Assessing the efficacy and zootechnical performance in laying hens after administration of a 1% aqueous solution of fluralaner (Exzolt) for treating natural infestation by Menacanthus cornutus.

A brood of laying hens infested with the lice Menacanthus cornutus (Phthiraptera: Menoponidae) evidenced itching, irritation, and damage to their zootechnical performance. A study was conducted to evaluate the zootechnical performance and infestation control using a 1% solution of fluralaner in a brood of white laying hens infested naturally with lice. The experiment was carried out using 10,560 naturally infested chickens divided into 2 groups: a treatment group of animals that received a 1% solution of fluralaner in drinking water, at a dose of 0.05 mL/kg of body weight, in 2 administrations, 7 d apart; and a control group of infested and untreated chickens. The groups of chickens were followed for 120 d to evaluate the score of infestation and zootechnical performance. It was observed that birds in the treatment group became free of lice infestation 7 d after the administration of the first dose of a 1% solution of fluralaner. For up to 120 d after the experiment was initiated, there was no evidence of subsequent lice infestation, while continued infestation with all life stages of lice (adults, young, or eggs) was evident in the untreated control group, remaining stable during all evaluations performed. The birds in the treatment group showed improved zootechnical performance when compared to a 9.94% egg production decrease in the control group. The feed conversion and egg mass data showed statistically significant differences between the 2 groups. This study allows us to conclude that treatment with a 1% solution of fluralaner effectively controlled Menacanthus cornutus lice infestation and promoted recovery of egg production in a brood of laying hens treated with the test formulation.

Productive and economic performance of broiler chickens fed diets with different nutritional levels.

The present study evaluated the productive characteristics, nutrient digestibility, and economic indexes of broiler chickens submitted to diets containing different nutritional levels, and identified advantages for the commercialization of poultry in the griller-type whole chicken model. A total of 180 COBB 500 chicks ™ were distributed in a completely randomized design, in a 2x3 factorial scheme: sex (male and female) and nutritional level (nutritional requirements for male, female or mixed flock); with 6 repetitions of 5 birds each. It was observed effect of the sex factor in the performance and the economic analysis, in which the male chickens presented the highest feed costs, in spite of exhibiting the best feed conversion rates and gross marketability, resulting from greater body weight. Considering nutritional levels, the most outstanding diet was that formulated according to the demands of the females, which did not affect the performance or carcass characteristics of the birds, obtained the highest gross margins with good feeding costs, showed good retention of dry matter and gross energy, regardless of sex. The diet of nutritional requirements of the females provides promising results for the production of broiler chickens. The female birds present marketing advantages in the griller-type chicken model.

Outcomes of lower trapezius transfer with hamstring tendons for irreparable rotator cuff tears.

Background: The aim of this study was to evaluate the results of the transfer of the lower trapezius with a graft from hamstring tendons in the treatment of irreparable rotator cuff tears . Level IV; Case Series; Treatment Study. Methods: Ten patients diagnosed with irreparable tears of the supraspinatus and infraspinatus tendons, were evaluated retrospectively -preoperatively, 6 and 12 months postoperatively. They underwent transfer of the prolonged lower trapezius with an autologous graft of the knee flexor tendons. Results: The Shoulder Subjective Value increased from 47 (preoperative) to 71 (1 year after surgery), American Shoulder and Elbow Surgeons Score increased from 26.63 to 75.24. Pain improved from 7.9 to 2.5 on the Visual Analogue Scale. The mean lateral rotation improved from 31° to 51°, flexion from 84° to 122°, and abduction from 76° to 101°. These results have not changed significantly between 6 and 12 months. Discussion: The transfer of the lower trapezius with autologous grafts from the hamstring tendons showed good results in patients under 65 years of age with irreparable rotator cuff tears . Longer follow-up and a greater number of cases are necessary to confirm the efficacy of the transfer.

OSTEOSYNTHESIS OF A SCAPHOID NECK FRACTURE WITH A CANNULATED COMPRESSION SCREW: EVALUATION OF 52 PATIENTS.

