are still controversial in the literature. The aims of this study were to review the literature studies that use LLLT as a treatment in burns conducted in an experimental model, discuss the main parameters used, and highlight the benefits found in order to choose an appropriate therapeutic window to be applied in this type of injury. The selection of the studies related to the theme was carried out in the main databases (PubMed, Cochrane Library, LILACS, Web of Science, and Scopus in the period from 2001 to 2017). Subsequently, the articles were then chosen that fell within the inclusion criteria previously established. In the end, 22 were evaluated, and the main parameters were presented. The analyzed studies presented both LLLT use in continuous and pulsed mode. Differences between the parameters used (power, fluence, and total energy) were observed. In addition, the protocols are distinct as to the type of injury and the number of treatment sessions. Among the results obtained by the authors are the improvements in the local microcirculation and cellular proliferation; however, a study reported no effects with LLLT as a treatment. LLLT is effective in accelerating the healing process. However, there is immense difficulty in establishing the most adequate protocol, due to the great discrepancy found in the applied dosimetry values.

Introduction Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined. Materials and methods This a 4-arm randomized placebo-controlled trial with patient and evaluator blinded. This study will be performed in Department of Physical Therapy at Federal University of Sao Carlos, Sao Carlos/SP, Brazil. One hundred and forty-four patients with chronic neck pain will be randomized into 4 groups: active photobiomodulation therapy with active electrical stimulation, active photobiomodulation therapy, active electrical stimulation, or placebo treatment. They will receive 10 sessions of treatment. Primary outcome pain intensity (measured by pain numerical rating scale) posttreatment. Secondary outcomes pain during movement, neck disability, range of motion, pressure pain threshold, temporal summation, conditioned pain modulation, depressive symptoms, pain catastrophizing, quality of life, analgesic intake, and global perceived effect at posttreatment (10 sessions). Pain intensity and global perceived effect will also be measured after 6 weeks randomization. Discussion The findings of this study might clarify the importance of using the photobiomodulation therapy and transcutaneous electrical nerve stimulation for patients with chronic neck pain. Trial registration NCT04020861. https://clinicaltrials.gov/ct2/show/NCT04020861?term=NCT04020861&draw=2&rank=1.

Objective. To establish differential diagnosis in patients presenting occipital neuralgia, tension-type headache, and migraine with aura. Method. We analyzed 32 patients with Occipital neuralgia (mean age=38.0; females=75%), 102 with tension-type headache (mean age=33.0; females=92.2%), and 16 with migraine without aura (mean age=37.0; females=56.3%). The specific symptoms of headaches were used in according to International Classification of Headache Dis­orders (ICHD) in patients with for craniomandibular disorders and bruxing behavior. Results. Occipital neuralgia group presented more nausea (78.1%; p=0.0001), vomiting (62.5%; p=0.0001), photopho­bia (71.8%; p=0.0001), throbbing (53.1%; p=0.0001), stabbing pain (78.1%; p=0.0001), severe pain (93.7%; p=0.0001), burning (68.8%; p=0.0001), and occipital nerve tenderness (100%; p=0.0001) than tension-type headache group. Occipital neuralgia group showed more stabbing (78.1%; p=0.0001), burning (68.8%; p=0.0005), and oc­cipital nerve tenderness (100%; p=0.0001) than migraine without aura group. Migraine without aura group showed more vomiting (94%; p=0.03) and photophobia (100%; p=0.02) than occipital neu­ralgia group. Conclusions. Nausea, vomiting, photophobia, throb­bing, stabbing, severer pain, a burning description and occipital nerve tenderness, better differentiated occipital neuralgia from tension-type headache. Stabbing pain, burning and occipital nerve tenderness, bet­ter differentiated occipital neuralgia from migraine without aura.

