Climate change is associated with higher phytoplankton biomass and longer blooms in the West Antarctic Peninsula.

The Antarctic Peninsula (West Antarctica) marine ecosystem has undergone substantial changes due to climate-induced shifts in atmospheric and oceanic temperatures since the 1950s. Using 25 years of satellite data (1998-2022), this study presents evidence that phytoplankton biomass and bloom phenology in the West Antarctic Peninsula are significantly changing as a response to anthropogenic climate change. Enhanced phytoplankton biomass was observed along the West Antarctic Peninsula, particularly in the early austral autumn, resulting in longer blooms. Long-term sea ice decline was identified as the main driver enabling phytoplankton growth in early spring and autumn, in parallel with a recent intensification of the Southern Annular Mode (2010-ongoing), which was observed to influence regional variability. Our findings contribute to the understanding of the complex interplay between environmental changes and phytoplankton responses in this climatically key region of the Southern Ocean and raise important questions regarding the far-reaching consequences that these ecological changes may have on global carbon sequestration and Antarctic food webs in the future.

A review on the diversity and distribution of athecate dinoflagellates in South Atlantic and in the Atlantic sector of the Southern Ocean: Research insights and gaps.

This review summarizes the state of knowledge on athecate dinoflagellates occurring within the South Atlantic Ocean and Atlantic sector of the Southern Ocean. We compiled data from 105 articles and selected 33 addressing any aspect of athecate dinoflagellate studies. Our aim is to discuss the patterns in athecate dinoflagellate distribution by building a thorough species list and an occurrence map based on species recorded in coastal and oceanic waters. We found 69 species totaling 141 occurrences in the entire South Atlantic Ocean basin. Contradicting global trends, most species distributed throughout this region are subtropical. We linked this trend to a higher local effort in dinoflagellate research instead of higher biodiversity, especially when compared to usual hotspots in biodiversity attributed to tropical oceans. The Subantarctic and Antarctic regions had a low number of occurrences, with 12 and 5, respectively. Except for the occurrence of Gyrodinium lachryma in the Antarctic Zone, all records are unique, poorly described and never recorded again for species such as Gymnodinium baccatum and Gymnodinium antarcticum. This demonstrates that the state of knowledge regarding athecate dinoflagellates in the South Atlantic and especially in the Antarctic region is still limited due to a lack of directed investigation.

Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea. / Etiología infecciosa e indicadores de malabsorción o daño intestinal en diarrea infantil

INTRODUCTION: The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease. OBJECTIVE: To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity. MATERIALS AND METHODS: The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests. RESULTS: We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method. CONCLUSIONS: Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.

Introducción. La etiología multifactorial de la gastroenteritis enfatiza la necesidad de usar diferentes métodos de laboratorio para identificar o excluir agentes infecciosos y evaluar la gravedad de la enfermedad diarreica. Objetivo. Diagnosticar la etiología infecciosa de la diarrea en niños y evaluar algunos marcadores fecales asociados con la integridad intestinal. Materiales y métodos. Se estudiaron 45 niños con enfermedad diarreica, en los cuales se evaluaron la presencia de enteropatógenos y los marcadores de malabsorción. Se analizaron las muestras fecales de 76 niños, mediante las pruebas de esteatocrito tradicional y esteatocrito ácido, para la cuantificación de la grasa. Resultados. Se observó diarrea aguda en el 80 % de los niños y diarrea persistente en el 20 %. De los individuos con diarrea, el 40 % fue positivo para enteropatógenos; los más diagnosticados fueron rotavirus (13,3 %) y Giardia duodenalis (11,1 %). Entre los pacientes infectados, la sangre oculta fue más evidente en aquellos portadores de bacterias patógenas (40 %) o enterovirus (40%), mientras que la esteatorrea se observó en infecciones por el protozoo G. duodenalis (35,7 %). Los niños con diarrea excretaron significativamente más lípidos en las heces que aquellos sin diarrea, según lo determinado por los métodos de esteatocrito tradicional (p<0,0003) y esteatocrito ácido (p<0,0001). Conclusiones. La diarrea infantil puede provocar deficiencias graves de nutrientes. La esteatorrea es distintiva de la malabsorción intestinal y puede detectarse mediante la estimación del esteatocrito ácido. Esta prueba podría utilizarse de forma rutinaria como una herramienta de laboratorio para la evaluación semicuantitativa de la malabsorción de grasas en niños con diarrea.

