bluuebunny/crossref_metadata_2025 huggingface dataset:
A influência da postura corporal nos parâmetros do sistema de oscilometria de impulso em crianças
Authors: Ferreira Letícia Goulart , Gonçalves Renata Maba , Assumpção Maíra Seabra de , Schivinski Camila Isabel Santos
Published: June 2022

Oscilometria de impulso (IOS) é um método alternativo e complementar de avaliação da mecânica respiratória, mas cuja técnica de execução ainda necessita padronização. Objetivo: Analisar e comparar os resultados de parâmetros do IOS quando realizado em escolares nas posições ortostática e sentada. Método: estudo analítico observacional transversal. Escolares saudáveis de 6 a 12 anos foram submetidos à espirometria e dois exames de IOS randomizados quanto à postura (sentada e ortostática). Os dados foram analisados no SPSS 20.0. Utilizou-se o teste Shapiro-Wilk e, segundo a normalidade dos dados, aplicou-se o teste de Wilcoxon ou t de Student para comparação das posturas. Na correlação entre dados antropométricos e as variáveis oscilométricas empregou-se o teste de Pearson ou Spearman, com p < 0,05. Resultados: participaram 72 crianças, idade média de 8,42 ± 1,26. Não houve diferença entre as variáveis oscilométricas nas duas posturas. Na posição sentada, houve correlação negativa baixa entre altura de tronco (Altronco) e variáveis: resistência a 20Hz (R20) (p = 0,034) e a 5Hz (R5) (p = 0,041), resistência central (Rescent) (p = 0,018) e impedância (Z) (p = 0,030). Em ortostatismo verificou-se correlação negativa baixa entre idade e resistência periférica (Resper) (p = 0,011), R5 (p = 0,014) e Z (p = 0,009). Conclusão: Não houve diferença nos valores das variáveis oscilométricas entre a postura sentada e ortostática. Contudo, a resistência das vias aéreas foi influenciada pela Altronco, estatura e idade. O ortostatismo parece ser a melhor posição para análise da Resper.
Functional evaluation of hemiplegic patients post-stroke using the Disabilities of the Arm, Shoulder And Hand - DASH questionnaire
Authors: Thinen Natalia Cristina , Tsukimoto Denise Rodrigues , Tsukimoto Gracinda Rodrigues
Published: June 2022

Hemiplegia after a stroke results in movement limitations of the upper and lower limbs, hindering the functional capacity of the individual to perform daily activities. Objective: To verify whether the Disability of the Arm, Shoulder, and Hand questionnaire (DASH) is an appropriate instrument to evaluate patients with hemiplegia due to a stroke. Methods: One hundred patients with hemiplegia due to stroke in treatment at the Occupational Therapy service of IMREA HC FMUSP were interviewed using the DASH instrument. Results: The DASH showed to be a valid and reproducible questionnaire because it evaluates the difficulties in performing the basic and instrumental activities of daily living regarding the motor limitations of hemiplegic patients. Conclusion: The questionnaire provided patient information on their opinion and personal satisfaction regarding their own physical condition and degree of independence for daily activities
Benefício da terapia de ondas de choque no tratamento de úlceras cutâneas: uma revisão da literatura
Authors: Pai Marcus Yu Bin , Toma Juliana Takiguti , Rampim Danielle Bianchini , Imamura Marta , Battistella Linamara Rizzo
Published: June 2022

A terapia de ondas de choque (TOC) extracorpórea possui ação analgésica e anti-inflamatória. Com a evolução e compreensão de seus mecanismos físicos e biológicos, foi se estudando a sua aplicação em outras patologias, principalmente em afecções ósseas e musculo-tendíneas. Recentemente, estudos em modelos animais demonstraram a sua capacidade angiogênica e maior taxa de re-epitelização local. Estas pesquisas levaram ao início do uso de TOC radial de baixa energia no tratamento e manejo de diversas lesões de pele de difícil tratamento. As úlceras cutâneas possuem diversas etiologias, variando desde úlceras de pressão, queimaduras, úlceras venosas ou arteriais e também úlceras diabéticas. Seu tratamento é um desafio, devido ao seu tempo prolongado de tratamento (resultando em dificuldades quanto ao seguimento clínico) e também elevados custos. Objetivo: Avaliar a eficácia da TOC na cicatrização de úlceras de diversas etiologias: diabéticas, por pressão, queimaduras, pós-traumáticas, vasculares venosas e arteriais, por meio de uma revisão da literatura. Métodos: Foi realizada uma revisão da literatura, sendo incluídos estudos clínicos em humanos Resultados: 9 artigos preencheram os critérios de inclusão. Os estudos inclusos compreenderam 788 pacientes. Os manuscritos trouxeram uma variedade de padrão de intervenções diferentes. Houve heterogeneidade no tempo de intervenção, número de pulsos e na frequência de sessões, bem como na quantidade de sessões, densidade de energia aplicada, e também no tipo de ondas de choque utilizados nas terapias. Alguns dos trabalhos descritos encontraram uma maior taxa na cicatrização e fechamento completo de lesões em pacientes com lesões crônicas, que não responderam ao tratamento conservador. Porém, há poucos estudos na literatura com qualidade metodológica adequada. Conclusão: A TOC surge como uma alternativa promissora para pacientes que não respondem bem à terapia conservadora. Os resultados são promissores porém com evidências limitadas quanto a diminuição do tempo de cicatrização e na aceleração do fechamento de lesões. Os estudos selecionados não relataram efeitos colaterais significativos, sendo uma terapia segura
Aquatic physical therapy in the treatment of a child with merosin-deficient congenital muscular dystrophy: case report
Authors: Albuquerque Santos Cinthya Patrícia de , Hengles Ricardo Cristian , Cyrillo Fábio Navarro , Rocco Fernanda Moraes , Braga Douglas Martins
Published: June 2022

