Peak torque angle, acceleration time and time to peak torque as additional parameters extracted from isokinetic test in professional soccer players: a cross-sectional study.

This study investigated additional and traditional variables from isokinetic test of thigh muscles in soccer players across different field positions. One hundred and eighty-nine athletes performed maximal concentric isokinetic knee contractions on dominant (DL) and non-dominant limb (NDL) at 60º/s and 240º/s. The additional outcomes peak torque angle (AngPT), acceleration time (AcT) and time to peak torque (TPT) and traditional outcomes Peak torque (PT), total work (TW) and power (Pw) were extracted from the exam. Goalkeepers (GK), side backs (SB), central backs (CB), central defender midfielders (CDM), central attacking midfielders (CAM) and forwards (FW) were considered. Comparisons between limbs and positions demonstrated that SB extensors of the DL presented TPT lower (p = 0.006) and AngPT higher (p = 0.011) than NDL at 60°/s. CDM extensors of the DL showed lower TPT at 60°/s (p = 0.003) and 240°/s (p = 0.024). CAM flexors of the DL showed lower TPT (p = 0.026) and AcT (p = 0.021) at 240°/s than NDL. CB, CDM and CAM extensors of the NDL showed higher PT, TW and Pw than DL (p < 0.05). In conclusion, there are muscle imbalances between limbs in SB, CDM and CAM and across different field positions.

Synthesis of bis(ylidene) cyclohexanones and their antifungal activity against selected plant pathogenic fungi.

Botrytis cinerea, Rhizoctonia solani and Hemileia vastatrix are three species of phytopathogenic fungi behind major crop losses worldwide. These have been selected as target models for testing the fungicide potential of a series of bis(ylidene) cyclohexanones. Although some compounds of this chemical class are known to have inhibitory activity against human pathogens, they have never been explored for the control of phytopathogens until now. In the present work, bis(ylidene) cyclohexanones were synthesized through simple, fast and low-cost base- or acid-catalyzed aldol condensation reaction and tested in vitro against B. cinerea, R. solani and H. vastatrix. bis(pyridylmethylene) cyclohexanones showed the highest activity against the target fungi. When tested at 200 nmol per mycelial plug against R. solani., these compounds completely inhibited the mycelial growth, and the most active bis(pyridylmethylene) cyclohexanone compound had an IC50 of 155.5 nmol plug-1. Additionally, bis(pyridylmethylene) cyclohexanones completely inhibited urediniospore germination of H. vastatrix, at 125 µmol L-1. The most active bis(pyridylmethylene) cyclohexanone had an IC50 value of 4.8 µmol L-1, which was estimated as approximately 2.6 times lower than that found for the copper oxychloride-based fungicide, used as control. Additionally, these substances had a low cytotoxicity against the mammalian Vero cell line. Finally, in silico calculations indicated that these compounds present physicochemical parameters regarded as suitable for agrochemicals. Bis(ylidene) cyclohexanones may constitute promising candidates for the development of novel antifungal agents for the control of relevant fungal diseases in agriculture.

Pharmacopuncture with a low dosage of B complex vitamins in the Da Zhui acupoint (Governing Vessel 14) for controlling gastrointestinal parasitism in periparturient ewes / Farmacopuntura com dose baixa de vitaminas do complexo B no acuponto Da Zhui (Vaso Governador 14) para o controle da parasitose gastrintestinal em ovelhas no periparto

Gastrointestinal parasites are a significant challenge in sheep farming, and periparturient ewes are one of the most susceptible categories in sheep flocks. This study aimed to verify whether the injection of B vitamins at the acupuncture point governing vessel 14 (GV14) can influence the parasitic load or host-parasite interaction in naturally infected ewes during the peripartum period. Four weeks before parturition, 25 ewes were divided into five treatment groups: (1) Dose Control: 0.2 mL of B complex via IM; (2) Drug Control: 2 mL Complex B via IM; (3) Acupoint Control: 0.2 mL of Water at GV14 point; (4) Control; (5) Test group: 0.2 mL of B complex at the GV14 point. Treatments were performed at weeks -3, -1, 2, 4, and 6 about the parturition time. Fecal samples to estimate the parasitic load by fecal egg counts (FEC) and total blood samples for hemogram examination were performed seven days after the treatment, coinciding with weeks -2, 3, 5, and 7 about the parturition time. The number of peripheral eosinophils was higher in group 3 than in group 1 (p <0.05). Although groups 3 and 5 had lower mean values of FEC and higher hematological values at the time of weaning, these differences were not statistically significant (p> 0.05) according to the F test. However, all animals in groups 3 and 5 maintained low parasitism levels until the end of the experiment. Further studies should be performed with larger sample sizes and minor changes to the experimental protocol to elucidate the role of GV14 acupoint stimulation in the host-parasite relationship.(AU)

