Effectiveness of mat pilates on fatigue in women with breast cancer submitted to adjuvant radiotherapy: randomized controlled clinical trial.

PURPOSE: This clinical trial aimed to evaluate the influence of Mat Pilates and time on the change in fatigue scores in women with breast cancer undergoing adjuvant radiotherapy (RT). Additionally, assess the adherence and adverse effects of Mat Pilates sessions and the association of the level of physical activity with severe fatigue symptoms. METHODS: One hundred fifty-six patients with non-metastatic breast cancer were randomized to usual care or supervised Mat Pilates exercise. Fatigue and physical activity level were measured at baseline, end of RT, 30 days, 3 and 6 months after RT. The generalized estimating equation (GEE) with intention to treat was applied. RESULTS: A significant difference in the fatigue mean between the end of RT and the baseline was found in patients of both groups. There was no adverse effect with the practice of Mat Pilates, and it was analyzed the reduction of the symptom pain after the end of RT in women of intervention group compared to the control. There was no significant effect on fatigue between the groups. Patients with severe fatigue after 3 and 6 months of RT reported a significantly lower level of physical activity in the last periods. CONCLUSION: Fatigue levels increased at the end of RT but returned to baseline values after 6 months. A lower level of physical activity was associated with severe fatigue symptoms. Mat Pilates was safe for these women and reduced the symptom pain after treatment, but it did not successfully reduce fatigue during adjuvant RT. REGISTRATION: NCT03333993. November 7, 2017.  https://clinicaltrials.gov/ct2/show/NCT03333993?term=breast+cancer&cond=pilates&draw=2&rank=1 .

N-Methyl-(2S,4R)-trans-4-hydroxy-L-proline isolated Sideroxylon obtusifolium attenuates TPA-induced irritant contact dermatitis in mice.

Dermatitis is defined as a set of inflammatory diseases that affect the skin, with varied causes. Among the different types of dermatitis, contact dermatitis is the most prevalent. Although the current therapy is often effective, it is associated with adverse effects and the possibility of drug tolerance. N-Methyl-(2S, 4R)-trans-4-hydroxy-L-proline is a L-proline amino acid derivative found in the leaves of Sideroxylon obtusifolium, a species traditionally used to treat inflammatory diseases. The aim of this study was to investigate the topical anti-inflammatory effect of N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline (NMP) in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced irritant contact dermatitis in mice. Topically administered NMP, at doses of 0.03 - 0.50 mg/ear, reduced TPA-induced ear edema and neutrophil migration, as evidenced by low tissue myeloperoxidase activity and verified by histological examination. In addition, NMP (0.06 mg/ear) reduced tissue levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-1ß, INF-γ and MCP-1) and of the anti-inflammatory cytokine IL-10, and reduced gene expression of TNF-α, IL-6 and IL-1ß increased by TPA. The data suggest that N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline acts as a topical anti-inflammatory agent that decreases the expression of inflammatory cytokines, making it useful for the treatment of skin inflammation. Further investigations are necessary for its development as a therapeutic agent.

Drought stress mitigation by foliar application of L-carnitine and its effect on radish morphophysiology.

Drought is the major abiotic stress limiting crop production worldwide, with drought events being expected to be harsher and more frequent due to the global warming. In this context, the development of strategies to mitigate the deleterious effects of drought, such as the use of biostimulants, is imperative. Radish is a globally cultivated root vegetable, with high nutritional and phytochemical value. Thus, this study aimed to evaluate the potential of exogenous carnitine application in the mitigation of drought stress on radish morphophysiology. For this, radish plants were grown for 30 days, being irrigated with 80% (well-watered) or 15% (drought stress) of water holding capacity and sprayed with carnitine (5, 50, and 500 µM) or water (0 µM-no carnitine). The experimental design was completely randomized, in a 4 × 2 factorial scheme (carnitine concentrations × water conditions) with six replicates, and each experimental unit consisted of one plant. The gas exchanges, chlorophyll a fluorescence, photosynthetic pigments, electrolyte leakage, relative water content, and biomass production and allocation were evaluated. Drought reduced the photosynthetic capacity of plants by impairing water balance and membrane integrity, decreasing biomass accumulation, mainly in globular roots. The application of low carnitine (5 µM) mitigated these negative effects caused by drought, increasing membrane integrity and water balance of plants, while higher carnitine concentration (50 and 500 µM) aggravated drought stress. This study highlights the potential of carnitine in the mitigation of drought stress on radish plants, supporting its role as a biostimulant. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-023-01308-6.

