Disparities in regional obesity rates in argentina by socioeconomic status / Disparidades en prevalencia de obesidad por región y estatus socioeconómico en Argentina

Abstract Background : Obesity rates in Latin America are increasing overall and among people with low socio economic status (SES). Obesity and SES disparities can vary by region-a valuable indicator of local drivers. The objective of this study was to examine regional and SES differences in obesity in Argentina. Methods : We used data from Argentina's 4th Na tional Risk Factors Survey (n = 29226) 2018 and defined obesity as BMI ≥ 30. Low SES was defined as not fin ished high school or having a household income in the lowest two quintiles. Descriptive analysis stratified by sex compared obesity rates by SES, province, and re gion. Age-adjusted logistic regression models explored the association between obesity, socioeconomic status, and region. Results : Obesity rates varied more by SES among women (39% for low SES vs. 26% for middle/high SES; p < 0.001) than among men (33% low SES vs. 29% middle/ high SES; p = 0.027). The Patagonian region had the high est obesity prevalence for both men (36%) and women (37%). A gender-stratified age-adjusted analysis with region and SES showed that low SES (OR 1.72, 95% CI 1.45, 2.03) and the Patagonian region (OR 1.29, 95% CI 1.02, 1.62) were the only significant predictors for women. Conclusions : SES associated disparities in obesity in Argentina were pronounced for women but not men. Disparities were particularly high in Patagonia. Further research is needed to understand the drivers behind these SES, regional, and gender disparities.

Resumen Introducción : Las tasas de obesidad en América La tina están aumentando, tanto en la población general como entre las personas con bajo nivel socioeconómi co (NSE). Las disparidades en obesidad y NSE pueden variar ampliamente según la región, un indicador po tencialmente valioso de fenómenos causales locales. El objetivo de este estudio fue examinar las diferencias en la prevalencia de obesidad a nivel regional y según el NSE en Argentina. Métodos : Utilizamos datos de la 4ª Encuesta Nacio nal de Factores de Riesgo realizada en Argentina en 2018 (n = 29226). Definimos obesidad como índice de masa corporal ≥ 30, y bajo NSE como no haber termi nado la escuela secundaria o tener un ingreso familiar en los dos quintiles más bajos. El análisis descriptivo estratificado por sexo comparó la prevalencia de obe sidad por NSE, provincia y región. Además, utilizamos modelos de regresión logística ajustados por edad para explorar la asociación entre obesidad, nivel socioeconó mico y región, tanto globalmente como estratificando por sexo.367 Resultados : Las tasas de obesidad variaron más por NSE entre las mujeres (39% NSE bajo vs. 26% NSE medio/ alto; p < 0.001) que entre los hombres (33% NSE bajo vs. 29% NSE medio/alto; p = 0.027). La región patagónica tuvo la mayor prevalencia de obesidad tanto para hom bres (36%) como para mujeres (37%). Un análisis estra tificado por género, con región y NSE como covariables, mostró que el bajo NSE (OR 1.72, IC 95% 1.45, 2.03) y la región patagónica (OR 1.29, IC 95% 1.02, 1.62) fueron los únicos predictores significativos para las mujeres; nin guno se asoció significativamente con un mayor riesgo de obesidad para los hombres. Conclusiones : Las disparidades asociadas al NSE en la obesidad en Argentina fueron pronunciadas entre mujeres, pero no entre hombres. Las disparidades fueron particularmente altas en la Patagonia. Se necesita más estudios para comprender los factores detrás de estas disparidades de NSE, regionales y de género.

Diseño de sistema basado en reglas para apoyar la toma de decisiones de la población en la obtención de los medicamentos

En Cuba, el acceso a los servicios farmacéuticos por parte de la población se ve afectado por la no disponibilidad de medicamentos y la lejanía de las farmacias. La falta de información acerca de la existencia de los medicamentos y la cantidad de estos en la red de farmacias cercanas a una ubicación geográfica, aparejados al poco suministro de medicamentos y la calidad de la prestación del servicio, genera descontento e inconformidad en la población. En la presente investigación se realiza un diseño para mejorar la problemática planteada a partir de un sistema basado en reglas como ayuda a la toma de decisiones para la obtención de los medicamentos por parte de la población. Se aplica un estudio de caso mediante el cual es posible sugerir al usuario las 5 farmacias más cercanas donde el paciente puede adquirir los medicamentos sobre las decisiones asumidas.

In Cuba, access to pharmaceutical services by the population is affected by the non-availability of medicines and the remoteness of pharmacies. The lack of information about the existence of medicines and the quantity of these in the network of pharmacies close to a geographical location, coupled with the low supply of medicines and the quality of service provision, generates discontent and nonconformity in the population. In the present investigation, a design is carried out to improve the problem raised from a system based on rules as an aid to decision-making to obtain medicines by the population. A case study is applied through which it is possible to suggest to the user the 5 closest pharmacies where the patient can acquire the medicines on the decisions made.