Blueberry Muffin Syndrome and Hyperleukocytosis in a Newborn: A Diagnostic Challenge.

Blueberry muffin syndrome (BMS) in neonates, characterized by widespread nodular lesions, presents diagnostic challenges due to its diverse etiologies. Hyperleukocytosis, with leukocyte counts exceeding 100,000/µL, is a rare phenomenon associated with severe complications in neonates. Congenital leukemia (CL), a rare diagnosis within the first month of life, is linked to high mortality. This case report presents a unique case of BMS with hyperleukocytosis as the initial presentation of CL. A full-term male newborn, born after an uncomplicated pregnancy, except for Kell isoimmunization, with an Apgar score of 9/10, and an irrelevant family history, showed widespread purple nodules consistent with BMS at birth. Laboratory workup revealed mild anemia, hyperleukocytosis with immature granulocytes on peripheral blood (PB) smear, positive direct antiglobulin test, and elevated alanine aminotransferase and lactate dehydrogenase, without hyperbilirubinemia. Empirical antibiotics and hyperhydration were started, and the neonate was transferred to a level 3 neonatal intensive care unit for further evaluation. A comprehensive etiological investigation was conducted, comprising infectious, immunological, metabolic, and neoplastic factors. A skin nodule biopsy revealed an infiltrate of blast cells, indicative of leukemia cutis, and a bone marrow aspirate confirmed acute myeloid leukemia (AML). The patient successfully completed the NOPHO-DBH-2012 chemotherapy protocol at five months and remains in complete remission at nine months. This case report contributes to the literature by highlighting the diagnostic approach and management strategies for CL presenting with BMS and hyperleukocytosis. This case aims to enhance awareness and understanding of BMS as an initial manifestation of CL. Additionally, the challenges of treating leukemia in neonates, coupled with the lack of specific guidelines for this age group, further underscore the complexities in managing such patients.

Curativo a vácuo simplificado: estudo de viabilidade operacional e financeira no tratamento de feridas / Simplified vacuum dressing system: operational and financial feasibility study in the management of wounds

Introdução: O alto custo da terapia de pressão negativa (TPN) torna o procedimento menos acessível em instituições com recursos limitados. Para resolver o problema, têm sido propostos os curativos a vácuo simplificados, mas a utilidade desses equipamentos ainda é pouco estudada. O objetivo desse trabalho é avaliar a viabilidade (operacional e financeira) de um modelo de curativo a vácuo simplificado (MCVS). Método: A viabilidade operacional foi avaliada por meio de estudo de tempo de instalação e quantidade de curativos realizados; a financeira, por análise de custos econômicos de trocas de curativos. Resultados: Foram tratadas 50 feridas (25 em cada grupo: MCVS x hidrofibra prata). Para o MCVS, o número de curativos por paciente foi menor, enquanto o tempo de instalação, maior. MCVS apresentou custos maiores. O aumento de custo associado a MCVS foi relacionado ao preço médio de comercialização do produto e quantidade de trocas de curativos; tempo de tratamento e tempo de instalação do MCVS não interferiram em custos. Em contraste, os custos do MCVS se mostraram bem inferiores aos custos anunciados para a TPN convencional. Conclusão: MCVS foi considerado viável desde que seja feito por equipes qualificadas e resulte em poucas trocas de curativos (< 3).

