A biosensor based on magnetoelastic waves for detection of antibodies in human plasma for COVID-19 serodiagnosis.

This study proposes a new efficient wireless biosensor based on magnetoelastic waves for antibody detection in human plasma, aiming at the serological diagnosis of COVID-19. The biosensor underwent functionalization with the N antigen - nucleocapsid phosphoprotein of the SARS-CoV-2 virus. Validation analyses by sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting (WB), atomic force microscopy (AFM), scanning electron microscopy (SEM), energy-dispersive X-ray (EDX) microanalysis and micro-Raman spectroscopy confirmed the selectivity and effective surface functionalization of the biosensor. The research successfully obtained, expressed and purified the recombinant antigen, while plasma samples from COVID-19 positive and negative patients were applied to test the performance of the biosensor. A performance comparison with the enzyme-linked immunosorbent assays (ELISA) method revealed equivalent diagnostic capacity. These results indicate the robustness of the biosensor in reliably differentiating between positive and negative samples, highlighting its potential as an efficient and low-cost tool for the serological diagnosis of COVID-19. In addition to being fast to execute and having the potential for automation in large-scale diagnostic studies, the biosensor fills a significant gap in existing SARS-CoV-2 detection approaches.

The Perceived Ease of Use and Perceived Usefulness of a Web-Based Interprofessional Communication and Collaboration Platform in the Hospital Setting: Interview Study With Health Care Providers.

BACKGROUND: Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospitals and during discharge planning. However, interprofessional communication and collaboration in inpatient settings are often fragmented and inefficient, leading to poor patient outcomes and provider frustration. Health information technology can potentially help improve team communication and collaboration; however, to date, evidence of its effectiveness is lacking. There are also concerns that current implementations might further fragment communication and increase the clinician burden without proven benefits. OBJECTIVE: In this study, we aimed to generate transferrable lessons for future designers of health information technology tools that facilitate team communication and collaboration. METHODS: A secondary analysis of the qualitative component of the mixed methods evaluation was performed. The electronic communication and collaboration platform was implemented in 2 general internal medicine wards in a large community teaching hospital in Mississauga, Ontario, Canada. Fifteen inpatient clinicians in those wards, including nurses, physicians, and allied health care providers, were recruited to participate in semistructured interviews about their experience with a co-designed electronic communication and collaboration tool. Data were analyzed using the Technology Acceptance Model, and themes related to the constructs of perceived ease of use (PEOU) and perceived usefulness (PU) were identified. RESULTS: A secondary analysis guided by the Technology Acceptance Model highlighted important points. Intuitive design precluded training as a barrier to use, but lack of training may hinder participants' PEOU if features designed for efficiency are not discovered by users. Organized information was found to be useful for creating a comprehensive clinical picture of each patient and facilitating improved handovers. However, information needs to be both comprehensive and succinct, and information overload may negatively impact PEOU. The mixed paper and electronic practice environment also negatively impacted PEOU owing to unavoidable double documentation and the need for printing. Participants perceived the tool to be useful as it improved efficiency in information retrieval and documentation, improved the handover process, afforded another mode of communication when face-to-face communication was impractical, and improved shared awareness. The PU of this tool depends on its optimal use by all team members. CONCLUSIONS: Electronic tools can support communication and collaboration among interprofessional teams caring for patients with complex needs. There are transferable lessons learned that can improve the PU and PEOU of future systems.

Evidence of validity and reliability of Jumpo 2 and MyJump 2 for estimating vertical jump variables.

Background: We investigated the concurrent validity and test-retest reliability of the Jumpo 2 and MyJump 2 apps for estimating jump height, and the mean values of force, velocity, and power produced during countermovement (CMJ) and squat jumps (SJ). Methods: Physically active university aged men (n = 10, 20 ± 3 years, 176 ± 6 cm, 68 ± 9 kg) jumped on a force plate (i.e., criterion) while being recorded by a smartphone slow-motion camera. The videos were analyzed using Jumpo 2 and MyJump 2 using a Samsung Galaxy S7 powered by the Android system. Validity and reliability were determined by regression analysis, typical error of estimates and measurements, and intraclass correlation coefficients. Results: Both apps provided a reliable estimate of jump height and the mean values of force, velocity, and power. Furthermore, estimates of jump height for CMJ and SJ and the mean force of the CMJ were valid. However, the apps presented impractical or poor validity correlations for velocity and power. Compared with criterion, the apps underestimated the velocity of the CMJ. Conclusions: Therefore, Jumpo 2 and MyJump 2 both provide a valid measure of jump height, but the remaining variables provided by these apps must be viewed with caution since the validity of force depends on jump type, while velocity (and as consequence power) could not be well estimated from the apps.

