ORTHOSTATIC SUPPORT IN PARAPLEGIC AND AMPUTEE PATIENTS: A CONTROLLED TRIAL.

Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.

Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento.

Minimum acceptable diet in a cohort of children aged between 6 and 15 months: Complementary feeding assessment and associated factors in the Brazilian western Amazon.

OBJECTIVE: The goal of the article was to assess complementary feeding patterns, and associated factors, of children between 6 and 15-month old in Rio Branco-Acre, Brazil, based on the minimum acceptable diet indicator. METHODS: This study was cross-sectional, including 857 children between ages 6 and 15 mo, from a 2015 birth cohort of Rio Branco, Brazil. The prevalence of complementary feeding indicators, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet was estimated based on the recommendations of the World Health Organization. Sociodemographic characteristics, infant and maternal habits, prenatal information, birth characteristics, breastfeeding, and complementary feeding were evaluated. Differences between the proportions were evaluated by the χ2 test and univariate and multiple logistic regression analyses, to determine associated factors with child minimum acceptable diet. RESULTS: The minimum frequencies of meals and dietary diversity were observed in 81.0% and 51.8% of the children, respectively. The minimum acceptable diet prevalence was 47.1%. Also, minimum acceptable diet was inversely associated with C, D, and E social classes (adjusted odds ratio = 0.49; 95% CI, 0.33-0.72), number of living siblings (adjusted odds ratio for two or three children = 0.69; 95% CI, 0.48-0.98, and adjusted odds ratio for ≥ 4 children = 0.56; 95% CI, 0.37-0.84). Maternal regular consumption of fruits, vegetables, and legumes (adjusted odds ratio = 2.62; 95% CI, 1.69-4.05), child age from 12 to 15 mo (adjusted odds ratio = 2.05; 95% CI, 1.32-3.18), and receiving guidance regarding complementary feeding during postnatal consultations (adjusted odds ratio = 1.38; 95% CI, 1.03-1.86) were directly associated with minimum acceptable diet. CONCLUSIONS: Fewer than 50% of the children received adequate food with adequate frequency and diversity. Low socioeconomic status and having ≥ 2 living siblings reduced the chance of minimum acceptable diet, whereas maternal healthy diet, child age (12-15 mo), and complementary feeding counseling during postnatal appointments increased the chance of minimum acceptable diet.

Orthostatic support in paraplegic and amputee patients: a controlled trial / Suporte ortostático em paraplégicos e amputados: um ensaio controlado

ABSTRACT Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.

RESUMO Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento.

Pressure pain threshold in people with amputation submitted to the use of postural lifting equipment: crossover experimental study / Limiar de dor por pressão em pessoas com amputação submetidas ao uso de equipamento de elevação postural: um estudo experimental cruzado

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation is an event that has consequences that can affect daily life, including pain, enhancing changes, whether in sleep or in quality of life. The objective of this study was to evaluate the pressure pain threshold (PPT) in people with amputations submitted to the use of different postural elevation equipment. METHODS: Experimental crossover study, carried out from September to October 2022, with people with lower limb amputation (n=15) and people without amputation (n=15). PPT in four regions (T12-L1, L5-S1, anterior tuberosity of the tibia and calcaneus) were evaluated before and after the use of different versions (A and B) of an equipment for postural elevation, gravity and pain interference. Presence of signs and symptoms of central sensitization (CS) and sleep quality. RESULTS: The groups did not present PPT alterations when compared between the different versions of the equipment (p<0.05) in the four locations analyzed. Furthermore, the groups did not show differences in relation to the evaluation days or among themselves regarding the severity and interference of pain and the presence of signs and symptoms of CS. The control group indicated poor sleep quality (p=0.0173) and remained worse than people with amputation. CONCLUSION: The versions of the equipment did not change PPT in the analyzed areas. The groups did not differ between themselves, suggesting that the equipment promoted similar responses, that is, no change in sensitivity was evidenced in the analyzed regions which have greater contact with stabilization elements and weight discharge of the equipment.

RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação é um evento que acarreta consequências que podem afetar o cotidiano, entre elas a dor, potencializando alterações, seja no sono ou na qualidade de vida. O objetivo deste estudo foi avaliar o limiar de dor por pressão (LDP) em pessoas com amputação submetidas ao uso de diferentes equipamentos de elevação postural. MÉTODOS: Estudo experimental cruzado, realizado de setembro a outubro de 2022, com pessoas com amputação no membro inferior (n=15) e pessoas sem amputação (n=15). Foram avaliados o LDP em quatro regiões (T12-L1, L5-S1, tuberosidade anterior da tíbia e calcâneo) pré e pós uso de distintas versões (A e B) de um equipamento de elevação postural, gravidade e interferência da dor. Presença de sinais e sintomas de sensibilização central (SC) e qualidade do sono. RESULTADOS: Os grupos não apresentaram alterações no LDP quando comparados em relação às diferentes versões do equipamento (p<0,05) nos quatro locais analisados. Além disso, os grupos não mostraram diferenças em relação aos dias de avaliação ou entre si quanto a severidade e interferência de dor e presença de sinais e sintomas de SC. O grupo controle indicou uma qualidade de sono ruim (p=0,0173) e manteve-se pior que as pessoas com amputação. CONCLUSÃO: As versões do equipamento não alteraram o LDP nas áreas analisadas. Os grupos não apresentaram diferença entre si, sugerindo que o equipamento promoveu respostas semelhantes, ou seja, não foi evidenciada uma alteração de sensibilidade nas regiões que possuem maior contato com elementos de estabilização e descarga de peso dos equipamentos.

Effect of prenatal care quality on the risk of low birth weight, preterm birth and vertical transmission of HIV, syphilis, and hepatitis.

BACKGROUND: Averse birth-outcomes still affect newborns worldwide. Although high-quality prenatal care is the main strategy to prevent these outcomes, the effect of prenatal care based on Kotelchuck index combined with consultation contents is still unclear. Thus, this article to evaluate the effect of the quality of prenatal care (PC) process on birth indicators in a cohort of puerperaes who attended maternity hospitals in Brazilian western Amazon, city of Rio Branco, in the state of Acre, Brazil, in 2015. METHODS: This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in the city between April 6 and June 30, 2015. This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in Rio Branco between April 6th. and June 30th., 2015. Prenatal care was classified as fully adequate when started ≤4th month; ≥80.0-109% expected consultations for GA according to the Kotelchuck Index; ≥5 records of blood pressure, weight, GA, fundal height, ≥4 records of fetal heart rate, fetal movements or equivalent to 75% of the number of consultations; in addition to recording ABO/RH, hemoglobin, VDRL, urine, glucose, anti-HIV and anti-toxoplamosis during the 1st trimester. The evaluated outcomes were low birth weight (LBW), preterm birth and vertical transmission of human immunodeficiency virus (HIV)/hepatitis/syphilis. Differences between proportions were assessed using the X² test, and the crude and adjusted odds ratios (OR) (95% CI) were estimated using unconditional logistic regression. RESULTS: Overall cohort, the outcomes incidences were 8.8% for LBW, 9.2% for preterm birth, and 1.1% for vertical transmission (syphilis/HIV/hepatitis). Crude and adjusted OR showed that inadequate PC increased the risk statistically significant of LBW (ORcrude: 1.84; 95%CI: 0.99-3.44; ORadjusted: 1.87; 95%CI: 1.00-3.52), and preterm birth (ORcrude: 1.79; 95%CI: 1.00-3.29; ORadjusted: 3.98; 95%CI: 1.40-11.29). CONCLUSION: The results draw attention to the importance of quality PC in reducing the risks of LBW, preterm birth, and vertical transmission of syphilis/HIV/hepatitis. Moreover, using this proposed quality prenatal care indicator based on Kotelchuck index combined with consultations contents adjusted by GA may accurately predict unfavorable outcomes.

RELIABILITY OF THE ISOMETRIC DYNAMOMETER IN CONTROL, PARAPLEGIC, AND AMPUTEE INDIVIDUALS.

Objective: To determine the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), and the Minimum Clinically Important Difference (MCID) of the isometric measurements of muscle strength of trunk extension and of flexion and knee extension at maximum contraction in healthy, paraplegic, and amputee individuals, by using an isometric dynamometer with a belt for stabilization. Methods: An observational cross-sectional study was carried out to assess the reliability of a portable isometric dynamometer in the trunk extension and flexion and knee extension movements of each group. Results: In all measurements, ICC ranged from 0.66 to 0.99, SEM from 0.11 to 3.73 kgf, and MDC from 0.30 to 10.3 kgf. The MCID of the movements ranged from 3.1 to 4.9 kgf in the amputee group and from 2.2 to 3.66 kgf in the paraplegic group. Conclusion: The manual dynamometer demonstrated good intra-examiner reliability, presenting moderate and excellent ICC results. Thus, this device is a reliable resource to measure muscle strength in amputees and paraplegics. Level of Evidence II, Cross-Sectional Study.

