Treatment of deep gingival recession in homologous molars using a modified laterally positioned flap and subepithelial connective tissue graft: a case report.

This case report describes the use of the modified laterally positioned flap (LPF) technique associated with a subepithelial connective tissue graft (SCTG) for root coverage of homologous mandibular molars with deep gingival recession (GR). A 25-year-old woman with deep GR affecting the mandibular right and left second molars (teeth 31 and 18, respectively) reported bilateral dentinal hypersensitivity. The defect in tooth 31 was 5 mm deep and 4 mm wide. In tooth 18, the defect was 6 mm deep and 5 mm wide. There was 1 mm of keratinized tissue at tooth 31, and no keratinized tissue was present at tooth 18. The modified LPF-SCTG technique with mesial to distal positioning of the flap was selected to treat the defects. The flap was modified by a submarginal incision in the tooth farthest from the GR to preserve the integrity of the donor site. One year postsurgery, tooth 31 had 80.0% coverage, a 66.6% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. Tooth 18 had 83.3% root coverage, a 71.4% gain in clinical attachment, and a 5-mm increase in keratinized tissue width. The patient's complaints of hypersensitivity were resolved, and the tissue gain provided better access and more comfort during cleaning of the teeth. The flap donor sites demonstrated no clinical signs of GR. Based on the 1-year follow-up assessments, the modified LPF-SCTG technique was effective for the treatment of deep single-tooth GR in mandibular molars without causing adverse affects on the flap donor sites.

Exploring the accuracy of tooth loss prediction between a clinical periodontal prognostic system and a machine learning prognostic model.

AIM: The aim of this analysis was to compare a clinical periodontal prognostic system and a developed and externally validated artificial intelligence (AI)-based model for the prediction of tooth loss in periodontitis patients under supportive periodontal care (SPC) for 10 years. MATERIALS AND METHODS: Clinical and radiographic parameters were analysed to assign tooth prognosis with a tooth prognostic system (TPS) by two calibrated examiners from different clinical centres (London and Pittsburgh). The prediction model was developed on the London dataset. A logistic regression model (LR) and a neural network model (NN) were developed to analyse the data. These models were externally validated on the Pittsburgh dataset. The primary outcome was 10-year tooth loss in teeth assigned with 'unfavourable' prognosis. RESULTS: A total of 1626 teeth in 69 patients were included in the London cohort (development cohort), while 2792 teeth in 116 patients were included in the Pittsburgh cohort (external validated dataset). While the TPS in the validation cohort exhibited high specificity (99.96%), moderate positive predictive value (PPV = 50.0%) and very low sensitivity (0.85%), the AI-based model showed moderate specificity (NN = 52.26%, LR = 67.59%), high sensitivity (NN = 98.29%, LR = 91.45%), and high PPV (NN = 89.1%, LR = 88.6%). CONCLUSIONS: AI-based models showed comparable results with the clinical prediction model, with a better performance in specific prognostic risk categories, confirming AI prediction model as a promising tool for the prediction of tooth loss.

Tape-Shaped, Multiscale, and Continuous-Readable Fiducial Marker for Indoor Navigation and Localization Systems.

The present study proposes a fiducial marker for location systems that uses computer vision. The marker employs a set of tape-shaped markers that facilitate their positioning in the environment, allowing continuous reading to cover the entire perimeter of the environment and making it possible to minimize interruptions in the location service. Because the marker is present throughout the perimeter of the environment, it presents hierarchical coding patterns that allow it to be robust against multiple detection scales. We implemented an application to help the user generate the markers with a floor plan image. We conducted two types of tests, one in a 3D simulation environment and one in a real-life environment with a smartphone. The tests made it possible to measure the performance of the tape-shaped marker with readings at multiple distances compared to ArUco, QRCode, and STag with detections at distances of 10 to 0.5 m. The localization tests in the 3D environment analyzed the time of marker detection during the journey from one room to another in positioning conditions (A) with the markers positioned at the baseboard of the wall, (B) with the markers positioned at camera height, and (C) with the marker positioned on the floor. The localization tests in real conditions allowed us to measure the time of detections in favorable conditions of detections, demonstrating that the tape-shaped-marker-detection algorithm is not yet robust against blurring but is robust against lighting variations, difficult angle displays, and partial occlusions. In both test environments, the marker allowed for detection at multiple scales, confirming its functionality.

A Dive Into Oblivion: A Case of Transient Global Amnesia.

Transient global amnesia (TGA) is an uncommon neurologic disorder that consists of a sudden and temporary loss of memory, both present and past. Its causes and risk factors are not well known. We describe a case of a 58-year-old woman who was brought to the emergency department (ED) with sudden onset loss of memory and disorientation after a dive in the ocean. She presented memory deficits with incapacity to retain new memories and amnesia for the previous 24 hours. All exams ordered were normal, including computed tomography of the brain and laboratory analysis. After six hours of close monitoring in the ED, she gradually started to retain short-term memories and was discharged after 48 hours with no memory or other deficits. The diagnosis of TGA was made based on the clinical presentation and the patient's rapid improvement. Follow-up neurology consultation and further testing did not demonstrate any evidence to exclude this diagnosis. Further research is needed on this topic to allow the identification of risk factors and causes to prevent it.

Association of a Skin Dressing Made With the Organic Part of Marine Sponges and Photobiomodulation on the Wound Healing in an Animal Model.

The present study aims to characterize and to evaluate the biological effects of a skin dressing manufactured with the organic part of the Chondrilla caribensis marine sponge (called spongin-like collagen (SC)) associated or not to photobiomodulation (PBM) on the skin wound healing of rats. Skin dressings were manufactured with SC and it was characterized using scanning electron microscopy (SEM) and a tensile assay. In order to evaluate its biological effects, an experimental model of cutaneous wounds was surgically performed. Eighteen rats were randomly distributed into three experimental groups: control group (CG): animals with skin wounds but without any treatment; marine collagen dressing group (DG): animals with skin wounds treated with marine collagen dressing; and the marine collagen dressing + PBM group (DPG): animals with skin wounds treated with marine collagen dressing and PBM. Histopathological, histomorphometric, and immunohistochemical evaluations (qualitative and semiquantitative) of COX2, TGFß, FGF, and VEGF were done. SEM demonstrates that the marine collagen dressing presented pores and interconnected fibers and adequate mechanical strength. Furthermore, in the microscopic analysis, an incomplete reepithelialization and the presence of granulation tissue with inflammatory infiltrate were observed in all experimental groups. In addition, foreign body was identified in the DG and DPG. COX2, TGFß, FGF, and VEGF immunostaining was observed predominantly in the wound area of all experimental groups, with a statistically significant difference for FGF immunostaining score of DPG in relation to CG. The marine collagen dressing presented adequate physical characteristics and its association with PBM presented favorable biological effects to the skin repair process.