OBJECTIVE: To evaluate the effectiveness of the dorsal fixation technique with a cannulated compression screw (CCS) for transverse scaphoid neck fractures. METHODS: A case series study was carried out with patients treated with a CSS between April 2014 and May 2021. The main outcome was the healing of the fracture, verified by radiographic evaluation that used images of the wrist in anteroposterior, lateral, radial deviation, ulnar deviation and oblique views, obtained in the postoperative period. RESULTS: Fifty-two patients aged between 15 and 65 years were analyzed, of which 43 (83%) were male. Of the 52 patients, 19 (36.53%) had a right-hand injury and 33 (63.46%) had a left-hand injury. Results were excellent in 47 patients (90.38%); good in 4 patients (7.69%), with reduced mobility compared to contralateral and poor in 1 patient (1.92%), with failure of consolidation and breakage of the synthesis material. In 51 cases (99%) there was bone consolidation at the end of six months. CONCLUSION: Osteosynthesis with a cannulated compression screw is a safe, effective and promising method for the treatment of scaphoid neck fractures. Level of Evidence IV, Case Series.

OBJETIVO: Avaliar a eficácia da técnica de fixação dorsal com parafuso canulado de compressão (CCS) para fraturas transversas do colo do escafoide. Métodos: Foi realizado um estudo de série de casos com pacientes tratados com CSS entre abril de 2014 e maio de 2021. O desfecho principal foi a consolidação da fratura, verificada por meio da avaliação radiográfica das imagens do punho em anteroposterior, perfil, desvio radial, desvio ulnar e oblíquo obtidas no pós-operatório. RESULTADOS: Foram analisados 52 pacientes com idade entre 15 e 65 anos, sendo 43 (83%) do sexo masculino. Dos 52 pacientes, 19 (36,53%) tinham lesão na mão direita e 33(63,46%) na mão esquerda. Os resultados foram excelentes em 47 dos pacientes (90,38%); bons em quatro (7,69%), com mobilidade reduzida comparada ao membro contralateral; e ruim em um (1,92%), com falha da consolidação e quebra do material de síntese. Em 51 casos (99%) houve consolidação óssea ao final de seis meses. Conclusão: A osteossíntese com parafuso canulado de compressão é um método seguro, eficaz e promissor para o tratamento das fraturas no colo do escafoide. Nível de Evidência IV, Série de Casos.

What are the Consequences of Incorrect Handling in the Treatment of Blunt-Cut Lip Injuries?

This study aimed report two cases of blunt-cut lip injury which occurred in postoperatory dehiscence. Patients were referred to the emergence attendance and the clinical examination revealed extensive laceration on the upper and lower lips of both patients, highly contaminated with asphalt residue. The affected regions were properly cleaned with saline and antiseptic solution, and, under local anesthesia, suturing was performed in layers in the muscle and oral mucosa region with 4-0 resorbable thread and in the skin region with 6-0 non-absorbable thread. Patients presented different levels of dehiscence on post-operatory evaluation. Thus, it was prescribed antibiotic and healing ointments for decontamination and improvement of the healing process. Third days post-operatory one of the patients presented a great healing of external lips and vermilion lip. However, the other patient presented aesthetic sequelae in the vermilion region of the lip, with a line of fibrosis and misalignment in the region, but not function sequelae. Thus, it was concluded that blunt injuries on the lip must strictly follow the established treatment protocols and must begin aiming for favorable results in the first intervention. Moreover, the postoperative care of the patient and the surgeon are as important as the procedure itself.

In vitro anti-inflammatory activity and ameliorative effects on gastric ulcers of Licania rigida benth seed extract.

Licania rigida Benth., a Brazilian endemic plant, has been traditionally used for treating inflammation and stomach pain. This work investigates the anti-inflammatory and gastroprotective activities of the ethanolic extract from L. rigida seeds (EELr) by in vitro and in vivo methods. The phytochemical profile was determined and the in vitro antioxidant activity was investigated by radical scavenging and thiobarbituric acid reactive substances methods. The ovalbumin denaturation method was used with sodium diclofenac as standard for the in vitro anti-inflammatory activity assessment. Acetylsalicylic acid was used to induce gastric ulcers in male mice and then to evaluate the preventive and therapeutic gastroprotective effect of EELr, using omeprazole as the reference drug. The extract exhibited relevant amount of phenolic compounds and flavonoids, in particular, demonstrating in vitro antioxidant capacity. EELr was able to inhibit almost 60% of ovalbumin denaturation at a concentration considered low. It also prevented the decrease of biochemical markers for oxidative stress such as superoxide dismutase (SOD) and reduced glutathione (GSH) in the stomach and SOD and catalase (CAT) in the liver. EELr also significantly decreased the number of lesions as well as reduced the ulcerated area when used as therapy. The observed effect may be due to its phenolic compounds, such as chlorogenic acid, caffeic acid and tannins, as previously reported. EELr is a potential source of compounds with anti-inflammatory activity, protects the liver from oxidative damage and improves healing of aspirin-induced ulcers. This work contributes to the knowledge of L. rigida species.

