Reamputation prevalence after minor feet amputations in patients with diabetic foot, a cross sectional study. / Prevalencia de reamputación en amputaciones menores del pie en pacientes con pie diabético, estudio de corte transversal.

INTRODUCTION: Reported prevalence for reamputation in diabetic foot is diverse, risk factors are not clear for minor amputations. This study aims to determine the prevalence for reamputation in diabetic foot from minor amputations and to evaluate associated factors for such outcome. METHODS: Cross sectional study developed in 2hospitals. Patients hospitalized for diabetic foot ulcer requiring a minor amputation were included. A descriptive analysis of all variables is presented, as well as prevalence ratios (PR) and a multivariate logistic regression. RESULTS: The prevalence was of 48% for 15 years. Toes were the most frequent minor amputation that required reamputation and above the knee amputation was the most frequent reamputation level (45%). Variables whose PR was associated to reamputation risk were: smoking history (PR 1.32, CI 95%: 1.02-1.67, P=0.03), vascular occlusion in doppler (PR 1.47, CI 95%: 1.11-1.73, P=0.01), revascularization (PR 1.73, CI 95%: 1.31-2.14, P=0.00002), Wagner> 3 (PR 1.75, CI 95%: 1.16-1.84, P=0.01) and leucocytosis> 11,000 (PR 1.39, CI 95%: 1.07-1.68, P=0.01). Leucocytosis> 11,000, Wagner> 3, vascular occlusion in doppler and revascularization were the variables that best predicted the outcome. Furthermore, leucocytosis was the best variable for predicting reamputation (OR 2.4, CI 95%: 1.1-5.6, P=0.04). CONCLUSIONS: Reamputation prevalence was 48%. The toes were the minor amputation more frequently requiring reamputation and above the knee was the most frequent reamputation level. Risk for reamputation was associated with variables related to vascular compromise and infection.

PAHs in franciscana dolphins from the Southwestern Atlantic Ocean: Concentration and maternal transfer assessments.

Polycyclic aromatic hydrocarbons (PAHs) are organic compounds ubiquitous in the environment and known for their toxic, mutagenic, and carcinogenic effects. These compounds can bioaccumulate in the biota and be transferred through trophic webs. The franciscana dolphin (Pontoporia blainvillei), as top predators, can be an environmental sentinels. Thus, this study aimed to provide data about PAHs concentration in their hepatic tissue collected on the coast of Espírito Santo (Franciscana Management Area, FMA Ia), Rio de Janeiro (FMA IIa), and São Paulo states (FMA IIb), in Southeastern Brazil. PAHs were detected in 86 % of franciscana dolphins (n = 50). The highest ∑PAHsTotal median concentration was reported in FMA Ia followed by FMA IIb and FMA IIa (1055.6; 523.9, and 72.1 ng.g-1 lipid weight, respectively). Phenanthrene was detected in one fetus and two neonates, showing maternal transfer of PAHs in these dolphins. Evaluating PAHs with potential toxic effects is of utmost importance for the conservation of a threatened species.

Phase angle and impedance ratio as meta-inflammation biomarkers after a colon cleansing protocol in a group of overweight young women.

Objective. Blood C-reactive protein (CRP) and the electrical bioimpedance spectroscopy (EBIS) variables phase angle (PhA) and impedance ratio (IR) have been proposed as biomarkers of metainflammation in overweight/obesity. CRP involves taking blood samples, while PhA and IR imply a less-than-2-minute-non-invasive procedure. In this study, values for these variables and percent body fat mass (PBFM) were obtained and compared before and immediately after a colon cleansing protocol (CCP), aimed at modulating intestinal microbiota and reducing metainflammation, as dysbiosis and the latter are intrinsically related, as well as along a period of 8 weeks after it.Approach. 20 female volunteers (20.9-24.9 years old) participated: 12 in an overweight group (OG), and 8 in a lean group (LG). TheOGwas divided in two subgroups (n= 6, each): control (CSG) and experimental (ESG). TheESGunderwent a 6-day CCP at week 2, while 5 volunteers in theCSGunderwent it at week 9.Main results.Pre/post-CCP mean values for the variables in theOGwere: PBFM (34.3/31.3%), CRP (3.7/0.6 mg dl-1), PhA (6.9/7.5°) and IR*10 (0.78/0.77). CalculatedR2correlation factors among these variables are all above 0.89. The favourable changes first seen in theESGwere still present 8 weeks after the CCP.Significance.(a) the CCP drastically lowers meta-inflammation, (b) EBIS can be used to measure metainflammation, before and after treatment, (c) for microbiota modulation, CCP could be a good alternative to more drastic procedures like faecal microbiota transplantation; (d) reestablishing eubiosis by CCP could be an effective coadjutant in the treatment of overweight young adult women.