A parasitose gastrointestinal é o principal desafio sanitário para a criação de ovinos a pasto, e as ovelhas no periparto são uma das categorias mais susceptíveis a esta infeção no rebanho. O objetivo deste trabalho foi verificar se a injeção de vitaminas do complexo B no acuponto Vaso Governador 14 (VG14) poderia influenciar a carga parasitária ou modular a interação hospedeiro-parasito em ovelhas naturalmente infectadas no período de periparto. Quatro semanas antes da data prevista para o parto, 25 ovelhas foram divididas em cinco grupos de tratamento (1) Controle da dose: 0,2 mL de vitaminas do complexo B via IM; (2) Controle do fármaco: 2mL complexo B via IM; (3) Controle do Ponto: 0,2 mL de água destilada no ponto VG14; (4) Controle sem tratamento; (5) Grupo teste: 0,2 mL de complexo B no pontoVG14. Estes tratamentos foram realizados nas semanas -3; -1; 2; 4 e 6 em relação à data do parto. Amostras de fezes para contagem de ovos por grama de fezes (OPG), assim como amostras de sangue para realizar o hemograma, foram obtidas dos animais sete dias após os tratamentos, coincidindo com as semanas -2, 3, 5 e 7 do parto. O número de eosinófilos periféricos foi superior no grupo 3 se comparado ao grupo 1 (p <0,05). Os animais dos grupos 3 e 5 tiveram menores valores de OPG e maior hematócrito, mas estas diferenças não foram consideradas significativas pelo teste F (p> 0,05). No entanto, todas as ovelhas dos grupos 3 e 5 se mantiveram com níveis baixos de parasitismo durante todo o experimento. Sugere-se que novos estudos sejam realizados com algumas modificações deste protocolo a fim de aprofundar o conhecimento do potencial imunomodulador do acuponto VG14.(AU)

Daylight LED promotes photochemical ring contraction of 2-amine-4H-pyran-3-carbonitriles with consequent loss of their antifungal activity.

The initial objective of our work was to synthesize a series of 2-amino-4H-pyran-3-carbonitriles to be tested for their antifungal activities against economically relevant phytopathogenic fungi. Fourteen compounds were prepared in up to 94% yield and shown percentages of Botrytis cinerea inhibition above 70%. Despite the promising biological results, we observed that stock solutions prepared for biological tests showed color changing when kept for a few days on the laboratory bench, under room conditions, illuminated by common LED daylight tubes (4500-6000 k). This prompted us to investigate the possible photo-induced degradation of our compounds. FT-IR ATR experiments evidenced variations in the expected bands for functional of -amino-4H-pyran-3-carbonitriles stored under LED daylight. Following, HPLC-UV analysis showed reductions in the intensity of chromatographic peaks of 2-amino-4H-pyran-3-carbonitriles, and but not for solutions kept in the dark. A solution of (E)-2-amino-8-(4-nitrobenzylidene)-4-(4-nitrophenyl)-5,6,7,8-tetrahydro-4H-chromene-3-carbonitrile underwent 84.4% of conversion after 72 h of exposure to continuous LED daylight in a BOD chamber, and the reaction product was isolated in 36% yield and characterized as (E)-7-cyano-5-(4-nitrobenzylidene)-8-(4-nitrophenyl)bicyclo[4.2.0]oct-1(6)-ene-7-carboxamide (7*). Despite freshly prepared solutions of 2-amino-4H-pyran-3-carbonitriles produced antifungal activities, these solutions lost biological activity when left on the bench for a week. Besides, compound 7* formed from photo-induced degradation of 7 also showed no antifungal activity. With this, we hope to bring two contributions: (1) production of cyclobutenes through photochemical reactions of 2-amino-4H-pyran-3-carbonitriles can be carried out through exposure to simple white LED daylight; (2) biological applications of such 2-amino-4H-pyran-3-carbonitriles may be impaired by their poor photostability.

Effect of Pain Education, Cryotherapy, and Transcutaneous Electrical Nerve Stimulation on the Pain, Functional Capacity, and Quality of Life in Patients With Nonspecific Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial.