Objetivo: Determinar o coeficiente de correlação intraclasse (CCI), o erro padrão da medida (EPM), a mínima mudança detectável (MMD) e a mínima mudança clinicamente importante (MMCI) das medidas isométricas de força muscular da extensão de tronco e da flexão e extensão de joelho em contração máxima de indivíduos saudáveis, paraplégicos e amputados, usando um dinamômetro isométrico com cinto para estabilização. Métodos: Foi realizado um estudo observacional transversal para avaliar a confiabilidade de um dinamômetro portátil isométrico nos movimentos de extensão de tronco e de flexão e extensão de joelho de cada grupo. Resultados: Em todas as medidas o CCI apresentou uma variação de 0,66 a 0,99, o EPM de 0,11 a 3,73 kgf e a MMD de 0,30 a 10,3 kgf. A MMCI dos movimentos variou de 3,1 a 4,9 kgf no grupo de amputados e de 2,2 a 3,66 kgf no grupo de paraplégicos. Conclusão: O dinamômetro manual demonstrou boa confiabilidade intraexaminador, com variação de CCI de moderada à excelente, apresentando-se como um recurso confiável para mensurar força muscular de amputados e paraplégicos. Nível de Evidência II, Estudo Observacional Transversal.

Reliability of the isometric dynamometer in control, paraplegic, and amputee individuals / Confiabilidade do dinamômetro isométrico em indivíduos controle, paraplégicos e amputados

ABSTRACT Objective: To determine the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), and the Minimum Clinically Important Difference (MCID) of the isometric measurements of muscle strength of trunk extension and of flexion and knee extension at maximum contraction in healthy, paraplegic, and amputee individuals, by using an isometric dynamometer with a belt for stabilization. Methods: An observational cross-sectional study was carried out to assess the reliability of a portable isometric dynamometer in the trunk extension and flexion and knee extension movements of each group. Results: In all measurements, ICC ranged from 0.66 to 0.99, SEM from 0.11 to 3.73 kgf, and MDC from 0.30 to 10.3 kgf. The MCID of the movements ranged from 3.1 to 4.9 kgf in the amputee group and from 2.2 to 3.66 kgf in the paraplegic group. Conclusion: The manual dynamometer demonstrated good intra-examiner reliability, presenting moderate and excellent ICC results. Thus, this device is a reliable resource to measure muscle strength in amputees and paraplegics. Level of Evidence II, Cross-Sectional Study.

RESUMO Objetivo: Determinar o coeficiente de correlação intraclasse (CCI), o erro padrão da medida (EPM), a mínima mudança detectável (MMD) e a mínima mudança clinicamente importante (MMCI) das medidas isométricas de força muscular da extensão de tronco e da flexão e extensão de joelho em contração máxima de indivíduos saudáveis, paraplégicos e amputados, usando um dinamômetro isométrico com cinto para estabilização. Métodos: Foi realizado um estudo observacional transversal para avaliar a confiabilidade de um dinamômetro portátil isométrico nos movimentos de extensão de tronco e de flexão e extensão de joelho de cada grupo Resultados: Em todas as medidas o CCI apresentou uma variação de 0,66 a 0,99, o EPM de 0,11 a 3,73 kgf e a MMD de 0,30 a 10,3 kgf. A MMCI dos movimentos variou de 3,1 a 4,9 kgf no grupo de amputados e de 2,2 a 3,66 kgf no grupo de paraplégicos. Conclusão: O dinamômetro manual demonstrou boa confiabilidade intraexaminador, com variação de CCI de moderada à excelente, apresentando-se como um recurso confiável para mensurar força muscular de amputados e paraplégicos. Nível de Evidência II, Estudo Observacional Transversal.

Immediate effect of an orthostatic device in amputees who practice physical activity / Efecto inmediato de un dispositivo ortostático en amputados que practican actividad física / Efeito imediato de um dispositivo ortostático em amputados praticantes de atividade física

ABSTRACT Introduction: Lower limb amputation affects mainly economically active young adults, causing great socio-economic impact due to impaired work capacity, socialization, and quality of life. Thus, the use of orthostatic devices could make reintegration of the individual back into the work environment possible. Objective: To evaluate the immediate effect of using a postural elevation device on physiological parameters and plantar pressure levels in amputees who practice physical activity. Methods: Sociodemographic and perceived sleep quality data were collected from 14 adults of both sexes with lower limb amputations, who practice physical activity. The participants were placed in postural elevation equipment for a period of 90 minutes with monitoring of physiological parameters such as blood pressure, heart rate, and oxygen saturation. Parameters related to the autonomic nervous system and plantar pressure levels were also evaluated. Data were also collected during recovery at 15- and 30-minute intervals after using the device. Data analysis was performed using two-way ANOVA or a mixed-effects model with Sidak's multiple comparisons test. Results: For all cardiovascular parameters (p>0.05) analyzed, the activation level of the autonomic nervous system (p>0.05), and plantar pressure (p>0.05), no evidence of differences was observed during use of the orthostatic device in all evaluated periods. Conclusion: The use of postural elevation equipment for 90 minutes does not generate, as an immediate effect, changes in physiological parameters and postural control in amputees who practice physical activity. Level of evidence II; Therapeutic studies - investigation of treatment results. Clinical relevance statement .

