Larval fish assemblages in selected Brazilian estuaries: Species-environment relationships under different anthropogenic influences.

We investigate the effects of spatial changes in environmental conditions and anthropogenic influences on larval fish communities in two tropical estuaries with varying levels of human impact. Our findings revealed a distinct structure of larval fish assemblages between the two estuaries located in northeastern Brazil, and we observed that eutrophication, characterized by high concentrations of nutrients, had adverse effects on the abundance and richness of larval fish assemblages. Additionally, we observed that a decrease in rainfall had an impact on larval fish assemblages, particularly during the dry season, when intermittent upstream rivers lead to changes in salinity and species composition within the estuaries. This study contributed to evaluating the community descriptors of two tropical estuaries under different levels of human influence, providing insights into the vulnerability of larval fish assemblages to climate change, specifically in relation to human influences and hypersalinity and the effects of marinization in shallow tropical estuaries in this region.

Interdecadal changes in ichthyofauna in a tropical bay with high anthropogenic influences: functional stability despite turnover predominance.

Functional characteristics of species are of great importance for understanding their roles in ecosystems and can be used to detect long-term chances in the environment. We evaluated temporal changes (1983-1985 and 2017-2019) in taxonomic and functional indices of the fish fauna in shallow areas of a tropical bay heavily impacted by anthropogenic activities in recent decades. The hypothesis that functional indices change over time as a result of environmental degradation was tested. Our results showed a significant decrease in species richness and abundance over time, and in functional richness, while others functional diversity indices (divergency, evenness, and originality) remained stable. Thirteen functional groups were detected, some of which contained only one species, raising concerns about the loss of ecosystem functions due to ongoing changes. We also observed an increase in beta diversity over time, which may be the result of a decrease in local richness without leading to regional extinctions. Turnover was the most important process in structuring the fish fauna at the evaluated time scale. The relative stability of the functional structure and the higher levels of turnover seem to be related to the dominance of functional groups, within which species replace each other according to their responses to environmental filters that select for specific functional traits. Incorporating functional diversity indices and beta diversity variations in the fish community helped to enhance the existing information about this coastal system by offering improved estimates of biological diversity through diverse approaches. The predominance of turnover identified in the preset study suggests a dynamic and fluctuating species composition within the habitat. In this sense, habitat preservation should prioritize the protection of diverse habitats to accommodate a broad spectrum of species.

Confiabilidade de instrumentos de avaliação de qualidade de vida em crianças e adolescentes com cicatrizes de queimaduras: revisão sistemática / Reliability of quality-of-life assessment instruments in children and adolescents with burn scars: systematic review / Fiabilidad de los instrumentos de evaluación de la calidad de vida en niños y adolescentes con cicatrices de quemaduras: revisión sistemática

Objetivo: investigar as medidas de confiabilidade de instrumentos de qualidade de vida relacionada a saúde (QVRS) em crianças ou adolescentes com cicatrizes de queimaduras. Métodos: trata-se de uma revisão sistemática da literatura, mediante busca no CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus e Web of Science, sem restrições quanto à data ou idioma de publicação. Foram incluídos estudos originais, nos quais se examinaram instrumentos de avaliação da QVRS de crianças e/ou adolescentes (≤ 18 anos) com cicatrizes de queimaduras. Para a análise das propriedades de medida dos instrumentos de QVRS, utilizaram-se os critérios das diretrizes do Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). Resultados: nove estudos foram incluídos, dos quais foram abordados os seguintes instrumentos: Children Burn Outcomes Questionnaire (BOQ) ­ versão de 0 a 4 anos, Children Burn Outcomes Questionnaire (BOQ) ­ versão 5 a 18 anos, Brisbane Burn Scar Impact Profile (BBSIP) ­ versão de 0 a menores de 8 anos, Brisbane Burn Scar Impact Profile (BBSIP) ­ versão de 8 a 18 anos e CARe Burn Scale(CBS) ­ 0 a 8 anos. Conclusão: o BBSIP foi o instrumento que atendeu o maior número de itens de qualidade pela COSMIN.

Objective: to investigate the reliability measures of health-related quality of life (HRQOL) instruments in children or adolescents with burn scars. Methods: systematic review of the literature performed through a search in CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus and Web of Science without restrictions on the date or language of publication. Original studies were included, in which instruments for assessing the HRQOL of children and/or adolescents (≤ 18 years old) with burn scars were examined. The criteria of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to analyze the measurement properties of HRQOL instruments. Results: nine studies were included, and they covered the following instruments: Children Burn Outcomes Questionnaire (BOQ) 0-4 years version; Children Burn Outcomes Questionnaire (BOQ) 5-18 years version; Brisbane Burn Scar Impact Profile (BBSIP) 0-under 8 years old version; Brisbane Burn Scar Impact Profile (BBSIP) 8-18 years old version; and CARe Burn Scale (CBS) 0-8 years old. Conclusion: the BBSIP was the instrument that met the greatest number of quality items according to the COSMIN.

Objetivo: investigar las medidas de confiabilidad de los instrumentos de calidad de vida relacionada con la salud (CVRS) en niños o adolescentes con cicatrices de quemaduras. Métodos: revisión sistemática de la literatura mediante búsqueda en CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus y Web of Science, sin restricciones de fecha o idioma de publicación. Se incluyeron estudios originales, en los que se examinaron instrumentos para evaluar la CVRS de niños y/o adolescentes (≤ 18 años) con cicatrices de quemaduras. Se utilizaron los criterios de las directrices de los Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) para analizar las propiedades de medición de los instrumentos de CVRS. Resultados: se incluyeron nueve estudios que abarcaron los siguientes instrumentos: Children Burn Outcomes Questionnaire (BOQ) ­ versión 0-4 años; Children Burn Outcomes Questionnaire (BOQ) ­ versión 5-18 años; Brisbane Burn Scar Impact Profile (BBSIP) ­ versión 0-menos de 8 años; Brisbane Burn Scar Impact Profile (BBSIP) ­ version 8-18 años; y CARe Burn Scale (CBS) ­ versión 0-8 años. Conclusión: el BBSIP fue el instrumento que cumplió con el mayor número de ítems de calidad según el COSMIN.

