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1.
Eur J Orthop Surg Traumatol ; 35(1): 61, 2025 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-39907802

RESUMO

BACKGROUND: The surgical management of complex proximal tibia shaft fractures that extend into the joint remains a difficult challenge. The existing body of literature outlines a variety of reduction and fixation strategies, ranging from traditional double-plate constructs, with or without the use of minifragment plates, to fragment-specific plates combined with intramedullary nails, nail-plate combinations, and circular frames. In patients with severely compromised soft tissues, conventional internal fixation techniques can elevate the risk of complications. Nail-plate combinations have emerged as a preferred solution for addressing tibia shaft fractures with proximal intra-articular extension. Nonetheless, these techniques demand meticulous attention to prevent further displacement or splitting of the plateau perimeter during IM nail insertion. In this study, we report a series of three patients presenting with complex proximal tibia plateau fractures with diaphyseal extension. We aim to demonstrate potential benefits of a novel nail-plate combination construct and to provide technical features to this approach using a "hoop stress" plate circling the tibial plateau perimeter prior the insertion of a suprapatellar tibia IM nail. PATIENT POPULATION AND SURGICAL TECHNIQUE: Our series entails three young patients presenting with complex proximal tibia fracture (AO 41-C3) following high-energy trauma. Definitive fixation of these injuries was performed using the "umbrella technique." The approach involves placement of a circumferentially precontoured minifragment plate under the patellar tendon to brace around the anteromedial and anterolateral perimeters of the tibial plateau closing the fracture split. This allows reconstruction of its perimeter, while maintaining and preventing displacement forces during suprapatellar nail insertion. Key clinical and radiological outcome measures included: pain, wound complications, function (standing/walking distance), range of motion, muscle strength, use of crutches, and radiological signs of bone healing, limb alignment and discrepancy, summarized with the modified "HSS knee score". RESULTS: Our series showed highly favorable results, reporting "Good and Excellent-HSS knee scores" (> 80 points). All fractures healed within a six-month postoperative period, and most importantly no evidence of limb deformity and/or discrepancy was observed. Furthermore, no other secondary clinical complications manifested within the first year of follow-up. CONCLUSION: This novel "umbrella technique" should be considered in complex situations where soft tissues around the knee are significantly compromised that can preclude traditional constructs. This technique is useful for protecting the tibial plateau perimeter when selecting nail-plate combination. Our fixation strategy, dubbed the "umbrella technique," entails an anterior minifragment hoop plate to mitigate hoop stress around the plateau facilitating suprapatellar nail insertion without losing the already reconstructed perimeter. This innovative nail-plate combination offers biomechanical advantages to these complex fracture patterns. LEVEL OF EVIDENCE: Level IV.


Assuntos
Pinos Ortopédicos , Placas Ósseas , Fixação Intramedular de Fraturas , Fraturas da Tíbia , Humanos , Fraturas da Tíbia/cirurgia , Fixação Intramedular de Fraturas/métodos , Fixação Intramedular de Fraturas/instrumentação , Fixação Intramedular de Fraturas/efeitos adversos , Masculino , Adulto , Feminino , Adulto Jovem
2.
Rev Lat Am Enfermagem ; 33: e4443, 2025.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-39907389

RESUMO

OBJECTIVE: to identify the main factors related to complications of the invasive blood pressure system. METHOD: prospective study conducted with patients over 18 years of age admitted to intensive care, using a device for measuring invasive blood pressure. Participants were monitored during the catheter dwell-time and sociodemographic, clinical and device data were collected. The outcome analyzed was removal due to non-indication of use or due to complications. Student's t-test, Mann-Whitney U test, chi-square test and Fisher's exact test were used for the analyses. RESULTS: 50 participants were included and monitored, and most devices were installed in the radial artery (86%), with a 20-gauge catheter (50%), all with a flexible catheter. Each patient remained, on average, 4.36 days (SD: 3.504) with the device. Regarding the outcomes, 60.0% of the devices were removed due to non-indication of use and 40.0% due to complications. Phlebitis was the most prevalent complication, and pressure in the bag was the factor associated with catheter removal before the time of indication (p=0.046). CONCLUSION: the main complications associated with this device were obstruction and phlebitis, while pressure in the bag was the factor related to catheter removal before indication. BACKGROUND: (1) Phlebitis was the most prevalent complication. (2) Pressure in the bag was associated with catheter removal before indication. (3) Length of stay and use of sedation were related to the onset of phlebitis.