The experience of a training course for physical activity promotion at the primary health care setting / A experiência de curso de capacitação para promoção da atividade física na atenção primária à saúde

Evidence demonstrates the importance of physical activity (PA) promotion strategies in primary health care (PHC) as well as the lack of professional qualification in this area. We aimed to report the experience of a basic training course to conduct group classes in a pilot study of the Program Brasil em Movimento from Brazilian Ministry of Health (PBM). The course covered eight topics within 22 hours delivered remotely. In 21 days of publicity, 630 people signed up, with an average of 439 views for each class. Students evaluated the course positively (95%) and would recommend it (93%). We observed that: 1- the number of subscribers and off-line classes views demonstrate the existence of a demand for this type of qualification; 2- the remote course offering was adequate to reach professionals from all regions of Brazil; 3- offering this type of training seems essential, given the background heterogeneity of the target audience.

Evidências demonstram a importância de estratégias de promoção da atividade física no contexto da atenção primária à saúde (APS) e a carência de qualificação profissional específica nesta área. Objetivou-se relatar a experiência de um curso básico de capacitação para condução de aulas coletivas junto ao estudo piloto do Programa Brasil em Movimento, do Ministério da Saúde (PBM). O curso abrangeu oito temas com carga de 22 horas oferecidas remotamente. Em 21 dias de divulgação inscreveram-se 630 pessoas, com média de 439 visualizações das aulas. Os discentes avaliaram o curso positivamente (95%) e o recomendariam (93%). Observou-se que: 1- o número de inscritos e de visualizações das aulas indicam interesse por este tipo de qualificação; 2- a oferta do curso de modo remoto foi adequada para atingir interessados de todas regiões do Brasil; 3- a oferta desse tipo de capacitação parece ser fundamental, frente à heterogeneidade de formação do público alvo

Laser scanner and drone photogrammetry: A statistical comparison between 3-dimensional models and its impacts on outdoor crime scene registration.

This work evaluated the accuracy of 3D models generated by a DJI Mavic Pro drone with 3DF Zephyr software photogrammetry. The models were compared to models generated by a Trimble X7 laser scanner. The tests were performed in the outdoor area of a vehicle parking inbound to simulate the characteristics of a crime scene. Ground control points (GCPs) were distributed in ten positions within the surroundings. In manual flight, the drone performed nadiral photographs from one side to the other side and with an elliptical 45° center pointed. Three altitudes where tested: 10 m, 20 m and 40 m. The Trimble X7 laser scanner performed six scans and generated one set of point clouds. Drone photogrammetry returned eligible data for distances of 20 m and 40 m with errors of ~0.25 mm. To increase the overlay in the photogrammetry procedure, all photographs from distances of 10-40 m were processed, returning an error of ~0.53 mm. The results of the measured distances, which were manually picked from the GCPs, from the 3D-scanned model and photogrammetric 3D models were then statistically analyzed. The Trimble X7 laser scanner showed an average error of 3 cm, which was approximately equivalent to the results obtained with all images or when using a known scale value for the drone photographs, presenting no significant differences among the evaluated methods.

Concurrent Achilles tendon vibration and tibial nerve stimulation to estimate persistent inward current strength in motoneurons.

