Inflammatory, synaptic, motor, and behavioral alterations induced by gestational sepsis on the offspring at different stages of life.

BACKGROUND: The term sepsis is used to designate a systemic condition of infection and inflammation associated with hemodynamic changes that result in organic dysfunction. Gestational sepsis can impair the development of the central nervous system and may promote permanent behavior alterations in the offspring. The aim of our work was to evaluate the effects of maternal sepsis on inflammatory cytokine levels and synaptic proteins in the hippocampus, neocortex, frontal cortex, and cerebellum of neonatal, young, and adult mice. Additionally, we analyzed the motor development, behavioral features, and cognitive impairments in neonatal, young and adult offspring. METHODS: Pregnant mice at the 14th embryonic day (E14) were intratracheally instilled with saline 0.9% solution (control group) or Klebsiella spp. (3 × 108 CFU) (sepsis group) and started on meropenem after 5 h. The offspring was sacrificed at postnatal day (P) 2, P8, P30, and P60 and samples of liver, lung, and brain were collected for TNF-α, IL-1ß, and IL-6 measurements by ELISA. Synaptophysin, PSD95, and ß-tubulin levels were analyzed by Western blot. Motor tests were performed at all analyzed ages and behavioral assessments were performed in offspring at P30 and P60. RESULTS: Gestational sepsis induces a systemic pro-inflammatory response in neonates at P2 and P8 characterized by an increase in cytokine levels. Maternal sepsis induced systemic downregulation of pro-inflammatory cytokines, while in the hippocampus, neocortex, frontal cortex, and cerebellum an inflammatory response was detected. These changes in the brain immunity were accompanied by a reduction of synaptophysin and PSD95 levels in the hippocampus, neocortex, frontal cortex, and cerebellum, in all ages. Behavioral tests demonstrated motor impairment in neonates, and depressive-like behavior, fear-conditioned memory, and learning impairments in animals at P30 and P60, while spatial memory abilities were affected only at P60, indicating that gestational sepsis not only induces an inflammatory response in neonatal mouse brains, but also affects neurodevelopment, and leads to a plethora of behavioral alterations and cognitive impairments in the offspring. CONCLUSION: These data suggest that maternal sepsis may be causatively related to the development of depression, learning, and memory impairments in the litter.

SARS-CoV-2 Infection in Pregnant Women: Neuroimmune-Endocrine Changes at the Maternal-Fetal Interface.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has devastating effects on the population worldwide. Given this scenario, the extent of the impact of the disease on more vulnerable individuals, such as pregnant women, is of great concern. Although pregnancy may be a risk factor in respiratory virus infections, there are no considerable differences regarding COVID-19 severity observed between pregnant and nonpregnant women. In these circumstances, an emergent concern is the possibility of neurodevelopmental and neuropsychiatric harm for the offspring of infected mothers. Currently, there is no stronger evidence indicating vertical transmission of SARS-CoV-2; however, the exacerbated inflammatory response observed in the disease could lead to several impairments in the offspring's brain. Furthermore, in the face of historical knowledge on possible long-term consequences for the progeny's brain after infection by viruses, we must consider that this might be another deleterious facet of COVID-19. In light of neuroimmune interactions at the maternal-fetal interface, we review here the possible harmful outcomes to the offspring brains of mothers infected by SARS-CoV-2.

Testing a new active learning approach to advance motor learning knowledge and self-efficacy in physical therapy undergraduate education.

