Analysis of the effectiveness coefficient in greco-roman fighting athletes at different levels of competition / Análisis del coeficiente de eficacia en atletas de lucha griego-romana en distintos niveles de competición / Análise do coeficiente de efetividade em atletas de luta greco-romana em diferentes níveis de competição

ABSTRACT Introduction: Wrestling is an ancient combat sport, individual and of complex performance, which integrates high technical and tactical complexity, associated with a bioenergetic interaction and a high coordinative pattern. In Brazil, the number of competitors at different levels has increased significantly in the last years, evidencing the need to search for answers that can help coaches in the different situations of the competitive calendar. The prescription of the means and methods of training in Greco-Roman wrestling aims at the development of the technical effectiveness. However, there is no evidence of indicators of technical effectiveness, in Brazilian elite athletes of Greco-Roman wrestling, in national and international competitions. Objectives: The objective of the study was to verify and to compare the technical effectiveness of the wrestlers of Greco-Roman fight of the Brazilian selection, in two competitions: one in the national level and the other international. Methods: Seven athletes of the Brazilian wrestling team participated of the investigation (age: 25±5 years; stature: 175±12 cm; corporal mass: 80± 21kg). Analysis of the effective, not effective and total technique were accomplished. After identifying the normality of the data (SHAPIRO WILKS), the Student's t test was used to compare the variables, according to the moment evaluated, considering the significance level of 5%. Results: The results showed a significant decrease (p = 0.03) in the standing effective technique and in the total effective technique (p = 0.01), comparing the national competition with the international competition. Conclusion: Technical effectiveness of Brazilian wrestlers was found to be below the indices presented in studies with competitors from countries considered to have high world performance. In international competition, it presents a negative impact compared to national events. Level of Evidence IV; Therapeutic Studies - Investigation of Treatment Results.

RESUMEN Introducción: El Wrestling es una modalidad de combate milenaria, individual y de rendimiento complejo, que integra elevada complejidad técnico-táctica, asociada a una interacción bioenergética y un alto patrón coordinativo. En Brasil, el número de competidores en diferentes niveles aumentó significativamente en los últimos años, evidenciando la necesidad en la búsqueda de respuestas que auxilien a los entrenadores en las diferentes situaciones del calendario competitivo. La prescripción de los medios y métodos de entrenamiento en la lucha greco-romana tiene como objetivo el desarrollo de la efectividad técnica. Entre tanto, no hay evidencias de indicadores de efectividad técnica, en atletas de alto rendimiento brasileño en la lucha greco-romana, en competencias nacionales e internacionales. Objetivos: El objetivo de este estudio fue verificar y comparar la efectividad técnica de los atletas de lucha greco-romana de la selección brasileña, en dos competencias: una a nivel nacional y otra internacional. Métodos: Participaron de la investigación siete atletas de la selección brasileña de lucha greco-romana (edad: 25±5 años; estatura: 175±12 cm; masa corporal: 80± 21kg). Fueron realizados análisis de la técnica efectiva, no efectiva y total. Después de identificar la normalidad de los datos (SHAPIRO WILKS), fue utilizado el test de t de Student para la comparación de las variables, según el momento evaluado, considerando el nivel de significación de 5%. Resultados: Los resultados mostraron una disminución significativa (p = 0,03) en la técnica efectiva en pie y en la técnica efectiva total (p = 0,01), comparándose la competencia nacional con la internacional. Conclusión: Se concluyó que la eficacia técnica de los luchadores brasileños está por debajo de los índices presentados en estudios con competidores de países considerados de alto rendimiento mundial. En la competición internacional, presenta un impacto negativo en comparación con los eventos nacionales. Nivel de Evidencia IV; Estudios Terapéuticos - Investigación de Los Resultados Del Tratamiento.

