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Introduction Surgery is one of the most frequently used options in the treatment of head and neck squamous cell carcinoma. In surgical patients, the use of arterial lactate to assess hypoxemia and severe inflammatory states is well-founded. However, there are few studies on its use in patients with head and neck squamous cell carcinoma. The aim of this study was to investigate whether the serum arterial lactate level on the 1st postoperative day would be a predictor of postoperative complications in head and neck squamous cell carcinoma surgeries. Methods This is a prospective cohort, which evaluated 44 adult patients of both genders, with HNSCC, who underwent surgery associated with monobloc neck dissection as an initial treatment. Patients were divided into two groups, according to the presence or absence of postoperative complications: with complication (Clavien-Dindo II-V) and without complications (Clavien-Dindo 0-I). Student’s t-test and its variants were used to compare continuous data. Pearson’s or Spearman’s test was used to correlate the data and p values 1.7 mmoL/L was identified, with a sensitivity of 65.38% and specificity of 66.67%. Conclusion Arterial lactate measured on the first postoperative day is a good predictor of postoperative complications in patients with head and neck squamous cell carcinoma. Resumo Introdução A cirurgia é uma das opções mais usadas no tratamento do carcinoma epidermoide de cabeça e pescoço. Nos pacientes cirúrgicos, o uso do lactato arterial para avaliação de hipoxemia e de quadros inflamatórios graves é bem fundamentado. Entretanto, existem poucos estudos sobre o seu uso em pacientes com carcinoma epidermoide de cabeça e pescoço. O objetivo deste estudo foi investigar se o lactato arterial sérico no 1° dia de pós‐operatório seria um preditor de complicações pós‐operatórias nas cirurgias do carcinoma epidermoide de cabeça e pescoço. Método Trata‐se de uma coorte prospectiva, que avaliou 44 pacientes adultos, de ambos os gêneros, com carcinoma epidermoide de cabeça e pescoço, submetidos a cirurgia associada ao esvaziamento cervical em monobloco como tratamento inicial. Os pacientes foram divididos em dois grupos, segundo a presença ou não de complicações pós‐operatórias: complicados (Clavien‐Dindo II a V) e sem complicações (Clavien‐Dindo 0-I). Na comparação dos dados contínuos, foi usado o teste t de Student e as suas variantes. Na correlação dos dados, usou‐se o teste de Pearson ou Spearman. Valores de p inferiores a 0,05 (p < 0,05) foram considerados estatisticamente significativos. Resultados Dos pacientes, 59% (n = 26/44) desenvolveram complicações pós‐operatórias. O lactato sérico foi significantemente maior no grupo com complicações em relação aos pacientes sem complicações, respectivamente 2,15 mmoL/L (1,10-3,90) e 1,59 mmoL/L (0,70-3,44); p = 0,03. A acurácia prognóstica do lactato arterial foi de 69% (95% IC 54%-82%; p = 0,03), estimada pela curva ROC. Foi identificado um cut‐off> 1,7 mmoL/L, com sensibilidade de 65,38% e especificidade de 66,67%. Conclusão O lactato arterial do primeiro dia de pós‐operatório é um bom preditor de complicações pós‐operatórias nos pacientes com carcinoma epidermoide de cabeça e pescoço.

Rationale and Objectives To evaluate associations between longitudinal changes of quantitative CT parameters and spirometry in patients with fibrotic hypersensitivity pneumonitis (HP). Materials and Methods Serial CT images and spirometric data were retrospectively collected in a group of 25 fibrotic HP patients. Quantitative CT analysis included histogram parameters (median, interquartile range, skewness, and kurtosis) and a pretrained convolutional neural network (CNN)-based textural analysis, aimed at quantifying the extent of consolidation (C), fibrosis (F), ground-glass opacity (GGO), low attenuation areas (LAA) and healthy tissue (H). Results At baseline, FVC was 61(44-70) %pred. The median follow-up period was 1.4(0.8-3.2) years, with 3(2-4) visits per patient. Over the study, 8 patients (32%) showed a FVC decline of more than 5%, a significant worsening of all histogram parameters (p≤0.015) and an increased extent of fibrosis via CNN (p=0.038). On histogram analysis, decreased skewness and kurtosis were the parameters most strongly associated with worsened FVC (respectively, r2=0.63 and r2=0.54, p

Background The ventriculoperitoneal shunt (VPS) procedure is still the most used technique for management of hydrocephalus. This article reports a case of hepatic cerebrospinal fluid (CSF) pseudocyst as a rare, but important, complication of the VPS insertion. Case Description An 18-year-old male presented to the hospital complaining of temporal headache and visual turbidity for approximately 3 months with a history of VPS insertion for treatment of hydrocephalus and revision of the valve in adolescence. The diagnosis was based on abdominal imaging, demonstrating an extra-axial hepatic CSF pseudocyst free from infection. Following the diagnosis, the management of the case consisted in the removal and repositioning of the catheter on the opposite site of the peritoneum. Conclusion The hepatic CSF pseudocyst is an infrequent complication of VPS procedure, but it needs to be considered when performing the first evaluation of the patient. Several techniques are considered efficient for the management of this condition, the choice must be made based on the variables of each individual case.

BACKGROUND: Augmentative and Alternative Communication (AAC) systems are used by people with motor disabilities, such as those with cerebral palsy (CP). The assessment of physical functional skills is crucial for appropriately choosing the computer access tool. OBJECTIVE: This study aimed to do a systematic literature review addressing the importance of the analysis of physical functional performance for the construction of specific tools to support communication. METHODS: The review followed PRISMA guidelines. We searched articles from 2009 to 2021 using three databases (PubMed, Lilacs in Portuguese, and SciELO). Three reviewers extracted the data. Registration was made to PROSPERO. The risk of bias was assessed using the Cochrane Collaboration tool. RESULTS: We found 132 articles in the databases. First, we excluded 31 articles because they did not provide evidence for the use of alternative communication in people with CP and did not use high technology resources. We also excluded 57 duplicated articles. At the end of this first step, 44 articles were left, 38 of them were excluded because they are not clinical trials. We selected 6 articles for the final analysis. CONCLUSIONS: The systematic review had a positive impact on the precise dissemination of knowledge ensuring comparisons of interventions and articles such as assistive technology programs.

Chronic hypersensitivity pneumonitis (cHP) is a heterogeneous condition, where both small airway involvement and fibrosis may simultaneously occur. Computer-aided analysis of CT lung imaging is increasingly used to improve tissue characterization in interstitial lung diseases (ILD), quantifying disease extension, and progression. We aimed to quantify via a convolutional neural network (CNN) method the extent of different pathological classes in cHP, and to determine their correlation to pulmonary function tests (PFTs) and mosaic attenuation pattern.The extension of six textural features, including consolidation (C), ground glass opacity (GGO), fibrosis (F), low attenuation areas (LAA), reticulation (R) and healthy regions (H), was quantified in 27 cHP patients (age: 56 ± 11.5 years, forced vital capacity [FVC]% = 57 ± 17) acquired at full-inspiration via HRCT. Each class extent was correlated to PFTs and to mosaic attenuation pattern.H showed a positive correlation with FVC%, FEV1% (forced expiratory volume), total lung capacity%, and diffusion of carbon monoxide (DLCO)% (r = 0.74, r = 0.78, r = 0.73, and r = 0.60, respectively, p0.001). GGO, R and C negatively correlated with FVC% and FEV1% with the highest correlations found for R (r = -0.44, and r = -0.46 respectively, p0.05); F negatively correlated with DLCO% (r = -0.42, p0.05). Patients with mosaic attenuation pattern had significantly more H (p = 0.04) and lower R (p = 0.02) and C (p = 0.0009) areas, and more preserved lung function indices (higher FVC%; p = 0.04 and DLCO%; p = 0.05), but did not show more air trapping in lung function tests.CNN quantification of pathological tissue extent in cHP improves its characterization and shows correlation with PFTs. LAA can be overestimated by visual, qualitative CT assessment and mosaic attenuation pattern areas in cHP represents patchy ILD rather than small-airways disease.

