Biochemical and Hormone Markers in Firefighters: Effects of "Search, Rescue, and Survival Training" and Its Recovery.

ABSTRACT: Ponce, T, Mainenti, MRM, de Barros, T, Cahuê, FLC, Fernanda, C, Piazera, BKL, Salerno, VP, and Vaisman, M. Biochemical and hormone markers in firefighters: effects of "search, rescue, and survival training" and its recovery. J Strength Cond Res 38(4): e189-e201, 2024-This study aimed to evaluate the hormonal and biochemical responses in military firefighter cadets to a search, rescue, and survival training (SRST) course. Forty-three male volunteers participated in the SRST over 15 days consisting of intense physical effort, sleep deprivation, and a survival period with food deprivation. At 3 timepoints (baseline, SRST, and 1 week rec), subjects submitted to blood collections, body composition examinations, physical performance evaluations, and cognitive function tests. After the SRST, lower values were registered for testosterone (764.0; 565.1-895.0 to 180.6; 133.6-253.5 ng·dl -1 ) and insulin-like growth factor-1 (IGF-1) (217; 180-238 to 116; 102-143 ng·ml -1 ). Increases were observed for cortisol (9.7; 8.2-11.7 to 18.3; 16.5-21,2 µg·dl -1 ), growth hormone (GH) (0.11; 0.06-0.20 to 2.17; 1.4-3.4 ng·ml -1 ), CP, GSSG, lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase as well as the antioxidant response of superoxide dismutase and glutathione peroxidase. The values of gamma-glutamyl transferase were reduced. After 1 week of recovery, levels of GH, creatine kinase, GSH, and GSSG returned to baseline values ( p < 0.05). Vertical jump performance presented a regular positive correlation with testosterone (rho = 0.56 and p < 0.0001) and a strong negative correlation with cortisol (rho = -0.61 and p < 0.0001). Body fat showed a regular and positive correlation with both testosterone and IGF-1. We conclude that participation in the SRST caused significant hormonal and biochemical changes in individuals that correlated with a loss in physical performance. Importantly, the results suggest the need for longer recovery times before a return to normal military duties.

O discurso antivacina no ontem e no hoje: a Revolta da Vacina e a pandemia da covid-19, uma abordagem a partir da Análise do Discurso / The anti-vaccine discourse yesterday and today: the Vaccine Revolt and the covid-19 pandemic, a Discourse Analysis approach / El discurso antivacunas ayer y hoy: la Revuelta de las Vacunas y la pandemia da covid-19, una aproximación desde el Análisis del Discurso

A pesquisa pretende identificar elementos ideológicos e históricos diante das formações discursivas do discurso antivacina no Brasil, à luz do passado (Revolta da Vacina) e do presente (pandemia da covid-19). Metodologicamente, trata-se de uma pesquisa documental-qualitativa. O corpus de análise é composto por seis enunciados, três da Revolta da Vacina e três da covid-19, tendo como método a Análise do Discurso. Como resultado, foram identificadas três facetas do discurso antivacina: a) medo do desconhecido e desconfiança na eficácia dos imunizantes; b) honra em jogo e interesse institucional sobre a vacinação; c) liberdade e morte, obrigatoriedade da vacina. Conclui-se que, ainda que o discurso antivacina no Brasil seja tão antigo quanto o primeiro método de vacinação, é fundamental superar o fosso entre comunidade científica e sociedade em geral, a fim de combater desinformação com informação científica, levando o fantasma do discurso antivacina ao esquecimento

The research aims to identify ideological and historical elements in the face of the discursive formations of the anti-vaccine discourse in Brazil, in the light of the past (Vaccine Revolt) and the present (covid-19 pandemic). Methodologically, this is a documentary-qualitative research. The corpus of analysis is com-posed of six statements, three from the Vaccine Revolt and three from the covid-19, using Discourse Anal-ysis as method. A result, three facets of the anti-vaccine discourse were identified: a) fear of the unknown and distrust in the effectiveness of immunizers; b) honor at stake and institutional interest in vaccination; c) freedom and death, the mandatory vaccine. It is concluded that, although the anti-vaccination discourse in Brazil is as old as the first vaccination method, overcoming the gap between scientific community and society in general is essential, in order to fight misinformation with scientific information, taking the ghost from the anti-vaccine discourse to oblivion