RESUMO Introdução: O Wrestling é uma modalidade de combate milenar, individual e de rendimento complexo, que integra elevada complexidade técnico-táctica, associada a uma interação bioenergética e um alto padrão coordenativo. No Brasil, o número de competidores em diferentes níveis aumentou significativamente nos últimos anos, evidenciando a necessidade da busca de respostas que auxiliem os treinadores nas diferentes situações do calendário competitivo. A prescrição dos meios e métodos de treinamento na luta greco-romana visa o desenvolvimento da efetividade técnica. Entretanto, não há evidências de indicadores de efetividade técnica, em atletas de elite brasileira de luta greco-romana, em competições nacionais e internacionais. Objetivo: o objetivo do estudo foi verificar e comparar a efetividade técnica dos lutadores de luta greco-romana da seleção brasileira, em duas competições: uma no nível nacional e a outra internacional. Métodos: Participaram da investigação sete atletas da seleção brasileira de luta greco-romana (idade: 25±5 anos; estatura: 175±12 cm; massa corporal: 80± 21kg). Foram realizadas análises da técnica efetiva, não efetiva e total. Após identificar a normalidade dos dados (SHAPIRO WILKS), foi utilizado o teste t de Student para a comparação das variáveis, segundo o momento avaliado, considerando nível de significância de 5%. Resultados: Os resultados mostraram uma diminuição significativa (p = 0,03) na técnica efetiva em pé e na técnica efetiva total (p = 0,01), comparando-se a competição nacional com a internacional. Conclusão: Concluiu-se que a efetividade técnica dos lutadores brasileiros está abaixo dos índices apresentados em estudos com competidores de países considerados de alto desempenho mundial. Em competição internacional, apresenta um impacto negativo comparativamente a eventos nacionais. Nível de Evidência IV; Estudos Terapêuticos - Investigação dos Resultados do Tratamento.

Comparative Effects of Different Materials on Alveolar Preservation.

OBJECTIVE: The purpose of this study was to compare different materials' effects on alveolar ridge preservation of postextraction sockets in anterior maxilla. MATERIALS AND METHOD: In this prospective, single center, randomized, controlled clinical trial, healthy patients who needed one single anterior maxillary tooth extraction (including bicuspids) were selected. After a minimally traumatic extraction without complications, 44 patients were randomly allocated into 4 groups: 1) natural socket healing (blood clot), 2) xenograft and gingival free graft, 3) dense polytetrafluoroethylene membrane, and 4) platelet rich fibrin plugs. Alveolar ridge height and width loss were evaluated in cone beam computed tomography (CBCT) and in dental casts at 3 moments: 1) preoperative (T1), 2) 7 days postoperative (T2), and 3) 120 days postoperative (T3). Height and width alveolar ridge loss detected in CBCT and in dental casts were compared among the groups (two-way analysis of variance [ANOVA]; P < .05). RESULTS: Forty patients (24 women and 16 men) ranging from 25 to 70 years old (mean of 42 years old) participated in this study. Group 2 showed the least alveolar ridge height loss results in CBCT (9.8 ± 1.9% at T3) and dental cast analysis (1.0 ± 0.2 mm). Groups 2 (12.7 ± 4.7% at T3) and 3 (15.4 ± 2.7% at T3) showed the least alveolar ridge width loss measured in CBCT compared with groups 1 and 4, but the difference between groups 2 and 3 were not statistically significant (P = .968). Group 3 (0.9 ± 0.2 mm) and group 2 (1.0 ± 0.2 mm) showed the least width loss compared with groups 1 and 4 in dental cast analysis. Again, the difference between groups 3 and 2 was not statistically significant (P = 1.000). CONCLUSION: In postextraction sockets of the anterior maxilla and bicuspid region, group 2 (xenogenous bone graft with free gingival graft) and group 3 (dense polytetrafluoroethylene) obtained the best results in alveolar preservation, with group 2 being more indicated when the vertical alveolar ridge preservation is mandatory.

Study on the zoonotic cycle of tegumentary leishmaniasis in an endemic area of a metropolitan region in the Northeastern region of Brazil.

This study was conducted to characterize the transmission cycle of the tegumentary leishmaniasis (TL) in an old colonization area at Pernambuco State, Brazil. The aims were to identify autochthonous cases, sandflies fauna, domestic animals as possible reservoir hosts and the Leishmania species involved in this endemic area. A total of 168 suspected human cases of TL and 272 domestic animals (canine, feline, equine, goat, and sheep) were included. The sandflies were captured and identified by species. Patients were predominantly male and the average age was 37+18.1 years old. Of 85 patients who had skin lesions, 25.6% of them had direct positive smears for TL and 34 isolates were identified as Leishmania (Viannia) braziliensis. The confirmation for TL diagnosed by molecular detection (PCR) was almost three times more sensitive than the direct test [p < 0.001; PR = 2.72] associated with clinical examination. The Kappa test on PCR between two different specimens, biopsy, and skin lesion swab was 60.8% (p < 0.001). More than 200 specimens of sandflies (80 males and 159 females) were captured and identified as Lutzomyia whitmani (99.6%) and Lu. evandroi (0.4%). The detection of L. (V.) braziliensis by Real-Time PCR in the blood of a captured fed female was positive in 59.3% of Lu. whitmani. Of the 272 domestic animals included, 61.76% were male (n = 168). Thirty-six animals (13.2%) had lesions compatible with TL (34 dogs, 1 cat and 1 sheep) and 3 of them, all dogs, had lesions on the snout, showing destruction of cartilage and mucosa. The study suggests the participation of domestic animals as possible reservoirs. However, further studies are necessary to better understand the transmission cycle and take recommended measures in order to control the disease.