Entomological indicators and food sources of triatomines in the Brazilian semi-arid region

ABSTRACT Background: Triatomines are biological vectors of Trypanosoma cruzi, the etiological agent of Chagas Disease (CD) and have various mammalian hosts. This study evaluated the entomological indicators and food sources of triatomines in Petrolina in the semi-arid region of Brazil, where CD is endemic. Methods: Triatomines were captured indoors and outdoors through an active search and entomological indices (household and natural infections) were calculated. Parasitological analyses were performed through microscopic visualization using Giemsa-stained insect feces, and DNA sequencing was employed to identify food sources from the gut contents of 82 insects (9.05%) that were better preserved. Results: We captured triatomines (906) in peridomicile (807) and intradomicile (99): Triatoma brasiliensis (84.7%, 767 specimens), Triatoma spp. (8.2%, 74 specimens), T. pseudomaculata (6.5%, 59 specimens), Rhodnius spp. (0.4%, four specimens), R. nasutus (0.1%, one specimen), and T. sordida (0.1%, one specimen). The household infestation index is 11.8%. Thirty-five triatomines were infected (33 T. brasiliensis and two T. pseudomaculata), corresponding to a natural infection index of 3.8%. The identified food sources were human T. pseudomaculata and T. brasiliensis, dogs for T. brasiliensis and rodents (Mus musculus) for T. brasiliensis. Conclusions: The results reinforce the need to intensify CD diagnosis, surveillance, and control actions, as an increase in entomological indices was recorded. Blood from humans and domestic and synanthropic animals was detected in the infected triatomines, suggesting a risk of CD vector transmission in Petrolina. As CD is a zoonosis, multidisciplinary and intersectoral CD surveillance must be conducted in the context of the One Health.

Neuroprotective Potential of Seed Extracts: Review of In Vitro and In Vivo Studies.

INTRODUCTION: Neurodegenerative diseases are characterized by neuronal dysfunction and death. Studies suggest that some seed extracts have a neuroprotective effect. Considering the increased incidence of these diseases and the need for new effective therapies with fewer side effects, this review aimed to assess the evidence of the efficacy and safety of seed extracts in experimental models of neurodegeneration. MATERIAL AND METHOD: The search was carried out through studies published between 2000 and 2021 in Science Direct, PubMed, Scientific Electronic Library Online (SciELO), and Latin American Literature in Health Sciences (LILACS) databases, in which the effects of seed extracts in in vitro and in vivo experimental models of neurodegeneration were investigated. Based on the eligibility criteria, 47 studies were selected for this review. RESULTS: In the in vitro models, the neuroprotection of the seed extracts was a result of their antioxidant, anti-inflammatory, and anti-apoptotic properties. In the in vivo models, neuroprotection resulted from the antioxidant and anti-inflammatory properties, a decrease in motor deficits, an improvement in learning and memory, as well as the increased release of neurotransmitters. The results show promise for the future of clinical research on new therapies for neurodegenerative diseases. However, the studies are still limited, which does not allow us to extrapolate the results to human beings with ND. CONCLUSIONS: Therefore, clinical trials are needed in order to prove the results of the in vitro and in vivo studies, as well as to assess the ideal, safe, and effective dose of these seed extracts in patients with neurodegenerative diseases.

Physiotherapy assessment and treatment of patients with tibial external fixator: a systematic scoping review.

PURPOSE: To map evidence regarding physiotherapy assessment and treatment of patients with tibial external fixator (EF), and to point out literature gaps for further research. METHODS: Systematic scoping review conducted in four databases. We included both experimental and non-experimental studies involving patients with tibial EF and outcomes of interest. We recorded study design, population, sample size, sample age, reason for EF use, type of surgery, type of EF used, instruments used for assessing function, pain, quality of life, satisfaction, psychosocial aspects, and physiotherapy treatment descriptions from included studies. We categorised data accordingly to outcomes assessed and physiotherapy treatments description. RESULTS: Eighty-six studies were included involving 3070 patients. Causes of fixator use were traumatic conditions, acquired and congenital deformities, and non-traumatic conditions, like compartmental osteoarthritis. Function was assessed in about three-quarters of included studies, though other outcomes were not presented in most studies. Only one study described satisfactorily the physiotherapy treatment. Almost half of the studies did not provide any description of the rehabilitation process. CONCLUSIONS: There is little evidence about the assessment of function, pain, quality of life, satisfaction, psychosocial aspects, and other outcomes in tibial EF patients. Physiotherapy treatment in these patients is poorly reported.Protocol registration: Open Science Framework: doi:10.17605/OSF.IO/UT2DAIMPLICATIONS FOR REHABILITATIONRehabilitation programmes and research should consider that most studies with tibial external fixator (EF) patients did not evaluate outcomes routinely used in physiotherapy assessment.Rehabilitation programmes should consider that the instruments used in evaluation of tibial EF patients have unknown measurement properties.Rehabilitation programmes should consider that treatment of patients with tibial EF involves different types of interventions, however, they are poorly described or not described in most studies.

Identifying Whitemouth Croaker (Micropogonias furnieri) Populations along the Rio de Janeiro Coast, Brazil, through Microsatellite and Otolith Analyses.

The inshore area of the Southwestern Atlantic between 22 °S and 29 °S (South Brazilian Bight) is a transitional climatic zone, where the tropical and warm temperate provinces mix. In its northern part, i.e., in the coastal waters of Rio de Janeiro, Brazil, local oceanographic conditions, such as upwelling in the north, and great bays with different degrees of anthropogenic influences in the center and south can determine the population structure of several fish stocks. The Whitemouth croaker (Micropogonias furnieri) is one the most heavily exploited fishing resources in this area, but there are still some doubts about its population structure. In this study, through combined analyses using nuclear genetic markers and morphological and geochemical signatures of otoliths, a divergence of individuals between two populations was identified using microsatellites, while a finer spatial structure with three populations (north, center and south, respectively) was found based on otolith shapes and elemental signatures. This regional population structure may have direct implications for rational fisheries management and conservation of the species.

