Navigating the Groove: A Unique Case of Groove Pancreatitis.

Groove pancreatitis (GP) is an uncommon form of chronic pancreatitis (CP) that affects the area between the duodenum, the head of the pancreas, and the common bile duct (CBD), which is known as the pancreaticoduodenal groove. Our case is based on a 68-year-old male with a past medical history of alcohol use disorder and a 50-pack-year smoking history who presented with nausea, vomiting, and poor oral intake. Computed tomography (CT) of the abdomen and pelvis showed gastric outlet obstruction due to a 6.0 cm mass in the pancreatic groove and the second portion of the duodenum, with dilation of the pancreatic, intrahepatic, and extrahepatic biliary ducts. In order to rule out malignancy and evaluate the acute symptoms, the patient underwent an open pancreaticoduodenectomy (PD). Pathologic findings and negative tumor markers confirmed GP. This case highlights a rare form of CP that symptomatically and radiographically mimics malignancy, but is benign.

Upper and lower limb bone mass accrual in adolescent footballers across a short period of training and competition

Abstract Objectives: To analyze bone mineral content (BMC) and area bone mineral density (aBMD) accrual in adolescent male footballers who started their first football season. Methods: 17 athletes (14.8 ± 0.4 years) were monitored across 15 weeks of football training. Participants were evaluated for somatic maturation (HPHV), BMC, and aBMD at three time points: before (M1) and after (M2) a preparatory phase, and at the end of the competitive phase (M3). BMC and aBMD were measured using DXA scans. Participants were divided into groups according to maturation status (circa-PHV and post-PHV), and the amount of accumulated training load (median split). Results: A significant effect (12.1 g/week, standard error (SE) = 2.6 g/week) was observed for lower limbs BMC across the three time points. There were no significant effects of time for upper limbs BMC. There was a significant effect of time for total body aBMD (0.007, SE = 0.003 g/cm2/week) across the three time points. Adolescents at post-PHV had a significant 245.6 g (SE = 56.1 g) higher BMC compared to adolescents at circa-PHV. No significant effects were observed for the accumulated training load. Conclusion: Systematic football training, even during the growth spurt, has a positive impact on adolescent bone markers despite the accumulated training load and maturation.

Long-Term Refractive Outcomes and Visual Quality of Multifocal Intraocular Lenses Implantation in High Myopic Patients: A Multimodal Evaluation.

Purpose: To perform a multimodal assessment of refractive outcomes and quality of vision (QoV) in patients with high myopia submitted to multifocal intraocular lens (IOL) implantation. Methods: Retrospective study that included consecutive eyes with high myopia (axial length [AL] >26.00mm) submitted to multifocal IOL implantation between January 2014 and February 2020. Minimum follow-up time was 3 years. QoV was evaluated with the Objective Scatter Index (OSI) and the Modular Transfer Function (MTF) by HD Analyzer®. Two QoV questionnaires were applied to patients in which both eyes were included: the McAlinden and the Catquest-9 SF. Results: We included 50 eyes (28 patients). The mean follow-up time was 5.4±1.0 years. Comparing to month 1 after surgery, at the last follow-up visit, there was a decrease in the uncorrected visual acuity (0.14±0.13 vs 0.08±0.09 LogMAR, p=0.024), a negative increase in the spherical equivalent (-0.31±0.60 vs -0.02±0.20, p=0.006) and no changes in the best-corrected visual acuity (p>0.999). An uncorrected near visual acuity of at least J2 was achieved in 89% of eyes one month after surgery and in 91% of eyes at the last follow-up visit (p=0.829). At the last follow-up, the mean OSI was 5.1±1.8 and the mean MTF was 17.5±10.6. Some degree of near vision difficulty was reported by 91% of patients, and 74% of patients reported photic phenomena (halos, glare, starbursts). However, most patients reported that these symptoms caused none to little bothersome. At the last follow-up, 87% of patients were at least fairly satisfied with the surgery. Conclusion: Even after a mean follow-up time of 5 years, patients maintained good uncorrected visual acuity. Even though most patients experienced some degree of near vision difficulty and visual symptoms, globally, our patients were satisfied with their current vision, and the experienced symptoms did not have a significant impact on their daily lives.

