The Influence of Body Fat and Lean Mass on HbA1c and Lipid Profile in Children and Adolescents with Type 1 Diabetes Mellitus.

Glycated hemoglobin (HbA1c) is used to assess glycemic control in Type 1 diabetes (DM1) patients. Apolipoproteins play an essential role in DM1 pathophysiology and may be associated with complications and HbA1c. This cross-sectional observational study of 81 children and adolescents of both sexes diagnosed with DM1 investigated the relationship between body fat distribution and lean mass with HbA1C and apolipoprotein values, analyzing biochemical and body composition measurements. A Shapiro-Wilk test with Lilliefors correction, a non-parametric Mann-Whitney test, and others were used with a significance level of 5%. The sample had a diagnosis time of 4.32 years and high blood glucose levels (mean 178.19 mg/dL) and HbA1c (mean 8.57%). Subjects also had a moderate level of adiposity, as indicated by arm and thigh fat areas. The study also found significant differences in the distribution of patients concerning levels of apolipoproteins A and B, with a smaller proportion of patients having undesirable levels. Finally, the study found a significant difference in the distribution of patients with estimated cardiovascular risk based on the ApoB/ApoA-I ratio. Conclusively, visceral fat in children and adolescents with DM1 may increase the risk of DM1 long-term complications owing to its association with elevated HbA1C and apolipoprotein values.

Algorithms for automated diagnosis of cardiovascular diseases based on ECG data: A comprehensive systematic review.

The prevalence of cardiovascular diseases is increasing around the world. However, the technology is evolving and can be monitored with low-cost sensors anywhere at any time. This subject is being researched, and different methods can automatically identify these diseases, helping patients and healthcare professionals with the treatments. This paper presents a systematic review of disease identification, classification, and recognition with ECG sensors. The review was focused on studies published between 2017 and 2022 in different scientific databases, including PubMed Central, Springer, Elsevier, Multidisciplinary Digital Publishing Institute (MDPI), IEEE Xplore, and Frontiers. It results in the quantitative and qualitative analysis of 103 scientific papers. The study demonstrated that different datasets are available online with data related to various diseases. Several ML/DP-based models were identified in the research, where Convolutional Neural Network and Support Vector Machine were the most applied algorithms. This review can allow us to identify the techniques that can be used in a system that promotes the patient's autonomy.

Thought on Food: A Systematic Review of Current Approaches and Challenges for Food Intake Detection.

Nowadays, individuals have very stressful lifestyles, affecting their nutritional habits. In the early stages of life, teenagers begin to exhibit bad habits and inadequate nutrition. Likewise, other people with dementia, Alzheimer's disease, or other conditions may not take food or medicine regularly. Therefore, the ability to monitor could be beneficial for them and for the doctors that can analyze the patterns of eating habits and their correlation with overall health. Many sensors help accurately detect food intake episodes, including electrogastrography, cameras, microphones, and inertial sensors. Accurate detection may provide better control to enable healthy nutrition habits. This paper presents a systematic review of the use of technology for food intake detection, focusing on the different sensors and methodologies used. The search was performed with a Natural Language Processing (NLP) framework that helps screen irrelevant studies while following the PRISMA methodology. It automatically searched and filtered the research studies in different databases, including PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Then, the manual analysis selected 30 papers based on the results of the framework for further analysis, which support the interest in using sensors for food intake detection and nutrition assessment. The mainly used sensors are cameras, inertial, and acoustic sensors that handle the recognition of food intake episodes with artificial intelligence techniques. This research identifies the most used sensors and data processing methodologies to detect food intake.

Can the Eight Hop Test Be Measured with Sensors? A Systematic Review.