This case report describes an aquatic therapy program for a child with Merosin-Deficient Congenital Muscular Dystrophy. Objective: This study sought to investigate the effect of aquatic physical therapy on the speed and the rate of energy expenditure while moving around on a flat surface, in addition to the functional reach of the upper limbs suffering from the proximal weakness that affects these patients seeking greater independence. Methods: The Motor Function Measurement (MFM) and the Functional Reach Test (FRT) were used as assessment tools; the Energy Expenditure Index (EEI) was measured in seated locomotion, as well as the time spent, and muscle activation was measured via electromyography (EMG). The program lasted 12 weeks and included activities to improve mobility and agility as well as reaching from the seated position. Results: In the MFM the change in the score of the two dimensions (D2 and D3) that the treatment focused on was 6.8%. The functional reach improved by 16 centimeters (cm) and the amount of time moving while sitting decreased by 19 seconds (s). Energy expenditure decreased by 252.31 beats per minute (bpm). Conclusion: The aquatic physical therapy was effective for agility improvement in seated locomotion and upper limb functionality of a 6-year-old child with Merosin-Deficient Congenital Muscular Dystrophy
Comparison of scores obtained in videogame with biomechanical variables in stroke
Authors: Tarallo Fernanda Botta , Silva Jéssica Santos da , Santos Mayara Luz Alcantara dos , Castro Pedro Claudio Gonsales de , Moreira Maria Cecília dos Santos
Published: June 2022

Virtual reality (VR) promotes intensive training of a single task, enabling the motor learning, thereby affecting the recovery of postural control (PC) in individuals with stroke. Video game with balance platform are used as a form of intervention and, at the end of the game, a score is provided, but there is no evidence that it can be used as a quantitative parameter of PC. Objective: To determine whether there is a correlation between the score obtained by a video game and stabilometric variables. Methods: Nine individuals with stroke participated in an experimental protocol using the game Penguin Slide as intervention. The score was collected in the first and last sessions. The 2.0 AMTI force platform was used, with an acquisition frequency of 200Hz for evaluating before and after intervention. The volunteers were positioned with open eyes (OE) and closed eyes (CE) in the upright position for 1 minute, with one foot on each platform. Using the Matlab software, the variables of center of pressure (COP) were obtained: total COP area (ACOPt), COP area on the mediolateral (ACOPx) and anteroposterior (ACOPy) axis, average speed of COP (VCOP). The non-parametric paired Wilcoxon test (p < 0.05) was used to compare the initial and final results of Penguin Slide game score and the pre and post intervention data obtained by the force platform in the OE and CE conditions. The analysis were done with the software R. Results: Comparison of initial and final score (p = 0.003). In OE condition, the initial and final comparison: ACOPt (p = 0.91), ACOPx (p = 0.57), ACOPy (p = 0.49), VCOP (p = 0.09). In CE condition, the initial and final comparison: ACOPt (p = 0.73) ACOPx (p = 1.0), ACOPy (p = 0.73) VCOP (p = 0.73). Conclusion: The VR did not provide PC improvement of the patients despite the score of the Penguin Slide game have increased significantly at the end of the protocol. Thus, there was no correlation between the score obtained by video game and the stabilometric variables
Muscle training program in patients with severe chronic obstructive pulmonary disease
Authors: Sagrillo Luiza Minato , Meereis Estele Caroline Welter , Gonçalves Marisa Pereira
Published: June 2022

Objective: The objective of this study was to analyze the effects of a muscle training program with neuromuscular electrical stimulation (NMES) for lower limbs (LL) and active resisted exercises for upper limbs (UL) for patients with severe Chronic Obstructive Pulmonary Disease. Methods: With a sample of 5 subjects (65.2 ± 6.09 years), the initial and final evaluations were: One-RepetitionMaximum testing; Sit-to-stand test; perimetry of the thigh; 6-minute walk test; Saint George’s Respiratory Questionnaire; Medical Research Council scale for dyspnea and the BODE index. The intervention was performed three times a week and was composed of 18 sessions of 30-minute NMES followed by 30 minutes of exercise for the UL based on the diagonal Kabat method. The NMES parameters were: 50Hz of frequency, 6s on and 8s off, increase slope of 2s and decrease slope of 2s, pulse width of 400µs, and intensity defined as patient tolerance and increased from 1 to 5mA each day. Results: The results have shown an increase in muscle strength (p = 0.01) and of muscle resistance (p = 0.01). There was an improvement tendency in the quality of life (p = 0.16) and in the cardiorespiratory fitness (p = 0.11). Conclusion: The association of physical exercises with diagonals and NMES can be a beneficial resource for the treatment of patients with severe COPD. It is suggested, however, the need for new researches with a wider sample size for assuring these benefits
Cross-cultural adaptation of the ABILOCO: a measure of locomotion ability for individuals with stroke
Authors: Avelino Patrick Roberto , Faria-Fortini Iza , Basílio Marluce Lopes , Menezes Kênia Kiefer Parreiras de , Magalhães Lívia de Castro , Teixeira-Salmela Luci Fuscaldi
Published: June 2022

