The influence of hemodialysis on intracranial pressure waveform in patients with chronic kidney disease: an observational study

ABSTRACT BACKGROUND: Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental. OBJECTIVES: This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy. DESIGN AND SETTING: An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study. METHODS: Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants' intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups. RESULTS: There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions. CONCLUSIONS: Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients' extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.

Evaluation of characteristics of periodontal probes

Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

Need for hemodialysis in patients undergoing hematopoietic stem cell transplantation: risk factors and survival in a retrospective cohort

ABSTRACT Introduction: Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) patients are exposed to acute and chronic nephrotoxic events (drugs, hypotension, infections, and microangiopathy). The need for hemodialysis (HD) may be associated with high mortality rates. However, the risk factors and clinical impact of HD are poorly understood. Aim: To analyze survival and risk factors associated with HD in allo-HSCT Patients and methods: single-center cohort study 185 (34 HD cases versus 151 controls) consecutive adult allo-HSCT patients from 2007-2019. We performed univariate statistical analysis, then logistic regression and competing risk regression were used to multivariate analysis. Survival was analyzed by Kaplan-Meier and Cox proportional-hazards models. Results: The one-year HD cumulative incidence was 17.6%. Univariate analysis revealed that HD was significantly associated with male gender, age (p 0.056), haploidentical donor, grade II-IV acute GVHD, polymyxin B, amikacin, cidofovir, microangiopathy, septic shock (norepinephrine use) and steroid exposure. The median days of glycopeptides exposure (teicoplanin/vancomycin) was 16 (HD) versus 10 (no HD) (p 0.088). In multivariate analysis, we found: norepinephrine (hazard ratio, HR:3.3; 95% confidence interval, 95%CI:1.2-8.9; p 0.024), cidofovir drug (HR:11.0; 95%CI:4.6 - 26.0; p < 0.001), haploidentical HSCT (HR:1.94; 95%CI:0.81-4.65; p 0.14) and Age (HR:1.01; 95%CI: 0.99-1.03; p 0.18). The HD group had higher mortality rate (HR:6.68; 95% CI: 4.1-10.9; p < 0.001). Conclusion: HD was associated with decreased survival in allo-HSCT. Carefully use of nephrotoxic drugs and improving immune reconstitution could reduce severe infections (shock) and patients requiring cidofovir, which taken together may result in lower rates of HD, therefore improving survival.

Periodontal disease and quality of life in patients with circulatory diseases / Doença periodontal e qualidade de vida em pacientes com doenças circulatórias

Introduction: Circulatory system diseases are one of the leading causes of death. Periodontal health is a component of oral and general health that contributes to quality of life. Objective: To analyze periodontal conditions and quality of life in patients with circulatory diseases. Material and method: Cross-sectional study, with patients with circulatory diseases (n=125). The clinical periodontal examination was performed considering: biofilm, bleeding on probing, suppuration, probing depth, gingival recession, and clinical attachment level. Quality of life was assessed with the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and Oral Health Impact Profile - short form (OHIP-14). Data were analyzed with parametric and nonparametric tests (α=5%). Result: Elderly and men had a greater severity of periodontal disease. The Elderly had lower values in the domains of "Functional capacity" and "Physical aspects" (SF-36). The domain "Pain" had lower values in subjects with health/gingivitis. OHIP-14 did not show differences in the comparisons. There was no correlation between quality of life and the severity of periodontal disease. Conclusion: Among patients with circulatory diseases, the elderly and men had greater severity of periodontal disease. The elderly had a poorer quality of life (functional capacity and physical aspects). There was no correlation between the severity of periodontal disease and quality of life.