Bariatric surgery has undeniable benefits for cardiovascular and metabolic health, but it can result in negative effects on mineral and bone metabolism. This study aimed to review the current data on fractures after the main types of bariatric surgery.Therefore, a systematic review was performed using the electronic literature available in the databases LILACS, CENTRAL, Web of Science, Embase, and PubMed/MEDLINE, with results until January 2021. Keywords were descriptors for bariatric surgery or bariatric medicine or bariatrics or gastroplasty and bone or bones or bone fractures, referenced in all words of the text in the study.The meta-analysis of observational studies and interventional trials showed that the risk of any type of fracture was higher in the surgical group than in the nonsurgical group (relative risk [RR], 1.20 [95% confidence interval {CI}, 1.15-1.26; P.00001; Phetero0.000001; IWe found that bariatric procedures are associated with an increased risk of fractures, especially the malabsorptive techniques.

Objectives The management of Optic Nerve Sheath Meningiomas (ONSM) has suffered a significant shift due to new radiation techniques. However, there is no conclusive information on which approach presents better results in the literature. This meta-analysis aims to evaluate the outcomes of different radiotherapy (RT) modalities in the management of ONSM. Methods A systematic review based on an electronic search was performed in MEDLINE, EMBASE, Cochrane, and Lilacs databases. Eligible studies included patients with ONSM treated with RT. Two reviewers independently assessed the eligibility of potential studies, extracted data, and performed the meta-analysis. Outcomes of interest were tumor control, visual acuity (VA), visual field, and complications. Results Thirty-nine non-comparative studies involving 736 eyes with ONSM treated with RT were included. Six different techniques were studied: 2-dimensional RT (2DRT), 3D-conformal RT (3CRT), Stereotactic Fractionation RT (SFRT), stereotactic radiosurgery (SRS), intensity-modulated RT (IMRT), and proton beam therapy (PBT). With a mean follow-up period of 46 months, tumor control was 97,4% (95% CI: 98–100%). No difference was observed regarding the rate of final VA post-treatment among the modalities. The 3CRT showed substantially higher rates of complication than other techniques. Conclusions RT produces remarkable tumor control. New radiation modalities such as SFRT, IMRT, SRS, and PBT resulted in better therapeutic results with fewer complications than 2DRT and 3CRT. Thus, they should be the preferential choices for treating ONSM regardless of initial clinical presentation.

Avaliar a qualidade assistencial através da utilização de indicadores é uma realidade dentro do conceito de boa administração hospitalar e, portanto, uma meta a ser alcançada para a execução de uma boa prática na gestão dos serviços hospitalares. Nesse trabalho, queremos nos debruçar sobre a melhor utilização dos indicadores já conhecidos e a possibilidade de construção de novos a partir dos dados contidos nos prontuários hospitalares que visem ao melhor gerenciamento do curso do paciente em sua jornada intra-hospitalar com ênfase em antecipação ou prevenção de complicações e, consequente redução de mortalidade na fase nosocomial. Para atingir esse objetivo, buscamos na literatura, através de revisão bibliográfica e análise de dissertações e teses como a construção de indicadores e sua utilização para análises do curso hospitalar em diversas patologias, podem propiciar um conhecimento fundamental para o manejo clínico da evolução dos pacientes hospitalizados. Em conclusão, propomos uma série de outros dados contidos nos prontuários em que tem, ao nosso ver, potencial para integrarem novos indicadores assistenciais e, que juntos com a análise sistemática daqueles já tradicionais possam de fato serem usados como indicadores de gravidade e desempenho durante a evolução do curso intra-hospitalar do paciente.

Objective The present study aimed to observe the differences in the dissipation of the main minimum stresses with the use of a fixed pontic partial prosthesis supported by two regular length implants in cortical and medullary bone tissues of different qualities. Materials and Methods Experimental groups were as follows: QI (two regular length implants with fixed pontic partial prosthesis and bony qualities consistent with type I), QII (identical to QI, with bony qualities consistent with type II), and QIII (identical to QI, with bony qualities consistent with type III). All the groups were developed and analyzed in virtual simulation environment using AnsysWorkbench software. Results The results showed highest stress concentrations in the region of the turns of the implants, especially in the apical region surrounding the implants and most notably in those positioned in the posterior region, supporting the molars. In addition, comparing the cortical bone among the groups, the results revealed increasing levels of stress in the order of QI, QII, and QIII. Comparing the medullary bone among the groups, the results revealed increasing levels of stress in the order of QIII, QII, and QI. Conclusion It was concluded that greater stress disparity occurred in the comparison between groups QI and QIII. There was a higher TMiP in QI in the cortical bone, but considering the literature values, it would not pose risks to its physiological limits. The use of a pontic fixed partial prosthesis on two regular implants of type III bone quality may cause unfavorable physiological repercussions for the posterior implant apical medullary bone.

Made available in DSpace on 2022-04-29T08:36:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives The aim of this study was to verify during facial expressions (happy, sad, fearful, angry, surprised, and disgusted) if: (1) there would be difference in the electromyography (EMG) of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles on the normal side (NS) compared with the affected side (AS) (without the use of an ocular prosthesis) in individuals with unilateral absence of the eyeball, and (2) the rehabilitation with a new ocular prosthesis would affect the EMG of the muscles studied on the AS in these individuals. Materials and Methods Thirteen individuals, without temporomandibular disorder, with good health, with unilateral absence of the eyeball (the eye must have been removed by evisceration or enucleation), and users or nonusers of an ocular prosthesis were included. EMG of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles was performed during rest and facial expressions (happy, sad, fearful, angry, surprised, and disgusted) before (T0) and 90 days after (T1) rehabilitation with a new ocular prosthesis. The analyses were performed in T0 on NS and AS (without the use of an ocular prosthesis), and in T1 on AS with the new ocular prosthesis. Statistical Analysis All data were submitted to the Student's t -test with p < 0.05. Results There was no statistically significant difference comparing the AS with the NS in T0 for all muscles studied, during all facial expressions evaluated (p > 0.05). There was no statistically significant difference comparing the AS in T0 with itself in T1 for all muscles studied, during all facial expressions evaluated (p > 0.05). Conclusion Eye loss did not affect the EMG of studied muscles when comparing NS with AS (without the use of an ocular prosthesis). The rehabilitation with ocular prosthesis was not capable of changing the EMG on AS. Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba

Made available in DSpace on 2022-04-28T19:47:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: The aim of this study was to investigate the TMJ components in patients with juvenile idiopathic arthritis (JIA) and to compare them with a control group based on magnetic resonance imaging (MRI) measurements. Methods: This study comprised an assessment of MRI measurements of 96 temporomandibular joints (TMJ) following classification criteria set by the International League of Associations for Rheumatology (ILAR). Three measurements were considered for study: condyle excursion angle (CEA), height of articular eminence (HAE) and inclination of articular eminence (IAE). All TMJs were assessed by linear measurements made by using the OnDemand 3D software. The comparison between the groups was performed by using Mann–Whitney’s test. Results: Lower measurement values were found for IAE, HAE and CEA in JIA patients (P-values < 0.001, 0.005 and < 0.001, respectively). Conclusion: The study showed the differences in MRI measurements between JIA patients and controls, with the former with the lowest indices. Postgraduate Program in Dentistry Cruzeiro Do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade Rheumatology Department Faculty of Medical Sciences University of Campinas (UNICAMP) Department of Diagnosis and Surgery São José Dos Campos School of Dentistry São Paulo State University (UNESP) Department of Orthodontics Univeritas UNG Department of Oral Medicine and Pathology Institute of Odontology The Sahlgrenska Academy University of Gothenburg Department of Diagnosis and Surgery São José Dos Campos School of Dentistry São Paulo State University (UNESP)