The ABILOCO, specific for adults with stroke, is a questionnaire for the assessment of locomotion ability. For the application with the Brazilian population, its cross-cultural adaptation is required. Objective: To translate the ABILOCO into the Brazilian-Portuguese language and adapt the questionnaire to the Brazilian culture. Methods: The process of cross-cultural adaptation followed standardized procedures and was conducted in five stages: translation, back-translation, synthesis of the translations, expert committee consultation, and testing of the pre-final version. The prefinal version was administered to 10 individuals with stroke, who were asked to interpret all of the items. Results: The cross-cultural adaptation process followed al of the recommended guidelines and minor modifications in two items were necessary to facilitate understanding. Satisfactory results were obtained during the test of the pre-final version, since there was not found any problem regarding the wording and clarity of the items or the objective of the questionnaire. Conclusions: The ABILOCO-Brazil showed satisfactory semantic, linguistic, cultural, and conceptual equivalence to be used within clinical and research contexts. Future studies should continue the process of validation of the questionnaire.
Intervention effects on shoulder physiotherapeutic range of motion and old map thermography submitted to surgery for breast cancer treatment
Authors: Petry Débora Melissa , Honório Gesilani Julia da Silva , Santos Keyla dos , Santos Saionara dos , Luz Clarissa Medeiros da , Luz Soraia Cristina Tonon da , Palú Marina
Published: June 2022

Age is the main risk factor for developing breast cancer and clinically, older women have a more difficult rehabilitation process. Objective: The aim of the study was to evaluate the effects of physiotherapy intervention in range of motion (ROM) of shoulder and thermographic map of elderly postoperative treatment of breast cancer. Methods: A total of 10 elderly, undergoing surgery for breast cancer. The evaluation was done before and after the intervention by means of the goniometer for ADM measures and thermographic camera Eletrophysics PV320T, to identify the temperature of the thoracic region. We used the Wilcoxon test and Spearman correlation, with a 0.05 significance level. Results: The patients showed significant improvement in range of all movements of the affected limb, except internal rotation. When comparing the assessment of temperature values with the revaluation, there was an increase in temperature of the thoracic regions, and only significant values preserved breast. By comparing the temperature of the region preserved with compromised in the evaluation, there was a significant difference, since the revaluation, there was an approximation of these values. Conclusion: The correlation between increased temperature and ADM was significant for both members adduction and internal rotation member preserved in the evaluation. Intervention assured resolution or reduction of amendments on physical examination, improved ROM, increased temperature of the thoracic regions, and correlation between temperature increase and ROM bilateral adduction and internal rotation member preserved in the initial evaluation
Evaluation of respiratory muscle strength and functional capacity in patients with cystic fibrosis
Authors: Silva Cássio Magalhães da Silva e , Araujo Adriele Mascarenhas , Silva Anna Lúcia Lima Diniz da , Sousa Valdívia Alves de , Gomes Neto Mansueto , Saquetto Micheli Bernadone
Published: June 2022

Objective: To correlate the respiratory muscle strength and functional capacity in patients with CF. Method: Cross-sectional study in adults with cystic fibrosis. Sampling data were cataloged in Microsoft Office Excel 2007 and the variables analyzed by SPSS version 20.0 using the Student t test and the Spearman coefficient. The level of significance adopted was p < 0.05. Results: We assessed 35 patients with cystic fibrosis (44.6 ± 19.0 years), the great majority of patients in FC (n=22) did not present weakness of the inspiratory muscles (MIP -90,7 ± 27.4 cmH2O). It was not found statistically significant differences only between the adult and elderly patients. There was a positive correlation between MIP and MEP and a six-minute walk test (6MWT) in participants with respiratory muscle weakness and in the elderly. There was statistically significant difference between the averages of the distance covered on the 6MWT and the maximal respiratory pressures with the average of what was envisaged for these variables. Conclusion: All groups presented limitation of respiratory strength and functional capacity. The correlations between the respiratory pressures with the 6MWT were low and small in adults and individuals without respiratory muscle weakness; moderate to high in the elderly; small to moderate in women; small and negative in men; and high in patients with respiratory muscle weakness.
Funcionalidade na doença de Alzheimer leve, moderada e grave: um estudo transversal
Authors: Haskel Maria Vaitsa Loch , Bonini Juliana Sartori , Santos Suzane Cristina , Silva Weber Cláudio Francisco Nunes , Bueno Camilla Fagundes de Oliveira , Bortolanza Marciane Conti Zornita , Daniel Christiane Riedi
Published: June 2022

Objetivo: Avaliar a funcionalidade de pacientes com Doença de Alzheimer (DA) residentes na comunidade, no município de Guarapuava - PR, região Sul do Brasil. Métodos: Foi realizado um estudo transversal, com pacientes com DA residentes na comunidade, no município de Guarapuava - PR. Os participantes foram classificados de acordo com a Escala Clínica de Demência em CDR 1 (DA leve), CDR 2 (DA moderada) e CDR 3 (DA severa). O estado mental foi avaliado através do Mini Exame do Estado Mental; as atividades básicas de vida diária (ABVD) através do Índice de Barthel e as atividades instrumentais de vida diária (AIVD) através do Índice de Lowton e Brody. Resultados: Foram avaliados 58 idosos com diagnóstico de DA, dos quais 14 (24,1%) estavam em CDR 1, 21 (36,2%) em CDR 2 e 23 (39,7%) em CDR 3. Houve diferença significativa entre os níveis de dependência para a realização das ABVD e AIVD entre todas as fases da DA (p <0,001), sendo que a dependência foi maior nos participantes estadeados em CDR 2 e CDR 3. Conclusão: O nível de dependência para a realização das atividades básicas e instrumentais de vida diária é maior nas fases mais avançadas da DA e a dependência para a realização das AIVD está presente em todas as fases da doença, sendo maior do que a dependência para a realização das ABVD desde a fase inicial da DA, sugerindo uma perda progressiva da funcionalidade.
Teste de caminhada de seis minutos em pediatria: discutindo evidências em situações específicas
Authors: Parazzi Paloma Lopes Francisco , Okuro Renata Tiemi , Ribeiro José Dirceu , Ribeiro Maria Ângela Gonçalves de Oliveira , Basso-Vanelli Renata Pedrolongo , Schivinski Camila Isabel Santos
Published: June 2022