Polymorphisms at CYP enzymes, NR1I2 and NR1I3 in association with virologic response to antiretroviral therapy in Brazilian HIV-positive individuals.

Virologic failure of antiretroviral therapy (ART) may be explained by single nucleotide polymorphisms (SNPs) in drug absorption and metabolism genes. Here, we characterized the associations between polymorphisms in cytochrome P450 enzymes' genes CYP2B6 and CYP3A4/A5, nuclear receptor genes NR1I2/3, and initial ART efficacy among 203 HIV-positive individuals from Rio de Janeiro. Association between SNPs and virologic control was evaluated after 6 and 12 months of follow-up using Cox regression models. The SNP rs2307424 (NR1I3) was associated with increased virologic response after 12 months of treatment, while rs1523127 (NR1I2), rs3003596, and rs2502815 (NR1I3) were associated with decreased response. Increased virologic response after 12 months (adjHR = 1.54; p = 0.02) was also observed among carriers of the NR1I3 haplotype rs2502815G-rs3003596A-rs2307424A versus the reference haplotype G-A-G. Our results suggest that NR1I2 and NR1I3 variants are associated with virologic responses to ART among Brazilians.

Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis.

BACKGROUND: Physical exercise in women with breast cancer has shown benefits in reducing fatigue levels during adjuvant radiotherapy and chemotherapy. However, it is not well understood which type of exercise is more effective. OBJECTIVE: Assess the impact of different types of physical exercises on fatigue and which is the most effective in reducing this adverse effect during adjuvant treatment in breast cancer. METHODS: The inclusion criteria were randomized clinical trials of physical exercise in women diagnosed with breast cancer in stages I to IV, above 18 years, evaluating fatigue using validated questionnaires. The meta-analysis pooled results by standardized mean difference (SMD). RESULTS: A total of 20 randomized clinical trials involving 1793 participants revealed that the practice of physical exercise was statistically effective in reducing fatigue (SMD = - 0.46; 95% CI: - 0.66, - 0.27). Our analysis of subgroups suggests that the supervised combination of resistance training (RT) with aerobic training (AT) is the most effective physical exercise to reduce fatigue (SMD = - 1.13; 95% CI: - 2.09, - 0.17). The supervised RT was more effective (SMD = - 0.30; 95% CI: - 0.46, - 0.15) than supervised AT or mind-body techniques. It was observed that only during chemotherapy, women with breast cancer in the intervention groups showed a significant reduction in fatigue (SMD = - 0.38; 95% CI: - 0.55 to - 0.20). CONCLUSION: Physical exercise during adjuvant chemotherapy and/or radiotherapy in women with breast cancer can be considered beneficial in reducing fatigue, especially for women undergoing chemotherapy and for supervised training of resistance or combined RT and AT.

Perception of community pharmacists about the work process of drug dispensing: a cross-sectional survey study.

BACKGROUND: Drug dispensing aims to promote rational medicine use. However, in many countries, the work processes are still not well defined. In this sense, the perception of pharmacists about dispensing practices presents an overview of how the service is being performed in the country and its main challenges. Thus, the purpose of this study was to determine the self-reported work process of Brazilian community pharmacists in relation to drug dispensing, challenges, and strategies for carrying out the service. METHOD: A cross-sectional survey was conducted between May and July 2021, with community pharmacists from all regions of Brazil. Pharmacists were invited to answer a validated, self-administered questionnaire, implemented through Google Forms, containing 33 questions related to the steps of drug dispensing (questions and counseling) and the main challenges and strategies to perform the service. The data were exported to Microsoft Office Excel and SPSS®. Multiple linear regression analysis was used to assess the association between responses and demographic information, with a significance level of less than 5% (p < 0.05). This study was approved by the Research Ethics Committee (number: 4.295.171). RESULTS: A total of 625 community pharmacists responded to the survey. Most pharmacists reported always or frequently performing 17 (54%) of the 31 steps described in the instrument. The steps that pharmacists reported performing more frequently were forming the medication name (n = 569, 91.04%), verifying the completeness and adequacy of the prescription according to current legislation (n = 567, 90.72%) and providing counseling on dosage (n = 549, 87.84%). Documentation was the main step in which pharmacists reported never or rarely performing (n = 424, 67.84%). The results showed that there was a significant influence of the variables of public education institution, age, and postgraduate education on the frequency of dispensing steps (F(3, 621) = 14.884, p < 0.001; R2ajdusted = 0,063). CONCLUSION: This study showed that most pharmacists reported always or frequently asking most of the questions and performing counseling contained in the instrument during drug dispensing. These results can contribute to an understanding of current dispensing practices and generate insights for developing strategies to qualify the service.