The analysis of drugs in wastewater for forensic purposes has been constantly increasing and the investigation of the potential interaction between drugs or metabolites and sewage microbiota is important. The results demonstrated that cocaine esterase genes were widely distributed in 1142 global wastewater samples collected from 64 countries and linked to several bacterial species. In addition, in silico predictions indicated that carfentanil, 4F-MDMB-BINACA, 5F-MDMB-PICA, MDMB-4en-PINACA and mitragynine might also undergo microbial hydrolysis, in a similar fashion of cocaine degradation by cocaine esterase. In conclusion, it was demonstrated the microbial potential to hydrolyze drugs of abuse in wastewater environments, contributing to the critical evaluation of potential metabolites as biomarkers for microbial and human transformation of drugs in wastewater.

Os microrganismos são altamente adaptáveis capazes de crescer em superfícies e até mesmo em seres humanos, visto que são oportunistas e utilizam somente a transcrição de genes para se adaptar e multiplicar. Sendo assim, os objetivos deste estudo foram de identificar os microrganismos presentes nos manguitos dos esfigmomanômetros (aparelho de pressão) utilizados nas Unidades Básicas de Saúde (UBS) e Estratégias de Saúde da Família (ESF) da cidade de Itajubá, MG. Trata-se de uma pesquisa quantitativa, transversal e descritiva. A amostra foi composta por 20 unidades e indicou-se a presença de microrganismos do tipo Staphylococcus Aureus (30%) e Serratia Marcescens (5%). Conclui-se que a colonização nos profissionais, aparelhos de pressão e demais equipamentos utilizados nas unidades, pois os mesmos passam a ser os principais reservatórios e disseminadores de bactérias no ambiente e de pessoa para pessoa.

Background: Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. Objective: To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. Methods: We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. Results: We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. Conclusion: This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians. Resumo Antecedentes: A percepção errônea da verticalidade é relativamente comum em pacientes após Acidente Vascular Cerebral (AVC) e pode ser avaliada pelas: (a) vertical visual subjetiva (SVV), (b) vertical háptica subjetiva (SVH) e (c) vertical postural subjetiva (SPV). Para melhor compreender esses métodos de avaliação, realizamos uma revisão sistemática das características metodológicas de diferentes protocolos para avaliações de SVV, SHV e SVP em indivíduos após AVC. Objetivo: Padronizar as características metodológicas de protocolos de avaliação da verticalidade após AVC. Métodos: Foi realizada busca nas bases de dados PUBMED, Portal Regional da BVS (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index, LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Biblioteca Cochrane e PEDro. Dois revisores avaliaram independentemente o QUADAS (Avaliação da Qualidade dos Estudos de Precisão de Diagnóstico) e extraíram os resultados. Resultados: Foram incluídos 21 estudos: a maioria (80,9%) utilizando a SVV, oito (38,1%) a SPV e quatro (19,0%) a SHV. Observou-se grande variabilidade na avaliação da verticalidade, devido às posições dos pacientes, dispositivos utilizados, número de repetições e ângulo de inclinação para iniciar os testes. Conclusão: Esta revisão sistemática é uma das primeiras a explorar todos os métodos de avaliação da verticalidade após o AVC e fornece informações cruciais sobre como realizar os testes para orientar os futuros pesquisadores e clínicos.

The objective of this work was to clarify the importance of using marketing strategies to build a brand that, in turn, will lead the company to success. The theoretical foundation is based on the concepts of marketing, integrated marketing communication, brand and branding. The integrated marketing communication contributes to the strengthening of the brand through branding actions, which allow a better strategic positioning in the market. The methodology of this work consists of a bibliographical study, due to the need to relate these three theoretical elements that, in a structured way, bring countless benefits for all organizations. This study has shown that brand management is an important strategic tool for the success of a company and that its rise depends on the message of trust that it expresses to customers.

Caminhar pelo espaço urbano pode propiciar trocas e atividades sociais durante o percurso do pedestre, além de constituir a forma de deslocamento mais natural, saudável, econômica e limpa para curtos trajetos, integrando ainda grande parte das viagens de transporte coletivo. No entanto, o ato de caminhar é sensível às condições ambientais e nem sempre nos deparamos com uma estrutura viária amigável para o pedestre. Estudar a caminhabilidade em regiões da cidade permite avaliar as condições do espaço urbano. Esse artigo buscou analisar a caminhabilidade no entorno de duas praças públicas inseridas na paisagem urbana da cidade de Campos dos Goytacazes – Praça do Santíssimo Salvador e Praça Santo Antônio – utilizando 15 indicadores para compor um Índice de Caminhabilidade, com classificações que variam de insuficiente a ótimo. Essa análise teve como propósito promover um novo olhar sobre o meio urbano sob a ótica do pedestre e foi dividida em seis diferentes categorias: calçada; mobilidade; atração; segurança viária; segurança pública; e ambiente. A análise resultou em um Índice de Caminhabilidade classificado como “bom” na Praça do Santíssimo Salvador e como “suficiente” na Praça Santo Antônio, demonstrando que o espaço destinado ao pedestre é mais bem estruturado na região central da cidade.

A anemia por carencia de ferro durante a gravidez tem alta prevalencia e compoem diferentes etiologias. E capaz de diminuir niveis de hemoglobina, eritropoiese e ferritina levando a desordens orgânicas e ate complicacoes graves para a gestante e o feto. O hemograma e a avaliacao dos niveis de ferritina serica ajudam no diagnostico. E necessario a suplementacao das deficiencias nutricionais adequadas como medidas preventivas e para diminuir o risco de complicacoes gestacionais. Nesse contexto, pretende-se com essa revisao integrativa apresentar os principais aspectos envolvidos na gravidez em decorrencia de anemia ferropriva.A anemia e uma doenca de multifatorial, sendo que na gravidez a sua prevalencia torna-se importante, pois afeta uma media de 50% das gestantes. Este estudo trata-se de uma revisao narrativa na qual foram consultadas as bases de dados MEDLINE, LILACS e SciELO. Foram selecionados 10 artigos em portugues e ingles que abordavam os cotermos “anemia gestacional” e “anemia ferropriva”. As alteracoes ocorridas no periodo gestacional, como a reducao dos niveis de hemoglobina e a eritropoiese ineficaz associadas a fatores de risco levam a uma deplecao de ferro gerando, assim, uma anemia ferropriva. Dessa forma, ocorrem manifestacoes clinicas como o descolamento prematuro de placenta, pre-eclâmpsia, parto prematuro e aborto espontâneo que estao associadas a maior morbimortalidade fetal e materna. Assim, visando amenizar os riscos da anemia gestacional, faz-se necessario a utilizacao de medidas preventivas, como proposto pela OMS e pelo MS, portanto faz-se importante a suplementacao com sulfato ferroso.