Introdução: As doenças do aparelho circulatório representam uma das principais causas de mortes. A saúde periodontal é um componente da saúde bucal e saúde geral que contribui para a qualidade de vida. Objetivo: Analisar as condições periodontais e a qualidade de vida em pacientes com doenças circulatórias. Material e método: Estudo transversal, com pacientes com doenças circulatórias (n=125). O exame clínico periodontal foi realizado considerando: biofilme, sangramento à sondagem, supuração, profundidade de sondagem, recessão gengival e nível de inserção clínica. A qualidade de vida foi avaliada com o Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e Oral Health Impact Profile - short form (OHIP-14). Os dados foram analisados com testes paramétricos e não paramétricos (α=5%). Resultado Idosos e os homens tiveram maior severidade da doença periodontal. Idosos apresentaram menores valores nos domínios "Capacidade funcional" e "Aspectos físicos" (SF-36). O domínio "Dor" teve menor valor nos indivíduos com saúde/gengivite. OHIP-14 não apresentou diferenças nas comparações. Não houve correlação entre qualidade de vida a severidade da doença periodontal. Conclusão Entre os pacientes com doenças circulatórias, os idosos e os homens tiveram maior severidade da doença periodontal. Idosos tiveram pior qualidade de vida (capacidade funcional e aspectos físicos). Não houve correlação entre a severidade da doença periodontal e a qualidade de vida.

Oral Mucositis in Children with Leukemia Undergoing Chemotherapy: A Case Series

ABSTRACT Objective: To report nine cases of pediatric patients with Acute Lymphoid Leukemia (ALL) or Acute Myeloid Leukemia who developed severe oral mucositis (SOM) at the first week of chemotherapy. Material and Methods: The cases were selected from a sample of 105 children followed for 10 consecutive weeks. Hematological and personal data were obtained from the patient's medical records. The oral cavity was examined weekly using the modified Oral Assessment Guide. Results: More of the patients were male (55.6%), had black/brown skin (55.6%), with ALL (66.7%), and the mean age was 5.55. Two patients had values below normal for leukocytes, platelets, and creatinine over the follow-up. However, all patients showed changes in the normality of hematological data in most weeks. The most used chemotherapeutic agents were aracytin, etoposide, and methotrexate, known for their high stomatotoxic potential. Patients had 2 to 6 (mean of 4) episodes of SOM and 4 to 7 (mean of 5.5) episodes of OM. One patient at week 7, one patient at week 5, and one patient at weeks 2 and 10 did not have OM. Saliva (84 times) and lips (44 times) were the most affected items. Conclusion: The patients showed oscillations in the severity of oral mucositis and hematological parameters over the follow-up. All patients were exposed to stomatotoxic drugs during the initial phase of cancer treatment.

Molecular profile of patients with myelofibrosis: a 10-year experience

ABSTRACT Objective To analyze the karyotype test and myeloid panel with next-generation sequencing findings in patients with myelofibrosis, and to compare transplant characteristics in patients referred for bone marrow transplantation. Methods Retrospective, single-center study with patients diagnosed with myelofibrosis treated at Hospital Israelita Albert Einstein between 2010 and 2020. Results A total of 104 patients with myelofibrosis were examined. Patients who had not been submitted to tests in our service were excluded. The final sample comprised 69 patients. Of these 69, 56 were submitted to karyotyping and 22 to myeloid panel with next-generation sequencing. Karyotype was normal in 60% of the patients and altered in 40%. The prevalence of high-risk molecular mutations was higher in patients referred for bone marrow transplantation (100% versus 50%). The median follow-up of transplant patients was 2.4 years and the overall survival at 2 years was 80% (95%CI: 62-100%). Conclusion The molecular analysis enables estimating the patient's risk and thus instituting more aggressive treatment such as bone marrow transplant for patients at higher risk, being a relevant tool to guide therapy. Given the significance of molecular analysis for therapeutic decision-making in myelofibrosis, collection and disclosure of data on the prevalence of cytogenetic changes and findings of next-generation sequencing in affected patients is important.

Desordens hiperostóticas em American Bully / Hiperostotic disorders in american bully

O complexo de desordens hiperostóticas é uma condição rara e autolimitante, que tem as mesmas características histopatológicas, que cursa com proliferação óssea de caráter não neoplásico. Acomete cães jovens de raças distintas, com variabilidade quanto ao tipo de proliferação óssea e quanto aos ossos acometidos. O complexo é composto pela osteopatia craniomandibular, hiperostose da calota craniana e osteodistrofia hipertrófica. Podendo estar presente nos ossos da calota craniana, mandíbulas, coluna cervical e esqueleto apendicular. O presente relato, descreveu o quadro de uma cadela, da raça American Bully, não castrada, três meses de idade, que foi atendida com queixa de aumento de volume doloroso das mandíbulas, hiporexia e sialorreia há 15 dias, apresentando ao exame físico, amplitude de movimento diminuída e sensibilidade dolorosa da articulação temporomandibular, espessamento firme bilateral do crânio em região de fossa temporal, espessamento palpável de consistência firme das mandíbulas e crepitação respiratória. Após avaliação clínica e realização de exames complementares, chegou-se ao diagnóstico presuntivo, de complexo de desordens hiperostóticas. Foi instituído como conduta terapêutica o suporte analgésico, sendo eficaz para a manutenção das necessidades fisiológicas até a paciente alcançar a fase adulta. O prognóstico para esta paciente foi considerado bom, uma vez que não havia indícios de anquilose da articulação temporomandibular e/ou manifestações neurológicas.