Teste de caminhada de seis minutos (TC6) tem se mostrado uma ferramenta bem tolerada, confiável e de baixo custo para monitorar a capacidade funcional de crianças e adolescentes saudáveis e em diferentes situações clínicas. Objetivo: Verificar e discutir as evidências científicas do TC6 utilizado em 4 situações específicas da criança com: 1) asma; 2) fibrose cística 3) obesidade e 4) higidez. Método: A busca nas bases de dados foi conduzida utilizando-se as palavras-chaves: teste de caminhada de seis minutos, crianças, adolescentes, obesos, fibrose cística e asma. Consultou-se as bases Pubmed (Medline), Lilacs e PEDro. Foram considerados os ensaios clínicos em português, inglês e espanhol, publicados no período de 2005 a 2016 e incluídos os estudos que abordam o TC6como método de avaliação, monitorização e prognóstico de crianças e adolescentes saudáveis, com diagnósticos de asma, fibrose cística e obesidade. Resultados: Identificou-se 97 artigos, sendo 48 duplicados. Conduziu-se a pré-seleção de 43 estudos dos quais 6foram excluídos, pelo título ou resumo, por não atenderem aos critérios de inclusão. A seleção final totalizou 39 manuscritos para a apreciação na íntegra e discussão na presente revisão. Conclusão: TC6 é reprodutível e validado para a população pediátrica, sendo considerado um instrumento importante para avaliar as implicações das doenças crônicas na capacidade funcional. 1) TC6 tem se mostrado útil pra identificação do prejuízo das atividades de vida diária durante a crise de asma e fora dela, assim como do comprometimento da capacidade funcional diante do hábito de vida sedentário. 2) É adequado para avaliação de programas de reeducação alimentar na obesidade. 3) Na fibrose cística é uma boa ferramenta para avaliação de programas de reabilitação pulmonar e acompanhamento da progressão da doença. 4) Entre os saudáveis observa-se a busca por valores de referência e falta de um consenso sobre a forma de aplicabilidade do teste.
Manifestações musculoesqueléticas na síndrome de Klippel-Trenaunay
Authors: Capucho Patricia Yuri , Thinen Natalia Cristina , Carvalho Mariana Cavazzoni Lima de
Published: June 2022

A síndrome de Klippel-Trenaunay é uma doença congênita rara de etiologia não definida, caracterizada pela presença da tríade: manchas vinho do porto, malformações venosas ou veias varicosas e hipertrofia óssea e/ou tecidual. Acomete mais frequentemente os membros inferiores. O tratamento em geral é conservador, sendo as intervenções limitadas ao tratamento das complicações. Objetivo: Apresentar relato de caso de uma criança com manifestações musculoesqueléticas da síndrome avaliada por equipe multiprofissional, composta pelo serviço social, psicologia, fisioterapia, terapia ocupacional, fonoaudiologia, enfermagem e médico fisiatra. Método: Após avaliação foi definido trabalhar consciência e correção da postura assim como a percepção corporal, realização de atividade em ortostatismo, treino de equilíbrio, dissociação de cinturas e trocas posturais. Resultados: Paciente participou dos atendimentos multiprofissionais por dois meses, obteve melhor estabilidade da marcha, passando a ter marcha independente na comunidade, com velocidade maior e menor número de quedas. Conclusão: Recebeu alta com objetivos atingidos e pais sensibilizados quanto à importância de manter o seguimento multiprofissional e seguir os objetivos traçados em domicílio.
Escola de Coluna: experiência do Hospital das Clínicas da Universidade de São Paulo
Authors: Chung Tae Mo
Published: June 2022

A Escola de Coluna representa um programa educacional e terapêutico eficaz para os pacientes com afecções da coluna vertebral, principalmente as que decorrem de posturas inadequadas. Estudamos 32 pacientes tratados na escola de coluna do Hospital das Clínicas da Universidade de São Paulo. Em 89% dos casos houve melhora da dor. 66% dos pacientes, seis meses após terem participado da escola, continuavam a seguir as suas recomendações.
Avaliação funcional multivariada em jogadores de futebol profissional: uma metanálise
Authors: Silva Paulo Roberto Santos , Visconti Ana Maria , Roldan Andrea , Teixeira Alberto Alves Azevedo , Seman Antonio Palma , Lolla Júlio Cesar Costa Rosa , Godoy Junior Rubens , Lepéra Cláudio , Pardini Fernanda Orsi , Firmino Mauro Theodoro , Zanin Marcelo Thimoteo , Roxo Carla Dal Maso Nunes , Rosa Albertina Fontana , Basílio Solange de Souza , Monteiro José Carlos Simões , Cordeiro José Roberto
Published: June 2022

