Biomechanical factors associated with patellofemoral pain in children and adolescents.

To investigate the biomechanical factors associated with patellofemoral pain in children and adolescents. A cross-sectional, population-based study conducted in Brazil from 2019 to 2023, involving students from public schools. Adjusted prevalence ratios and their respective 95% confidence intervals for the outcome in relation to independent variables were calculated for association analysis, adopting a significance level of 5%. Out of the total of 283 students, 152 were female and 182 were aged between 16 and 18 years old. A positive association was observed between the presence of patellofemoral pain and a poor movement quality in both lower limbs (right side: p = 0.04 and left side: p = 0.04) as well as with dynamic valgus of the left lower limb (p < 0.01). Patellofemoral pain in children and adolescents is associated with poor movement quality in the lower limbs and dynamic valgus of the left lower limb. Actions targeting these biomechanical factors may be crucial for early diagnosis and clinical treatment of this disfunction.

Patellofemoral pain syndrome in children and adolescents: A cross-sectional study.

OBJECTIVES: To assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in children and adolescents. METHOD: A population-based cross-sectional study was conducted with children and adolescents aged 10 to 18 years, who presented a history of peripatellar and/or retropatellar pain, attending elementary or high school in urban public schools in Natal, Brazil. The sample size was calculated based on a minimum outcome prevalence of 22%. RESULTS: A prevalence of 24.7% of PFPS was found. There was a positive association of PFPS with active students (p < 0.01; PR: 2.5; CI: 1.4-4.5), low functional capacity (p < 0.01; PR: 8.0; CI: 5.0-12.8), and those classified as pubertal (p < 0.03; PR: 1.8; CI: 1.0-3.2). CONCLUSION: There was a considerable prevalence of PFPS in children and adolescents, as well as an association between the level of sexual maturation and adjustable determinants, such as the level of physical activity and low functional capacity in this group.

Effects of primary health care and socioeconomic aspects on the dispersion of COVID-19 in the Brazilian Northeast: Ecological study of the first pandemic wave.

BACKGROUND: The COVID-19 pandemic has had a negative impact on socioeconomic and public health conditions of the population. AIM: To measure the temporal evolution of COVID-19 cases in cities near the countryside outside metropolitan areas of northeastern Brazil and the impact of the primary care organization in its containment. METHODS: This is a time-series study, based on the first three months of COVID-19 incidence in northeastern Brazil. Secondary data were used, the outcome was number of COVID-19 cases. Independent variables were time, coverage and quality score of basic health services, and demographic, socioeconomic and social isolation variables. Generalizable Linear Models with first order autoregression were applied. RESULTS: COVID-19 spreads heterogeneously in cities near the countryside of Northeastern Brazilian cities, showing associations with the city size, socioeconomic and organizational indicators of services. The Family Health Strategy seems to mitigate the speed of progression and burden of the disease, in addition to measures such as social isolation and closure of commercial activities. CONCLUSION: The spread of COVID-19 reveals multiple related factors, which require coordinated intersectoral actions in order to mitigate its problems, especially in biologically and socially vulnerable populations.

The challenge in detecting risk areas of snakebite when case rates are low: the case of Amazonian coral snakes.

Identifying risk areas for envenomation by animals is relevant for public health, such as strategic distribution of antivenoms. Coral snakes are highly diverse in the Amazon, inhabit natural and human-modified environments, and the outcome of the cases tends to be serious and potentially lethal due to their neurotoxic venom. By integrating species' geographical records and environmental variables, we used species distribution modeling to predict the distribution of coral snake species in the Brazilian Amazonia. We analyzed the relationship between the predicted distribution of coral snake species, along with envenomation data in the region, to propose actions to reduce the number of cases and to provide tools for a better policy of public health. We conclude that the entire Amazon shows high environmental suitability for coral snakes, and such suitability explains little about the incidence of cases. This is probably due to the low human density in the Amazon and to coral snake traits such as secretive habits and non-agressive behavior. Differently from other venomous snakes, the scenario regarding coral snakebites precludes the detection of prominent geographical areas of concern and demands a broad and equitable availability of health centers throughout Amazonia and along other areas of occurrence of the genus Micrurus.