Assuntos
Determinação da Pressão Arterial , Humanos , Estudos Prospectivos , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Determinação da Pressão Arterial/instrumentação , Adulto , Idoso de 80 Anos ou mais , Flebite/etiologia , Flebite/epidemiologia
3.
J Med Virol ; 97(1): e70177, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39835625

RESUMO

Human papillomavirus (HPV) infections rank as the most prevalent sexually transmitted infections globally. The Brazilian Ministry of Health recommends the topical use of 70%-90% trichloroacetic acid (TAA) for treating condyloma acuminata, yet this method suffers from a high recurrence rate of 36% and requires roughly six applications. Topical photodynamic therapy (PDT) has shown effectiveness in targeting subclinical lesions, but it also necessitates multiple sessions for complete lesion clearance. This randomized clinical trial evaluates the efficacy of 80% TAA monotherapy against a combined approach of ultrasonic scalpel excision followed by a single PDT session (US + PDT). The US + PDT group required fewer treatment sessions, exhibited superior cosmetic outcomes, and reported zero lesion recurrence during an 18-month follow-up, in contrast to the TAA group's recurrence rate of 33.3%. Notwithstanding, patient-reported pain during PDT application emerged as a significant barrier, affecting treatment adherence and completion rates. Innovating new PDT protocols could potentially address this challenge, enhancing patient compliance and therapeutic success.


Assuntos
Condiloma Acuminado , Fotoquimioterapia , Ácido Tricloroacético , Humanos , Ácido Tricloroacético/uso terapêutico , Fotoquimioterapia/métodos , Masculino , Adulto , Feminino , Condiloma Acuminado/tratamento farmacológico , Condiloma Acuminado/cirurgia , Resultado do Tratamento , Pessoa de Meia-Idade , Infecções por Papillomavirus/tratamento farmacológico , Infecções por Papillomavirus/virologia , Adulto Jovem , Brasil , Terapia Combinada , Procedimentos Cirúrgicos Ultrassônicos/métodos , Procedimentos Cirúrgicos Ultrassônicos/instrumentação
4.
Biosens Bioelectron ; 273: 117089, 2025 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-39818181

RESUMO

Smartphone-based colorimetric (bio)sensing is a promising alternative to conventional detection equipment for on-site testing, but it is often limited by sensitivity to lighting conditions. These issues are usually avoided using housings with fixed light sources, increasing the cost and complexity of the on-site test, where simplicity, portability, and affordability are a priority. In this study, we demonstrate that careful optimization of color space can significantly boost the performance of smartphone-based colorimetric sensing, enabling housing-free, illumination-invariant detection. We evaluated the quantification performance of smartphone-based colorimetry using monotonal shadings of colors with spectral compositions covering a wide range of visible spectra. The color coordinates were extracted from regions of interest (ROI) that were automatically selected using a homemade algorithm. Compared to absorbance-based models, smartphone-based colorimetry offered a broader measurement range with a comparable limit of detection. However, models based on RGB space proved highly sensitive to illumination changes, limiting their reliability. In contrast, the CIELAB color space-specifically the a∗ and b∗ chromatic coordinates-, exhibited inherent resistance to illumination changes. Our concept of equichromatic surfaces explains this inherent resilience to lightning variations, providing a theoretical basis for designing illumination-invariant optical (bio)sensors.


Assuntos
Algoritmos , Técnicas Biossensoriais , Cor , Colorimetria , Smartphone , Colorimetria/instrumentação , Colorimetria/métodos , Técnicas Biossensoriais/instrumentação , Humanos , Desenho de Equipamento , Limite de Detecção
5.
Biomater Adv ; 169: 214165, 2025 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-39823944