Considering the importance of the evaluation of quality and performance attributes of herbal medicines, this work evaluated a gynecological gel containing aroeira (Schinus terebinthifolius Raddi), which was previously registered in 2001, and is still marketed in Brazil. Using the updated guides and legislation as a basis, the product was evaluated by checking the pH, spreadability, rheological behavior, in vitro release test, ex vivo permeation and retention study using porcine vaginal mucosa in Franz diffusion cells, and histological evaluation of the porcine vaginal mucosa before and after application of the product. After the permeation study, it was verified that gallic acid (chemical marker quantified) does not cross the mucosa, therefore, it is safe for local use. In addition, the pH of the formulation is within the range considered normal for use in healthy women. Finally, the histological evaluation of the mucosa showed changes compatible with the application of tannins (major compounds of the plant), and without changes indicative of loss of tissue integrity.

Background: Neural cells undergo functional or sensory loss due to neurological disorders. In addition to environmental or genetic factors, oxidative stress is a major contributor to neurodegeneration. In this context, there has been a growing interest in investigating the effects of EOs (EOs) in recent years, especially in the treatment of neuropathologies. The chemical and biological effects of EOs have led to important treatment tools for the management of various neurological disorders. Objective: In the present study we performed a systematic review that sought to comprehend the neuroprotective effects of different EOs. Method: This work is a systematic review where an electronic search was performed on PubMed, ScienceDirect, Cochrane Library and SciELO (Scientific Electronic Library Online) databases, covering the last 10 years, using “Essential oil” and “Neuroprotective effect” as reference terms. Results: A total of 9 articles were identified, in which the efficacy of EOs was described in experimental models of anxiety, dementia, oxidative stress, cerebral ischemia, Alzheimer’s disease, and oxidative toxicity. Conclusion: EOs from different species of medicinal plants have shown positive responses in neurological disorders such as anxiety, dementia, oxidative stress, cerebral ischemia, and oxidative toxicity. Thus, EOs emerges with the potential to be used as alternative agents in the treatment of neurological disorders.

Introdução: A COVID-19 espalhou-se pelo mundo em 2020, tornando-se um problema de saúde pública mundial, responsável pela morte de milhares de pessoas em diversos países, especialmente os pais populosos, como o Brasil. Nessa perspectiva, o Sistema Único de Saúde no âmbito de suas diversas atribuições e complexidades, de modo a garantir o acesso integral e universal a saúde, em seus diversos níveis de atenção, reorganizou os cenários de modo a ofertar e atender às demandas necessárias diante do novo cenário. Objetivo: Avaliar a importância das estratégias de prevenção e condutas dos serviços de Atenção Primária a Saúde no enfrentamento da pandemia da COVID-19. Métodos: Trata-se de uma Revisão Sistemática da literatura e as plataformas literárias utilizadas para a busca dos periódicos foram LILACS e Pubmed. Discussão: A APS torna-se fundamental no controle da transmissão do COVID-19, pois detém de estratégias eficientes de contenção da transmissão, proteção e cuidado. Conclusão: A APS tem grande potencial de dar resolutividade aos casos suspeitos, com síndrome gripal e de manejar quadros leves, de modo a auxiliar na manutenção de leitos livres e diminuição dos custos ao sistema de saúde.

Submitted by Aline Silva (alineslv@ufba.br) on 2022-05-26T20:04:50Z No. of bitstreams: 1 Artigo - Gillian L. Lima.pdf: 364716 bytes, checksum: 56e9595730da19c0f68ff09d791c8022 (MD5) Approved for entry into archive by Urania Araujo (urania@ufba.br) on 2022-06-02T19:45:40Z (GMT) No. of bitstreams: 1 Artigo - Gillian L. Lima.pdf: 364716 bytes, checksum: 56e9595730da19c0f68ff09d791c8022 (MD5) Made available in DSpace on 2022-06-02T19:45:40Z (GMT). No. of bitstreams: 1 Artigo - Gillian L. Lima.pdf: 364716 bytes, checksum: 56e9595730da19c0f68ff09d791c8022 (MD5) Previous issue date: 2021-10-08 Objetivo: realizar análise bibliométrica sobre as aplicações da ciência de dados no âmbito das organizações hospitalares. Método: por meio de pesquisa na base de dados Web of Science, verificou-se a existência de termos relacionados à ciência de dados, tais como “big data”, “data analytics”, “businesss intelligence”, “data mining”, “data warehouse”, “text mining” e “data science", relacionando-os a hospitais. A análise de dados pautou-se na técnica de análise de redes sociais. O período considerado foi de 2015 a 2019 . Resultado: “machine learning” e “electronic health records” despontam como assuntos relevantes. As interações mais expressivas refletem a inclinação da informática médica em assuntos relacionados à tomada de decisão, sistemas de informação para hospitais e unidade de cuidados intensivos. Sobre os campos científicos, nota-se a predominância esperada da área de saúde e dos domínios pertencentes ou fronteiriços à tecnologia. No mais, vê-se que a grande variedade de áreas encontradas acusa a natureza multidisciplinar do assunto, inclusive com importante participação da Ciência da Informação (CI). Em relação à geografia do conhecimento, observa-se um razoável grau de descentralização, havendo produções representativas na América do Norte, Europa e Ásia. Quanto aos veículos de publicação, destaque para os Studies in Health Technology and Informatics, que compreendem uma série de publicações. Os dois periódicos mais representativos da lista, integram, respectivamente, os grupos Springer Nature e Elsevier, grandes players do mercado editorial científico. Conclusões: por fim, evidencia-se a multidisciplinaridade existente em torno do assunto estudado e a relevância da tecnologia para o progresso das organizações hospitalares. Objective: to carry out the bibliometric analysis on the applications of Data Science in the context of hospital associations. Methods: Through research in the Web of Science database, it was verified the existence of terms related to Data Science, such as, big data, data analysis, businesss intelligence, data mining, data warehouse, text mining and data science, relating them to hospitals. Data analysis was based on the social network analysis technique. The period considered was from 2015 to 2019. Results: Machine learning and electronic health records emerge as relevant issues. The most expressive interactions reflect the inclination of Medical Informatics in matters related to decision making, information systems for hospitals and intensive care units. Regarding the fields, it is noted the expected predominance of the Health area and of the domains belonging or bordering on Technology. In addition, it can be seen that the wide variety of areas found accuses the interdisciplinary nature of the subject, including, with an important participation of Information Science. Regarding the geography of knowledge, there is a reasonable degree of decentralization, with representative productions in North America, Europe and Asia. As for the publication vehicles, emphasis is given to Studies in Informatics and Health Technology, which comprise a series of publications. The two most representative journals on the list are, respectively, members of the Springer Nature and Elsevier groups, major players in the scientific publishing market. Conclusions: Finally, there is evidence of the multidisciplinarity around the subject studied and the technology company for the progress of hospital associations.

Introduction. In clinical practice, it is difficult to define the prognosis of patients with acute encephalopathy; a syndrome characterized by cognitive dysfunction and altered sensorium. Discharges with triphasic morphology (DTM) are an electroencephalographic pattern that might be useful to establish the risk of death. The aim of this study was to define the prognostic value of DTM regarding mortality in patients with acute encephalopathy. Methods. We conducted an observational retrospective cohort study including patients with acute encephalopathy with and without DTM paired by age and gender in a 1:2 ratio. We calculated the odds ratio (OR) to determine the association between DTM and mortality. In addition, we calculated sensibility, specificity, and predictive values. Results. We included 72 patients, 24 with DTM and 48 without DTM. Mortality was higher in patients with DTM (41.6% vs 14.5%, P = .01). Factors associated with a higher risk of death were DTM (OR = 4.1, 95% confidence interval [CI] 1.3-13, P = .01) and sequential organ failure assessment score (OR = 1.3, 95% CI 1.04-1.67, P = .02). A higher Glasgow coma scale score was associated with a lower risk of death (OR = 0.65, 95% CI 0.51-0.83, P = .001). The sensibility and specificity of DTM were 59% and 75%, respectively. Positive and negative likelihood ratios were 2.36 and 0.55. Discussion. Our results revealed high mortality in patients with acute encephalopathy and DTM. This electroencephalographic pattern was associated with 4 times higher risk of death. However, its usefulness for predicting death was limited.