Relationship between intestinal flora and location and nature of diarrheal irritable bowel syndrome in Traditional Chinese Medicine / 国际中医中药杂志

Irritable bowel syndrome is a common functional gastrointestinal disorder, among which diarrhea-type irritable bowel syndrome (IBS-D) is the main type in China, which is seriously affecting the quality of life for patients. The pathogenesis of IBS-D is still unclear. It has been found that Intestinal flora disorder is an important pathogenesis of IBS-D. There is a close relationship between intestinal flora and IBS-D TCM syndrome types, and there are differences in intestinal flora of different TCM syndrome types of IBS-D. However, TCM syndrome types are a complex and multi-factor combination. Therefore, based on the TCM theory of nature and location of disease, this article proposed the following conclusions through analyzing previous studies on intestinal flora of different TCM syndromes of IBS-D, including that the intestinal flora of different TCM syndromes have different characteristics and there are differences in the functions of flora, deficiency and excess of disease are associated with the diversity and abundance of intestinal flora, cold and heat of disease are related to the proportion of beneficial bacteria and opportunistic pathogens, and the characteristics of intestinal flora are the microcosmic manifestation of the disease position of TCM. In addition, this article also proposed the application of fecal bacteria transplantation based on the theory of nature and location of disease. Based on this theory, the study on intestinal flora of IBS-D can provide help for objectification of TCM syndrome types, and also provide TCM research ideas for revealing the pathogenesis of IBS-D.

Development of a portable radiation detector for nuclide identification based on CdZnTe / 中国辐射卫生

Objective To develop a portable nuclear radiation detector with low-energy γ-nuclide recognition capability for rapid measurement of the dose levels in low-energy radiation fields and identification of nuclides. Methods A digital multi-channel circuit was developed for a detector based on the room temperature semiconductor cadmium zinc telluride, nuclide recognition was achieved using an intelligent nuclide recognition algorithm, and the energy response function G(E) was used to calculate the real-time ambient dose equivalent rate H*(10). Results The portable spectrometer had a minimum detectable energy of 20 keV, and the typical energy resolution for low-energy X-rays was > 4.10% at 59.5 keV and 20℃, enabling accurate identification of 241Am nuclide. Conclusion The device has a good measurement performance for low-energy γ/X rays, effectively addressing the limitations of existing devices for monitoring low-energy radiation fields, and provide reliable technical methods for monitoring and emergency response in spent fuel reprocessing plants or nuclear material production plants.

Clinical significance of distally located periurethral calcification in patients with lower urinary tract symptoms of benign prostate hyperplasia / 亚洲男科学杂志(英文版)

This study evaluated the association of periurethral calcification (PUC) with uroflowmetric parameters and symptom severity in male patients with lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH). The data were collected from a prospectively maintained database of 1321 men with LUTS of BPH who visited Chonnam National University Hospital (Gwang-ju, Korea) from January 2015 to December 2019. PUC severity and location were evaluated on the midsagittal plane during transrectal ultrasonography. Relationships among age, prostate-related parameters, International Prostate Symptom Score (IPSS), and uroflowmetric parameters were assessed. Among the 1321 patients in this study, 530 (40.1%) had PUC. Patients with PUC had significantly higher IPSS (mean ± standard deviation [s.d.]: 15.1 ± 8.7 vs 13.1 ± 7.9; P < 0.001) and lower peak flow rate (Qmax; mean ± s.d.: 12.4 ± 6.6 ml s-1 vs 14.7 ± 13.3 ml s-1; P < 0.001), compared with patients who did not have PUC. Analyses according to PUC severity revealed that patients with severe PUC had higher prostate-specific antigen (PSA) level (P = 0.009), higher total IPSS (P < 0.001), lower Qmax (P = 0.002), and smaller prostate volume (P < 0.001), compared with patients who had non-severe (mild or moderate) PUC. Multivariate analysis showed that distal PUC was independently associated with high total IPSS (P = 0.02), voiding symptom score (P = 0.04), and storage symptom score (P = 0.023), and low Qmax (P = 0.015). In conclusion, PUC was significantly associated with worse LUTS parameters in terms of IPSS and Qmax. Furthermore, distally located PUC was independently associated with worse LUTS of BPH in men.

Thyroid malignancy in children: where does it locate?

ABSTRACT Objective: As far as we know, in English literature, a limited number of studies has examined the relationship between the location of the nodule and malignancy risk. The studies were performed with adults and their results were mainly inconsistent. We aim to evaluate the potential association between the location of the thyroid nodules and risk for malignancy in the pediatric population. Materials and methods: Patients younger than 18 years old with a pathological diagnosis were included. Nodules were divided into 5 categories according to the Thyroid Imaging Reporting and Data System (TI-RADS) algorithm. The location of the nodules was recorded: Right lobe, left lobe, isthmus, upper pole, lower pole, and middle. Thyroid glands were divided into 3 equal longitudinal areas to define upper, lower, and middle portions. Results: Ninety-seven nodules of 103 children were included. The mean age of the population was 14.9 ± 2.51 years (7-18 years). Eighty-one participants were female (83.5%) and 16 male (16.5%). Fifty nodules were benign (51.5%) and 47 nodules were malignant (48.5%). We did not detect a significant correlation between the risk of malignancy and location of the nodule as right or left lobes or isthmus (P = 0.38). Rate of malignant nodules were significantly higher in middle lobe (23%, P = 0.002). Being located at middle part of thyroid gland increases the possibility of malignancy 11.3 times (OR = 11.3, P = 0.006). Conclusion: Nodule location can be used as a predictor for thyroid malignancy in pediatric patients, similar to adults. Middle lobe location increases the risk of malignancy. Using nodule location along with TI-RADS categorization can increase the efficacy of malignancy prediction.