Potential Effects of Essential Oil from Plinia cauliflora (Mart.) Kausel on Leishmania: In Vivo, In Vitro, and In Silico Approaches.

In the search for new chemotherapeutic alternatives for cutaneous leishmaniasis (CL), essential oils are promising due to their diverse biological potential. In this study, we aimed to investigate the chemical composition and leishmanicidal and anti-inflammatory potential of the essential oil isolated from the leaves of Plinia cauliflora (PCEO). The chemical composition of PCEO showed ß-cis-Caryophyllene (24.4%), epi-γ-Eudesmol (8%), 2-Naphthalenemethanol[decahydro-alpha] (8%), and trans-Calamenene (6.6%) as its major constituents. Our results showed that the PCEO has moderate cytotoxicity (CC50) of 137.4 and 143.7 µg/mL on mice peritoneal exudate cells (mPEC) and Vero cells, respectively. The PCEO was able to significantly decrease mPEC infection by Leishmania amazonensis and Leishmania braziliensis. The value of the inhibitory concentration (IC50) on amastigote forms was about 7.3 µg/mL (L. amazonensis) and 7.2 µg/mL (L. braziliensis). We showed that PCEO induced drastic ultrastructural changes in both species of Leishmania and had a high selectivity index (SI) > 18. The in silico ADMET analysis pointed out that PCEO can be used for the development of oral and/or topical formulation in the treatment of CL. In addition, we also demonstrated the in vivo anti-inflammatory effect, with a 95% reduction in paw edema and a decrease by at least 21.4% in migration immune cells in animals treated with 50 mg/kg of PCEO. Taken together, our results demonstrate that PCEO is a promising topical therapeutic agent against CL.

Validity of a technological rehabilitation nursing program for people undergoing knee arthroplasty / Validación del programa de enfermería tecnológica en rehabilitación de personas realizadas en artroplastia de rodilla / Validação do programa de enfermagem de reabilitação tecnológico para pessoas submetidas a artroplastia do joelho

ABSTRACT Objective: to validate a Technological Rehabilitation Nursing Program for people undergoing total knee arthroplasty. Methods: this is a qualitative study, carried out through a focus group, with 12 nurses, considered experts in the area of rehabilitation. The program was developed using digital technology, such as an application for a mobile device. Experts assessed the program structure, the content made available to people undergoing total knee arthroplasty pre-operatively and post-operatively and the follow-up and communication strategies with nurses. Results: after content validity by experts, the final version of the program integrated three thematic areas and their respective categories: Rehabilitation program (Program phases, Program operationalization, Exercise plans included in the program); Useful information (Preparation for surgery, Care to be taken during surgery recovery); and Communication channel with nurses (Talk to a rehabilitation nurse, Self-assessment of health condition and Help with decision-making). Conclusion: experts' contributions made it possible to achieve the content validity of the program and, consequently, improve patient literacy about the procedure, complication prevention and self-care; training patients to carry out exercise plans in the pre- and post-operative periods; and communication with nurses through application.

RESUMEN Objetivo: validar un Programa Tecnológico de Enfermería de Rehabilitación para personas sometidas a artroplastia total de rodilla. Métodos: estudio cualitativo, realizado a través de un focus group, con 12 enfermeros, considerados expertos en el área de rehabilitación. El programa fue desarrollado utilizando tecnología digital, como una aplicación para un dispositivo móvil. Los expertos evaluaron la estructura del programa, los contenidos puestos a disposición de las personas sometidas a artroplastia total de rodilla en el preoperatorio y postoperatorio, y las estrategias de seguimiento y comunicación con la enfermera. Resultados: luego de la validación de contenido por parte de expertos, la versión final del Programa integró tres áreas temáticas y sus respectivas categorías: Programa de rehabilitación (Fases del programa, Operacionalización del programa, Planes de ejercicio incluidos en el programa); Información útil (Preparación para la cirugía, Cuidados a tener durante la recuperación quirúrgica); y Canal de Comunicación con la Enfermera (Hablar con una enfermera de rehabilitación, Autoevaluación del estado de salud y Ayuda en la toma de decisiones). Conclusión: los aportes de los expertos permitieron lograr la validez de contenido del programa y, en consecuencia, mejorar la alfabetización de los pacientes sobre el procedimiento, la prevención de complicaciones y el autocuidado; entrenar al paciente para que lleve a cabo planes de ejercicios en los períodos pre y postoperatorios; y comunicación con la enfermera a través de la aplicación.

RESUMO Objetivo: validar um Programa de Enfermagem de Reabilitação Tecnológico para pessoas submetidas à artroplastia total do joelho. Métodos: estudo qualitativo, realizado por meio de focus group, com 12 enfermeiros, considerados peritos na área de reabilitação. O Programa foi desenvolvido com recurso de uma tecnologia digital, do tipo aplicativo para dispositivo móvel. Os peritos avaliaram a estrutura do Programa, os conteúdos disponibilizados às pessoas submetidas a artroplastia total do joelho no pré-operatório e pós-operatório e as estratégias de acompanhamento e comunicação com o enfermeiro. Resultados: após a validação de conteúdo pelos peritos, a versão final do Programa integrou três áreas temáticas e suas respectivas categorias: Programa de Reabilitação (Fases do Programa, Operacionalização do Programa, Planos de exercícios incluídos no Programa); Informação Útil (Preparação para a cirurgia, Cuidados a ter durante a recuperação cirúrgica); e Canal Comunicacional com o Enfermeiro (Fale com enfermeiro de reabilitação, Autoavaliação da condição de saúde e Ajuda na tomada de decisão). Conclusão: os contributos dos peritos permitiram alcançar a validade de conteúdo do Programa e, consequentemente, melhorar a literacia do paciente sobre o procedimento, prevenção de complicações e autocuidado; instrumentalização do paciente para a realização dos planos de exercícios nos períodos pré e pós-operatório; e a comunicação com o enfermeiro pelo aplicativo.

Analysis of the Influence of Abdominal Obesity on Systemic Arterial Hypertension and on the Lipid Profile on Cardiometabolic Risk Stratification in Adult Women

Abstract Background: Obesity is a public health problem and has been associated with the development of metabolic disorders that have a strong relationship with the onset of cardiovascular diseases (CVD). Objective: The objective was to analyze the influence of abdominal obesity (AO) on systemic arterial hypertension (SAH) and on the lipid profile in cardiovascular risk stratification in adult women. Methods: Altogether, 91 women participated in the research. Lifestyle information was collected, in addition to the analysis of clinical measures of cardiovascular risk and biochemical parameters. Unpaired Student's t-test, logistic regression, and Pearson's correlation were performed for data analysis, with a value of p <0.05 considered significant. Results: The prevalence of AO was 62.6%. Logistic regression showed that AO increased the chance of developing SAH by 2.9-fold. The same behavior was observed in the TG/HDL-c lipid ratio (3.93 ± 0.3 vs. 2.16 ± 0.2), representing an 82% increase in obese women. The present study also demonstrated that the best anthropometric parameter to analyze cardiovascular risk in the studied population was the waist/height ratio (AUC = 0.707). Conclusions: It can therefore be concluded that AO plays a significant role in the development of SAH and changes in lipid values that predict increased cardiovascular risk, configuring a strong influence factor for CVD.