Ações de educação em saúde em grupo apresentam vantagens em relação às intervenções individualizadas. A educação alimentar e nutricional realizada em grupos possui baixo custo de operacionalização, ampla abrangência, contribui com o fortalecimento de redes sociais, além de ser um método efetivo de promoção da saúde. No entanto, é necessário conhecer os participantes, a fim de que as intervenções possam ser orientadas. Nesse sentido, o objetivo desse estudo foi caracterizar o perfil socioeconômico, padrão de consumo alimentar e o estado nutricional de participantes de uma ação de educação alimentar e nutricional em grupo. Trata-se de um estudo seccional realizado com 26 indivíduos matriculados em uma Universidade Aberta à Pessoa Idosa. Os dados foram obtidos por meio de questionários socioeconômico, inquéritos dietéticos e avaliação antropométrica. Os resultados indicaram que a população estudada apresenta renda mensal e escolaridade superior à média da população brasileira, elevada frequência de inadequação quanto a distribuição dos macronutrientes, em especial, de lipídios (n=13); elevada frequência de ingestão aumentada de ácidos graxos saturados (n=16), trans (n=14) e de sódio (n=9); elevado número de participantes consumindo fibras alimentares (n=18) e cálcio abaixo (n=23) do preconizado; e inadequação para a ingestão de vitamina D (n=26). Houve predomínio de sobrepeso, risco cardiovascular e frequência acima de 35% de situação de atenção para a redução de massa muscular. A realização desta pesquisa permitiu entender o contexto social dos participantes e identificar as necessidades nutricionais, norteando a escolha de temas e as metodologias para as ações de educação alimentar e nutricional em grupo.

Beaches are key territories for tourist development but at risk of impacts of climate change—specifically with the consequent intensification of coastal erosion. This study examines the effects of coastal erosion on the distribution of lodging facilities and the value of daily rates practiced on the beaches of Tabuba and Cumbuco on the northeast coast of Brazil. The methodology comprises collecting information on the means of accommodation (distribution and daily rate), quantifying coastline variation and measuring the field to validate data. A total of 13.9 km of coastline were analyzed; erosion tendency was observed in 26.8% of the coast (9.0% erosion, 14.4% intense erosion, and 3.4% severe erosion). With the highest erosion rates, Tabuba's Beach has a low density in accommodation distribution and daily rates practiced in tourism. Cumbuco's Beach, conversely, has a lower risk of erosion, and the means of accommodation are concentrated. Coastal erosion has affected tourism development in Caucaia, influencing the choice of tourism accommodation entrepreneurs. the results indicate that there is a clear concentration of tourist accommodations in areas without notorious problems with coastal erosion, influencing in the distribution of tourist facilities and their daily rates. So, there is a direct connection does exist between local tourism system income and the beaches with problems with coastal erosion.

Purpose: We performed an exploratory analysis of prostate cancer-related pain and fatigue on health-related quality of life in patients with metastatic castration-sensitive prostate cancer receiving apalutamide (240 mg/day) or placebo, with continuous androgen deprivation therapy (ADT), in the phase 3, randomized, double-blind, placebo controlled TITAN trial (NCT02489318). Materials and Methods: Patient-reported outcomes for pain and fatigue were evaluated using the Brief Pain Inventory-Short Form and Brief Fatigue Inventory. Time to deterioration (TTD) was estimated by Kaplan-Meier method; hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards model. General estimating equations for logistic regression estimated treatment-related differences in the likelihood of worsening pain or fatigue. Results: Compliance for completing the Brief Pain Inventory-Short Form and Brief Fatigue Inventory was high (96% to 97%) in the first year. Median followup times were similar between treatments (19 to 22 months). Median pain TTD was longer with apalutamide than placebo for pain at its least in the last 24 hours (28.7 vs 21.8 months, respectively; p=0.0146), pain interfered with mood (not estimable vs 22.4 months; p=0.0017), pain interfered with walking ability (28.7 vs 20.2 months; p=0.0027), pain interfered with relations (not estimable vs 23.0 months; p=0.0139) and pain interfered with sleep (28.7 vs 20.9 months; p=0.0167). Likelihood for fatigue and worsening fatigue were similar between groups. Conclusions: Patients with metastatic castration-sensitive prostate cancer receiving apalutamide plus ADT vs placebo plus ADT reported consistently favorable TTD of pain. No difference for change in fatigue was observed with apalutamide vs placebo. Janssen Research Development; Janssen Global Services, LLC The authors would like to thank the patients who participated in this study and their families, as well as the investigators, study coordinators, study teams and nurses. The TITAN study was funded by Janssen Research & Development. Editorial assistance was provided by Patricia McChesney, PhD, of Parexel, with funding from Janssen Global Services, LLC.

Objective To assess the change in temperature caused by different short wave diathermy (SWD) methods of application in different healthy tissues. Data sources The Cochrane Central Register of Controlled Trials, MEDLINE, Science Direct, CINAHL, SciELO, PEDro, ClinicalTrials.gov , Brazilian Registry of Clinical Trials and the World Health Organization ICTRP were searched (1990–April 2020). Methods Randomized, quasi-randomized, and single-arm controlled trials assessing temperature change after SWD application in healthy adults were included. Group analysis was done according to SWD mode and where temperature was collected, risk of bias was assessed using the Cochrane tool and the quality of evidence using GRADE. A narrative synthesis was conducted since methodological homogeneity was not sufficient to undertake a meta-analysis. Results Eleven studies were included, reporting data of 240 subjects. Regarding skin temperature change, the application that increased temperature the most was under the electrode using continuous SWD on coplanar arrangement of capacitive technique (7.9 [1.76] °C), coplanar arrangement also had the slowest temperature decay, and the lowest temperature found was through a low dose application of pulsed SWD (0.34 [0.69] °C). Regarding muscle temperature change, the application that increased temperature the most was using the inductive technique of pulsed SWD (4.58 [0.87] °C), this technique also had the slowest temperature decay, and the lowest temperature found was through ReBound shortwave diathermy (2.31 [0.87] °C). Conclusion SWD efficacy depends on setting choices. This review provides a detailed description of SWD methods of application and a quantitative data set of resulting temperature change.

Background Adoption of molecular pathology in Brazil is currently very limited. Of note, there are no programs for training new molecular pathologists in the country; thus, documents compiling nationally applicable information on molecular pathology are few. Methods A selected panel of Brazilian experts in fields related to molecular pathology were provided with a series of relevant questions to address prior to the multi-day conference. Within this conference, each narrative was discussed and edited by the entire group, through numerous drafts and rounds of discussion until a consensus was achieved. Results The panel proposes specific and realistic recommendations for implementing molecular pathology in cancer care in Brazil. In creating these recommendations, the authors strived to address all barriers to the widespread use and impediments to access mentioned previously within this manuscript. Conclusion This manuscript provides a review of molecular pathology principles as well as the current state of molecular pathology in Brazil. Additionally, the panel proposes practical and actionable recommendations for the implementation of molecular pathology throughout the country in order to increase awareness of the importance molecular pathology in Brazil.