Predicting post-discharge complications in cardiothoracic surgery: A clinical decision support system to optimize remote patient monitoring resources.

Cardiac surgery patients are highly prone to severe complications post-discharge. Close follow-up through remote patient monitoring can help detect adverse outcomes earlier or prevent them, closing the gap between hospital and home care. However, equipment is limited due to economic and human resource constraints. This issue raises the need for efficient risk estimation to provide clinicians with insights into the potential benefit of remote monitoring for each patient. Standard models, such as the EuroSCORE, predict the mortality risk before the surgery. While these are used and validated in real settings, the models lack information collected during or following the surgery, determinant to predict adverse outcomes occurring further in the future. This paper proposes a Clinical Decision Support System based on Machine Learning to estimate the risk of severe complications within 90 days following cardiothoracic surgery discharge, an innovative objective underexplored in the literature. Health records from a cardiothoracic surgery department regarding 5 045 patients (60.8% male) collected throughout ten years were used to train predictive models. Clinicians' insights contributed to improving data preparation and extending traditional pipeline optimization techniques, addressing medical Artificial Intelligence requirements. Two separate test sets were used to evaluate the generalizability, one derived from a patient-grouped 70/30 split and another including all surgeries from the last available year. The achieved Area Under the Receiver Operating Characteristic curve on these test sets was 69.5% and 65.3%, respectively. Also, additional testing was implemented to simulate a real-world use case considering the weekly distribution of remote patient monitoring resources post-discharge. Compared to the random resource allocation, the selection of patients with respect to the outputs of the proposed model was proven beneficial, as it led to a higher number of high-risk patients receiving remote monitoring equipment.

Intraocular lens power calculation: angle κ and ocular biomechanics.

PURPOSE: To study the effect of ocular biomechanics on the prediction error of intraocular lens (IOL) power calculation. SETTING: Centro Hospitalar Universitário do Porto, Porto, Portugal. DESIGN: Prospective longitudinal study. METHODS: This study included 67 subjects. Before cataract surgery subjects underwent biometry with IOLMaster 700 and biomechanical analysis with Corvis Scheimpflug technology. The targeted spherical equivalent was calculated with SRK-T and Barrett Universal II. Associations between prediction error (PE), absolute prediction error (AE), and biometric and biomechanical parameters were performed with stepwise multivariate linear correlation analysis. RESULTS: Using the SRKT formula, there was association between PE and Corvis Biomechanical Index (CBI, B = -0.531, P = .011) and between AE and the horizontal offset between the center of the pupil and the visual axis (angle κ, B = -0.274, P = .007). Considering the Barret Universal II formula, PE was independently associated with anterior chamber depth ( B = -0.279, P = .021) and CBI ( B = -0.520, P = .013) and AE was associated with angle κ ( B = -0.370, P = .007). CONCLUSIONS: A large angle κ may reduce the predictability of IOL power calculation. Ocular biomechanics likely influence the refractive outcomes after IOL implantation. This study showed that eyes with softer corneal biomechanics had more myopic PE. This may relate to anteriorization of the effective lens position. Dynamic measurements may be the way to progress into future formulas.