Analysis of ocular emergencies in a reference eye center in Brazil / Análise das emergências oculares em um centro de referência oftalmológica no Brasil

ABSTRACT Purpose: To determine the incidence of ocular emergencies and patient profiles in a public health eye center in Brazil. Methods: The medical record database of the Fundação Altino Ventura, Recife, Brazil was retrospectively analyzed and included all patients assisted at the ophthalmic emergency room between January 2017 and January 2018. Medical records with incomplete data and outpatient complaints were excluded. For records with multiple visits, only the initial visit was considered. Results: In 1 year, 134,788 patients (mean age at admission: 38.7 ± 22 years; range: 0-99 years) were admitted at the emergency room of the Fundação Altino Ventura. The most frequent diagnoses were conjunctivitis (52,732 cases; 37.3%), blepharitis (7,213 cases; 5.1%), and corneal/conjunctival foreign body (6,925 cases; 4.9%). Corneal/conjunctival foreign body and ocular trauma had an eight- and two-fold higher incidence in male patients, respectively (both p<0.001). Female patients presented a two-fold higher incidence of trichiasis and blepharitis than males (p<0.001). Corneal/conjunctival foreign body and ocular trauma affected more patients in a productive age (>15 years), while corneal ulcers, blepharitis, and trichiasis affected more elderly patients. All diagnostic clusters (e.g., infectious diseases, ocular trauma, foreign bodies, retinopathies, eyelid disorders, corneal diseases, glaucomatous crisis, and neuroophthalmological diseases) were more common during the spring season (p<0.001). Conclusion: The most common ocular emergencies in the present study were infectious diseases and foreign body. However, the incidence of ophthalmological emergencies was influenced by the age and sex of patients, as well as the time of the year.

RESUMO Objetivo: Determinar a incidência de emergências oculares em um centro oftalmológico de referência no Brasil. Métodos: O banco de dados de prontuários da Fundação Altino Ventura, Recife, Brasil, foi analisado retrospectivamente e incluiu pacientes atendidos, entre janeiro de 2017 e janeiro de 2018, na sala de emergência oftalmológica. Foram excluídos os prontuários com dados incompletos e com quadros ambulatoriais. Apenas o primeiro atendimento na emergência foi considerado para análise. Resultados: Em um ano, 134.788 pacientes (idade média de 38,7 ± 22 anos [0-99 anos]) foram admitidos na emergência da Fundação Altino Ventura. Os diagnósticos mais frequentes foram conjuntivite (52.732 casos [37,3%]), blefarite (7.213 casos [5,1%]) e corpo estranho na córnea/conjuntiva (6.925 casos [4,9%]). Corpo estranho na córnea/conjuntiva e trauma ocular foram cerca de 8 vezes e 2 vezes mais incidente em indivíduos do sexo masculino, respectivamente (p<0,001 em ambos). Triquíase e blefarite afetaram ~2 vezes mais pacientes do sexo feminino, respectivamente (p<0,001 em ambos). Corpo estranho na córnea/conjuntiva e trauma ocular afetaram mais pacientes em idade produtiva (>15 anos), enquanto úlcera, blefarite e triquíase da córnea afetaram mais pacientes idosos. Todos os grupamentos de diagnóstico (doenças infecciosas, trauma ocular, corpos estranhos, retinopatias, doenças das pálpebras, doenças da córnea, crise glaucomatosa e doenças neurooftalmológicas) foram mais incidentes na primavera (valor de p<0,001). Conclusão: As emergências oftalmológicas mais comuns no presente estudo foram as doenças infecciosas e o corpo estranho. Porém, a incidência das emergências oculares são fluências pela faixa etária e gênero do paciente, além da época do ano.

Perspectivas do uso de extratos de plantas amazônicas (açaí, copaíba, salva-do-marajó, pupunha e bacuri) como potenciais moduladores da fermentação ruminal: um breve panorama / Perspectives on the use of extracts from Amazonian plants and fruits (açai, copaiba, salva-do-marajo, pupunha and bacuri) as potential modulators of ruminal fermentation: a brief overview / Perspectivas del uso de extractos de plantas y frutos amazónicos (açaí, copaíba, salva-do-marajó, pupunha y bacuri) como potenciales moduladores de la fermentación ruminal: un breve panorama

Resumo Na flora amazônica, incontáveis plantas possuem compostos bioativos, que potencialmente podem ser utilizados como moduladores da fermentação ruminal. Apesar da importância, poucos estudos têm sido desenvolvidos para avaliar a utilização de plantas amazônicas como aditivos alimentares naturais na nutrição de ruminantes. Assim, objetiva-se apresentar um panorama dos dados científicos da literatura sobre os efeitos do uso dos extratos de açaí, copaíba, salva-do-marajó, pupunha e bacuri na fermentação ruminal e os seus potenciais de utilização na dieta de ruminantes. O açaí (Euterpe oleracea Mart.), possui 16,08 mg/g de matéria seca de flavonoides, compostos com potente ação antimicrobiana. Estudos com suplementação do óleo de açaí tem mostrado efeitos modulatórios na fermentação ruminal e na produção de leite de ovelhas e vacas. Adicionalmente, a oleoresina de copaíba (Copaifera spp.) e a manteiga das sementes de bacuri (Platonia insignis Mart.), possuem, respectivamente, 88% e 41% de terpenos; a composição fitoquímica do óleo de salva-do-marajó (Hyptis crenata Pohl ex Benth) ainda não está completamente caracterizada, mas esta fonte está majoritariamente composta por terpenos cânfora (33,62%), 1,8-cineol (19,76%) e α-pineno (15,24%), que apresentam atividade in vitro antimicrobiana, capaz de reduzir a produção total de gás em ambiente ruminal in vitro. A pupunha, fruto da pupunheira (Bactris gasipaes Kunth.), possui 355,95 mg/kg de carotenoides, com efeito antimicrobiano in vitro contra algumas cepas bacterianas. Os achados desta revisão demonstram as potencialidades dos extratos amazônicos na maximização da produção animal, em razão dos possíveis efeitos na modulação da fermentação ruminal, sendo encorajada a realização de estudos adicionais visando uma maior exploração deles. Embora, atualmente, não existam estudos associados aos efeitos do açaí, salva-do-marajó, pupunha e bacuri na fermentação ruminal, pressupõe-se que pela sua composição fitoquímica, poderiam ter um efeito semelhante aos ionóforos na produção de ruminantes.