La investigación tiene como objetivo identificar elementos ideológicos e históricos frente a las formaciones discursivas del discurso antivacunas en Brasil, la luz del pasado (Revuelta de las Vacunas) y del presente (pandemia de covid-19). Metodológicamente se trata de una investigación documental-cualitativa. El corpus consta de seis enunciados, tres de la Revuelta de las Vacunas y tres del covid-19, utilizando como método el Análisis del Discurso. Como resultado, se identificaron tres facetas del discurso antivacunas: a) miedo a lo desconocido y desconfianza en la efectividad de los inmunizadores; b) honor en juego e interés institucional en la vacunación; c) libertad y muerte, vacunación obligatoria. Se concluye que, aunque el discurso antivacunas en Brasil es tan antiguo como el primer método de vacunación, es fundamental superar la brecha entre la comunidad científica y la sociedad, para combatir con información científica la desinformación, liderando el fantasma de la el discurso antivacunas al olvido

Stable fly outbreaks in Brazil: a 50-year (1971-2020) retrospective.

Over the last decades, stable fly (Stomoxys calcitrans) outbreaks associated with agricultural and/or livestock production systems have become a serious problem in some Brazilian locations. This article presents a survey on the history, evolution and mapping of such outbreaks in Brazil over five decades (1971-2020). Outbreaks (n= 579) were recorded in 285 municipalities from 14 states, mainly associated with by-products from the ethanol industry (82.7%), in natura organic fertilizers (12.6%) and integrated crop-livestock systems (3.1%). Few cases were reported until the mid-2000s, progressively increasing since then. Outbreaks associated with ethanol mills occurred in 224 municipalities, mainly in Southeast and Midwest states, while those associated with organic fertilizers (mainly poultry litter and coffee mulch) affected 39 municipalities, mostly in the Northeast and Southeast states. More recently, outbreaks in integrated crop-livestock systems during the rainy season have occurred in Midwest states. This survey highlights the magnitude of the problem of stable fly outbreaks in Brazil and its relationship with environmental public policies, agricultural production chains and regional trends. Specific public actions and policies are urgently needed to prevent their occurrence and impact in the affected regions.

EFFECT OF HYPERBARIC OXYGEN THERAPY ON NERVE REGENERATION IN RATS.

Objective: To evaluate histological changes in peripheral nerves of rats after sciatic nerve neurorrhaphy, according to the time of exposure to hyperbaric oxygen chamber treatment. Methods: Twenty-five Wistar rats were divided into 5 groups according to the amount of exposure to hyperbaric oxygen chamber treatment. Group 1 was the control and there was no use of hyperbaric oxygen chamber; group 2 received one week of therapy; group 3, two weeks; group 4, three weeks; and group 5, four weeks. After the fourth postoperative week, the animals were submitted to euthanasia and a sciatic nerve sample sent for histological analysis. Axons proximal and distal to the neurorrhaphy were counted with axonal regeneration index measurement. Results: We observed that the number of axons distal to neurorrhaphy increases with the amount of hyperbaric oxygen chamber exposure, the results were more expressive from the third week of treatment. However, the statistical analysis found no significant difference between the groups. Conclusion: The descriptive analysis suggests benefit of using hyperbaric oxygen chamber directly proportional to the time of therapy. The study, however, did not present statistically relevant results, probably due to the reduced sample size. Subsequent studies with more significant sampling would be of great value. Level of Evidence II, Prospective Comparative Study.