OBJECTIVE: The aim of the study was to analyze the effects of pain education and the combined use of cryotherapy and transcutaneous electrical nerve stimulation on the pain sensation, functional capacity, and quality of life of patients with nonspecific chronic low back pain. DESIGN: This is a randomized controlled and blind clinical trial including patients with nonspecific chronic low back pain in the following 4 groups: control group, cryotherapy group, burst transcutaneous electrical nerve stimulation group, and cryotherapy combined with burst transcutaneous electrical nerve stimulation group. They were evaluated at baseline and after the protocol was concluded using the following: Roland-Morris questionnaire and sit-to-stand test; quality-of-life questionnaire; and pain. The protocol consisted of 10 sessions with pain education associated the combination of the electrophysical agents. RESULTS: There were no statistical differences between groups after the intervention protocol. In the within analysis, all groups presented an improvement in visual analog scale scores, Roland-Morris questionnaire, sit-to-stand test, and pain domain of quality-of-life questionnaire. CONCLUSIONS: This study showed that with pain education, there was no difference between cryotherapy and transcutaneous electrical nerve stimulation alone, combined, or placebo mode in improving pain, functional capacity, and quality of life in patients with nonspecific chronic low back pain.

BEHAVIORAL CHARACTERISTICS OF CHILDREN WITH SICKLE CELL DISEASE.

OBJECTIVE: To evaluate sociodemographic and clinical aspects of children with sickle cell disease (SCD) and their behavioral characteristics. METHODS: Interview with parents of patients with SCD from four to ten years old, addressing socioeconomic aspects and other health conditions, and using the Strengths and Difficulties Questionnaire (SDQ). Clinical data were obtained from medical records. Exclusion criteria were the use of hydroxyurea, previous diagnosis of stroke, chronic encephalopathy and/or intellectual disability. RESULTS: 45 patients (19 girls and 26 boys) were assessed. The median age was seven years. Diagnosis of SCD: 26 hemoglobinopathy SC; 19 hemoglobinopathy SS. Socioeconomic class: D: 24.4%; C2: 44.4%; C1: 28.9%; B2: 2.2%. Clinical history: acute chest syndrome: 40%; transfusions: 66.7%; hospitalizations: 82.2%. SDQ findings: 88.9% clinical impact (emotional subscale: 68.9%); total score: impact in 48.9%. It was not possible to establish a relation between the severity of the disease and the results of the SDQ. Regarding socioeconomic class: among individuals of classes B2 and C1, 21.4% had impact at the total score; in classes C2 and D, this percentage was 61.3%. Regarding the schooling of the head of the family, with Elementary School at least, 39.3% of the children had impacts; for fewer education, this percentage was 64.7%. CONCLUSIONS: Behavioral impacts are highly prevalent in children with SCD. Individuals in socioeconomic classes C2 and D suffered more behavioral impacts than individuals in classes B2 and C1.

Behavioral characteristics of children with sickle cell disease / Características comportamentais de crianças com doença falciforme

ABSTRACT Objective: To evaluate sociodemographic and clinical aspects of children with sickle cell disease (SCD) and their behavioral characteristics. Methods: Interview with parents of patients with SCD from four to ten years old, addressing socioeconomic aspects and other health conditions, and using the Strengths and Difficulties Questionnaire (SDQ). Clinical data were obtained from medical records. Exclusion criteria were the use of hydroxyurea, previous diagnosis of stroke, chronic encephalopathy and/or intellectual disability. Results: 45 patients (19 girls and 26 boys) were assessed. The median age was seven years. Diagnosis of SCD: 26 hemoglobinopathy SC; 19 hemoglobinopathy SS. Socioeconomic class: D: 24.4%; C2: 44.4%; C1: 28.9%; B2: 2.2%. Clinical history: acute chest syndrome: 40%; transfusions: 66.7%; hospitalizations: 82.2%. SDQ findings: 88.9% clinical impact (emotional subscale: 68.9%); total score: impact in 48.9%. It was not possible to establish a relation between the severity of the disease and the results of the SDQ. Regarding socioeconomic class: among individuals of classes B2 and C1, 21.4% had impact at the total score; in classes C2 and D, this percentage was 61.3%. Regarding the schooling of the head of the family, with Elementary School at least, 39.3% of the children had impacts; for fewer education, this percentage was 64.7%. Conclusions: Behavioral impacts are highly prevalent in children with SCD. Individuals in socioeconomic classes C2 and D suffered more behavioral impacts than individuals in classes B2 and C1.