Abstract In the Amazonian Forest, diverse plants have bioactive compounds, which can potentially be used as modulators of ruminal fermentation. Despite the importance, few studies have been developed to evaluate the use of extracts from Amazonian plants as natural feed additives in ruminant nutrition. Thus, the objective of this study is to present a brief overview of the scientific data in the literature regarding the effects of the use of extracts of açaí, copaíba, sage-do-marajó, peach palm, and bacuri on the ruminal fermentation and their potential for use in the diet of ruminants. Açaí (Euterpe oleracea Mart.) has 16.08 mg/g of dry matter of flavonoids, compounds with potent antimicrobial activity. Studies with açaí oil supplementation have shown modulatory effects on rumen fermentation and milk production in sheep and cows. Additionally, the copaiba oleoresin (Copaifera spp.) and the bacuri (Platonia insignis Mart.) seed butter have 88% and 41% of terpenes, respectively; the phytochemical composition of marajó sage oil (Hyptis crenata Pohl ex Benth) is not completely resolved, but this source is mostly composed of the terpenes, camphor (33.62%), 1,8-cineole (19.76%) and α-pinene (15.24%), which have in vitro antimicrobial effects against different bacterial strains. The findings of this review demonstrate the potential of Amazonian extracts in maximizing animal production, due to the possible effects on the modulation of ruminal fermentation, being encouraged to carry out additional studies aiming at a greater exploration of them. Although, there are no current studies associated with the effects of açaí, sage, peach palm, and bacuri on rumen fermentation, it is inferred that, due to their phytochemical composition, they may have a similar effect to ionophores on ruminant production.

Resumen En la selva amazónica, innumerables plantas poseen compuestos bioactivos, que potencialmente pueden ser utilizados como moduladores de la fermentación ruminal. A pesar de la importancia, han sido desarrollados pocos estudios evaluando el uso de extractos de plantas amazónicas como aditivos alimentarios naturales en la nutrición de rumiantes. Así, el objetivo de este estudio es presentar un breve panorama de los datos científicos en la literatura sobre los efectos del uso de extractos de açaí, copaíba, salvia-do-marajó, chontaduro y bacuri en la fermentación ruminal y su potencial de uso en la dieta de los rumiantes. Açaí (Euterpe oleracea Mart.) tiene 16,08 mg/g de materia seca de flavonoides, compuestos con potente acción antimicrobiana. Los estudios con suplementos de aceite de açaí han demostrado efectos moduladores sobre la fermentación ruminal y la producción de leche en ovejas y vacas. Adicionalmente, la oleorresina de copaiba (Copaifera spp.) y la mantequilla de semilla de bacuri (Platonia insignis Mart.) poseen 88% y 41% de terpenos, respectivamente; la composición fitoquímica del aceite de salvia de marajó (Hyptis crenata Pohl ex Benth) no está completamente resuelta, sin embargo esta fuente está mayoritariamente compuesta de los terpenos alcanfor (33,62%), 1,8-cineol (19,76%) y α-pineno (15,24%), los cuales poseen efecto antimicrobiano in vitro frente a diferentes cepas bacterianas. Los hallazgos de esta revisión demuestran el potencial de los extractos amazónicos en la maximización de la producción animal, debido a sus posibles efectos sobre la modulación de la fermentación ruminal, siendo incentivados a realizar estudios adicionales con el objetivo de una mayor exploración de estos. Aunque actualmente no existen estudios asociados a los efectos del açaí, la salvia, el chontaduro y el bacuri en la fermentación ruminal, se supone que, por su composición fitoquímica, podrían tener un efecto similar a los ionóforos en la producción de rumiantes.

+Perto® programa de enfermagem de reabilitação tecnológico / +Perto® technological rehabilitation nursing program

Com o aumento da expetativa de vida e o consequente envelhecimento das populações, a prevalência da osteoartrose, sobretudo da osteoartrose do joelho, tem vindo a expandir-se, traduzindo-se num aumento da morbilidade e incapacidade. A artroplastia total do joelho é a intervenção cirúrgica capaz de devolver funcionalidade e qualidade de vida a pessoas com estadio avançado de osteoartrose do joelho. O Enfermeiro Especialista em Enfermagem de Reabilitação, considerando a exponencial utilização das novas tecnologias por parte da população em geral, é detentor de um amplo conjunto de competências que permitem responder às necessidades específicas das pessoas com osteoartrose que são submetidas a artroplastia total do joelho, desenvolvendo e implementando programas que visem a maximização da funcionalidade e promovam a literacia em saúde. Objetivo: Construção e desenvolvimento de um programa de enfermagem de reabilitação para pessoas submetidas a artroplastia total do joelho, passível de ser acoplado numa aplicação móvel, dividido em três fases: Fase 1 ­ fase de preparação, reabilitação pré-operatória; Fase 2 ­ Fase de internamento; Fase 3 ­ fase de recuperação, reabilitação pós-operatória. Metodologia: Através da metodologia investigação-ação foi possível a criação e desenvolvimento da imagem gráfica e marca e a construção do programa de reabilitação digital, acompanhado de canal comunicacional e monitorização de pessoas submetidas a artroplastia total do joelho desde o período pré-operatório até às seis semanas do pós-operatório. Resultados: O programa de enfermagem de reabilitação tecnológico contará com um módulo de planos de exercícios diários, focado na preparação e recuperação; um módulo de informação útil, com o intuito de aumentar o conhecimento e literacia em saúde, através de recomendações, estratégias e técnicas fornecidas ao longo do programa; um módulo comunicacional com a equipa de enfermagem de reabilitação e algoritmos automáticos de apoio à tomada de decisão com feedback à medida que o programa é utilizado através de resposta a questionários e formulários. A identificação precoce de sinais e sintomas permitirá a atempada deteção e monitorização de complicações pós-operatórias capazes de diminuir a taxa de infeções e reinternamentos. Conclusão: Esta nova forma de olhar sobre o mundo digital em simbiose com a saúde que o programa de enfermagem de reabilitação tecnológico vem permitir, cria valor, reduz as barreiras geográficas e aproxima a saúde das populações preparando-as para uma proveitosa transição no processo saúde/doença, tornando as pessoas doentes na peça central de uma linha orientadora que pretende projetar os cuidados de saúde para o futuro mais eficiente, humano e sustentável.