[People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic]. / Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora.

BACKGROUND AND OBJECTIVE: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical-clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. PATIENTS AND METHODS: Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. INCLUSION CRITERIA: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. EXCLUSION CRITERIA: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. RESULTS: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. CONCLUSIONS: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.

Preliminary study on parameterization of raw electrical bioimpedance data with 3 frequencies.

This study tests the geometrical parameterization method for Electrical Bio-Impedance Spectroscopy (EBIS) readings previously proposed by one of the authors. This method uses the data of just three frequencies (therefore called 3P method). The test was carried out by the analysis of parameterization from 26 spectra (selected from 13 data sets) by the non-linear square (NLS) method, the 3P method and a combination of the two (3P-NLS). Additionally, the behaviour of the 3P method for 4 levels of noise and 3 different ways of segmenting the spectra were also explored with a MATLAB simulation of 400 spectra. Finally, a system for the classification of EBIS readings is presented, based on deviations of the raw data from the semi-circle obtained by the parameterization methods. Overall, the results suggest a very good performance of the 3P method when compared with the other two. The 3P method performs very well with levels of noise of 1 and 2%, but performs poorly with levels of noise of 5% and 10%. The results support the idea that the 3P method could be used with confidence for the parameterization of EBIS spectra, after the selection of three adequate frequencies according to specific applications.

[Has sexuality changed in pregnancy? Baby boom generation versus millennial generation]. / ¿Ha variado la sexualidad en el embarazo? Generación baby boom versus generación millennial.

Sexuality is a complex and multidimensional phenomenon that constitutes a fundamental component in human relationships. Pregnancy is a crucial period in women's life and the physiological changes that happen in this period affect their sexuality. OBJECTIVE: Knowing how pregnancy impacts on sexual behaviors in millenial generation compared to baby boom generation. MATERIAL AND METHODS: Descriptive and cross-sectional study, by means of a self-completed, population-based survey, to a sample of pregnant women in the third trimester of gestation who attended Primary Care. A descriptive study of the frequency distribution of all the variables was carried out. RESULTS: In baby boom generation and millennial generation, it is observed that during pregnancy couple's attraction decreases slightly. According to variables desire and frequency of intercourse, results obtained show that as the pregnancy progresses there is a marked decrease in desire and intercourse frequency. Women state that they do not have enough information about sexuality in their current state, despite years having passed. CONCLUSIONS: During last 35 years, sexual behaviors have not changed in pregnant women. In both generations, changes in desire and intercourse domains were particularly significant, being in third trimester of pregnancy when frequency of intercourse decline. Pregnant women continue to hold erroneous beliefs about sexuality and request more sexual education.

Anadenanthera colubrina (Fabaceae) logs in the Atlantic Forest biome: first host plant for Thoracibidion lineatocolle (Col: Cerambycidae) and a new host for Temnopis megacephala (Col: Cerambycidae) / Troncos de Anadenanthera colubrina (Fabaceae) no bioma da Mata Atlântica: primeira planta hospedeira de Thoracibidion lineatocolle (Col: Cerambycidae) e uma nova planta hospedeira para Temnopis megacephala (Col: Cerambycidae)

Wood-boring beetles develop in live trees and dead wood, performing ecological services such as decomposition and regulation of forest resources. Species of the Cerambycidae family, widely distributed in the world, bore into the trunks of trees and dead wood in native and cultivated areas. The objective is to report the first host plant for Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) and a new host plant for Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) in the Brazilian Atlantic Forest biome. Three logs, with one-meter-long by 20 cm in diameter, were cut from the trunk of a healthy Anadenanthera colubrina (Fabaceae) tree in October 2013 and tied in the understory at 1.5m high in the Rio Doce State Park, Minas Gerais State, Brazil. The logs, exposed in the forest, were each removed after 40, 80 and 120 days and stored individually in a cardboard box in the "Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq)" in the Rio Doce State Park. A total of 94 individuals of T. lineatocolle and 228 of T. megacephala emerged from the A. colubrina logs. This is the first report of a host plant for T. lineatocolle and a new host plant for T. megacephala.