Perfil dos fonoaudiólogos com formação em motricidade orofacial no Brasil / Profile of speech therapists trained in orofacial myology in Brazil

RESUMO Objetivo Caracterizar o perfil do fonoaudiólogo brasileiro com formação especializada em motricidade orofacial (MO). Métodos Estudo descritivo e exploratório, transversal, de abordagem quantitativa, realizado entre setembro 2022 e fevereiro 2023, com parceria do Conselho Federal de Fonoaudiologia. Participaram 87 fonoaudiólogos com formação em MO. Resultados Evidenciou-se predominância feminina, faixa etária entre 41 e 50 anos e tempo de formação especializada em MO entre 16 e 20 anos; maioria com título de especialista e da Região Sudeste do Brasil, atuando em consultórios/ambulatórios e/ou clínicas, com ações interdisciplinares com Medicina e Odontologia, abrangendo adultos e crianças, principalmente na rede privada. Prevaleceram os domínios da MO quanto à reabilitação de estruturas moles e hábito oral e maior uso de tecnologias: leve - acolhimento e assistência; leve-dura - avaliação e terapia e dura - fotobiomodulação. Conclusão Os fonoaudiólogos brasileiros com formação especializada em MO, participantes do estudo, são, em sua maioria, mulheres com mais de 41 anos de idade, que detêm titulação de especialista, com práticas nos vários domínios e níveis de tecnologia da área, principalmente em diagnóstico e reabilitação dos distúrbios miofuncionais orofaciais.

ABSTRACT Purpose To characterize the profile of Brazilian speech therapists with specialized training in orofacial myology (OM). Methods Descriptive and exploratory, cross-sectional study, with a quantitative approach, carried out between September 2022 and February 2023, in partnership with CFFa. Eighty-seven speech therapists with specialized training in OM participated. Results showed female predominance, age between 41 and 50 years, and time of specialized training in OM between 16-20 years; most with specialist titles in the Southeast of Brazil. Most work in offices/outpatient clinics and/or clinics with interdisciplinary actions with Medicine and Dentistry; seeing adults and children, mainly in a private sector. As to OM domains there was a predominance of rehabilitation of soft structures and oral habits, and most use technologies: light - reception and assistance, light-hard - evaluation and therapy, and hard - photobiomodulation (40.2%). Conclusion The Brazilian speech therapists with specialized training in OM participating in the study are mostly women over 41 years old, who hold the title of specialists, and carry out practices in various domains and levels of technology in the area, with a predominance of diagnosis and rehabilitation of oromyofunctional disorders.

Experience in the Treatment of Reverse Psoriasis Based on Location-Based Syndrome Differentiation / 中医杂志

To summarize the experience in treating reverse psoriasis based on location-based syndrome differentiation. It is believed that the main pathological factors in the onset of reverse psoriasis are dampness， heat， stasis， and toxins. In clinical practice， treatment is tailored based on the location-based syndrome differentiation and treatment according to the presence of dampness， heat， stasis， and toxins. For cases that manifest predominantly in the upper body with wind-heat attacking the surface， the treatment focuses on clearing heat， dispersing wind， and relieving itching， and a self-designed Sanhua Decoction （三花汤） is used. Alternatively， for cases with blood heat accumulating and stagnation， the treatment emphasizes on clearing heat and toxins， and cooling blood to eliminate skin lesions， and self-designed Sancao Decoction （三草汤） is employed. For cases that mainly affect the middle part of the body with damp-heat stagnating in the spleen， the treatment focuses on clearing heat， resolving toxins， and drying dampness while invigorating the spleen， and a self-designed Sanhuang Decoction （三黄汤） is applied. For cases with stasis and heat intertwining， the treatment aims to resolve stasis， clear heat， and activate collaterals while detoxifying， and a self-designed Santeng Decoction （三藤汤） is used. For cases that predominantly affect the lower part of the body with damp-heat descending， the treatment focuses on detoxification， eliminating dampness， and clearing and promoting the lower jiao， and a self-made Sanling Decoction （三苓汤） is used. For cases with cold and dampness accumulating and toxins， the treatment emphasizes on warming yang， supplementing qi， and detoxification while eliminating dampness， and a self-made Sanshen Decoction （三参汤） is prescribed.

Construction of eukaryotic expression plasmid of human promyelocytic leukemia gene of six transcripts and subcellular location analysis of its recombinant proteins / 中国生物制品学杂志

@#Objective To construct eukaryotic expression plasmids of human promyelocytic leukaemia(hPML) gene of six transcripts and analyze the subcellular location of the recombinant proteins.Methods Primers were designed according to the hPML gene sequences registered in GenBank databases.Six transcripts of hPML gene fragments(hPML Ⅰ,Ⅱ,Ⅳ,Ⅴ,Ⅵ and Ⅶ) were amplified by RT-PCR,which were linked to the eukaryotic expression vector pCAGGS respectively.The obtained eukaryotic expression plasmids of six transcripts of hPML gene were transfected into 293T cells respectively and detected for their protein expression by Western blot,while transfected into Vero cells and detected for their subcellular location by indirect immunofluorescence assay(IFA).Results The target gene fragments of the six eukaryotic expression plasmids were consistent with the hPML gene sequences registered in GenBank.All the six recombinant proteins showed specific binding with Myc antibody,among which the recombinant protein hPML Ⅰ,Ⅱ,Ⅳ,Ⅴ and Ⅵ were located in the nucleus and cytoplasm,while the recombinant protein hPML Ⅶ was mainly located in the cytoplasm,rarely in the nucleus.Conclusion The eukaryotic expression plasmids of six transcripts of hPML gene all can be expressed correctly in mammalian cells,and the expressed recombinant proteins were located in nucleus and cytoplasm simultaneously or mainly in cytoplasm.This study provides an experimental basis for subsequent study on the antiviral and other biological functions of recombinant protein hPML.