Discovering the diversity of tadpoles in the mid-north Brazil: morphological and molecular identification, and characterization of the habitat.

Brazil stands out for presenting the highest amphibian anuran diversity in the world. However, taxonomic studies that address characteristic of larval stage of anurans are incipient, representing only 62% of known species. We assess the species diversity of tadpoles from eastern Maranhão state, mid-northern region of Brazil based on morphological and molecular identification (i.e., 16S rRNA gene fragment), and we also provide characteristics of the habitats occupied by each species. We carried out 30 field samplings during 13 months in 16 environments along an ecotonal area, over five cities inside the limits of state of Maranhão, between the Maranhão Babaçu Forest and Cerrado ecoregions. We searched for tadpoles in a variety of water bodies, and the tadpoles that reached the developmental stage between 34 to 40 Gosner were morphologically identified. The tadpoles collected herein represent 26 species belonging to five families. The external morphology enabled the identification of 24 species, while the molecular data recognized 22 unique evolutionary units. The most represented family was Hylidae (Hylinae 11 spp., Phyllomedusinae one spp.) followed by Leptodactylidae (Leptodactylinae seven spp., Leiuperinae three spp.), Microhylidae (Gastrophryninae two spp.), and Bufonidae (two spp.). Our results show that oral morphology was the most important character for identifying tadpoles based on morphology, and the specific 16S rRNA primer was suitable for molecular identification. This study pioneers the use of both morphological and molecular data to identify tadpoles in the state of Maranhão. It also provides, for the first-time, habitat characteristic for the species. Our study reveals a high number of anuran species sampled at the larval stage in the region, identifies species that require further taxonomic and systematic attention, and extends the geographic distribution of six species, three of which represent new occurrences for the state. Our results strengthen the hypothesis that the diversity of amphibians from Maranhão is underestimated and highlight the importance of herpetological inventories in poorly sampled areas, decentralizing the knowledge of biodiversity.

Sexual dysfunction in women with breast cancer of Northeast Brazil: a retrospective longitudinal study.

Breast cancer treatment leads to physical and psychological changes. The aim of this study was to analyze the incidence of sexual dysfunction and its risk factors in women diagnosed with breast cancer. This retrospective cohort study included women diagnosed and treated for breast cancer (exposed group, n = 90) and healthy women (non-exposed group, n = 93). Data were collected from February 2019 to October 2021 in the state of Rio Grande do Norte (Northeast Brazil), from medical records and using the Female Sexual Function Index (FSFI) questionnaire. Data were collected from medical records and using the Female Sexual Function Index (FSFI) questionnaire. Primary outcomes were analyzed using binary logistic regression. The Mann-Whitney test was used to analyze FSFI domains between groups. The exposed group had a 74% incidence of sexual dysfunction and 3.9 times increased chances of having sexual dysfunction compared with the non-exposed group (OR 3.9, CI 1.8 to 8.2, p < 0.001). Presence of comorbidities increased the chances of sexual dysfunction by 2.5 times (OR 2.5, CI 1.2 to 4.9, p = 0.009). Women diagnosed and treated for breast cancer had a higher incidence of sexual dysfunction than healthy women. Furthermore, comorbidities also increased the chances of sexual dysfunction regardless of exposure to breast cancer.

Snakebites in Northeastern Brazil: accessing clinical-epidemiological profile as a strategy to deal with Neglected Tropical Diseases.