Introduction: The high cost of negative pressure wound therapy (NPWT) makes the procedure less accessible in institutions with limited resources. To solve the problem, streamlined vacuum dressings have been proposed, but the usefulness of these devices has been poorly studied. The objective of this work is to evaluate the feasibility (operational and financial) of a simplified vacuum dressing system model (SVDM). Methods: Operational viability was assessed by studying application time and quantity of dressings performed; financial viability, by analyzing the economic costs of dressing changes. Results: Fifty wounds were treated (25 in each group: SVDM x silver hydrofiber). For SVDM, the number of dressings per patient was lower, while the application time was higher. The SVDM showed higher costs. The increase in the expenses associated with the SVDM was related to the average selling price of the product and the number of dressing changes; treatment time and application time of the SVDM did not interfere with costs. In contrast, SVDM costs proved to be below the announced expenses for conventional NPWT. Conclusion: SVDM was considered viable as long as qualified teams perform it and results in few dressing changes (< 3).

Temporal relation between human mobility, climate, and COVID-19 disease.

Using the example of the city of São Paulo (Brazil), in this paper, we analyze the temporal relation between human mobility and meteorological variables with the number of infected individuals by the COVID-19 disease. For the temporal relation, we use the significant values of distance correlation t0(DC), which is a recently proposed quantity capable of detecting nonlinear correlations between time series. The analyzed period was from February 26, 2020 to June 28, 2020. Fewer movements in recreation and transit stations and the increase in the maximal temperature have strong correlations with the number of newly infected cases occurring 17 days after. Furthermore, more significant changes in grocery and pharmacy, parks, and recreation and sudden changes in the maximal pressure occurring 10 and 11 days before the disease begins are also correlated with it. Scanning the whole period of the data, not only the early stage of the disease, we observe that changes in human mobility also primarily affect the disease for 0-19 days after. In other words, our results demonstrate the crucial role of the municipal decree declaring an emergency in the city to influence the number of infected individuals.

Physical-biological drivers modulating phytoplankton seasonal succession along the Northern Antarctic Peninsula.

The Northern Antarctic Peninsula (NAP) shows shifts in phytoplankton distribution and composition along its warming marine ecosystems. However, despite recent efforts to mechanistically understand these changes, little focus has been given to the phytoplankton seasonal succession, remaining uncertainties regarding to distribution patterns of emerging taxa along the NAP. To fill this gap, we collected phytoplankton (pigment and microscopy analysis) and physico-chemical datasets during spring and summer (November, February and March) of 2013/2014 and 2014/2015 off the NAP. Satellite measurements (sea surface temperature, sea ice concentration and chlorophyll-a) were used to extend the temporal coverage of analysis associated with the in situ sampling. We improved the quantification and distribution pattern of emerging taxa, such as dinoflagellates and cryptophytes, and described a contrasting seasonal behavior and distinct fundamental niche between centric and pennate diatoms. Cryptophytes and pennate diatoms preferentially occupied relatively shallower mixing layers compared with centric diatoms and dinoflagellates, suggesting differences between these groups in distribution and environment occupation over the phytoplankton seasonal succession. Under colder conditions, negative sea surface temperature anomalies were associated with positive anomalies of sea ice concentration and duration. Therefore, based on sea ice-phytoplankton growth relationship, large phytoplankton biomass accumulation was expected during the spring/summer of 2013/2014 and 2014/2015 along the NAP. However, there was a decoupling between sea ice concentration/duration and phytoplankton biomass, characterizing two seasonal periods of low biomass accumulation (negative chlorophyll-a anomalies), associated with the top-down control in the region. These results provide an improved mechanistic understanding on physical-biological drivers modulating phytoplankton seasonal succession along the Antarctic coastal waters.

Cryptophytes: An emerging algal group in the rapidly changing Antarctic Peninsula marine environments.