Prevalence of burnout among healthcare workers in six public referral hospitals in northeastern Brazil during the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

Prevalence of burnout among healthcare workers in six public referral hospitals in northeastern Brazil during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has placed considerable psychological stress on frontline healthcare workers (HCWs). OBJECTIVE: To evaluate the prevalence of burnout syndrome among HCWs facing the COVID-19 outbreak. DESIGN AND SETTING: Cross-sectional study conducted in six public intensive care units (ICUs) in the city of Fortaleza, Brazil. METHODS: An online survey was conducted among HCWs to measure the three dimensions of burnout. RESULTS: A total of 62 physicians (23.4%), 65 nurses (24.5%), 58 nurse technologists (21.9%) and 80 physiotherapists (30.2%) completed the questionnaire. Nearly half of the participants (48.6%) had high levels of emotional exhaustion, and almost one-third of them (29.4%) had high levels of depersonalization. Low levels of professional efficacy were observed in 18.1% of the sample. The independent determinants of depersonalization burnout were age < 33 years (odds ratio, OR 2.03; 95% confidence interval, CI 1.15-3.56; P = 0.01) and female gender (OR 0.33; 95% CI 0.18-0.62; P = 0.01). Increased workload was associated with both depersonalization (OR 2.37; 95% CI 2.02-5.50; P = 0.04) and emotional exhaustion (OR 1.89; 95% CI 1.04-3.58; P = 0.030). CONCLUSION: The COVID-19 pandemic has had a great impact on the dimensions of depersonalization and emotional exhaustion. Consideration of these dimensions is important when designing future burnout prevention programs for frontline personnel.

Study on the zoonotic cycle of tegumentary leishmaniasis in an endemic area of a metropolitan region in the Northeastern region of Brazil

ABSTRACT This study was conducted to characterize the transmission cycle of the tegumentary leishmaniasis (TL) in an old colonization area at Pernambuco State, Brazil. The aims were to identify autochthonous cases, sandflies fauna, domestic animals as possible reservoir hosts and the Leishmania species involved in this endemic area. A total of 168 suspected human cases of TL and 272 domestic animals (canine, feline, equine, goat, and sheep) were included. The sandflies were captured and identified by species. Patients were predominantly male and the average age was 37+18.1 years old. Of 85 patients who had skin lesions, 25.6% of them had direct positive smears for TL and 34 isolates were identified as Leishmania (Viannia) braziliensis. The confirmation for TL diagnosed by molecular detection (PCR) was almost three times more sensitive than the direct test [p < 0.001; PR = 2.72] associated with clinical examination. The Kappa test on PCR between two different specimens, biopsy, and skin lesion swab was 60.8% (p < 0.001). More than 200 specimens of sandflies (80 males and 159 females) were captured and identified as Lutzomyia whitmani (99.6%) and Lu. evandroi (0.4%). The detection of L. (V.) braziliensis by Real-Time PCR in the blood of a captured fed female was positive in 59.3% of Lu. whitmani. Of the 272 domestic animals included, 61.76% were male (n = 168). Thirty-six animals (13.2%) had lesions compatible with TL (34 dogs, 1 cat and 1 sheep) and 3 of them, all dogs, had lesions on the snout, showing destruction of cartilage and mucosa. The study suggests the participation of domestic animals as possible reservoirs. However, further studies are necessary to better understand the transmission cycle and take recommended measures in order to control the disease.

Unveiling the contribution of the reproductive system of individual Caenorhabditis elegans on oxygen consumption by single-point scanning electrochemical microscopy measurements.