RESUMO Objetivo: Avaliar aspectos sociodemográficos e clínicos de crianças com doença falciforme (DF) e suas características comportamentais. Métodos: Aplicação de entrevista sobre aspectos socioeconômicos e outras condições de saúde e do questionário de capacidades e dificuldades (SDQ) em pais de pacientes de quatro a dez anos com DF, em um ambulatório de referência. Dados clínicos foram obtidos dos prontuários médicos. Critérios de exclusão: uso de hidroxiureia, diagnóstico prévio de acidente vascular cerebral, encefalopatia crônica e/ou deficiência intelectual. Resultados: Analisados 45 pacientes (19 meninas e 26 meninos). Mediana de idade=7 anos. Diagnóstico da DF=26 hemoglobinopatia SC; 19 hemoglobinopatia SS. Classe econômica (SES): D=24,4%; C2=44,4%; C1=28,8%; B2=2,2%. Antecedentes clínicos: síndrome torácica aguda=40%; transfusões=66,7%; internações=82,2%. Achados SDQ=88,9% alteração clínica (subescala emocional=68,9%); pontuação total=alterada em 48,9%. Não foi possível estabelecer relação entre gravidade da doença e os resultados do SDQ. Com relação à SES, entre indivíduos das classes B2 e C1, 21,4% tiveram alteração na pontuação total; nas classes C2 e D, esse percentual foi de 61,3%. Quanto à escolaridade do chefe da família, com no mínimo ensino fundamental completo, 39,3% das crianças tiveram alteração; para menor escolaridade, esse percentual foi 64,7%. Conclusões: Alterações comportamentais são altamente prevalentes em crianças com DF. Indivíduos das classes C2 e D tiveram mais alterações comportamentais em relação aos indivíduos das classes B2 e C1.

Núcleo ampliado de saúde da família e atenção básica: formação e atuação em saúde / Expanded family health center and basic care: health training and performance

Objetivo: Caracterizar o perfil de formação e atuação, o conhecimento sobre as diretrizes e a rotina de planejamento dos profissionais integrantes das equipes dos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB) de um município do leste de Minas Gerais. Métodos: Foi realizado um estudo transversal, no qual foi aplicado um questionário estruturado a todos os profissionais dos NASF-AB do município, com questões referentes à formação, atuação, conhecimento das diretrizes e planejamento do NASF-AB. Resultados: A maioria dos profissionais era mulher (88,2%), com idade entre 30 e 39 anos (50,0%) e graduação em Nutrição (20,6%) e Psicologia (20,6%). O ingresso no programa ocorreu principalmente por análise de currículo (47,1%). Metade dos profissionais não teve experiência profissional em Saúde Pública prévia ao ingresso no programa e 52,9% desses informaram não terem participado de curso anterior a sua atuação. A diretriz do NASF-AB mais referida foi a relacionada à Promoção à Saúde (82,4%) e as menos citadas foram a Educação Permanente em Saúde (14,7%) e o Controle Social (17,6%). Metade dos profissionais relatou integração satisfatória entre as equipes do NASF-AB e da Estratégia de Saúde da Família e a maioria soube dizer como ocorriam as ações desenvolvidas (61,7%). Foi identificado conhecimento sobre os instrumentos necessários para o planejamento por 53,0% dos participantes e informada ausência da participação da população assistida no planejamento de saúde por 56,0% dos entrevistados. Conclusões: Os profissionais foram conhecedores das ações desenvolvidas no NASF-AB e apresentaram integração satisfatória entre as equipes. Foram identificadas lacunas no processo formativo para atuação no NASF-AB, bem como na realização de ações de educação permanente e na participação da população no planejamento em saúde.

T cell assays differentiate clinical and subclinical SARS-CoV-2 infections from cross-reactive antiviral responses

A major issue in identification of protective T cell responses against SARS-CoV-2 lies in distinguishing people infected with SARS-CoV-2 from those with cross-reactive immunity generated by exposure to other coronaviruses. We characterised SARS-CoV-2 T cell immune responses in 168 PCR-confirmed SARS-CoV-2 infected subjects and 118 seronegative subjects without known SARS-CoV-2 exposure using a range of T cell assays that differentially capture immune cell function. Strong ex vivo ELISpot and proliferation responses to multiple antigens (including M, NP and ORF3) were found in those who had been infected by SARS-CoV-2 but were rare in pre-pandemic and unexposed seronegative subjects. However, seronegative doctors with high occupational exposure and recent COVID-19 compatible illness showed patterns of T cell responses characteristic of infection, indicating that these readouts are highly sensitive. By contrast, over 90% of convalescent or unexposed people showed proliferation and cellular lactate responses to spike subunits S1/S2, indicating pre-existing cross-reactive T cell populations. The detection of T cell responses to SARS-CoV-2 is therefore critically dependent on the choice of assay and antigen. Memory responses to specific non-spike proteins provides a method to distinguish recent infection from pre-existing immunity in exposed populations.