Vibratory (Tvib) and sustained (Tsust) torque responses to concurrent Achilles tendon vibration and neuromuscular electrical stimulation applied over the muscle belly (vib+stim) are used as indicators of motoneuron facilitation and, theoretically, persistent inward current strength. However, neuromuscular electrical stimulation (NMES) applied to the nerve trunk may potentiate motoneuronal excitability more than muscle belly NMES, yet it remains unclear whether NMES applied over the nerve evokes robust Tvib and Tsust responses when used during the vib+stim protocol. This study tested whether a nerve-targeted vib+stim protocol elicits Tvib and Tsust responses in the ankle plantar flexors with acceptable intra- and inter-session reliability. Fifteen men performed the vib+stim protocol with NMES applied over the tibial nerve three times across two sessions; twice in a single session (5-min apart) to test intrasession reliability and then again after 48 h to test intersession reliability. Intraclass correlation coefficients (ICC3,1), within-participant coefficients of variation (CV) and pairwise comparisons were used to verify relative and absolute reliability as well as systematic bias. Thirteen men presented Tvib and Tsust responses (response rate of 87%). Intrasession Tvib and Tsust ICCs were >0.73 but inter-session ICCs were <0.5. Although no systematic bias was detected (p>0.05), both intra- and inter-session CVs were large (>10%) for Tvib and Tsust. The Vib+stim protocol with NMES applied over the nerve evoked Tvib and Tsust in almost all participants, but presented a large intra- and inter-session variability. The method does not appear to be effective for assessing motoneuron facilitation in the plantar flexors.

What Is the Best Discipline to Predict Overall Triathlon Performance? An Analysis of Sprint, Olympic, Ironman® 70.3, and Ironman® 140.6.

Objective: To analyze the proportion of dedication in each triathlon discipline (swimming, cycling, and running) and the importance of each separate discipline to predict overall performance of elite triathletes across different triathlon distances. Methods: Data from 2015 to 2020 (n = 16,667) from official races and athletes in Sprint, Olympic distance, IM 70.3 (Half-Ironman distance), and IM 140.6 (Full-Ironman distance) competitions were included. The proportion of each discipline was calculated individually and compared using general linear models by event distance, sex, and performance level. Automatic linear regression models were applied for each distance considering overall performance as the dependent variable. Results: A within-distance analysis showed that the best predictor for Sprint is cycling, for Olympic is swimming, for IM 70.3 is cycling, and for IM 140.6 is running. A between-distance analysis revealed that swimming is a better predictor in Olympic distance than in other triathlon distances. Cycling is a poor predictor for overall performance in IM 140.6, and the importance of running to predict overall performance is the highest in IM 140.6 and diminishes with decreasing race distance. Conclusion: Each discipline represents a different relative portion and importance to predict overall performance depending on the triathlon distance. Swimming is the most important predictor discipline in Sprint- and Olympic-distance triathlon, cycling in IM 70.3, and running in IM 140.6.

Herbal medicines as anxiolytics prior to third molar surgical extraction. A randomized controlled clinical trial.

OBJECTIVES: This study aimed to compare the effects of Passiflora incarnata, Erythrina mulungu, and midazolam in controlling anxiety in patients undergoing mandibular third molar extraction. METHODS: The volunteers underwent extraction of their third mandibular molars in a randomized, placebo-controlled, triple-blind, and parallel clinical trial. Passiflora incarnata (500 mg), Erythrina mulungu (500 mg), or midazolam (15 mg) was orally administered 60 min before the surgery. The anxiety level of participants was evaluated using questionnaires and measurements of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2). RESULTS: A total of 200 volunteers were included in this clinical trial. Considering each procedure independently, no significant differences (p > 0.05) in BP, HR, and SpO2 were observed among the protocols. CONCLUSIONS: Passiflora incarnata showed a similar effect to midazolam but differed from placebo and mulungu, which were unable to control anxiety in this situation. Therefore, the results suggest that Passiflora configures an herbal medicine with an anxiolytic effect, adequate to use in third molar extractions. CLINICAL RELEVANCE: The use of Passiflora incarnata may be an alternative to benzodiazepines for controlling anxiety in patients scheduled for oral surgery under local anesthesia. TRIAL REGISTRATION: ClinicalTrials.gov : ANSI-388.427.

Heart rate cost of running in track estimates velocity associated with maximal oxygen uptake.