BACKGROUND: Motor learning (ML) science is foundational for physical therapy. However, multiple sources of evidence have indicated a science-practice gap. Clinicians report low self-efficacy with ML concepts and indicate that the lack of access to systematic training is a barrier for practical implementation. The general goal of this preliminary study was to describe the effects of a new educational intervention on physical therapy student's ML self-efficacy and knowledge. METHODS: Self-efficacy was assessed with the Physical Therapists' Perceptions of Motor Learning questionnaire. Data was acquired from third-semester students before their participation in the ML educational intervention. Reference self-efficacy data was also acquired from physical therapy professionals and first and last-semester students. The educational intervention for third-semester students was designed around an established framework to apply ML principles to rehabilitation. A direct experience, the "Learning by Doing" approach, in which students had to choose a motor skill to acquire over 10 weeks, provided the opportunity to apply ML theory to practice in a personally meaningful way. After the intervention self-efficacy was re-tested. ML knowledge was tested with an objective final exam. Content analysis of coursework material was used to determine how students comprehended ML theory and related it to their practical experience. The Kruskal-Wallis and Mann-Whitney U tests were used to compare self-efficacy scores between the four groups. Changes in self-efficacy after the educational intervention were analyzed with the Wilcoxon test. Spearman rank correlation analysis was used to test the association between self-efficacy and final exam grades. RESULTS: By the end of the intervention, students' self-efficacy had significantly increased (p < 0.03), was higher than that of senior students (p < 0.00) and experienced professionals (p < 0.00) and correlated with performance on an objective knowledge test (p < 0.03). Content analysis revealed that students learned to apply the elements of ML-based interventions present in the scientific literature to a real-life, structured ML program tailored to personal objectives. CONCLUSIONS: Positive improvements were observed after the intervention. These results need confirmation with a controlled study. Because self-efficacy mediates the clinical application of knowledge and skills, systematic, active training in ML may help reduce the science-practice gap.

Stress, anxiety, self-efficacy, and the meanings that physical therapy students attribute to their experience with an objective structured clinical examination.

BACKGROUND: Excessive stress and anxiety can impair learning. The objective structured clinical examination (OSCE) is a valuable tool to assess and promote the acquisition of clinical skills. However, significant OSCE-related stress and anxiety are frequently reported. The aim of this study was to investigate the relationships between physiological stress, self-reported levels of anxiety due to an OSCE, self-efficacy, and the meanings that physical therapy students attribute to their experience with the exam. DESIGN: Concurrent mixed methods study. METHODS: A total of 32 students took part in this study. All were enrolled in the third semester of a 10-semester Physical Therapy Bachelor Program. Salivary cortisol levels, self-reported anxiety (State-Trait Anxiety Inventory, STAI) were measured before the OSCE. Exam scores and self-efficacy ratings were also recorded. Correlations between variables were tested with the Pearson correlation, with ɑ at 0.05. Semi-structured interviews were used to explore the personal perspectives of students. Thematic analysis was used to investigate emergent themes. RESULTS: Trait anxiety scores were significantly higher than normative values (p < 0.001). A high proportion of students showed high (STAI> 49) state anxiety (37.5%) and trait anxiety (65.6%). Salivary cortisol was not associated anxiety (p > 0.05). Neither stress nor anxiety correlated with OSCE scores. A moderate and significant direct correlation was found for self-efficacy scores and OSCE scores (r = 0.475, p = 0.007). Students reported that confidence had a calming effect and led to better self-perceived performance. They also reported that the OSCE can provide meaningful learning experiences despite being stressful. CONCLUSIONS: A high proportion of our students reported a stable/lingering negative affect. However, neither stress nor anxiety related to OSCE scores. Students' confidence in their capabilities was correlated with their performance. Their subjective reports suggest that self-confidence may have protected them from the negative effects of stress and anxiety on academic performance.

Biomechanics in Keratoconus Diagnosis.

Purpose: To prospectively review the importance of biomechanical assessment in the screening, diagnosis, prognosis, individualized planning, and clinical follow-up for ectatic corneal diseases.Methods: We demonstrate two commercially available devices to assess the corneal biomechanics in vivo, the Ocular Response Analyzer (ORA, Reichester, NY, USA) and the Corvis ST (Oculus, Wetzlar, Germany). Novel devices have been demonstrated to provide in vivo biomechanical measurements, including Brillouin optical microscopy and OCT elastography. Conclusion: The integration of biomechanical data and other data from multimodal refractive imaging using artificial intelligence demonstrated the ability to enhance accuracy in diagnosing ectatic corneal diseases.

Community-Based Pediatric Palliative Care: How Services Support Children's and Families' Quality of Life.