Alimentação e diabetes: material de educação alimentar e nutricional para profissionais de saúde no contexto da atenção primária à saúde / Food and diabetes: food and nutrition education material for health professionals in the context of primary health care

Durante minha prática ambulatorial, na Residência Multiprofissional em Saúde do Grupo Hospitalar Conceição, percebi que a maior demanda dos encaminhamentos estava relacionada aos pacientes diabéticos, doença de grande prevalência e responsável por taxas elevadas de morbidade e mortalidade. O Diabetes tipo 2 compreende cerca de 90% dos casos de diabetes na população. Considerando-se que o diabetes é uma condição de saúde sensível à atenção primária à saúde (APS), é possível evitar hospitalizações e mortes decorrentes de suas complicações. Nesse coletivo, foram trabalhadas diversas temáticas sobre diabetes. Pude observar a grande demanda que os participantes traziam sobre alimentação, mesmo que não fosse o tema do encontro no dia. Em ambas as situações, senti falta de materiais educativos que auxiliassem no processo de educação alimentar e nutricional (EAN), inerente ao aconselhamento nutricional individual e coletivo. Nesse sentido, optei por centrar meu TCR nesse tema: a produção de materiais educativos sobre alimentação e diabetes para uso em atendimento individual e/ou coletivo no cenário da atenção primária à saúde. Os materiais educativos aqui propostos foram concebidos na perspectiva do autocuidado, visando um processo de mudança do comportamento alimentar centrado em um indivíduo capaz de mudar a realidade na qual está condicionado. Os materiais educativos aqui propostos, quando integrados a um processo de trabalho multiprofissional, têm por objetivo melhorar os padrões de alimentação e nutrição dos pacientes diabéticos atendidos na APS, assim como contribuir para a promoção da saúde dessa população. (AU)

Fragilidade na formação dos profissionais de saúde quanto à Língua Brasileira de Sinais: reflexo na atenção à saúde dos surdos / Fragility in the training of health professionals regarding the Brazilian Sign Language: a reflection on the health care of the deaf

RESUMO Objetivos Identificar como é a formação de profissionais da saúde quanto à Língua Brasileira de Sinais (Libras). Métodos Trata-se de estudo descritivo e transversal, desenvolvido com dados secundários, coletados no banco de dados eletrônico do Ministério da Educação. Foram analisados a grade curricular e o projeto pedagógico de todos os cursos de graduação na área da saúde em Instituições de Ensino Superior (IES) brasileiras, procurando-se identificar e caracterizar a disciplina de Libras. Resultados Foram localizados 5317 cursos e, destes, 2293 (43,1%) ofereciam disciplina de Libras, sendo 16,7% como disciplina obrigatória e a maioria (83,3%) como optativa. Em relação ao período ofertado, não houve um padrão, variando desde o primeiro até o décimo. Quanto à carga horária destinada à disciplina, dentre os 2077 cursos que disponibilizavam essa informação, 11,1% ofertavam a disciplina com carga horária de até 20 horas, 49,4% com carga horária entre 21 e 40 horas, 29,9% entre 41 e 60 horas, 9,1% entre 61 e 80 horas. Apenas 0,5% dos cursos destinavam mais que 80 horas para o ensino de Libras. Em média, os cursos de graduação em IES públicas (N=217) dedicavam 53,1 horas ao ensino de Libras, enquanto os cursos de IES privadas (N=1860) dedicavam 45,8 horas. Conclusão Há evidências de fragilidade na formação dos profissionais de saúde quanto ao ensino da Libras, o que reflete diretamente no atendimento integral dos surdos.

ABSTRACT Purpose To identify how Brazilian Sign Language (Libras) training is being conducted in undergraduate health care courses at Higher Education Institutions. Methods This is a descriptive and cross-sectional study, developed using secondary data taken from the Ministry of Education electronic database. The curriculum and pedagogical design of all undergraduate health care courses at Brazilian Higher Education Institutions (HEIs) were analyzed, aiming to identify and characterize the Libras discipline. Results 5317 courses were found and, from these, 2293 (43.1%) offered Libras, 16.7% as mandatory and the majority (83.3%) as optional. Regarding the period offered, there was no pattern, ranging from the first to the tenth. Regarding the workload for the discipline, among the 2077 courses that provided this information, 11.1% offered the discipline with a workload of up to 20 hours, 49.4% with a workload between 21 and 40 hours, 29.9% between 41 and 60 hours, and 9.1% between 61 and 80 hours. Only 0.5% of the courses devoted more than 80 hours to teaching Libras. On average, undergraduate courses in public HEIs (N = 217) devoted 53.1 hours to teaching Libras, while private HEI courses (N = 1860) dedicated 45.8 hours. Conclusion There is evidence of weakness in training programs for health professionals regarding teaching Libras, which directly reflects in comprehensive care for the deaf.