Evaluation of pharmacist's practices regarding the antimicrobials dispensing: a simulated patient study.

BACKGROUND: The indiscriminate use of antimicrobials is considered a major contributing factor to the increase in antimicrobial resistance. Community pharmacies are the main source of access to antimicrobials, and pharmacists are in a strategic position to promote rational use of these medicines. Therefore, it is important to know dispensing service quality. OBJECTIVE: To evaluate the behavior of pharmacists in dispensing antimicrobials in community pharmacies in northeast Brazil. METHODS: This cross-sectional pilot study was conducted from August to October 2021 in a private community pharmacy chain in Sergipe. Dispensing was evaluated using the simulated patient (SP) technique. Two SP asked the pharmacists for the antimicrobials (case clinic 1: upper respiratory infection; case clinic 2: urinary tract infection) and recorded the service through audio. Dispensing practices were independently analyzed by two researchers based on the tools available in the literature. Data were presented using descriptive statistics. RESULTS: A total of 54 simulated patient visits were conducted. Based on the 12 steps recommended by the research team for good dispensing, pharmacists asked an average of 1 (±1.17) question for upper respiratory infections and 0.3 (±0.54) for urinary tract infections, as well as provided counseling (mean number of recommendations, 2.6 (±1.44) and 4.5 (±2.35), respectively). As for communication skills, pharmacists had a regular score (3.07 ± 0.34). Furthermore, there was no significant difference in the number of steps and counseling recommendations by pharmacists in dispensing clinical cases 1 and 2 (p = 0.0674). CONCLUSION: The quality of antimicrobial dispensing was evaluated as suboptimal, requiring improvements in practice and multifaceted strategies to promote continuing education of these professionals. In addition, awareness actions for the population must be implemented to promote the rational use of antimicrobials and reduce microbial resistance.

Does drug dispensing improve the health outcomes of patients attending community pharmacies? A systematic review.

BACKGROUND: Drug dispensing is a clinical pharmacy service that promotes access to medicines and their rational use. However, there is a lack of evidence for the impact of drug dispensing on patients' health outcomes. Thus, the purpose of this study was to assess the influence of drug dispensing on the clinical, humanistic, and economic outcomes of patients attending community pharmacies. METHODS: A systematic literature search was performed in April 2021 using PubMed, Web of Science, Cochrane Library, LILACS, and Open Thesis. Two reviewers screened titles, abstracts, and full-text articles according to the eligibility criteria. Methodological quality was assessed using tools from the Joanna Briggs Institute, and the literature was synthesized narratively. RESULTS: We retrieved 3,685 articles and included nine studies that presented 13 different outcomes. Regarding the design, they were cross-sectional (n = 4), randomized clinical trials (n = 4), and quasi-experimental (n = 1). A positive influence of drug dispensing on health outcomes was demonstrated through six clinical, four humanistic and three economic outcomes. Eight studies (88,9 %) used intermediate outcomes. The assessment of methodological quality was characterized by a lack of clarity and/or lack of information in primary studies. CONCLUSIONS: Most articles included in this review reported a positive influence of drug dispensing performed by community pharmacists on patients' health outcomes. The findings of this study may be of interest to patients, pharmacists, decision makers, and healthcare systems, since they may contribute to evidence-based decision-making, strengthening the contribution of community pharmacists to health care. TRIAL REGISTRATION: Registration: PROSPERO CRD42020191701 .

Effect of systemic photobiomodulation in the course of acute lung injury in rats.