Background: The Massachusetts Department of Public Health's Pediatric Palliative Care Network (PPCN) provides Community-Based Pediatric Palliative Care (CBPPC) to children with life-limiting conditions and their families. CBPPC services aim to improve children and families' quality of life (QOL). Objectives: To identify perceived domains of QOL important for children and families and to understand whether and how CBPPC supports QOL. Design: A community-based participatory research framework was used to develop recruitment and data collection materials for eight focus groups and seven interviews. Collected data were transcribed and analyzed with an inductive approach. Setting/Subjects: A convenience sample of 33 PPCN caregivers, 20 providers, and seven key informants, including policymakers, community organizations, and hospital-based clinicians, were interviewed virtually in the United States. Measurements: Perceived QOL domains for children and families, respectively, and perceived impact of CBPPC services on QOL. Results: Reported QOL domains described as important for children were socialization/community integration and accessibility; expression/play; and physical wellness. Control or autonomy, psycho-emotional wellness, and self-care were identified as important for families. Clinical services were described as "integral to mental health" through offered spiritual support; advocacy in the community; and education. PPCN's integrative services were noted as distractions from pain and helped improve communication and bonding. Sibling support and bereavement care were also mentioned as impactful on QOL. Conclusions: Family-centered CBPPC was described as supportive of children's and families' QOL. Future studies should consider using population-based QOL measures, leveraging the QOL domains identified through this analysis and other outcome measures in a cost-effectiveness analysis.

Live births of immigrant mothers in Brazil: A population-based study.

Introduction: Migration has become a major challenge for many countries, and women constitute half of the migrants in the world. Few studies have been conducted on migrant mothers in Brazil. We aim to identify differences in the pregnancies, childbirths, and live birth (LB) indicators of immigrant women, compared with those of Brazilian women living in the municipality of São Paulo (MSP), Brazil. Methods: The LB characteristics of immigrant mothers from Bolivia (15,886), China (3861), Paraguay (1370), and Peru (1039) were compared with those of Brazilian mothers (967,921) living in the MSP between 2012 and 2017. Pearson's chi-square test was used to compare proportions with a significance level of 5%. Results: Teenage pregnancy and low education were more frequent among Bolivian (13.1 and 31.7%, respectively) and Paraguayan mothers (13.1 and 36.2%). Bolivian women exhibited a high percentage of late-onset prenatal care (8.7%), few prenatal visits (14.3%), vaginal birth (77.0%), home delivery (1.6%), and postterm (3.6%). Bolivian (13.6%), Peruvian (10.6%), and Paraguayan (7.9%) women exhibited a higher prevalence of macrosomia than Chinese (4.3%) and Brazilian (4.0%) women. There was a high prevalence of preterm and low birth weights among Paraguayan (12.5 and 7.7%, respectively) and Brazilian mothers (11.0 and 9.7%) and a high rate of cesarean sections among Chinese (42.1%) and Brazilian (53.5%). Conclusion: Differences were observed in the sociodemographic profiles for the pregnancies, childbirths, and LBs of immigrant mothers, in view of their increase and diversity in the MSP. There was greater vulnerability among immigrant mothers, compared with Brazilian mothers, particularly regarding access to prenatal care.

Corneal biomechanics for corneal ectasia: Update.

Knowledge of biomechanical principles has been applied in several clinical conditions, including correcting intraocular pressure measurements, planning and following corneal treatments, and even allowing an enhanced ectasia risk evaluation in refractive procedures. The investigation of corneal biomechanics in keratoconus (KC) and other ectatic diseases takes place in several steps, including screening ectasia susceptibility, the diagnostic confirmation and staging of the disease, and also clinical characterization. More recently, investigators have found that the integration of biomechanical and tomographic data through artificial intelligence algorithms helps to elucidate the etiology of KC and ectatic corneal diseases, which may open the door for individualized or personalized medical treatments in the near future. The aim of this article is to provide an update on corneal biomechanics in the screening, diagnosis, staging, prognosis, and treatment of KC.

Chronic back pain among Brazilian adults: data from the 2019 National Health Survey. / Dor crônica na coluna entre adultos brasileiros: dados da Pesquisa Nacional de Saúde 2019.