Objetivo: Avaliar as alterações histológicas nos nervos periféricos após neurorrafia do nervo ciático de ratos, de acordo com o tempo de exposição ao tratamento com câmara hiperbárica de oxigênio. Métodos: Vinte e cinco ratos da raça Wistar foram divididos em cinco grupos conforme o tempo de exposição ao tratamento com câmara hiperbárica de oxigênio. O grupo 1 não recebeu o tratamento; o grupo 2 recebeu uma semana de terapia; o grupo 3, duas semanas; o grupo 4, três semanas; e o grupo 5, quatro semanas. Após quatro semanas de pós-operatório, os animais foram submetidos à eutanásia e uma amostra do nervo ciático foi enviada para análise histológica. Foram feitas contagens do número de axônios proximalmente e distalmente à neurorrafia, com medição do índice de regeneração axonal. Resultados: Observamos que o aumento do número de axônios distais à neurorrafia foi diretamente proporcional ao tempo de exposição à câmara hiperbárica de oxigênio, sendo mais expressivo a partir da terceira semana de tratamento. Entretanto, a análise estatística não encontrou diferença significativa entre os grupos. Conclusão: A análise descritiva sugere benefício do uso da câmara hiperbárica de oxigênio. Porém, devido à amostra reduzida, o estudo não apresentou resultados estatisticamente relevantes, sendo necessária a realização de estudos subsequentes com amostragem mais significativa. Nível de Evidência II, Estudo Prospectivo Comparativo.

A systematic review of hormone levels, biomarkers of cellular injury and oxidative stress in multi-stressor military field training exercises

ABSTRACT The fundamental objective of military field training exercises (FTX) is to prepare military personnel for real-life operations through simulated scenarios. These training sessions often require extreme physical efforts with prolonged, high-intensity exercises that can be combined with food restrictions and partial, or total, sleep deprivation. Such conditions can compromise an individual's physical performance and cause tissue damage, thus affecting their health. This study aimed to perform a systematic review of the literature to identify studies that measured the changes in hormone levels and biomarkers of cellular injury and oxidative stress resulting from FTX with high levels of energy expenditure combined with food and sleep restrictions. PubMed and the Scopus database were searched for articles that combined physical effort/food restriction/sleep deprivation with military training. The initial database search identified 158 articles that were reduced to 18 after confirmation. Significant reductions were reported in thyroid hormones, T3, T4, and anabolic hormones such as testosterone, insulin and androstenedione. An exception for GH was found, which increased throughout FTX. Less distinct responses to FTX were observed with cortisol, TSH and LH. The presence of biomarkers for cellular damage (myoglobin, TNF, and CRP) and increased immune response activities were also described. The scarcity of information on oxidative stress, analyses of cellular injury and biomarkers of inflammatory responses warrants the future study of these topics, which could be helpful in facilitating the safe and effective physical preparations of the members of the armed forces.

A systematic review of hormone levels, biomarkers of cellular injury and oxidative stress in multi-stressor military field training exercises.

The fundamental objective of military field training exercises (FTX) is to prepare military personnel for real-life operations through simulated scenarios. These training sessions often require extreme physical efforts with prolonged, high-intensity exercises that can be combined with food restrictions and partial, or total, sleep deprivation. Such conditions can compromise an individual's physical performance and cause tissue damage, thus affecting their health. This study aimed to perform a systematic review of the literature to identify studies that measured the changes in hormone levels and biomarkers of cellular injury and oxidative stress resulting from FTX with high levels of energy expenditure combined with food and sleep restrictions. PubMed and the Scopus database were searched for articles that combined physical effort/food restriction/sleep deprivation with military training. The initial database search identified 158 articles that were reduced to 18 after confirmation. Significant reductions were reported in thyroid hormones, T3, T4, and anabolic hormones such as testosterone, insulin and androstenedione. An exception for GH was found, which increased throughout FTX. Less distinct responses to FTX were observed with cortisol, TSH and LH. The presence of biomarkers for cellular damage (myoglobin, TNF, and CRP) and increased immune response activities were also described. The scarcity of information on oxidative stress, analyses of cellular injury and biomarkers of inflammatory responses warrants the future study of these topics, which could be helpful in facilitating the safe and effective physical preparations of the members of the armed forces.

Body Composition Modifications Due to the "Search, Rescue and Survival Training" in Male Military Firefighter Cadets.