The western Antarctic Peninsula (WAP) is a climatically sensitive region where foundational changes at the basis of the food web have been recorded; cryptophytes are gradually outgrowing diatoms together with a decreased size spectrum of the phytoplankton community. Based on a 11-year (2008-2018) in-situ dataset, we demonstrate a strong coupling between biomass accumulation of cryptophytes, summer upper ocean stability, and the mixed layer depth. Our results shed light on the environmental conditions favoring the cryptophyte success in coastal regions of the WAP, especially during situations of shallower mixed layers associated with lower diatom biomass, which evidences a clear competition or niche segregation between diatoms and cryptophytes. We also unravel the cryptophyte photo-physiological niche by exploring its capacity to thrive under high light stress normally found in confined stratified upper layers. Such conditions are becoming more frequent in the Antarctic coastal waters and will likely have significant future implications at various levels of the marine food web. The competitive advantage of cryptophytes in environments with significant light level fluctuations was supported by laboratory experiments that revealed a high flexibility of cryptophytes to grow in different light conditions driven by a fast photo-regulating response. All tested physiological parameters support the hypothesis that cryptophytes are highly flexible regarding their growing light conditions and extremely efficient in rapidly photo-regulating changes to environmental light levels. This plasticity would give them a competitive advantage in exploiting an ecological niche where light levels fluctuate quickly. These findings provide new insights on niche separation between diatoms and cryptophytes, which is vital for a thorough understanding of the WAP marine ecosystem.

Simplified vacuum dressing system: effectiveness and safety in wounds management.

PURPOSE: Negative pressure wound therapy (NPWT) has revolutionized wound care, but its high cost reduces the procedure's availability. To solve the problem, streamlined vacuum dressings systems have been proposed, but the utility of these devices has been poorly studied. The objective of this study was to evaluate a simplified vacuum dressing system model (SVDM). METHODS: Randomized clinical trial in which wounds were treated with SVDM compared to a complex occlusive dressing (silver hydrofiber, SHF). The analyzed outcomes were cleaning, presence of granulation tissue, clinical appearance, and indication for surgical closure of wounds. RESULTS: Fifty injuries were treated (25 in each group), most located on lower limbs. SVDM proved to be more effective than SHF in the evaluated outcomes. Wound recalcitrance reduced the effectiveness of the equipment used. Despite its efficacy, complications occurred, the most frequent related to dressing changes: minor bleeding, foam adherence to a wound bed, and pain. Only for bleeding no favorable risk-benefit ratio was found. There were no severe complications, worsening conditions of injuries, or deaths. CONCLUSIONS: SVDM proved to be an effective and acceptably safe device for managing studied wounds.

Análise quanti e semiquantitativa do colágeno no reparo tecidual - um estudo comparativo / Quantitative and semiquantitative analysis of collagen in wound healing - a comparative study

Introdução: diversos estudos têm destacado a relevância do colágeno no contexto do reparo tecidual, em especial, sob influência de diferentes terapias biomoduladoras. A análise do colágeno tem sido realizada mediante diferentes abordagens metodológicas, entre as quais se destacam as análises semiquantitativa e histomorfométrica. Objetivos: O presente estudo Objetivou comparar os Resultados de dois tipos de análise acerca da presença de fibras colágenas na matriz extracelular durante a cicatrização cutânea, em ferimentos fotobiomodulados. Metodologia: vinte ratos machos Wistar, foram submetidos à indução de uma ferida cutânea padronizada dorsal e divididos em dois grupos, Controle (GC) e Fotobiomodulado com laser (GL). Os períodos de morte corresponderam ao 5º. e 10º. dias. As secções histológicas foram coradas com Sírius vermelho para análise semiquantitativa e histomorfométrica do colágeno. Resultados: dois parâmetros foram utilizados para comparar o desfecho primário, um critério de grandeza quantitativa em porcentagem (área de colágeno), e o segundo critério semiquantitativo, com grandezas conferidas de acordo com escores que variaram de leve a intenso. Não foram observados Resultados divergentes entre os dois tipos de análise. No 5º. dia, independente do tipo de análise, constatou-se diferença estatisticamente significativa entre o grupo controle e o submetido à Fotobiomodulação (p<0,05), embora tal efeito tenha sido considerado pequeno. Conclusão: estes dados sugerem que ambos os métodos de análise foram capazes de reproduzir Resultados semelhantes, cabendo ao pesquisador eleger aquele que melhor se adeque ao escopo de sua pesquisa.