RESUMEN Introducción: La amputación de miembros inferiores afecta mayoritariamente a jóvenes adultos económicamente activos, lo que provoca un gran impacto socioeconómico debido al compromiso de la capacidad laboral, la socialización y la calidad de vida. Así, el uso de dispositivos ortostáticos permitiría la reinserción del individuo en el entorno laboral. Objetivo: Evaluar el efecto inmediato del uso de un dispositivo de elevación postural en los parámetros fisiológicos y en los niveles de presión plantar de amputados que practican actividad física. Métodos: Se recogieron datos sociodemográficos y la percepción de la calidad del sueño de 14 adultos de ambos sexos con amputaciones de miembros inferiores, practicantes de actividad física. Los participantes fueron colocados en equipos de elevación postural durante 90 minutos con monitoreo de parámetros fisiológicos como presión arterial, frecuencia cardíaca, saturación y sistema nervioso autónomo, además de los niveles de presión plantar. También se recopilaron datos durante la recuperación a intervalos de 15 y 30 minutos después de usar el dispositivo. El análisis de datos se realizó mediante ANOVA two-way o un modelo de efectos mixtos con la prueba de comparaciones múltiples de Sidak, p < 0,05. Resultados: Para todos los parámetros cardiovasculares (p> 0,05) analizados, el nivel de activación del sistema nervioso autónomo (p> 0,05) y la presión plantar (p> 0,05), no se observaron diferencias a lo largo del uso del dispositivo ortostático en todos los períodos evaluados. Conclusión: El uso del equipo de elevación postural durante 90 minutos no genera, como efecto inmediato, cambios en los parámetros fisiológicos y en el control postural de los amputados que practican actividades físicas. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados de los tratamientos. Declaración de relevancia clínica .

RESUMO Introdução: A amputação de membros inferiores afeta em sua maioria adultos jovens economicamente ativos, o que ocasiona grande impacto socioeconômico devido ao comprometimento da capacidade laboral, socialização e qualidade de vida. Desta forma, as utilizações de dispositivos ortostáticos possibilitariam a reinserção do indivíduo no ambiente de trabalho. Objetivo: Avaliar o efeito imediato da utilização de um dispositivo de elevação postural nos parâmetros fisiológicos e nos níveis da pressão plantar de amputados praticantes de atividade física. Métodos: Foram coletados os dados sociodemográficos e a percepção da qualidade do sono de 14 adultos de ambos os sexos com amputações de membro inferior que praticam atividade física. Os participantes foram colocados em um equipamento de elevação postural durante 90 minutos com monitorização dos parâmetros fisiológicos como pressão arterial, frequência cardíaca, saturação e sistema nervoso autônomo, além dos níveis da pressão plantar. Os dados também foram coletados durante a recuperação (15 e 30 minutos depois do uso do dispositivo). A análise dos dados foi realizada pela ANOVA two-way ou modelo de efeitos mistos com teste de comparações múltiplas de Sidak, p < 0,05. Resultados: Para todos os parâmetros cardiovasculares (p > 0,05) analisados, nível de ativação sistema nervoso autônomo (p > 0,05) e pressão plantar (p > 0,05) não foram observadas diferenças ao longo do uso do dispositivo ortostático em todos os períodos avaliados. Conclusão: A utilização do equipamento de elevação postural por 90 minutos não gera como efeito imediato, alterações nos parâmetros fisiológicos e no controle postural de amputados praticantes de atividade física. Nível de evidência II; Estudos terapêuticos: investigação dos resultados dos tratamentos Declaração de relevância clínica.

People with amputation and musculoskeletal pain show reduced electrical activity of Alpha brain waves: cross-sectional study / Pessoas com amputação e relato de dor musculoesquelética apresentam redução da atividade elétrica das ondas cerebrais Alpha: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation causes associated clinical conditions, such as musculoskeletal pain (MSP), which causes sufering and interferes in the patient's life. Therefore, the development of diagnostic methods to measure these changes are encouraged, such as quantitative electroencephalography (qEEG). The aim of the study was to compare the electroencephalographic pattern of Alpha brain waves (8-12 Hz) in individuals with amputation with MSP unrelated to phantom limb pain and without MSP. METHODS: Study conducted between January and February 2022, with 20 people with amputations divided equally into two groups (Control Group and with MSP report not related to the amputated segment). Pain intensity and interference were evaluated (Brief Pain Inventory), as well as the presence of central sensitization (CS) signs and symptoms (CS inventory) and qEEG (assessed with eyes open) with spectral analysis to measure the amplitude of the Alpha wave, standardized Low Resolution brain electromagnetic Tomography (sLORETA) to identify the differential generation site of said wave and Phase-Amplitude Coupling (PAC) to identify its interaction with fast waves. RESULTS: People with amputation and MSP reported mild pain severity and interference. No diference was identifed between individuals regarding the presence of signs and symptoms associated with CS. Regarding electrical activity, the Pain Group had lower Alpha wave amplitude compared to the Control Group (p=0.01), specifically in the parieto-occipital region. CONCLUSION: People with amputation and reported MSP unrelated to the phantom limb had reduced electrical activity (activation) of the Alpha brain wave in the sensory cortex.

RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação acarreta quadros clínicos associados, como a dor musculoesquelética (DME), que causa sofrimento e interfere na vida do paciente. Por isso, o desenvolvimento de métodos diagnósticos para mensurar essas alterações são incentivados, como a eletroencefalografia quantitativa (EEGq). O objetivo deste estudo foi comparar o padrão eletroencefalográfico das ondas cerebrais Alpha (8-12 Hz) em pessoas com amputação com DME não relacionada à dor no membro fantasma e sem DME. MÉTODOS: Estudo realizado entre janeiro e fevereiro de 2022, com 20 pessoas com amputação divididas igualmente em dois grupos (Grupo Controle e Grupo com relato de DME não relacionada ao segmento amputado). Avaliou-se intensidade e interferência da dor (Inventário Breve de Dor), presença de sinais e sintomas de sensibilização central (SC) (Inventário de SC) e a EEGq (avaliados com olhos abertos) com análise espectral para medir a amplitude da onda Alpha, standardized Low Resolution brain electromagnetic Tomography (sLORETA) para identificar o local de geração diferencial da referida onda e Phase-Amplitude Coupling (PAC) para identificar sua interação com ondas rápidas. RESULTADOS: As pessoas com amputação e relato de DME apresentaram baixa gravidade e interferência de dor. Não se identificou diferença entre os indivíduos em relação a presença de sinais e sintomas associados à SC. Quanto à atividade elétrica, o Grupo Dor apresentou menor amplitude da onda Alpha em relação ao Grupo Controle (p=0,01), especificamente na região parieto-occipital. CONCLUSÃO: Pessoas com amputação e relato de DME não relacionada ao membro fantasma apresentaram atividade elétrica (ativação) reduzida da onda cerebral Alpha no córtex sensorial.

Adherence to literature search reporting guidelines in leading rheumatology journals' systematic reviews: umbrella review protocol.

Literature searches are important components of systematic reviews. They are not only informative of the retrieval process, but they also set the data to be analyzed and influence additional components of systematic reviews. Despite the available guidelines, several studies have shown that the quality of reporting in systematic reviews is deficient in several medical fields. Systematic reviews may not comply completely with those guidelines despite explicitly stating they do. This protocol intends to answer to what extent systematic reviews published in rheumatology journals have complied with the PRISMA's search strategy guidelines published in 2009. The objective of the study is to analyze the compliance with the PRISMA (2009) search strategy guidelines among systematic reviews published in leading rheumatology journals. Inclusion criteria for this umbrella review protocol are systematic reviews (with or without meta-analyses) that mention having followed the PRISMA statement (2009) in their methods section, and published in journals listed in the Rheumatology category of the Journal of Citations Report 2020. Exclusion criteria are articles published before 2009; retraction letters, notes, expressions of concern; systematic reviews using PRISMA 2020. Databases to be consulted are Web of Science, PubMed and Scopus, from inception to present. Data summaries will be presented in graphs, figures, tables and network maps. A narrative synthesis will be described. This protocol complies with guidelines such as PRISMA 2020, PRISMA-A, PRISMA-P, PRISMA-S, PRESS, and JBI Manual for evidence synthesis, as long as it is suitable for umbrella review protocols. Articles in any language will be considered.

Experimental and Theoretical DFT Study of Cu(I)/N,N-Disubstituted-N'-acylthioureato Anticancer Complexes: Actin Cytoskeleton and Induction of Death by Apoptosis in Triple-Negative Breast Tumor Cells.