BACKGROUND: Brazil ranks first in the number of snakebites in South America. A detailed analysis of these cases is required to improve the public health planning. In this study, we retrospectively examined the clinical and epidemiological profiles of snakebites in Maranhão between January 2009 and December 2019. METHODS: Data were obtained from the compulsory notification forms provided by the Health Department of Maranhão. RESULTS: A total of 17,658 cases were recorded during the study period. Most of the bites were from snakes belonging to the genus Bothrops. Medical care was mostly within three hours after the bite. Most cases were classified as mild and most victims recovered; however, 139 deaths were recorded. Most bites occurred among people aged 20-39 years, mainly among rural workers. The most frequent local clinical manifestations were pain, edema, and ecchymosis. The most common systemic clinical manifestations include neuroparalysis, vagal syndrome, and myolysis. Most snakebites occurred between January and March. The municipalities with the highest number of notifications were Buriticupu (936 cases), Arame (705 cases), and Grajaú (627 cases). CONCLUSIONS: The clinical profile of snakebites in Maranhão is similar to that observed in other states of Northeast Brazil. However, we found that some systemic manifestations are not compatible with the etiology of snakebites, which leads us to believe that the problem could be the lack of knowledge of the health professionals at the site of envenomation, who may not be ready for attendance, and an important lack of health centers with snake antivenom to treat snakebites.

Snakebites in Northeastern Brazil: accessing clinical-epidemiological profile as a strategy to deal with Neglected Tropical Diseases

ABSTRACT Background: Brazil ranks first in the number of snakebites in South America. A detailed analysis of these cases is required to improve the public health planning. In this study, we retrospectively examined the clinical and epidemiological profiles of snakebites in Maranhão between January 2009 and December 2019. Methods: Data were obtained from the compulsory notification forms provided by the Health Department of Maranhão. Results: A total of 17,658 cases were recorded during the study period. Most of the bites were from snakes belonging to the genus Bothrops. Medical care was mostly within three hours after the bite. Most cases were classified as mild and most victims recovered; however, 139 deaths were recorded. Most bites occurred among people aged 20-39 years, mainly among rural workers. The most frequent local clinical manifestations were pain, edema, and ecchymosis. The most common systemic clinical manifestations include neuroparalysis, vagal syndrome, and myolysis. Most snakebites occurred between January and March. The municipalities with the highest number of notifications were Buriticupu (936 cases), Arame (705 cases), and Grajaú (627 cases). Conclusions: The clinical profile of snakebites in Maranhão is similar to that observed in other states of Northeast Brazil. However, we found that some systemic manifestations are not compatible with the etiology of snakebites, which leads us to believe that the problem could be the lack of knowledge of the health professionals at the site of envenomation, who may not be ready for attendance, and an important lack of health centers with snake antivenom to treat snakebites.

Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies.

BACKGROUND: Several factors affect sexual function, including cancer development and treatment. This study summarized the risk of women with cancer of developing sexual dysfunctions. METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the EMBASE, PubMed, LILACS, SciELO, CINAHL, Scopus, and Web of Science databases using the descriptors cancer, neoplasms, sexual dysfunction, sexual function, and women. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies assessed the quality of studies. RESULTS: Sixteen studies were included in this review. Women with cancer presented sexual dysfunctions in 14 out of 16 included studies. The incidence of sexual dysfunctions ranged from 30% to 80%, while the risk of developing sexual dysfunction increased 2.7- and 3.5-fold in women with cervical and breast cancer, respectively. CONCLUSION: Different cancer treatments increase the risk of developing sexual dysfunction in women, especially desire, arousal, and orgasm, leading to biopsychosocial changes in the health of this population.

Use of geospatial analyses to address snakebite hotspots in mid-northern Brazil - A direction to health planning in shortfall biodiversity knowledge areas.