Allelopathic activity and chemical constituents of extracts from roots of Euphorbia heterophylla L.

Euphorbia heterophylla L. is regarded as a major weed worldwide. Its high aggressiveness in agricultural environment prompted us to investigate the allelopatic activity and chemical constitution of extracts from roots of this plant. Hexane extract showed low phytotoxic activity. Methanol extract at 2.0 mg mL-1 inhibited 100% of germination, root and shoot growth of the indicator plants Sorghum bicolor and Lactuca sativa. ß-sitosterol, stigmasterol, and esters of lupeol, germanicol, taraxasterol, pseudotaraxasterol, α-amyrin and ß-amyrin were isolated from the hexane extract and their structures elucidated on the basis of MS and 1H, 13C and DEPT-135 NMR data. GC-MS analysis of the derivatized methanol extract allowed for identifying a series of allelopathic organic acids potentially involved in allelopathic interactions of E. heterophylla. This is the first study on the allelopathic activity of extracts and identification of metabolites from roots of E. heterophylla.

A Guide for Planning and Implementing Successful Mental Health Educational Programs.

INTRODUCTION: Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. METHODS: The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. RESULTS: We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. IMPLICATIONS FOR PRACTICE: These results will be helpful for planning and improving the quality of future educational programs in mental health.

Axillary nerve neurotization by a triceps motor branch: comparison between axillary and posterior arm approaches / Neurotização do nervo axilar por um ramo do tríceps: comparação entre acesso axilar e posterior

ABSTRACT Objectives: This study is aimed at comparing the functional outcome of axillary nerve neurotization by a triceps motor branch through the axillary approach and posterior arm approach. Methods: The study included 27 patients with post-traumatic brachial plexus injury treated with axillary nerve neurotization by a triceps motor branch for functional recovery of shoulder abduction and external rotation. The patients were retrospectively evaluated and two groups were identified, one with 13 patients undergoing axillary nerve neurotization by an axillary approach and the second with 14 patients using the posterior arm approach. Patients underwent assessment of muscle strength using the scale recommended by the British Medical Research Council, preoperatively and 18 months postoperatively, with useful function recovery considered as grade M3 or greater. Results: In the axillary approach group, 76.9% of patients achieved useful abduction function recovery and 69.2% achieved useful external rotation function recovery. In the group with posterior arm approach, 71.4% of patients achieved useful abduction function recovery and 50% achieved useful external rotation function recovery. The difference between the two groups was not statistically significant (p = 1.000 for the British Medical Research Council abduction scale and p = 0.440 for external rotation). Conclusion: According to the British Medical Research Council grading, axillary nerve neurotization with a triceps motor branch using axillary approach or posterior arm approach shows no statistical differences.

RESUMO Objetivos: Comparar o resultado funcional da neurotização do nervo axilar por um ramo motor do tríceps através do acesso axilar e do acesso posterior. Métodos: Foram incluídos no estudo 27 pacientes com lesão pós-traumática de plexo braquial submetidos à neurotização do nervo axilar por um ramo motor do tríceps para recuperação funcional do ombro de 2010 a 2014. Os pacientes foram avaliados e dois grupos foram identificados, um com 13 pacientes submetidos a neurotização do nervo axilar por um acesso axilar e o segundo com 14 pacientes nos quais foi usada a via de acesso posterior. Os pacientes foram submetidos a avaliação da força muscular com a escala preconizada pelo British Medical Research Council (BMRC) no pré-operatório e com 18 meses de pós-operatório, foi considerada força motora efetiva graduação M3 ou maior. Resultados: No grupo que fez o acesso axilar, 76,9% dos pacientes obtiveram força motora efetiva de abdução e 69,2% de rotação externa. Já no grupo com acesso posterior, 71,4% dos pacientes conseguiram força motora efetiva de abdução e 50% de rotação externa. A diferença entre os dois grupos não foi estatisticamente significante (p = 1,000 para escala BMRC de abdução e p = 0,440 para rotação externa). Conclusão: Na avaliação da graduação de força na escala BRMC, o uso do acesso axilar para neurotização de um ramo motor do tríceps para o nervo axilar não apresenta diferenças estatísticas em relação ao uso do acesso posterior.

Axillary nerve neurotization by a triceps motor branch: comparison between axillary and posterior arm approaches.