OBJECTIVE: To estimate the prevalence of chronic back pain (CBP) and its associated factors. METHODS: This cross-sectional study analyzed the 2019 National Health Survey, with 88,531 adults, using logistic regression to identify associated factors. RESULTS: CBP was reported by 21.6% of adults and was more likely to occur among women (odds ratio - OR=1.27; 95% confidence interval - 95%CI 1.19-1.35), increased with age: 25-34 years (OR=1.30; 95%CI 1.11-1.51), 35-44 (OR=1.78; 95%CI 1.54-2.07), 45-54 years (OR=2.23; 95%CI 1.91-2.59), 55-64 years (OR=2.47; 95%CI 2.12-2.88), and 65 years or older (OR=2.17; 95%CI 1.85-2.54); among smokers (OR=1.24; 95%CI 1.13-1.35); ex-smokers (OR=1.30; 95%CI 1.21-1.39); those who mentioned heavy housework (OR=1.41; 95%CI 1.31-1.53); obesity (OR=1.12; 95%CI 1.03-1.21); hypertension (OR=1.21; 95%CI 1.11-1.32); high cholesterol (OR=1.53; 95%CI 1.42-1.65); with self-rated health - with a very good reference - in the gradients: good (OR=1.38; 95%CI 1.23-1.55), regular (OR=2.64; 95%CI 2.34-2.98), poor (OR=4.24; 95%CI 3.64-4.94), and very poor (OR=5.24; 95%CI 4.13-6.65); its likelihood was lower in adults with complete elementary school/incomplete high school (OR=0.82; 95%CI 0.75-0.90) and complete high school/incomplete higher education (OR=0.87; 95%CI 0.81-0.95). CONCLUSION: Back pain has a high prevalence and shows associations with demographic and socioeconomic factors, lifestyle, chronic diseases, and self-rated health.

OBJETIVO: Estimar a prevalência da dor crônica na coluna (DCC) e os fatores associados à sua ocorrência. MÉTODOS: Estudo transversal analisando a Pesquisa Nacional de Saúde 2019, com 88.531 adultos, usando regressão logística para identificar fatores associados. RESULTADOS: A DCC foi apontada por 21,6% dos adultos, mostrou maior chance em mulheres (odds ratio ­ OR=1,27; intervalo de confiança de 95% ­ IC95% 1,19­1,35), aumentou com a idade de 25­34 anos (OR=1,30; IC95% 1,11­1,51), 35­44 (OR=1,78; IC95% 1,54­2,07), 45­54 anos (OR=2,23; IC95% 1,91­2,59), 55­64 anos (OR=2,47; IC95% 2,12­2,88) e 65 anos ou mais (OR=2,17; IC95% 1,85­2,54); fumantes (OR=1,24; IC95% 1,13­1,35); ex-fumantes (OR=1,30; IC95% 1,21­1,39); que citaram atividade física doméstica pesada (OR=1,41; IC95% 1,31­1,53); obesidade (OR=1,12; IC95% 1,03­1,21); hipertensos (OR=1,21; IC95% 1,11­1,32); colesterol aumentado (OR=1,53; IC95% 1,42­1,65); autoavaliação, cuja referência era muito boa, mostrou gradiente boa (OR=1,38; IC95% 1,23­1,55); regular (OR=2,64; IC95% 2,34­2,98), ruim (OR=4,24; IC95% 3,64­4,94), e muito ruim (OR=5,24; IC95% 4,13­6,65); e menor chance em adultos com ensino fundamental completo/ensino médio incompleto (OR=0,82; IC95% 0,75­0,90) e médio completo/superior incompleto (OR=0,87; IC95% 0,81­0,95). CONCLUSÃO: A dor na coluna tem elevada prevalência e mostra associação com fatores demográficos, socioeconômicos, estilo de vida, doenças crônicas e autoavaliação de saúde.

Is it just an obstructive pyelonephritis?

Pyelocaliceal obstruction is a diagnostic challenge, and it is important to identify the obstruction cause. Some patients present extra-renal compressive masses that need further imagiologic investigation and a biopsy, to establish the diagnosis.

PMA treatment fosters rat retinal ganglion cell survival via TNF signaling.