BACKGROUND: Running velocity associated with VO2max (vVO2max) is a parameter widely used for exercise prescription and is related to endurance performance. However, the vVO2max determination usually requires a maximal effort test and equipped laboratory for expired gas analysis, what make difficulty its assessment. OBJECTIVE: We aimed to test the validity of a simple method of vVO2max prediction through the heart rate cost of running (HRC) in a submaximal 6-min running test, both in treadmill and in a 400-meter track. METHODS: Male recreational runners (n = 16; 30.3 ±â€¯8.0 years; VO2max of 46.2 ±â€¯3.2 ml·kg-1·min-1) randomly underwent an incremental test in treadmill with gas analysis, and a 3000-m time trial in a track, to determine vVO2max. Before every maximal test, participants also performed a submaximal 6-min running (~85% HRmax), both in the treadmill and in a track, to assess HRC (bpm-1m·min-1) by dividing the submaximal running velocity by its respective HR. The vVO2max (km·h-1) was predicted by dividing the HRmax (bpm)/HRC (bpm-1m·min-1). RESULTS: No differences were verified (p > .05) among vVO2max determined both in the treadmill (13.8 ±â€¯0.9 km·h-1) and track (13.6 ±â€¯0.9 km·h-1) to those predicted by the HRC method both in treadmill (13.5 ±â€¯0.8 km·h-1) and track (13.6 ±â€¯1.0 km·h-1). The vVO2max measured directly with expired gas analysis was highly correlated with vVO2max estimated through HRC in treadmill and track (p < .05). Additionally, the intraclass correlation coefficient (ICC) and Bland-Altman technique revealed good agreement and reliability classified with substantial agreement [ICC = 0.673 (95% CI 0.064-0.886; p = .019)] and almost perfect agreement [ICC = 0.870 (95% CI 0.628-0.955 p = .0001)] between methods to identify vVO2max, respectively. CONCLUSION: A submaximal 6-min exercise test protocol to assess HRC of running was considered valid to estimate vVO2max of recreational runners both in treadmill and outdoor track.

Análise das características de indivíduos com sequelas de traumatismo cranioencefálico (TCE) em um centro de referência em reabilitação (características de TCE) / Analysis of the characteristics of individuals with traumatic brain injury (TBI) in a rehabilitation reference center (TBI characteristics)

INTRODUÇÃO: O Traumatismo Cranioencefálico (TCE)é definido como uma alteração na função encefálica, devido a uma causa externa, ou seja, algum trauma físico de origem externa e que leva à morbimortalidade e incapacidades em todo o mundo. OBJETIVO: Analisar as características (aspectos sociodemográficos, causa do TCE; custos com saúde) de indivíduos com sequelas de traumatismo cranioencefálico em um centro de referência em reabilitação. METODOLOGIA: Estudo de natureza descritiva,retrospectiva e quantitativa no período de janeiro de 2009 a dezembro de 2013, por meio de análise documental, resultando em uma amostra final de 88 prontuários analisados. Foram incluídos indivíduos de ambos os sexos, com idade igual ou superior a dois anos de vida. RESULTADOS: Dos indivíduos com sequelas de TCE, 86,36% eram do sexo masculino, com idade entre 18 e 59 anos (80,68%), apresentando ensino médio completo (26,14%), de cor parda (52,27%) e com renda familiar entre um e cinco salários mínimos (60,23%). A causa mais frequente de TCE foi o acidente motociclístico (68,18%). Não houve diferença estatística entre tipos de causa de TCE e custos com saúde. CONCLUSÃO: O presente estudo demonstrou que grande parte dos indivíduos eram homens jovens e vítimas de acidente motociclístico.(AU)

INTRODUCTION: traumatic brain injury (TBI) is defined as a change in brain function due to an external cause, that is, some external physical trauma that leads to morbidity and mortality, disabilities and mortality worldwide. OBJECTIVE: To analyze the characteristics (Socio-demographic aspects; causes of TBI; Health costs) of individuals with traumatic brain injury sequelae in a referral center for rehabilitation. METHODOLOGY: descriptive, retrospective and quantitative study from January 2009 to December 2013, Through documentary analysis, resulting in a final sample of 88 analyzed medical records. Individuals of both sexes, aged 2 years or more, were included. RESULTS: Of the individuals with TBI sequelae, 86.36% were male, aged between 18 and 59 years (80.68%), with completed secondary education (26.14%), mulatto (52.27 %) and family income between 1 and 5 minimum wages (60.23%). The most frequent cause of TBI were motorcycle accidents (68.18%). There was no statistical difference between types of cause of TBI and health care costs. CONCLUSION: This study showed that most individuals were young men, motorcycle accident victims and who lost work capacity. (AU)

Plantar fibromatosis: Surgical approach of a giant bilateral case.