Low back pain is one of the main musculoskeletal complaints, and may be associated with central sensitization (CS). The physical capacity of patients with low back pain and CS is not very clear.A cross-sectional study, with 92 patients divided into two groups according to their risk of CS. The patient's physical capacity ability was assessed using 6-min walking test (6MWT); timed up and go test (TUG); sit-to-stand test (STS); and trunk flexor, extensor and side-bridge endurance tests. In addition, participants completed questionnaires regarding disability, kinesiophobia, catastrophization and quality of life.The group with a higher risk of CS had worst performance in the 6MWT (U = 1248; p 0.001), STS (t(83) = 3.63; p 0.001) and TUG (t(83) = -4.46; p 0.001). Similarly, endurance in the right (U = 1453,5; p = 0,002) and left (U = 1467; p = 0,003) side-bridge tests, and the trunk extensor test (U = 1546; p = 0,003) was worse. Disability (U = 1272; p 0.001), physical capacity kinesiophobia (t(83) = -2.21; p = 0.03) work kinesiophobia (U = 1452; p 0.001), and pain catastrophization (t(77.57) = -5.03; p 0.001), were also higher in the group with a higher risk of CS. Quality of life indicators were worse in the higher risk group for all domains of the EQ-5D-3L: Mobility (XPatients with low back pain and higher risks of CS appear to show lower performance in physical capacity tests, higher rates of disability, kinesiophobia, pain catastrophization, and lower quality of life compared to those with lower risks of CS.

Laser therapies are noninvasive techniques with painless, safe, and low-cost therapeutic procedures for chronic pain. No systematic review has evaluated the effects of laser in the treatment of multi-site chronic pain. Objective: To evaluate the effects of laser in the treatment of generalized multi-site chronic pain. Methods: This pioneering study presents a PRISMA systematic review protocol designed to up-to-date the current literature on Laser Therapy in patients with chronic multi-site pain from all founded etiologies. This protocol was registered on the PROSPERO website before data extraction (registration no. CRD42019152345). Results: About 1391 articles met the inclusion criteria and 15 studies were selected for the data extraction. We found 12 studies in patients with fibromyalgia, 01 study about myofascial pain syndrome, 01 study about rheumatoid arthritis and 01 study about diabetic sensorimotor polyneuropathy. Homogeneity was not found in the Laser protocols, clinical conditions studied, the evaluation methods, or in the controlled groups but together studies suggested that Laser could have benefits in the treatment of pain severity, quality of life, fatigue, stiffness, depression, and anxiety compared to placebo and other therapies for fibromyalgia and for pain at Rheumatoid Arthritis and Diabetic Polyneuropathy. Conclusion: Laser therapy plus the standardized exercise or amitriptilyne provided no extra advantage in the relief of symptoms at fibromyalgia. For TMD myofascial pain no benefits were founded. Studies showed numerous different points and locations of light application but none of the selected studies used spinal stimulation as the Laser application site.

This study aimed to evaluate the renal function of six bitches of various breeds and ages, with open pyometra, attended in the Small Animal Medical Clinic sector of the Veterinary Hospital from Federal University of Campina Grande, through the measurement of laboratory tests: urea and creatinine serum, dosage of the urinary Protein-Creatinine Ratio (PCR), urinary gamma-glutamyltransferase (GGT) and determination of the renal resistivity index (RI). The levels of urea and creatinine were elevated in 16.6% (1/6) of the female dogs; the urinary protein-creatinine ratio was increased in 66.6% (4/6), while the urinary gamma-glutamyltransferase value was elevated in 50% (3/6). The renal resistivity index was increased in the right and left kidneys by 66.6% (4/6) of bitches, with no statistical difference between them. It was concluded that the renal resistivity index was a practical and effective method to assist in the diagnosis of acute kidney injury, along with other early markers, such as PCR and urinary GGT.

Case report

The aim of this study was to determine whether the first sensation of stretching (ROMFSS) may predict the maximum range of motion (ROMMAX) in male (N = 37) and female (N = 32) volunteer subjects, and to assess the reliability of the ROM perceived by subjects in relation to a pre-determined ROM (ROM50%). Subjects attempted three experimental sessions with 48 hours between sessions 1 and 2 and 28 days between sessions 1 and 3. Within each session, five trials were performed with isokinetic equipment to assess posterior thigh muscle flexibility. The results revealed a strong and significant correlation between ROMMAX and ROMFSS for both sexes, females (r = 0.96, p < 0.001, R2 = 0.92) and males (r = 0.91, p < 0.001; R2 = 0.82). The accuracy of the model verified by the standard error of estimate (SEE) was high in the equations proposed for both female (SEE = 4.53%) and male (SEE = 5.45%). Our results revealed that ROMFSS may predict the ROMMAX for both male and female subjects. The ROMFSS may contribute to the development of evaluation methods that do not subject the individuals to conditions that may include unnecessary risk of injury and is well suited to monitor the training process of stretching exercises with submaximal loads. Key points An individual’s tolerance to stretching can be considered a continuum marked by the first sensation of stretching and the maximum range of motion as the continuum’s end-points. The first sensation of stretching and the point representing halfway between the first sensation and maximal range of motion are reliable measures in young men and women. The first sensation of stretching may be a safe and useful predictor of maximal range of motion.

Made available in DSpace on 2022-04-29T08:31:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19. Department of Internal Medicine Medical School Universidade Federal de Minas Gerais Telehealth Center University Hospital Universidade Federal de Minas Gerais Institute for Health Technology Assessment IATS/ CNPq)., Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507 Department of Statistics Universidade Federal de Minas Gerais Center for Research and Graduate Studies in Business Administration Universidade Federal de Minas Gerais Universidade Federal de São João del-Rei Infectious Diseases Department Vall d'Hebron University Hospita Universitat Autònoma de Barcelona Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor Grupo Hospitalar Conceição Pontifícia Universidade Católica do Rio Grande do Sul RGS) Hospital São Lucas PUCRS Rede Mater Dei de Saúde Hospital Márcio Cunha Universidade do Sul de Santa Catarina UNISUL Dissertare Scientific Advice SOS Cardio Hospital Internal Medicine Department University Hospital Universidade Federal de Minas Gerais Faculdade de Medicina de Botucatu Universidade Estadual Paulista Júlio de Mesquita Filho Hospital das Clínicas da Faculdade de Medicina de Botucatu Universidade Federal do Rio Grande do Sul Hospital Bruno Born Research Center of Vale do Taquari. Hospital Mãe de Deus Hospital Universitário de Canoas Mucuri Medical School FAMMUC Universidade Federal dos Vales do Jequitinhonha e Mucuri – UFVJM Hospital Santa Rosalia Hospital Metropolitano Doutor Célio de Castro Hospital Moinhos de Vento Hospital Unimed BH Hospital Risoleta Tolentino Neves Post-graduation Center Medical School Universidade Federal de Minas Gerais Hospital Metropolitano Odilon Behrens Hospital Eduardo de Menezes Universidade FUMEC Hospital Julia Kubitschek Hospital Universitário de Santa Maria Departamento de Medicina Interna Universidade Federal de Santa Maria Hospital São João de Deus Hospital Regional Antônio Dias Faculdade Ciências Médicas de Minas Gerais Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul Faculdade de Ciências Humanas de Curvelo Hospital João XXIII Av. Professor Alfredo Balena Hospital Santo Antônio Hospital Universitário Ciências Médicas Vall d'Hebron University Hospital PROSICS Barcelona Instituto René Rachou-FIOCRUZ Minas. Universidade Federal da Fronteira Sul Hospital Regional do Oeste Pontifícia Universidade Católica de Minas Gerais Hospital Tacchini Centro Universitário de Patos de Minas. RPatos de Minas Hospital Semper Hospital Santa Cruz Universidade de Santa Cruz Fundação Hospitalar do Estado de Minas Gerais – FHEMIG. Universidade Federal de Ouro Preto Hospital das Clínicas da Universidade Federal de Pernambuco Universidade Federal de Pernambuco Centro de Ciências Médicas Centro Universitário de Belo Horizonte UniBH) Erasmus MC University Medical Center Rotterdam Department of Cardiology Faculdade de Medicina de Botucatu Universidade Estadual Paulista Júlio de Mesquita Filho Hospital das Clínicas da Faculdade de Medicina de Botucatu