O objetivo deste trabalho foi verificar, de modo amplo, o comportamento de variáveis importantes para a saúde preventiva e o desempenho atlético, em jogadores de futebol profissional. Além disso, o estudo tece comentários, através de longa revisão bibliográfica, sobre os resultados de nossos atletas e os observados na literatura especializada, nessa modalidade esportiva. Os futebolistas foram submetidos a uma bateria de testes clínicos, laboratoriais e de aptidão cardiorespiratória, metabólica e muscular, pré-participação ao Campeonato Brasileiro de Futebol de 1996, que constou das seguintes variáveis: consumo de oxigênio, limiar anaeróbio ventilatório, eletrocardiografia em repouso e no exercício, potência muscular ( wingate), flexibilidade, hemograma, reações sorológicas para doença de Chagas, protoparasitológico, glicose, uréia, creatinina, colesterol total e frações, hormônios, eletrólitos, minerais, composição corporal, avaliação fisioterápica, odontológica e nutricional. Os resultados obtidos indicaram que o emprego de uma avaliação multifatorial, em atletas de alto rendimento, é um procedimento importante para verificar se o nível de aptidão física está adequado e/ou detectar possíveis deficiências, que possam interferir no desempenho atlético dos futebolistas, durante os treinamentos e jogos.
Espiritualidade baseada em evidências
Authors: Saad Marcelo , Masiero Danilo , Battistella Linamara Rizzo
Published: June 2022

Espiritualidade pode ser definida como um sistema de crenças que enfoca elementos intangíveis, que transmite vitalidade e significado a eventos da vida. Tal crença pode mobilizar energias e iniciativas extremamente positivas, com potencial ilimitado para melhorar a qualidade de vida da pessoa. As implicações da espiritualidade na saúde vêm sendo estudadas cientificamente e documentadas em centenas de artigos. Há relação entre envolvimento espiritualista e vários aspectos da saúde mental, sendo que pessoas vivenciam melhor saúde mental e se adaptam com mais sucesso ao estresse se são religiosas. Pessoas religiosas são fisicamente mais saudáveis, têm estilos de vida mais salutares e requerem menos assistência de saúde. Existe uma associação entre espiritualidade e saúde que provavelmente é válida, e possivelmente causal. É plenamente reconhecido que a saúde de indivíduos é determinada pela interação de fatores físicos, mentais, sociais e espirituais. Os profissionais da saúde já contam com indicações científicas do benefício da exploração da espiritualidade na programação terapêutica de virtualmente qualquer doença. O presente artigo cita os trabalhos mais relevantes sobre o assunto.
Geometria do fêmur proximal em ossos de brasileiros
Authors: Mourão Ana Lúcia Mourão , Vasconcellos Henrique Ayres de
Published: June 2022

Objetivo: Fornecer dados sobre a morfometria do fêmur proximal adulto para que se estabeleçam parâmetros e correlações entre as diversas medidas dessa porção do osso de brasileiros. Material e Método: Realizamos a avaliação da geometria da extremidade proximal de 183 fêmures secos de adultos brasileiros, de ambos os sexos, sem idade cronológica determinada. A morfometria constou da obtenção das medidas: comprimento do colo do fêmur (CCF); largura do colo do fêmur (LCF); comprimento do eixo femoral (CEF); ângulo colodiafisário (ACD). Foi realizada também a densitometria óssea (DEXA) de 18 fêmures. A análise estatística constou do cálculo da média aritmética (X); desvio-padrão (SD) e mediana (Me), sendo testadas essas variáveis quanto ao lado através dos testes t de Student e Não- Paramétrico de Mann Whitney. Realizamos a correlação e a regressão linear simples entre as variáveis que apresentavam associação com o CEF. Resultado: Correlacionamos as medidas morfométricas com a densidade mineral óssea (DMO) e as densidades entre si. Encontramos os seguintes valores médios para os lados direito e esquerdo: CCF = 24,9 ± 4,5 mm e 24,3 ± 4,2 mm; LCF = 26,7 ± 3,1 mm e 26,3 ± 3,3 mm; CEF = 92,1 ± 6,9 mm e 92,0 ± 7,1 mm; ACD = 111,2° ± 5,9 e 114,2° ± 5,5. A correlação entre CEF x ACD não foi significante. As correlações entre morfometria e DMO foram menos significativas que as correlações das densidades entre si. Conclusão: Podemos acreditar que a associação entre o CEF e as outras medidas pode ter valor preditivo no risco de fratura. Considerando a importância desse fator, procedemos a este estudo para podermos fornecer dados da geometria femoral de ossos de brasileiros, bem como possibilitar aplicação desses dados na prática clínica.
Classificação Internacional de Funcionalidade (CIF)
Authors: Battistella Linamara Rizzo , Brito Christina May Moran de
Published: June 2022

O presente artigo tem por objetivo a atualização e a familiarização de profissionais envolvidos com a reabilitação daClassificação Internacional de Funcionalidade (CIF) desenvolvida pela Organização Mundial de Saúde. São abordados seu histórico, finalidade e perspectivas de aplicação na área de reabilitação.
Dentifrício fluoretado, vigilância sanitária e o SUS: o caso de Manaus-AM
Authors: Ramos Mayara Costa Carneiro , Rebelo Maria Augusta Bessa , Vieira Janete Maria Rebelo , Miranda Luís Fernando Bandeira , Tabchoury Cinthia Pereira Machado , Cury Jaime Aparecido
Published: June 2022