Metabolic analysis in animals is usually either evaluated as whole-body measurements or in isolated tissue samples. To reveal tissue specificities in vivo, this study uses scanning electrochemical microscopy (SECM) to provide localized oxygen consumption rates (OCRs) in different regions of single adult Caenorhabditis elegans individuals. This is achieved by measuring the oxygen reduction current at the SECM tip electrode and using a finite element method model of the experiment that defines oxygen concentration and flux at the surface of the organism. SECM mapping measurements uncover a marked heterogeneity of OCR along the worm, with high respiration rates at the reproductive system region. To enable sensitive and quantitative measurements, a self-referencing approach is adopted, whereby the oxygen reduction current at the SECM tip is measured at a selected point on the worm and in bulk solution (calibration). Using genetic and pharmacological approaches, our SECM measurements indicate that viable eggs in the reproductive system are the main contributors in the total oxygen consumption of adult Caenorhabditis elegans. The finding that large regional differences in OCR exist within the animal provides a new understanding of oxygen consumption and metabolic measurements, paving the way for tissue-specific metabolic analyses and toxicity evaluation within single organisms.

Cuidado de enfermagem e desafios em saúde mental na estratégia de saúde da família a partir do apoio matricial / Nursing care and mental health challenges in the family health strategy based on matrix support / Los desafíos de la atención de enfermería y la salud mental en la estrategia de salud de la familia basada en el soporte matricial

Objetivo: avaliar a produção científica sobre o cuidado do enfermeiro em saúde mental na estratégia de saúde da família a partir da implantação do apoio matricial, bem como identificar os desafios ao cuidar em enfermagem nesse setor. Método: Trata-se de uma revisão narrativa da literatura, realizada em novembro de 2020 nas bases de dados: Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Biblioteca Virtual em Saúde, bem como documentos do Ministério da Saúde. Os materiais foram buscados por meio da seguinte estrutura: Saúde Mental; Apoio Matricial; Capacitação de Enfermeiros; Saúde da Família. Incluíram-se artigos da língua portuguesa, nos períodos de 2007 a 2018. Excluíram-se artigos com mais de 15 anos de publicação tendo em vista a atualidade do tema. Resultados: 11 artigos científicos compuseram a amostra da pesquisa. Embora os profissionais enfermeiros tenham reportado estarem preparados para lidar com seus pacientes e conhecerem os principais transtornos, poucos foram capazes de detalhar esses conhecimentos. As capacitações e cursos de residência foram citados como estratégia de preparação, mas a insegurança e tempo disposto para lidar com esses pacientes foram impasses para a qualidade do cuidado prestado. Conclusão: é necessária maior preparação dos enfermeiros na área de saúde mental a fim de se proporcionar um atendimento resolutivo aos pacientes. Os envolvidos reconhecem que a necessidade da auto avaliação dos apoiadores matriciais e enfermeiros, enfatizam o (re) pensamento das práticas instituídas nas políticas públicas e gestão da estratégia matricial de apoio para a saúde mental.

Objective: to assess the scientific production on mental health nurse care in the family health strategy from the implementation of matrix support, as well as to identify the challenges in nursing care in this sector. Method: This is a narrative review of the literature, carried out in November 2020 in the databases: Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences and Virtual Health Library, as well as documents from the Ministry of Health. Health. The materials were sought through the following structure: Mental Health; Matrix Support; Training of Nurses; Family Health. Articles from the Portuguese language were included in the periods from 2007 to 2018. Articles with more than 15 years of publication were excluded in view of the current nature of the topic. Results: 11 scientific articles comprised the research sample. Although professional nurses reported being prepared to deal with their patients and knowing the main disorders, few were able to detail this knowledge. The training and residency courses were cited as a preparation strategy, but the insecurity and time available to deal with these patients were impasses for the quality of care provided. Conclusion: greater preparation of nurses in the mental health area is necessary in order to provide resolutive care to patients. Those involved recognize that the need for self-assessment by matrix supporters and nurses, emphasizes the (re) thinking of the practices instituted in public policies and management of the matrix support strategy for mental health

Objetivo: evaluar la producción científica sobre la atención de enfermería en salud mental en la estrategia de salud de la familia a partir de la implementación de la matriz de soporte, así como identificar los desafíos en la atención de enfermería en este sector. Método: Se trata de una revisión narrativa de la literatura, realizada en noviembre de 2020 en las bases de datos: Biblioteca Científica Electrónica en Línea, Literatura Latinoamericana y del Caribe en Ciencias de la Salud y Biblioteca Virtual en Salud, así como documentos del Ministerio de Salud. Salud Los materiales se buscaron a través de la siguiente estructura: Salud Mental; Soporte de matriz; Formación de enfermeras; Salud familiar. Los artículos en lengua portuguesa se incluyeron en los períodos 2007 a 2018. Se excluyeron los artículos con más de 15 años de publicación debido a la naturaleza actual del tema. Resultados: 11 artículos científicos conformaron la muestra de investigación. Aunque las enfermeras profesionales informaron estar preparadas para tratar con sus pacientes y conocer los principales trastornos, pocas pudieron detallar este conocimiento. Los cursos de capacitación y residencia fueron citados como una estrategia de preparación, pero la inseguridad y el tiempo disponible para atender a estos pacientes fueron un callejón sin salida para la calidad de la atención brindada. Conclusión: es necesaria una mayor preparación del personal de enfermería en el área de salud mental para brindar atención resolutiva a los pacientes. Los involucrados reconocen que la necesidad de autoevaluación por parte de los apoyadores de la matriz y las enfermeras, enfatiza el (re) pensamiento de las prácticas instituidas en las políticas públicas y la gestión de la estrategia de soporte de la matriz para la salud mental.