The complex of hyperostotic disorders is a rare and self-limiting condition, which has the same histophatological characteristics, which courses with non-neoplastic bone proliferations. It affects young dogs of different breeds, with variability the bones affected. The complex is composed of craniomandibular osteopathy, calvarial hyperostotic syndrome and hypertrophic osteodystrophy. It may be present in the bones of the skullcap, jaws, cervical spine and appendicular skeleton. The present report describes the condition of a female dog, American Bully breed, entire, three months old, with a complaint of painful swelling of the jaws, hyporexia and drooling for 15 days, presenting on physical examination, reduced amplitude and pain of the temporomandibular joint, bilateral firm thickening of the skull in the temporal fossa region, palpable firm-consistent thickening of the mandibles and respiratory crackle. After clinical evaluation and complementary tests, a presumptive diagnosis of hyperostotic disorders complex was reached. It was instituted pain management as a treatment, being effective for the maintenance of physiological needs until the patient reaches the adulthood. The prognosis for this patient was considered good, since there was no evidence of temporomandibular joint ankylosis and/or neurological manifestations.

Estabilização de ombro em um gato ­ Relato de caso / Shoulder estabilization in a cat ­ Case report

A estabilidade da articulação do ombro é garantida por ligamentos, cápsula articular, tendões e músculos, contudo traumas podem causar falência dos mecanismos estabilizadores, com consequente luxação ou instabilidade articular. Objetivou-se relatar o caso de instabilidade medial e lateral de ombro direito em felino sem raça definida, atendido com queixa de claudicação aguda de membro torácico secundária a trauma por confronto com outro animal. Inicialmente foi realizado tratamento clínico por meio de imobilização articular. Contudo, devido ao insucesso da técnica, procedeu-se para o tratamento cirúrgico de estabilização articular com prótese ligamentar sintética. No pós-operatório imediato, evidenciou-se ausência de crepitações e instabilidade articular. Após oito dias da cirurgia, o paciente apresentou retorno total às funções de apoio do membro e sem sinais de dor ou redução de movimentos. Concluiu-se que, embora de reduzida ocorrência, a instabilidade de origem traumática do ombro configura-se como um diferencial para claudicação aguda de membro torácico e que o tratamento cirúrgico pode ser necessário, mostrando-se eficiente na resolução de tais casos com o acesso e técnica de estabilização propostos.

The stability of the shoulder joint is granted by ligaments, joint capsule, tendons and muscles. However, traumatic injuries can cause failure of the stabilization mechanisms, which leads to articular luxation or instability. The aim of the paper is to report a case of medial and lateral right shoulder joint instability in a mixed-breed cat, presenting acute forelimb lameness after a fight trauma with another cat. Initially, it was recommended a conservative treatment through articular immobilization. However, the technique was unsuccessful, and the surgery treatment was performed, to stabilize the joint with synthetic ligament prosthetic. In the postoperative period, no crepitation or instability were identified. After eight days of surgery, the patient returned totally to the normal function of the forelimb, without movement restriction or pain. It was concluded that, although rare, the traumatic shoulder joint instability is a differential diagnosis for acute forelimb lameness and the surgical treatment can be necessary, showing a good result in the resolution of these injuries with the surgical approach and stabilization method proposed.