OBJETIVO: Determinar o potencial anticárie dos dentifrícios distribuídos pelas unidades básicas de saúde (UBS) de Manaus-AM. MÉTODOS: Noventa e nove bisnagas de dentifrícios de quatro marcas comerciais foram coletadas de 7 de outubro de 2019 a 11 de outubro de 2019 em 16 UBS, que foram codificados por marca e UBS de origem. De acordo com a embalagem, os dentifrícios das quatro marcas e seus lotes foram formulados com monofluorfosfato de sódio (Na2FPO3) e a maioria (91%) tinha carbonato de cálcio (CaCO3) como abrasivo. Foram determinadas as concentrações de fluoreto total (FT = FST + Fins) e de fluoreto solúvel total (FST = íons F- ou FPO32-), para certificar se atendiam à Resolução ANVISA RDC Nº530 (máximo de 1.500 ppm de FT) e se tinham potencial anticárie (mínimo de 1.000 ppm de FST). As análises foram feitas com eletrodo íon específico. RESULTADOS: As concentrações (ppm F) de FT [média; desvio padrão (DP); n] encontradas nos dentifrícios A (1.502,3; DP = 45,6; n = 33), B (1.135,5; DP = 52,7; n = 48) e D (936,8; DP = 20,5; n = 8) foram próximas ao descrito na embalagem, 1.500, 1.100 e 1.000 ppm F, respectivamente. No dentifrício C, foi encontrada média de 274,1 ppm (DP = 219,7; n = 10) de FT, divergindo da concentração declarada de 1.500 ppm F. Em acréscimo, as cinco bisnagas do lote no 11681118 do dentifrício C não foram fluoretadas. Quanto ao FST, à exceção do dentifrício D (937,9; DP = 40,29), os demais apresentaram concentração inferior ao seu respectivo FT. CONCLUSÃO: Observou-se problemas graves de quantidade e qualidade do fluoreto nos dentifrícios distribuídos pelo SUS em Manaus, mostrando a necessidade de vigilância desses produtos e ratificando a urgência da revisão da resolução ANVISA RDC Nº 530.
Toward a Better Understanding of Sex- and Gender-Related Differences in Endovascular Stroke Treatment: A Scientific Statement From the American Heart Association/American Stroke Association
Authors: Ospel Johanna M. , Schaafsma Joanna D. , Leslie-Mazwi Thabele M. , Amin-Hanjani Sepideh , Asdaghi Negar , Gordon-Perue Gillian L. , Couillard Philippe , Hadidi Niloufar N. , Bushnell Cheryl , McCullough Louise D. , Goyal Mayank ,   on behalf of the American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; and Council on Epidemiology and Prevention
Published: June 2022

There are many unknowns when it comes to the role of sex in the pathophysiology and management of acute ischemic stroke. This is particularly true for endovascular treatment (EVT). It has only recently been established as standard of care; therefore, data are even more scarce and conflicting compared with other areas of acute stroke. Assessing the role of sex and gender as isolated variables is challenging because they are closely intertwined with each other, as well as with patients’ cultural, ethnic, and social backgrounds. Nevertheless, a better understanding of sex- and gender-related differences in EVT is important to develop strategies that can ultimately improve individualized outcome for both men and women. Disregarding patient sex and gender and pursuing a one-size-fits-all strategy may lead to suboptimal or even harmful treatment practices. This scientific statement is meant to outline knowledge gaps and unmet needs for future research on the role of sex and gender in EVT for acute ischemic stroke. It also provides a pragmatic road map for researchers who aim to investigate sex- and gender-related differences in EVT and for clinicians who wish to improve clinical care of their patients undergoing EVT by accounting for sex- and gender-specific factors. Although most EVT studies, including those that form the basis of this scientific statement, report patient sex rather than gender, open questions on gender-specific EVT differences are also discussed.
Explaining the Decline of Rural Population in Spain (1900–2018)
Authors: Cañal-Fernández Verónica , Álvarez Antonio
Published: June 2022

The analysis of data at the municipality level from the Municipal Enumerator Books demonstrates that rural population in Spain has declined as a percentage of total population since 1900. A highly granular case study of Asturias, a region in northern Spain, reveals that internal infrastructure and the proximity of a medium-size town were crucial to maintaining population in the countryside. The income gap between rural and urban municipalities, however, also led to significant migration from rural areas.
The Recognition of War Refugees: Lapland, Love, and
Care
Authors: Autti Outi , Intonen Saara
Published: June 2022

According to Honneth, the mutual recognition essential for individual autonomy and a just society divides into three forms—love in primary relationships, rights in legal relationships, and solidarity in the community of value. Such recognition has three corresponding forms of disrespect—abuse, exclusion, and denigration, all of which can raise struggles for recognition. An analysis of empirical data—in this case, oral-history reports from Finnish evacuees to Sweden during the Lapland War (1944–1945)—within this framework of recognition reveals detailed information about the refugees’ wartime experiences, particularly those that they deemed significant enough to be remembered decades after the event.
A new high-altitude species of Penaincisalia Johnson, 1990 (Lepidoptera, Lycaenidae) from the Peruvian Andes
Authors: BÁLINT ZSOLT , BOYER PIERRE , FARFÁN JACKIE , CERDEÑA JOSÉ , PYRCZ TOMASZ W.
Published: June 2022

A new Penelfin species, Penaincisalia jadwigae sp. nov. is described from very high elevations, 4510–4620 m, in the Department of Huancavelica, Peru. Superficially it is somewhat similar to P. perezi Bálint, 2001, but can easily be recognized by wing colour and pattern. A key for the identification of species in the Penaincisalia s. str. group with orange dorsal wing surface colouration is provided. A list of the local butterfly fauna is given, and spatial distribution, thermal regulation and discoloration are briefly discussed. The taxon Shapiroana matusikorum Johnson, 1992 is reinstated from synonymy with Penaincisalia aurulenta Johnson, 1990, as Rhamma matusikorum (Johnson, 1992), stat. rev., comb. n. 17 figures are provided.
Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance
Authors: Yang Yun , Wang Xinqiang , Mao Weiliang , He Tongyun , Xiong Zhaodong
Published: June 2022

Background

Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization.

Methods

The study included 30 volunteers. The volunteer’s head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6–14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides – heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis.

Results

There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles.

Conclusion

The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent.