Introduction: several studies highlighted the relevance of collagen in the context of wound healing, especially under the influence of different biomodulatory therapies. Collagen analysis has been performed using different methodological approaches, among which semi-quantitative and histomorphometric analyzes stand out. The present study aimed to compare the Results of two methods of analysis regarding the presence of collagen fibers in the extracellular matrix during wound healing, in photobiomodulated wounds. Methods: twenty male Wistar rats were submitted to the induction of a standardized dorsal skin wound and divided into two groups, Control (GC) and Laser Photobiomodulated (GL). The periods of death corresponded to the 5th. and 10th. days. Histological sections were stained with Sirius red for semiquantitative and histomorphometric analysis of collagen. Results: two parameters were used to compare the primary outcome, a quantitative magnitude criterion in percentage (collagen area), and the second semiquantitative criterion, with magnitudes conferred according to scores that varied from mild to severe. No divergent Results were observed between the two types of analysis. On the 5th. day, regardless of the type of analysis, there was a statistically significant difference between the control group and the group submitted to Photobiomodulation (p<0.05), although this effect was considered small. Conclusion:these data suggest that both analysis methods were able to reproduce similar Results, leaving the researcher to choose the one that best fits the scope of his research.

Prospective study of the Iliac Bicrest Pubic Angle through the 3D reconstruction of the bone pelvis and the correlation with giant incisional hernia.

OBJECTIVE: to describe and measure the Bicrista Iliaca Pubo Angle (APBCI) as a new anthropometric parameter. Correlate the measurement with patients with giant incisional hernia (HIG), in the midline of the anterior abdominal wall (AAW). METHODS: measurement of APBCI, through 3D reconstruction from computed tomography (CT). Measurements performed by two observers, R and C, in 246 women and 60 men, normal adults, in order to obtain the APBCI measurement and its correlation in patients with HIG of the AAW. RESULTS: after sample calculations, the measurement of APBCI in men: 92.5+6.3º to 93.8+6.7º; in women: 90+6.7° to 94.3+6.8° [p-value 0.337(R)/0.628(C)]. The mean age was 57.9+15.9 years (22 to 91 years). Female gender 57+15.7 years (22 to 91 years) and male 61.7+16.5 years (23 to 89 years) p=0.067. As for the distribution of the ranges from 5 to 5 degrees, there is no difference in the distribution of the angle [p-value 0.455(R)/0.672(C)]. The correlation between age and angle showed that the higher the age, the higher the APBCI. There was no variability between angle measurements: 0.97 (95% CI 0.97; 0.98). In men with HIG, the average is between 108.3+5.37º (102.92º to 113.67º), and in women, 107.8+6.64 (101.16º to 114.44º). CONCLUSION: the study allowed us to conclude that HIG is not just an isolated AAW defect. Determines skeletal changes, as the APBCI is influenced by the distance of the iliac crests.

Chemotaxonomic characterization of the key genera of diatoms in the Northern Antarctic Peninsula.

Diatoms are successful in occupying a wide range of ecological niches and biomes along the global ocean. Although there is a recognized importance of diatoms for the Southern Ocean ecosystems and biogeochemical cycles, the current knowledge on their ecology and distribution along the impacted Antarctic coastal regions remains generalized at best. HPLC-CHEMTAX approaches have been extensively used to this purpose, providing valuable information about the whole phytoplankton community, even for those small-size species which are normally difficult to identify by light microscopy. Despite that, the chemotaxonomic method has reserved minimal focus on great diversity of types associated with diatom genera or species. Here, we show a coupling between the key genera and the corresponding chemotaxonomic subgroup type-A or type-B of diatoms via HPLC-CHEMTAX and microscopic analysis, using chlorophyll-c 1 and chlorophyll-c 3 as biomarker pigments, respectively. The results demonstrated strong correlations for nine of the fifteen most abundant diatom genera observed along the Northern Antarctic Peninsula, from which five (four) were statistically associated with chlorophyll-c 1 (chlorophyll-c 3). Our study highlights the importance to observe diatoms in greater detail, beyond being only one functional group, for a better understanding on their responses under a climate change scenario.