INTRODUCTION: To train and prepare cadets for a career as firefighters in Rio de Janeiro, the second-year students of the Officers Training Course are submitted to a Search, Rescue, and Survival Training (SRST) course, which is characterized by long periods of high physical exertion and sleep restriction during a 9-day instruction module, and food restriction during a 7-day survival module. The present study investigated changes in the body composition of 39 male cadets submitted to SRST during training and 4 weeks of recovery with no restrictions in food consumption. MATERIALS AND METHODS: Each cadet was evaluated by anthropometric measurements at six time points: pre-SRST; after the first module; after the second module; and after 1, 2, and 4 weeks of recovery. Measurements included body girths and skinfolds, to estimate trunk (chest and waist) and limbs (arm and thigh) dimensions, as well as body composition. Repeated measures ANOVA and Friedman test were applied (depending on each data distribution). RESULTS: Statistically significant decreases in body weight (76.2; 69.8-87.2 to 63.9; 58.9-73.5 kg) and fat free mass (FFM, 69.2; 63.7-77.2 to 60.1; 56.2-68.0 kg) were observed following the second module of SRST. Following a single week of recovery, the FFM returned to pre-SRST values. Body weight returned to pre-training levels in 2 weeks. Body fat percentage and mass also significantly decreased during SRST (9.0; 7.7-12.3 to 6.5; 5.1-9.3% and 6.9; 5.6-10.0 to 6.9; 5.6-10.0 kg, respectively), which showed a slower and more gradual recovery that reached pre-SRST values after 4 weeks. The girths of arm, thigh, chest and waist significantly decreased due to SRST. The girths of the limbs (arm and thigh) returned to pre-training values after one month of recovery, while the girths of the trunk (chest and waist) did not return to pre-SRST values during the study period. CONCLUSIONS: The findings suggest that men who experience periods of high energy demands and sleep restriction followed by a period of food restriction will endure unavoidable physical consequences that can be mostly reversed by a 1-month recovery.

Assessment of black liquor hydrothermal treatment under sub- and supercritical conditions: Products distribution and economic perspectives.

This study reports an alternative method for black liquor treatment with potential for energy and process savings in the paper and pulp industry. Gasification of black liquor was carried out under sub- and supercritical conditions, varying the black liquor feed composition (0.10, 2.55 and 5.00 wb%) and temperature (350, 425 and 500 °C). Liquid products were identified by high resolution mass spectrometry (FT-Orbitrap MS) and compounds belonging to classes O3 and O4 were found to be the most representative in the products of reactions performed at 500 °C. The mass spectra results also revealed the overall selectivity of reactions, where decarboxylation and demethoxylation reactions were favored under subcritical and supercritical conditions, respectively. Among the gaseous products, hydrogen and methane were produced with maximum of 69.04 and 28.75 mol%, respectively, at 2.55 wb% and 425 °C. The proposed thermodynamic modelling of the reaction system satisfactorily predicted the gas phase behavior of the system. In the economic analysis, the simulated conditions indicated that the main energy requirements for a scaled-up black liquor gasification process are related to the necessary heat exchangers and pressurizing of the black liquor solution. Furthermore, the cost of the black liquor gasification is around 0.06 US$ per kg of feed stream. Liquid and gaseous products from gasification could be obtained at a cost of 56.64 US$ and 3.35 US$ per tonne of stream, respectively. Therefore, black liquor gasification is an interesting route for obtaining combustible gases and value-added bioproducts.