LAPAROSCOPIC VERSUS OPEN SURGERY IN GASTRIC GASTROINTESTINAL STROMAL TUMORS LARGER THAN 5 CM: A SYSTEMATIC REVIEW AND META-ANALYSIS.

BACKGROUND: Surgical resection represents the main treatment for resectable nonmetastatic gastric gastrointestinal stromal tumors. Despite the feasibility and safety of laparoscopic resection, its standard use in gastric tumors larger than 5 cm is yet to be established. AIMS: This study aimed to compare the current evidence on laparoscopic resection with the classical open surgical approach in terms of perioperative, postoperative, and oncological outcomes. METHODS: The PubMed, Scopus, and Web of Science databases were consulted. Articles comparing the approach to gastric gastric gastrointestinal stromal tumors larger than 5 cm by open and laparoscopic surgery were eligible. A post hoc subgroup analysis based on the extent of the surgery was performed to evaluate the operative time, blood loss, and length of hospital stay. RESULTS: A total of nine studies met the eligibility criteria. In the study, 246 patients undergoing laparoscopic surgery and 301 patients undergoing open surgery were included. The laparoscopic approach had statistically significant lower intraoperative blood loss (p=0.01) and time to oral intake (p<0.01), time to first flatus (p<0.01), and length of hospital stay (0.01), compared to the open surgery approach. No significant differences were found when operative time (0.25), postoperative complications (0.08), R0 resection (0.76), and recurrence rate (0.09) were evaluated. The comparative subgroup analysis between studies could not explain the substantial heterogeneity obtained in the respective outcomes. CONCLUSION: The laparoscopic approach in gastric gastrointestinal stromal tumors larger than 5 cm compared to the open surgical approach is a technically safe and feasible surgical method with similar oncological results.

Knowledge and use of extrinsic feedback characteristics: A survey of current practice among Brazilian physical therapists.

OBJECTIVES: This study aimed to identify the knowledge about the different characteristics of and the use of extrinsic feedback (EF) by Brazilian physical therapists. METHODS: This is a cross-sectional study, and we used an internet-based survey with questions about knowledge and application of extrinsic feedback in clinical practice. We analyzed the responses in relation to the best available evidence on motor control and learning. We recruited Brazilian registered physical therapists from different regions in Brazil. Participants' demographics and survey responses were analyzed using descriptive statistics. RESULTS: Two hundred and forty-six Brazilian physical therapists participated in the study. Most participants affirmed not knowing the definition of EF (55.69%), confirmed using some form of EF in their clinical practice (86.59%), and reported using it in 50% to 90% of their patients (26.42%). Brazilian physical therapists reported using mainly summary feedback (69.10%) with external focus of attention (63.41%). Participants reported using concurrent feedback (82.83%) and delivered it after every exercise repetition (63.82%). Most participants (43.09%) did not assess learning retention. Answers were similar regardless of education level or time from graduation. CONCLUSIONS: The results of this survey suggest that Brazilian physical therapists do not have sufficient knowledge about the different characteristics of EF; however, they do consider EF useful and use it for most of their patients. Brazilian physical therapists adopted adequate content characteristics of EF but not adequate use of timing characteristics of EF.

Effects of CPAP on cardiorespiratory outcomes in patients with obstructive sleep apnea and heart failure: a systematic review / Efectos de la presión positiva continua en las vías aéreas en los resultados cardiorrespiratorios en pacientes con apnea obstructiva del sueño e insuficiencia cardíaca: una revisión sistemática / Efeitos da pressão positiva contínua nas vias aéreas nos desfechos cardiorrespiratórios em pacientes com apneia obstrutiva do sono e insuficiência cardíaca: uma revisão sistemática

ABSTRACT Obstructive sleep apnea (OSA) is a public health problem with a great economic impact. It is estimated that the prevalence of patients with OSA ranges from 4% to 6% of men and 2% to 4% of women in the general population. Strong evidence suggests that both sleep disorders and heart failure (HF) are related. Continuous positive airway pressure (CPAP) is the gold standard non-pharmacological treatment for this population. However, there is still a gap in the literature and its effects in patients with OSA and HF are not entirely clear. This study aimed to evaluate, by randomized clinical trials, the effects of positive pressure on cardiorespiratory function in patients with OSA and HF. Randomized clinical trials were included, with publication in the MEDLINE, PEDro, Cochrane Library, SciELO and PubMed databases and the risk bias was assessed using the PEDro scale. Six articles were included in this study, involving 165 participants. Our findings demonstrate that CPAP in the treatment of OSA in patients with HF promotes an increase in left ventricular ejection fraction, oxygen saturation and a reduction in blood pressure, apnea/hypopnea indices and awakenings from sleep during the night. We conclude that treatment with CPAP promotes an improvement in cardiorespiratory outcomes in patients with OSA and HF, improving the prognosis and reducing the risk of sudden death. However, their data must be cautiously interpreted considering the bias of the studies and their limitations.

RESUMEN La apnea obstructiva del sueño (APS) es un problema de salud pública con gran impacto económico. Se estima que la prevalencia de portadores de AOS es del 4% al 6% en los hombres y del 2% al 4% en las mujeres en la población general. Existe una fuerte evidencia de que tanto los trastornos del sueño como la insuficiencia cardíaca (IC) tienen una asociación entre sí. La presión positiva continua en las vías respiratorias (CPAP) es el tratamiento no farmacológico estándar de oro para esta población. Sin embargo, aún existe un vacío en la literatura y sus efectos en pacientes con AOS e IC no están del todo claros. Ante esto, el objetivo de este estudio es evaluar, mediante ensayos clínicos aleatorizados, los efectos de la CPAP sobre la función cardiorrespiratoria en pacientes con AOS e IC. Se incluyeron seis ensayos clínicos aleatorizados, con publicación en las bases de datos MEDLINE, PEDro, Cochrane Library, SciELO y PubMed, con un total de 165 participantes. El riesgo de sesgo se evaluó mediante la escala PEDro. Nuestros hallazgos demuestran que la CPAP en el tratamiento de la AOS en pacientes con IC promueve un aumento de la fracción de eyección del ventrículo izquierdo y de la saturación de oxígeno, y una reducción de la presión arterial, de los índices de apnea/hipopnea y de los despertares nocturnos. Se concluye que el tratamiento con CPAP promueve una mejora en los resultados cardiorrespiratorios en pacientes con AOS e IC, mejorando el pronóstico y reduciendo el riesgo de muerte súbita. Sin embargo, sus datos deben interpretarse con cautela considerando el sesgo de los estudios y sus limitaciones.