Six complexes with the general formula [Cu(acylthioureato)(PPh3)2] were synthesized and characterized using spectroscopic techniques (IR, UV/visible, and 1D and 2D NMR), mass spectrometry, elemental analysis, and X-ray diffraction. Interpretation of the in vitro cytotoxicity data of Cu(I) complexes took into account their stability in cell culture medium. DFT calculations showed that NMR properties, such as the shielding of carbon atoms, are affected by relativistic effects, supported by the ZORA Hamiltonian in the theoretical calculations. Additionally, the calculation of the energies of the frontier molecular orbitals predicted that the structural changes of the acylthiourea ligands did not cause marked changes in the reactivity descriptors. All complexes were cytotoxic to the evaluated tumor cell lines [MDA-MB-231 (triple-negative breast cancer, TNBC), MCF-7 (breast cancer), and A549 (lung cancer)]. In the MDA-MB-231 cell line, complex 1 significantly altered the cytoskeleton of the cells, reducing the density and promoting the condensation of F-actin filaments. In addition, the compound caused an increase in the percentage of cells in the fragmented DNA region (sub-G0) and induced cell death via the apoptotic pathway starting at the IC50 concentration. Taken together, the results show that complex 1 has cytotoxic and apoptotic effects on TNBC cells, which is a cell line originating from an aggressive, difficult-to-treat breast cancer.

Caracterização dos Casos de Câncer de Cavidade Oral e Faringe da Região Norte do Brasil, 2012-2015 / Characterization of Oral Cavity and Pharyngeal Cancer Cases in Northern Brazil, 2012-2015 / Caracterización de Casos de Cáncer de Cavidad Oral y Faringe en el Norte de Brasil, 2012-2015

Introdução: O câncer de cavidade oral e faringe é um problema de saúde pública, apresentando elevadas taxas de incidência e mortalidade. Objetivo: Caracterizar o perfil clínico-epidemiológico e os atrasos no diagnóstico e tratamento de casos atendidos nas unidades de referência da Região Norte do Brasil. Método: Estudo descritivo dos casos de câncer de cavidade oral e faringe registrados nas bases de dados dos Registros Hospitalares de Câncer (RHC) de 2012 a 2015. Foram analisados os intervalos entre a primeira consulta e o diagnóstico, e o diagnóstico e o tratamento. As variáveis contínuas foram avaliadas por meio de medidas de tendência central e de dispersão. As diferenças entre proporções nas variáveis categóricas foram avaliadas pelo teste qui-quadrado, considerando-se o nível de significância de 5%. Resultados: Entre os homens, os casos de orofaringe foram mais incidentes (19,2%) e nas mulheres os mais incidentes (16,3%) de outras partes e partes não especificadas da língua. A maior parte dos casos era de homens, cor parda, >60 anos, sem cônjuge, com escolaridade até o nível fundamental. O carcinoma de células escamosas foi o mais comum. Com relação ao tempo, 69,6% dos casos que chegaram ao hospital sem diagnóstico e sem tratamento foram diagnosticados até 30 dias após a primeira consulta, e 67,8% dos casos receberam o primeiro tratamento em até 60 dias. Conclusão: A maioria dos casos analisados apresentou tempo de diagnóstico dentro do prazo recomendado, porém foi observado que os casos com diagnóstico e sem tratamento demoraram mais de 60 dias

Introduction: Oral cavity and pharyngeal cancer is a public health problem with high incidence and mortality rates. Objective: To characterize the clinical-epidemiological profile and delays in diagnosis and treatment of cases of oral cavity and pharyngeal cancer treated in reference units in Brazil's North Region. Method: Descriptive study of oral cavity and pharyngeal cancer registered in the Hospital-based Cancer Registry (HBCR) in the North Region from 2012 to 2015. The intervals between the 1st consultation and diagnosis and diagnosis and treatment were analyzed. Continuous variables were evaluated using measures of central tendency and dispersion. Differences between proportions in categorical variables were assessed using the chi square test, considering a significance level of 5%. Results: Among men, cases of oropharynx were more incidents (19.2%) and in women, the most incidents (16.3%) were from other parts and unspecified parts of the tongue. Most of the cases were males, brown, >60 years old, without spouse and elementary education. Squamous cell carcinoma was the most common. 69.6% of cases that arrived at the hospital without diagnosis and without treatment were diagnosed within 30 days after the 1st consultation and 67.8% of cases received the 1st treatment within 60 days. Conclusion: Most of the cases analyzed were diagnosed within the recommended timeframe. However, cases with diagnosis and without treatment took more than 60 days