RESUMO

Current hemodialysis treatments can cause adverse effects, many of which are linked to the membranes used in the process. These issues are being addressed through new materials and technologies, making it urgent to establish minimum guidelines for evaluating such membranes. This review proposes standardizing the biological tests and variables to evaluate the performance of new membranes, aiming to replicate hemodialysis conditions closely. The tests were categorized into protein adsorption, protein transmission, platelet adhesion, platelet activation, blood coagulation times, hemolysis, complement activation, and cytotoxicity. For protein adsorption, static tests are recommended as an initial step to rule out membrane adhesion, followed by dynamic tests that must be conducted using a crossflow system (>250 mL/min flow) and a solution mimicking real conditions (BSA, lysozyme, trypsin, pepsin, creatinine, urea, albumin, fibrinogen, and γ-globulin). Protein transmission tests must employ dynamic conditions, using human blood or platelet-rich plasma for a minimum time of 3.5 h. Complement activation should be tested using human blood and ELISA assays to detect C3, C5 TCC, and SC5b-9. Blood coagulation times (APTT, TT, FT, TCT, and TAT) should be measured with platelet-poor and platelet-rich plasma. Hemolysis tests should transition from water bath to continuous mode for at least 3.5 h. Cytotoxicity tests should compare the MTT assay with other methods (Alamar Blue, Lactate Dehydrogenase Assay, Flow Cytometry, or Trypan Blue Exclusion Test) and use different cell types for comprehensive validation. By implementing these minimum biological tests, membrane evaluations would more accurately reflect the real-world applications, ensuring biocompatibility, effectiveness, and efficiency.


Assuntos
Hemólise , Teste de Materiais , Membranas Artificiais , Diálise Renal , Humanos , Diálise Renal/normas , Diálise Renal/instrumentação , Diálise Renal/métodos , Teste de Materiais/normas , Teste de Materiais/métodos , Ativação do Complemento , Adsorção , Ativação Plaquetária/fisiologia , Adesividade Plaquetária , Coagulação Sanguínea/fisiologia
6.
Mikrochim Acta ; 192(2): 60, 2025 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-39779543

RESUMO

The use of 3D-printed electrodes is reported fabricated from in-house conductive filament composed of a mixture of recycled poly (lactic acid) (rPLA), graphite (Gpt), and carbon black (CB) for fast detection of the abused drug ketamine. Firstly, the performance of these electrodes was evaluated in comparison to 3D-printed electrodes produced employing a commercially available conductive filament. After a simple pretreatment step (mechanical polishing), the new 3D-printed electrodes presented better performance than the electrodes produced from commercial filament in relation to peak-to-peak separation of the redox probe [Fe(CN)6]3-/4- (130 mV and 759 mV, respectively), charge transfer resistance (Rct = 1.04 ± 0.05 kΩ and 9.62 ± 0.03 kΩ, respectively), and heterogeneous rate constant (k0 = 7.16 ± 0.05 × 10-3 cm s-1 and 3.57 ± 0.03 × 10-3 cm s-1, respectively). Excellent analytical characteristics for the detection of ketamine were achieved, including wide linear range (10 to 250 µmol L-1), excellent sensitivity (0.024 ± 0.001 µA µmol L-1), low limit of detection (LOD = 0.7 µmol L-1), and recovery values from 82 to 115% for beverage samples (white and red wines, beer, water, and vodka) spiked with the abused drug ketamine.


Assuntos
Técnicas Eletroquímicas , Eletrodos , Ketamina , Limite de Detecção , Poliésteres , Ketamina/análise , Ketamina/química , Poliésteres/química , Técnicas Eletroquímicas/métodos , Técnicas Eletroquímicas/instrumentação , Grafite/química , Impressão Tridimensional , Condutividade Elétrica , Fuligem/química , Reciclagem , Drogas Ilícitas/análise
7.
Lasers Med Sci ; 40(1): 22, 2025 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-39827299

RESUMO

The Endolift® technique, introduced in 2005, gained popularity among medical and non-medical professionals as a non-surgical approach using subdermal laser devices. However, its widespread adoption lacked a thorough understanding of its physiological interaction, resulting in controversies over its effectiveness and safety. This study aimed to assess the evidence of Endolift® efficacy, parametrization, and safety by analyzing adverse events. A systematic literature review was conducted by searching the following databases: NCBI/PubMed, Medline, Embase, CINAHL, and the Cochrane Central Library. These searches resulted in 111 articles. Seven articles were selected after removing duplicates and screening titles, abstracts, and full texts. These articles exhibited a high risk of bias, a lack of standardization in treatment parameters, and reports of adverse events that did not align with clinical reality, often occurring with off-label use.In conclusion, due to insufficient high-quality research and inconsistent indications and parameter adjustments, asserting the efficacy and safety of Endolift® is challenging. Randomized studies are recommended to curb indiscriminate use, which may compromise patient safety. This analysis underscores the importance of evidence-based clinical practices for patient safety and ethical treatment.