Acute lung injury (ALI) is a severe, multifactorial lung pathology characterized by diffuse alveolar injury, inflammatory cell infiltration, alveolar epithelial barrier rupture, alveolar edema, and impaired pulmonary gas exchange, with a high rate of mortality; and sepsis is its most common cause. The mechanisms underlying ALI due to systemic inflammation were investigated experimentally by systemic lipopolysaccharide (LPS) administration. Photobiomodulation (PBM) has been showing good results for several inflammatory diseases, but there are not enough studies to support the real benefits of its use, especially systemically. Considering that ALI is a pathology with high morbidity and mortality, we studied the effect of systemic PBM with red light-emitting diode (LED) (wavelength 660 nm; potency 100 mW; energy density 5 J/cm; total energy 15 J; time 150 s) in the management of inflammatory parameters of this disease. For this, 54 male Wistar rats were submitted to ALI by LPS injection (IP) and treated or not with PBM systemically in the tail 2 and 6 h after LPS injection. Data were analyzed by one-way ANOVA followed by Student's Newman-Keuls. Our results point to the beneficial effects of systemic PBM on the LPS-induced ALI, as it reduced the number of neutrophils recruited into the bronchoalveolar lavage, myeloperoxidase activity, and also reduced interleukins (IL) 1ß, IL-6, and IL-17 in the lung. Even considering the promising results, we highlight the importance of further studies to understand the mechanisms involved, and especially the dosimetry, so that in near future, we can apply this knowledge in clinical practice.

Uremic toxins promote accumulation of oxidized protein and increased sensitivity to hydrogen peroxide in endothelial cells by impairing the autophagic flux.

Chronic kidney disease (CKD) is associated with high mortality rates, mainly due to cardiovascular diseases (CVD). Uremia has been considered a relevant risk factor for CVD in CKD patients, since uremic toxins (UTs) promote systemic and vascular inflammation, oxidative stress and senescence. Here, we demonstrate that uremic toxins indoxyl sulfate (IxS), p-cresyl sulfate (pCS) and indole acetic acid (IAA) are incorporated by human endothelial cells and inhibit the autophagic flux, demonstrated by cellular p62 accumulation. Moreover, isolated and mixed UTs impair the lysosomal stage of autophagy, as determined by cell imaging of the mRFP-GFP-LC3 protein. Endothelial cells exposed to UTs display accumulation of carbonylated proteins and increased sensitivity to hydrogen peroxide. Rapamycin, an autophagy activator which induces both autophagosome formation and clearance, prevented these effects. Collectively, our findings demonstrate that accumulation of oxidized proteins and enhanced cell sensitivity to hydrogen peroxide are consequences of impaired autophagic flux. These data provide evidence that UTs-induced impaired autophagy may be a novel contributor to endothelial dysfunction.

Are Clinical Outcomes Associated With Medication Regimen Complexity? A Systematic Review and Meta-analysis.

Background: Current evidence of the influence of the medication regimen complexity (MRC) on the patients' clinical outcomes are not conclusive. Objective: To systematically and analytically assess the association between MRC measured by the Medication Regimen Complexity Index (MRCI) and clinical outcomes. Methods: A search was carried out in the databases Cochrane Library, LILACS, PubMed, Scopus, EMBASE, Open Thesis, and Web of Science to identify studies evaluating the association between MRC and clinical outcomes that were published from January 1, 2004, to April 2, 2018. The search terms included outcome assessment, drug therapy, and medication regimen complexity index and their synonyms in different combinations for case-control and cohort studies that used the MRCI to measure MRC and related the MRCI with clinical outcomes. Odds ratios (ORs), hazard ratios (HRs), and mean differences (WMDs) were calculated, and heterogeneity was assessed using the I2 test. Results: A total of 12 studies met the eligibility criteria. The meta-analysis showed that MRC is associated with the following clinical outcomes: hospitalization (HR = 1.20; 95% CI = 1.14 to 1.27;I2 = 0%) in cohort studies, hospital readmissions (WMD = 7.72; 95% CI = 1.19 to 14.25; I2 = 84%) in case-control studies, and medication nonadherence (adjusted OR = 1.05; 95% CI = 1.02 to 1.07; I2 = 0%) in cohort studies. Conclusion and Relevance: This systematic review and meta-analysis gathered relevant scientific evidence and quantified the combined estimates to show the association of MRC with clinical outcomes: hospitalization, hospital readmission, and medication adherence.

Development and content validation of an instrument to document the dispensing of prescribed medicines.