Nexo causal entre trabalho e saúde/doença e o problema das perícias / Causal nexus between work and health/illness and the issue of expert testimonies

Resumo A esfera das perícias comumente reduz a questão do estabelecimento do nexo de causalidade entre trabalho e saúde/doença apenas ao binômio trabalho/vida pessoal. Partindo dos pressupostos dos campos Saúde do Trabalhador (ST) e Saúde Mental Relacionada ao Trabalho (SMRT), este ensaio visa problematizar o resultado da questão, que reside na existência de dificuldades enfrentadas por trabalhadores na obtenção do nexo causal entre seus agravos/adoecimentos, cuja causalidade mais complexa se explica a partir de várias mediações pouco consideradas nos atos periciais circunscritos apenas às anamneses clínicas de cunho biomédicas pautadas nos pressupostos da Medicina do Trabalho, Higiene e Saúde Ocupacional. As formas de superação à ideia de causa-efeito passam pelo entendimento de que o processo de adoecimento é social e histórico e de que é preciso buscar mediações entre trabalho e adoecimento para elucidar sintomatologias singulares a partir da experiência do desgaste coletivo. Tal averiguação deve, ao mesmo tempo, problematizar os próprios processos de trabalho dos atores sociais envolvidos nas investigações periciais e partir das prioridades definidas pelos próprios trabalhadores que atuam como sujeitos da análise da nocividade do trabalho para a saúde.

Abstract Expert testimonies commonly reduce the establishment of causal links between work and health/illness solely to the dichotomy of work/personal life. Based on the assumptions from the fields of Workers Health and Work-Related Mental Health, this essay problematizes the results of this issue, namely the difficulties faced by workers in establishing the causal link between their ailments/illnesses, whose more complex causality is explained through several mediations that are often overlooked by the limited expert acts restricted only to clinical anamneses based on Occupational Medicine, Hygiene, and Occupational Health. Overcoming the idea of cause and effect involves understanding that the process of falling ill is social and historical, and requires exploring the mediations between work and illness to elucidate singular symptomatology based on the collective wear and tear experience. Such an investigation should simultaneously problematize the very work processes of the social actors involved in the expert investigations, starting from the priorities defined by the workers themselves who act as subjects in the analysis of work-related harm to health.

Avaliação do perfil do egresso e da residência médica em ortopedia e traumatologia do HCFMRP-USP / Evaluation of the graduate profile and of the medical residency in orthopedics and traumatology at HCFMRP-USP

Resumo Introdução: Bons programas de residência médica (PRM) devem investir na estruturação e no desenvolvimento contínuo dos serviços de assistência no contexto da rede de saúde, na organização da estrutura de apoio às atividades didáticas e assistenciais, e na remuneração e capacitação contínua de preceptores e coordenadores. Objetivo: Este estudo observacional, transversal e descritivo buscou caracterizar o perfil dos egressos do Programa de Residência Médica em Ortopedia e Traumatologia (PRMOT) do HCFMRP-USP e coletar dados sobre as características do programa que orientem ações de aperfeiçoamento na metodologia de ensino. Método: Participaram do estudo egressos do PRMOT ou que concluíram os programas de complementação especializada e residência médica em cirurgia da mão entre 1964 e 2020. Resultado: Foi encaminhado um questionário a 302 indivíduos (73,6% do total de egressos), obtendo 214 respostas (70,8% dos indivíduos contatados ou 52,2% do total de egressos). Indivíduos do sexo masculino correspondem a 92,5% dos egressos, e 71,9% residem no estado de São Paulo. As duas subespecialidades mais cursadas foram cirurgia do joelho e da mão. A pós-graduação stricto sensu fez parte da formação acadêmica de 40,6% dos egressos, dos quais 60,7% trabalharam com ensino médico. Dos egressos, 71% atuam na subespecialidade escolhida. Na avaliação do ensino do PRMOT e do grau de satisfação profissional, os aspectos que se destacaram positivamente foram: capacitação para atendimento em níveis terciário e secundário, número de atendimentos, variabilidade dos casos e preparo para o mercado de trabalho. Os aspectos que se destacaram negativamente foram: remuneração mensal, carga horária de aulas teóricas e realização de procedimentos cirúrgicos. Conclusão: O estudo conseguiu traçar o perfil do egresso e determinar os pontos fortes e as oportunidades de melhoria do PRMOT do HCFMRP-USP.