Perfil epidemiológico dos pacientes amputados acompanhados em um grande centro referência em reabilitação de Pernambuco / Epidemiological profile of amputee patients monitored at a large reference rehabilitation center in Pernambuco

A amputação de um membro se reveste de maior dramaticidade e limitações sensório-motoras em pacientes jovens, assim como, na população adulta ou idosa com comorbidades. Objetivo: Traçar o perfil demográfico e epidemiológico dos pacientes atendidos em um grande centro de referência em reabilitação em Pernambuco. Métodos: Realizou-se um estudo de corte transversal com revisão de prontuários ativos. Os resultados foram tratados pelo Microsoft Excel® e o programa utilizado para os cálculos estatísticos foi o IBM® SPSS® na versão 23. Resultados: Observou-se idade média de 48,36 anos, gênero masculino (76,6%), casados (47,7%), ensino fundamental (64,8%) e oriundos de todas as regiões do estado. Quanto à amputação, sem predileção por lado, mais frequente nos membros inferiores transfemoral (55,1%), cotos de comprimento variável e causas vasculares e traumáticas mais frequentes. No exame físico, cotos em condições de reabilitação, utilização de aditamento comunitário ou domiciliar na primeira consulta e sem uso prévio de prótese. Em 83,6% dos casos, os pacientes usavam sua prótese mais de 7h/dia e 58,6% possuíam marcha independente na comunidade, com durabilidade da prótese em até 36 meses (75,8%). Conclusão: A amputação ocorre em idade jovem, sendo os homens mais acometidos, as doenças vasculares e acidentes envolvendo veículos motorizados são as principais causas, as cirurgias ocorrem mais nas diáfises ósseas. O tempo de terapias foi efetivo. Fazem-se necessárias políticas públicas que agilizem o acesso do paciente a centros especializados e desses aos centros de reabilitação e para melhoria dos materiais e componentes que compõem as próteses oferecidas pelo SUS

The amputation of a limb is more dramatic and sensorimotor limitations in young patients, as well as in the adult or elderly population with comorbidities. Objective: This study outlined the demographic and epidemiological profile of patients treated at a large referral rehabilitation center in Pernambuco. Methods: A cross-sectional study was carried out with a review of active medical records. The results were processed by Microsoft Excel® and the program used for the statistical calculations was the IBM® SPSS® version 23. Results: It was observed a mean age of 48.36 years, male gender (76.6%), married (47.7%), elementary education (64.8%) and from all regions of the state. As for amputation, with no predilection for the side, more frequent in the lower limbs transfemoral (55.1%), variable length stumps and more frequent vascular and traumatic causes. On physical examination, stumps in rehabilitation conditions, use of community or home addition in the first consultation and no previous use of prosthesis. In 83.6% of the cases, the patients used their prosthesis more than 7h/day and 58.6% had independent walking in the community, with prosthesis durability of up to 36 months (75.8%). Conclusion: Amputation occurs at a young age, with men being more affected, vascular diseases and accidents involving motor vehicles are the main causes, surgeries occur more in bone diaphyses. The therapy time was effective. Public policies are needed to speed up patient access to specialized centers and from them to rehabilitation centers and to improve the materials and components that make up the prostheses offered by the SUS.

Glycerol Electro-Oxidation in Alkaline Medium with Pt-Fe/C Electrocatalysts Synthesized by the Polyol Method: Increased Selectivity and Activity Provided by Less Expensive Catalysts.

We have investigated platinum catalysts containing iron as a modifier to obtain catalysts with superior electrocatalytic activity toward glycerol electro-oxidation in an alkaline medium. The electrocatalysts, supported on carbon Vulcan, were synthesized by the polyol method. The physicochemical characterization data showed that the metals were well distributed on the carbon support and had small particle size (2 nm). The Pt:Fe metal ratio differed from the nominal composition, indicating that reducing iron with platinum was difficult, even though some parameters of the synthesis process were changed. Electrochemical analyses revealed that PtFe/C was more active and stable than commercial Pt/C was, and analysis of the electrolysis by-products showed that iron addition to Pt/C boosted the glycerol conversion and selectivity for glyceric acid formation.

EVALUATION OF TENOTOMY IN THE HIP SUBLUXATION TREATMENT OF CHILDREN WITH ZIKA SYNDROME.