Trail registration

ChiCTR2000034233, Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.
Comparisons in polypharmacy over a decade in community-dwelling older adults-findings from Israel national health and nutrition surveys
Authors: Goldsmith Rebecca , Dichtiar Rita , Shimony Tal , Nitsan Lesley , Axelrod Rachel , Laxer-Asael Irit , Rasooly Iris , Sinai Tali , Berry Elliot M.
Published: June 2022

Background

Polypharmacy increases with age and is associated with serious health and economic costs. This study reports changes over a decade in medication-use patterns and polypharmacy, in Israeli community-dwelling older adults aged ≥ 65 years.

Methods

Demographic and health data from two representative national health cross-sectional surveys – MABAT ZAHAV 1 (MZ1) in 2005–2006, and MZ2 in 2014–2015 were analyzed. Polypharmacy was defined as use of ≥ 5 medications. Risk factors for polypharmacy were estimated by multivariable logistic regression with adjusted odds ratios (aOR) and their 95% confidence intervals (CI).

Results

Self-reported data on medications taken were available for 1647 participants (91.5%) in MZ1, and for 833 participants (80.2%) in MZ2, 55% women, and about 20% aged ≥ 80, in both surveys. The prevalence of polypharmacy was significantly lower in MZ2 than in MZ1: 64.2% versus 56.3%, p = .0001; with an aOR (95%CI) of 0.64 (0.52, 0.80). The most commonly taken drugs were for hypertension (27.0%, 25.3%), dyslipidemia (9.7%, 12.4%) and anticoagulation (9.2%, 9.8%). For approximately 10% of drugs, indications were either unknown or incorrect. Polypharmacy was significantly associated with poor self-health assessment 2.47 (1.99, 3.06), ≥ 4 versus 1–3 chronic illnesses 6.36 (3.85, 10.50), and age ≥ 80 versus younger 1.72 (1.32, 2.24). Similar associations were observed with major polypharmacy of ≥ 8 medications.

Conclusion

Polypharmacy, although reduced in the last decade, requires constant attention, especially concerning lack of knowledge of indications which leads to poor adherence and adverse side effects. Health-care teams should carry out regular medicine reconciliation in at-risk elderly patients.
Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review
Authors: Pan Xiao-hong , Xu Jie-kun , Pan Lei , Wang Cai-hong , Huang Xiao-qing , Qiu Jun-ke , Ji Xiao-bo , Mao Min-jie
Published: June 2022

Background

Tuberculosis is a bacterial infection involving multiple organs and systems. Its hematological presentation mainly includes anemia and leukocytosis. Evans syndrome is a rare autoimmune disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and neutropenia, with positive results for the direct Coombs test and platelet antibodies. The cooccurrence of tuberculosis and Evans syndrome is rarely reported.

Case presentation

A 69-year-old female presented with a fever and shortness of breath. Her chest computerized tomography scan showed extensive miliary nodules in the bilateral lung fields. She rapidly developed respiratory failure that required endotracheal intubation and mechanical ventilation. The acid-fast bacilli sputum smear results indicated a grade of 3+. Later on, blood testing revealed hemolytic anemia, a positive direct Coombs test result, and the presence of the platelet antibody IgG. This patient was diagnosed as having disseminated pulmonary tuberculosis and Evans syndrome. She successfully recovered after treatment with antituberculosis drugs and glucocorticoids.

Conclusions

Tuberculosis can occur together with Evans syndrome. Affected patients should receive both antituberculosis and immunosuppressive drugs.
Busy day effect on the use of obstetrical interventions and epidural analgesia during labour: a cross-sectional register study of 601 247 deliveries
Authors: Vilkko Riitta , Räisänen Sari , Gissler Mika , Stefanovic Vedran , Kalliala Ilkka , Heinonen Seppo
Published: June 2022

Background

Daily delivery volume might affect the quality of obstetric care. We explored the busy day effect on selected obstetrical interventions and epidural analgesia performed during labour in different sized delivery hospitals and on the Finnish obstetric ecosystem.

Methods

We conducted a cross-sectional study on Finnish Medical Birth Register data of singleton pregnancies (N = 601,247) from 26 delivery hospitals from 2006 to 2016. Delivery hospitals were stratified by annual delivery volume: C (category) 1: < 1000, C2: 1000–1999, C3: 2000–2999, C4: ≥3000, and C5: university hospitals. The exposure variables were defined as quiet, optimal, and busy days determined based on daily delivery volume distribution in each hospital category. Quiet and busy days included approximately 10% of the lowest and highest delivery volume days, while the rest were defined as optimal. Outcome measures were unplanned caesarean section (CS), instrumental delivery, induction of labour, and epidural analgesia. We compared the incidence of outcomes in quiet vs. optimal, busy vs. optimal, and busy vs. quiet days using logistic regression. The statistical significance level was set at 99% to reduce the likelihood of significant spurious findings.

Results

In the total population, the incidence of instrumental delivery was 8% (99% CI 2–15%) lower on quiet than on optimal days. In smaller hospitals (C1 and C2), unplanned caesarean sections were performed up to one-third less frequently on busy than optimal and quiet days. More (27%, 99% CI 12–44%) instrumental deliveries were performed in higher delivery volume hospitals (C4) on busy than quiet days. In C1-C3, deliveries were induced (12–35%) less often and in C5 (37%, 99% CI 28–45%) more often on busy than optimal delivery days. More (59–61%) epidural analgesia was performed on busy than optimal and quiet days in C4 and 8% less in C2 hospitals.