Abstract Introduction: Good Medical Residency Programs (PRM) must invest in the structuring and continuous development of care services in the health network setting; in the organization of the support structure for teaching and care activities and in the remuneration and continuous training of preceptors and coordinators. Objective: This study is an observational, cross-sectional, and descriptive investigation aimed at providing an in-depth understanding of the characteristics of individuals who have successfully completed the medical residency program in Orthopedics and Traumatology (MRPOT) at the Clinic Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo. Additionally, the study seeks to gather comprehensive data regarding the features of the educational program in order to offer insights for potential enhancements. The study encompassed a total of 418 participants who completed their training between 1964 and 2020. Methods: This group includes physicians who not only graduated from the MRPOT but also those who completed supplementary specialized programs and medical residencies in hand surgery, all within the same department. Data were systematically collected through an electronic questionnaire. Results: Among the participants, 302 graduates (73.6% of the total cohort) were identified, and responses were obtained from 214 individuals, which corresponds to 70.8% of the reached contacts or 52.2% of the entire graduate pool. The predominant demographic of the sample is male, with 198 respondents (92.5%), most of whom reside in the state of São Paulo (154 individuals, 71.9%). A significant portion of the participants, 184 (86%), pursued further specialized training or embarked on additional medical residencies within the field. The most prevalent subspecialties within this group are Knee Surgery, accounting for 63 individuals (34.2%), and Hand Surgery, comprising 49 individuals (26.6%). Postgraduate education played a role in the academic training of 87 respondents (40.6%). Research activities primarily took place within public universities (81%) and were carried out by 79 graduates (36.9%). A substantial proportion, 130 individuals (60.7%), had prior experience in medical education, either as preceptors or professors for both undergraduate and medical residency levels. The majority of participants, 152 individuals (71%), currently practice within their respective subspecialties. However, a considerable number of graduates also engage in traumatology (34.1%) and general orthopedics (31.8%). The evaluation of the educational framework of the program and the level of professional satisfaction revealed notable aspects that received positive assessments from the respondents. These included the diversity and volume of cases, training tailored for tertiary and secondary care, and preparation for the professional sphere. On the other hand, concerns were raised regarding the adequacy of monthly remuneration, the scarcity of theoretical instruction, and the limited exposure to surgical training. These specific areas garnered lower scores both in the objective metrics and subjective feedback. Conclusion: This study effectively delineated the characteristics of MRPOT graduates and identified the program's key strengths. Simultaneously, it highlights areas that have drawn criticism and warrant attention.

Total Wrist Arthrodesis: A Preoperative Test to Predict Functional Outcomes.

Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication. Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure. Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA. Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

Metastatic Melanoma Invading the Minor Duodenal Papilla in a Patient With Pancreas Divisum Causing Acute Recurrent Pancreatitis: A Case Report.

Metastasis to the gastrointestinal (GI) tract should always be a consideration when melanoma, particularly metastatic disease, is diagnosed. While metastasis to the small intestine is common, given its rich blood supply, metastasis to the pancreatic ducts is extremely rare. In patients with pancreatic divisum, disease spread to the minor papilla can greatly increase the chance of developing pancreatitis due to the potential for increased pancreatic intraductal pressure. We present one unique case of metastatic melanoma to the minor duodenal papilla causing pancreatitis.