With the increase in life expectancy and the consequent aging of populations, the prevalence of osteoarthritis, especially knee osteoarthritis, has been expanding, increasing morbidity and disabilities. Total knee arthroplasty is a surgical intervention capable of restoring functionality and quality of life to people with advanced stages of knee osteoarthrosis. The Nurse Specialist in Rehabilitation Nursing, considering the exponential use of new technologies by the general population, has a wide range of skills that allow responding to the specific needs of people with osteoarthrosis who undergo total knee arthroplasty, developing and implementing programs aimed at maximizing functionality and promoting health literacy. Objective: Construction and development of a rehabilitation nursing program for people undergoing total knee arthroplasty, which can be attached to a mobile application, divided into three phases: Phase 1 ­ preparation phase, preoperative rehabilitation; Phase 2 ­ Hospitalization phase; Phase 3 ­ recovery phase, postoperative rehabilitation. Methodology: Through the action-research methodology, it was possible to create and develop the graphic image and brand and the construction of the digital rehabilitation program, accompanied by a communication channel and monitoring of people undergoing total knee arthroplasty from the preoperative period to the six weeks of postoperative period. Results: The technological rehabilitation nursing program will have a module of daily exercise plans, focused on preparation and recovery; a useful information module, to increase health knowledge and literacy, through recommendations, strategies and techniques provided throughout the program; a communication module with the rehabilitation nursing team and automatic algorithms to support decision-making with feedback as the program is used by answering questionnaires and forms. Early identification of signs and symptoms will allow timely detection and monitoring of postoperative complications capable of reducing the rate of infections and readmissions. Conclusion: This new way of looking at the digital world in symbiosis with health that the technological rehabilitation nursing program allows, creates value, reduces geographical barriers and brings health closer to populations, preparing them for a useful transition in the health process /disease, making sick people the centerpiece of a guideline that aims to design healthcare for a more efficient, humane and sustainable future.

Burnout e metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de universidade em tríplice fronteira / Burnout and active teaching-learning methodology among medical students at a university in a triple border region

Resumo: Introdução: A metodologia de ensino-aprendizagem constitui importante fator na formação do estudante de Medicina e pode estar associada também à exposição de fatores estressantes crônicos que culminam em sofrimento mental como é observado na síndrome de burnout (SB). Objetivo: Este estudo teve como objetivos determinar a prevalência da SB e analisar suas dimensões e a relação com a metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de uma universidade de tríplice fronteira. Método: Trata-se de estudo transversal realizado com 279 acadêmicos do curso de Medicina que responderam a questionários sociodemográfico, de hábitos de vida e de aspectos do processo ensino-aprendizagem, e ao Inventário de Burnout de Maslach (IBM). Verificou-se associação entre a SB e as variáveis sociodemográficas, os hábitos de vida e o processo ensino-aprendizagem, por meio do teste de qui-quadrado de Pearson, do teste exato de Fisher e do teste t de Student. Realizaram-se análise descritiva dos dados, análise bivariada e regressão logística multivariada. Resultado: A prevalência de burnout foi de 4,7%, com 26,2% de alta exaustão emocional, 37,6% de alta despersonalização e 20,4% de baixa realização profissional. Os estudantes de Medicina avaliados neste estudo possuem níveis baixos ou moderados de SB. A insatisfação com o aprendizado da metodologia ativa, a falta de compreensão do fundamento da metodologia ativa e a percepção de que a minoria/nenhum docente aplica a metodologia ativa adequadamente foram preditores importantes associados ao burnout. Conclusão: Esta investigação pode servir para que escolas médicas possam desenvolver estratégias institucionais para enfrentamento dessa realidade no sentido de reduzir o risco do desenvolvimento de SB entre os estudantes de Medicina.

Abstract: Introduction: The teaching-learning methodology is an important factor in the training of medical students and may also be associated with the exposure to chronic stressors that culminate in mental suffering, as observed in the Burnout Syndrome (BS). Objective: To determine the prevalence of Burnout Syndrome and analyze its dimensions and the relationship with the active teaching-learning methodology in medical students at university located in a triple-border region. Method: Cross-sectional study with 279 medical students who answered questionnaires on sociodemographic data, life habits, aspects of the teaching-learning process and the Maslach Burnout Inventory (IBM). There was an association between the BS and sociodemographic variables, life habits and the teaching-learning process, using Pearson's Chi-Square tests, Fisher's exact test and Student's T test. Descriptive data analysis, bivariate analysis and multivariate logistic regression were performed. Result: The prevalence of Burnout was 4.7%, with 26.2% of high Emotional Exhaustion, 37.6% of high Depersonalization and 20.4% of low Professional Achievement. The medical students evaluated in this study have low or moderate levels of BS. Dissatisfaction with the active methodology learning, the lack of understanding of the foundation of the active methodology and the perception that the minority/none of the teachers apply the active methodology adequately were important predictors associated with Burnout. Conclusion: This investigation can help medical schools to develop institutional strategies to face this reality aiming to reduce the risk of the development of BS among medical students.

Efeito de um programa de acompanhamento farmacoterapêutico em pacientes com hipertensão arterial sistêmica / Effect of a pharmacotherapeutic follow-up program in patients with systemic arterial hypertension

A Hipertensão Arterial Sistêmica (HAS) é uma condição clínica multifatorial, com tratamento não-farmacológico e/ou farmacológico, que necessita de acompanhamento farmacoterapêutico para gestão da condição de saúde. O objetivo foi avaliar o impacto de um programa de acompanhamento farmacoterapêutico em pacientes com HAS, através do estudo quase-experimental, longitudinal e prospectivo. Foram avaliados 28 pacientes, 50% estavam com pressão arterial descompensada, os PRM (Problemas Relacionados à Medicamentos) identificados foram interações medicamentosas (57,1%), duplicidade farmacoterapêutica (28,8%), medicamentos potencialmente inapropriados para idosos (38,5 %) e não adesão ao tratamento (89,3%). Dos RNM (Resultado Negativos associados à Medicação) 56,2% relacionavam-se à segurança e 37,5% à efetividade. Após o acompanhamento, 56,3% dos RNM foram resolvidos, 57,1% dos pacientes aderiram ao tratamento e houve redução da Pressão Arterial Sistólica (p=0,010) e Pressão Arterial Diastólica (p=0,020). O programa mostrou-se favorável na redução da pressão arterial sistêmica e resolução dos PRM e RNM.

Systemic Arterial Hypertension (SAH) is a multifactorial clinical condition with non-pharmacological and/or pharmacological treatment that requires pharmacotherapeutic monitoring in order to manage the health condition. The objective was to evaluate the impact of a pharmacotherapeutic follow-up program of patients with SAH through a quasi-experimental, longitudinal, and prospective study. Twenty-eight patients were evaluated, 50% of which had decompensated blood pressure; the DRPs identified were drug interactions (57.1%), pharmacotherapeutic duplication (28.8%), potentially inappropriate medication use in older adults (38.5%), and non-adherence to treatment (89.3%). Of the NOM identified (Negative Outcomes associated with Medication), 56.2% were related to safety, and 37.5% to effectiveness. After the follow-up, 56.3% of the NOM were resolved, 57.1% of patients adhered to treatment, and there was a reduction in the Systolic Blood Pressure (p = 0.010) and Diastolic Blood Pressure (p = 0.020). The program proved to be efficient in reducing systemic blood pressure and resolving DRPs and NOM.