Rehabilitation aims to increase the independence and physical function after injury, surgery, or other trauma, so that patients can recover to their previous ability as much as possible. To be able to measure the degree of recovery and impact of the treatment, various functional performance tests are used. The Eight Hop Test is a hop exercise that is directly linked to the rehabilitation of people suffering from tendon and ligament injuries on the lower limb. This paper presents a systematic review on the use of sensors for measuring functional movements during the execution of the Eight Hop Test, focusing primarily on the use of sensors, related diseases, and different methods implemented. Firstly, an automated search was performed on the publication databases: PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Secondly, the publications related to the Eight-Hop Test and sensors were filtered according to several search criteria and 15 papers were finally selected to be analyzed in detail. Our analysis found that the Eight Hop Test measurements can be performed with motion, force, and imaging sensors.

Prevalence of Coxiella burnetii antibodies in Portuguese dairy cattle herds.

Q fever is an important zoonotic disease which has been recently diagnosed, mainly in sheep and goats, in Portugal. The aim of the present study was to determine the prevalence of bovine Coxiella burnetii antibodies in dairy farms from the northwest of Portugal. Bulk tank milk samples were randomly obtained, on November 2013, from 90 dairy farms and assayed using an ELISA kit. The apparent prevalence was 61.1% (95% C.I. from 50.8 to 70.5%). The proportion of negative and intermediate (inconclusive) herds was 34.5% (25.5 to 44.7%) and 4.4% (1.7 to 10.9%), respectively. In conclusion, a high level of exposure to Coxiella burnetii was observed in Portuguese dairy cattle herds, highlighting the needs to better understand the epidemiology of Q fever in Portugal by the implementation of a monitoring program based on harmonized serologic and molecular methodologies and elucidation of the infection status of the herds.

Gestão em terapia intensiva: conceitos e inovações / Management in intensive care: concepts and innovations

JUSTIFICATIVA E OBJETIVOS: Atualmente, várias propostas são feitas com o objetivo de resolver ou pelo menos, controlar o grande problema da gestão na área da saúde: reduzir ou conter custos ao mesmo tempo em que a melhoria contínua da qualidade é promovida. A Unidade de Terapia Intensiva (UTI) é um dos setores mais importantes do hospital, local onde mudanças são essenciais. A procura por modelos em que medicina baseada em evidênciase utilização de rotinas e protocolos em UTI convivam como conceito de gestão ocorre em velocidade nunca vista antes. Cabe ao líder da UTI, tornar o setor modelo de unidade de negócios,preocupando-se com aspectos financeiros, segurança, qualidade, educação e inovação no atendimento ao cliente interno e externo. CONTEÚDO: Revisão da literatura incluindo modelos estudados e aplicados em outras áreas de conhecimento humano, bem como a proposta inovadora da utilização do instrumento Product Lifecycle Management (PLM) como opção de implementação de serviços médicos em UTI. CONCLUSÃO: O conhecimento de conceitos fundamentais e aplicação de modelos de gestão que priorizam a redução de margem de erro, segurança e aplicação da medicina baseada em evidência para o paciente crítico, podem estar relacionados a melhor utilização de recursos em Medicina Intensiva, colaborando na solução do dilema da área da saúde, manter qualidade e conter ou reduzir custos.

BACKGROUND AND OBJECTIVES: As each day passes, various proposals are made to resolve or at least control the major problem of health care: to reduce or contain costs at the same time as continuous quality improvement is promoted. One of the most important sectors of a hospital, where changes are essential,is the Intensive Care Unit (ICU). The search for models in which evidence-based medicine and the use of routines and protocols in ICU mingle with the concept of management occurs at a rate never seen before. It is for the leader of ICU, making the sector a business model unit, concerned with financial aspects, safety, quality, education and innovation in customer service. CONTENTS: Review of literature including models studied and applied in other areas of human knowledge and a innovative approach,using the tool Product Lifecycle Management (PLM), asan option for implementation of medical services in Intensive Care Units. CONCLUSION: Knowledge of fundamental concepts and application of management models that emphasize the reduction of error, security and implementation of evidence-based medicine for the critically ill patient, may be related to better utilization of resources in intensive care, collaborating in the solution of health care dilemma, maintain quality and contain or reduce costs.