Total Wrist Arthrodesis: A Preoperative Test to Predict Functional Outcomes / Artrodese total do punho: Um teste pré-operatório para prever resultados funcionais

Abstract Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication. Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure. Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA. Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

Resumo Objetivo O estudo tem como objetivo demonstrar um método de avaliação para predizer o sucesso funcional da artrodese total do punho (ATP) e auxiliar na sua indicação. Métodos Um estudo prospectivo incluindo dez pacientes submetidos a ATP por artrite pós-traumática. Os critérios de exclusão foram pacientes que perderam o acompanhamento pós-operatório ou informações incompletas no prontuário. A avaliação funcional objetiva (força de preensão manual, pinça de três pontos, pinça lateral e pinça polpa-a-polpa) e a avaliação funcional subjetiva (DASH, PRWE, EVA) foram avaliadas em 3 momentos diferentes: (1) Antes da cirurgia sem anestesia articular, (2) Antes da cirurgia sob anestesia articular e (3) 12 semanas após o procedimento cirúrgico. Resultados Houve aumento da força de preensão palmar nas três medidas de pinça após o alívio da dor, tanto após a anestesia articular quanto após a consolidação da artrodese (p < 0,05). Nas comparações entre as avaliações subjetivas (DASH, PRWE e VAS), os pacientes tiveram melhores escores na avaliação pós-operatória após 12 semanas (p < 0,05). Não houve diferença estatística ao comparar os valores médios de força encontrados após a anestesia e após 12 semanas de ATP.

Detailed characterization of iron-rich tailings after the Fundão dam failure, Brazil, with inclusion of proximal sensors data, as a secure basis for environmental and agricultural restoration.

Following the Fundão dam failure in Brazil, 60 million m3 of iron-rich tailings were released impacting an extensive area. After this catastrophe, a detailed characterization and monitoring of iron-rich tailings is required for agronomic and environmental purposes. This can be facilitated by using proximal sensors which have been an efficient, fast, and cost-effective tool for eco-friendly analysis of soils and sediments. This work hypothesized that portable X-ray fluorescence (pXRF) spectrometry combined with a pocket-sized (Nix™ Pro) color sensor and benchtop magnetic susceptibilimeter can produce substantial data for fast and clean characterization of iron-rich tailings. The objectives were to differentiate impacted and non-impacted areas (soils and sediments) based on proximal sensors data, and to predict attributes of agronomic and environmental importance. A total of 148 composite samples were collected on totally impacted, partially impacted, and non-impacted areas (natural soils). The samples were analyzed via pXRF to obtain the total elemental composition; via Nix™ Pro color sensor to obtain the red (R), green (G), and blue (B) parameters; and assessed for magnetic susceptibility (MS). The same samples used for analyses via the aforementioned sensors were wet-digested (USEPA 3051a method) followed by ICP-OES quantification of potentially toxic elements. Principal component analysis was performed to differentiate impacted and non-impacted areas. The pXRF data alone or combined with other sensors were used to predict soil agronomic properties and semi-total concentration of potentially toxic elements via random forest regression. For that, samples were randomly separated into modeling (70%) and validation (30%) datasets. The pXRF proved to be an efficient method for rapid and eco-friendly characterization of iron-rich tailings, allowing a clear differentiation of impacted and non-impacted areas. Also, important soil agronomic properties (clay, cation exchange capacity, soil organic carbon, pH and macronutrients availability) and semi-total concentrations of Ba, Pb, Cr, V, Cu, Co, Ni, Mn, Ti, and Li were accurately predicted (based upon the lowest RMSE and highest R2 and RPD values). Sensor data fusion (pXRF + Nix Pro + MS) slightly improved the accuracy of predictions. This work highlights iron-rich tailings from the Fundão dam failure can be in detail characterized via pXRF ex situ, providing a secure basis for complementary studies in situ aiming at identify contaminated hot spots, digital mapping of soil and properties variability, and embasing pedological, agricultural and environmental purposes.