ResumoObjetivosDescrever o caso clínico de uma criança que apresenta comportamento agressivo e fala recorrente do tema de morte, e relatar a experiência da equipe de autores na proposição de uma alternativa à medicalização por meio da formação de uma Rede de Proteção e da aplicação Intersetorial do conceito de Círculo de Segurança da Criança.Descrição do casoCriança de 5 anos apresenta comportamento violento e agressivo na creche que frequenta. Foi diagnosticado pelo Centro de Saúde com Transtorno Depressivo e Transtorno de Conduta, sendo medicado com Sertralina e Risperidona. Apresentou efeitos colaterais, interrompendo o uso das medicações. Apesar de ações como conversas, trabalho em grupos, acompanhamento psicológico e psiquiátrico, a criança manteve esse comportamento.ComentáriosFoi desenvolvido um Projeto Terapêutico Singular por alunos do curso de Medicina da Universidade Estadual de Campinas (UNICAMP), com o objetivo de criar um vínculo entre as instituições responsáveis pelo cuidado da criança (Creche, Centro de Saúde e família), o que possibilitou o desenvolvimento de uma rede de proteção para o cuidado na Atenção Básica. A aplicação intersetorial do Círculo de Segurança, assim como a comunicação e a colaboração entre as equipes, mostrou resultados muito positivos neste caso, configurando-se como uma alternativa acessível e eficaz à Medicalização da criança.AbstractObjectivesTo describe the clinical history of a child with aggressive behavior and recurring death-theme speech, and report the experience of the team of authors, who proposed an alternative to medication through the establishment of a protection network and the inter-sector implementation of the circle of security concept.Case descriptionA 5-year-old child has a violent and aggressive behavior at the day-care. The child was diagnosed by the healthcare center with depressive disorder and behavioral disorder, and was medicated with sertraline and risperidone. Side effects were observed, and the medications were discontinued. Despite several actions, such as talks, teamwork, psychological and psychiatric follow-up, the child's behavior remained unchanged.RemarksA unique therapeutic project was developed by Universidade Estadual de Campinas’ Medical School students in order to establish a connection between the entities responsible for the child's care (daycare center, healthcare center, and family). Thus, the team was able to develop a basic care protection network. The implementation of the inter-sector circle of security, as well as the communication and cooperation among the teams, produced very favorable results in this case. This initiative was shown to be a feasible and effective alternative to the use of medication for this child.

ObjectiveTo describe the clinical history of a child with aggressive behavior and recurring death-theme speech, and report the experience of the team of authors, who proposed an alternative to medication through the establishment of a protection network and the inter-sector implementation of the circle of security concept.Case descriptionA 5-year-old child has a violent and aggressive behavior at the day-care. The child was diagnosed by the healthcare center with depressive disorder and behavioral disorder, and was medicated with sertraline and risperidone. Side effects were observed, and the medications were discontinued. Despite several actions, such as talks, teamwork, psychological and psychiatric follow-up, the child's behavior remained unchanged.RemarksA unique therapeutic project was developed by Universidade Estadual de Campinas' Medical School students in order to establish a connection between the entities responsible for the child's care (daycare center, healthcare center, and family). Thus, the team was able to develop a basic care protection network. The implementation of the inter-sector circle of security, as well as the communication and cooperation among the teams, produced very favorable results in this case. This initiative was shown to be a feasible and effective alternative to the use of medication for this child.

Neuropathic pain can be defined as the pain initiated or caused by a primary lesion or dysfunction of the central or peripheral nervous system. Photobiomodulation therapy (PBM) stands out among the physical therapy resources used for analgesia. However, application parameters, especially the energy density, remain controversial in the literature. Therefore, this study aimed to investigate the PBM effect, in different energy densities to control neuropathic pain in mice. Fifty (50) mice were induced to neuropathy by chronic constriction surgery of the sciatic nerve (CCI), treated with PBM (808 nm), and divided into five groups: GP (PBM simulation), GS (sham), GL10, GL20, GL40 (energy density of 10, 20, and 40 J/cm2, respectively). The evaluations were carried out using the hot plate test and Randall and Selitto test, before and after the CCI surgery, every 15 days during the 90 days experiment. β-Endorphin blood dosage was also tested. For both the hot plate and Randall and Selitto tests, the GL20 and GL40 groups presented reduction of the nociceptive threshold from the 30th day of treatment, the GL10 group only after day 75, and the GP group did not show any improvement throughout the experiment. The β-endorphin dosage was higher for all groups when compared to the GP group. However, only the GL20 group and GL40 presented a significant increase. This study demonstrates that PBM in higher energy density (20, 40 J/cm2) is more effective in the control of neuropathic pain.