Besouros broqueadores se desenvolvem em árvores vivas e madeira morta, realizando serviços ecológicos como decomposição e regulação de recursos da floresta. Espécies da família Cerambycidae, amplamente distribuídas no mundo, perfuram o caule de árvores e madeira morta em áreas nativas e cultivadas. O objetivo é relatar a primeira planta hospedeira de Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) e uma nova planta hospedeira para Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) no bioma da Mata Atlântica brasileira. Três toras, com um metro de comprimento por 20 cm de diâmetro, foram cortadas de uma árvore sadia de Anadenanthera colubrina (Fabaceae) em outubro de 2013 e amarradas no sub-bosque a 1,5m de altura no Parque Estadual do Rio Doce, estado de Minas Gerais, Brasil. As toras, expostas na floresta, foram removidas, cada uma, após 40, 80 e 120 dias e armazenadas, individualmente, em caixas de papelão no "Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq)" no Parque Estadual do Rio Doce. Um total de 94 indivíduos de T. lineatocolle e 228 de T. megacephala emergiu das toras de A. colubrina. Esse é o primeiro registro de uma planta hospedeira para T. lineatocolle e o de uma nova planta hospedeira para T. megacephala.

Anadenanthera colubrina (Fabaceae) logs in the Atlantic Forest biome: first host plant for Thoracibidion lineatocolle (Col: Cerambycidae) and a new host for Temnopis megacephala (Col: Cerambycidae) / Troncos de Anadenanthera colubrina (Fabaceae) no bioma da Mata Atlântica: primeira planta hospedeira de Thoracibidion lineatocolle (Col: Cerambycidae) e uma nova planta hospedeira para Temnopis megacephala (Col: Cerambycidae)

Wood-boring beetles develop in live trees and dead wood, performing ecological services such as decomposition and regulation of forest resources. Species of the Cerambycidae family, widely distributed in the world, bore into the trunks of trees and dead wood in native and cultivated areas. The objective is to report the first host plant for Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) and a new host plant for Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) in the Brazilian Atlantic Forest biome. Three logs, with one-meter-long by 20 cm in diameter, were cut from the trunk of a healthy Anadenanthera colubrina (Fabaceae) tree in October 2013 and tied in the understory at 1.5m high in the Rio Doce State Park, Minas Gerais State, Brazil. The logs, exposed in the forest, were each removed after 40, 80 and 120 days and stored individually in a cardboard box in the "Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq)" in the Rio Doce State Park. A total of 94 individuals of T. lineatocolle and 228 of T. megacephala emerged from the A. colubrina logs. This is the first report of a host plant for T. lineatocolle and a new host plant for T. megacephala.

Besouros broqueadores se desenvolvem em árvores vivas e madeira morta, realizando serviços ecológicos como decomposição e regulação de recursos da floresta. Espécies da família Cerambycidae, amplamente distribuídas no mundo, perfuram o caule de árvores e madeira morta em áreas nativas e cultivadas. O objetivo é relatar a primeira planta hospedeira de Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) e uma nova planta hospedeira para Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) no bioma da Mata Atlântica brasileira. Três toras, com um metro de comprimento por 20 cm de diâmetro, foram cortadas de uma árvore sadia de Anadenanthera colubrina (Fabaceae) em outubro de 2013 e amarradas no sub-bosque a 1,5m de altura no Parque Estadual do Rio Doce, estado de Minas Gerais, Brasil. As toras, expostas na floresta, foram removidas, cada uma, após 40, 80 e 120 dias e armazenadas, individualmente, em caixas de papelão no “Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq)” no Parque Estadual do Rio Doce. Um total de 94 indivíduos de T. lineatocolle e 228 de T. megacephala emergiu das toras de A. colubrina. Esse é o primeiro registro de uma planta hospedeira para T. lineatocolle e o de uma nova planta hospedeira para T. megacephala.