A ponta do iceberg: o teletrabalho durante a pandemia / The tip of the iceberg: telework during the pandemic

Resumo A pandemia do novo coronavírus levou o trabalho para a residência de milhares de trabalhadores no mundo, de maneira compulsória. Portanto, este ensaio objetiva evidenciar os fatores psicossociais de riscos à saúde e o panorama do teletrabalho no primeiro ano da pandemia de covid-19 e, neste contexto, analisar a política do teletrabalho no Brasil. Apresentamos os diferentes conceitos do teletrabalho e discutimos sobre como não é uma modalidade ausente de riscos. Fatores psicossociais, como o isolamento social e profissional, a intensificação do trabalho e sobreposição de atividades profissionais e familiares são alguns dos destacados na literatura. A partir de dados secundários obtidos da Pesquisa Nacional por Amostra de Domicílios e análises do Instituto de Pesquisa Econômica Aplicada durante a pandemia, revelou-se um panorama de desigualdade no perfil daqueles que tem acesso ao teletrabalho, além da acentuação das diferenças regionais. Por fim, identificamos um descompasso entre a regulamentação do teletrabalho e as necessidades dos trabalhadores, impactadas pela pandemia de covid-19. Assim, é necessária a elaboração, reformulação e implementação de políticas, visando garantir os direitos e saúde dos teletrabalhadores.

Abstract The new coronavirus pandemic compulsorily brought work into the homes of thousands of workers worldwide. Therefore, this essay aims to highlight the psychosocial factors of health risks and telework's panorama in the first year of the COVID-19 pandemic and, in this context, to analyze the telework policy in Brazil. We presented the different concepts of telework and discuss how and why it is not a risk-free modality. The literature highlights psychosocial factors, such as social and professional isolation, work intensification and overlapping of professional and family activities. Secondary data obtained from the National Household Sample Survey and analyses by the Institute of Applied Economic Research during the pandemic revealed a panorama of inequality in the profile of those who have access to telework, in addition to the accentuation of regional differences. Finally, we identified a mismatch between the regulation of telework and the workers' needs, impacted by the COVID-19 pandemic. Thus, it is necessary to elaborate, reformulate and implement policies, aiming to guarantee the rights and health of teleworkers.

Epidemiological study on the lip and oral cavity cancer in Brazil: connecting science and clinical applicability.

OBJECTIVE: The aim of this study was to describe and discuss the epidemiological indicators of lip and oral cavity cancer in Brazil, in 2017, according to data from the Global Burden of Disease data. METHODS: This is a descriptive study reported according to STROBE guidelines. We identified epidemiological indicators using the Global Burden of Disease results tool. Mortality/incidence rates were described per 100,000 population. Global Burden of Disease 2017 reviews were completed using Python version 2.7, Stata version 13.1, and R version 3.3. RESULTS: In 2017, there were 5,237 deaths from the lip or oral cavity cancer in Brazil, most of them were males aged between 50 and 69 years (2,730 cases, which was equivalent to 52% of the universe of deaths resulting from this cause). Regarding the burden of lip and oral cavity cancer, per 100,000 Brazilians, we observed an incidence of 3.99, prevalence of 15.46, and mortality of 2.29 (with higher indicators in the South and Southeast regions of the country). CONCLUSIONS: Epidemiological indicators of lip and oral cavity cancer were higher in men, with higher mortality indicators in individuals aged 50-69 years, and higher rates (incidence, prevalence, and mortality) in the South and Southeast regions of Brazil. From 2002-2015, there was a reduction in mortality; however, in the period from 2015-2017, there was a resumption in the growth of this indicator.

Epidemiological study on the lip and oral cavity cancer in Brazil: connecting science and clinical applicability

SUMMARY OBJECTIVE: The aim of this study was to describe and discuss the epidemiological indicators of lip and oral cavity cancer in Brazil, in 2017, according to data from the Global Burden of Disease data. METHODS: This is a descriptive study reported according to STROBE guidelines. We identified epidemiological indicators using the Global Burden of Disease results tool. Mortality/incidence rates were described per 100,000 population. Global Burden of Disease 2017 reviews were completed using Python version 2.7, Stata version 13.1, and R version 3.3. RESULTS: In 2017, there were 5,237 deaths from the lip or oral cavity cancer in Brazil, most of them were males aged between 50 and 69 years (2,730 cases, which was equivalent to 52% of the universe of deaths resulting from this cause). Regarding the burden of lip and oral cavity cancer, per 100,000 Brazilians, we observed an incidence of 3.99, prevalence of 15.46, and mortality of 2.29 (with higher indicators in the South and Southeast regions of the country). CONCLUSIONS: Epidemiological indicators of lip and oral cavity cancer were higher in men, with higher mortality indicators in individuals aged 50-69 years, and higher rates (incidence, prevalence, and mortality) in the South and Southeast regions of Brazil. From 2002-2015, there was a reduction in mortality; however, in the period from 2015-2017, there was a resumption in the growth of this indicator.