Characterization and Biological Performance of Marine Sponge Collagen

Abstract This study characterized the morphological aspects of marine collagen - spongin (SPG) extract from marine sponges, as well as, evaluating its in vitro and in vivo biological performance. Aplysina fulva marine sponge was used for the SPG extraction. It was investigated the physicochemical and morphological properties of SPG by using scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction and compared to PMMA and bovine collagen. Additionally, the SPG cytotoxicity and its influence on cell proliferation, through in vitro tests. Moreover, the in vivo biological response was investigated using an experimental model of tibial bone defect. The results demonstrated that SPG presented an irregular granular aspect, with a composition of OH, C=O, NH, CN and an amorphous profile. Also, in vitro viability results for the L929 and MC3T3 cell lines cultured with SPG extracts demonstrated normal growth in comparison to controls, except for MC3T3 viability at day 3. For in vivo analysis, using tibial bone defects in rats, SPG treated animals presented an increased rate of material resorption and higher granulation and bone formation deposition in the region of the defect, mainly after 45 days. As a conclusion, SPG was successfully extracted. The in vitro and in vivo studies pointed out that SPG samples produced an increase in L929 and MC3T3 viability and improved the performance in tibial bone defects. It can be concluded that SPG can be used as a bone graft for bone regeneration.

In vitro and in vivo genotoxicity and cytotoxicity analysis of protein extract from Aplysina fulva sponges

This study evaluated the physicochemical and morphological properties of a marine sponge protein extract (PE) using scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDS), analysis of mass loss and pH and in vitro and in vivo. Scanning electron microscopy showed that PE fibers present a granular aspect and irregular structure and the element carbon followed by oxygen was detected in the EDS analysis. Moreover, a 29% of mass loss was observed after 14 days and the pH slightly modified after 14 days. Cell viability of fibroblast cells (L929) of control and PE at a concentration of 25% demonstrated higher values compared to the groups. Osteoblast cell viability of PE at 25 and 50% was significantly higher. Comet assay on day 1 showed higher values for PE at 25%. In addition, in vivo experiments demonstrated that in the treated animals, the bone defects were filled with biomaterial particles, granulation tissue and some areas of newly formed bone. Furthermore, similar immunoexpression of Runx-2 and Cox-2 was observed. Taken together, all results suggest that PE is biocompatible, present non-citotoxicity in the in vitro studies (at the lower concentration) and in the in vivo studies and it can be considered as an alternative source of collagen for tissue engineering proposals.

Evaluation of physical and biological properties of conventional glass ionomer cements / Avaliação das propriedades físicas e biológicas de cimentos de ionômero de vidro convencionais

Objetivo: avaliar as propriedades físicas e biológicas dos cimentos de ionômero de vidro convencionais (CIVs). Metodologia: foram avaliados os seguintes CIVs: Fuji IX (GC Europe, Bélgica), Ketac Molar (3M ESPE, Estados Unidos), Maxxion R (FGM, Brasil) e Vitro Molar (Nova DFL, Brasil). O tempo de presa, a alteração dimensional, a radiopacidade, a sorção e a solubilidade em água foram avaliados para todos os materiais. A resistência à compressão foi analisada em intervalos de 1h, 24h, 7 dias e 28 dias; e liberação de íons fluoreto em 3h, 24h e 72h. A viabilidade celular foi avaliada após 24 e 48 horas com células de fibroblastos. A análise estatística foi realizada por meio do software SigmaPlot 12 (Systat Inc, San Jose, CA, EUA), com nível de significância estabelecido em α = 0,05. Resultado: apenas o Fuji IX teve um tempo de presa dentro da faixa recomendada pela Especificação Padrão da ADA 96 (2012), não superior a 6 minutos. Vitro Molar e Maxxion R apresentaram radiopacidade que não estava de acordo com a especificação ADA 96 (2012). Maxxion R e Vitro Molar mostraram uma alteração dimensional estatisticamente semelhante. Quanto às propriedades mecânicas, o Fuji IX foi o único CIV que apresentou aumento da resistência à compressão durante o período de avaliação de 28 dias. O Ketac Molar apresentou a maior viabilidade celular, enquanto o Maxxion R apresentou citotoxicidade severa e o maior valor cumulativo de liberação de flúor. Conclusão: Fuji IX e Ketac Molar apresentaram as propriedades físicas e biológicas mais adequadas entre os CIVs avaliados.(AU)

Objective: to evaluate the physical and biological properties of conventional glass ionomer cements (GICs). Methodology: the following GICs were evaluated: Fuji IX (GC Europe, Belgium), Ketac Molar (3M ESPE, United States), Maxxion R (FGM, Brazil) and Vitro Molar (Nova DFL, Brazil). Setting time, dimensional change, radiopacity, water solubility and water absorption were evaluated for all materials. Compressive strength was analyzed after intervals of 1h, 24h, 7 days and 28 days; and release of fluoride ions at 3 am, 24 am and 72 am. Cell viability was assessed after 24 and 48 hours with fibroblast cells. Statistical analysis was performed using SigmaPlot 12 software (Systat Inc, San Jose, CA, USA), with a significance level set at α = 0.05. Result: only the Fuji IX had an adjustment time within the range recommended by the Standard Specification of ADA 96 (2012) of not exceeding 6 minutes. Vitro Molar and Maxxion R had radiopacity that was not in accordance with the ADA 96 (2012) specification. Maxxion R and Vitro Molar showed a statistically similar dimensional change. As for mechanical properties, Fuji IX was the only GIC that showed an increase in compressive strength during the evaluation period of 28 days. Ketac Molar showed the highest cell viability, while Maxxion R showed severe cytotoxicity and the highest cumulative fluoride release value. Conclusion: Fuji IX and Ketac Molar showed the most appropriate physical and biological properties among the evaluated GICs.(AU)

Patients compliance to clinical treatment that benefit from the Brazilian National Glaucoma Program / Adesão ao tratamento clínico em pacientes beneficiados pelo Programa Nacional do Glaucoma

Abstract Objective: To evaluate the adherence to clinical glaucoma treatment in patients that benefit from the Brazilian National Glaucoma Program and receive antiglaucomatous eye drops free of charge. Methods: This cross-sectional study included 255 patients that benefit from the Brazilian National Glaucoma Program (BNGP) and were assisted at the Altino Ventura Foundation (FAV), Pernambuco state, Brazil. The Morisky's Adhesion Scale (MAS) was used to evaluate adhesion profile to treatment. Patients with a Morisky's Adhesion score ≥ 6 was considered adherent to treatment. The analyzed variables included sex, educational level, distance from home to the treatment center, number of eye drops used, time since the glaucoma diagnosis, patients' subjective classification of their quality of vision, and prevalence of other comorbidities. Results: A total of 255 patients [167 (65.4%) females] were included in this study with a mean age was 65.9 ± 13.8 years (range, 11-99 years). Adherence to clinical glaucoma treatment was seen in 155 patients (60.8%). Worse adherence to treatment was observed in female patients (p=0.034), with low education level (p=0.046), who presented other comorbidities (p=0.048), living in remote areas (p=0.038), judged their vision as satisfactory (p=0.046), and who were recently diagnosed with glaucoma (p=0.001). Conclusion: 40% of patients who benefited from the Brazilian National Glaucoma Program were not compliant to treatment. Low adhesion rate was mostly seen in female patients, socially vulnerable, living in remote areas, recently diagnosed with glaucoma, using fewer eyedrops, presenting other comorbidities, and in those that considering themselves of having a satisfactory vision.