Effect of hyperbaric oxygen therapy on nerve regeneration in rats / Efeito da terapia hiperbárica de oxigênio na regeneração nervosa em ratos

ABSTRACT Objective: To evaluate histological changes in peripheral nerves of rats after sciatic nerve neurorrhaphy, according to the time of exposure to hyperbaric oxygen chamber treatment. Methods: Twenty-five Wistar rats were divided into 5 groups according to the amount of exposure to hyperbaric oxygen chamber treatment. Group 1 was the control and there was no use of hyperbaric oxygen chamber; group 2 received one week of therapy; group 3, two weeks; group 4, three weeks; and group 5, four weeks. After the fourth postoperative week, the animals were submitted to euthanasia and a sciatic nerve sample sent for histological analysis. Axons proximal and distal to the neurorrhaphy were counted with axonal regeneration index measurement. Results: We observed that the number of axons distal to neurorrhaphy increases with the amount of hyperbaric oxygen chamber exposure, the results were more expressive from the third week of treatment. However, the statistical analysis found no significant difference between the groups. Conclusion: The descriptive analysis suggests benefit of using hyperbaric oxygen chamber directly proportional to the time of therapy. The study, however, did not present statistically relevant results, probably due to the reduced sample size. Subsequent studies with more significant sampling would be of great value. Level of Evidence II, Prospective Comparative Study.

RESUMO Objetivo: Avaliar as alterações histológicas nos nervos periféricos após neurorrafia do nervo ciático de ratos, de acordo com o tempo de exposição ao tratamento com câmara hiperbárica de oxigênio. Métodos: Vinte e cinco ratos da raça Wistar foram divididos em cinco grupos conforme o tempo de exposição ao tratamento com câmara hiperbárica de oxigênio. O grupo 1 não recebeu o tratamento; o grupo 2 recebeu uma semana de terapia; o grupo 3, duas semanas; o grupo 4, três semanas; e o grupo 5, quatro semanas. Após quatro semanas de pós-operatório, os animais foram submetidos à eutanásia e uma amostra do nervo ciático foi enviada para análise histológica. Foram feitas contagens do número de axônios proximalmente e distalmente à neurorrafia, com medição do índice de regeneração axonal. Resultados: Observamos que o aumento do número de axônios distais à neurorrafia foi diretamente proporcional ao tempo de exposição à câmara hiperbárica de oxigênio, sendo mais expressivo a partir da terceira semana de tratamento. Entretanto, a análise estatística não encontrou diferença significativa entre os grupos. Conclusão: A análise descritiva sugere benefício do uso da câmara hiperbárica de oxigênio. Porém, devido à amostra reduzida, o estudo não apresentou resultados estatisticamente relevantes, sendo necessária a realização de estudos subsequentes com amostragem mais significativa. Nível de Evidência II, Estudo Prospectivo Comparativo.

Traditional approaches to estimate length at first maturity (L50 ) retrieve better results than alternative ones in a Neotropical heptapterid.

Length at first maturity (L50 ) is an important tool for the management and conservation of fish populations. Traditional approaches based on macroscopic and microscopic maturity staging exhibit high accuracy and precision, while alternative approaches (e.g., Ig -based staging, stanza changing point) are less resource-demanding. Herein, we compare four approaches to estimate L50 in a population of the heptapterid Rhamdioglanis transfasciatus from Atlantic Forest streams. Fish were sampled monthly during a year by using electrofishing. We measured the length (cm), mass (g), and gonad mass (g) of each specimen, then classified their maturity status macroscopically and microscopically. Alternative approaches were strongly discordant from traditional ones. Logistic curves considering mature individuals as those displaying at least 1% of the maximum Ig in the sample greatly underestimated L50 for females and overestimated L50 for males. The stanza changing point derived from the polyphasic growth model underestimated L50 in both cases. Despite the increasing development of less onerous approaches, it seems that they are not suitable for all fish populations and the requirements to use such approaches demand further investigation.

The influence of body composition on the motor capacities of first-year university students from Physical Education course / A influência da composição corporal na capacidade motora de ingressantes do curso de Educação Física