Diagnosis and treatment of systemic mastocytosis in Brazil: Recommendations of a multidisciplinary expert panel

ABSTRACT Introduction: Systemic Mastocytosis comprises a group of neoplastic diseases characterized by clonal expansion and infiltration of mast cells into several organs. The diagnosis and treatment of this disease may be challenging for non-specialists. Objective: Make suggestions or recommendations in Systemic Mastocytosis based in a panel of Brazilian specialists. Method and results: An online expert panel with 18 multidisciplinary specialists was convened to propose recommendations on the diagnosis and treatment of Systemic Mastocytosis in Brazil. Recommendations were based on discussions of topics and multiple-choice questions and were graded using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Chart. Conclusion: Twenty-two recommendations or suggestions were proposed based on a literature review and graded according to the findings.

Prevalence of sensitization to Malassezia spp. in adults with atopic dermatitis and psoriasis and its correlation with disease severity / Prevalência da sensibilização a Malassezia spp. em pacientes adultos portadores de dermatite atópica e psoríase e sua correlação com a gravidade das doenças

Fundamentals: Atopic Dermatitis (AD) and Psoriasis (PS) share clinical and physiopathological similarities. Objective: Determine the prevalence of sensitization to Malassezia spp. in adults with AD and PS and its correlation with disease severity. Methods: A cross-sectional study was carried out from January 2016 to August 2017 with adults. Malassezia spp.-specific IgE dosages were measured, and skin scrapings for fungal culture performed. Parametric or nonparametric tests were used for analysis. Results: Median age of the 20 participants with AD was 29 years old, and the mean SCO-RAD was 45.35 ± 18.32. Malassezia spp.- specific IgE median dosage was 0.63 kU/l. M. furfur and M. sympodialis were isolated. Spearman's nonparametric correlation analysis showed no correlation between sensitization to Malassezia spp. and disease severity. The median age of the 36 participants with PS was 61 years old, the median body surface area affected was 22%, and Malassezia spp.-specific IgE median dosage was 0.00 kU/l. M. furfur and Malassezia spp. were identified. Study limitations: Assessing the sensitization to Malasseziaspp. was difficult due to the reduced number of participants in the study. Furthermore, there was no uniformity in the location to collect skin scrapings. The use of topical medication was not suspended before collecting skin specimens for mycological examination, therefore interfer-ing with fungal isolation. Conclusion: Sensitization to Malassezia spp. was only detected in the AD sample. Malassezia spp.-specific IgE test did not prove to be a marker for disease severity in our AD sample (AU)

Fundamentos: Dermatite atópica (DA) e psoríase apresentam similaridades clínicas e fisiopatológicas. Objetivos: Avaliar a frequência da sensibilização a Malasseziaspp. em adultos portadores de DA e psoríase e correlacionar à gra-vidade dos quadros clínicos. Métodos: De janeiro de 2016 a agosto de 2017, conduziu-se um estudo observacional em indivíduos adultos onde foram realizadas dosagem de IgE específica anti-Malassezia spp. e raspados das lesões para cultura micológica. Testes paramétricos ou não paramétricos foram utilizados para análise. Resultados: Nos 20 portadores de DA, a mediana da idade foi 29 anos. O valor médio do Scoring Atopic Dermatitis foi 45,35 ± 18,32. A mediana de IgE específica anti-Malasseziaspp. foi 0,63 kU/l. M. furfur e M. sympodialis foram isolados. A análise de correlação não-paramétrica de Spearman não mostrou correlação entre a sensibilização à Malassezia spp. e a gra-vidade. Nos 36 pacientes com psoríase, foram obtidas as seguintes medianas: idade 61 anos, comprometimento de superfície corpórea 22% e IgE específica anti-Malassezia spp. 0,00 kU/l. Houve identificação de M. furfur e Malasse-zia spp. Limitações do estudo: O número reduzido de participantes dificultou a avaliação da sensibilização por IgE a Malasseziaspp. Não houve uniformidade nos locais de coleta dos raspados cutâneos. Medicamentos tópicos não foram suspensos anteriormente ao exame micológico, prejudicando o isolamento dos fungos. Conclusões: Sensibili-zação a Malassezia spp. apenas ocorreu nos portadores de DA. O teste de IgE específica anti-Malassezia spp. não se mostrou um marcador de gravidade para a DA neste grupo (AU)

New possibilities for chromoblastomycosis and phaeohyphomycosis treatment: identification of two compounds from the MMV Pathogen Box® that present synergism with itraconazole

