Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review.

Introduction Tympanoplasty is a reparative surgery that has multiple indications. The aid of a microscope or an endoscope is necessary to carry out the procedure. The classic method utilizes the microscope; however, in the recent decades, the endoscope has been popular. Although many articles try to compare these two techniques, there is still no robust evidence that confirms the superiority of either technique. In the present work, we seek to perform a systematic review contribute with this. Objectives The present systematic review attempted to compare endoscopic and microscopic surgery techniques and to discover whether there would be superiority in the results of any of them, based on data currently available in the literature. Data Synthesis The objectives of the present review were organized according to the PICO planning and strategy adapted for systematic reviews. The inclusion and exclusion criteria were established aiming to select only select primary data. The main medical databases were searched using an optimized search string with appropriate descriptors. The searched databases were MEDLINE, LILACS, SciELO, and EMBASE. A total of 99 studies were selected and 38 were fully assessed after the inclusion criteria were applied. All included articles were reviewed by all authors and their results were discussed and summarized. Conclusion The endoscopic technique was shown to be a safer technique comparable in effectiveness to the use of microscopy. In addition, it provides possible advantages such as shortening the surgical time and better postoperative pain outcomes.

Intensive Olfactory Training in Post-COVID-19 Patients: A Multicenter Randomized Clinical Trial.

BACKGROUND: Olfactory dysfunction (OD)-including anosmia and hyposmia-is a common symptom of COVID-19. Previous studies have identified olfactory training (OT) as an important treatment for postinfectious OD; however, little is known about its benefits and optimizations after SARS-CoV-2 infection. OBJECTIVE: This study aimed to assess whether olfactory training performance can be optimized using more fragrances over a shorter period of time in patients with persistent OD after COVID-19. In addition, we determined the presence of other variables related to OD and treatment response in this population. METHODS: This multicenter randomized clinical trial recruited 80 patients with persistent OD and prior COVID-19 infection for less than 3 months. The patients were divided into 2 groups receiving either 4 or 8 essences over 4 weeks. Subjective assessments and the University of Pennsylvania Smell Identification Test (UPSIT) were performed before and after the treatment. RESULTS: Significant olfactory improvement was measured subjectively and using the UPSIT in both groups; however, no significant differences between the groups were observed. Additionally, the presence of olfactory fluctuations was associated with higher UPSIT scores. CONCLUSION: These data suggest that training intensification by increasing the number of essences for 4 weeks does not show superiority over the classical method. Moreover, fluctuant olfaction seems to be related to a higher score on the UPSIT.

Author Correction: Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing.

The aim of this study was to investigate whether the use of handrail support during maximal exercise treadmill testing (ETT) would interfere in cardiac autonomic modulation kinetics when compared to not using handrail support. The hypothesis of overestimation in cardiac autonomic dynamics when the ETT is performed using handrail was tested. Thirty-five undergraduates (21.08 ± 2.98 years old) of both sexes, volunteered to undertake two ETT under the Ellestad protocol, in non-consecutive days. The first test (T1) was performed with handrail support and, after 7 days, the second test was performed (T2) without the support. Autonomic function was measured by heart rate variability (HRV) during both tests and resting. Estimated value of peak oxygen uptake (VO2) was 22.4% (p < 0.0001) higher in T1 when compared to T2. Overall, parasympathetic pathway was deactivated earlier in T2 than in T1, with NNxx measures variating in T1 from 10.74 ± 14.59 (ms) and in T2 from 3.48 ± 3.79 (ms). In stage two, mean values of HF in T2 corresponded to 32% of values in T1. Stage three presented a difference of 60% (p < 0.014) in LF between means reached in T1 and T2. Lastly, the association of LF and VO2 persisted longer in T1 stages than in T2 and was verified in early stages (S2 and S3) of both ETTs. Our findings suggest that parasympathetic influences on HR were slightly prolonged during ETT when subjects hold onto the treadmill.

Baixos Níveis de Atividade Física e suas Associações com o Estado de Humor, Sonolência Diurna e Consumo Alimentar em Universitários / Low Levels of Physical Activity and its Associations with Mood State, Daytime Sleepiness and Food Consumption in University Students

O ingresso em um curso universitário leva a mudanças significativas no estilo de vida e na rotina do estudante, com impacto na prática de atividade física, saúde mental, hábitos de sono e hábitos alimentares. O objetivo do estudo foi verificar o nível de atividade física dos jovens universitários e suas associações com estado de humor, qualidade do sono e consumo alimentar. Trata-se de uma pesquisa de corte transversal, realizada com estudantes universitários do curso de Medicina de uma Instituição de Ensino Superior Pública. Realizou-se avaliação de medidas antropométricas, do nível de atividade física (NAF) por meio do acelerômetro GT3x (Actigraph), do consumo alimentar (inventário de 24h), e utilizando os questionários de BECK e BRUMs / POMS avaliou-se os distúrbios de sono e estado de humor. Utilizando o software SPSS realizou análise comparativa com teste t Student para grupos independentes, análise inferencial de correlação de Pearson e Regressão logística binária. Dos universitários analisados (n=75), 54,7% (n=41) eram do sexo masculino e, quando comparado com as mulheres, apresentaram maior nível de atividade física (NAF). Aproximadamente 1/3 de toda a amostra do estudo realizou menos de 300min de atividade física moderada/vigorosa. O perfil alimentar dos universitários não foi satisfatório. Verificou-se para ambos os sexos o Escore Total de POMS (Profile of Mood States) se associou com universitários que realizam menos de 300min de atividade física por semana. As mulheres têm 65% mais chances de apresentar Escala de Tensão (POMS) quando são menos ativas, e nos homens, a razão de chances é de aproximadamente três vezes maior de apresentar Confusão (BRUMS - Escala de Humor de Brunel). Conclui-se que os estudantes universitários do curso estudado, em sua maioria, foram insuficientemente ativos fisicamente e apresentam algumas alterações no estado de humor, sonolência diurna e um consumo alimentar insatisfatório.