WHAT IS KNOWN AND OBJECTIVE: Qualified dispensing is fundamental for the promotion of the rational use of medicines. Documentation is an indicator of quality and one of the essential steps in the care process. However, in Brazil, there are no models of clinical documentation applicable to dispensing practices. Thus, the objective of this study was to develop and validate an instrument to document the dispensing process of prescribed medicines. METHODS: A methodological development study was carried out from February 2017 to October 2017 in two stages, which were (i) the development of the instrument and (ii) content validation of the proposed instrument. The development phase comprised three stages, which were (i) the elaboration of the prototype based on a previously performed systematic review, (ii) academic brainstorming and (iii) a pre-Delphi consensus. The content validation process was performed using the Delphi technique. The instrument was sent to 40 experts with experience in dispensing, and the consensus among them was calculated using the content validity index (CVI). The study was approved by the Ethics Committee, and all participants signed an informed consent document detailing the terms of the study. RESULTS: In the development stage, three versions of the instrument were generated, which were the prototype, version 1 (changed after academic brainstorming) and version 2 (changed after the pre-Delphi). In the content validation process of version 2 of the instrument, 23 experts returned their evaluation in the first round of the Delphi process and 17 in the second. All the items obtained a CVI >0.83, which resulted in the validation of the instrument. The final instrument comprised the following sections: general information, the identification of technical and legal problems of prescriptions, the conduct for the resolution of the technical and legal problems of prescriptions, medication dispensed, suspected drug-related problems, verbal guidance, written guidance, referral and the referral result. WHAT IS NEW AND CONCLUSION: The developed and validated instrument presents the main variables that should be documented during the dispensing process.

Effects of cigarette smoke on color change of resin composites.

PURPOSE: To evaluate the color change caused by cigarette smoke in both microhybrid and nanohybrid resin composites of three different manufacturers (Z100, Z350, Charisma, and Opallis). METHODS: Samples of microhybrid (n= 40) and nanohybrid (n= 40) resin composites (A2) were prepared for each resin brand, totaling 240 samples. The samples were divided into subgroups: Control: control group without exposure; C5: five cigarettes, 25 minutes/ exposure; C10: 10 cigarettes, 50 minutes/ exposure; C20: 20 cigarettes, 100 minutes/ exposure. The samples were then photographed and color change was measured by a computerized image analysis. L*a*b* values were obtained and color change was calculated. The Kolmogorov-Smirnov test was used to examine data normality; color change associated with an individual brand and the number of smoked cigarettes was analyzed with differentiation across the groups by the Tukey test (P≤ 0.05). The student t-test (P≤ 0.05) was used for the differentiation of inorganic fillers. RESULTS: The color change was significant between five and 10 cigarettes (P= 0.01), between five and 20 cigarettes (P= 0.000), and not significant between 10 and 20 cigarettes (P= 0.585). Charisma showed a significant color change when compared to Opallis (P= 0.008) and Z100 and Z350 (P= 0.000). CLINICAL SIGNIFICANCE: Different brands, inorganic fillers, and number of smoked cigarettes are variables that influence color change of resin composites. Nanohybrid resins Z100, Z350, and Opallis exhibited less color variation when they were exposed to cigarette smoke.

Central role of PAFR signalling in ExoU-induced NF-κB activation.

ExoU is an important virulence factor in acute Pseudomonas aeruginosa infections. Here, we unveiled the mechanisms of ExoU-driven NF-κB activation by using human airway cells and mice infected with P. aeruginosa strains. Several approaches showed that PAFR was crucially implicated in the activation of the canonical NF-κB pathway. Confocal microscopy of lungs from infected mice revealed that PAFR-dependent NF-κB activation occurred mainly in respiratory epithelial cells, and reduced p65 nuclear translocation was detected in mice PAFR-/- or treated with the PAFR antagonist WEB 2086. Several evidences showed that ExoU-induced NF-κB activation regulated PAFR expression. First, ExoU increased p65 occupation of PAFR promoter, as assessed by ChIP. Second, luciferase assays in cultures transfected with different plasmid constructs revealed that ExoU promoted p65 binding to the three κB sites in PAFR promoter. Third, treatment of cell cultures with the NF-κB inhibitor Bay 11-7082, or transfection with IκBα negative-dominant, significantly decreased PAFR mRNA. Finally, reduction in PAFR expression was observed in mice treated with Bay 11-7082 or WEB 2086 prior to infection. Together, our data demonstrate that ExoU activates NF-κB by PAFR signalling, which in turns enhances PAFR expression, highlighting an important mechanism of amplification of response to this P. aeruginosa toxin.