Advances in indications of anatomical pulmonary segmentectomy for early-stage lung cancer / 中国胸心血管外科临床杂志

@#Whether anatomical segmentectomy can replace lobectomy in the treatment of early-stage lung cancer remains controversial. A large number of studies have been conducted for decades to explore whether pulmonary segmentectomy can treat early-stage lung cancer, which is actually to explore the indications of intentional segment-ectomy. With the development of scientific researches, it is found that many characteristics affect the malignancy of lung cancer, and the different grades of each characteristic affect the prognosis of patients. It is worth exploring whether different surgical approaches can be used for early-stage lung cancer with different characteristics and different grades. This article reviews the literature and studies to discuss the advances in indications of segmentectomy for early-stage lung in terms of tumor size, consolidation-to-tumor ratio, pathological classification and tumor location, respectively. The objective of this review is to help thoracic surgeons to objectively and scientifically select the surgical method according to the clinical characteristics of early-stage lung cancer.

Clinical efficacy and prognostic factors of postoperative adjuvant radiotherapy for pediatric ependymoma / 中华放射肿瘤学杂志

Objective:To investigate the clinic opathological features, treatment and prognosis of children newly diagnosed with ependymoma.Methods:Clinical data of 127 pediatric ependymoma (EPN) patients (0-16 years old) treated with tumor resection and postoperative radiotherapy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between 2001 and 2021 were retrospectively analyzed. Among them, 53 children were female and 74 were male. Local control (LR), event-free survival (EFS) and overall survival (OS) rates were analyzed by Kaplan-Meier method. The relationship between clinic opathological factors and clinical prognosis, and the effect of treatment on clinical prognosis of patients were analyzed by Cox proportional hazards model.Results:At a median follow-up time of 29 months (3-251 months), the 3-year OS and EFS rates were 89.5% and 71.5%, respectively. For patients undergoing incomplete resection followed by postoperative adjuvant radiotherapy, the 3-year LR, OS and EFS rates were 78.3%, 65.8% and 85.7%, respectively. A total of 43 children were aged <3 years old when diagnosed and 84 aged ≥3 years old. The interval time between surgery and radiotherapy in children aged <3 years old was 91 d, and 35.5 d in those aged ≥3 years old ( P<0.001). For patients <3 years old, the median EFS was 90 months when initiating radiotherapy within ≤70 d after surgery, compared to 43 months for those who initiated radiotherapy at >70 d after surgery ( P=0.053). According to fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5), 39 children were classified as posterior fossa ependymoma group A (PFA group). The OS and EFS rates in the PFA group were significantly less than those in other groups (3-year OS rate were 69.2% vs. 94.6%, P<0.001; 3-year EFS rate were 46.9% vs. 79.1%, P<0.001). In the PFA group, 12 patients received postoperative adjuvant chemotherapy, 14 did not receive chemotherapy, and whether chemotherapy was given was unknown in 13 cases. No significant differences were observed in OS and EFS between patients treated with and without chemotherapy ( P=0.260, P=0.730). Univariate Cox analysis showed that tumor location and WHO CNS5 molecular classification were significantly associated with EFS, and WHO CNS5 molecular classification was significantly correlated with OS. Multivariate Cox analysis showed that tumor location in the posterior fossa was an independent risk factor for EFS ( HR=2.72, 95% CI=1.1~6.71, P=0.03). Conclusions:Patients newly diagnosed with pediatric ependymoma can obtain favorable survival after surgery combined with postoperative adjuvant radiotherapy. Patients with residual tumors can achieve favorable LC and survival after postoperative adjuvant radiotherapy. Delaying of radiotherapy tends to lead to poor survival for patients aged <3 years old when diagnosed. Children in the PFA group obtain worse prognosis compared to their counterparts in other groups. The tumor location in the posterior fossa is an independent risk factor for pediatric ependymoma.

Application of improved 3D digital guide plate-assisted guided puncture in microballoon compression for primary trigeminal neuralgia / 口腔疾病防治

Objective @#To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). @*Methods @# This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P<0.05 indicating a statistically significant difference. @*Results @#The experimental group was significantly better than the control group in terms of the success rate of the first puncture (χ2 = 21.51, P<0.001), puncture time (Z = -5.51, P<0.001), operative time (t = 9.37, P<0.001), and the number of C-arm scans (Z = -4.59, P<0.001). Postoperative BNI scores of the experimental group included 21 cases of grade Ⅰ (91.5%) and 1 case of grade Ⅱ, while the control group included 17 cases of grade Ⅰ (85.0%), 2 cases of grade Ⅱ (10.0%) and 1 case of grade Ⅲ (5.0%), with no statistical significance (P>0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. @* Conclusions @#3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.