Anadenanthera colubrina (Fabaceae) logs in the Atlantic Forest biome: first host plant for Thoracibidion lineatocolle (Col.: Cerambycidae) and a new host for Temnopis megacephala (Col.: Cerambycidae)

Abstract Wood-boring beetles develop in live trees and dead wood, performing ecological services such as decomposition and regulation of forest resources. Species of the Cerambycidae family, widely distributed in the world, bore into the trunks of trees and dead wood in native and cultivated areas. The objective is to report the first host plant for Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) and a new host plant for Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) in the Brazilian Atlantic Forest biome. Three logs, with one-meter-long by 20 cm in diameter, were cut from the trunk of a healthy Anadenanthera colubrina (Fabaceae) tree in October 2013 and tied in the understory at 1.5m high in the Rio Doce State Park, Minas Gerais State, Brazil. The logs, exposed in the forest, were each removed after 40, 80 and 120 days and stored individually in a cardboard box in the Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq) in the Rio Doce State Park. A total of 94 individuals of T. lineatocolle and 228 of T. megacephala emerged from the A. colubrina logs. This is the first report of a host plant for T. lineatocolle and a new host plant for T. megacephala.

Resumo Besouros broqueadores se desenvolvem em árvores vivas e madeira morta, realizando serviços ecológicos como decomposição e regulação de recursos da floresta. Espécies da família Cerambycidae, amplamente distribuídas no mundo, perfuram o caule de árvores e madeira morta em áreas nativas e cultivadas. O objetivo é relatar a primeira planta hospedeira de Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) e uma nova planta hospedeira para Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) no bioma da Mata Atlântica brasileira. Três toras, com um metro de comprimento por 20 cm de diâmetro, foram cortadas de uma árvore sadia de Anadenanthera colubrina (Fabaceae) em outubro de 2013 e amarradas no sub-bosque a 1,5m de altura no Parque Estadual do Rio Doce, estado de Minas Gerais, Brasil. As toras, expostas na floresta, foram removidas, cada uma, após 40, 80 e 120 dias e armazenadas, individualmente, em caixas de papelão no Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq) no Parque Estadual do Rio Doce. Um total de 94 indivíduos de T. lineatocolle e 228 de T. megacephala emergiu das toras de A. colubrina. Esse é o primeiro registro de uma planta hospedeira para T. lineatocolle e o de uma nova planta hospedeira para T. megacephala.

A geometrical method for modeling bioelectrical impedance measurements and remove the hook effect deviations.

OBJECTIVE: to describe a simple and straightforward method to calculate the circle parameters that can be used to fit Electrical Bioimpedance Spectroscopy (EBIS) raw data to the complex plane and remove the hook effect, a deviation of that model especially seen at higher frequencies and considered as an artifact due to instrumental limitations. APPROACH: under the assumption that raw EBIS data in the middle frequencies best represent the beta dispersion, the authors of this article propose a geometrical procedure to calculate parameters for this dispersion and remove the hook effect. For this purpose, data obtained with two different devices were used with apparently very good results. MAIN RESULTS: the results of this study suggest that circle parameters for the beta dispersion can be obtained, but, also, that the residuals of the hook effect correction seem to adjust to a circle and, therefore, they could also be parameterized using the same approach. SIGNIFICANCE: the method proposed in this article is very easy to perform and could help end EBIS users not familiar with mathematical models and fitting processes, to better understand and interpret their data.

Vasculitis y vasculopatía con compromiso cutáneo, nasal y pulmonar inducida por consumo de cocaína-levamisol / Vasculitis and vasculopathy with cutaneous, nasal and pulmonary involvementinduced by cocaine-levamisole use

Resumen La cocaína pura y la contaminada con levamisol producen múltiples dermatosis, siendo las más frecuentes las lesiones destructivas de línea media y las vasculitis similares a las ANCA. Las bases fisiopatológicas de estas manifestaciones se sustentan en el daño vascular secundario a vasculitis y/o vasculopatía, originado por ambas sustancias y en muchos casos se puede encontrar solapamiento de las formas clínicas, lo que puede llevar a diagnósticos erróneos. Los patrones de positividad de los auto anticuerpos, el patrón de las lesiones cutáneas y el contexto social, serán claves en el abordaje y tratamiento adecuado de estos pacientes.

