Retroperitoneoscopic lumbar sympathectomy for plantar hyperhidrosis.

OBJECTIVE: The objective of this study was to assess the reduction in quality of life (QoL) caused by the persistence of primary plantar hyperhidrosis (PPH) symptoms and the level of satisfaction in PPH patients after retroperitoneoscopic lumbar sympathectomy (RLS). The efficacy, safety, and procedure of bilateral RLS in both sexes are also described in this study. METHODS: This is a longitudinal study of consecutive patients who sought specific treatment from a private practitioner for severe PPH as classified on the Hyperhidrosis Disease Severity Scale (HDSS) from October 2005 to October 2014. The patients were asked to report the symptoms of PPH experienced in the immediate preoperative period and to complete a standardized QoL questionnaire developed by de Campos at least 12 months after RLS. Disease outcomes, recurrence of symptoms, and any adverse effects of surgery were evaluated after 30 days and at least 12 months after RLS. RESULTS: Lumbar sympathectomy was performed 116 times in 58 patients; 30 days after surgery, PPH was resolved in all patients. Three patients (5.2%) reported transient thigh neuralgia, and 19 (32.7%) reported transient paresthesia in the lower limbs. There were no reports of retrograde ejaculation. At a minimum of 12 months after RLS, 49 of the 58 patients had fully and correctly answered the follow-up questionnaire and noted a mild (HDSS 2) to moderate (HDSS 3) increase in pre-existing compensatory sweating. One patient had a PPH relapse within 6 months. Improvement in QoL due to the resolution of PPH was reported in 98% of the 49 patients. None of the operations necessitated a change in the laparotomy approach, and none of the patients died. CONCLUSIONS: RLS is safe and effective for the treatment of severe PPH in both sexes. There were no reports of retrograde ejaculation after resection of L3 and L4 ganglia. There was a mild to moderate increase in compensatory sweating in about half of the patients, but without any regret or dissatisfaction for having undergone the surgery because of a significant improvement in QoL.

Epidemiology of COVID-19 in the State of Sergipe/Brazil and Its Relationship with Social Indicators.

A pandemic is capable of generating a great impact, not only from the point of view of health, but also socioeconomically. In March 2020, the World Health Organization (WHO) declared that a new pandemic situation had arisen, due to the SARS-CoV-2 virus, whose probable origin was zoonotic. The largest number of cases of this disease is concentrated in the United States of America (USA), India, and Brazil. The mortality rate is estimated at 3.4%, but regional differences may exist, and places with a high demographic density have become true epicentres and may be related to higher rates of transmission. In addition to the above, lower human development indexes (HDI) can be related to worse outcomes, especially in the North and Northeast regions of Brazil since they are the least developed places. The Northeast region is the second-most-affected place in the number of COVID-19 cases in Brazil. An analytical observational study of an ecological type was carried out from April to October 2020 to assess the epidemiological situation of COVID-19 in the state of Sergipe and specifically to analyse the incidence of cases and deaths resulting from COVID-19 in the different health regions of the state of Sergipe, in relation to the values of the HDI and demographic density. During the study period, 84,325 cases of COVID-19 were identified, in which 2205 resulted in death. In most of the regions studied, there was a positive association between the number of cases and deaths and the greater the demographic density, but there was no increase in the risk of becoming ill, nor of dying the lower the HDI. Large and crowded cities are places of greatest vulnerability to illness, due to their greater capacity of transmitting the virus; however, further studies are needed to identify other factors that are decisive in the outcomes of this new disease.

A systematic review and meta-analysis to evaluate the efficacy of lumbar sympathectomy for plantar hyperhidrosis.

On July 25, 2017, we conducted an extensive database tracking to identify all studies published from January 1990 to July 2017. Screening updates were performed until December 2017. RESULTS: There were no deaths, and the resolution of symptoms of primary plantar hyperhidrosis (PPH) occurred in 92% of patients after mechanical sympathectomy. A total of 177 patients (44%) were reported to have mild to severe compensatory sweating after a mean 6 months follow-up. The preservation of L2 did not interfere with the primary outcome, and it is possible to perform lumbar sympathectomy in men with L2 preservation, achieving satisfactory cure results of PPH, minimizing the risk of sexual dysfunction. There were no deaths, and the resolution of symptoms of PPH occurred in 10% of patients after chemical sympathicolysis after a mean 6 months follow-up. A total of 13 patients (12.5%) were reported to have mild to severe compensatory sweating using the same technique. CONCLUSION: The mechanical lumbar sympathectomy is effective and safe and improves quality of life, evaluated by the high symptom resolution of PPH and low rate of complications. The chemical sympathicolysis in the immediate postoperative period presented satisfactory results; however, it was shown to be significantly less effective than the mechanical approach in a follow-up of at least 6 months.