Análisis de las lesiones más frecuentes en miembros inferiores en el fútbol / Análise das lesões mais freqüentes nos membros inferiores do futebol / Analysis of the most frequent injuries in lower limbs in football

RESUMEN Introducción: La presente investigación se originó a partir del notable incremento de lesiones en futbolistas de Honduras. Objetivo: El objetivo fue conocer las lesiones más frecuentes e identificar su localización, clasificación y factores de riesgo. Materiales y métodos: El estudio utilizó el método empírico cualitativo indirecto o no interactivo: consulta a documentos oficiales a través de la búsqueda en la base de datos, PMC US National Library of Medicine se utilizó las palabras claves: futbol, lesiones más frecuentes y factores de riesgos quedando 28 documentos relacionados directamente con la temática. Resultados: Los principales resultados se centran en la revisión realizada donde se verificó que las lesiones más frecuentes de miembros inferiores en el futbol se localizan en: muslo-tobillo, ingle-cadera, cuádriceps-isquiotibiales, ligamento interno, cruzado y externo. Referente a la clasificación se encontró la del grupo de prevención en el deporte de la Sociedad Española de Medicina del Deporte y la asumida por la Unión de Federaciones Europeas de Futbol (UEFA) Champions League. Entre los factores de riesgos identificados se evidencian: la biomecánica alterada del movimiento, composición corporal, lesiones previas, déficit de flexibilidad, insuficiente desarrollo de la resistencia a la fuerza isométrica de los músculos estabilizadores, desbalance músculo-tendón entre cuádriceps e isquitibiales y los altos volúmenes de cargas y horas de entrenamiento. Conclusiones: El presente estudio permitió valorar las lesiones más frecuentes de miembros inferiores, su localización y factores de riesgo en el fútbol.

SÍNTESE Introdução: A presente pesquisa teve origem no notável aumento do número de lesões em jogadores de futebol em Honduras. Objetivo: O objetivo era descobrir as lesões mais freqüentes e identificar sua localização, classificação e fatores de risco. Materiais e métodos: O estudo utilizou o método empírico qualitativo indireto ou não interativo: consulta de documentos oficiais através de uma pesquisa no banco de dados da PMC US National Library of Medicine, utilizando as palavras-chave: futebol, lesões mais freqüentes e fatores de risco, deixando 28 documentos diretamente relacionados com o assunto. Resultados: Os principais resultados estão centrados na revisão realizada onde foi verificado que as lesões mais freqüentes nos membros inferiores do futebol se localizam em: coxa, virilha, quadríceps-ischiotibial, ligamento interno, cruciforme e externo. Com relação à classificação, encontramos a do grupo de prevenção no esporte da Sociedade Espanhola de Medicina Esportiva e a assumida pela Liga dos Campeões da União das Federações Européias de Futebol (UEFA). Entre os fatores de risco identificados, são evidentes os seguintes: biomecânica alterada do movimento, composição corporal, lesões anteriores, déficit de flexibilidade, desenvolvimento insuficiente da resistência isométrica de força de músculos estabilizadores, desequilíbrio músculo-tendão entre quadríceps e tendões e altos volumes de cargas e horas de treinamento. Conclusões: O presente estudo nos permitiu avaliar as lesões mais freqüentes nos membros inferiores, sua localização e fatores de risco no futebol.

ABSTRACT Introduction: The present research originated from the notable increase in injuries in football players in Honduras. Objective: The objective was to know the most frequent injuries and identify their location, classification and risk factors. Material and methods: The study used the indirect or non-interactive qualitative empirical method: consultation of official documents through the search in the database, PMC US National Library of Medicine, the keywords were used: football, most frequent injuries and risk factors, remaining 28 documents directly related to the theme. Results: The main results focus on the review carried out where it was verified that the most frequent lower limb injuries in football are located in: thigh-ankle, groin-hip, quadriceps-hamstrings, internal, cruciate and external ligaments. Regarding the classification, it was found that of the sports prevention group of the Spanish Society of Sports Medicine and that assumed by the Union of European Football Federations (UEFA) Champions League. Among the risk factors identified are: altered biomechanics of movement, body composition, previous injuries, flexibility deficit, insufficient development of endurance to isometric strength of the stabilizing muscles, muscle-tendon imbalance between quadriceps and hamstrings and the upper load volumes and training hours. Conclusion: The present study allowed assessing the most frequent injuries of the in lower limbs in football.

Tofo gotoso en dorso nasal: reporte de caso / Nasal gouty tophus: case report

La gota es el trastorno del metabolismo de las purinas que se caracteriza por acumulación de ácido úrico por aumento de su producción o por disminución de su excreción. Con el paso del tiempo, el exceso de urato monosódico permite que se deposite en diferentes tejidos del organismo; siendo particularmente infrecuente la presentación de tofos a nivel facial. Paciente masculino adulto de 56 años, con antecedente de gota hace 38 años y presencia de tofos gotosos a nivel de miembros superiores e inferiores que acude por cuadro de 4 años de evolución de lesión indurada, levemente dolorosa a nivel de tercio medio de dorso nasal que ha ido aumentando de tamaño, que causa deformidad de pirámide nasal y leve sensación de obstrucción nasal bilateral por lo que se planifica resolución quirúrgica. El análisis histopatológico de las muestras enviadas bajo exéresis quirúrgica confirma que tejido enviado corresponde a tofo gotoso. Los tofos gotosos pueden aparecer en diferentes tejidos, como cartílagos, membranas y líquido sinovial, superficies articulares, siendo excepcionalmente raro, en el miocardio, válvulas mitral y aórtica, ojos, nariz y médula espinal. El lugar de presentación puede ser muy variable, al igual que su tamaño