Isotonic exercises and relaxing techniques in individuals with temporomandibular dysfunction.

Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.

Simplified vacuum dressing system: effectiveness and safety in wounds management

Purpose: Negative pressure wound therapy (NPWT) has revolutionized wound care, but its high cost reduces the procedure's availability. To solve the problem, streamlined vacuum dressings systems have been proposed, but the utility of these devices has been poorly studied. The objective of this study was to evaluate a simplified vacuum dressing system model (SVDM). Methods: Randomized clinical trial in which wounds were treated with SVDM compared to a complex occlusive dressing (silver hydrofiber, SHF). The analyzed outcomes were cleaning, presence of granulation tissue, clinical appearance, and indication for surgical closure of wounds. Results: Fifty injuries were treated (25 in each group), most located on lower limbs. SVDM proved to be more effective than SHF in the evaluated outcomes. Wound recalcitrance reduced the effectiveness of the equipment used. Despite its efficacy, complications occurred, the most frequent related to dressing changes: minor bleeding, foam adherence to a wound bed, and pain. Only for bleeding no favorable risk-benefit ratio was found. There were no severe complications, worsening conditions of injuries, or deaths. Conclusions: SVDM proved to be an effective and acceptably safe device for managing studied wounds.

Prospective study of the Iliac Bicrest Pubic Angle through the 3D reconstruction of the bone pelvis and the correlation with giant incisional hernia / Estudo prospectivo do Ângulo Pubo Bicrista Ilíaca através da reconstrução 3D da pelve óssea e a correlação com a hérnia incisional gigante

ABSTRACT Objective: to describe and measure the Bicrista Iliaca Pubo Angle (APBCI) as a new anthropometric parameter. Correlate the measurement with patients with giant incisional hernia (HIG), in the midline of the anterior abdominal wall (AAW). Methods: measurement of APBCI, through 3D reconstruction from computed tomography (CT). Measurements performed by two observers, R and C, in 246 women and 60 men, normal adults, in order to obtain the APBCI measurement and its correlation in patients with HIG of the AAW. Results: after sample calculations, the measurement of APBCI in men: 92.5+6.3º to 93.8+6.7º; in women: 90+6.7° to 94.3+6.8° [p-value 0.337(R)/0.628(C)]. The mean age was 57.9+15.9 years (22 to 91 years). Female gender 57+15.7 years (22 to 91 years) and male 61.7+16.5 years (23 to 89 years) p=0.067. As for the distribution of the ranges from 5 to 5 degrees, there is no difference in the distribution of the angle [p-value 0.455(R)/0.672(C)]. The correlation between age and angle showed that the higher the age, the higher the APBCI. There was no variability between angle measurements: 0.97 (95% CI 0.97; 0.98). In men with HIG, the average is between 108.3+5.37º (102.92º to 113.67º), and in women, 107.8+6.64 (101.16º to 114.44º). Conclusion: the study allowed us to conclude that HIG is not just an isolated AAW defect. Determines skeletal changes, as the APBCI is influenced by the distance of the iliac crests.