BACKGROUND Black fungi of the Herpotrichiellaceae family are agents of chromoblastomycosis and phaeohyphomycosis. There are few therapeutic options for these infections and it is common to associate antifungal drugs in their treatment. OBJECTIVES To investigate the Medicines for Malaria Venture (MMV) Pathogen Box® for possible compounds presenting synergism with antifungal drugs used to treat black fungal infections. METHODS An initial screening of the Pathogen Box® compounds was performed in combination with itraconazole or terbinafine at sub-inhibitory concentrations against Fonsecaea pedrosoi. Hits were further tested against eight Herpotrichiellaceae using the checkerboard method. FINDINGS No synergism was observed with terbinafine. MMV687273 (SQ109) and MMV688415 showed synergism with itraconazole against F. pedrosoi. Synergism of these compounds was confirmed with some black fungi by the checkerboard method. SQ109 and itraconazole presented synergism for Exophiala dermatitidis, F. pedrosoi, F. monophora and F. nubica, with fungicidal activity for F. pedrosoi and F. monophora. MMV688415 presented synergism with itraconazole only for F. pedrosoi, with fungicidal activity. The synergic compounds had high selectivity index values when combined with itraconazole. MAIN CONCLUSIONS These compounds in combination, particularly SQ109, are promising candidates to treat Fonsecaea spp. and E. dermatitidis infections, which account for most cases of chromoblastomycosis and phaeohyphomycosis.

Trombose de seio sigmoide secundária a fístula liquórica espontânea para osso temporal: um relato de caso / Sigmoid sinus thrombosis secondary to spontaneous temporal bone cerebrospinal fluid fistula: a case report

A fístula liquórica para o osso temporal constitui um evento raro que decorre da comunicação anormal entre o espaço subaracnóideo e as células da mastoide, permitindo que o líquido cefalorraquidiano flua para as porções pneumatizadas do osso temporal. Tem como consequência a hipotensão intracraniana espontânea, caracterizada por perda de líquor e pela manifestação clínica de cefaleia ortostática. Acredita-se que a hipotensão intracraniana espontânea crie condições hemodinâmicas favoráveis à ocorrência de trombose venosa cerebral, uma desordem potencialmente fatal e de difícil diagnóstico, visto a inespecificidade de sinais clínicos e sintomas. Dessa forma, é pertinente atentar para a possibilidade de trombose venosa cerebral em pacientes com fístulas liquóricas, especialmente quando houver mudança do padrão da cefaleia, que passa de ortostática a intensa e contínua.

Temporal bone cerebrospinal fluid fistula is a rare event that results from abnormal communication between the subarachnoid space and the mastoid cells, allowing the cerebrospinal fluid to flow into the pneumatized portions of the temporal bone. It leads to spontaneous intracranial hypotension, characterized by loss of cerebrospinal fluid and orthostatic headache as a clinical manifestation. Spontaneous intracranial hypotension is believed to create favorable hemodynamic conditions to the occurrence of cerebral venous thrombosis, a potentially fatal disorder of difficult diagnosis given the nonspecific clinical signs and symptoms. Therefore, it is pertinent to consider the possibility of cerebral venous thrombosis in patients with cerebrospinal fluid fistulas, especially when there is a modification in the headache pattern from orthostatic to intense and continuous pain.

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil

Abstract Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions.

Clinical and behavioral conditions in the oral health of volleyball and soccer athletes: a cross-sectional study

Aim: In this cross-sectional study, we evaluated the oral hygiene habits, oral health conditions, and the perception about the influence of oral health conditions on the physical performance of youth and professional volleyball and soccer athletes. Methods: A total of 96 male athletes participated: 48 volleyball players (25 youth and 23 professional players); and 48 soccer players, of whom 22 were youth, and 26 were professional players. We analyzed the oral hygiene and oral health condition (daily toothbrush, flossing, mouthwash, dental plaque, orthodontic treatment, dental/facial trauma, temporomandibular dysfunction, malocclusion, and the athletes' perception about the influence of oral health conditions on the physical performance (yes or no)). Comparisons were made between the youth and professional athletes for each sport (volleyball and soccer). According to each variable, we applied the Chi-square, Fisher's Exact, and Mann-Whitney tests. Results: For soccer athletes, we found significant differences between youth and professionals for: flossing (p=0.014), orthodontic treatment (p=0.028), dental/facial trauma (p=0.041), and the athletes' perception about oral health and physical performance (p<0.001). Considering the category (youth and professional) regardless of the type of sport, we found significant differences for dental plaque (p=0.024) and dental/facial trauma (p=0.005). According to the sport (volleyball and soccer), independent of the category, we found significant differences for daily brushing, dental/facial trauma (p=0.005), and the athletes' perception about oral health and physical performance (p=0.006). Conclusion: We concluded that the surveyed athletes had good oral health and believed that oral health can influence sports performance