Assuntos
Terapia a Laser , Humanos , Terapia a Laser/métodos , Terapia a Laser/instrumentação , Dermatopatias/terapia , Dermatopatias/radioterapia
8.
Palliat Support Care ; 23: e20, 2025 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-39801420

RESUMO

BACKGROUND: Pain is a frequent symptom in cancer patients (CP), and its multidimensional assessment is essential for a comprehensive approach and to establish clinical prognoses. The Short-Form McGill Pain Questionnaire (SF-MPQ) is an internationally recognized tool for the multidimensional assessment of pain, both in clinical and research settings. However, no studies have been reported in Latin America that determine its psychometric properties in CP and chronic pain. OBJECTIVES: To determine the psychometric properties of the SF-MPQ in adult Mexican cancer patients with chronic pain. METHODS: An instrumental design was used with a non-probabilistic convenience sample of 222 cancer patients treated at the pain clinic of a tertiary care hospital. Analyses were conducted to evaluate factorial structure (exploratory and confirmatory factor analysis [CFA]), reliability (internal consistency), measurement invariance, and criterion validity (concurrent and divergent). RESULTS: CFA verified a 9-item structure divided into 2 factors: (1) Affective-Nociceptive and (2) Neuropathic. A global Cronbach's alpha coefficient of .82 and a global McDonald's Omega index of .82 were identified. Configural, metric, and scalar invariance (ΔCFI ≤ .01; ΔRMSEA ≤ .015) were confirmed regarding the sex variable. Finally, the SF-MPQ showed a positive correlation with the Numerical Rating Scale (rho = .436, p< .01) and a negative correlation with the EORTC-QLQ C30 (rho = -.396, p< .01). SIGNIFICANCE OF RESULTS: The Mexican version of the SF-MPQ presented adequate psychometric properties and fit indices, making it a valid and reliable instrument for use in clinical and research settings in Mexico. Its use is recommended for the comprehensive assessment of pain in oncology in Mexico, as it allows for the understanding of pain characteristics beyond intensity, guiding the establishment of clinical prognoses.


Assuntos
Dor Crônica , Neoplasias , Medição da Dor , Psicometria , Humanos , Psicometria/instrumentação , Psicometria/métodos , Psicometria/normas , Masculino , Feminino , México , Pessoa de Meia-Idade , Inquéritos e Questionários , Medição da Dor/métodos , Medição da Dor/normas , Medição da Dor/estatística & dados numéricos , Dor Crônica/psicologia , Dor Crônica/complicações , Adulto , Reprodutibilidade dos Testes , Neoplasias/complicações , Neoplasias/psicologia , Idoso , Dor do Câncer/psicologia
9.
Anesth Analg ; 140(2): 334-341, 2025 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-39804596

RESUMO

BACKGROUND: Proficiency in endotracheal intubation (ETI) is essential for medical professionals and its training should start at medical schools; however, large caseload may be required before achieving an acceptable success rate with direct laryngoscopy. Video laryngoscopy has proven to be an easier alternative for intubation with a faster learning curve, but its availability in medical training may be an issue due to its high market prices. We devised a low-cost 3-dimensionally printed video laryngoscope (3DVL) and performed a randomized trial to evaluate if the intubation success rate on the first attempt with this device is noninferior to a standard commercially available video laryngoscope (STVL). METHODS: Two hundred and nine medical students from 5 medical schools were enrolled and randomized to start with the STVL (McGrath MAC) or the 3DVL. Four stations (standard airway using the STVL/3DVL and difficult airway using the STVL/3DVL) were set to simulate ETI with standard Airway Management Trainer manikins (Laerdal Medical Ltd.). The noninferiority margin of 7.5% was defined for the success rate on the first attempt, considering the difference in proportions between the STVL (expected to be higher) and 3DVL groups. RESULTS: Regarding the standard airway station, 60.7% (n = 65) of the students successfully performed TI on the first attempt with the STVL within the established timeframe, compared to 36.3% (n = 37) of the students using the 3DVL. This represented a difference of 24.4% (95% confidence interval, 17.5%-31.3%). Considering the difficult airway station, the success rates on the first intubation attempt with the 2 VLs did not differ. CONCLUSIONS: The 3DVL was inferior in achieving first-attempt intubation when compared with the STVL with a difference in success rate >7.5% margin in simulated scenarios with medical students. Tracheal intubation might require a set of psychomotor skills for which the McGrath MAC device is superior to the low-cost alternative.