Knowing the distribution of venomous snakes of medical importance is essential to identify areas at risk for snakebites. Thus, we used an integrative approach based on the application of geographic distribution data of venomous snakes, species distribution modeling (SDM), spatial organization of snakebites, and information on human population density for mapping the potential distribution of snakes and identifying areas at risk of snakebites in the state of Maranhão (mid-northern Brazil). From a compiled database of venomous snake records deposited in biological collections and the literature, we predict the potential distribution of venomous snakes in Maranhão, a state whose diversity and geographic distribution of venomous snake species are poorly known. With this, we constructed potential distribution maps for each venomous snake species with at least one occurrence record within state boundaries, as well as generalized maps by family (Viperidae and Elapidae) and the total number of venomous snakes in Maranhão State. We also obtained data on the number of snakebites recorded in each municipality of Maranhão over a decade (2009-2019) and we ran a Generalized Linear Model to test for relationships between the number of venomous snakebites, the area of occurrence of snakes, and human population density. We obtained 1046 records of venomous snake species for Maranhão, represented by 17 viperid and elapid species. Most of the records were from Viperidae (mostly Bothrops atrox and B. marajoensis) and were concentrated mainly in the Amazon of the northern portion of the state. The models showed accurate predictive performance for all modeled species. The entire area of Maranhão exhibits environmental conditions for the occurrence of venomous snakes, with higher suitability indices in the northern region, in the Amazon rainforest. The number of snakebites was positively correlated with the interaction between high-risk areas (i.e., greater distribution of venomous snakes) and human population density. Our study is a pioneer in using species distribution modeling in mid-northern Brazil to address the scarcity of data on snakebite-causing species, directly contributing to the theme of neglected tropical diseases of the World Health Organization.

Unveiling an enigma from the Cerrado: taxonomic revision of two sympatric species of Apostolepis Cope, 1862 (Dipsadidae: Xenodontinae: Elapomorphini) from central Brazil

Apostolepis albicollaris and A. cerradoensis are two Elapomorphini snake species, described within a short timespan, from the Cerrado of central Brazil. In their brief descriptions, these two species were diagnosed from congeners largely based on highly variable external morphological characters. Interestingly enough, A. cerradoensis has remained known based on a single specimen since its description. Here, we present a reanalysis of both type specimens, as well as a careful examination of a large series of specimens formerly assigned to these species, based on the comparison of internal and external morphology. We conclude that both species are synonymous, providing evidence for the recognition of A. cerradoensis as a junior synonym of A. albicollaris. Furthermore, an account of its updated diagnosis, morphological variation, geographic distribution, hemipenial morphology, phylogenetic relationships and an osteological description are also provided. We also discuss its conservation status, suggesting that the species is under threat and qualifies to be listed as Vulnerable (VU ab(iii)), considering its rarity, small geographic range, and persistent environmental threats.

Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil.

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0-50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23-1.68/PR = 1.38; CI95% 1.08-1.75), having informal social support (PR = 1.26; CI95% 1.10-1.44/PR = 1.19; CI95% 1.05-1.34), A social class (PR = 0.43; CI95% 0.25-0.73/PR = 0.46; CI95% 0.26-0.80), high schooling (PR = 0.34; CI95% 0.23-0.51/PR = 0.33; CI95% 0.24-0.46) as well as paid work (PR = 0.87; CI95% 0.78-0.96/PR = 0.89; CI95% 0.79-0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28-1.57), no having some disability (PR = 1.31; CI95% 1.03-1.66) and having private health insurance (PR = 1.26; CI95% 1.13-1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05-1.42), not be white (PR = 0.85; CI95% 0.77-0.95) and not having restful sleep (PR = 1.23; CI95% 1.08-1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

Species richness and distribution patterns of the snake fauna of Rio Grande do Norte state, northeastern Brazil.