RESUMO Objetivo: descrever e medir o Ângulo Pubo Bicrista Iliaca (APBCI) como novo parâmetro antropométrico. Correlacionar a medida com portadores de hérnia incisional gigante (HIG), da linha média da parede anterior do abdome (PAA). Métodos: medida do APBCI, através de reconstrução 3D a partir de tomografia computadorizada (TC). Realização de medidas por dois observadores, R e C, em 246 mulheres e 60 homens, adultos normais, afim de obter a medida do APBCI e sua correlação em portadores de HIG da PAA. Resultados: após cálculos de amostra, a medida do APBCI nos homens: 92,5+6,3º a 93,8+6,7º; nas mulheres: 90+6,7º a 94,3+6,8º [p-valor 0,337(R)/0,628(C)]. A média de idade foi de 57,9+15,9 anos (22 a 91 anos). Gênero feminino 57+15,7 anos (22 a 91 anos) e o masculino 61,7+16,5 anos (23 a 89 anos) p=0,067. Quanto à distribuição das faixas de 5 em 5 graus, inexiste diferença na distribuição do ângulo [p-valor 0,455(R)/0,672(C)]. A correlação idade e o ângulo demonstrou que quanto maior a idade, maior o APBCI. Não houve variabilidade entre as medidas do ângulo: 0,97 (IC95% 0,97; 0,98). Nos homens com HIG, a média está entre 108,3+5,37º (102,92º a 113,67º), e nas mulheres 107,8+6,64 (101,16º a 114,44º). Conclusão: o estudo permitiu concluir que a HIG não é apenas um defeito da PAA isolado. Determina alterações esqueléticas, na medida que o APBCI sofre a influência quanto ao afastamento das cristas ilíacas.

Distribution of HLA-DRB1 alleles in BRICS countries with a high tuberculosis burden: a systematic review and meta-analysis.

INTRODUCTION: Tuberculosis (TB) is the leading cause of death worldwide caused by a single infectious disease agent. Brazil, Russia, India, China, and South Africa (BRICS) account for more than half of the world's TB cases. Bacillus Calmette-Guérin (BCG) remains the only vaccine available despite its variable efficacy. Promising antigen-based vaccines have been proposed as prophylactic and/or immunotherapeutic approaches to boost BCG vaccination. Relevant antigens must interact with the range of human leukocyte antigen (HLA) molecules present in target populations; yet this information is currently not available. METHODS: MEDLINE and EMBASE were systematically searched for articles published during 2013-2020 to measure the allelic frequencies of HLA-DRB1 in the BRICS. RESULTS: In total, 67 articles involving 3,207,861 healthy individuals were included in the meta-analysis. HLA-DRB1 alleles *03, *04, *07, *11, *13, and *15 were consistently identified at high frequencies across the BRICS, with a combined estimated frequency varying from 52% to 80%. HLA-DRB1 alleles *01, *08, *09, *10, *12, and *14 were found to be relevant in only one or two BRICS populations. CONCLUSIONS: By combining these alleles, it is possible to ensure at least 80% coverage throughout the BRICS populations.

Laparoscopic colorectal surgery and discharge within 24 h-who is at risk for readmission?

AIM: The aim was to describe risk factors for hospital readmission in patients undergoing laparoscopic colorectal procedures and being discharged in ≤24 h. METHOD: All consecutive patients undergoing minimally invasive colorectal surgery between 2010 and 2019 from a single institution were retrospectively reviewed. All patients were included in an enhanced recovery programme. Patients who met criteria for hospital discharge were compared according to the need for readmission in a 45-day follow-up. RESULTS: In all, 664 patients underwent minimally invasive colorectal surgery during the study period and 237 (35.7%) were discharged in ≤24 h. Readmission was required in 16 (6.8%) patients discharged in ≤24 h and no postoperative mortality was observed in this group. Patients discharged in ≤24 h were more likely to have benign disease (P < 0.001), fewer associated procedures (P < 0.025) and intracorporeal anastomoses (P < 0.001). The type of surgical procedure (abdominoperineal resection), low rectal tumour, malignant disease, older age and longer operating time were associated with readmission. Age (OR 1.06; P = 0.037), malignant disease (OR 4.39; P = 0.05) and operating time (OR 1.03; P < 0.001) were identified as independent predictive factors for readmission amongst patients being discharged in ≤24 h. CONCLUSION: Highly selected patients undergoing minimally invasive procedures in colorectal surgery may be safely discharged within 24 h following the procedure. High-risk features for readmission include older age, malignant disease and longer operating time.