Assuntos
Competência Clínica , Intubação Intratraqueal , Laringoscópios , Laringoscopia , Manequins , Impressão Tridimensional , Estudantes de Medicina , Humanos , Feminino , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Masculino , Laringoscopia/instrumentação , Laringoscopia/métodos , Laringoscopia/educação , Adulto Jovem , Gravação em Vídeo , Adulto , Desenho de Equipamento
10.
Rev Bras Enferm ; 77Suppl 4(Suppl 4): e20230539, 2025.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39813495

RESUMO

OBJECTIVE: to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care. METHOD: a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population). RESULTS: the instrument had 44 items, distributed across four dimensions. FINAL CONSIDERATIONS: the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses' practice in the pre-hospital setting.


Assuntos
Serviços Médicos de Emergência , Psicometria , Humanos , Brasil , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/ética , Serviços Médicos de Emergência/normas , Feminino , Adulto , Pesquisa Qualitativa , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
11.
Biomed Microdevices ; 27(1): 5, 2025 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-39873777

RESUMO

The overexpression of Human Epidermal Growth Factor Receptor 2 (HER2) protein is specifically related to tumor cell proliferation in breast cancers. Its presence in biological serum samples indicates presence or progression of cancer, becoming a promise biomarker. However, their detection needs a simple and high accuracy platform. In this study, we report the develop and optimization of a simple highly sensitive electrochemical platform for HER2. Gold electrode surface was modified with a self-assembled monolayer composed by DNA aptamer, 6-(ferrocenyl) hexanethiol and 6-mercapto-1-hexanethiol. Electrochemical impedance spectroscopy was used to quantify the changes in capacitance on the interface due to the presence ferrocene, whether acting as a redox charge or its behavior under different HER2 concentration in PBS and undiluted human serum. As a result, the approach allows detection of HER2 with a limit of detection of 3.61 pg/mL, 12.28 nF sensitivity per decade and a linear range from 1 pM to 1 [Formula: see text]M in serum. This electrochemical aptasensor can be applied to different arrays for aptamer screening and has a significant importance to interaction study of biological systems.


Assuntos
Aptâmeros de Nucleotídeos , Capacitância Elétrica , Receptor ErbB-2 , Receptor ErbB-2/metabolismo , Receptor ErbB-2/sangue , Aptâmeros de Nucleotídeos/química , Aptâmeros de Nucleotídeos/metabolismo , Humanos , Técnicas Biossensoriais/instrumentação , Eletrodos , Técnicas Eletroquímicas/instrumentação , Limite de Detecção , Ouro/química , Espectroscopia Dielétrica
12.
Port J Card Thorac Vasc Surg ; 31(4): 41-43, 2025 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-39863981

RESUMO

We demonstrate that performing anatomical pulmonary resection by video-assisted thoracoscopic surgery without staplers or energy devices is feasible. This technique is an alternative for surgeons with limited access to expensive technologies.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Cirurgia Torácica Vídeoassistida , Humanos , Cirurgia Torácica Vídeoassistida/métodos , Cirurgia Torácica Vídeoassistida/instrumentação , Pneumonectomia/métodos , Pneumonectomia/instrumentação , Neoplasias Pulmonares/cirurgia , Masculino , Feminino , Estudos de Viabilidade , Pessoa de Meia-Idade , Idoso
13.
J Wound Ostomy Continence Nurs ; 52(1): 54-57, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39836001

RESUMO

PURPOSE: The purpose of this study was to examine health-related quality of life and adaptation of persons with a colostomy before and after use of a colostomy plug. DESIGN: Single group before-and-after study. SUBJECTS AND SETTING: The study sample comprised 19 people with a colostomy who attended an outpatient clinic João Pessoa, in Paraiba, Brazil. Inclusion criteria were: over 18 years, protruding colostomy, diameter 20 to 45 mm, elimination pattern of up to 3 solid or pasty fecal stools per day, and medical prescription for the use of the colostomy plug. METHODS: Data were collected between November 2018 and February 2019. Three outpatient visits per participant were completed; informed consent and baseline data were collected during clinic visit one. Data collected at baseline included demographic and pertinent clinic data. Stoma specific quality of life was measured using the City of Hope Quality of Life - Ostomy Questionnaire; adaptation to an ostomy was measured using the Scale for the Level of Adaptation of Ostomy Patients (SLAOP). Participants were also taught to use a colostomy plug during this visit. A second visit occurred between the 8th and 10th day of use; participants' ability to use the device was assessed during this visit. A third visit occurred 30 to 35 days after plug use; instruments used to measure adaptation and health-related quality of life were readministered. RESULTS: Participants who had significantly higher scores for quality of life and adaptation were identified in people who used the plug in all dimensions of the Scale for Level of Adaptation of people with stomas and City of Hope Quality of Life - Ostomy Questionnaire, except for the interdependence mode. Significant, positive and strong correlations were identified between adaptation and quality of life before (r = 0.823; P = .000015) and after (r = 0.808; P = .000028) use of the colostomy plug. CONCLUSION: Findings suggest that use of a colostomy plug improved adaptation and quality of life in some patients living with a colostomy.