Gout is a purine metabolism disorder characterized by accumulation of uric acid due to increased production or decreased excretion. Over time, excess monosodium urate allows it to be accumulated in different body tissues, although the occurrence in the facial area is particularly infrequent. A 56- year-old male patient with a gout antecedent from 38 years ago that presented gouty tophi at the level of the upper and lower limbs seek medical advice due to an indurated slightly painful lesion at the level of the middle third of the nasal dorsum that started 4 years before and has been increasing in size. The lesion was causing nasal pyramid deformity and a slight sensation of bilateral nasal obstruction, for which surgical resolution is planned. The histopathological analysis of the samples sent under surgical exeresis confirms that the tissue sample corresponds to gouty tophi. Gouty tophi can appear in different tissues, such as cartilage, membranes and synovial fluid, joint surfaces, being exceptionally rare in the myocardium, mitral and aortic valves, eyes, nose and spinal cord. The place of presentation can be very variable, as well as its size

Factors Influencing Depression In Patients Of Cerebrovascular Accidents-A Study

Background: Post Stroke Depression (PSD) is one of the most frequent Neuropsychiatric consequences of stroke. It affects almost 29%-70% of Stroke Survivors (SS). There is paucity of research data in determining the risk factors and especially severity and associa?on of depression with site of lesion loca?on in Indian community. Aim and Objec?ves: To determine factors associated with PSD and associa?on between Socio-demographic profiles, Stroke symptoms, Site of lesion with depression. Materials and Methods: It’s a cross-sec?onal study including par?cipants from the outpa?ents sec?on of Department of Neurology at Prathima Ins?tute of Medical Sciences. A predetermined sample size of 60 pa?ents with CVA pa?ents was enrolled in the study and their socio demographic details are collected along with administering Beck’s Depression Inventory for Depression. Neuro-imaging provided informa?on on lesion loca?on. Collected data was analysed using SPSS version 19 and using descrip?ve and inferen?al sta?s?cs. Results: In this study 18 out of 60 subjects with stroke were diagnosed with PSD. Risk factors found to be mainly associated with PSD are lack of family support, Joint family types, Stroke with Aphasia, Cranial Nerve involvement and Motor System weakness whereas, Substance use is found to be a protec?ve factor. Significant numbers of subjects were found to have le?-anterior-sub-cor?cal lesions associated with PSD. Conclusion: This study highlights the variables which are to be considered in the recogni?on of PSD for Neurologists and Mental health care workers for early interven?on and a be?er outcome in view of stroke recovery

Banco de Leite Humano: possibilidades de atuação fonoaudiológica / Human Milk Bank: possibilities of speech therapy activities / Banco de leche humana: posibilidades de actuación fonoaudiológica

Introdução: os bancos de leite humano foram criados para apoiar e incentivar o aleitamento materno, atuando como estratégia de política pública na redução da mortalidade neonatal e proteção à saúde do binômio. Por se tratar de um espaço de atuação multidisciplinar, os bancos de leite tornam-se um ambiente ideal para a atuação do fonoaudiólogo, profissional que contribui no suporte às mães, especialmente durante o estabelecimento da amamentação exclusiva. Objetivo: relatar as possibilidades de atuação fonoaudiológica em um banco de leite humano. Descrição da experiência: estudo de abordagem qualitativa descritiva do tipo relato de experiência, realizado entre os meses de março e julho de 2020, em um Banco de Leite Humano de uma maternidade pública do Nordeste, credenciada na Iniciativa Hospital Amigo da Criança. A vivência compreendeu dois seguimentos: atuação técnica e atuação assistencial. As experiências foram apresentadas por meio da narração discursiva. O espaço de atuação da Fonoaudiologia em um banco de leite humano pode ser diversificado, pois abrange a atuação técnica e assistencial, desde o recebimento do leite humano doado à assistência a puérpera e ao recém-nascido. É necessário capacitação específica para que o profissional seja inserido dentro da equipe de um banco de leite humano. Considerações finais: Foi possível identificar, por meio da experiência, o papel do fonoaudiólogo no banco de leite humano, bem como compreender a necessidade da sua inserção na equipe deste setor no âmbito hospitalar.

Introduction: human milk banks were created to support and encourage breastfeeding, acting as a public policy strategy to reduce neonatal mortality and protect the health of the binomial. Because it is a space for multidisciplinary activities, milk banks become an ideal environment for the performance of the speech therapist, a professional who contributes to support mothers, especially during the establishment of exclusive breastfeeding. Objective: to report the possibilities of speech therapy activities in a human milk bank. Description of the experience: a qualitative descriptive study of an experience report type, carried out between March and July 2020, at a Human Milk Bank of a public maternity hospital in the Brazilian Northeast, accredited by the Baby Friendly Hospital Initiative. The experience comprised two segments: technical performance and assistance performance. The experiences were presented through discursive narration. The area of performance of Speech Therapy in a human milk bank can be diversified, as it covers technical and assistance activities, from the receipt of donated human milk to assistance to the puerperal woman and the newborn. Specific training is necessary for the professional to be inserted into the team of a human milk bank. Final considerations: It was possible to identify, through experience, the role of the speech therapist in the human milk bank, as well as to understand the need for his insertion in the team of this sector in the hospital environment.