Split Crest Technique with Immediate Implant to Treat Horizontal Defects of the Alveolar Ridge: Analysis of Increased Thickness and Implant Survival.

OBJECTIVE: To assess bone thickness augmentation and implant survival in ridges with horizontal atrophy managed through split crest technique with concomitant installation of dental implants. MATERIALS AND METHODS: Thirteen patients with maxillary bone atrophy underwent surgery and had their bone thickness assessed through cone beam computed tomography 6 months pre- and postoperatively. Comparative measurements of initial and final bone height and thickness were taken using Dolphin Imaging® 11.5 software. The distance between the nasal fossa floor or the maxillary sinus and the alveolar crest determined the bone height, while the measurement of bone thickness took into account the distance between the vestibular cortical bone and the palatal cortical bone at the crest level, and at 5 mm and 10 mm from it. RESULTS: The bone height loss of 0.68 mm was statistically significant (p = 0.01). The average horizontal bone gain was 3.45 mm at ridge level, 3.03 mm at 5 mm from it and 2.42 mm at 10 mm from it. The mean horizontal gain for the three regions was 2.97 mm, and the values were statistically significant for all three regions assessed (p < 0.01). No complications were associated with the surgical procedures, and 23 implants were installed following the surgical expansion. No implants were lost (100% survival). CONCLUSION: The split crest technique proved to be viable and predictable, enabling a significant increase in ridge thickness and a high percentage of implant survival.

Lifespan-extending interventions enhance lipid-supported mitochondrial respiration in Caenorhabditis elegans.

Dietary restriction and reduced reproduction have been linked to long lifespans in the vast majority of species tested. Although decreased mitochondrial mass and/or function are hallmarks of aging, little is known about the mechanisms by which these organelles contribute to physiological aging or to the effects of lifespan-extending interventions, particularly with respect to oxidative phosphorylation and energy production. Here, we employed the nematode Caenorhabditis elegans to examine the effects of inhibition of germline proliferation and dietary restriction, both of which extend the lifespan of C. elegans, on mitochondrial respiratory activity in whole animals and isolated organelles. We found that oxygen consumption rates and mitochondrial mass were reduced in wild-type (WT) C. elegans subjected to bacterial deprivation (BD) compared with animals fed ad libitum (AL). In contrast, BD decreased the rate of oxygen uptake but not mitochondrial mass in germline-less glp-1(e2144ts) mutants. Interestingly, mitochondria isolated from animals subjected to BD and/or inhibition of germline proliferation showed no differences in complex I-mediated respiratory activity compared to control mitochondria, whereas both interventions enhanced the efficiency with which mitochondria utilized lipids as respiratory substrates. Notably, the combination of BD and inhibition of germline proliferation further increased mitochondrial lipid oxidation compared to either intervention alone. We also detected a striking correlation between lifespan extension in response to BD and/or inhibition of germline proliferation and the capacity of C. elegans to generate ATP from lipids. Our results thus suggest that the ability to oxidize lipids may be determinant in enhanced longevity.

Lipase-like 5 enzyme controls mitochondrial activity in response to starvation in Caenorhabditis elegans.

The C. elegans lipase-like 5 (lipl-5) gene is predicted to code for a lipase homologous to the human gastric acid lipase. Its expression was previously shown to be modulated by nutritional or immune cues, but nothing is known about its impact on the lipid landscape and ensuing functional consequences. In the present work, we used mutants lacking LIPL-5 protein and found that lipl-5 is important for normal lipidome composition as well as its remodeling in response to food deprivation. Particularly, lipids with signaling functions such as ceramides and mitochondrial lipids were affected by lipl-5 silencing. In comparison with wild type worms, animals lacking LIPL-5 were enriched in cardiolipins linked to polyunsaturated C20 fatty acids and coenzyme Q-9. Differences in mitochondrial lipid composition were accompanied by differences in mitochondrial activity as mitochondria from well-fed lipl-5 mutants were significantly more able to oxidize respiratory substrates when compared with mitochondria from well-fed wild type worms. Strikingly, starvation elicited important changes in mitochondrial activity in wild type worms, but not in lipl-5 worms. This indicates that this lipase is a determinant of mitochondrial functional remodeling in response to food withdrawal.