BACKGROUND: Plantar fibromatosis or Ledderhose disease is characterized by a benign fibroblastic proliferation of the plantar fascia. It is an illness with unknown etiology and a complex treatment in its most intense manifestation. OBJECTIVE: The authors describe a surgical option for extensive cases where conservative treatments are not successful. Surgical techniques may vary according to the site and extent of the lesions. METHODS: Surgical treatment with wide resection of the lesion and second intention healing using a hydrocolloid dressing. RESULTS: After a 3-year follow-up with no recurrence, the authors demonstrated an excellent result, which led to an important improvement in the patient's quality of life. CONCLUSION: Surgical treatment can be a good option for plantar fibromatosis. Giant lesions can be treated with wide excisions and second intention healing, with low risk of aesthetic and functional complications.

Single-run capillary electrophoresis method for the fast simultaneous determination of amoxicillin, clavulanate, and potassium.

We report a new fast method for the simultaneous determination of amoxicillin, clavulanate, and potassium by capillary electrophoresis with capacitively coupled contactless conductivity detection. Samples containing potassium as the cation, and both amoxicillin and clavulanate as anions were determined simultaneously in a single run (in less than 45 s) using 10 mmol/L of both 2-amino-2-hydroxymethyl-propane-1,3-diol and 3-{[2-hydroxy-1,1-bis(hydroxymethyl)ethyl]amino}-1-propanesulfonic acid (pH 8.4) as the background electrolyte. Limits of detection were 25.0, 5.0, and 4.0 µmol/L for amoxicillin, clavulanate, and potassium, respectively. The proposed method is inexpensive, simple, fast (75 injections h-1 ), environment friendly (minimal waste generation), and accurate (recovery values between 98 and 103%). The results obtained with the proposed method were statistically similar (95% confidence level) to those obtained by using high-performance liquid chromatography (amoxicillin and clavulanate) and flame photometry (potassium).

Mechanism for optimization of signal-to-noise ratio of dopamine release based on short-term bidirectional plasticity.

Repeated electrical stimulation of dopamine (dopamine) fibers can cause variable effects on further dopamine release; sometimes there are short-term decreases while in other cases short-term increases have been reported. Previous studies have failed to discover what factors determine in which way dopamine neurons will respond to repeated stimulation. The aim of the present study was therefore to investigate what determines the direction and magnitude of this particular form of short-term plasticity. Fixed potential amperometry was used to measure dopamine release in the nucleus accumbens in response to two trains of electrical pulses administered to the ventral tegmental area of anesthetized mice. When the pulse trains were of equal magnitude we found that low magnitude stimulation was associated with short-term suppression and high magnitude stimulation with short-term facilitation of dopamine release. Secondly, we found that the magnitude of the second pulse train was critical for determining the sign of the plasticity (suppression or facilitation), while the magnitude of the first pulse train determined the extent to which the response to the second train was suppressed or facilitated. This form of bidirectional plasticity might provide a mechanism to enhance signal-to-noise ratio of dopamine neurotransmission.

Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets.

OBJECTIVE: To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. METHODS: A case-cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors ("miscellaneous"). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. RESULTS: In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00-1.24) and the adjusted OR was 1.02 (CI: 0.90-1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00-1.55) and the adjusted OR was 1.04 (CI: 0.82-1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. CONCLUSIONS: The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with "miscellaneous" tumors.

Fast determination of codeine, orphenadrine, promethazine, scopolamine, tramadol, and paracetamol in pharmaceutical formulations by capillary electrophoresis.