Introducción: los bancos de leche humana fueron creados para apoyar e incentivar en el amamantamiento materno, actuando como estrategia de política pública en la reducción de la mortalidad neonatal y la protección de la salud del binomio. Por tratarse de un espacio de actuación multidisciplinar, los bancos de leche se convirtieron en un ambiente ideal para la actuación del fonoaudiólogo, profesional que contribuye en apoyo a las madres, especialmente durante el establecimiento del amamantamiento exclusivo. Objetivo: relatar las posibilidades de actuación fonoaudiológica en un banco de leche humana. Descripción de la experiencia: estudio de abordaje cualitativo descriptivo de tipo relato de experiencia, realizado entre los meses de marzo a julio del 2020, en un Banco de leche humana de una maternidad pública del Noroeste, bajo la iniciativa del Hospital Amigo de los Niños. La vivencia comprendió dos seguimientos: actuación técnica y actuación asistencial. Las experiencias fueron presentadas por medio de la narración discursiva. El espacio de actuación de la fonoaudiología en un banco del hecho humana puede ser diversificado, pues comprende tanto la actuación técnica como la asistencial, desde el recibimiento de la leche materna donada a la asistencia, la matrona y al recién nacido. Es necesario capacitación específica para que el profesional sea inserto dentro del equipo de un Banco de leche humana. Consideraciones finales: fue posible identificar, por medio de la experiencia del papel del fonoaudiólogo en el banco de leche humana, así como comprender la necesidad de su inserción en el equipo de este sector en el ámbito hospitalario.

Characteristics of No.253 lymph node metastasis in middle and low rectal cancer and its influencing factors: a report of 2 316 cases / 中华消化外科杂志

Objective:To investigate the characteristics of No.253 lymph node metastasis in middle and low rectal cancer and its influencing factors.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 316 patients with middle and low rectal cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2013 to October 2021 were collected. There were 1 339 males and 977 females, aged (61±12)years. All patients underwent D 3 radical surgery for rectal cancer. Observation indicators: (1) No.253 lymph node metastasis in patients with middle and low rectal cancer; (2) analysis of influencing factors for No.253 lymph node metastasis in patients with middle and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD. Count data were expressed as absolute numbers and percentages, and comparison between groups was performed by the chi-square test. Logistic regression model was used for multivariate analysis. Results:(1) No.253 lymph node metastasis in patients with middle and low rectal cancer. There were 128 of 2 316 patients with positive No.253 lymph node and 2 188 cases with negative No.253 lymph node. The No.253 lymph node metastasis rate was 5.527%(128/2 316). There were 568 of 2 316 patients with the distance from distal margin of tumor to anal margin as 8?10 cm, 766 cases as ≥6 cm and<8 cm, 982 cases as <6 cm. Of the 568 patients with the distance from distal margin of tumor to anal margin as 8?10 cm, 57 cases had positive No.253 lymph node, including 3 cases(5.263%) of high differentiated tumor, 9 cases(15.789%) of moderate differentiated tumor, 45 cases(78.948%) of low differentiated tumor, respectively. There was 0 case of the above 57 patients with positive No.253 lymph node in TNM stage Ⅰ, 0 case in TNM stage Ⅱ, 20 cases(35.088%) in TNM stage Ⅲ, 37 cases(64.912%) in TNM stage Ⅳ, respectively. Of the 766 patients with the distance from distal margin of tumor to anal margin as ≥6 cm and <8 cm, 42 cases had positive No.253 lymph node, including 4 cases(9.524%) of high differentiated tumor, 11 cases(26.190%) of moderate differentiated tumor, 27 cases(64.286%) of low differentiated tumor, respectively. There was 0 case of the above 42 patients with positive No.253 lymph node in TNM stage Ⅰ, 0 case in TNM stage Ⅱ, 19 cases(45.238%) in TNM stage Ⅲ, 23 cases(54.762%) in TNM stage Ⅳ, respectively. Of the 982 patients with the distance from distal margin of tumor to anal margin as <6 cm, 29 cases had positive No.253 lymph node, including 1 case (3.448%) of high differentiated tumor, 3 cases (10.345%) of moderate differentiated tumor, 25 cases (86.207%) of low differentiated tumor, respectively. There was 0 case of the above 29 patients with positive No.253 lymph node in TNM stage Ⅰ, 0 case in TNM stage Ⅱ, 12 cases(41.379%) in TNM stage Ⅲ, 17 cases(58.621%) in TNM stage Ⅳ, respectively. (2) Analysis of influencing factors for No.253 lymph node metastasis in patients with middle and low rectal cancer. Results of univariate analysis showed that tumor T staging, tumor N staging, tumor TNM staging, tumor differentiation degree, the distance from distal margin of tumor to anal margin were related factors for No.253 lymph node metastasis in patients with middle and low rectal cancer ( χ2=28.48, 44.58, 172.62, 227.67, 34.57, P<0.05). Results of multivariate analysis showed that tumor T staging as stage T4, tumor N staging as stage N2, tumor TNM staging as stage Ⅳ, low differentiated tumor, the distance from distal margin of tumor to anal margin as ≥6 cm and <8 cm, 8?10 cm were independent risk factors for No.253 lymph node metastasis in patients with middle and low rectal cancer ( odds ratio=2.74, 3.48, 10.72, 21.47, 1.92, 3.67, 95% confidence intervals as 1.91?3.92, 2.42?4.98, 7.36?15.62, 10.33?44.60, 1.27?2.91, 2.31?5.81, P<0.05). Conclusions:The risk of No.253 lymph node metastasis is relatively high in middle and low rectal cancer patients with long distance from distal margin of tumor to anal margin, low differentiated tumor, and in high TNM stages. Tumor T staging as stage T4, tumor N staging as stage N2, tumor TNM staging as stage Ⅳ, low differentiated tumor, the distance from distal margin of tumor to anal margin as ≥6 cm and <8 cm, 8?10 cm are independent risk factors for No.253 lymph node metastasis in patients with middle and low rectal cancer.