Motivação para a escolha da motocicleta: uma análise sob a perspectiva de motociclistas acidentados / Motivation for choosing the motorcycle as a means of transportation: an analysis from the perspective of injured motorcyclists

Resumo Introdução A partir da década de 1990, começou a ocorrer um aumento significativo na produção e uso de motocicletas no Brasil; paralelamente, o número de vítimas fatais de acidentes de transporte terrestre aumentou. Em 2015, os motociclistas foram as principais vítimas fatais. Objetivo Identificar os fatores que motivam os motociclistas a escolher a motocicleta, apesar dos riscos, como um meio de transporte. Este estudo foi fundamentado no conceito de motivação, proposto por Bergamini, e na noção de tempo e espaço, proposta por Harvey. Método Estudo qualitativo, com seleção de amostra por saturação, desenvolvido com os motociclistas vítimas de acidentes de trânsito em um hospital de referência para trauma. O método de coleta de dados foi a entrevista, utilizando um questionário semiestruturado com análise de conteúdo. Resultados Foram entrevistados 15 motociclistas, todos homens, com mediana de idade de 26 anos. Os fatores motivacionais foram: "o tempo", "aspectos financeiros", "gosto pela motocicleta" e "único veículo disponível". Conclusão A motivação maior para o indivíduo escolher a motocicleta como meio de transporte, independentemente de ser ou não motoboy, foi a possibilidade de gerar economia financeira e, ao mesmo tempo, proporcionar um ganho de tempo no dia a dia, embora outros fatores pessoais também tenham contribuído para essa motivação.

Abstract Background Since the 1990s, there has been a significant increase in the production and use of motorcycles in Brazil. At the same time, the number of fatal victims of land transport accidents has increased. In 2015, motorcyclists were the main fatal victims of these accidents. Objective To identify the factors that motivate motorcyclists to choose the motorcycle as a means of transportation despite the risks. This study was based on the concept of motivation proposed by Bergamini and on the notion of time and space proposed by Harvey. Method A qualitative study, with sample selection by saturation, conducted with motorcyclists who were victims of traffic accidents in a reference trauma hospital. The data were collected through semi-structured interviews and analyzed. Results Fifteen motorcyclists, all men with median age of 26 years, were interviewed. The motivational factors revealed were "time", "financial aspects", "motorcycle appreciation", "only vehicle available". Conclusion The greatest motivation for choosing the motorcycle as a means of transportation was the possibility of generating financial savings while providing a daily gain of time, although other factors also contributed to this motivation.

Lâminas de irrigação e hidrogel nas taxas de crescimento e produção de tomateiro / Irrigation depths and hydrogel on tomato growth and production rates / Láminas de riego e hidrogel en las tasas de crecimiento y producción de tomate

O tomateiro é uma das hortaliças de maior importância econômica a nível mundial. No entanto, sua produção pode ser limitada por diversos fatores, sendo o manejo da água o principal fator limitante. Dessa forma, o uso de tecnologias que melhorem a eficiência no uso da água é de extrema importância, destacando-se entre estas o uso de hidrogel. Nesse sentido, objetivou-se nesse trabalho avaliar as taxas de crescimento e produção do tomateiro sob lâminas de irrigação e volumes de hidrogel. O experimento foi conduzido em esquema fatorial 3x4, em blocos ao acaso com quatro repetições, sendo os fatores: três volumes de hidrogel previamente hidratado (0, 50 e 100 ml por planta); e 4 lâminas de irrigação (40, 60, 80 e 100% da evapotranspiração da cultura). Foram avaliadas as taxas de crescimento absoluto e relativo da altura de planta e diâmetro do caule, massa média dos frutos e a produtividade por planta. Os resultados evidenciaram que a redução das lâminas de irrigação levou a redução linear das taxas de crescimento absolutas e relativas de altura e diâmetro. Perante essas mesmas condições, também houve redução da massa média dos frutos e da produtividade por planta. O uso de hidrogel não afetou nenhuma das características avaliadas, dessa forma, recomenda-se a sua não utilização nas condições desse estudo. Indica-se a utilização da lâmina de reposição de 100% da ETc.(AU)