An insult can trigger a protective response or even cell death depending on different factors that include the duration and magnitude of the event and the ability of the cell to activate protective intracellular signals, including inflammatory cytokines. Our previous work showed that the treatment of Lister Hooded rat retinal cell cultures with 50 ng/mL phorbol 12-myristate 13-acetate (PMA), a protein kinase C activator, increases the survival of retinal ganglion cells (RGCs) kept in culture for 48 h after axotomy. Here we aim to analyze how PMA modulates the levels of TNF-α and IL-1ß (both key inflammatory mediators) and the impact of this modulation on RGCs survival. We hypothesize that the increase in RGCs survival mediated by PMA treatment depends upon modulation of the levels of IL-1ß and TNF-α. The effect of PMA treatment was assayed on cell viability, caspase 3 activation, TNF-α and IL-1ß release and TNF receptor type I (TNFRI) and TNF receptor type II (TNFRII) levels. PMA treatment increases IL-1ß and TNF-α levels in 15 min in culture and increases the release of both cytokines after 30 min and 24 h, respectively. Both IL-1ß and TNF-α levels decrease after 48 h of PMA treatment. PMA treatment also induces an increase in TNFRII levels while decreasing TNFRI after 24 h. PMA also inhibited caspase-3 activation, and decreased ROS production and EthD-1/calcein ratio in retinal cell cultures leading to an increase in cell viability. The neutralization of IL-1ß (anti-IL1ß 0,1ng/mL), the neutralization of TNF-α (anti-TNF-α 0,1ng/mL) and the TNF-α inhibition using a recombinant soluble TNFRII abolished PMA effect on RGCs survival. These data suggest that PMA treatment induces IL1ß and TNF-α release and modulation of TNFRI/TNFRII expression promoting RGCs survival after axotomy.

e-SUS APS: necessidades de melhorias operacionais na percepção dos cirurgiões-dentistas de um distrito sanitário do Recife-PE

Objetivo: Neste estudo, tem-se por objetivo analisar as necessidades de melhorias dos registros, monitoramento e avaliação do e-SUS APS na perspectiva dos cirurgiões-dentistas do Distrito Sanitário I do Recife-PE. Métodos: Trata-se de um estudo com abordagem qualitativa. Os dados foram coletados por meio de entrevistas individuais semiestruturadas, realizadas entre os meses de julho e agosto de 2022, com 8 (oito) cirurgiões-dentistas de equipes de saúde bucal. Para análise dos dados, foi utilizada a técnica de análise de conteúdo. Resultados: Percebe-se que a integração das informações, por meio do software e-SUS APS, facilitou o processo de trabalho dos cirurgiões-dentistas, entretanto, constata-se a necessidade de capacitações dos profissionais de saúde e gestores para o planejamento de atividades com base nas informações produzidas, além do aperfeiçoamento do referido software para incluir especificidades da saúde bucal. Conclusões: O e-SUS APS trouxe melhorias na qualidade e consistência das informações produzidas pelos cirurgiões-dentistas, porém apresenta vários aspectos que necessitam ser melhorados.

Registros, monitoramento e avaliação no e-SUS APS por cirurgiões-dentistas em um distrito sanitário de Recife/PE

Objetivo: A presente pesquisa teve por objetivo analisar a percepção dos cirurgiões-dentistas de um Distrito Sanitário da cidade do Recife-PE sobre registros, monitoramentos e avaliações realizadas no e-SUS APS. Métodos: Trata-se de um estudo com abordagem qualitativa. Os dados foram coletados através de entrevista individual com roteiro semiestruturado, entre os meses de julho e agosto de 2022, com oito cirurgiões-dentistas de equipes de saúde bucal do Distrito Sanitário I do município de Recife, Pernambuco. Em seguida, realizou-se a análise das informações produzidas através da técnica de análise de conteúdo. Resultados: O e-SUS APS facilitou o processo de trabalho dos pesquisados ao simplificar o registro e a consulta das informações dos usuários, proporcionando o acompanhamento da situação de saúde. No entanto, este vem sendo subutilizado. Já no que se refere às fragilidades, os entrevistados destacaram barreiras relacionadas à estrutura das unidades de saúde, como situações técnicas de conectividade da internet, assim como necessidade de capacitações eficazes e periódicas. Conclusões: O estudo revelou que um dos problemas que permeiam a operacionalização do e-SUS APS diz respeito a sua subutilização. Existe a necessidade de capacitação dos cirurgiões-dentistas para o uso do e-SUS APS e há investimento na infraestrutura das unidades básicas de saúde, pois a informatização ainda é precária.