Convites, incentivos e direitos de homens em participar do pré-natal e parto / Invitations, incentives and men's rights to participate in prenatal care and childbirth / Invitaciones, incentivos y derechos de los hombres a participar en la atención prenatal y del parto

Objetivo:quantificar os homens que foram convidados, incentivados e sabem sobre o direito em participar do pré-natal e parto.Método:trata-se de um estudo transversal, descritivo e com abordagem quantitativa, realizado com 67 homens que já vivenciaram a paternidade. A coleta de dados ocorreu em julho de 2019, em um município no interior de Mato Grosso, Brasil. Utilizou-seum questionário semiestruturado. Para análise, aplicou-se estatística descritiva. Resultados: observou-se desconhecimento dos participantes sobre o pré-natal (84%). A maioria relatou que nunca foram convidados (80%) ou incentivados (72%) a participarem do pré-natal no processo gestacional e desconhecem seu direito de participar do parto (88%). Conclusão: o quantitativo de homens que são convidados, incentivados e sabem sobre o direito em participar do pré-natal e parto é insuficiente para a efetivação do pré-natal masculino, logo, tornando essa realidade distante de melhores perspectivas de paternidade.

Objective:to quantify the men who were invited, encouraged and knew about their right to participate in prenatal care and childbirth. Method:this is a cross-sectional, descriptive study with a quantitative approach, carried out with 67 men who have already experienced fatherhood. Data collection took place in July 2019, in a municipality in the interior of Mato Grosso, Brazil. A semi-structured questionnaire was used. For analysis, descriptive statistics were applied. Results:there was a lack of knowledge of the participants about prenatal care (84%). Most reported that they were never invited (80%) or encouraged (72%) to participatein prenatal care in the gestational process and were unaware of their right to participate in childbirth (88%). Conclusion:the number of men who are invited, encouraged and know about the right to participate in prenatal care and childbirth is insufficient for the realization of male prenatal care, therefore, making this reality far from better prospects for fatherhood

Objetivo:cuantificar los hombres que fueron invitados, estimulados yconocieron su derecho a participar en el prenatal y el parto. Método:se trata de un estudio transversal, descriptivo, con abordaje cuantitativo, realizado con 67 hombres que ya han vivido la paternidad. La recolección de datos ocurrió en julio de 2019, en un municipio del interior de Mato Grosso, Brasil. Se utilizó un cuestionario semiestructurado. Para el análisis se aplicó estadística descriptiva. Resultados:hubo desconocimiento de las participantes sobre el control prenatal (84%). La mayoría informó que nunca fueron invitadas (80%) o animadas (72%) a participar en la atención prenatal en el proceso gestacional y desconocían su derecho a participar en el parto (88%). Conclusión:el número de hombres que son invitados, estimulados y conocen sobre el derecho a participar en el prenatal y el parto es insuficiente para la realización del prenatal masculino, por lo tanto, alejando esta realidad de mejores perspectivas de paternidad.

On Growth and Morphology of TiO2 Nanotubes on CP-Ti by Anodic Oxidation in Ethylene Glycol Electrolyte: Influence of Electrolyte Aging and Anodization Parameters.