RESUMO A apneia obstrutiva do sono (AOS) é um problema de saúde pública de grande impacto econômico. Estima-se que a prevalência de portadores de AOS seja de 4% a 6% entre os homens e de 2% a 4% entre as mulheres da população em geral. Há fortes evidências de que os distúrbios do sono e a insuficiência cardíaca (IC) estão relacionados. A pressão positiva contínua nas vias aéreas (CPAP) é o tratamento não farmacológico padrão ouro para essa população. No entanto, ainda há uma lacuna na literatura, e seus efeitos em pacientes com AOS e IC não estão plenamente estabelecidos. Assim, o objetivo deste estudo foi avaliar através da revisão de ensaios clínicos randomizados os efeitos da CPAP na função cardiorrespiratória em pacientes com AOS e IC. Foram incluídos seis ensaios clínicos randomizados, publicados nas bases de dados MEDLINE, PEDro, Cochrane Library, SciELO e PubMed, totalizando 165 participantes. O risco de viés foi avaliado através da escala PEDro. Nossos achados demonstraram que a CPAP no tratamento da AOS em pacientes com IC promove um aumento da fração de ejeção do ventrículo esquerdo e da saturação de oxigênio e uma redução da pressão arterial, dos índices de apneia/hipopneia e dos despertares durante a noite. Concluímos que o tratamento com CPAP promove uma melhora nos desfechos cardiorrespiratórios em pacientes com AOS e IC, beneficiando o prognóstico e reduzindo os riscos de morte súbita. Porém, os resultados devem ser interpretados com cautela, considerando o viés dos estudos e suas limitações.

New occurrences of the endangered Notholebias minimus (Cyprinodontiformes: Rivulidae) in coastal plains of the State of Rio de Janeiro, Brazil: populations features and conservation

Notholebias minimus is an endangered annual killifish endemic to the coastal plains of the State of Rio de Janeiro, Brazil. This study aimed to present new occurrences in the Atlantic Forest biome, provide unprecedented population features (body and egg size, fecundity, sexual ratio, and length-weight relationship - LWR), and compare changes in land use and coverage between 1985 and 2021 in biotopes located inside and outside protected areas. Three new occurrence localities were found in shallow temporary wetlands with acidic pH (6.4 ± 0.2) and low concentrations of dissolved oxygen (2.0 ± 0.9 mg/L). Males and females total length ranged from 11.1 to 31 mm and 11 to 26 mm, respectively. Batch fecundity ranged from 18 to 40 oocytes (24.8 ± 8.8), corresponding to oocytes with sizes between 800-1,006 µm (905 ± 56). Males were significantly larger than females (W = 2193.5, p = 0.0067), but both sexes occurred in similar proportions (p = 0.472). LWR showed positive allometry (b = 3.18). Biotopes located within protected areas exhibited higher conservation. Our discoveries expand the knowledge about habitat and population features of N. minimus and reinforce the importance of establishing protected areas for the conservation of annual fish biotopes.

Notholebias minimus é um peixe anual ameaçado de extinção, endêmico das planícies costeiras do Estado do Rio de Janeiro, Brasil. Neste estudo, objetivamos apresentar novas ocorrências no bioma Mata Atlântica, fornecer características populacionais inéditas (tamanho do corpo e dos ovos, fecundidade, proporção sexual e relação peso-comprimento), e comparar mudanças no uso e cobertura do solo entre 1985 e 2021 em biótopos localizados dentro e fora de unidades de conservação. Registramos três novos locais em áreas úmidas temporárias rasas com pH ácido (6,4 ± 0,2) e baixas concentrações de oxigênio dissolvido (2,0 ± 0,9 mg/L). O comprimento total de machos e fêmeas variou de 11,1 a 31 mm e de 11 a 26 mm, respectivamente. A fecundidade do lote variou entre 18-40 oócitos (24,8 ± 8,8), correspondendo a diâmetros entre 800-1.006 µm (905 ± 56). Os machos foram significativamente maiores que as fêmeas (W = 2193,5; p = 0,0067), mas ocorreram em proporções similares (p = 0,472). A relação peso-comprimento detectou alometria positiva (b = 3,18). Biótopos localizados dentro de áreas protegidas exibiram maior preservação ambiental. Nossas descobertas ampliam o conhecimento sobre as características do habitat e da população de N. minimus e reforçam a importância do estabelecimento de áreas protegidas para a conservação dos biótopos dos peixes anuais.

Patients Who Present with Functional Limitations, Limited Range of Motion and Reduced Muscle Strength 6 Months after Total Hip Arthroplasty: A Cross-Sectional Study.

Objective To evaluate levels of pain, range of motion, hip isometric peak torque, and functional task performance in patients 6 months after total hip arthroplasty (THA) and to compare them to asymptomatic control participants (CG). Methods We recruited participants with unilateral THA due to hip osteoarthritis (OA) within a median of 6 months who had not developed postoperative complications. We assessed the pain levels, hip range of motion, peak isometric torque, self-reported assessment (Harris Hip Score) and objectively measured function (Timed Up & Go Test [TUG]) of the patients. The THA group was compared with a group of asymptomatic participants ≥50 years old recruited in the community. Comparisons are presented as mean differences (MDs) and 95% confidence intervals (CIs). Results A total of 23 participants were included in each group. Pain levels were low in the THA group (1.48 [1.60]), and 91.3% of the patients reported to be satisfied with the surgical procedure. Participants in the THA group reported significantly lower objectively measured (THA 12.2 [10.0-21.6]; CG 9.0 [6.7-12.2]) and self-reported function (THA 78.5 [43.8-93.9]; CG 100.0 [95.8-100.0]) compared with CG. The THA group also had significantly reduced range of motion for flexion ( p < 0.001), internal ( p < 0.001) and external rotation ( p = 0.003) movements and reduced peak torque for flexion ( p < 0.001), extension ( p < 0.001), abduction ( p < 0.001) and adduction ( p = 0.024) movements compared with participants of the CG. Conclusions Despite reporting overall low pain scores and satisfaction with the surgery, the patients present with functional limitations, limited range of motion, and reduced muscle strength 6 months after THA. Evidence Level 3b.