BACKGROUND: Oxygen uptake efficiency slope (OUES) is a method for investigating cardiorespiratory fitness and is proposed as an alternative to overcome the limitations of traditional measures such as peak oxygen consumption (VO(2peak)) for patients who do not achieve a maximum response, such as in Parkinson's disease (PD). OBJECTIVE: To assess the performance of individuals with PD during the six-minute walk test (6MWT) using the OUES. METHODS: This is an observational cross-sectional study including 12 individuals with PD and 12 healthy controls. Participants performed the 6MWT along with an analysis of exhaled gas kinetics. The OUES was determined from the last 16 s of the walk test. Multiple linear regression analyses were computed to explore associations between the independent (OUES) and the dependent variables (VO(2peak)) controlled by group. RESULTS: The OUES was associated to VO(2peak) on the 6MWT (β=0.24, p

This study sought to analyze the viability of the use of solar energy, for the operation in boiler economizers, in the replacement of the thermal energy of the exhaust gases. The experiment was divided in two steps: analysis of the boiler yield with different feed water temperatures and addition of the solar field to the initial set. For the modeling of the economizer-boiler set, the software used was Engineering Equation Solver (Software F-Chart, Wisconsin, USA). The technology chosen for the second stage was the high-pressure vacuum solar collector, installed at the inlet of the feed water heater. The thermal power of 2014W (per plate) and the solar radiation peak of 1000W / m² were standardized, taking into account the calculations for a steady state system at noon. The variable was the number of solar panels to be used at the plant. After analyzing the data, it was verified that the efficiency varied by approximately 7.4%, when the feed water temperature was increased by 20 ° C, close to 48 ° C. In order for this variation to occur, it was necessary to use 50 plates.

Objective: To evaluate radiographic outcomes in patients undergoing minimally invasive Chevron/Akin osteotomy (MICA) for hallux valgus correction. Methods: We have treated 31 patients (40 feet). Preoperative and postoperative hallux metatarsophalangeal angles (hallux valgus angles, HVA), intermetatarsal angles (IMA) between the first and second metatarsals, and distal metatarsal articular angles (DMAA) were followed up for 12 months. Results: The mean age of the patients was 53.2 years. Mean preoperative HVA, IMA, and DMAA values were 28.85°, 15.38°, and 14.35°, respectively. The mean postoperative angles measured after 1 year were 10.60°, 7.95°, and 7.48°. Improvements in HVA, IMA, and DMAA values showed statistical relevance. There were no losses in angular parameters during follow-up. Conclusion: The radiographic outcomes in patients undergoing MICA osteotomy for hallux valgus correction followed up for 12 months showed significant improvements and no recurrence of the deformity. Our results suggest that this technique is effective for correcting hallux valgus. Level of Evidence III; Therapeutic Studies; Comparative Retrospective Study.

o objetivo foi relatar um caso de megaesôfago idiopático que foi tratado por cardiomiotomia videolaparoscópica a Heller-Pinotti em um paciente masculino, de 29 anos. Foi realizada triagem inicial com anamnese e exame físico e o paciente alegou disfagia progressiva sem alterações dos hábitos intestinais associadas; exame físico abdominal sem alterações. A investigação diagnóstica laboratorial incluiu tireoideopatia, doença de Chagas e doença do refluxo gastroesofágico. Após extensa investigação foi detectada acalasia (confirmada por esofagomanometria) idiopática, sendo assim realizada a cardiomiotomia videolaparoscópica a Heller-Pinotti. Posteriormente ao tratamento cirúrgico, o paciente apresentou boa evolução pós-operatória, não havendo queixas de pirose ou regurgitação e desaparecendo a queixa de disfagia. Declara-se boa experiência com o tratamento cirúrgico proposto, no entanto, novos estudos se tornam necessários para aprimoramento da técnica cirúrgica e consequente maior benefício para o paciente com acalasia idiopática. the goal was to report a case of idiopathic achalasia that was treated by Heller-Pinotti’s videolaparoscopic cardiomyotomy in a male patient of 29 years. The initial assessment was done with clinical history and physical examination and the patient claimed progressive dysphagia without changes in bowel habits associated; abdominal physical examination without abnormalities. Laboratory diagnostic investigation included thyroidopathy, Chagas’ disease and gastroesophageal reflux disease. After extensive research, it was detected idiopathic achalasia (confirmed by esophageal manometry) and Heller- Pinotti’s videolaparoscopic cardiomyotomy was realized. After surgery, the patient presented good postoperative evolution, with no complaints of heartburn or regurgitation and the dysphagia complaint had gone. We can declare good experience with the proposed surgical treatment, however, further studies are needed to make improvements in surgical technique and consequent greater benefit to the patient with idiopathic achalasia.

A infecção pelo Vírus da Imunodeficiência Humana (HIV) é uma pandemia que continua como grave problema de saúde pública. Sabe-se que alguns pacientes acometidos por HIV/ Síndrome da Imunodeficiência Humana Adquirida (SIDA) sofrem com algum tipo de transtorno ou sofrimento mental devido à infecção. Este estudo analítico e transversal trata-se de uma análise realizada com 54 pacientes portadores do HIV atendidos em centros de referência no tratamento de infecções sexualmente transmissíveis localizados nas cidades de Juazeiro/BA e Petrolina/PE. O objetivo do trabalho foi analisar a presença de sintomas de depressão em portadores do HIV nas duas cidades. A coleta de dados foi realizada pela aplicação do Inventário Beck de Depressão (BDI-I) e um questionário sobre o perfil epidemiológico dos pacientes. Os resultados mostraram prevalência de cerca de 31% de sintomas moderados a graves na amostra, sendo que 11% dos pacientes apresentaram sintomas graves; além disso, apontam ainda para a presença de sofrimento mental na amostra, bem como para a necessidade da realização de estudos longitudinais que avaliem as possíveis implicações que a depressão pode trazer para portadores do vírus HIV ao longo do tempo.

This paper reports part of the experiences of the UFSC extension project entitled “Community Garden and Environmental Education in Morro do Horacio”, carried out at the Beneficent Educational and Assistance Association Gente Amiga (Florianopolis/SC), between 2018 and 2020. Among the activities developed, highlights to the implementation of a community vegetable garden, actions of Agroecology, Permaculture and Environmental Education with the children and adolescents served by the Association and with the community in general. It was noted the importance of acknowledgement, approximation and exchange of popular and academic knowledge, reinforcing the commitment of the University to adjacent communities and the role of the university extension.