Incontinência Urinária Em Mulheres Jovens E Nulíparas: Fatores Associados E Prevalência / Urinary Incontinence in Young and Nulliparous Women: Associated Factors and Prevalence / Incontinencia Urinaria en Mujeres Jóvenes Nulíparas: Factores Asociados Y Prevalencia

Objetivo:Verificar a prevalência e os fatores de risco associados à incontinência urinária em mulheres jovens nulíparas. Método: Revisão integrativa da literatura, realizada através de busca nas bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências de Saúde (LILACS), Índice Bibliográfico Espanhol em Ciências da Saúde (IBECS) e na Base de Dados de Enfermagem (BDENF), no período de março a junho de 2021, utilizando os descritores: "incontinência urinária", "prevalência", "mulheres", "estudantes" e "adulto jovem" combinados através do operador booleano "AND". Resultados: A busca inicial resultou em 234 artigos e, após aplicação dos critérios de elegibilidade, obteve-se uma amostra final de 5 artigos. Após as análises, evidenciou-se prevalência de incontinência urinária em mulheres jovens nulíparas de 48%. Os fatores de risco foram: atividade física de alto impacto, duração da atividade física, sintomas intestinais e urinários concomitantes. Conclusão: Observou-se que a ocorrência de incontinência urinária em mulheres jovens nulíparas é uma condição comum, os fatores de risco associados demonstram a necessidade de orientação em saúde a essas mulheres para evitar a cronificação do agravo.

Objective:To verify the prevalence and risk factors associated with urinary incontinence in nulliparous young women. Methods: Integrative literature review, performed by searching the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Spanish Bibliographic Index in Health Sciences (IBECS) and in the Nursing Database (BDENF), from March to June 2021, using the descriptors: "urinary incontinence", "prevalence", "women", "students" and "young adult" combined with the Boolean operator "AND". Results: The initial search resulted in 234 articles and, after applying the eligibility criteria, a final sample of 5 articles was obtained. After the analyses, a prevalence of urinary incontinence in young nulliparous women of 48% was evidenced. Risk factors were: high-impact physical activity, duration of physical activity, concomitant bowel and urinary symptoms. Conclusion: It was observed that the occurrence of urinary incontinence in nulliparous young women is a common condition. The associated risk factors demonstrate the need for health guidance to these women to avoid the chronification of the disease.

Objetivo:Verificar la prevalencia y los factores de riesgo asociados a incontinencia urinaria en mujeres jóvenes nulíparas. Método: Revisión integral de literatura realizada a través de búsqueda en las bases de datos: Medical Literature Analysis and Retrieval System Online (MEDILINE) Literatura Latinoamericana y del Caribe en Ciencias De Salud (LILACS), Índice bibliográfico español en ciencias de salud (IBECS) y en la Base de Datos de Enfermería (BDENF), en el periodo de marzo a junio del 2021 utilizando los descriptores "incontinencia urinaria", "prevalencia", "mujeres", "estudiantes" y "adulto joven" combinados a través del operador booleano "AND". Resultados: Después del análisis se evidenció una prevalencia de incontinencia urinaria en mujeres jóvenes nulíparas de 48%. Los factores de riesgo fueron: actividad física de alto impacto, duración de actividad física, síntomas intestinales y urinarios concomitantes. Conclusión: Se observó que la ocurrencia de incontinencia urinaria en mujeres jóvenes nulíparas es una condición común. Los factores de riesgo asociados demuestran la necesidad de orientación en salud a esas mujeres para evitar la cronificación de la gravedad.