Objectives: Evaluate the efficacy and effects of releasing the muscles of subluxated hips of patients with SCZ. Methods: This is a retrospective study with 29 patients with subluxation of the hip, corresponding to 55 hips operated in a public hospital in Recife, Brazil. Preoperative femoral head migration (PM) percentages were evaluated and compared with 6- and 12-month postoperative results. Results: Twenty-nine patients were eligible, representing 55 hips evaluated. 19 were female (65.5%), with a mean age of 31.45 months (ranging from 23 to 42 years). 19 patients were GMFCS level V (65.5%), 34.5% were level IV, and 20 of the 29 patients (69%) had no complications. The PM had an absolute reduction of 11.6% (GMFCS IV) and 13.31% (GMFCS V) in the first six months. After 12 months, there was a regression of MP of 7.14% (GMFCS V) and 11.25% (GMFCS IV) compared to preoperative values, with no significant statistical difference among MP values presented between 6 and 12 months after surgery. Conclusions: The surgery was effective in PM regression during the analyzed period and presented a low complication rate. Level of Evidence III; Comparative retrospective study.

Objetivos: Avaliar a eficácia e os efeitos da liberação das musculaturas de quadris subluxados de pacientes com SCZ. Métodos: Trata-se de um estudo do tipo retrospectivo com 29 pacientes CZS com subluxação do quadril, correspondendo a 55 quadris operados em um hospital público de Recife, Brasil. Foram avaliados os percentuais migratórios da cabeça femoral (PM) no pré-operatório e comparados com os resultados pós-operatórios de 6 e 12 meses. Resultados: Foram elegíveis 29 pacientes, representando 55 quadris avaliados. 19 eram do sexo feminino (65,5%), com média de idade de 31,45 meses (variando de 23 a 42 anos). 19 pacientes eram GMFCS nível V (65,5%), 34,5% eram nível IV e 20 dos 29 pacientes (69%) não apresentaram complicações. O PM teve redução absoluta de 11,6% (GMFCS IV) e de 13,31% (GMFCS V), nos primeiros seis meses. Após 12 meses, houve regressão do PM de 7,14% (GMFCS V) e de 11,25% (GMFCS IV) em relação aos valores pré-operatórios, sem diferença estatística entre os valores do PM apresentados entre 6 e 12 meses da cirurgia. Conclusões: A cirurgia foi eficaz em regredir o PM no período analisado e apresentou uma baixa taxa de complicações. Nível de Evidência III; Estudo retrospectivo comparativo.

Relationship between Payment for Ecosystem Services Programs and Disasters in Southeast Atlantic Forest region, Brazil.

Ecosystem services significantly contribute to ecosystems resilience and stability. In this sense, payment for ecosystem services can be designed and applied to prevent or decrease environmental disaster risks. This study aimed at verifying whether municipalities taking part in PES programs present higher number of natural disasters (flood, drought, landslide and fire) between 2009 and 2020 in the Paraíba do Sul river basin. We expected that municipalities having more disaster events would take part in more projects, which we found. Programs can be implemented in response to the increase in natural disasters. We also expected PES calls to explicitly target natural disaster prevention measures and actions, which we did not observe. We found actions related to soil conservation and vegetation cover that might prevent risks, but there were no mentions of disasters. It is concerning that PES in Vale do Paraíba Paulista programs have not been addressing natural disaster risk reduction in a landscape, where floods, droughts, anthropogenic fires and erosion problems associated with hilly reliefs have been increasing in the last years.

Prevalence of reported incidental adrenal findings in chest computerized tomography scans performed during the COVID-19 pandemic in a single center in Northeast Brazil.

Objective: We investigated the prevalence of adrenal incidentalomas (AIs) in a nonselected Brazilian population in chest computed tomography (CT) performed during the COVID-19 pandemic. Materials and methods: This was a retrospective cross-sectional observational study using chest CT reports from a tertiary in- and outpatient radiology clinic from March to September 2020. AIs were defined by changes in the shape, size, or density of the gland initially identified in the released report. Individuals with multiple studies were included, and duplicates were removed. Exams with positive findings were reviewed by a single radiologist. Results: A total of 10,329 chest CTs were reviewed, and after duplicate removal, 8,207 exams were included. The median age was 45 years [IQR 35-59 years], and 4,667 (56.8%) were female. Thirty-eight lesions were identified in 36 patients (prevalence 0.44%). A higher prevalence was observed with age, with 94.4% of the findings in patients aged 40 years and over (RR 9.98 IC 2.39-41.58, p 0.002), but there was no significant difference between the sexes. Seventeen lesions (44.7%) had more than 10 HU, and five lesions (12.1%) were more than 4 cm. Conclusion: The prevalence of AIs in an unselected and unreviewed population in a Brazilian clinic is low. The impact on the health system caused by AIs discovered during the pandemic should be small regarding the need for specialized follow-up.