Influence of non-pharmacological methods on duration of labor: a systematic review.

The article aims to verify the influence of MNFs on the duration of the birth process. A systematic review was carried out in the MEDLINE, Web of Science and LILACS databases, through a combination of terms that cover the topic addressed, from 1996 to 2021/April. The Excel spreadsheet was used to collect data to extract information regarding each selected article, in turn, data analysis included the evaluation and classification of quality, reliability and risk of bias, thus, the following tools were used: Cochrane RoB 2, Checklist and Newcastle-Ottawa Scale. Warm bath, walking, exercises with a birthing ball, breathing techniques, supine position, acupuncture, acupressure and water birth reduced labor time. While spontaneous pushing, massage and immersion baths prolonged labor. Non-pharmacological methods capable of reducing the duration of labor were hot/warm shower, walking, birth ball exercises, breathing techniques, maternal mobility, dorsal position, acupuncture, acupressure and water birth, as well. associated applied techniques such as hot/warm bath, ball exercises and lumbosacral massage, as well as immersion bath, ball exercises, aromatherapy, vertical postures and maternal mobility with alternating vertical postures, shortened the birth time.

Salicylic Acid and Water Stress: Effects on Morphophysiology and Essential Oil Profile of Eryngium foetidum.

The exogenous application of bioregulators, such as salicylic acid (SA), has exhibited promising outcomes in alleviating drought stress. Nevertheless, its impact on culantro (Eryngium foetidum L.) remains unexplored. Thus, the aim of this study was to assess how SA impacts the growth, morphophysiology, and essential oil composition of culantro when subjected to drought. To achieve this, culantro plants were grown under three different watering regimes: well-watered, drought-stressed, and re-watered. Additionally, they were either treated with SA (100 µM) or left untreated, with water serving as the control. SA application did not mitigate the effects of drought in biomass production but increased biomass, leaf number, leaf area, and photosynthetic pigments under well-irrigated and re-watered conditions. After a drought period followed by re-watering, plants recovered membrane integrity independently of SA application. Water stress and the exogenous application of SA also modulated the profile of essential oils. This is the first report about SA and drought affecting growth and essential oil composition in culantro.

Reference values for heavy metals in soils of the Brazilian agricultural frontier in Southwestern Amazônia.

Guideline values are used to identify polluted or contaminated areas based on background values. Brazilian law establishes three guideline values for pollutants: a quality reference value (QRV), a prevention value, and an intervention value. Reference values refer to the natural concentration of an element or a substance in soils that have not been modified by anthropogenic impacts. These values inform assessments of soil quality and are used to establish maximum permissible limits. The objective of this study was to determine the natural levels and reference values for Cd, Co, Cr, Cu, Ni, Pb, and Zn in samples from the surface layer (0-20 cm) of 19 representative soils of the states of Mato Grosso and Rondônia, on Brazil's agricultural frontier. Pseudo-total metal concentrations were obtained following microwave-assisted digestion using the aqua regia and EPA3051 methods. QRVs were calculated for each element as the 75th and 90th percentiles of the frequency distribution of the data. Natural levels of heavy metals in the soil samples followed the order: Cr > Zn > Cu > Co > Pb > Ni > and Cd (aqua regia) and Cr > Co > Cu > Pb > Zn > Ni > Cd (EPA3051). These values are generally lower than those reported in the Brazilian and international literature, which highlights the importance of establishing reference values for each state or for each soil type, taking into account the geomorphological, pedological, and geological diversity of the region under study.

Spectrographic Vocal Characteristics in Female Teachers: Finger Kazoo Intensive Short-term Vocal Therapy.

OBJECTIVE: Verify the results from intensive short-term vocal therapy using the Finger Kazoo technique about the spectrographic vocal measurements of teachers. METHODS: Controlled and randomized trial. Spectrographic vocal assessment was performed by judges before and after intensive short-term vocal therapy with Finger Kazoo. Sample was composed of 41 female teachers. There were two study groups (with vocal nodules and without structural affection of the vocal folds) and the respective control groups. For the statistical analysis of the data, nonparametric tests were used (Mann-Whitney test and Wilcoxon test). RESULTS: After intensive short-term vocal therapy with Finger Kazoo, improvement in voice spectral parameters, such as improvement in tracing (color intensity and regularity), greater definition of formants and harmonics, increased replacement of harmonics by noise, and a greater number of harmonics, mainly in the group without structural affection of the vocal folds. CONCLUSION: There was an improvement in the spectrographic vocal parameters, showing greater stability, quality, and projection of the emission, especially in female teachers without structural affection of the vocal folds.