Paracetamol is an active ingredient commonly found in pharmaceutical formulations in combination with one of the following compounds: codeine, orphenadrine, promethazine, scopolamine, and tramadol. In this work, we propose a unique analytical method for determination of these active ingredients in pharmaceutical samples. The method is based on capillary electrophoresis with capacitively coupled contactless conductivity detection. The separation was achieved on a fused silica capillary (50 cm total length, 40 cm effective length, and 50 µm id) using an optimized background electrolyte composed of 20 mmol/L ß-alanine/4 mmol/L sodium chloride/4 µmol/L sodium hydroxide (pH 9.6). Each sample can be analyzed in a single run (≤2 min) and the limits of detection were 2.5, 0.62, 0.63, 2.5, 15, and 1.6 µmol/L for scopolamine, tramadol, orphenadrine, promethazine, codeine, and paracetamol, respectively. Recovery values for spiked samples were between 94 and 104%.

Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets / El peso al nacer y el riesgo de formación de tumores sólidos en la niñez en el Brasil: vinculación de registros entre conjuntos de datos poblacionales

Objective. To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. Methods. A case–cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors (“miscellaneous”). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. Results. In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00–1.24) and the adjusted OR was 1.02 (CI: 0.90–1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00–1.55) and the adjusted OR was 1.04 (CI: 0.82–1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. Conclusions. The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with “miscellaneous” tumors.

Objetivo. Analizar la relación entre la aparición de tumores sólidos en la niñez y 1) el peso al nacer y 2) el crecimiento fetal, a partir de dos conjuntos de datos poblacionales del Brasil. Métodos. Se efectuó un estudio de casos en una cohorte a partir de dos conjuntos de datos poblacionales y se vinculó el sistema de información de nacidos vivos (Sistema de Informação sobre Nascidos Vivos, SINASC) con 14 registros oncológicos poblacionales. Se eligieron al azar cuatro controles por caso del conjunto de datos del SINASC. Los tumores se clasificaron en tres tipos: del sistema nervioso central (SNC), embrionarios ajenos al SNC y otros (“misceláneos”). Se hicieron ajustes en función de los posibles factores de confusión (edad materna, modalidad de parto, educación materna, orden de nacimiento, edad gestacional, sexo y región geográfica) y se calcularon las razones de posibilidad (OR) con un intervalo de confianza (IC) del 95 % mediante análisis de la regresión logística incondicional. Resultados. En el análisis de las tendencias, se observó que, en todos los tumores, cada 500 g adicionales de peso al nacer la OR bruta fue de 1,12 (IC: 1,00-1,24) y la OR ajustada, de 1,02 (IC: 0,90-1,16), mientras que, cada 1 000 g adicionales, la OR bruta fue de 1,25 (IC: 1,00-1,55) y la OR ajustada, de 1,04 (IC: 0,82-1,34). En cuanto a los niños diagnosticados después de los 3 años de edad, en la categoría de tumores misceláneos, la OR fue significativamente más alta con cada 500 g y 1 000 g adicionales de peso al nacer. Conclusiones. Los datos del estudio indican que el peso alto al nacer está asociado a la aparición de tumores sólidos en la niñez, especialmente de la categoría “misceláneos” y en los niños mayores de 3 años de edad.

Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets / El peso al nacer y el riesgo de formación de tumores sólidos en la niñez en el Brasil: vinculación de registros entre conjuntos de datos poblacionales

ABSTRACT Objective To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. Methods A case–cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors (“miscellaneous”). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. Results In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00–1.24) and the adjusted OR was 1.02 (CI: 0.90–1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00–1.55) and the adjusted OR was 1.04 (CI: 0.82–1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. Conclusions The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with “miscellaneous” tumors.