Dor crônica na coluna entre adultos brasileiros: dados da Pesquisa Nacional de Saúde 2019 / Chronic back pain among Brazilian adults: data from the 2019 National Health Survey

RESUMO Objetivo: Estimar a prevalência da dor crônica na coluna (DCC) e os fatores associados à sua ocorrência. Métodos: Estudo transversal analisando a Pesquisa Nacional de Saúde 2019, com 88.531 adultos, usando regressão logística para identificar fatores associados. Resultados: A DCC foi apontada por 21,6% dos adultos, mostrou maior chance em mulheres (odds ratio — OR=1,27; intervalo de confiança de 95% — IC95% 1,19-1,35), aumentou com a idade de 25-34 anos (OR=1,30; IC95% 1,11-1,51), 35-44 (OR=1,78; IC95% 1,54-2,07), 45-54 anos (OR=2,23; IC95% 1,91-2,59), 55-64 anos (OR=2,47; IC95% 2,12-2,88) e 65 anos ou mais (OR=2,17; IC95% 1,85-2,54); fumantes (OR=1,24; IC95% 1,13-1,35); ex-fumantes (OR=1,30; IC95% 1,21-1,39); que citaram atividade física doméstica pesada (OR=1,41; IC95% 1,31-1,53); obesidade (OR=1,12; IC95% 1,03-1,21); hipertensos (OR=1,21; IC95% 1,11-1,32); colesterol aumentado (OR=1,53; IC95% 1,42-1,65); autoavaliação, cuja referência era muito boa, mostrou gradiente boa (OR=1,38; IC95% 1,23-1,55); regular (OR=2,64; IC95% 2,34-2,98), ruim (OR=4,24; IC95% 3,64-4,94), e muito ruim (OR=5,24; IC95% 4,13-6,65); e menor chance em adultos com ensino fundamental completo/ensino médio incompleto (OR=0,82; IC95% 0,75-0,90) e médio completo/superior incompleto (OR=0,87; IC95% 0,81-0,95). Conclusão: A dor na coluna tem elevada prevalência e mostra associação com fatores demográficos, socioeconômicos, estilo de vida, doenças crônicas e autoavaliação de saúde.

ABSTRACT Objective: To estimate the prevalence of chronic back pain (CBP) and its associated factors. Methods: This cross-sectional study analyzed the 2019 National Health Survey, with 88,531 adults, using logistic regression to identify associated factors. Results: CBP was reported by 21.6% of adults and was more likely to occur among women (odds ratio — OR=1.27; 95% confidence interval — 95%CI 1.19-1.35), increased with age: 25-34 years (OR=1.30; 95%CI 1.11-1.51), 35-44 (OR=1.78; 95%CI 1.54-2.07), 45-54 years (OR=2.23; 95%CI 1.91-2.59), 55-64 years (OR=2.47; 95%CI 2.12-2.88), and 65 years or older (OR=2.17; 95%CI 1.85-2.54); among smokers (OR=1.24; 95%CI 1.13-1.35); ex-smokers (OR=1.30; 95%CI 1.21-1.39); those who mentioned heavy housework (OR=1.41; 95%CI 1.31-1.53); obesity (OR=1.12; 95%CI 1.03-1.21); hypertension (OR=1.21; 95%CI 1.11-1.32); high cholesterol (OR=1.53; 95%CI 1.42-1.65); with self-rated health — with a very good reference — in the gradients: good (OR=1.38; 95%CI 1.23-1.55), regular (OR=2.64; 95%CI 2.34-2.98), poor (OR=4.24; 95%CI 3.64-4.94), and very poor (OR=5.24; 95%CI 4.13-6.65); its likelihood was lower in adults with complete elementary school/incomplete high school (OR=0.82; 95%CI 0.75-0.90) and complete high school/incomplete higher education (OR=0.87; 95%CI 0.81-0.95). Conclusion: Back pain has a high prevalence and shows associations with demographic and socioeconomic factors, lifestyle, chronic diseases, and self-rated health.

Brazilian Amazon Traditional Medicine and the Treatment of Difficult to Heal Leishmaniasis Wounds with Copaifera.