Pulmonary sequestration and endovascular treatment: a case report.

Pulmonary sequestration is a congenital anomaly defined as a nonfunctioning mass of lung parenchyma. Presence of an independent pleural envelope classifies it as intralobar, accounting for approximately 75% of the cases, while absence classifies cases as extralobar, accounting for the remaining 25%. Diagnosis is made through radiography and confirmed by computed tomography, magnetic resonance, or angiography. The traditional treatment is open surgical repair, but endovascular techniques have been used, with good results. We report the case of a 29-year-old-woman presenting with recurrent pneumonia for 5 years. A CT scan of the chest revealed poor vascular formation in the lower region of the right lung. The pulmonary sequestration was treated by embolization of the anomalous branch.

Brain Innate Immune Response in Diet-Induced Obesity as a Paradigm for Metabolic Influence on Inflammatory Signaling.

Obesity is a predisposing factor for numerous morbidities, including those affecting the central nervous system. Hypothalamic inflammation is a hallmark of obesity and is believed to participate in the onset and progression of the obese phenotype, by promoting changes in neuronal functions involved in the control of metabolism. The activation of brain immune cells in the hypothalamus, which are represented by microglia and brain macrophages, is associated with obesity and has been the focus of intense research. Despite the significant body of knowledge gathered on this topic, obesity-induced metabolic changes in brain cells involved in innate immune responses are still poorly characterized due, at least in part, to limitations in the existing experimental methods. Since the metabolic state influences immune responses of microglia and other myeloid cells, the understanding and characterization of the effects of cellular metabolism on the functions of these cells, and their impact on brain integrity, are crucial for the development of efficient therapeutic interventions for individuals exposed to a long-term high fat diet (HFD). Here we review and speculate on the cellular basis that may underlie the observed changes in the reactivity and metabolism of the innate immune cells of the brain in diet-induced obesity (DIO), and discuss important points that deserve further investigation.

Melatonin multiple effects on brown adipose tissue molecular machinery.

Brown adipose tissue (BAT) influences energy balance through nonshivering thermogenesis, and its metabolism daily and seasonal variations are regulated by melatonin through partially known mechanisms. We evaluated the role of melatonin in BAT molecular machinery of male Control, pinealectomized (PINX), and melatonin-treated pinealectomized (PINX/Mel) adult rats. BAT was collected either every 3 hours over 24 hours or after cold or high-fat diet (HFD) acute exposure. HFD PINX animals presented decreased Dio2 expression, while HFD PINX/Mel animals showed increased Dio2, Ucp1, and Cidea expression. Cold-exposed PINX rats showed decreased Dio2 and Lhs expression, and melatonin treatment augmented Adrß3, Dio2, Ucp1, and Cidea expression. Daily profiles analyses showed altered Dio2, Lhs, Ucp1, Pgc1α, and Cidea gene and UCP1 protein expression in PINX animals, leading to altered rhythmicity under sub-thermoneutral conditions, which was partially restored by melatonin treatment. The same was observed for mitochondrial complexes I, II, and IV protein expression and enzyme activity. Melatonin absence seems to impair BAT responses to metabolic challenges, and melatonin replacement reverses this effect, with additional increase in the expression of crucial genes, suggesting that melatonin plays an important role in several key points of the thermogenic activation pathway, influencing both the rhythmic profile of the tissue and its ability to respond to metabolic challenges, which is crucial for the organism homeostasis.

Use of electromyographic signals for characterization of voluntary coughing in humans with and without spinal cord injury-A systematic review.