Assuntos
Colostomia , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Colostomia/psicologia , Colostomia/métodos , Colostomia/instrumentação , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso , Adulto , Brasil , Estudos Controlados Antes e Depois
14.
JMIR Aging ; 8: e55455, 2025 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-39841997

RESUMO

BACKGROUND: The prevalence of stroke is high in both males and females, and it rises with age. Stroke often leads to sensor and motor issues, such as hemiparesis affecting one side of the body. Poststroke patients require torso stabilization exercises, but maintaining proper posture can be challenging due to their condition. OBJECTIVE: Our goal was to develop the Postural SmartVest, an affordable wearable technology that leverages a smartphone's built-in accelerometer to monitor sagittal and frontal plane changes while providing visual, tactile, and auditory feedback to guide patients in achieving their best-at-the-time posture during rehabilitation. METHODS: To design the Postural SmartVest, we conducted brainstorming sessions, therapist interviews, gathered requirements, and developed the first prototype. We used this initial prototype in a feasibility study with individuals without hemiparesis (n=40, average age 28.4). They used the prototype during 1-hour seated sessions. Their feedback led to a second prototype, which we used in a pilot study with a poststroke patient. After adjustments and a kinematic assessment using the Vicon Gait Plug-in system, the third version became the Postural SmartVest. We assessed the Postural SmartVest in a within-subject experiment with poststroke patients (n=40, average age 57.1) and therapists (n=20, average age 31.3) during rehabilitation sessions. Participants engaged in daily activities, including walking and upper limb exercises, without and with app feedback. RESULTS: The Postural SmartVest comprises a modified off-the-shelf athletic lightweight compression tank top with a transparent pocket designed to hold a smartphone running a customizable Android app securely. This app continuously monitors sagittal and frontal plane changes using the built-in accelerometer sensor, providing multisensory feedback through audio, vibration, and color changes. Patients reported high ratings for weight, comfort, dimensions, effectiveness, ease of use, stability, durability, and ease of adjustment. Therapists noted a positive impact on rehabilitation sessions and expressed their willingness to recommend it. A 2-tailed t-test showed a significant difference (P<.001) between the number of the best-at-the-time posture positions patients could maintain in 2 stages, without feedback (mean 13.1, SD 7.12) and with feedback (mean 4.2, SD 3.97), demonstrating the effectiveness of the solution in improving posture awareness. CONCLUSIONS: The Postural SmartVest aids therapists during poststroke rehabilitation sessions and assists patients in improving their posture during these sessions.


Assuntos
Postura , Smartphone , Reabilitação do Acidente Vascular Cerebral , Tronco , Dispositivos Eletrônicos Vestíveis , Humanos , Masculino , Feminino , Adulto , Reabilitação do Acidente Vascular Cerebral/instrumentação , Reabilitação do Acidente Vascular Cerebral/métodos , Postura/fisiologia , Tronco/fisiopatologia , Pessoa de Meia-Idade , Estudos de Viabilidade , Acidente Vascular Cerebral/fisiopatologia , Idoso , Projetos Piloto , Equilíbrio Postural/fisiologia
15.
Food Chem ; 470: 142652, 2025 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-39787764

RESUMO

The escalating environmental impact of non-biodegradable plastic waste has intensified global efforts to seek sustainable alternatives, with biodegradable polymers from renewable sources emerging as a promising solution. This manuscript provides the current perspectives, challenges, and opportunities within the field of sustainable and biodegradable packaging. Despite a significant market presence of conventional non-biodegradable petrochemical-based plastics, there is a growing trend towards the adoption of bio-based polymers from renewable resources driven by environmental sustainability and regulatory measures. However, the transition to biodegradable packaging is fraught with challenges, including scalability, cost-effectiveness, technological limitations, comprehensive waste management systems, and infrastructural needs. The manuscript highlights the intrinsic technological challenges and the need for advancements in material science to enhance the performance and adoption of biodegradable packaging. This paper also supply insights into the development and implementation of biodegradable packaging, offering a comprehensive overview of its role in achieving global sustainability goals.