Absences due to illness and health problems of the teachers of municipal public schools in Rio Branco, Acre, Brazil.

Introduction: Absenteeism is defined as the absence of workers from their workplace, resulting from a complex phenomenon. Objectives: To analyze the profile of absence due to illness and health problems of the permanent teachers of early childhood education (day care and preschool) and elementary school (years 1-5) in the city of Rio Branco - Acre, Brazil, from 2014 to 2017. Methods: An observational, analytical, individual, cross-sectional, retrospective cohort study with data from 1,584 teachers from 100 municipal public schools in Rio Branco. The period prevalence was calculated by chapters of the International Classification of Diseases, 10th revision, and by specific reasons for absence for those chapters with higher proportions. Additionally, the absenteeism-illness frequency index and mean sickness absence duration were calculated. Results: The chapters of the International Classification of Diseases, 10th revision, with the highest prevalence of absences were Chapter XIII (diseases of the musculoskeletal system and connective tissue) with 7.83%, Chapter V (mental and behavioral disorders) with 7.45%, and Chapter X (diseases of the respiratory system) with 6.12%. The absenteeism-illness frequency index was 0.72, and the mean sickness absence duration was 24.07 days. Conclusions: The present study showed that diseases of the musculoskeletal system and connective tissue, mental and behavioral disorders, and diseases of the respiratory system are the main problems that lead the permanent teachers of municipal public schools in Rio Branco to be absent from the classroom.

Introdução: Absenteísmo é definido como a ausência do trabalhador no seu local de trabalho, sendo resultado de um fenômeno complexo. Objetivos: Analisar o perfil de afastamento por motivo de doenças e agravos de saúde dos professores efetivos da educação infantil (creche e pré-escola) e ensino fundamental I (1º ao 5º ano) do município de Rio Branco - Acre, de 2014 a 2017. Métodos: Estudo observacional, analítico, individual, transversal, retrospectivo de coorte com dados de 1.584 professores das 100 escolas municipais de Rio Branco. Foram calculadas as prevalências de período por capítulos da Classificação Internacional de Doenças, 10ª revisão, e por motivos específicos de afastamentos para aqueles capítulos com maiores proporções. Adicionalmente, foram calculados o índice de frequência de absenteísmo-doença e a duração média das ausências. Resultados: Os capítulos da Classificação Internacional de Doenças, 10ª revisão, com as maiores prevalências de afastamento foram: Capítulo XIII (doenças do sistema osteomuscular e do tecido conjuntivo) com 7,83%; Capítulo V (transtornos mentais e comportamentais) com 7,45%; e Capítulo X (doenças do aparelho respiratório) com 6,12%. O índice de frequência de absenteísmo-doença foi de 0,72 e a duração média dos afastamentos foi de 24,07 dias. Conclusões: O presente estudo evidenciou que as doenças osteomusculares e conjuntivas, os transtornos mentais e comportamentais e as doenças respiratórias são os principais agravos que levam os professores efetivos das escolas públicas municipais de Rio Branco a se ausentarem da sala de aula.

Exposure to pesticides and breast cancer in the city of Petrópolis, Brazil.

To investigate the association between pesticide use and breast cancer. A hospital-based case-control study was conducted in Petrópolis city, Brazil. The study data were obtained through interviews, and the magnitude of the association between self-reported pesticide exposure and breast cancer was determined using unconditional logistic regression. A higher estimated risk for breast cancer was found in women exposed to pesticides for 10 or more years, where this association was not statistically significant after adjusting for potential confounders (OR = 1.40; 95% CI 0.85-2.49). A positive statistically significant association was found between breast cancer and higher educational level or previous use of hormone replacement therapy (HRT), whereas having had 2 or more pregnancies to term proved a protective factor. Further studies elucidating the contribution of pesticide exposure to the development of breast cancer are needed, given that current findings in the literature are conflicting.