RESUMEN Objetivo Analizar la relación entre la aparición de tumores sólidos en la niñez y 1) el peso al nacer y 2) el crecimiento fetal, a partir de dos conjuntos de datos poblacionales del Brasil. Métodos Se efectuó un estudio de casos en una cohorte a partir de dos conjuntos de datos poblacionales y se vinculó el sistema de información de nacidos vivos (Sistema de Informação sobre Nascidos Vivos, SINASC) con 14 registros oncológicos poblacionales. Se eligieron al azar cuatro controles por caso del conjunto de datos del SINASC. Los tumores se clasificaron en tres tipos: del sistema nervioso central (SNC), embrionarios ajenos al SNC y otros (“misceláneos”). Se hicieron ajustes en función de los posibles factores de confusión (edad materna, modalidad de parto, educación materna, orden de nacimiento, edad gestacional, sexo y región geográfica) y se calcularon las razones de posibilidad (OR) con un intervalo de confianza (IC) del 95 % mediante análisis de la regresión logística incondicional. Resultados En el análisis de las tendencias, se observó que, en todos los tumores, cada 500 g adicionales de peso al nacer la OR bruta fue de 1,12 (IC: 1,00-1,24) y la OR ajustada, de 1,02 (IC: 0,90-1,16), mientras que, cada 1 000 g adicionales, la OR bruta fue de 1,25 (IC: 1,00-1,55) y la OR ajustada, de 1,04 (IC: 0,82-1,34). En cuanto a los niños diagnosticados después de los 3 años de edad, en la categoría de tumores misceláneos, la OR fue significativamente más alta con cada 500 g y 1 000 g adicionales de peso al nacer. Conclusiones Los datos del estudio indican que el peso alto al nacer está asociado a la aparición de tumores sólidos en la niñez, especialmente de la categoría “misceláneos” y en los niños mayores de 3 años de edad.

Comparação do nível álgico no bloqueio do nervo alveolar inferior através de duas técnicas distintas / Comparison of pain level in the inferior alveolar nerve block through two different techniques

Introdução: O bloqueio do nervo alveolar inferior está entre as anestesias mais utilizadas e importantes da Odontologia; porém, não há estudos que comparem a anestesia eletrônica (Morpheus) e a anestesia tradicional manual, utilizando a seringa Carpule. Objetivo: Avaliar comparativamente dois sistemas de anestesia com relação à sensibilidade dolorosa durante e após a anestesia, com a administração de lidocaína 2% associada à epinefrina 1:100.000, na técnica anestésica para o nervo alveolar inferior. Material e método: Este ensaio clínico foi executado de modo randomizado, cruzado e duplamente cego, envolvendo 30 voluntários, que necessitavam de tratamento odontológico e que se submeteram ao bloqueio do nervo alveolar inferior, utilizando a seringa tipo Carpule na primeira sessão e o injetor de velocidade controlada Morpheus, o qual foi realizado em duas sessões, com intervalo de pelo menos duas semanas entre cada sessão. Ao final de cada sessão, foi aplicada a Escala Visual Analógica (EAV), para avaliação da sensibilidade dolorosa à injeção. Resultado: A comparação entre os métodos revelou que o convencional mostrou induzir maiores valores na EAV do que o Morpheus. O teste do Qui-Quadrado, para proporções esperadas iguais, mostrou que a técnica com Morpheus obteve maior (p=0,0062) preferência do que a convencional. Conclusão: No conjunto, os dados revelam que a técnica empregando o Morpheus foi superior à convencional nos três momentos. A execução da anestesia realizada com Morpheus mostrou ser mais confortável e ter aceitação e maior preferência dos voluntários.

Introduction: Blockade of the inferior alveolar nerve is among the most used and important anesthesia in dentistry, but there are no studies that compare the electronic anesthesia (Morpheus) and traditional manual anesthesia, using a syringe Carpule. Objective: To evaluate and compare two anesthesia systems with respect to pain sensitivity during and after anesthesia with lidocaine 2% associated with epinephrine 1: 100,000 in anesthetic techniques for inferior alveolar nerve. Material and method: This clinical trial was performed in a randomized, crossover, double-blind, involving 30 volunteers, who required dental treatment and who underwent blockade of the lower alveolar nerve, using the syringe type Carpule in the first session and the gun controlled speed Morpheus, where it was held in two sessions, with an interval of at least two weeks between each session. At the end of each session was applied to Visual Analogue Scale (VAS) to assess pain sensitivity to injection. Result: A comparison between the conventional methods revealed that induce showed higher values ​​than the EVA Morpheus. The chi -square for expected equal proportions showed that the technique with Morpheus had a higher (p = 0.0062) preference than conventional. Conclusion: Taken together, the data show that the technique employing the Morpheus was superior to conventional in 3 times. The implementation of anesthesia performed with Morpheus proved to be more comfortable, have greater acceptance and preference for volunteers.