Background: Obesity is a highly disabling comorbidity, being considered a risk factor for chronic diseases, especially cardiovascular diseases. This metabolic alteration is closely related to lifestyle, food consumption, and physical inactivity. Amid a nomadic routine psychological disorders prevail.Objective: To establish the relationship between dyslipidemia and changes in glucose metabolism in obese women in a nomadic routine.Methods: 86 women were assisted. Of these, 54 had completed a follow-up at the nutrition service outpatient clinic of a Military Hospital in the Area from September 2019 to June 2020. Retrospective data collected were as follows: socioeconomic and anthropometric data, food consumption, and biochemical profile (p0.05).Results: The age group was 31-49 years (68.52%). The seasonality caused by nomadism generated depression, anxiety, and binge eating, conditions worsened by cardiovascular risk factors, namely, systemic arterial hypertension (55.56%), heart failure (35.19%), and diabetes mellitus (44.44%). As for the nutritional diagnosis, 47.2% were grade 1 obese, with 91 kg average weight. Average values for high-density lipoprotein were low, at 45.98 mg/dl; fasting glucose was 107.04 mg/dl. It was observed that prediabetic patients with changes in glycated hemoglobin tended to have change in lipid metabolism. Diabetic diagnoses related to lower dyslipidemic change.Conclusion: The best way to treat and prevent dyslipidemia and diabetes mellitus are lifestyle changes. Glucose intolerance directly affects care toward nutrition and the lifestyle.

Infecções do trato respiratório inferior são um problema comum tanto em equinos adultos quanto potros e pode variar desde infecções virais leves a infecções bacterianas severas. A pleuropneumonia é uma afecção caracterizada por inflamação do parênquima pulmonar associada a colonização bacteriana, desenvolvimento de abscessos pulmonares e/ou pneumonia, com posterior extensão à pleura visceral e ao espaço pleural. Este artigo tem por objetivo relatar os achados clínicos e abordagem terapêutica em um caso de pleuropneumonia séptica em potro. Os principais achados clínicos observados foram letargia, anorexia, febre, taquicardia, taquipnéia, esforço respiratório aumentado e pleurodinia. Staphylococcus sp. foi isolado na cultura bacteriano do fluido pleural. O protocolo terapêutico consistiu na instituição de terapia antimicrobiana, anti-inflamatória, além de cuidados de suporte. O protocolo antimicrobiano inicial escolhido foi penicilina associada à gentamicina e metronidazol. Flunixina Meglumina foi utilizado como agente anti-inflamatório. O protocolo terapêutico adotado foi eficaz na resolução da enfermidade, e nenhuma complicação foi observada durante o período de acompanhamento clínico.

Um método diagnóstico comumente utilizado por especialistas na detecção da Doença Arterial Coronariana (DAC) é a Cintilografia de Perfusão Miocárdica (CPM). Segundo Lindner et al. (2007), esse método oferece a possibilidade de estabelecimento de indicadores quantitativos que permitem a instituição de estratificações de risco cardíaco. O presente trabalho visou estabelecer um ponto de corte (“cut off”) baseado em um desses índices de estratificação - “SSS%” - capaz de influenciar na decisão terapêutica entre dois tipos de tratamento para DAC disponíveis – clínico (farmacológico) ou invasivo (angioplastia ou revascularização miocárdica). Além disso, este estudo também objetivou fornecer informações clínicas pertinentes que possam auxiliar os profissionais da área na propedêutica para DAC. Foram avaliados, indiretamente, sem acesso a prontuário, a partir de dados registrados em equipamento específico, via código de identificação, 2.529 pacientes. Desse total, foram analisados 129, dentre os quais 39,53% se submeteram ao tratamento clínico e 60,47% se submeteram ao tratamento invasivo para DAC após o resultado do primeiro exame. Houve quantidade importante de pacientes submetidos ao tratamento invasivo que apresentou piora do estado de perfusão cardíaca após a terapêutica e, no geral, os pacientes submetidos ao tratamento clínico apresentaram maior redução dos defeitos perfusionais em relação àqueles submetidos ao tratamento invasivo. Não foi possível determinar o valor “cut off”; entretanto, através das análises com comprovação estatística, concluiu-se que pacientes com grandes defeitos perfusionais cardíacos apresentam resposta positiva ao tratamento invasivo. Pacientes com pequenos defeitos perfusionais apresentam piora quando submetidos ao tratamento invasivo. A diagnostic method commonly used by specialists in the detection of Coronary Artery Disease (CAD) is the Myocardial Perfusion Scintigraphy (MPC). According to Lindner et al. (2007), this method offers the possibility of establishing quantitative indicators that allow the establishment of cardiac risk stratifications. The present study aimed to establish a cut-off point based on one of these stratification indexes - "SSS%" - capable of influencing the therapeutic decision between two types of available treatment for CAD - clinical (pharmacological) or invasive (angioplasty or coronary artery bypass grafting). In addition, this study also aimed to provide pertinent clinical information that may assist practitioners in the propedeutics for CAD. We indirectly evaluated 2,529 patients, without access to medical records, from data recorded in specific equipment via identification code. Of this total, 129 were analyzed, among which 39.53% underwent clinical treatment and 60.47% underwent invasive treatment for CAD after the result of the first exam. There was a significant number of patients undergoing invasive treatment that presented worsening of cardiac perfusion status after therapy and, in general, patients undergoing clinical treatment showed greater reduction of perfusion defects compared to those undergoing invasive treatment. It was not possible to determine the "cut off" value; however, through statistically proven analyses, it was concluded that patients with large cardiac perfusion defects have a positive response to invasive treatment. Patients with small perfusion defects show worsening when undergoing invasive treatment.

The aim of this study was to analyze the association between multimorbidity and fear of falling among hospitalized older adults. This is a quantitative study with an analytical sectional design, conducted with 83 individuals aged 60 years or older, hospitalized for falls in a referral hospital for emergency treatment in Brazil. Data collection took place through the application of a questionnaire containing socioeconomic and health information as well as characteristics of the fall. The logistic regression analysis revealed that older people who reported multimorbidity are 3.16 times more likely to be afraid of falling than older people who did not report multimorbidity, regardless of sex, age, frailty, and the number of falls in the last year. These results could aid in improving hospital approaches in relation to multimorbidity and fear of falling, decreasing preventable hospitalizations due to falls.

To evaluate prospectively the feasibility of magnetic resonance neurography (MRN) in identifying the anatomical characteristics of thenar muscular branch (TMB) of the median nerve, also known as the “million dollar nerve,” in patients and controls. Thirteen patients affected by carpal tunnel syndrome (CTS) and four healthy controls had their hands scanned on a 3-T MR imaging scanner for TMB visualization. Median nerve anatomical variations were classified into four groups according to Poisel’s classification system modified by Lanz. TMB signal intensity and diameter were assessed for the diagnosis of neuropathy. TMB was successfully identified in all patients and subjects by using MRN. The most suitable pulse sequences to identify and measure nerve diameter were 3D DW-PSIF and T2-FS-TSE. The axial oblique and sagittal oblique planes are complementary in demonstrating its entire course. TMB had mostly an extraligamentous course with radial side origin (93.8%, each). All patients experienced increased T2 signal intensity (p < 0.001) and thickened nerves. Mean TMB diameters were 1.27 ± 0.21 mm (range, 1.02–1.74 mm) and 0.87 ± 0.16 mm (0.73–1.08 mm) (p = 0.008) in the patient and control groups, respectively. MRN is a reliable imaging technique for identification and anatomical characterization of TMB in patients affected by CTS. This innovative imaging workup may therefore be included in the preoperative evaluation of patients scheduled for carpal tunnel release, especially in CTS with TMB involvement or even in isolated TMB neuropathy. • Magnetic resonance neurography allows precise visualization of the thenar muscular branch of the median nerve. • Thenar muscular branch anatomical variations can be correctly identified. • Preoperative scanning can contribute to reducing the risk of iatrogenic injuries during carpal tunnel release, especially in carpal tunnel syndrome with thenar muscular branch involvement or even in isolated thenar muscular branch neuropathy.