Conclusions

Pooled analysis showed that busyness had no effect on outcomes at the obstetric ecosystem level, but 10% fewer instrumental deliveries were performed in quiet than on busy days overall. Furthermore, dissecting the data shows that small hospitals perform less, and large non-tertiary hospitals perform more interventions during busy days.
Collaborative care compared to enhanced standard treatment of depression with co-morbid medical conditions among patients from rural South India: a cluster randomized controlled trial (HOPE Study)
Authors: Srinivasan Krishnamachari , Heylen Elsa , Johnson Pradeep R. , Mony Prem K. , Ekstrand Maria L.
Published: June 2022

Background

Depression is common among primary care patients in LMIC but treatments are largely ineffective. In this cluster-randomized controlled trial, we tested whether depression outcomes are different among recipients of a collaborative care model compared to enhanced standard treatment in patients with co-morbid chronic medical conditions.

Methods

We conducted a cluster randomized controlled trial among participants 30 years or older seeking care at 49 primary health centers (PHCs) in rural Karnataka, diagnosed with major depressive disorder, dysthymia, generalized anxiety disorder, or panic disorder on the MINI-International Neuropsychiatric Interview plus either hypertension, diabetes, or ischemic heart disease. From a list of all PHCs in the district, 24 PHCs were randomized a priori to deliver collaborative care and 25 PHCs enhanced standard treatment. The collaborative care model consisted of a clinic-based and a community-based component. Study assessment staff was blinded to treatment arm allocation. The primary outcome was the individual-level PHQ-9 score over time.

Results

Between May 2015 and Nov 2018, 2486 participants were enrolled, 1264 in the control arm, and 1222 in the intervention arm. They were assessed at baseline, 3, 6 and 12 months. The mean PHQ-9 depression score was around 8.5 at baseline. At each follow-up PHQ-9 scores were significantly lower in the intervention (5.24, 4.81 and 4.22 at respective follow-ups) than in the control group (6.69, 6.13, 5.23, respectively). A significant time-by-treatment interaction (p < 0.001) in a multi-level model over all waves, nested within individuals who were nested within PHCs, confirmed that the decrease in depression score from baseline was larger for collaborative care than enhanced standard care throughout follow-up.

Conclusions

The collaborative care intervention resulted in significantly lower depression scores compared to enhanced standard care among participants with co-morbid physical conditions. The findings have potential implications for integrating mental health and chronic disease treatment in resource constrained settings.

Trial registration

ClinicalTrials.govNCT02310932, registered on December 8, 2014, and Clinical Trials Registry IndiaCTRI/2018/04/013001, registered on April 4, 2018. Retrospectively registered.
Effect of bone morphology of the tibia plateau on joint line convergence angle in medial open wedge high tibial osteotomy
Authors: Itou Junya , Kuwashima Umito , Itoh Masafumi , Okazaki Ken
Published: June 2022

Background

Change in the joint line convergence angle (JLCA) of the knee after high tibial osteotomy (HTO) is difficult to predict accurately. Given that any change in JLCA is intra-articular, the shape of the articular surface, including the bone morphology of the proximal tibia, may affect the alignment of the knee joint postoperatively. The purpose of this study was to investigate the relationship between the shape of the tibial plateau and postoperative alignment of the knee joint by focusing on changes in JLCA.

Methods

One hundred and nine knees that underwent HTO were retrospectively reviewed. The shape of the tibial plateau was classified based on the slope of the medial and lateral articular surfaces as depressed, flat (within 3 degrees), or convex (pagoda-like). The relationship between the shape of the tibial plateau and radiological parameters was investigated.

Results

The shape of the tibial plateau was depressed in 38 knees, flat in 52 knees, and pagoda-like in 19 knees. There was a moderate correlation between the postoperative change in JLCA and the preoperative hip-knee-ankle angle for knees with a pagoda-shaped tibial plateau (r = 0.56) but not for the other two shapes.

Conclusions

These findings suggest that knees with marked varus deformity before HTO are likely to show more change in JLCA postoperatively if the tibial plateau is pagoda-shaped than if it has a depressed or flat shape. The advantage of focusing on the bone morphology of the proximal tibia is that surgeons can easily perform visual assessment using preoperative radiograph.
The protective effects of hyperoside on Ang II-mediated apoptosis of bEnd.3 cells and injury of blood-brain barrier model in vitro
Authors: Xie Yu Yan , Lu Yun Wei , Yu Gu Ran
Published: June 2022

Background

Hypertension and its associated dysfunction of the blood-brain barrier (BBB) are considered to contribute to cerebral small vessel disease (cSVD). Angiotensin II (Ang II), as an important vasoactive peptide of the renin-angiotensin system (RAS), is not only a pivotal molecular signal in hypertension, but also causes BBB leakage, cSVD and its related cognitive impair. Hyperoside (Hyp), a flavone glycoside, has antioxidant, antiphlogistic and anti-apoptosis effects. In this study, we investigate the protection of Hyp on apoptosis of bEnd.3 cells and BBB disruption in vitro induced by Ang II.

Methods

We used bEnd.3 cells to imitate a BBB monolayer model and explored the protection of Hyp on Ang II-induced BBB leakage. The apoptotic activity was assessed by TUNEL staining and flow cytometry. The expression of apoptosis pathway related proteins, tight junction proteins and transcytosis related proteins were detected by western blot assay. The BBB model permeability was detected through measuring the flux of sodium fluorescein (Na-F).

Results

We found that Hyp can not only effectively inhibit the apoptosis of bEnd.3 induced by Ang II, but also protect the structural soundness and functional integrity of BBB model by affecting the expression levels of junctional adhesion molecule A (JAM-A), Claudin-5, zonula occludens-1 (ZO-1), Caveolin-1 (Cav-1) and major facilitator superfamily domain-containing protein 2a (Mfsd2a).

Conclusion

Hyp might be a potent compound for preventing Ang II-induced BBB disruption.