Assuntos
Plásticos Biodegradáveis , Biodegradação Ambiental , Embalagem de Alimentos , Polímeros , Embalagem de Alimentos/instrumentação , Plásticos Biodegradáveis/química , Polímeros/química , Gerenciamento de Resíduos/métodos
16.
Rev Bras Enferm ; 77(6): e20230190, 2025.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39813521

RESUMO

OBJECTIVES: to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care. METHODS: methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory. RESULTS: the validation determined the retention of five factors and 63 items. The instrument's internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit. CONCLUSIONS: the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.


Assuntos
Infecções por HIV , Atenção Primária à Saúde , Humanos , Atenção Primária à Saúde/normas , Infecções por HIV/terapia , Masculino , Feminino , Inquéritos e Questionários , Adulto , Reprodutibilidade dos Testes , Análise Fatorial , Psicometria/instrumentação , Psicometria/métodos , Pessoa de Meia-Idade , Brasil
17.
Dental Press J Orthod ; 29(6): e24spe6, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39813579

RESUMO

INTRODUCTION: It is known that the stability of the results obtained with orthodontic treatment depends, in addition to the functional and aesthetic aspects, also on the adequate planning of the retention devices, the patient's compliance with this new phase, and the physiological changes that the human body experiences over the years, throughout the craniofacial aging process. OBJECTIVE: This article discusses the importance of the orthodontic retention phase and the influence of diagnosis, planning and execution of corrective treatment of malocclusions, in order to achieve the expected success. METHODS: Throughout the text, different types of retainers and approaches during this phase will be presented, with the aim of ensuring the stability of the results obtained after correcting problems in the vertical, transverse and anteroposterior directions. RESULTS: Orthodontic retainers are not all the same. The retention protocol must be performed in an individualized and planned manner, taking the initial dental positions as a reference. CONCLUSIONS: The orthodontist must inform the patient and parents about important aspects of how to maintain the occlusion achieved with orthodontic treatment. The retainers installed after the end of corrective treatment are not everlasting, they can suffer damage with use and must be replaced. Therefore, the patient must be aware of the importance of using retainers as prescribed by the orthodontist, and of returning for scheduled review appointments.


Assuntos
Má Oclusão , Desenho de Aparelho Ortodôntico , Contenções Ortodônticas , Humanos , Má Oclusão/terapia , Ortodontia Corretiva/métodos , Ortodontia Corretiva/instrumentação , Planejamento de Assistência ao Paciente
18.
Turk Neurosurg ; 35(1): 12-21, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39840557

RESUMO

AIM: To determine if low-cost magnification devices (USB computer microscope, smartphone) enable the acquisition and maintenance of basic microsurgical skills by comparing skills learned using these devices against those learned using a surgical microscope. Determining whether skills acquired using these devices can be transferred to the surgical microscope. MATERIAL AND METHODS: Twelve neurosurgical participants, ranging from faculty to postgraduate year-1 trainees, were randomly divided into three groups for training using a surgical microscope, smartphone, or USB microscope. All performed a pre-training evaluation for two surgical skills (round-the-clock suturing, anastomosis) using the surgical microscope, followed by 10 training exercises using only the assigned device. Upon completion, these tasks were evaluated again using the surgical microscope, and pre- and post-training exercise completion times and quality were compared. RESULTS: Following training, the durations for pre- and post-training exercises, as well as quality, were compared. All groups significantly reduced the time to complete each task, and all groups significantly improved task completion quality. There were no significant differences in task quality or time to complete between the three groups, either pre- or post-training. CONCLUSION: Microsurgical skills training using smartphones or USB microscopes enabled the acquisition and improvement of the examined microsurgical skills that were equivalent to skill improvement obtained by training with a surgical microscope. These acquired skills transferred from the low-cost magnification devices to the surgical microscope. Thus, training using smartphones and inexpensive USB microscopes can provide an affordable alternative for teaching and individual study to learn and maintain basic microsurgical skills, especially when access to operative microscopes are limited.