INTRODUCTION: University entrance is a milestone in behavior change for young people. Changes that occur during university attendance are crucial for a healthy adult life. Worldwide high rates of obesity and low levels of physical activity are worrying, and they are related to motor coordination, which is a predictor of sustained motor practice. OBJECTIVE: To analyze the influence of body composition on the motor skills of incoming university students. METHODS: 137 university students of the program in Physical Education (21.8±3.6 years) took part in the study. Body composition (body mass index, percentage of fat, waist/hip ratio), motor coordination without/with ball (KTK and TECOBOL-short tests), and physical fitness tests (PROESP-br) were analyzed through descriptive statistics, t-student test and Pearson correlation. The statistical significance was p≤0.05. RESULTS: Comparisons between sexes revealed differences in the physical and motor tests, with the exception of the sit-and-reach tests and the balance beam. There was correlation between body composition and both physical and motor tests. Moreover, the percentage of fat was correlated with cardiorespiratory fitness tests (r=-0.769; p≤0.001), lower limb strength (r=-0.710; p≤0.001), upper limb strength (r=-0.604; p≤0.001), velocity (r=0.672; p≤0.001), and dribble of TECOBOL (r=0.502; p≤0.001). CONCLUSION: Motor skills are related to body composition indicators in young university students who engaged in Physical Education program.

INTRODUÇÃO: A entrada na universidade é um marco na mudança de comportamento dos jovens. As mudanças que ocorrem na fase da formação inicial são determinantes para uma vida adulta saudável. Mundialmente, os altos índices de obesidade e os baixos níveis de atividade física são preocupantes, estes que associam com a coordenação, que é preditora de continuidade da prática motora. OBJETIVO: Analisar a influência da composição corporal na capacidade motora de ingressantes nos cursos de Educação Física. MÉTODOS: Participaram do estudo 137 universitários (21,8±3,6 anos), de ambos os sexos. A composição corporal (índice de massa corporal, percentual de gordura, relação cintura/quadril), coordenação motora sem e com bola (KTK, TECOBOL-curto), e testes de aptidão física (PROESP-br) foram analisados por meio de estatística descritiva, teste t-student e Correlação de Pearson, adotando-se p≤0,05. RESULTADOS: Comparações entre os sexos revelaram diferenças significativas (p≤0,05) nos testes físicos e motores, exceto nos testes de sentar e alcançar e trave de equilíbrio. Houve correlações significativas entre a composição corporal, os testes físicos e motores. O percentual de gordura apresentou correlação com os testes de aptidão cardiorrespiratória (r=-0,769; p≤0,001), força de membros inferiores (r=-0,710; p≤0,001), força de membros superiores (r=-0,604; p≤0,001), velocidade (r=0,672; p≤0,001) e drible do TECOBOL (r=0,502; p≤0,001). CONCLUSÃO: Os resultados indicam que as capacidades motoras estão relacionadas com os indicadores da composição corporal em jovens ingressantes no curso de Educação Física.

Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire.

PASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS: 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics. We performed the analysis of semantic equivalence in eight steps. For psychometric equivalence, we evaluated the data quality, reliability, construct validity, well-known groups and discriminant characteristics of the items, as well as a ROC curve to determine optimal PASE-P cutoff points in case identification and their sensitivity / specificity. The final version presented excellent reproducibility (CCI = 0.97) and reliability (Cronbach's alpha> 0.9). A cut-off point of 25 distinguished between patients with and without psoriatic arthritis, with sensitivity of 69.5 and specificity of 86.8. PASE-P proved to be culturally valid and reliable to screen for psoriatic arthritis in Brazilian patients with psoriasis.

Distúrbios renais em unidade de terapia intensiva / Renal disorders in intensive care units

Objetivo: identificar os principais distúrbios renais em pacientes internados em Unidade de Terapia Intensiva. Método: revisão integrativa, percorrendo seis etapas para sistematizar a pesquisa. A questão elaborada foi >. Os dados foram coletados nas bases de dados Lilacs e Medline e na Biblioteca Virtual SciELO. Oito artigos atenderam aos critérios de inclusão. Resultados: a infecção renal é de alta incidência em pacientes internados em Unidade de Terapia Intensiva e os principais distúrbios renais relacionavam-se à IRA, como sepses, choque séptico, ITU, doenças respiratórias e cardiovasculares. Conclusão: a contribuição do estudo subsidiará o desenvolvimento de novas pesquisas, bem como revisar anteriores para entendimento dos distúrbios renais em pacientes de UTI. É de fundamental relevância a presença do enfermeiro em UTI na atenção ao paciente com IRA para detecção e prevenção desta patologia, visto ser este o profissional que está próximo ao doente em tempo integral.