Introducción: El cáncer de cavidad oral y faringe es un problema de salud pública, con altas tasas de incidencia y mortalidad. Objetivo: Caracterizar el perfil clínico-epidemiológico y las demoras en el diagnóstico y tratamiento de los casos de cáncer de cavidad oral y faringe atendidos en unidades de referencia del Norte de Brasil. Método: Se realizó un estudio descriptivo de los casos analíticos de cáncer de cavidad oral y faringe registrados en las bases de datos del Registros Hospitalarios de Cáncer (RHC) en la Región Norte de 2012 a 2015. Se analizaron los intervalos entre la primera consulta y el diagnóstico y diagnóstico y tratamiento. Las variables continuas se evaluaron mediante medidas de tendencia central y dispersión. Las diferencias entre proporciones en variables categóricas se evaluaron mediante la prueba chi cuadrado, considerando un nivel de significancia del 5%. Resultados: Entre los hombres, los casos de orofaringe fueron más incidentes (19,2%) y entre las mujeres los de otras partes y partes no especificadas del idioma fueron los más incidentes (16,3%). La mayoría de los casos fueron del sexo masculino, moreno, >60 años, sin pareja, con educación hasta el nivel elemental. El carcinoma de células escamosas fue el más común. En cuanto al tiempo, el 69,6% de los casos que llegaron al hospital sin diagnóstico y sin tratamiento fueron dentro de los 30 días posteriores a la primera consulta y el 67,8% de los casos recibieron el 1er tratamiento dentro de los 60 días. Conclusión: La mayoría de los casos analizados presentaron tiempo de diagnóstico dentro del período recomendado. Sin embargo, se observó que los casos con diagnóstico y sin tratamiento demoran más de 60 días

Sexual violence against women in the Western Amazon.

OBJECTIVE: To characterize sexual violence cases suffered by women notified by the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) in the city of Rio Branco (AC - Brazil) from 2011 to 2016. METHODS: Descriptive study based on information from the Notifiable Diseases Information System. The study population consisted on women victims of sexual violence reported in the city of Rio Branco (AC), from 2011 to 2016. RESULTS: The results show a higher number of notifications during 2012, especially among single, brown, and aged between 10 and 14 years victims; usually they have 5 to 8 years of schooling. Normally violence occurred in residences and by a single aggressor, male and non-alcoholic. DISCUSSION: The large number of notifications of pregnant women aged 10 to 14 years corresponds to the compulsory notification of rape of a vulnerable person, identified at the time of prenatal care or childbirth. CONCLUSION: We confirm the susceptibility to sexual violence of young women in Rio Branco, raising the issue of child marriage and teenage pregnancy.

Prevalence of chronic pain in Brazil: systematic review / Prevalência de dor crônica no Brasil: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain is considered a worldwide public health problem, can lead to physical and emotional stress, in addition to high financial and social costs for the population. The aim of this study was to produce a systematic review to identify the prevalence of chronic pain in Brazil, considering its geographical regions and mechanisms subclassifications by the International Association for the Study of Pain (IASP). CONTENTS: A systematic review was carried out on the following databases: Scielo, Pubmed, Periódicos Capes, Science Direct and Virtual Health Library. 35 studies that investigated the prevalence of chronic pain in Brazil were included. The prevalence ranged from 23.02 to 76.17%, presenting a national average of 45.33% between studies, affecting more women. The Brazilian region with the highest prevalence among the included studies was the Midwest region (56.25%), however the region with the most studies and the largest population analyzed was the Southeast region (42.2%). Regarding the classifications of IASP mechanisms, possibly nociceptive pain had a prevalence of 36,70%, whereas neuropathic pain was 14,5% and nociplastic pain 12,5%. CONCLUSION: The present study observed a high prevalence of chronic pain in Brazil, being the majority in women. Regarding chronic pain mechanisms, the possibly nociceptive predominance was the most prevalent. As for the national geographic region, the highlight of the highest prevalence of chronic pain was for the Midwest region, however the region with the most studies and the largest population analyzed was the Southeast region.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica é considerada um problema de saúde pública mundial, pode levar ao estresse físico e emocional, além de altos custos financeiros e sociais para a população. O objetivo deste estudo foi produzir uma revisão sistemática para identificar a prevalência da dor crônica no Brasil, considerando suas regiões geográficas e subclassificações de mecanismos pela International Association for the Study of Pain (IASP). CONTEÚDO: Foi realizada uma revisão sistemática nas seguintes bases de dados: Scielo, Pubmed, Periódicos Capes, Science Direct e Biblioteca Virtual em Saúde. Foram incluídos 35 estudos que investigavam a prevalência de dor crônica no Brasil. A prevalência variou de 23,02 a 76,17%, apresentando média nacional de 45,59% entre os estudos, afetando mais o sexo feminino. A região do Brasil com maior prevalência dentre os estudos incluídos foi a região centro-oeste (56,25%), porém a região com mais estudos e maior população analisada foi a região sudeste (42,2%). Quanto às classificações de mecanismos da IASP, a dor possivelmente nociceptiva obteve prevalência de 36,70%, já a neuropática foi de 14,5% e a dor nociplástica de 12,5%. CONCLUSÃO: O presente estudo identificou alta prevalência de dor crônica no Brasil, maior em mulheres. Em relação aos seus mecanismos, a dor de predomínio possivelmente nociceptivo foi a mais prevalente. Quanto a região geográfica nacional, o destaque de maior prevalência foi para a região Centro-Oeste, porém a região com mais estudos e maior população analisada foi a região Sudeste.