Patients Who Present with Functional Limitations, Limited Range of Motion and Reduced Muscle Strength 6 Months after Total Hip Arthroplasty: A Cross-Sectional Study / Pacientes que apresentam limitações funcionais, amplitude de movimento limitada e força muscular reduzida, 6 meses após a artroplastia total do quadril: Um estudo de corte transversal

Abstract Objective To evaluate levels of pain, range of motion, hip isometric peak torque, and functional task performance in patients 6 months after total hip arthroplasty (THA) and to compare them to asymptomatic control participants (CG). Methods We recruited participants with unilateral THA due to hip osteoarthritis (OA) within a median of 6 months who had not developed postoperative complications. We assessed the pain levels, hip range of motion, peak isometric torque, self-reported assessment (Harris Hip Score) and objectively measured function (Timed Up & Go Test [TUG]) of the patients. The THA group was compared with a group of asymptomatic participants ≥50 years old recruited in the community. Comparisons are presented as mean differences (MDs) and 95% confidence intervals (CIs). Results A total of 23 participants were included in each group. Pain levels were low in the THA group (1.48 [1.60]), and 91.3% of the patients reported to be satisfied with the surgical procedure. Participants in the THA group reported significantly lower objectively measured (THA 12.2 [10.0-21.6]; CG 9.0 [6.7-12.2]) and self-reported function (THA 78.5 [43.8-93.9]; CG 100.0 [95.8-100.0]) compared with CG. The THA group also had significantly reduced range of motion for flexion (p< 0.001), internal (p< 0.001) and external rotation (p= 0.003) movements and reduced peak torque for flexion (p< 0.001), extension (p< 0.001), abduction (p< 0.001) and adduction (p= 0.024) movements compared with participants of the CG. Conclusions Despite reporting overall low pain scores and satisfaction with the surgery, the patients present with functional limitations, limited range of motion, and reduced muscle strength 6 months after THA. Evidence Level 3b

Resumo Objetivo Avaliar os níveis de intensidade da dor, amplitude de movimento, pico de torque isométrico do quadril e desempenho da tarefa funcional em pacientes 6 meses após a artroplastia total do quadril (ATQ), e comparar estes valores com os de participantes assintomáticos do grupo controle (GC). Métodos Recrutamos participantes com ATQ unilateral devida a osteoartrite (OA) do quadril, dentro de uma mediana de tempo de 6 meses, que não tinham desenvolvido complicações pós-operatórias. Os participantes foram avaliados quanto à intensidade da dor, à amplitude de movimento do quadril, ao pico de torque isométrico, à autoavaliação (questionário de avaliação do quadril Harris Hip Score [HHS, na sigla em inglês) e à função medida objetivamente por meio do teste Timed Up and Go (TUG, na sigla em inglês). O grupo ATQ foi comparado com um grupo de participantes assintomáticos com idade ≥ 50 anos recrutados na comunidade. As comparações são apresentadas como diferenças médias (DMs) e intervalos de confiança (ICs) de 95%. Resultados Cada grupo contou com 23 participantes. A intensidade da dor foi baixa no grupo ATQ (1,48 [1,60]), sendo que 91,3% dos pacientes relataram estar satisfeitos com o procedimento cirúrgico. Os participantes do grupo ATQ relataram uma função medida objetivamente significativamente menor (ATQ 12,2 [10,0-21,6]; GC 9,0 [6,7-12,2]) e a função autoavaliação (ATQ 78,5 [43,8-93,9]; GC 100,0 [95,8-100,0]), em comparação com o GC. O grupo ATQ também teve reduzida de forma significativa a amplitude de movimento para flexão (p< 0,001), os movimentos internos (p< 0,001) e de rotação externa (p= 0,003). O grupo ATQ também apresentou pico de torque reduzido para flexão (p< 0,001), extensão (p <0,001), movimentos de abdução (p< 0,001) e adução (p = 0,024) em comparação com os participantes do GC. Conclusões Apesar de informarem escores gerais de dor de baixa intensidade e satisfação com a cirurgia, os pacientes apresentaram limitações funcionais, amplitude de movimento limitada e redução da força muscular após 6 meses do procedimento cirúrgico de ATQ. Nível de Evidência3B.

O efeito da educação na dor e funcionalidade em pacientes com disfunções musculoesqueléticas do membro superior: uma revisão sistemática / El efecto de la educación sobre el dolor y la funcionalidad en pacientes con trastornos musculoesqueléticos de miembro superior: una revisión sistemática / The effect of education on pain and functionality on patients with musculoskeletal dysfunctions of the upper limb: a systematic review

RESUMO Este estudo teve como objetivo verificar os efeitos da educação ao paciente (EP) em pacientes com disfunções musculoesqueléticas do membro superior (MS) para os desfechos de dor e/ou funcionalidade. Dois revisores realizaram independentemente buscas nas bases de dados PubMed, Cochrane, PEDro, SciELO e LILACS, considerando o período desde o início das publicações nessas bases até abril de 2021. Foram incluídos ensaios clínicos randomizados com seres humanos com disfunções musculoesqueléticas no MS; que tenham realizado intervenção com EP; e com desfechos de dor e/ou funcionalidade. Os revisores, separadamente, determinaram a elegibilidade dos estudos, extraíram dados e avaliaram a qualidade metodológica por meio da escala PEDro. Oito estudos foram incluídos nesta revisão, totalizando 603 participantes. A EP teve resultados superiores em três dos estudos no alívio da dor e/ou melhora da função em relação ao grupo comparativo. Sugere-se que a EP é mais eficaz quando associada a exercícios.