Maternal and Birth Characteristics and Childhood Embryonal Solid Tumors: A Population-Based Report from Brazil.

BACKGROUND: Several maternal and birth characteristics have been reported to be associated with an increased risk of many childhood cancers. Our goal was to evaluate the risk of childhood embryonal solid tumors in relation to pre- and perinatal characteristics. METHODS: A case-cohort study was performed using two population-based datasets, which were linked through R software. Tumors were classified as central nervous system (CNS) or non-CNS-embryonal (retinoblastoma, neuroblastoma, renal tumors, germ cell tumors, hepatoblastoma and soft tissue sarcoma). Children aged <6 years were selected. Adjustments were made for potential confounders. Odds ratios (OR) with 95% confidence intervals (CI) were computed by unconditional logistic regression analysis using SPSS. RESULTS: Males, high maternal education level, and birth anomalies were independent risk factors. Among children diagnosed older than 24 months of age, cesarean section (CS) was a significant risk factor. Five-minute Apgar ≤8 was an independent risk factor for renal tumors. A decreasing risk with increasing birth order was observed for all tumor types except for retinoblastoma. Among children with neuroblastoma, the risk decreased with increasing birth order (OR = 0.82 (95% CI 0.67-1.01)). Children delivered by CS had a marginally significantly increased OR for all tumors except retinoblastoma. High maternal education level showed a significant increase in the odds for all tumors together, CNS tumors, and neuroblastoma. CONCLUSION: This evidence suggests that male gender, high maternal education level, and birth anomalies are risk factors for childhood tumors irrespective of the age at diagnosis. Cesarean section, birth order, and 5-minute Apgar score were risk factors for some tumor subtypes.

Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery? / Existe algum benefício em associar a anestesia neuroaxial à anestesia geral para revascularização miocárdica?

ABSTRACT BACKGROUND AND OBJECTIVES: The use of neuraxial anesthesia in cardiac surgery is recent, but the hemodynamic effects of local anesthetics and anticoagulation can result in risk to patients. OBJECTIVE: To review the benefits of neuraxial anesthesia in cardiac surgery for CABG through a systematic review of systematic reviews. CONTENT: The search was performed in Pubmed (January 1966 to December 2012), Embase (1974 to December 2012), The Cochrane Library (volume 10, 2012) and Lilacs (1982 to December 2012) databases, in search of articles of systematic reviews. The following variables: mortality, myocardial infarction, stroke, in-hospital length of stay, arrhythmias and epidural hematoma were analyzed. CONCLUSIONS: The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.

RESUMO JUSTIFICATIVA E OBJETIVOS: O uso da anestesia neuroaxial em cirurgia cardíaca é recente, porém os efeitos hemodinâmicos dos anestésicos locais e a anticoagulação podem trazer riscos aos pacientes. OBJETIVO: Revisar os benefícios da anestesia neuroaxial em cirurgia cardíaca para revascularização miocárdica por meio de uma revisão sistemática de revisões sistemáticas. CONTEÚDO: Foi feita pesquisa nas bases de dados Pubmed (de janeiro de 1966 a dezembro de 2012), Embase (1974 a dezembro 2012), The Cochrane Library (volume 10, 2012) e Lilacs (1982 a dezembro de 2012) em busca de artigos de revisões sistemáticas. Foram analisadas as seguintes variáveis: mortalidade, infarto do miocárdio, acidente vascular cerebral, tempo de internação hospitalar, arritmias e hematoma peridural. CONCLUSÕES: O uso da anestesia neuroaxial para revascularização miocárdica permanece controverso. O maior benefício encontrado por meio desta revisão foi a possibilidade de redução das arritmias pós-operatórias, porém esse resultado foi contraditório entre as evidências identificadas. Os resultados das evidências encontradas referentes à mortalidade, ao infarto do miocárdio, ao acidente vascular cerebral e ao tempo de internação hospitalar não mostraram maior efetividade da anestesia neuroaxial.