Resumo Objetivo: Avaliar a adesão ao tratamento clínico do glaucoma em uma população que recebe colírios antiglaucomatosos gratuitamente pelo Programa Nacional do Glaucoma (PNG). Métodos: Estudo transversal que incluiu 255 pacientes inscritos no PNG e acompanhados na Fundação Altino Ventura, Recife, Pernambuco, Brasil. A Escala de Adesão de Morisky (EAM) foi usada para avaliar a adesão ao tratamento. Pacientes que pontuavam ≥ 6 na EAM eram considerados aderentes ao tratamento. As variáveis analisadas incluíram: gênero, escolaridade, distância entre a moradia e o centro de referência, número de colírios utilizados, tempo de diagnóstico de glaucoma, qualidade subjetiva da visão e prevalência de doenças sistêmicas associadas. Resultados: Total de 255 pacientes [167 (65,4%) mulheres] foram incluídos no estudo, com média de idade dos participantes de 65,9 ± 13,8 anos (variação, 11-99 anos). A adesão ao tratamento clínico do glaucoma foi encontrada em 155 pacientes (60,8%). Pior adesão foi identificada em pacientes do sexo feminino (p=0,034), com baixa escolaridade (p=0,046), com outras comorbidades (p=0,048), que moravam longe do centro de tratamento (p=0,038), apresentavam boa qualidade de visão subjetiva (p=0,046) e apresentavam diagnóstico recente de glaucoma (p=0,001). Conclusão: Quarenta por cento (40%) dos pacientes beneficiados do PNG não estão aderentes ao tratamento. A baixa taxa de adesão foi associada a pacientes do sexo feminino, com baixa escolaridade, vivendo longe do centro de tratamento, com diagnóstico recente de glaucoma, em uso de poucos colírios antiglaucomatosos e que apresentavam comorbidades.

Treinamento auditivo: zumbido e habilidades auditivas em idosos com perda auditiva / Hearing Training: Tinnitus and Hearing Skills on Elderly People with Hearing Loss / Entrenamiento auditivo: zumbido y habilidad auditiva en ancianos con pérdida auditiva

Introdução: O zumbido juntamente com a perda auditiva, é uma percepção acústica anormal que pode levar a uma desorganização no Sistema Nervoso Auditivo Central. Por isso sujeitos portadores são suscetíveis ao Transtorno do Processamento Auditivo Central. O Treinamento Auditivo, baseado nos conceitos de neuroplasticidade pode auxiliar na redução do incômodo com o zumbido, por objetivar sincronia na via auditiva. Objetivo: Estimar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido e nas alterações das habilidades auditivas em idosos com perda auditiva usuários de próteses auditivas. Material e Método: Estudo transversal quantitativo e qualitativo, no qual foram reabilitados cinco idosos com zumbido, alteração em pelo menos uma habilidade auditiva e perda auditiva. Foram realizadas avaliações pré e pós intervenção, sendo elas: anamnese e avaliação audiológica básica, aplicação do questionário Tinnitus Handicap Inventory, testes comportamentais do processamento auditivo e avaliação eletrofisiológica. Realizou-se o tratamento com o software Escuta Ativa, em 16 sessões de em média 30 minutos cada. Resultados: Houve diferença estatisticamente significante em relação aos valores pré e pós tratamento no questionário Tinnitus Handicap Inventory e nos testes comportamentais. Não houve mudanças eletrofisiológicas pré e pós tratamento. Conclusão: Foi possível avaliar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido, por meio do questionário escolhido.

Auditory Nervous System. Subjects with hearing loss are susceptible to Auditory Processing Disorder, as by sensory deprivation also disorganize the Central Auditory Nervous System. Auditory Training can help in reducing the annoyance with tinnitus, by objectifying synchrony in the auditory pathway. Objective: To estimate the effects of Computerized Auditory Training on the reduction of annoyance with tinnitus and changes in auditory abilities in elderly people with hearing loss and hearing aids users. Material and Method: A quantitative and qualitative cross-sectional study in which five elderly people with tinnitus were rehabilitated with difficulty at least in one auditory ability and hearing loss. Evaluations Pre and PostAuditory Training were performed, such as: anamnesis and basic audiological evaluation, application of the Tinnitus Handicap Inventory, behavioral auditory processing tests and electrophysiological evaluation. The treatment was performed with Escuta Ativa software, in 16 sessions with approximately 30 minutes each one. Results: There was a statistically significant difference in relation to the pre and post treatment values in the Tinnitus Handicap questionnaire and Behavioral auditory processing tests. There were no pre and post treatment electrophysiological changes. Conclusion: It was possible to evaluate the effects of the Computerized Auditory Training in the reduction of annoyance with tinnitus, through the chosen questionnaire applied pre and post-intervention. Furthermore, some behavioral auditory abilities also.

Introducción: El zumbido junto con la pérdida auditiva, es una percepción acústica anormal que puede conducir a una desorganización en el Sistema Nervioso Auditivo Central. Por eso sujetos portadores son susceptibles al Trastorno del Procesamiento Auditivo Central. El Entrenamiento Auditivo, basado en los conceptos de neuroplasticidad puede auxiliar en la reducción de la incomodidad con el zumbido, por objetivar la sincronía en la vía auditiva. Objetivo: Estimar los efectos del Entrenamiento Auditivo Acústicamente Controlado Ordenado en la reducción de la incomodidad con el zumbido y los cambios de las habilidades auditivas en ancianos con pérdida auditiva usuarios de prótesis auditivas. Material y método: Estudio transversal cuantitativo y cualitativo, en el cual fueron rehabilitados cinco ancianos con zumbido, alteración en por lo menos una habilidad auditiva y pérdida auditiva. Se realizaron evaluaciones pre y post intervención, siendo ellas: anamnesis y evaluación audiológica básica, aplicación del cuestionario Tinnitus Handicap Inventory, pruebas conductuales del procesamiento auditivo y evaluación electrofisiológica. Se realizó el tratamiento con el software Escucha Activa, en 16 sesiones de en promedio 30 minutos cada una. Resultados: Hubo diferencia estadísticamente significativa en relación a los valores pre y post tratamiento en el cuestionario Tinnitus Handicap Inventory y en las pruebas de comportamiento. No hubo cambios electrofisiológicos pre y post tratamiento. Conclusión: Fue posible evaluar los efectos del Entrenamiento Auditivo Acusticamente Controlado Computadorizado en la reducción de la incomodidad con el zumbido, por medio del cuestionario escogido aplicado pre y post-intervención. Además, algunas habilidades auditivas de comportamiento también mejoraron con dicha intervención. Sólo no fue posible observar cambios electrofisiológicos en el Potencial Evocado Auditivo Larga Latencia.