Implantação de serviço estadual de teleassistência: estratégia de resposta na pandemia da Covid-19

Este artigo tem como objetivo apresentar o serviço de teleassistência implantado no estado de Pernambuco/Brasil, como estratégia de enfrentamento à Covid-19. Método: Trata-se de estudo descritivo, de natureza qualitativa, do tipo relato de experiência. Pretende-se descrever a experiência na perspectiva de gestores e trabalhadores da Secretaria Estadual de Saúde, identificando componentes do serviço, os fluxos de acesso, a atuação dos profissionais de saúde, desafios e potencialidades. Resultados: O governo desenvolveu uma plataforma/aplicativo, em caráter emergencial, visando à ampliação do acesso da população à teleassistência, contribuindo também para a reorganização da atuação dos profissionais de saúde enquadrados nos grupos de risco, reduzindo, assim, a exposição desses profissionais à contaminação. O serviço oferta teleorientação, telemonitoramento, teleacolhimento e agendamento de testes para Covid-19, com a participação de trabalhadores médicos, enfermeiros, psicólogos, sanitaristas, residentes médicos e em área profissional de saúde. Considerações finais: A teleassistência se mostrou como importante ponto de atenção à saúde na esfera estadual em um cenário de pandemia, no qual as medidas de distanciamento social e isolamento domiciliar são as principais formas de redução do contágio, enquanto a rede de saúde reorganiza a sua estrutura para atender à demanda. O serviço em desenvolvimento no estado de Pernambuco contribui para a produção de informações e conhecimento sobre as potencialidades da teleassistência no contexto pandêmico, aponta para potencialidades de uso no período póspandemia e sinaliza a necessidade de estudos sobre os resultados e as implicações da telemedicina no cuidado em saúde.

INCIDENCE AND EPIDEMIOLOGY OF ADHESIVE CAPSULITIS DURING THE COVID-19 PANDEMIC.

Objective: To evaluate a possible increase of adhesive capsulitis incidence during the COVID-19 pandemic. Methods: A total of 1,983 patients with shoulder disorders were retrospectively analyzed regarding gender, age, development of adhesive capsulitis and comorbidities (systemic arterial hypertension, diabetes mellitus, dyslipidemia, hypothyroidism, hyperthyroidism, depression, and anxiety) in two different periods: from March 2019 to February 2020 and from March 2020 to February 2021. Descriptive and quantitative variables were statistically analyzed. The program used for the calculations was SPSS 17.0 for Windows. Results: During the pandemic, there was a 2.41-fold increase (p < 0.001) in cases of adhesive capsulitis (compared to the previous year). Patients with depression and anxiety had a significantly increased risk by 8.8 (p < 0.001) and 14 (p < 0.001) times, respectively, of developing frozen shoulder (regarding the two periods studied). Conclusion: A significant increase in the incidence of frozen shoulder was observed after the onset of the COVID-19 pandemic in addition to a simultaneous increase of psychosomatic disorders. Prospective studies would help to ratify the idea contained in this research. Level of Evidence III, Observational Cross-Sectional Study.

Objetivo: Avaliar se houve aumento da incidência de capsulite adesiva durante a pandemia de COVID-19. Métodos: Foram analisados, retrospectivamente, 1.983 pacientes com desordens do ombro quanto a sexo, idade, desenvolvimento de capsulite adesiva e comorbidades (hipertensão arterial sistêmica, diabetes mellitus, dislipidemia, hipo/hipertireoidismo, depressão e ansiedade) em dois períodos distintos: de março de 2019 a fevereiro de 2020 e de março de 2020 a fevereiro de 2021. Procedeu-se à análise estatística das variáveis descritivas e quantitativas, utilizando o software SPSS 17.0 for Windows para os cálculos. Resultados: Durante a pandemia, houve aumento de 2,41 vezes (p < 0,001) de casos de capsulite adesiva em relação ao ano anterior. Considerando os períodos estudados, pacientes com depressão e ansiedade apresentaram um risco significativamente aumentado em 8,8 (p < 0,001) e 14 (p < 0,001) vezes, respectivamente, de desenvolver a patologia em questão. Conclusão: Observou-se um aumento significativo da incidência de ombro congelado após o início da pandemia de COVID-19, além de sua relação com distúrbios psicossomáticos. São necessários estudos prospectivos futuros para ratificar a ideia contida nesta pesquisa. Nível de Evidência III, Estudo Transversal Observacional.