The Neotropics are one of the richest regions in biodiversity globally. Still, much remains unknown about the mechanisms and processes responsible for the accumulation of species in this region. Among the many limitations on our current knowledge on the region's biodiversity, understanding of community composition and species distributions is limited and greatly biased in many Brazilian regions. We present information on species composition, habitat use, geographic distribution, taxonomic accounts, and conservation of snakes from Rio Grande do Norte state, Northeastern Brazil. We compiled, from primary and literature data, 851 snake records from seven families and 47 species, with five new records for the state. Species are mainly terrestrial and semi-arboreal and associated with at least six vegetation types from Caatinga and Atlantic Forest domains. None of the species is listed in threatened categories of IUCN, while two species are listed in the Brazilian Threatened Fauna list. Our data covers 32.34% of the state's area, a consequence of locally limited inventories and lack of long-term studies on snakes' fauna. The richest areas within the state are near large cities, which lack protected areas for the species they harbor, and highlights the necessity of protective policies and conservation actions.

Dissemination of COVID-19 in inland cities of Northeastern Brazil.

BACKGROUND: SARS-CoV-2 causes the new coronavirus disease (COVID-19) and it is weakening all health systems. Therefore, the most vulnerable populations are exposed to harmful consequences, such as illness and death. Thus, this study aims to estimate the temporal effect of COVID-19 dissemination on social indicators of the Northeastern region of Brazil. METHODS: An ecological time-series study was developed with the following: diagnosed cases of COVID-19 in the largest inland cities of Northeast Brazil, Human Development Index (HDI), poverty incidence, and Gini coefficient. Cities with high HDI, poverty rate, and Gini presented a larger number of patients. RESULTS: It was observed by evaluating case trends that COVID-19 spreads unevenly in inland cities of the Northeastern region of Brazil. CONCLUSIONS: In this sense, we emphasize that regional health managers should support small cities with vulnerable population and social assistance.

Urinary Incontinence in Physically Active Older Women of Northeast Brazil.

Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson's Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06-2.07) and nocturia (PR 1.63; 95% CI 1.05-2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the public.

Back in time to unlock the future: tracing the type-specimens of Corallus hortulana (Linnaeus, 1758) (Serpentes: Boidae), with designation of a lectotype for the Amazon tree boa.

Corallus hortulana presents a large array of tones and color pattern variability throughout its distribution (= polychromatism), which trigged the description of several taxa now considered to be primary synonyms. Linnaeus described two of these (Boa enydris and Boa hortulana) on the same page of the 10th Edition of the Systema Naturae. However, both names had been widely used in literature almost in an optional way, until their formal synonymization more than two centuries after the original description. Additionally, the type specimen of Boa hortulana was reported as missing since the late 19th century. These two factors may have enabled the unjustified switched association of types, which was perpetuated in the literature to the present day. Our main goals here were to trace the correct type specimens for each species through a literature review and specimen examination, and to amend the switched association of type material. We found two specimens in the collection of the Uppsala University that are unmistakably associated with Boa hortulana. Herein we designate one of them as its lectotype in order to promote nomenclatural stability considering its huge phenotypic variability and the future possibility of eventually splitting the species.

Why we shouldnt blame women for gender disparity in academia: perspectives of women in zoology

The following letter, from a network of women zoologists, is a reply to the article of AlShebli et al. (2020), which suggests that female protégés reap more benefits when mentored by men and concludes that female mentors hinder the success of their female protégés and the quality of their impact. This contribution has two parts. First, we highlight the most relevant methodological flaws which, in our opinion, may have impacted the conclusions of AlShebli et al. (2020). Second, we discuss issues pertaining to women in science, bring a perspective of Women in Zoology and discuss how current diversity policies are positively changing our field.(AU)

Why we shouldn’t blame women for gender disparity in academia: perspectives of women in zoology

The following letter, from a network of women zoologists, is a reply to the article of AlShebli et al. (2020), which suggests that female protégés reap more benefits when mentored by men and concludes that female mentors hinder the success of their female protégés and the quality of their impact. This contribution has two parts. First, we highlight the most relevant methodological flaws which, in our opinion, may have impacted the conclusions of AlShebli et al. (2020). Second, we discuss issues pertaining to women in science, bring a perspective of Women in Zoology and discuss how current diversity policies are positively changing our field.