Starting a university course leads to significant changes in the student's lifestyle and routine, with an impact on physical activity, mental health, sleeping habits and eating habits. The objective of the study was to verify the level of physical activity of young university students and its associations with mood, sleep quality and food consumption. This is a cross-sectional survey, carried out with university students studying Medicine at a Public Higher Education Institution. Anthropometric measurements, physical activity level (PAL) were assessed using the GT3x accelerometer (Actigraph), food consumption (24-hour inventory), and using the BECK and BRUMs / POMS questionnaires, health disorders were assessed. sleep and mood. Using SPSS software, comparative analysis was carried out with Student's t test for independent groups, Pearson correlation inferential analysis and binary logistic regression. Of the university students analyzed (n=75), 54.7% (n=41) were male and, when compared to women, they had a higher physical activity level (PAL). Approximately 1/3 of the entire study sample performed less than 300 minutes of moderate/vigorous physical activity. The dietary profile of university students was not satisfactory. For both sexes, the POMS Total Score (Profile of Mood States) was found to be associated with university students who perform less than 300 minutes of physical activity per week. Women are 65% more likely to present with Tension Scale (POMS) when they are less active, and in men, the odds ratio is approximately three times greater for presenting Confusion (BRUMS - Brunel Mood Scale). It is concluded that the majority of university students on the course studied were insufficiently physically active and presented some changes in mood, daytime drowsiness and unsatisfactory food consumption.

Endoscopic or Microscopic Tympanoplasty Advantages and Disadvantages: A Theory Domain Systematic Review

Abstract Introduction Tympanoplasty is a reparative surgery that has multiple indications. The aid of a microscope or an endoscope is necessary to carry out the procedure. The classic method utilizes the microscope; however, in the recent decades, the endoscope has been popular. Although many articles try to compare these two techniques, there is still no robust evidence that confirms the superiority of either technique. In the present work, we seek to perform a systematic review contribute with this discussion. Objectives The present systematic review attempted to compare endoscopic and microscopic surgery techniques and to discover whether there would be superiority in the results of any of them, based on data currently available in the literature. Data Synthesis The objectives of the present review were organized according to the PICO planning and strategy adapted for systematic reviews. The inclusion and exclusion criteria were established aiming to select only select primary data. The main medical databases were searched usingan optimized search string with appropriate descriptors. The searched databases were MEDLINE, LILACS, SciELO, and EMBASE. A total of 99 studies were selected and 38 were fully assessed after the inclusion criteria were applied. All included articles were reviewed by all authors and their results were discussed and summarized. Conclusion The endoscopic technique was shown to be a safer technique comparable in effectiveness to the use of microscopy. In addition, it provides possible advantages such as shortening the surgical time and better postoperative pain outcomes.

Infecção congênita e perinatal por citomegalovírus: clínica, laboratório e condutas / Congenital and perinatal infection by cytomegalovirus: clinical, laboratory and treatment

Racional: O impacto da infeção congênita e perinatal pelo CMV na saúde pública é muito relevante, sendo a infecção congênita mais predominante, porém pouco abordada. Objetivos: Avaliar o perfil dos pacientes com diagnóstico positivo para infecção congênita e perinatal por citomegalovírus. Métodos: Estudo observacional, analítico, transversal, com coleta de dados retrospectiva. Os dados foram obtidos segundo critérios demográficos, imunológicos, virológicos, terapêuticos e de análise dos exames de imagem.Resultados: Foram coletados dados de 35 pacientes que inicialmente receberam o diagnóstico, entretanto somente 17 preenchiam os critérios de inclusão. Conclusões: A amostra estudada foi de casos sintomáticos e reflete proporcionalmente pouco de uma doença tão prevalente. Isto se deve a dificuldade diagnóstica maternofetal; portanto, é importante enfocar e investir em pesquisa e novas ferramentas para um diagnóstico precoce.

Background: The impact of congenital and perinatal CMV infection on public health is very relevant, with congenital infection being the most prevalent, but little addressed. Objective: To evaluate, through the analysis of medical records, the profile of patients with diagnosis of congenital or perinatal cytomegalovirus infection during the stipulated study time. Methods: Observational study, analytical, cross-sectional, with retrospective data collection. The data were obtained according to demographic, immunologic, virologic and therapeutic criteria, as well as imaging exams analysis. Results: Data were collected from 35 patients who initially received the congenital or perinatal infection diagnosis during the time stipulated by the study, but only 17 met the inclusion criteria. Conclusions: The studied sample of symptomatic patients proportionally reflects little of such a prevalent disease. This happens because of the difficult mother-fetus diagnosis. Therefore, it is important to focus and invest in research and new tools seeking the early diagnosis.