RESUMEN Este estudio tuvo como objetivo verificar los efectos de la educación del paciente (EP) en individuos con trastornos musculoesqueléticos del miembro superior (MS) sobre los resultados de dolor y/o funcionalidad. Dos revisores realizaron búsquedas de forma independiente en las bases de datos PubMed, Cochrane, PEDro, SciELO y LILACS, desde el comienzo de las publicaciones en estas bases hasta abril de 2021. Se incluyeron ensayos clínicos aleatorizados con seres humanos con trastornos musculoesqueléticos en el MS; que han sido intervenidos con EP; y con resultados de dolor y/o funcionalidad. Los revisores determinaron de forma independiente la elegibilidad del estudio, extrajeron los datos y evaluaron la calidad metodológica mediante la escala PEDro. En esta revisión se incluyeron ocho estudios con un total de 603 participantes. La EP tuvo resultados superiores en tres de los estudios en cuanto al alivio del dolor o la mejora de la función en el grupo comparativo. Aparentemente, la EF es más efectiva cuando se combina con ejercicio.

ABSTRACT This study verifies the effects of patient education (PE) in patients with musculoskeletal disorders of the upper limb (UL) on pain and/or functionality. The PubMed, Cochrane, PEDro, SciELO, and LILACS databases were independently searched by two reviewers, from the beginning of the publications until April 2021. We included randomized clinical trials with individuals with musculoskeletal disorders of the UL with pain and/or functionality outcomes, who have undergone intervention with PE. Reviewers independently determined study eligibility, extracted data, and assessed methodological quality using the PEDro scale. We included eight studies, totaling 603 participants. Compared to the controlled group, the PE intervention showed better results in three studies for pain relief and/or functionality improvement. Apparently, PE is more effective when combined with exercise.

The Cichlidae fish Geophagus brasiliensis (Quoy & Gaimard, 1824) has suitability as a sentinel species for changes caused by xenobiotics?

Industrial wastewater and agricultural practices are among the main activities discharging organic pollutants, such as Polychlorinated biphenyl (PCB) congeners and organochlorine insecticides (e.g. DDT - dichloro diphenyl trichloroethane), to the environment. In this study, we used the native Cichlidae fish species Geophagus brasiliensis as a sentinel to evaluate the hepatic 7-ethoxyresorufin-O-deethylase EROD activity, a biomarker of exposure to CYP1A-inducing pollutants, to assess the bioavailability of xenobiotics in two reaches of a large lotic system in Southeast Brazil: a less disturbed area (site 1) in the upper stretch, and an area in the middle stretch, which receives various industrial and agricultural effluents from upstream cities (site 2). In addition, G. brasiliensis were exposed to a single dose of 50 mg kg-1 beta-naphthoflavone (BNF) or of 50 mg kg-1 dimethylbenzoanthracene (DMBA) to test the effects on, respectively, the hepatic EROD activity in S9 supernatant fraction, and the frequency of micronucleated erythrocytes three days after the i.p. treatments, and compared to an unexposed group, to test its potential as a sentinel for biomonitoring studies. The EROD activity was approximately two-fold higher in fish from the impacted stretches than in fish from the less disturbed stretches (p < 0.05). Micronuclei (MN) frequency was also significantly different (p < 0.01) in DMBA-treated fish. The induced EROD activity in the impacted site suggests that organochlorinated pollutants are reaching the biota of the Paraíba do Sul River, confirming the suitability of Geophagus brasiliensis as a useful sentinel species to detect changes caused by xenobiotics(AU)

Underwater drones reveal different fish community structures on the steep slopes of a tropical reservoir.

A new approach for visual fish survey in reservoirs using underwater drones (remotely operated vehicle- ROV) is presented. The ROV was applied to identify abiotic gradients and to compare fish assemblages on the steep slopes in a tropical reservoir. The tested hypothesis is that fish are concentrated in the littoral zone due to the better physicochemical and habitat conditions, compared to deep and hypoxic layers. Twelve species were recorded (seven native, five exotic), with all species occurring in the littoral zone, seven species in the transition, and four in the profundal zone. A greater fish abundance and richness was found in the littoral zone corroborating the main hypothesis. The littoral zone was dominated by exotic cichlids (Cichla spp., Coptodon rendalli), while native catfish (Loricariichthys castaneus, Pimelodella lateristriga) occupied deeper areas. The fish distribution seems to be driven by local factors, such as oxygen availability and habitat structure. The preference for the littoral zone by alien cichlids may have led to the extirpation/decrease of native characids and induced catfishes to occupy deep habitats. Underwater drones can be a valuable tool for the simultaneous collection of abiotic/biotic data, especially in deep reservoirs with complex habitats, resulting in advances in the environmental monitoring. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10750-021-04790-9.

Laparoscopic versus open surgery in gastric gastrointestinal stromal tumors larger than 5 cm: a systematic review and meta-analysis / Abordagem laparoscópica versus cirurgia aberta em tumores estromais gástricos superiores a 5 cm: revisão sistemática e meta-análise

ABSTRACT BACKGROUND: Surgical resection represents the main treatment for resectable nonmetastatic gastric gastrointestinal stromal tumors. Despite the feasibility and safety of laparoscopic resection, its standard use in gastric tumors larger than 5 cm is yet to be established. AIMS: This study aimed to compare the current evidence on laparoscopic resection with the classical open surgical approach in terms of perioperative, postoperative, and oncological outcomes. METHODS: The PubMed, Scopus, and Web of Science databases were consulted. Articles comparing the approach to gastric gastric gastrointestinal stromal tumors larger than 5 cm by open and laparoscopic surgery were eligible. A post hoc subgroup analysis based on the extent of the surgery was performed to evaluate the operative time, blood loss, and length of hospital stay. RESULTS: A total of nine studies met the eligibility criteria. In the study, 246 patients undergoing laparoscopic surgery and 301 patients undergoing open surgery were included. The laparoscopic approach had statistically significant lower intraoperative blood loss (p=0.01) and time to oral intake (p<0.01), time to first flatus (p<0.01), and length of hospital stay (0.01), compared to the open surgery approach. No significant differences were found when operative time (0.25), postoperative complications (0.08), R0 resection (0.76), and recurrence rate (0.09) were evaluated. The comparative subgroup analysis between studies could not explain the substantial heterogeneity obtained in the respective outcomes. CONCLUSION: The laparoscopic approach in gastric gastrointestinal stromal tumors larger than 5 cm compared to the open surgical approach is a technically safe and feasible surgical method with similar oncological results.