Evidence of the Cardioprotective Effects of Aloysia polystachya in Isoproterenol-Induced Myocardial Infarction in Rats.

Aloysia polystachya is a plant species that is widely used in Brazilian folk medicine for the treatment of different disorders that affect the cardiovascular system. The aim of the study was to investigate the cardioprotective effects of an ethanol-soluble fraction of A. polystachya (ESAP) on isoproterenol-induced myocardial infarction in rats. Different groups of rats (n = 8) were orally treated with ESAP (30, 100, and 300 mg/kg), carvedilol (10 mg/kg), or vehicle (filtered water; 1 mL/100 g) for 7 days. Naive rats received no treatment. On the morning of day 6, acute myocardial infarction was induced by the acute oral administration of isoproterenol (100 mg/kg). On the morning of day 8, all rats underwent electrocardiography and transthoracic echocardiography. Blood samples were then collected, and serum levels of creatine kinase-MB fraction (CK-MB) and cardiac troponin T (cTNT) were quantified. ESAP significantly reduced electrocardiographic changes, improved the ventricular ejection fraction, and reduced serum levels of CK-MB and cTNT in infarcted rats. The cardioprotective effects of ESAP could be exploited as an effective tool against isoproterenol-induced myocardial infarction in rats.

High-touch surfaces disinfection compliance in a COVID-19 intensive care unit.

Environmental cleaning and disinfection are fundamental health care-associated infection prevention measures. This study aimed to evaluate the disinfection compliance of high-touch surfaces in a COVID-19-only intensive care unit, using a fluorescent marker. It was divided into 3 phases, baseline assessment, educational feedback, and post feedback. Disinfection compliance improved significantly from the first to the third phase, 14.3% to 51.4% (P < .001), respectively.

Evaluation of tenotomy in the hip subluxation treatment of children with zika syndrome / Avaliação da tenotomia no tratamento da subluxação do quadril de crianças com zika

ABSTRACT Objectives: Evaluate the efficacy and effects of releasing the muscles of subluxated hips of patients with SCZ. Methods: This is a retrospective study with 29 patients with subluxation of the hip, corresponding to 55 hips operated in a public hospital in Recife, Brazil. Preoperative femoral head migration (PM) percentages were evaluated and compared with 6- and 12-month postoperative results. Results: Twenty-nine patients were eligible, representing 55 hips evaluated. 19 were female (65.5%), with a mean age of 31.45 months (ranging from 23 to 42 years). 19 patients were GMFCS level V (65.5%), 34.5% were level IV, and 20 of the 29 patients (69%) had no complications. The PM had an absolute reduction of 11.6% (GMFCS IV) and 13.31% (GMFCS V) in the first six months. After 12 months, there was a regression of MP of 7.14% (GMFCS V) and 11.25% (GMFCS IV) compared to preoperative values, with no significant statistical difference among MP values presented between 6 and 12 months after surgery. Conclusions: The surgery was effective in PM regression during the analyzed period and presented a low complication rate. Level of Evidence III; Comparative retrospective study.

RESUMO Objetivos: Avaliar a eficácia e os efeitos da liberação das musculaturas de quadris subluxados de pacientes com SCZ. Métodos: Trata-se de um estudo do tipo retrospectivo com 29 pacientes CZS com subluxação do quadril, correspondendo a 55 quadris operados em um hospital público de Recife, Brasil. Foram avaliados os percentuais migratórios da cabeça femoral (PM) no pré-operatório e comparados com os resultados pós-operatórios de 6 e 12 meses. Resultados: Foram elegíveis 29 pacientes, representando 55 quadris avaliados. 19 eram do sexo feminino (65,5%), com média de idade de 31,45 meses (variando de 23 a 42 anos). 19 pacientes eram GMFCS nível V (65,5%), 34,5% eram nível IV e 20 dos 29 pacientes (69%) não apresentaram complicações. O PM teve redução absoluta de 11,6% (GMFCS IV) e de 13,31% (GMFCS V), nos primeiros seis meses. Após 12 meses, houve regressão do PM de 7,14% (GMFCS V) e de 11,25% (GMFCS IV) em relação aos valores pré-operatórios, sem diferença estatística entre os valores do PM apresentados entre 6 e 12 meses da cirurgia. Conclusões: A cirurgia foi eficaz em regredir o PM no período analisado e apresentou uma baixa taxa de complicações. Nível de Evidência III; Estudo retrospectivo comparativo.