Assuntos
Competência Clínica , Microscopia , Microcirurgia , Microcirurgia/educação , Microcirurgia/instrumentação , Humanos , Microscopia/instrumentação , Procedimentos Neurocirúrgicos/educação , Procedimentos Neurocirúrgicos/instrumentação , Procedimentos Neurocirúrgicos/métodos , Smartphone , Masculino , Feminino , Adulto , Neurocirurgia/educação
19.
Sci Rep ; 15(1): 1419, 2025 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-39789178

RESUMO

The characteristics of spontaneous movements in infants are essential for the early detection of neurological pathologies, with the Prechtl method being a widely recognized approach. While the Prechtl method is effective in predicting motor risks, its reliance on the evaluator's expertise limits its scalability, particularly in low-income areas. In such contexts, the use of inertial sensors combined with automated analysis presents a promising accessible alternative; however, more research is necessary to get results comparable to those of the Precht method. This research aims to determine the more important metrics of trunk and limbs to assess spontaneous movement in healthy infants during the first semester of life as the basis of a sensor-based alternative. It was a cross-sectional study with 116 separate subjects divided into 3 groups: 0 M Group (N = 43), 3 M Group (N = 44), and 6 M (N = 29). Participants' movements were recorded using 6 wireless inertial sensors (4 limbs, thorax, and pelvis). Parameters from the acceleration signal were estimated in relation to velocity, cross-correlation, kurtosis, skewness, area, and periodicity. The different stages (0 M,3 M, and 6 M) have different profiles of accelerometric parameters. Trunk and limb parameters can differentiate between 0 of 3 months (13/25 trunk and 17/36 limb parameters) and between 0 and 6 months (10/25 trunk and 20/36 limb). Mainly, trunk parameters can differentiate between 3 and 6 months (9/25 trunk vs. 3/36 limb). Additionally, only 2 trunk parameters (kurtosis and periodicity) can differentiate the 3 stages. Wearable devices can effectively detect significant differences in spontaneous movements during the first six months of life, particularly trunk-related data. The extremities could be insufficient to distinguish movements between 3 and 6 months. On the other hand, two key parameters-kurtosis of thorax velocity and periodicity of trunk velocity-successfully differentiate between the three age groups analyzed.


Assuntos
Movimento , Tronco , Dispositivos Eletrônicos Vestíveis , Humanos , Lactente , Movimento/fisiologia , Masculino , Tronco/fisiologia , Feminino , Estudos Transversais , Acelerometria/instrumentação , Acelerometria/métodos , Recém-Nascido
20.
Clin Oral Investig ; 29(1): 90, 2025 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-39862315

RESUMO

OBJECTIVE: This study investigated the associations among endodontic instruments, ultrasonic tips and various final irrigation protocols for removing intracanal and intratubular biofilms in long oval canals. METHODOLOGY: One hundred mandibular premolars inoculated with Enterococcus faecalis were divided into two groups: the control group (CG: n = 10), which received no treatment; and the test groups (n = 30), which included saline (SS), sodium hypochlorite (2.5% NaOCl) and chlorhexidine (2% CHX). The samples were prepared with Reciproc® Blue 25/0.08, Flatsonic, Clearsonic and Reciproc Blue 40/0.06. Each test group was divided into three subgroups (n = 10): conventional irrigation (CI) with syringes and needles, passive ultrasonic irrigation (PUI) and continuous ultrasonic irrigation (CUI) with an Irrisonic tip. The root canals were examined using confocal laser scanning microscopy. Mann‒Whitney and Kruskal‒Wallis tests followed by Dunn post hoc tests (p < 0.05) were used for statistical analysis. RESULTS: NaOCl and CHX were effective for intracanal and intratubular decontamination. Saline showed significant decontamination in the intratubular areas when CUI was used. The CI method was the least effective for intracanal decontamination. CONCLUSION: The use of Flatsonic and Clearsonic ultrasonic tips is promising for root canal disinfection. CLINICAL RELEVANCE: The disinfection techniques in endodontic treatment focus on the removal of biofilms from long oval canals, which is crucial for effective cleaning during root canal procedures.


Assuntos
Dente Pré-Molar , Biofilmes , Clorexidina , Enterococcus faecalis , Microscopia Confocal , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica , Humanos , Hipoclorito de Sódio/farmacologia , Clorexidina/farmacologia , Irrigação Terapêutica/métodos , Irrigação Terapêutica/instrumentação , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Técnicas In Vitro , Cavidade Pulpar/microbiologia , Ultrassom , Mandíbula
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