Abstract Pure cocaine and contaminated cocaine with levamisole produce multiple cutaneous and systemic manifestations, being midline destructive lesions and ANCA-like vasculitis the most frequent ones. The pathophysiological bases of these manifestations are based on secondary vascular damage to vasculitis and/or vasculopathy caused by both substances and in many cases it may be found an overlapping of the clinical forms, which might lead to erroneous diagnoses. The patterns of positivity of the autoantibodies, the pattern of skin lesions and the social context of the patient will be key in the proper approach and management of these patients. The following case describes a patient with cutaneous, nasal and pulmonary manifestations due to cocaine / levamisole consumption. Also, a review of the literature is carried out.

Anadenanthera colubrina (Fabaceae) logs in the Atlantic Forest biome: first host plant for Thoracibidion lineatocolle (Col.: Cerambycidae) and a new host for Temnopis megacephala (Col.: Cerambycidae).

Wood-boring beetles develop in live trees and dead wood, performing ecological services such as decomposition and regulation of forest resources. Species of the Cerambycidae family, widely distributed in the world, bore into the trunks of trees and dead wood in native and cultivated areas. The objective is to report the first host plant for Thoracibidion lineatocolle (Thomson, 1865) (Coleoptera: Cerambycidae) and a new host plant for Temnopis megacephala (Germar, 1824) (Coleoptera: Cerambycidae) in the Brazilian Atlantic Forest biome. Three logs, with one-meter-long by 20 cm in diameter, were cut from the trunk of a healthy Anadenanthera colubrina (Fabaceae) tree in October 2013 and tied in the understory at 1.5m high in the Rio Doce State Park, Minas Gerais State, Brazil. The logs, exposed in the forest, were each removed after 40, 80 and 120 days and stored individually in a cardboard box in the "Laboratório de Campo do Projeto de Ecologia de Longa Duração (PELD-CNPq)" in the Rio Doce State Park. A total of 94 individuals of T. lineatocolle and 228 of T. megacephala emerged from the A. colubrina logs. This is the first report of a host plant for T. lineatocolle and a new host plant for T. megacephala.

Salivary gland cancer in Southern Brazil: a prognostic study of 107 cases.

BACKGROUND: Salivary gland cancers (SGC) represent an uncommon group of heterogeneous tumors. We performed a retrospective survey of SGC diagnosed in a reference center for treatment of malignant tumors from the south of Brazil aiming to determine the prognostic value of demographic, clinic and pathologic features. MATERIAL AND METHODS: Cases diagnosed as SGC between 2006 and 2016 were retrospectively collected. Medical records were examined to extract demographic, clinic, pathologic and follow-up information. RESULTS: One-hundred and seven cases of SGC were identified. The most common SGC were mucoepidermoid carcinoma (MEC) (n = 39) followed by adenoid cystic carcinoma (AdCC) (n = 29). Among AdCCs, 55.2% of cases were classified as cribriform, 27.6% as tubular and 17.2% as solid. The tubular subtype had the highest percentage of cases with perineural invasion (p=0.01). Among MEC, 61.5% of cases were classified as low grade, 15.4% as intermediate grade and 19.9% as high grade. Low grade MEC had the lowest percentage of cases with perineural invasion (p=0.04). The 5-year survival for loco-regional control, disease-free survival (DFS) and disease-specific survival were 75%, 70% and 84%, respectively. The following features were associated with poor DFS: advanced age (p=0.03), rural residency (p=0.01), being a smoker or former smoker (p=0.01), pain (p=0.03), nodal metastasis (p<0.001), need for chemotherapy (p=0.02), neck dissection (p=0.04), perineural invasion (p=0.01), and being diagnosed with AdCC compared to MEC (p=0.02). CONCLUSIONS: The clinco-demographic and pathologic features identified as prognostic factors reveal the profile of patients at increased risk of recurrence and who would benefit from closer follow-up.

[Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review]. / Propiedades psicométricas de instrumentos observacionales para evaluar habilidades en silla de ruedas en sujetos con lesión medular espinal: revisión sistemática.

A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. OBJECTIVE: To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies. PROSPERO registration: CRD42020161430.