Prevalence of reported incidental adrenal findings in chest computerized tomography scans performed during the COVID-19 pandemic in a single center in Northeast Brazil

ABSTRACT Objective: We investigated the prevalence of adrenal incidentalomas (AIs) in a nonselected Brazilian population in chest computed tomography (CT) performed during the COVID-19 pandemic. Materials and methods: This was a retrospective cross-sectional observational study using chest CT reports from a tertiary in- and outpatient radiology clinic from March to September 2020. AIs were defined by changes in the shape, size, or density of the gland initially identified in the released report. Individuals with multiple studies were included, and duplicates were removed. Exams with positive findings were reviewed by a single radiologist. Results: A total of 10,329 chest CTs were reviewed, and after duplicate removal, 8,207 exams were included. The median age was 45 years [IQR 35-59 years], and 4,667 (56.8%) were female. Thirty-eight lesions were identified in 36 patients (prevalence 0.44%). A higher prevalence was observed with age, with 94.4% of the findings in patients aged 40 years and over (RR 9.98 IC 2.39-41.58, p 0.002), but there was no significant difference between the sexes. Seventeen lesions (44.7%) had more than 10 HU, and five lesions (12.1%) were more than 4 cm. Conclusions: The prevalence of AIs in an unselected and unreviewed population in a Brazilian clinic is low. The impact on the health system caused by AIs discovered during the pandemic should be small regarding the need for specialized follow-up.

Incidence and epidemiology of adhesive capsulitis during the covid-19 pandemic / Incidência e epidemiologia de capsulite adesiva durante a pandemia de covid-19

ABSTRACT Objective: To evaluate a possible increase of adhesive capsulitis incidence during the COVID-19 pandemic. Methods: A total of 1,983 patients with shoulder disorders were retrospectively analyzed regarding gender, age, development of adhesive capsulitis and comorbidities (systemic arterial hypertension, diabetes mellitus, dyslipidemia, hypothyroidism, hyperthyroidism, depression, and anxiety) in two different periods: from March 2019 to February 2020 and from March 2020 to February 2021. Descriptive and quantitative variables were statistically analyzed. The program used for the calculations was SPSS 17.0 for Windows. Results: During the pandemic, there was a 2.41-fold increase (p < 0.001) in cases of adhesive capsulitis (compared to the previous year). Patients with depression and anxiety had a significantly increased risk by 8.8 (p < 0.001) and 14 (p < 0.001) times, respectively, of developing frozen shoulder (regarding the two periods studied). Conclusion: A significant increase in the incidence of frozen shoulder was observed after the onset of the COVID-19 pandemic in addition to a simultaneous increase of psychosomatic disorders. Prospective studies would help to ratify the idea contained in this research. Level of Evidence III, Observational Cross-Sectional Study.

RESUMO Objetivo: Avaliar se houve aumento da incidência de capsulite adesiva durante a pandemia de COVID-19. Métodos: Foram analisados, retrospectivamente, 1.983 pacientes com desordens do ombro quanto a sexo, idade, desenvolvimento de capsulite adesiva e comorbidades (hipertensão arterial sistêmica, diabetes mellitus, dislipidemia, hipo/hipertireoidismo, depressão e ansiedade) em dois períodos distintos: de março de 2019 a fevereiro de 2020 e de março de 2020 a fevereiro de 2021. Procedeu-se à análise estatística das variáveis descritivas e quantitativas, utilizando o software SPSS 17.0 for Windows para os cálculos. Resultados: Durante a pandemia, houve aumento de 2,41 vezes (p < 0,001) de casos de capsulite adesiva em relação ao ano anterior. Considerando os períodos estudados, pacientes com depressão e ansiedade apresentaram um risco significativamente aumentado em 8,8 (p < 0,001) e 14 (p < 0,001) vezes, respectivamente, de desenvolver a patologia em questão. Conclusão: Observou-se um aumento significativo da incidência de ombro congelado após o início da pandemia de COVID-19, além de sua relação com distúrbios psicossomáticos. São necessários estudos prospectivos futuros para ratificar a ideia contida nesta pesquisa. Nível de Evidência III, Estudo Transversal Observacional.