Construction and Evaluation of Metastatic Risk Model in Left and Right Colorectal Cancer / 肿瘤防治研究

Objective To identify the influence factors and construct a predicted model for liver, lung, bone, or brain metastasis among patients with left or right colorectal cancer. Methods Patients with colorectal cancer with information on liver, lung, bone, and brain metastasis were retrospectively filtered and analyzed from 2010 to 2018 from the SEER database. These patients were divided into three groups based on their primary tumor location. Multivariate logistic regression analysis was conducted to identify the influence factors on metastasis. A nomogram that could predict metastasis was established and further validated by the AUC of ROC curves. Results A total of 49335 eligible patients were chosen from the SEER database. N stage and CEA were identified as risk factors for all metastases, which were unrelated to primary tumor location. By contrast, race had varying effects on liver metastasis between different groups (P < 0.05). The nomogram model predicting liver metastasis was successfully established, and the AUCs based on the three groups were 0.821 (95%CI: 0.813-0.830), 0.841 (95%CI: 0.833-0.848), and 0.796 (95%CI: 0.782-0.811), respectively. Conclusion The influence factors and predictive models on liver metastasis were different in patients with colorectal cancer and different primary tumor locations.

The etiologies of post-stroke depression: Different between lacunar stroke and non-lacunar stroke

Abstract Objectives: Depression is common after both lacunar stroke and non-lacunar stroke and might be associated with lesion locations as proven by some studies. This study aimed to identify whether lesion location was critical for depression after both lacunar and non-lacunar strokes. Methods: A cohort of ischemic stroke patients was assigned to either a lacunar stroke group or a non-lacunar stroke group after a brain MRI scan. Neurological deficits and treatment response was evaluated during hospitalization. The occurrence of depression was evaluated 3 months later. Logistic regressions were used to identify the independent risk factors for depression after lacunar and non-lacunar stroke respectively. Results: 83 of 246 patients with lacunar stroke and 71 of 185 patients with non-lacunar stroke developed depression. Infarctions in the frontal cortex, severe neurological deficits, and a high degree of handicap were identified as the independent risk factors for depression after non-lacunar stroke, while lesion location was not associated with depression after lacunar stroke. Conclusion: The main determinants for depression after lacunar and non-lacunar stroke were different. Lesion location was critical only for depression after non-lacunar stroke.

Multimodal deep learning model for staging diabetic retinopathy based on ultra-widefield fluorescence angiography / 中华眼底病杂志

Objective:To apply the multi-modal deep learning model to automatically classify the ultra-widefield fluorescein angiography (UWFA) images of diabetic retinopathy (DR).Methods:A retrospective study. From 2015 to 2020, 798 images of 297 DR patients with 399 eyes who were admitted to Eye Center of Renmin Hospital of Wuhan University and were examined by UWFA were used as the training set and test set of the model. Among them, 119, 171, and 109 eyes had no retinopathy, non-proliferative DR (NPDR), and proliferative DR (PDR), respectively. Localization and assessment of fluorescein leakage and non-perfusion regions in early and late orthotopic images of UWFA in DR-affected eyes by jointly optimizing CycleGAN and a convolutional neural network (CNN) classifier, an image-level supervised deep learning model. The abnormal images with lesions were converted into normal images with lesions removed using the improved CycleGAN, and the difference images containing the lesion areas were obtained; the difference images were classified by the CNN classifier to obtain the prediction results. A five-fold cross-test was used to evaluate the classification accuracy of the model. Quantitative analysis of the marker area displayed by the differential images was performed to observe the correlation between the ischemia index and leakage index and the severity of DR.Results:The generated fake normal image basically removed all the lesion areas while retaining the normal vascular structure; the difference images intuitively revealed the distribution of biomarkers; the heat icon showed the leakage area, and the location was basically the same as the lesion area in the original image. The results of the five-fold cross-check showed that the average classification accuracy of the model was 0.983. Further quantitative analysis of the marker area showed that the ischemia index and leakage index were significantly positively correlated with the severity of DR ( β=6.088, 10.850; P<0.001). Conclusion:The constructed multimodal joint optimization model can accurately classify NPDR and PDR and precisely locate potential biomarkers.