OBJECTIVES: This study is aimed at comparing the functional outcome of axillary nerve neurotization by a triceps motor branch through the axillary approach and posterior arm approach. METHODS: The study included 27 patients with post-traumatic brachial plexus injury treated with axillary nerve neurotization by a triceps motor branch for functional recovery of shoulder abduction and external rotation. The patients were retrospectively evaluated and two groups were identified, one with 13 patients undergoing axillary nerve neurotization by an axillary approach and the second with 14 patients using the posterior arm approach. Patients underwent assessment of muscle strength using the scale recommended by the British Medical Research Council, preoperatively and 18 months postoperatively, with useful function recovery considered as grade M3 or greater. RESULTS: In the axillary approach group, 76.9% of patients achieved useful abduction function recovery and 69.2% achieved useful external rotation function recovery. In the group with posterior arm approach, 71.4% of patients achieved useful abduction function recovery and 50% achieved useful external rotation function recovery. The difference between the two groups was not statistically significant (p = 1.000 for the British Medical Research Council abduction scale and p = 0.440 for external rotation). CONCLUSION: According to the British Medical Research Council grading, axillary nerve neurotization with a triceps motor branch using axillary approach or posterior arm approach shows no statistical differences.

OBJETIVOS: Comparar o resultado funcional da neurotização do nervo axilar por um ramo motor do tríceps através do acesso axilar e do acesso posterior. MÉTODOS: Foram incluídos no estudo 27 pacientes com lesão pós-traumática de plexo braquial submetidos à neurotização do nervo axilar por um ramo motor do tríceps para recuperação funcional do ombro de 2010 a 2014. Os pacientes foram avaliados e dois grupos foram identificados, um com 13 pacientes submetidos a neurotização do nervo axilar por um acesso axilar e o segundo com 14 pacientes nos quais foi usada a via de acesso posterior. Os pacientes foram submetidos a avaliação da força muscular com a escala preconizada pelo British Medical Research Council no pré-operatório e com 18 meses de pós-operatório, foi considerada força motora efetiva graduação M3 ou maior. RESULTADOS: No grupo que fez o acesso axilar, 76,9% dos pacientes obtiveram força motora efetiva de abdução e 69,2% de rotação externa. Já no grupo com acesso posterior, 71,4% dos pacientes conseguiram força motora efetiva de abdução e 50% de rotação externa. A diferença entre os dois grupos não foi estatisticamente significante (p = 1,000 para escala British Medical Research Council de abdução e p = 0,440 para rotação externa). CONCLUSÃO: Na avaliação da graduação de força na escala British Medical Research Council, o uso do acesso axilar para neurotização de um ramo motor do tríceps para o nervo axilar não apresenta diferenças estatísticas em relação ao uso do acesso posterior.

Effect of photodynamic therapy in the reduction of halitosis in patients with multiple sclerosis: clinical trial.

Smell and odours play a vital role in social interaction. Halitosis is a social problem that affects one third of the population, causing a negative impact on the quality of life. There is little knowledge on the prevalence and management of halitosis in multiple sclerosis (MS) patients. The present study aims to evaluate the presence of halitosis in patients with MS when compared to a control group, and also evaluate treatment of the problem with antimicrobial photodynamic therapy (aPDT). This is a case-control clinical study in which 60 patients were evaluated: 30 MS patients in treatment at the Specialties Clinic School of Medicine, and 30 healthy patients, matched in age and gender for the control group. Data was collected on the duration of the disease as well as the degree of disability and medication use in the MS group. For all patients, halitosis was assessed with Oral Chroma™. Individuals with halitosis underwent treatment with tongue scraping and aPDT. The photosensitizer was methylene blue (0.005%) and a THERAPY XT-EC® laser (660 nm, 9 J, 100 mW for 90 s per point, 320 J cm-2, 3537 mW cm-2) was used. Six points 1 cm apart from each other were irradiated in the tongue dorsum. There was a positive correlation between the disability and disease duration. No parameter was correlated with halitosis. Patients with MS have higher levels of SH2 compounds when compared to the control group (p = 0.003, Mann-Whitney), but after aPDT both groups significantly reduced the levels to under the halitosis threshold. The aPDT scraping treatment was effective in the immediate reduction of halitosis in both groups.

Distance Learning Course for Healthcare Professionals: Continuing Education in Tuberculosis.