A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis.

OBJECTIVES:: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS:: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP) from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS:: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS:: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis

OBJECTIVES: Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification. METHODS: Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP) from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test. RESULTS: Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters. CONCLUSIONS: Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.

Morphological variation among populations of Hemigrammus coeruleus (Characiformes: Characidae) in a Negro River tributary, Brazilian Amazon

We explored patterns of phenotypic variation in Hemigrammus coeruleus from the Unini River basin, a blackwater river in the Brazilian Amazon. Geometric morphometrics was used to evaluate variation in body shape among populations from four tributaries (UN2-UN5). We found no evidence for sexual dimorphism in body size and shape. However, morphological differences among populations were detected as the analyses recovered significant groups corresponding to each sub-basin, with some overlap among them. The populations from UN2, UN3 and UN5 had more elongate bodies than fish from UN4. The most morphologically divergent population belonged to UN4, the tributary with the most divergent environmental conditions and the only one with seasonally-muddy waters. The morphological variation found among these populations is likely due to phenotypic plasticity or local adaptation, arising as a product of divergent ecological selection pressures among sub-basins. This work constitutes one of the first to employ a population-level geometric morphometric approach to assess phenotypic variation in Amazonian fishes. This method was able to distinguish subtle differences in body morphology, and its use with additional species can bring novel perspectives on the evaluation of general patterns of phenotypic differentiation in the Amazon.(AU)

Neste estudo foram explorados os padrões de variação fenotípica em Hemigrammus coeruleus da bacia do rio Unini, um rio de água preta na Amazônia brasileira. Métodos de morfometria geométrica foram aplicados para avaliar as variações na forma do corpo entre populações provenientes de quatro tributários (UN2-UN5). Os resultados mostraram ausência de dimorfismo sexual relacionado ao tamanho e formato do corpo. Entretanto, diferenças morfológicas entre populações foram detectadas, uma vez que as análises apontaram agrupamentos correspondendo a cada sub-bacia, com certo grau de sobreposição entre populações. As populações dos rios Preto, Arara e Pauini (UN2, UN3 e UN5) apresentaram formato de corpo mais alongado do que a amostra do igarapé Solimõezinho (UN4). A população mais divergente morfologicamente pertenceu ao igarapé Solimõezinho (UN4), o tributário que apresentou a condição ambiental mais divergente e o único com águas sazonalmente barrentas. A variação morfológica encontrada nessas populações de H. coeruleus é provavelmente devido a plasticidade fenotípica ou adaptação local por seleção induzida por diferentes pressões seletivas entre as sub-bacias. Este estudo constitui a primeira contribuição científica usando métodos de morfometria geométrica para avaliar a variação fenotípica entre populações em peixes amazônicos. Esse método foi capaz de distinguir diferenças sutis na morfologia e sua replicação em outras espécies amazônicas pode trazer novas perspectivas na avaliação de padrões gerais de diferenciação fenotípica na região.(AU)

Manejo da analgesia peri e pós-operatória / Peri and post-operative analgesia management

Objetivos: Esse estudo tem como propósito a análise da analgesia pós-operatória em adultos. Um dos principais objetivos dos cuidados pós-operatórios é o correto tratamento da dor. Isso evita a demora na recuperação e o aumento do custo hospitalar. A ausência de dor tende a minimizar as complicações pós-operatórias por ela causadas em todos os sistemas e aparelhos do organismo. Métodos: Esse estudo constitui-se de uma revisão da literatura especializada, realizada em maio de 2017 e junho de 2017, na qual se realizou uma consulta a artigos científicos selecionados através de busca no banco de dados, Medline, Medscape, Up to date com artigos publicados nos últimos cinco anos, e literaturas consagradas em Anestesiologia. Resultados: Descritos abaixo, a partir dos artigos e bibliografias utilizadas. Conclusões: Após uma abordagem prática multimodal da analgesia pós-operatória, analisando tal riqueza de opções para o manejo da dor pós-operatória, é fundamental ressaltar a importância no investimento em estudos com esta mesma abordagem, visando um aperfeiçoamento na analgesia pós-operatória, nunca esquecendo a atual tendência de redução de uso de opioides.