Socioeconomic and demographic profile of occupational morbidity and mortality in Brazil from 2009 to 2016.

INTRODUCTION: Occupational accidents occur as a result of work, and can lead to bodily harm or functional impairments that lead to death, or to the reduction or loss of working capacity. Occupational accidents are associated with two possible outcomes: morbidity or mortality. Morbidity refers to the subset of a population that develops an illness over a given period of time, while mortality refers to the number of individuals who die over a specified time period. OBJECTIVES: To assess occupational morbidity and mortality in Brazil in the period of 2009 to 2016. METHODS: An ecological study was conducted based on secondary data collected from incident records in the Social Security database. RESULTS: The outcomes of all occupational accidents reported in Brazil from 2009 to 2016 were extracted from the database. These data were then classified by geographical region and category in the National Classification of Economic Activities (Classificação Nacional de Atividades Econômicas), so as to calculate the prevalence of each outcome and the accident mortality rates, and compare these values across regions and occupational categories. CONCLUSIONS: The data show that the outcomes of occupational accidents are directly associated with socioeconomic sectors and the sociocultural characteristics of different regions in the country. These results make an important contribution to the characterization of occupational morbidity and mortality in Brazil.

Sexual violence against women in the Western Amazon / Violência sexual em mulheres na Amazônia Ocidental

ABSTRACT OBJECTIVE: To characterize sexual violence cases suffered by women notified by the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) in the city of Rio Branco (AC - Brazil) from 2011 to 2016. METHODS: Descriptive study based on information from the Notifiable Diseases Information System. The study population consisted on women victims of sexual violence reported in the city of Rio Branco (AC), from 2011 to 2016. RESULTS: The results show a higher number of notifications during 2012, especially among single, brown, and aged between 10 and 14 years victims; usually they have 5 to 8 years of schooling. Normally violence occurred in residences and by a single aggressor, male and non-alcoholic. DISCUSSION: The large number of notifications of pregnant women aged 10 to 14 years corresponds to the compulsory notification of rape of a vulnerable person, identified at the time of prenatal care or childbirth. CONCLUSION: We confirm the susceptibility to sexual violence of young women in Rio Branco, raising the issue of child marriage and teenage pregnancy.

RESUMO OBJETIVO: Caracterizar os casos de violência sexual sofridos por mulheres notificadas pelo Sistema de Informação de Agravos de Notificação no município de Rio Branco (AC) no período de 2011 a 2016. MÉTODOS: Estudo descritivo com base nas informações do Sistema de Informação de Agravos de Notificação. A população do estudo foi constituída por mulheres vítimas de violência sexual notificadas no município de Rio Branco (AC), de 2011 a 2016. RESULTADOS: Os resultados da investigação apresentam maior número de notificação durante o ano de 2012, se destacando entre as vítimas aquelas com idade entre 10 e 14 anos, solteiras, pardas e com 5 a 8 anos de formação educacional. O local de ocorrência mais notificado foi a residência, predominando agressor único, do sexo masculino e não alcoolizado. DISCUSSÃO: O grande número de notificações de gestantes na faixa etária de 10 a 14 anos corresponde à notificação compulsória do estupro de vulnerável, identificado no momento de realização do pré-natal ou parto. CONCLUSÃO: Confirmou-se a suscetibilidade à violência sexual de mulheres jovens de Rio Branco, levantando a problemática do casamento infantil e da gravidez na adolescência.

Food Insecurity during Pregnancy in a Maternal-Infant Cohort in Brazilian Western Amazon.

The aim of this study was to determine the prevalence and analyze the factors associated with food insecurity during gestation in a maternal-infant cohort in Brazilian Western Amazon. A population-based cross-sectional study was conducted with parturients from a maternal-infant cohort in Rio Branco, located in the Western Brazilian Amazon. The dependent variable food insecurity (FI) was obtained through the Brazilian Scale of Food Insecurity, and associated factors were identified through multiple logistic regression. The prevalence of FI in pregnancy was of 34.8%. Regarding severity, the prevalence of mild food insecurity was 24.6%, moderate food insecurity was 4.8%, and severe food insecurity was 5.4%. The factors directly associated with FI were the presence of open sewage in the peridomestic environment; belonging to the lower economic classes; being an income transfer program beneficiary, while the factors inversely associated with FI were schooling equal to or greater than 8 years; having a partner; primigestation; and regular consumption of fruits and vegetables during pregnancy. These findings reinforce the need for the ratification of actions aimed at the domestic economy in the income transfer programs and the development of actions of food and nutritional education in the gestational period.