Zumbido, qualidade de vida e questões emocionais de sujeitos usuários de próteses auditivas / Tinnitus, quality of life and emotional issues of hearing aids users / Zumbido, calidad de vida y aspectos emocionales de pacientes usuarios de prótesis auditivas

Introdução: O zumbido pode provocar diferentes reações nos sujeitos, sendo prejudicial à qualidade de vida e podendo gerar alterações emocionais. Objetivo: Avaliar a relação entre a presença de sintomas de ansiedade e depressão, qualidade de vida e gravidade do zumbido em idosos usuários de próteses auditivas. Métodos: Para o estudo quantitativo, participaram idosos, de ambos os gêneros; com queixa de zumbido; perda auditiva neurossensorial de grau até moderado e usuários de próteses auditivas. Foi realizado anamnese, avaliação audiológica básica, acufenometria, aplicação dos questionários Tinnitus Handicap Inventory, Hospital Depression and Anxiety Scale e Questionário de Qualidade de Vida SF-36, sendo os dois últimos realizados por uma psicóloga. Resultados: Oito sujeitos foram avaliados, o zumbido foi médio forte e de pitch alto, a gravidade do zumbido foi de desprezível a severo, os questionários psicológicos evidenciaram Ansiedade e Depressão moderada e maior pontuação nos componentes: Aspectos Sociais e Saúde Mental. Conclusão: Não houve correlação entre qualidade de vida, questões emocionais e grau de incômodo com o zumbido, na amostra estudada.

Introduction: Tinnitus symptom can provoke different reactions in the subjects, being harmful to the quality of life and being able to generate emotional changes. Objective: To evaluate a relation between the presence of symptoms of anxiety and depression, quality of life and severity of tinnitus in the elderly, users of hearing aids. To evaluate a relation between the presence of anxiety and depression symptoms, life quality and severity of tinnitus in the elderly, users of hearing aids. Methods: For the quantitative study, the elderly of both genders; with tinnitus complaint; sensorineural hearing loss until moderate grade and users of hearing aids participated. Anamnesis, basic audiological evaluation, acuphenometry, application of Tinnitus Handicap Inventory, Hospital Depression and Anxiety Scale and SF-36 Quality of Life Questionnaire were performed, the last two being performed by a psychologist. Results: Eight subjects were evaluated, the tinnitus was strong and high pitch, the severity of tinnitus was negligible to severe, psychological questionnaires evidenced moderate anxiety and depression and higher scores in the components: Social Aspects and Mental Health. Conclusion: There was no correlation between life quality, emotional issues and grade of annoyance with tinnitus, in the sample.

Introducción: El zumbido puede causar diferentes reacciones en los sujetos, perjudica la calidad de vida y puede generar alteraciones emocionales. Objetivo: Evaluar la relación entre presencia de síntomas de ansiedad y depresión, calidad de vida y gravedad del zumbido en adultos mayores usuarios de prótesis auditivas. Métodos: Para el estudio cuantitativo, participaron adultos mayores de ambos géneros, con queja de zumbido, pérdida auditiva neurosensorial de grado moderado y usuarios de prótesis auditivas. Fueron realizados: anamnesis, evaluación audiológica básica, acufenometría y aplicaron de los cuestionarios Tinnitus Handicap Inventory, Hospital Depression and Anxiety Scale e Questionário de Qualidade de Vida SF-36, siendo que los dos últimos aplicados por una psicóloga. Resultados: Ocho pacientes fueron evaluados, el zumbido fue medio / fuerte y de pitch alto, la gravedad del zumbido fue de insignificante hasta severo, los cuestionarios psicológicos mostraron ansiedad y depresión moderada y mayor puntuación en los componentes: Aspectos sociales y Salud mental. Conclusión: No hubo correlación entre calidad de vida, aspectos emocionales y grado de incomodidad provocado por el zumbido en la muestra estudiada.

Obese with higher FNDC5/Irisin levels have a better metabolic profile, lower lipopolysaccharide levels and type 2 diabetes risk

ABSTRACT Objective: Thus, the aim of this study was to compare if higher or smaller fibronectin type 3 domain-containing protein 5 (FNDC5)/irisin levels are associated with inflammatory and metabolic markers, caloric/macronutrient intake, physical fitness and type 2 diabetes mellitus (T2DM) risk in obese middle-aged men, and also to correlate all variables analyzed with FNDC5/irisin. Subjects and methods: On the basis of a cluster study, middle-aged obese men (IMC: 31.01 ± 1.64 kg/m2) were divided into groups of higher and smaller levels of FNDC5/irisin. The levels of leptin, resistin, adiponectin, tumor necrosis factor alpha (TNFα), interleukin 6 and 10 (IL6, IL10), lipopolysaccharide (LPS), glucose, insulin, glycated hemoglobin, insulin resistance and sensibility, lipid profile, risk of T2DM development, body composition, rest energy expenditure, caloric/macronutrient intake and physical fitness were measured. Results: The higher FNDC5/ irisin group presented improved insulin sensibility (homeostasis model assessment - sensibility (HOMA-S) (p = 0.01) and QUICKI index (p < 0.01)), insulin (p = 0.02) and triglyceride levels (p = 0.01), lower insulin resistance (homeostasis model assessment - insulin resistance (HOMA-IR) (p = 0.01), triglycerides/glucose (TYG index) (p = 0.02), neck circumference (p = 0.02), risk of T2DM development (p = 0.02), tendency to decrease serum resistin (p = 0.08) and significant lower LPS levels (p = 0.02). Inverse correlations between FNDC5/irisin and body weight (r −0.46, p = 0.04), neck circumference (r −0.51, p = 0.02), free fat mass (r −0.49, p = 0.02), triglycerides (r −0.43, p = 0.05) and risk of developing T2DM (r −0.61, p = 0.04) were observed. Conclusions: These results suggest that higher FNDC5/irisin levels in obese middle-aged men are related to a better metabolic profile and lower risk of T2DM development and serum LPS, a potential inducer of insulin resistance.