INTRODUCTION: Individuals with spinal cord injury (SCI) frequently have an ineffective cough ability due to dysfunctions in expiratory muscles. In such cases, several articles have reported the occurrence of residual muscular activity in muscles that are accessory to coughing. The knowledge about this activity may be useful for building cough assistance devices. The goal of this review is to investigate and to describe the electromyographic signals generated during voluntary coughing in healthy people and in patients with SCI. METHODS: Two researchers performed, blindly and independently, a systematic review of the following databases: PubMed, PEDro, LILACS, and Science Direct. We conducted the searches using descriptors in English, Portuguese, and Spanish, with no limitations regarding the publication year. The review included articles describing experiments performed in humans and with the use of electromyographic signals in the analysis of voluntary coughing. RESULTS: Among the 156 initially found articles, only nine had results that described the study of electromyographic signals associated with voluntary coughing. The results showed evidence that, during voluntary coughing, electromyographic signals are generated both in expiratory and accessory muscles in healthy subjects. In individuals with SCI below the 5th cervical level (C5), the electromyographic signal appeared only in the clavicular portion of the pectoralis major, especially in the explosive cough phase. CONCLUSION: Our evaluation of the current literature shows that, according to the analysed studies, the electromyographic signals are more pre-eminent in the expiratory phase of the pectoralis major, during voluntary cough of individuals with SCI (C5-T12).

Sequestro pulmonar e tratamento endovascular: um relato de caso / Pulmonary sequestration and endovascular treatment: a case report

O sequestro pulmonar refere-se à anomalia congênita definida por massa de parênquima pulmonar não funcionante. É dividido pela existência de envoltório pleural próprio em intralobar, representando cerca de 75% dos casos, ou extralobar, responsável pelos 25% restantes. O diagnóstico é feito através de radiografia e confirmado com tomografia computadorizada, ressonância nuclear magnética e arteriografia. Tradicionalmente, o tratamento proposto é cirúrgico, mas a técnica endovascular tem apresentado bons resultados. É relatado o caso de uma mulher, 29 anos, com quadro clínico de pneumonias de repetição desde os 5 anos. A tomografia de tórax revelou malformação vascular em região inferior de pulmão direito. O tratamento vascular foi realizado através de embolização do ramo anômalo

Pulmonary sequestration is a congenital anomaly defined as a nonfunctioning mass of lung parenchyma. Presence of an independent pleural envelope classifies it as intralobar, accounting for approximately 75% of the cases, while absence classifies cases as extralobar, accounting for the remaining 25%. Diagnosis is made through radiography and confirmed by computed tomography, magnetic resonance, or angiography. The traditional treatment is open surgical repair, but endovascular techniques have been used, with good results. We report the case of a 29-year-old-woman presenting with recurrent pneumonia for 5 years. A CT scan of the chest revealed poor vascular formation in the lower region of the right lung. The pulmonary sequestration was treated by embolization of the anomalous branch

Parâmetros e efeitos do laser não ablativo no tratamento de melasma facial / Parameters and effects of non-ablative laser in facial melasma

O uso do laser não ablativo no tratamento do melasma tem sido abordado em diversos estudos, porém, não há consenso na literatura quanto aos parâmetros e feitos de intervenções baseadas neste recurso. O objetivo deste estudo foi identificar e descrever parâmetros e efeitos do laser não ablativo no tratamento de hiperpigmentação de pele (melasma). Trata-se de uma revisão sistemática da literatura baseada no Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca eletrônica compreendeu as seguintes bases de dados: PubMed, Physiotherapy Evidence Database (PEDro), Science Direct e SciELO. Foram identificados inicialmente 641 documentos nas bases de dados eletrônicas, enquanto na busca manual 26 artigos foram encontrados, após leitura e análise 7 artigos foram selecionados. Foram analisados 7 artigos correspondentes as bases de dados PubMed e Science Direct, todos na língua inglesa e publicados a partir do ano de 2010. Apenas um estudo utilizou uma amostra maior que 30 indivíduos, os demais utilizaram em média 16 participantes, com predomínio do sexo feminino e classificação segundo Fitzpatrick entre III-V. O comprimento de onda variou entre 1064 nm a 1550 nm e a energia máxima não ultrapassou 4 J/cm². De acordo com as variáveis avaliadas, os protocolos testados demonstraram que o laser não ablativo foi ineficaz no tratamento de melasma facial, sobretudo após a interrupção da terapia. (AU)

The use of non-ablative laser in the treatment of melasma has been used in several studies, however, there is no consensus in the literature regarding the parameters and interventions based on this resource. The objective of this study was to identify and describe parameters and effects of nonablative laser in the treatment of skin hyperpigmentation (melasma). This is a systematic review of the literature based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The study included the following databases: PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and SciELO. We initially identified 641 documents in the electronic databases, while in the manual search 26 articles were found, and after reading and analyzing 7 articles were selected. We analyzed these 7 articles corresponding to the PubMed and Science Direct databases, all in the English language and published after the year 2010. Only one study used a sample > 30 individuals, the others used on average 16 participants, with a predominance of female gender and Fitzpatrick classification according to III-V. The wavelength ranged from 1064 nm to 1550 nm and the maximum energy did not exceed 4 J/cm². According to the variables evaluated, the protocols tested demonstrated that the non-ablative laser was ineffective in the treatment of facial melasma, especially after the end of the therapy. (AU)