Neurophysiological aspects of isotonic exercises in temporomandibular joint dysfunction syndrome.

PURPOSE: The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. METHODS: The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. RESULTS: The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. CONCLUSION: According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions.

Perfil epidemiológico das parasitoses intestinais em moradores de uma comunidade da Ilha de Boipeba, Bahia, Brasil / Epidemiological profile of intestinal parasites in residents of a community on the island of Boipeba, Bahia, Brazil

Introdução: as parasitoses intestinais constituem-se um importante problema de saúde pública mundial. Estas infecções são mais prevalentes em regiões tropicais impactando na morbimortalidade e aumento nos custos para o sistema de saúde. Objetivo: avaliar a prevalência das enteroparasitoses e sua associação com as condições socioeconômicas, sanitárias, ambientais e hábitos de vida em uma comunidade costeira do Nordeste brasileiro. Metodologia: estudo epidemiológico, descritivo e transversal, realizado de modo não probabilístico entre março a junho de 2017, com 105 moradores da Ilha de Boipeba, localizada no Sul da Bahia. O exame parasitológico de fezes foi realizado pelos métodos de sedimentação espontânea, Baermann-Moraes e FAUST. Um questionário foi aplicado para avaliar o perfil sociodemográfico da população. Resultados: do total de indivíduos avaliados, 52,4% eram do sexo feminino e 57,1% tinham entre 15 a 59 anos. Todos os indivíduos possuíam água encanada, porém não tratada, enquanto 91,4% referiu ingerir vegetais crus e 45,7% não higienizavam as mãos antes as refeições. Sintomas gastrointestinais foram relatados em 82,8% dos indivíduos e infecções enteroparasitárias foram diagnosticadas em 69,6%. Os parasitos mais frequentemente encontrados foram Ancilostomídeo (18,1%) e Entamoeba coli (43,8%). O principal fator de risco potencial para contrair a infecção por ancilostomídeos foi a não existência de poço artesiano na residência (RP=4,35), enquanto para Trichuris trichiura foi não dispor de pia no banheiro (RP=3,82). Conclusão: a comunidade analisada apresentou elevada prevalência de enteroparasitoses. Os hábitos precários de higiene e de acesso à água tratada, associados às condições ambientais e climáticas do local, podem ter contribuído para a elevada transmissão de geohelmintos observada.

Introduction: Intestinal parasitic infections are an important public health problem worldwide. They are more prevalent in tropical regions impacting in morbidity and mortality and costs for the health system. Objective: To evaluate the prevalence of enteroparasitosis and its association with socioeconomic, sanitary and environmental conditions and lifestyle habits in a coastal community in the Northeast Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study, carried out in a non-probabilistic manner between March and June 2017, with 105 residents of Boipeba Island in the Southern Bahia. The parasitological examination of feces was carried out by the methods of spontaneous sedimentation, Baermann-Moraes and FAUST. A questionnaire was applied to assess the sociodemographic profile of the population. Results: Of the total of individuals evaluated, 52.4% were female and 57.1% were between 15 and 59 years old. All individuals had piped, but untreated water, while 91.4% reported eating raw vegetables and 45.7% did not wash their hands before meals. Gastrointestinal symptoms were observed in 82.8% individuals and 69.6% were diagnosed with enteroparasitic infections. The most frequent parasites were the hookworm (18.1%) and Entamoeba coli (43.8%). The main potential risk factor for hookworm infection was the non-existence of an artesian well in the residence (PR=4.35) and Trichuris trichiura it was not having a sink in the toilet (PR=3.82). Conclusion: The analyzed community has a high prevalence of enteroparasitosis, in addition to environmental and climatic conditions that contribute to the transmission of these infections.