BACKGROUND: Continuing education of healthcare workers (HCWs) is an essential strategy for the control of tuberculosis (TB) transmission, enabling HCWs in early detection and appropriate treatment of TB cases. METHODS: We developed a distance learning (DL) course on TB for nurses. We conducted a quasi-experimental before and after study to evaluate the DL community at the participant's learning level. In addition, to evaluate the DL community at the level of participant satisfaction, a cross-sectional study was carried out after the course. Nurses involved in active inpatient or outpatient care of patients were recruited to participate in the study. RESULTS: Sixty-six participants started and completed the course and they were included in the analysis. The overall mean pretest and post-test scores were 10.3 ± 2.2 and 11.4 ± 2.7, respectively. Participants increased their knowledge to a statistically significant degree (p < 0.0001). At baseline, the frequency of correct answers was very low in some questions: number of people infected by Mycobacterium tuberculosis in the world (10.6%); number of TB cases in Brazil (36.4%); contagiousness of latent TB infection (LTBI) (28.8%); and definition of active case finding (45.5%). Course feedback was mostly positive, with majority of users saying they were satisfied or totally satisfied. CONCLUSIONS: A brief DL course on TB was associated with some improvement in knowledge among nurses. The baseline knowledge was low regarding TB epidemiologic data, concepts on LTBI, and active case finding. This finding emphasizes the need to further improve the competencies and knowledge of nurses.

High-Definition Video System for Peripheral Neurorrhaphy in Rats.

BACKGROUND: Although all microsurgeries are based on the use of surgical microscopes, several alternative magnification systems have shown promising results. Improvements in image quality facilitated the use of video systems in microsurgeries with safety and accuracy. The aim of this study was to evaluate the use of a low-cost, video-assisted magnification system in peripheral neurorrhaphy in rats. METHODS: Twenty Wistar rats were randomly divided into 2 matched groups according to the magnification system used: the microscope group, with neurorrhaphy performed under a microscope with an image magnification of 40×; and the video system group, with the procedures performed under a video system composed of a high-definition Sony camcorder DCR-SR42 set to 52× magnification, macro lenses, 42-inch television, and a digital HDMI cable. We analyzed weight, nerve caliber, total surgery time, neurorrhaphy time, number of stitches, and number of axons in both ends (proximal and distal). RESULTS: There were no significant differences between groups in weight, nerve caliber, or number of stitches. Neurorrhaphy under the video system took longer (video: 5.60 minutes; microscope: 3.20 minutes; P < .05). Number of axons was similar between groups, both in proximal and distal stumps. CONCLUSION: It is possible to perform a peripheral neurorrhaphy in rats through video system magnification, but with a longer surgical time.

A Low-Cost High-Definition Video System for Microsurgical Hindlimb Replantation in Rats.

Background The surgical microscope is still essential for microsurgery, but several alternatives that show promising results are currently under development, such as endoscopes and laparoscopes with video systems; however, as yet, these have only been used for arterial anastomoses. The aim of this study was to evaluate the use of a low-cost video-assisted magnification system in replantation of the hindlimbs of rats. Methods Thirty Wistar rats were randomly divided into two matched groups according to the magnification system used: the microscope group, with hindlimb replantation performed under a microscope with an image magnification of 40× and the video group, with the procedures performed under a video system composed of a high-definition camcorder, macrolenses, a 42-in television, and a digital HDMI cable. The camera was set to 50× magnification. We analyzed weight, arterial and venous caliber, total surgery time, arterial and venous anastomosis time, patency immediately and 7 days postoperatively, the number of stitches, and survival rate. Results There were no significant differences between the groups in weight, arterial or venous caliber, or the number of stitches. Replantation under the video system took longer (p < 0.05). Patency rates were similar between groups, both immediately and 7 days postoperatively. Conclusion It is possible to perform a hindlimb replantation in rats through video system magnification, with a satisfactory success rate comparable with that for procedures performed under surgical microscopes.

Recovering lead from cupel waste generated in gold analysis by Pb-Fire assay.

Because of its precision and accuracy, Pb-Fire assay is the most employed method for gold analysis in geological materials. At the second stage of the method, namely cupellation, lead is oxidized to PbO which is absorbed by the cupel, leading to metallic gold as a tiny bend at the bottom of the recipient. After cupellation, cupel becomes highly contaminated with lead, making its disposal a serious risk of environmental contamination. In the present work, a leaching process for removing lead from cupel waste is proposed, which allowed for removing 96% of PbO by weight. After a precipitation step, 92.0% of lead was recovered from leachates in the form of PbSO4. Lead in the solid wastes left by the extraction was above the limit established by Brazilian legislation and these were classified as non-hazardous. Finally, secondary effluents generated after the precipitation step presented lead content more than twenty times lower than that of leachates from cupel waste. Tons of cupel waste are annually generated from gold analysis by Pb-Fire assay. Thus, the proposed method can contribute to prevent the discharge of high amounts of lead into the environment. Also, recovery of lead can help to partially meet the industrial demand for lead compounds.