Neuropathic pain can be defined as pain initiated or caused by a primary lesion or dysfunction in the central or peripheral nervous system. The low level laser therapy (LLLT) has gained great prominence as a treatment in this type of pain; however, the application parameters are still controversial in the literature. This study aimed to review the literature on the use of LLLT in neuropathic pain with the goal of establishing a "therapeutic window" for the effective use of this treatment. We analyzed 14 articles, 10 in experimental animals and 4 in humans. The results are presented in three tables, the first being for comparison of the studies' application parameters, the second showing the average and median parameters experimental studies and third showing the clinical studies embodiment. The experimental studies revealed better results for LLLT and infrared laser powers above 70mW. Clinical studies are inconclusive as to the application parameters, due to the discrepancy; however all demonstrate the effectiveness of LLLT. According to the data presented, it was concluded that LLLT has positive effects on the control of analgesia for neuropathic pain, but further studies with high scientific rigor are needed in order to define treatment protocols that optimize the action LLLT in neuropathic pain.

Objective: To analyze the applicability of Body Knowledge dynamics in sensitizing children, through the expression of their experiences, to the practice of self-care. Methods: This descriptive and analytical study was conducted in May and June 2013 with six diabetic school-aged children attending the outpatient clinic of a referral hospital in Fortaleza, CE, Brazil. Results: The dynamics promoted a relaxed environment conducive to the expression of feelings and the reporting of basic care provided for diabetes. Sensitization was permeated with reflections upon the onset of the disease and current time. Thus, the children shared with their peers the need for care actions and learning concerning metabolic control. Conclusion: The application of Body Knowledge dynamics favored the development of educational activities with the participation of children, which promoted learning regarding self-care.

Congenital goiter is a rare cause of neonatal neck mass and may result from a fetal defectin synthesis of thyroxine, or administration of antithyroid drugs or iodides during pregnancy. The thyroid dysfunction often accompanies it. This report describes a case of a male term newborn with congenital goiter and primary hypothyroidism. Hormonal replacement treatment was started leading to normal levels of free thyroxine and triiodothyronine. In face of a maternal negative investigation, dyshormonogenesis was considered to be the most probable cause of hypothyroidism.

We report on a 9-year-old female patient who had bilateral severe visual loss and was treated with oral corticosteroids. Visual improvement occurred in one eye. Nine years later she presented relapse of visual loss in her only seeing eye. Pulse corticosteroid therapy resulted in dramatic visual improvement followed, however, by progressive and complete visual loss as soon as the corticosteroid was tapered. Repeat treatment did not result in visual improvement. Clinical and laboratory investigation failed to find a systemic disease but the patient had positive antinuclear (1/640), anti-Ro and anti-La antibodies. Autoimmune optic neuropathy is a rare condition that may mimic an idiopathic optic neuritis and is characterized by acute visual loss, without systemic disease but with laboratory evidence of an autoimmune disorder, usually a positive ANA. A skin biopsy usually shows evidence of vasculitis. This condition should be treated aggressively, with corticosteroids and immunosuppressant, since the visual involvement is usually worse than that of idiopathic/desmyelinating optic neuritis.

This study aimed to identify and characterize, in the health curriculum policy proposals at the State University of Ceara (UECE), the strategies used to organize the curriculum, interrelating and inte grating teaching and research. Sources included the curriculum policy proposals from the various courses and prevailing Brazilian national legislation for higher education. There are a total of 16 disciplines in Research Methodology: 5 in Nursing, 4 each in Biology and Physical Education; 2 in Nutrition; and 1 in Medicine. Physical Education was the only course that provided a continuous supply of disciplines throughout undergraduate training. The course syllabi showed a concentration of technical information in introductory disciplines during the early semesters and applied disciplines during the subsequent semesters. Positive changes were observed, like the implementation of a disci pline for writing the course monograph. However, the requirement of teaching scientific methodology and the course monograph are not sufficient to integrate research into teaching. There is a need for curricular adjustments and on-going evaluation of the curriculum policy proposals.

An accurate numerical visualization for streamlines of fluid flows is a fundamental tool in computational fluid dynamics. However, the standard finite element formulation to compute streamlines suffers from the disadvantage of requiring the determination of boundary integrals. This shortcoming requires the implementation of two distinct mappings in the finite element code, one for the interior domain employing two-dimensional elements and another with one-dimensional elements to approximate the boundary domain. We introduce an efficient way to determine the streamlines for the above-mentioned flows, which does not need the computation of contour integrals. In order to illustrate the good performance of the alternative formulation proposed, we capture the streamlines of two classical viscous models: Stokes and Navier-Stokes flows