Nubac disc arthroplasty: preclinical studies and preliminary safety and efficacy evaluations.

BACKGROUND: Disc arthroplasty is gaining popularity for treatment of low-back pain caused by degenerative disc disease (DDD). It can involve total disc replacement or partial disc or nucleus replacement (or augmentation). Compared with total disc replacement, nucleus replacement is less invasive, has less surgical risk, has faster postoperative recovery, and doesn't "burn bridges" should further surgery be required. However, nucleus replacement has a high risk of implant expulsion because the device is not fixed to the vertebrae. Nubac is the first polyetheretherketone (PEEK)-on-PEEK articulated disc arthroplasty device designed to optimally restore the lumbar anatomy and biomechanics. METHODS: ISO 10993 standards were used to evaluate the biocompatibility of the PEEK material. Chemical and thermal-mechanical tests and in vivo study assessed PEEK's biostability after exposure to high g irradiation and harsh oxidative conditions. Biomechanical tests to evaluate kinematic properties and anatomical restoration of the implanted lumbar motion segments and implant expulsion risk assessments were performed with a human cadaveric model. Because of the novelty of PEEK-on-PEEK as a self-mating articulating material, extensive wear tests were conducted with unidirectional and coupled motions. Static and fatigue strength also were tested. Animal study with a baboon model was conducted with gross, radiographic, biomechanical, and histological evaluations at 6 and 12 months postoperatively. Preliminary clinical data were collected through a prospective multicenter cohort study. RESULTS: PEEK demonstrated exceptional biocompatibility and biodurability. Nubac restored disc height and motion segment range of motion. The unique articulating design of the Nubac demonstrated low risk of implant expulsion in a human cadaveric model. Wear tests showed that the Nubac has minimal wear and compares favorably to other disc arthroplasty materials. The Nubac also had excellent static and fatigue properties for the intended application. The animal study showed that the Nubac caused no adverse local or systematic tissue reaction and there was no detectable wear debris. The preliminary clinical data showed no major intraoperative vascular and neurological complications. There was significant Visual Analog Scale and Oswestry Disability Index score improvement. CONCLUSIONS: The preclinical data supported the design rationale, and the preliminary clinical data (level II evidence) on safety and efficacy were encouraging. CLINICAL RELEVANCE: The Nubac could be a viable first surgical option for patients with back pain caused by DDD.

Resistência a microtração entre uma cerâmica hidrotérmica e um cimento resinoso, submetidos ou não à ciclagem térmica / Microtensile bond strength between a hidrotermal ceramic and a resin cement, submitted or not to thermal cycling treatment

Objetivou-se, com este trabalho, avaliar por ensaio de microtração, a resistência adesiva entre uma cerâmica (Symbio Ceram, Degussa Dental) e um cimento resinoso (Panavia F, Kuraray), submetidos ou não à ciclagem térmica. Para tanto, foram obtidos três blocos cerâmicos com dimensões de 5mmx6mmx6mm; sua suprefície de colagem (6mm x 5mm) foi polida com lixa (#600), acondicionada com ácido fluorídrico a 10% e silanizada, de acordo com as recomendações do fabricante. A seguir, os blocos foram cimentados a outros de resina composta com as mesmas dimensões, sob carga de 1 Kg. Após isso, foram mantidos em água destilada à temperatura ambiente durante 7 dias e cortados de forma a se obteram 20 corpos-de-prova com dimentsões de 10mmx1mmx1mm, propiciando área adesiva de 1mm²±0,1mm² e dividios em dois grupos submetidos aos seguintes tratamentos: G1 (controle) - manutenção em água destilada a temperatura ambiente durante três dias - e G2 - ciclagem térmica (1500 ciclos) em dois banhos (5ºC e 55ºC), com tempo de permanência de 30 segundos cada, após o que, foram tracionados em máquinas de ensaio universal (EMIC), com célula de carga de 10kgf e velocidade de 0,5mm.min-1. Os resultados númericos (MPa) foram lançados em tabela própria e submetidos à análise estatística Mann-Whitney (alfa=0,05), demonstrando que G1 (27,06±10,59) não diferiu estatisticamente de G2 (22,55±4,81). Considerando a metodologia aplicada e os resultados obtidos, parece-nos lícito concluir que a ciclagem térmica não influenciou a resistência adesiva entre os materiais estudados