Anodic oxidation of CP-Ti, for production of TiO2 nanotubes, has been extensively described in terms of the electrochemical mechanism of tubular growth or the effect of the parameters on the final tube morphology. Recently, a kinetic growth model was proposed to describe the distinct morphologies of the anodic oxide layer as phases of the nanotubular development process, offering a new perspective for the tuning of nanotube production. In this work, the anodizing behavior of a CP-Ti alloy in an ethylene glycol electrolyte was investigated in light of this new model. The final morphology of the nanotubes was characterized by SEM, considering the effects of electrolyte aging, the microstructure, the applied potential difference and time on the morphological development of nanotubes. Electrolyte aging was shown to lead to a decreased dissolution effect on the oxide. The applied potential difference was shown to lead to an increased dissolution effect and more rapid nanotube growth kinetics, while time resulted in extended dissolution. Moreover, the obtained results were analyzed considering a previous study focused on the anodizing behavior of the α- and ß-phases of Ti6Al4V alloy. Overall, the tube morphology resembled that obtained for the Al-containing α-phase of the Ti6Al4V alloy, but the growth kinetics were considerably slower on CP-Ti.

Tétano acidental em Santa Catarina: Evolução temporal e perfil sociodemográfico da última década / Accidental tetanus in Santa Catarina: temporal trend and sociodemographic profile in the last decade

Introdução: O tétano acidental é definido como uma doença não contagiosa e prevenível com vacinação, decorrente da ação de exotoxinas do Clostridium tetani, desencadeando um estado de hiperexcitabilidade do sistema nervoso central, em pacientes não neonatais. O número de casos no país está reduzindo; contudo, a mortalidade é elevada. Dessa forma, o presente estudo objetivou avaliar o perfil e a tendência temporal da ocorrência de tétano acidental no estado de Santa Catarina, no período de 2008 a 2018. Métodos: Estudo observacional do tipo ecológico com a população do estado de Santa Catarina, sendo excluídos os residentes com idade de 0 a 4 anos. O número de notificações e as variáveis clínico-epidemiológicas foram extraídos da base de dados da Diretoria de Vigilância Epidemiológica do estado de Santa Catarina (DIVE) e do Departamento de Informática do Sistema Único de Saúde (DATASUS). Resultados: Observou-se uma maior ocorrência do tétano acidental em homens; faixa etária entre os 50 e 64 anos; residentes de zonas urbanas. O principal desfecho foi a cura. Notou-se uma correlação significativa (p<0,05) para a redução da incidência de casos nos seguintes grupos: sexo feminino e idosos a partir dos 80 anos. Conclusão: Denota-se que, apesar de possuir uma forma simples de profilaxia, o tétano acidental persiste como um problema de saúde pública e, portanto, deve-se investir em estratégias para aumentar a cobertura vacinal, em especial, nos grupos de maior incidência.

Introduction: Accidental tetanus is defined as a non-communicable disease preventable by vaccination; it is caused by exotoxins produced by Clostridium tetani, triggering a state of central nervous system hyperexcitability in non-neonatal patients. The number of cases in the country is decreasing, but mortality rates are high. This study thus aimed to evaluate the profile and temporal trend of the occurrence of accidental tetanus in the state of Santa Catarina between 2008 and 2018. Methods: This is an observational ecological study performed with the population of the state of Santa Catarina, excluding residents aged 4 years or less. The number of reported cases and clinical and epidemiological variables were extracted from databases of the Epidemiological Surveillance Department of the State of Santa Catarina (DIVE) and the Informatics Department of the Unified Health System (DATASUS). Results: We observed a higher occurrence of accidental tetanus among men, people aged between 50 and 64 years, and individuals living in urban areas. The main outcome observed in this study was cure. We noticed a significant correlation (p<0.05) for a reduction in cases among the following groups: women and older adults aged 80 years or older. Conclusion: Despite its simple prophylaxis, accidental tetanus remains a public health problem; investments should thus be made in strategies that increase vaccination coverage, especially considering groups with higher incidence rates.