RESUMO RACIONAL: A resseção cirúrgica representa a principal forma de tratamento de tumores estromais gástricos não metastáticos ressecáveis. Apesar da viabilidade e segurança da ressecção laparoscópica, a sua utilização generalizada em tumores gástricos com mais de 5 centímetros ainda não foi estabelecida. OBJETIVOS: Comparar as evidências atuais sobre a resseção por via laparoscópica com a cirurgia aberta, em termos de resultados peri-, pós-operatórios e oncológicos. MÉTODOS: Foram consultadas as bases de dados PubMed, Scopus e Web of Science. Artigos que comparassem a abordagem de tumores estromais gástricos gástricos com tamanho superior a 5 centímetros por cirurgia aberta e por via laparoscópica foram incluídos. Uma análise de subgrupos post-hoc, com base na extensão da cirurgia, foi realizada para os outcomes tempo intra-operatório, perdas de sangue e tempo de hospitalização. RESULTADOS: Nove estudos cumpriram os critérios de elegibilidade, tendo sido incluídos 246 pacientes submetidos a cirurgia por via laparoscópica e 301 pacientes submetidos a cirurgia aberta. A abordagem laparoscópica apresentou perdas de sangue intra-operatórias (p=0,01) e tempos até alimentação oral (p<0,01), para primeiro flato (p<0,01) e de hospitalização (0,01) estatisticamente inferiores relativamente à abordagem por cirurgia aberta. Não foram encontradas diferenças significativas quando avaliados o tempo operatório (0,25), complicações pós-operatórias (0,08), resseção R0 (0,76) e taxa de recorrência (0,09). A análise de subgrupos comparativa não permitiu explicar a heterogeneidade substancial obtida nos respetivos outcomes. CONCLUSÕES: A via laparoscópica em tumores estromais gástricos superiores a 5 centímetros comparativamente com a abordagem por cirurgia aberta, constitui um método cirúrgico tecnicamente seguro e viável, com resultados oncológicos semelhantes.

Dentoalveolar trauma induced by intubation in urgent maxillofacial surgery: case report / Trauma dentoalveolar induzido por intubação em cirurgia bucomaxilofacial de urgência: relato de caso

ABSTRACT Dental trauma is a common complication in general anesthesia, especially when using nasotracheal intubation during the classic laryngoscopy. Risk factors range from difficult intubation through difficult airways to occlusal changes in the patient, with incisors being widely affected by dental elements. Tooth avulsion is the most frequent type of trauma, followed by lateral dislocation and root fracture. Male patient, 39 years old, presented at the Emergency and Trauma Hospital in Caruaru/PE, a motorcycle accident victim with a bilateral jaw fracture. Given the need to fix fractures, the patient underwent a surgical procedure under general anesthesia. During laryngoscopy, heavy bleeding was observed in the oral cavity. After inspection, root fracture of lateral incisor and avulsion of right central incisor were noted. The avulsionated tooth was not found. An orthopedic image intensifier was used to locate the dental element in the thoracic region. However, it was not possible to determine its location. Therefore, an upper gastrointestinal (UGI) endoscopy was requested, and the dental element was in the digestive tract at the esophagus level. The tooth was removed, and the surgical procedure for osteosynthesis of bilateral mandible fracture was carried on. Dentoalveolar traumas induced by general anesthesia are frequent and require preventive measures since they can directly affect the patient's physical, economic, and medical conditions, along with anesthesiologists and maxillofacial surgeon's risk of receiving a civil lawsuit.

RESUMO O trauma dental é classificado como uma complicação comum em anestesia geral, em especial quando utilizada a intubação nasotraqueal durante o uso do laringoscópio clássico. Os fatores de risco envolvem desde dificuldade de intubação por via aérea difícil até alterações oclusais do paciente, sendo os incisivos, elementos dentários amplamente acometidos. A avulsão é o tipo de trauma mais frequente, seguido de luxação lateral e fratura radicular. Paciente do gênero masculino, melanoderma, 39 anos, apresentou-se no Hospital de Emergência e Trauma em Caruaru/PE vítima de acidente motociclístico, apresentando fratura bilateral de mandíbula. Visto a necessidade de fixação das fraturas, o paciente foi submetido a procedimento cirúrgico sob anestesia geral. Durante a laringoscopia, observou-se sangramento intenso na cavidade oral. Após inspeção, constatou-se fratura radicular do incisivo lateral esquerdo, e avulsão do incisivo central direito, sendo este último não encontrado. Com o intuito de preservar a via área, utilizou-se intensificador de imagem ortopédico, onde foi observado que o elemento dentário estava na região torácica, porém não foi possível apontar sua localização. Sendo assim, solicitou-se vídeo endoscopia, onde o elemento dentário se encontrava na via digestiva, na altura do esôfago. O mesmo foi removido e deu-se sequência ao procedimento cirúrgico de osteossíntese de fratura bilateral de mandíbula. Conclui-se que os traumas dentoalveolares induzidos por anestesia geral são frequentes e requerem condutas com finalidade preventivas, já que podem repercutir diretamente nas condições físicas, econômicas e médico-legais do paciente, bem como, processo cível dos profissionais envolvidos.

Prevalence and factors associated with metabolic syndrome in a vulnerable population in northern Brazil: a cross-sectional study / Prevalência e fatores associados à síndrome metabólica em população vulnerável do norte do Brasil: um estudo transversal