Osteosynthesis of a scaphoid neck fracture with a cannulated compression screw: evaluation of 52 patients / Osteossíntese de fratura no colo do escafoide com parafuso canulado de compressão: avaliação de 52 pacientes

ABSTRACT Objective: To evaluate the effectiveness of the dorsal fixation technique with a cannulated compression screw (CCS) for transverse scaphoid neck fractures. Methods: A case series study was carried out with patients treated with a CSS between April 2014 and May 2021. The main outcome was the healing of the fracture, verified by radiographic evaluation that used images of the wrist in anteroposterior, lateral, radial deviation, ulnar deviation and oblique views, obtained in the postoperative period. Results: Fifty-two patients aged between 15 and 65 years were analyzed, of which 43 (83%) were male. Of the 52 patients, 19 (36.53%) had a right-hand injury and 33 (63.46%) had a left-hand injury. Results were excellent in 47 patients (90.38%); good in 4 patients (7.69%), with reduced mobility compared to contralateral and poor in 1 patient (1.92%), with failure of consolidation and breakage of the synthesis material. In 51 cases (99%) there was bone consolidation at the end of six months. Conclusion: Osteosynthesis with a cannulated compression screw is a safe, effective and promising method for the treatment of scaphoid neck fractures. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar a eficácia da técnica de fixação dorsal com parafuso canulado de compressão (CCS) para fraturas transversas do colo do escafoide. Métodos: Foi realizado um estudo de série de casos com pacientes tratados com CSS entre abril de 2014 e maio de 2021. O desfecho principal foi a consolidação da fratura, verificada por meio da avaliação radiográfica das imagens do punho em anteroposterior, perfil, desvio radial, desvio ulnar e oblíquo obtidas no pós-operatório. Resultados: Foram analisados 52 pacientes com idade entre 15 e 65 anos, sendo 43 (83%) do sexo masculino. Dos 52 pacientes, 19 (36,53%) tinham lesão na mão direita e 33(63,46%) na mão esquerda. Os resultados foram excelentes em 47 dos pacientes (90,38%); bons em quatro (7,69%), com mobilidade reduzida comparada ao membro contralateral; e ruim em um (1,92%), com falha da consolidação e quebra do material de síntese. Em 51 casos (99%) houve consolidação óssea ao final de seis meses. Conclusão: A osteossíntese com parafuso canulado de compressão é um método seguro, eficaz e promissor para o tratamento das fraturas no colo do escafoide. Nível de Evidência IV, Série de Casos.

Nasal irrigation with corticosteroids in Brazil: the clinical response of 1% compounded budesonide drops and betamethasone cream

Abstract Introduction: High-volume corticosteroid nasal irrigation is a treatment option in patients with chronic rhinosinusitis. In Brazil, alternatives are used to optimize its cost and popularize its use, such as 1% compounded budesonide drops or betamethasone cream, and it is necessary to study these treatment modalities. Objective: To evaluate the clinical response of nasal irrigation with 1% compounded budesonide drops or betamethasone cream compared to nasal sprays utilized in patients with chronic rhinosinusitis. Methods: This was a retrospective observational study with 257 patients. One hundred and eight patients using corticosteroid nasal irrigation (292 treatment cycles) and 149 using corticosteroid nasal spray (300 treatment cycles) were included. Evaluation of subjective improvement, adverse events, exacerbations, and objective assessments with SNOT-22 and Lund-Kennedy endoscopic score were performed, in addition to sub-analyses related to nasal polyps and previous surgery. Results: Corticosteroid nasal irrigation and corticosteroid nasal spray improved the Lund-Kennedy endoscopic score, with more adverse events in the corticosteroid nasal irrigation group. Previous surgery increased corticosteroid nasal irrigation improvement, with greater subjective improvement and fewer exacerbations. 1% compounded budesonide drops were better than betamethasone cream in the Lund-Kennedy endoscopic score, with fewer adverse events. A 1,000 μg dose of 1% compounded budesonide drops was more effective than 500 μg. Conclusion: Corticosteroid nasal irrigation was effective in improving the Lund-Kennedy endoscopic score in chronic rhinosinusitis, especially in patients with nasal polyps and previous surgery, in addition to promoting a higher rate of subjective improvement and fewer exacerbations than corticosteroid nasal spray, but with more adverse events. 1% compounded budesonide drops improved the Lund-Kennedy endoscopic score with fewer adverse events than betamethasone cream, particularly at higher doses (1000 μg).