Aims: This study has the analysis of postoperative analgesia in adults as a purpose. One of the main objectives of post-operative care is the correct treatment of pain. This avoids a delay in recovery and an increase in hospital cost. The absence of pain tends to minimize the postoperative complications caused by it in all systems in the organism. Methods: This study constitutes in a specialized literary review, conducted in may, 2017 to june, 2017, in wich was performed a consult in scientific articles selected through the research in data base, Medline, Medscape, Up to Date for references published within the last 5 years, and renowed literature in anesthesiology. Results: Descripted below, through the articles and references used. Conclusions: After a practical and multimodal approach in postoperative analgesia, analyzing such variety of options in the management of postoperative pain, it´s crucial to emphasize the importance in investment in studies with this same approach, looking forward an improvement in postoperative analgesia, never forgetting a current tendency to decrease the use of opioids.

COMPARATIVE STUDY OF MICROANASTOMOSIS WITH DISTINCT 10-0 NYLON SUTURES IN RATS.

OBJECTIVE: The aim of this study is to compare micro-sutures commonly used in our midst. METHODS: In this double-blind study, 30 Wistar rats were operated randomly divided into three groups matched according to the suture used (Nylon 10-0, 75micron, brands Microsuture((r)), Polysuture((r)) and Ethicon((r))). We analyzed the number of surgical nodes required, bleeding, surgical time and histological evaluation. RESULTS: There was no significant difference between the amount of stitches of arterial suture per anastomosis. Surgical time was longer in Microsuture((r)) group as compared to Polysuture((r)) (p ≤ 0.05). Bleeding in Microsuture((r)) group was higher when compared to the others (p <0.01). In the histological analysis, the Microsuture((r)) group showed a greater tendency to develop fibrosis and aneurysm in surgical site than the others (p <0.01 and p≤0,05, respectively). Similarly, the Ethicon((r)) group showed less tendency to myointimal proliferation than the rest. (p = 0.025). CONCLUSION: The results confirm the relevance of the choice of surgical thread as an independent determining factor for the success of the procedure, besides serving as a rational subsidy for a better cost-benefit analysis. Level of Evidence I, Experimental Study, Controlled Animal Study.

COMPARATIVE STUDY OF MICROANASTOMOSIS WITH DISTINCT 10-0 NYLON SUTURES IN RATS

ABSTRACT Objective: The aim of this study is to compare micro-sutures commonly used in our midst. Methods: In this double-blind study, 30 Wistar rats were operated randomly divided into three groups matched according to the suture used (Nylon 10-0, 75micron, brands Microsuture(r), Polysuture(r) and Ethicon(r)). We analyzed the number of surgical nodes required, bleeding, surgical time and histological evaluation. Results: There was no significant difference between the amount of stitches of arterial suture per anastomosis. Surgical time was longer in Microsuture(r) group as compared to Polysuture(r) (p ≤ 0.05). Bleeding in Microsuture(r) group was higher when compared to the others (p <0.01). In the histological analysis, the Microsuture(r) group showed a greater tendency to develop fibrosis and aneurysm in surgical site than the others (p <0.01 and p≤0,05, respectively). Similarly, the Ethicon(r) group showed less tendency to myointimal proliferation than the rest. (p = 0.025). Conclusion: The results confirm the relevance of the choice of surgical thread as an independent determining factor for the success of the procedure, besides serving as a rational subsidy for a better cost-benefit analysis. Level of Evidence I, Experimental Study, Controlled Animal Study.

Prevalence of psoriatic arthritis in a large cohort of Brazilian patients with psoriasis.

OBJECTIVE: To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers. METHODS: A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist. RESULTS: A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%). CONCLUSION: In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.