INTRODUCTION: metabolic syndrome (SM) is a set of metabolic imbalances that are associated with the development of cardiovascular diseases, type 2 diabetes mellitus, in addition to other chronic non-communicable diseases. SM has been gaining prominence in the scientific community mainly due to link with the increase of the obesity epidemic in the worldOBJECTIVE: To analyze the factors associated with metabolic syndrome and its prevalence in a vulnerable population in the Northern Region of BrazilMETHODS: This is a cross-sectional study with artisanal fishers from the state of Tocantins, and data collected between 2016 and 2017 were used. The outcome variable for MS was defined according to the criteria of the International Diabetes Federation. The following variables were assessed: socioeconomic and demographic information, fish consumption, and smoking. For statistical and data analysis, the Shapiro-Wilk test, Poisson regression, Student's t-test, and interquartile regression were evaluatedRESULTS: The general prevalence rate (PR) of MS was 31.9% higher in women than in men. The factors associated with MS were economic class and smoking, and there was an association between socioeconomic class and smoking (p=0.015). The most prevalent component was abdominal obesity with a rate of 62.5% (95% confidence interval [CI]: 54.5, 70.5). The prevalence of MS in terms of sex (PR=2.27, 95% 1.04 CI, 4.92, p=0.037), smoking (PR=2.40, 95% CI, 30, p=0.003) and years of professional experience (>10 PR=2.07, 95% CI 1.06, 4.05, p=0.033) was also assessedCONCLUSION: In the present study, the prevalence of SM was associated with smoking and socioeconomic status, which is considered high when compared to the worldwide prevalence. These findings highlight the importance of looking at public policies so that health services can develop actions that generate greater adherence to good health practices by the population

INTRODUÇÃO: A síndrome metabólica (SM) é um conjunto de desequilíbrios metabólicos que estão associados ao desenvolvimento de doenças cardiovasculares, diabetes mellitus tipo 2 além de outras doenças crônicas não transmissíveis. A SM vem ganhando destaque na comunidade científica principalmente por sua ligação com o aumento da epidemia de obesidade no mundoOBJETIVO: Analisar os fatores associados à síndrome metabólica e sua prevalência em população vulnerável da Região Norte do BrasilMÉTODO: Trata-se de um estudo transversal com pescadores artesanais do estado do Tocantins, e foram utilizados dados coletados entre 2016 e 2017. A variável desfecho para SM foi definida de acordo com os critérios da International Diabetes Federation. As seguintes variáveis foram avaliadas: informações socioeconômicas e demográficas, consumo de peixe e tabagismo. Para análise estatística e de dados, foram avaliados o teste de Shapiro - Wilk, regressão de Poisson, teste t de Student e regressão interquartilRESULTADOS: A taxa geral de prevalência (RP) da SM foi 31,9% maior em mulheres do que em homens. Os fatores associados à SM foram classe econômica e tabagismo e houve associação entre classe socioeconômica e tabagismo (p = 0,015). O componente mais prevalente foi obesidade abdominal com uma taxa de 62,5% (intervalo de confiança de 95% [IC]: 54,5, 70,5). A prevalência de SM em termos de sexo (RP = 2,27, IC 95% 1,04, 4,92, p = 0,037), tabagismo (RP = 2,40, IC 95%, 30, p = 0,003) e anos de experiência profissional (> 10 RP = 2,07, IC 95% 1,06, 4,05, p = 0,033) também foi avaliadoCONCLUSÃO: No presente estudo, a prevalência de SM esteve associada ao tabagismo e ao nível socioeconômico, sendo considerada elevada quando comparada a prevalência mundial. Esses achados assinalam a importância de um olhar das políticas públicas para que os serviços de saúde possam desenvolver ações que geram maior adesão as boas práticas de saúde pela população

A look at vulnerability: analysis of the lack of access to health care for quilombolas in Brazil / Um olhar para a vulnerabilidade: análise da ausência de acesso à saúde pelos quilombolas no Brasil

INTRODUCTION: In Brazil, access to health care is a constitutional right guaranteed by the Unified Health System that provides, in its guiding principles, universality, and equity of access to health servicesOBJECTIVE: To analyze the factors associated with the quilombola population's access to health servicesMETHODS: Cross-sectional study with 91,085 quilombolas. To measure the absence of access to health, the variables sex, ethnicity, work, disability, age group, illiteracy, place of residence, and average family income were used. The lack of access to health services was due to the identification of health care establishments by quilombola families in the Cadastro Único database. The association between socioeconomic characteristics and the lack of access to health services were assessed using the chi-square test and the measures of magnitude of the association and respective confidence intervals were estimated by Poisson Regression with robust varianceRESULTS: Among the factors associated with access to health services for the quilombola population, it is observed that the group with the highest risk is the elderly quilombolas, who declare themselves indigenous and who reside in the central west region It is noted that in 2004 there was a reduction in the lack of access to health by quilombolas to health services, however, between 2005 and 2015, there is an increase in the lack of access to health by quilombolas, after that period there is an ascendancy of access to health by this populationCONCLUSION: Several factors are associated with access to health by quilombola populations, which, related to the inequalities experienced by this population, directly impact government actions

INTRODUÇÃO: No Brasil, o acesso à saúde é um direito constitucional garantido a partir do Sistema Único de Saúde que prevê, em seus princípios norteadores, a universalidade e a equidade de acesso aos serviços de saúdeOBJETIVO: Analisar os fatores associados ao acesso da população quilombolas aos serviços de saúdeMÉTODO: Estudo transversal com 91.085 quilombolas. Para mensurar a ausência do acesso à saúde utilizou-se as variáveis sexo, etnia, trabalho, deficiência, faixa etária, analfabetismo, local de domicílio e a renda média familiar. A ausência do acesso aos serviços de saúde se deu a partir da identificação dos estabelecimentos de assistência à saúde pelas famílias quilombolas na base de dados do Cadastro Único. A associação entre as características socioeconômicas e a ausência do acesso aos serviços de saúde foram avaliadas pelo teste qui-quadrado e as medidas de magnitude da associação e respectivos intervalos de confiança foram estimados por Regressão de Poisson com variância robustaRESULTADOS: Dentre os fatores associados ao acesso aos serviços de saúde da população quilombolas, observa-se que o grupo com maior risco é os quilombolas idosos, que se autodeclaram indígenas e que residem na região centro oeste. Nota-se que no ano de 2004 houve uma redução na ausência do no acesso à saúde dos quilombolas aos serviços de saúde, entretanto entre 2005 a 2015 iniciou-se um aumento na ausência do acesso à saúde, a partir desse período uma ascendência do acesso à saúde por parte dessa populaçãoCONCLUSÃO: Diversos fatores estão associados ao acesso à saúde pelas populações quilombolas, os quais, relacionado às desigualdades vivenciadas por essa população, impactam diretamente nas ações governamentais