Deficiência de zinco na doença de Alzheimer: um estudo transversal com grupo comparação / Zinc deficiency in alzheimer's disease: a cross-sectional study with a control group

Resumo Objetivo Identificar se há diferença na concentração plasmática e eritrocitária de zinco na pessoa idosa com e sem a doença de Alzheimer. Métodos Estudo transversal com grupo comparação, realizado com pessoas idosas com e sem doença de Alzheimer, pareadas por sexo, escolaridade e idade. A concentração de zinco foi medida através de espectrofotometria de absorção atômica em forno grafite. Resultados Total de 102 pessoas, 68 no grupo saudável (NDA-g) e 34 o grupo com doença (DA-g). O grupo DA-g apresentou menores concentrações plasmáticas e maior frequência no primeiro quartil para concentrações intraeritrocitárias de zinco. As concentrações plasmáticas e eritrocitárias não apresentaram correlação com tempo de diagnóstico e a idade em ambos os grupos. Na análise de regressão logística, a concentração plasmática esteve associada à DA-g (OR=0,964; p=0,028). Conclusão Pessoas idosas com doença de Alzheimer apresentam menores concentrações plasmáticas e eritrocitárias de zinco.

Abstract Objective To identify whether there is a difference in plasma and erythrocyte zinc concentration in older adults with and without Alzheimer's disease. Methods Crosssectional study with a comparative group, conducted with older adults with and without Alzheimer's disease, matched by sex, education, and age. Zinc concentration was measured by atomic absorption spectrophotometry in a graphite furnace. Results There were 102 people, 68 in the healthy group (NDA-g) and 34 in the group with disease (AD-g). The AD-g group had lower plasma zinc concentrations and higher frequency in the first quartile for intraerythrocyte zinc concentrations. Plasma and erythrocyte concentrations did not correlate with the time of diagnosis and age in both groups. In the logistic regression analysis, plasma concentration was associated with AD-g (OR=0.964; p=0.028). Conclusion Older people with Alzheimer's disease have lower plasma and erythrocyte zinc concentrations.

Avaliação da composição corporal em estudantes de escolas públicas no município de Aracaju/SE / Assessment of body composition of students in public schools in the city of Aracaju/SE

A avaliação da composição corporal é de grande relevância para se traçar estratégias de combate à desnutrição, ao sobrepeso e à obesidade. O objetivo desse estudo foi avaliar a composição corporal em escolares com idade entre 7 e 10 anos, pertencentes à Rede Estadual de Ensino, no município de Aracaju/SE. Foram avaliados 487 escolares, sendo 250 meninas e 237 meninos. A Composição Corporal foi avaliada através do Percentual de Gordura (% G), medido a partir do somatório das dobras cutâneas subescapular e tríceps. Os dados foram comparados entre si, de acordo com gênero e faixa etária dos escolares através da Análise de Variância com um fator (ANOVA ONE WAY), com nível de significância de 5% (p _ 0,05). Com relação ao Percentual de Gordura, apenas 7,6% do gênero feminino apresentaram valores categorizados como “baixos”, enquanto que em 35,8% dos meninos e 33,2% das meninas os níveis foram considerados elevados. Concluiu-se que, a despeito da maioria dos escolares ter sido categorizados com percentual de gordura ótimo, um considerável número de estudantes encontravam-se dentro de alguma faixa de risco para a saúde, em virtude de desnutrição, e principalmente do sobrepeso ou obesidade.

The assessment of body composition is very important to devise strategies to combatmalnutrition, overweight and obesity. The aim of this study was to evaluate the body composition ofschoolchildren aged between 7 and 10 years, belonging to the State Schools in the city of Aracaju / SE.We evaluated 487 students, 250 girls and 237 boys. Body composition was assessed by the percentage offat (% BF) measured from the sum of skinfold subscapular and triceps. The data were compared accordingto gender and age group of students through analysis of variance with one factor (ANOVA ONE WAY)with significance level of 5% (p _ 0.05). According to fat percentage, only 7.6% of females had valuescategorized as "low", while in 35.8% of boys and 33.2% of girls levels were considered high. It wasconcluded that, despite the majority of students have been categorized with great fat percentage, aconsiderable number of students were within a certain range of health risk due to malnutrition, especiallyin overweight or obese.

Enhancement of liver regeneration by the association of Hyptis pectinata with laser therapy.

Since new molecules that normally would accelerate regeneration can also be potentialized by light, the use of new substances combined with laser therapy seems to be a natural type of experiment. Therefore, the purpose of this study was to assess the effects of Hyptis pectinata leaves on liver regeneration after partial hepatectomy (PH) associated with laser therapy. Twenty-four rats were divided into four groups--PH(control), PHL (laser therapy), PH200 (200 mg/kg of Hyptispectinata), and PHL200 (200 mg/kg of the plant and laser)--which were submitted to 67% hepatectomy. Laser treatment consisted of focusing the light on the remaining liver after hepatectomy. The data analyzed were serum levels of aminotransferases, liver regeneration, and mitochondrial function. Group PH200 showed a statistically significant decrease in AST levels, and PHL200 disclosed an augmentation in ALT levels. The liver regeneration index was significantly increased in group PHL200. Concerning liver mitochondrial respiratory assay, groups PH200 and PHL200 showed lower state 3 levels than groups PH and PHL. Group PHL showed an increase in state 4 levels and a reduction in membrane potential and RCR. The present study shows that the association of the aqueous extract of Hyptis pectinata leaves at 200 mg/kg with intraoperative laser therapy can stimulate liver regeneration and cause a reduction in liver mitochondrial respiratory function without altering its phosphorylative activity.