The present study describes the use of the traditional species Copaifera for treating wounds, such as ulcers scarring and antileishmanial wounds. It also relates phytochemical studies, evaluation of the leishmanicidal activity, and toxicity. The species of Copaifera with a higher incidence in the Amazon region are Copaifera officinalis, Copaifera reticulata, Copaifera multijuga Hayne. The copaiba oil is used in the Amazon's traditional medicine, especially as anti-inflammatory ingredient, in ulcers healing, and in scarring and for leishmaniasis. Chemical studies have shown that these oils contain diterpenes and sesquiterpenes. The copaiba oil and terpenes isolated have antiparasitic activity, more promising in the amastigote form of L. amazonensis. This activity is probably related to changes in the cell membrane and mitochondria. The oil showed low cytotoxicity and genotoxicity. Furthermore, it may interfere with immune response to infection and also has a healing effect. In summary, the copaiba oil is promising as leishmanicidal agent.

Ingested microplastics (>100 µm) are translocated to organs of the tropical fiddler crab Uca rapax.

Microplastics, which are accumulating in marine sediments, are assumed to pose a risk for deposit feeding invertebrates. We tested whether the fiddler crab Uca rapax ingests and retains microplastics in its body. Furthermore, we investigated whether retention rates depend on (a) the quality of the marine environment in which the plastics were pre-weathered and on (b) their abundance. For this, polystyrene pellets were submersed at a polluted and a pristine site near Niterói, Brazil, for 2 weeks. Then specimens of U. rapax were, in laboratory experiments, exposed to fragments (180-250 µm) derived from these pellets for 2 months. After this period, microplastics were observed in the gills, stomach and hepatopancreas of the animals. However, fragment retention was not influenced by the two factors that we manipulated. The presence of microplastics in different organs of the crab supports the assumption that these particles have the potential to harm marine invertebrates.

Hypopituitarism and amenorrhea-galactorrhea syndrome caused by thrombosis of both internal carotid artery and giant intrasellar aneurysm: case report.

Giant intra and parasellar aneurysm with a spontaneous thrombosis of internal carotid artery is rare. We report the case of a 34 years old woman presenting a unique giant sellar and parasellar aneurysm associated with hypopituitarism and amenorrhea-galactorrhea syndrome. Computed tomographic scans and magnetic resonance images were suggestive of a sellar tumor with a cystic component. Digital cerebral angiography showed spontaneous thrombosis of a intrasellar and parasellar carotid artery aneurysm and left internal carotid artery in the neck. A transseptal endoscopic biopsy was done and confirmed a thrombosed aneurysm. No other surgical treatment was required in this patient but permanent endocrinological treatment was necessary.

Predicting Acute Pancreatitis Severity: Comparison of Prognostic Scores.

BACKGROUND: Acute pancreatitis has a broad clinical spectrum, from mild illness to multiple organ failure and death. Prognostic scores have been developed or adapted to predict disease severity. This study aimed to compare the prognostic scores according to sensitivity and specificity, receiver operating characteristic curves and area under the curve. Statistical correlation with disease severity, length of hospital stay, mortality and complication rates. METHODS: Retrospective analysis of the clinical data of patients admitted to an Internal Medicine ward with the diagnosis of acute pancreatitis over a ten year period. Evaluation of prognostic scores: Ranson, Glasgow-Imrie, Balthazar, APACHE II (admission and at 48 hours) and C-reactive protein (48 hours), was carried out as well as statistical analysis using Microsoft Excel 2007® and SPSS 16®. The confidence interval used was 95%. RESULTS: Data from 193 clinical files was collected. However, 67 were excluded due to lack of information. According to the Atlanta criteria, 90 cases were deemed as mild and 36 severe. The mortality rate was 6% and the local complication rate was 9.3%. Ranson, Glasgow and APACHE II scores had significant correlation with mortality. Apart from C-reactive protein levels at 48 hours, all scores had significant correlation with disease severity. The scores with best area under the curve correlation were APACHE II (48 hours): 0.892, Ranson: 0.879, and APACHE II (admission): 0.861. CONCLUSIONS: The most accurate prognostic scores in this study were APACHE II (48 hours) and Ranson. APACHE II at admission was a good indicator, impaired only by high false positive ratio.