Avaliação da dureza superficial das resinas compostas: efeito da complementação da fotopolimerização por diferentes métodos / Evaluation of the superficial hardness of resin composite: effect of complement of light curing for diferent methods

O objetivo desta pesquisa foi avaliar a dureza superficial das resinas compostas, comparando o efeito da fotopolimerização convencional com a complementação da polimerização por dois métodos diferentes: a fototermopolimerização, mediante o uso do Light Box, e a pneumotermopolimerização, utilizando uma autoclave. Os resultados mostraram que a complementação da fotopolimerização aumenta a dureza das resinas compostas, independente do método utilizado

Cerômeros: avaliação da microdureza superficial, efeito de marcas comerciais / Ceromer: superficial microhardness evaluation, trademark effect

O propósito deste estudo foi avaliar in vitro a microdureza superficial de dois cerômeros de diferentes fabricantes, sendo divididos em dois grupos: G1 - Targis (Ivoclar) e G2 - Artglass (Heraeus Kulzer). Foi confeccionada uma matriz de aço inoxidável, medindo 6 mm de diâmetro por 2 mm de altura. Para confecção dos corpos-de-prova, os materiais foram inseridos em um único incremento com os instrumentais fornecidos pelos seus respectivos fabricantes, sobre este material foi colocada uma tira de poliéster, uma placa de vidro fina e por último foi colocado um peso de 1 kg. Em seguida, o peso e a placa de vidro foram retiradas e a matriz levada à unidade polimerizadora correspondente ao material utilizado. Foram confeccionados 10 corpos-de-prova para cada material. O armazenamento dos corpos-de-prova foi feito em um vidro de cor âmbar, contendo água destilada, e mantidos em estufa de 37±1ºC por 24 horas. O aparelho utilizado foi um microd-urômetro eletrônico acoplado a um monitor Future Tech-FM. A leitura adotada foi a Knoop, com aplicação de força de 25g por um tempo de 30 segundos. A leitura da microdureza foi à média de cinco pontos de aplicação de força, feitos dentro do perímetro da circunferência do corpo-de-prova. A partir dos resultados obtidos, pudemos concluir que: os cerômeros estudados apresentaram microdurezas superficiais diferentes e estatisticamente significantes; o material G1 apresentou valores de microdureza superficial maiores, em relação ao G2

Fraturas do piläo tibial: avaliaçäo do tratamento em 25 pacientes / Tibial pilon fractures: evaluation of the treatment in 25 patients

Os autores analisam 25 pacientes portadores de fraturas do pilpo tibial ocorridas entre janeiro de 1989 e julho de 1995, com seguimento médio de 3 anos (mínimo de 1 ano e máximo de 6 anos e 6 meses) e idade variando de 19 a 60 anos (média de 42 anos). Todas as fraturas foram causadas por queda de altura ou acidente automobilístico. As fraturas foram classificadas de acordo com Müller (1991), sendo somente incluídos os tipos B e C. O tratamento conservador foi eficaz nas fraturas articulares simples. O tratamento cirúrgico, com reduçäo aberta e fixaçäo interna, foi utilizado quando as condiçöes de pele eram favoráveis; caso contrário, utilizaram-se fixador externo e sfntese percutânea. Os resultados foram relacionados ao tipo de fratura, condiçöes de pele e tratamento realizado. Obtiveram-se 76 por cento de resultados satisfatórios, segundo o critério clínico objetivo de Ayeni. O tipo de fratura e as condiçöes de partes moles tiveram influência no resultado final. A presença e o grau de artrose näo se correlacionaram, bem com os resultados clínicos subjetivos.