Novas perspectivas de fisioterapia respiratória em lesão medular - uma revisão sistemática / New perspectives for chest physical therapy in spinal cord injury - a systematic review

Resumo Objetivo: Descrever e analisar parâmetros e efeitos da estimulação elétrica de superfície na função muscular respiratória de pessoas com lesão medular, sobretudo durante a tosse. Métodos: Foi realizada uma revisão sistemática da literatura, com base no Preferred Reporting items for Systematic Reviews and Meta-Analyses. A busca foi realizada nas bases de dados PubMed, PEDro e LILACS, por meio dos seguintes descritores: "estimulação elétrica funcional", "eletroestimulação, estimulação elétrica", "tosse", "higiene brônquica", "quadriplegia", "lesão medular espinhal", "tetraplegia" e "sujeito com tetraplegia" - em espanhol, inglês e português, sem restrição quanto ao ano de publicação. Foram incluídos artigos com amostra de indivíduos com lesão medular assistidos por estimulação elétrica com desfecho relacionado ao sistema respiratório, e foram excluídos artigos com ensaios invasivos de estímulo a tosse. Resultados: Os 12 artigos incluídos revelam heterogeneidade nos protocolos de eletroestimulação da função expiratória, que podem incluir frequências de 30 a 50 Hz, com pulsos de 25 a 400 μs, aplicada por até oito eletrodos distribuídos pelos músculos expiratórios e acessórios. O tempo de aplicação também foi variável e a amplitude de corrente frequentemente estimada pela percepção do paciente, podendo chegar a valores superiores a 100mA. Conclusão: Apesar de não ser possível estabelecer parâmetros rigorosos de fisioterapia por meio da estimulação elétrica, pela escassez e qualidade de estudos que comparem sistematicamente parâmetros de estimulação em subgrupos, foram observadas alterações positivas nas variáveis de função muscular respiratória avaliadas, como o pico de fluxo expiratório e de tosse, em pessoas com lesão medular cervical e torácica.

Abstract Objective: To describe and analyze parameters and effects of surface electrical stimulation on the respiratory muscular function among individuals with spinal cord injuries, especially while coughing. Methods: A systematic literature review was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search was conducted in the PubMed, PEDro, and LILACS databases, using the following descriptors: "functional electrical stimulation," "electrostimulation, electrical stimulation," "coughing," "bronchial hygiene," "quadriplegia," "spinal cord injury", "tetraplegia", and "individual with tetraplegia" - in Spanish, English and Portuguese, with no restrictions on year of publication. Inclusion criteria were: articles describing studies with samples of individuals with spinal cord injuries treated with electrical stimulation and outcomes related to the respiratory system. Articles containing studies with invasive cough stimulation trials were excluded. Results: The 12 selected articles revealed the heterogeneity of electrostimulation protocols for expiratory function, which can include frequencies ranging from 30 to 50 Hz; pulse from 25 to 400 μs; applied in up to eight electrodes distributed across the expiratory and accessory muscles. Time of administration also varied, and the current amplitude was usually estimated by the patient's perception, reaching values higher than 100mA. Conclusion: Even though the review did not find rigorous parameters for physical therapy using electrical stimulation, because of the shortage and low-quality of the studies that systematically compare stimulation parameters among subgroups, positive changes were observed in the assessed respiratory muscle function variables, such as peak expiratory and cough flow in individuals with cervical and thoracic spinal cord injury.

Mitochondrial form, function and signalling in aging.

Aging is often accompanied by a decline in mitochondrial mass and function in different tissues. Additionally, cell resistance to stress is frequently found to be prevented by higher mitochondrial respiratory capacity. These correlations strongly suggest mitochondria are key players in aging and senescence, acting by regulating energy homeostasis, redox balance and signalling pathways central in these processes. However, mitochondria display a wide array of functions and signalling properties, and the roles of these different characteristics are still widely unexplored. Furthermore, differences in mitochondrial properties and responses between tissues and cell types, and how these affect whole body metabolism are also still poorly understood. This review uncovers aspects of mitochondrial biology that have an impact upon aging in model organisms and selected mammalian cells and tissues.