Tomato is one of the most economically relevant vegetables worldwide. However, its production can be limited by several factors, with water management being the main limiting factor. Thus, the use of technologies that improve efficiency in the use of water are extremely important, with emphasis on the use of hydrogel. In this sense, the objective of this study was to evaluate the growth and production rates of tomato under irrigation depths and hydrogel volumes. The experiment was carried out in a 3x4 factorial scheme, in randomized blocks with four replications, with the following factors: three volumes of previously hydrated hydrogel (0, 50 and 100 ml per plant); and 4 irrigation depths (40, 60, 80 and 100% evapotranspiration of the crop). The absolute and relative growth rates of plant height and stem diameter, average fruit mass, and productivity per plant were evaluated. The results showed that the reduction of irrigation depths led to a linear reduction in absolute and relative growth rates in both height and diameter. Under these same conditions, there was also a reduction in the average fruit mass and productivity per plant. The use of hydrogel did not affect any of the evaluated characteristics; therefore, it is recommended not to use it under the conditions of this study. It is recommended to use the 100% ETc replacement blade.(AU)

El tomate es una de las hortalizas de mayor importancia económica a nivel mundial. Sin embargo, su producción puede verse limitada por varios factores, siendo la gestión del agua el principal factor limitante. Por ello, el uso de tecnologías que mejoren la eficiencia en el uso del agua es de suma importancia, con énfasis en el uso de hidrogel. En ese sentido, el objetivo de este estudio fue evaluar las tasas de crecimiento y producción de tomate en láminas de riego y volúmenes de hidrogel. El experimento se realizó en un esquema factorial 3x4, en bloques al azar con cuatro repeticiones, siendo los factores: tres volúmenes de hidrogel previamente hidratado (0, 50 y 100 ml por planta); y 4 láminas de riego (40, 60, 80 y 100% evapotranspiración del cultivo). Se evaluaron las tasas de crecimiento absoluto y relativo de la altura de la planta y el diámetro del tallo, la masa promedio de frutos y la productividad por planta. Los resultados mostraron que la reducción de las láminas de riego condujo a una reducción lineal en las tasas de crecimiento absoluto y relativo en altura y diámetro. En estas mismas condiciones, también se redujo la masa media de frutos y de la productividad por planta. El uso de hidrogel no afectó ninguna de las características evaluadas, por lo que se recomienda no utilizarlo en las condiciones de ese estudio. Se recomienda utilizar la lámina de repuesto del 100% del ETc.(AU)

Trigeminal Ophthalmic Branch Schwannoma: Case Report and Literature Review

Schwannomas are the fourth most common primary neoplasms affecting the brain and cranial nerves. Central lesions commonly arise from sensory nerve roots, and a common intracranial site is the vestibular branch of the 8th nerve (>85%). We present the case report of a patient who has a schwannoma extending from the pterygopalatine fossa to the orbit, complaining about facial pain in the trajectory of the trigeminal ophthalmic branch. Schwannomas represent 1 to 2% of all neoplasms of the orbit, and trigeminal schwannomas are extremely rare, accounting for less than 0.5% of all intracranial tumors.

Prevalência de morbidade hospitalar por doenças crônicas não transmissíveis em Salvador (BA): dados DATASUS / Prevalence of hospital morbidity due to chronic non-communicable diseases in Salvador (BA): Datasus data

Introdução: as doenças crônicas não transmissíveis (DCNT) são consideradas como um dos maiores problemas globais de saúde pública da atualidade. Entre elas, podem-se destacar o diabetes mellitus (DM), a hipertensão arterial sistêmica (HAS) e a obesidade. As DCNT causam agravos à saúde e altas taxas de internação e óbitos, quando observadas isoladamente. Além disso, quando associadas, tendem a elevar o grau de morbidade, causando grandes prejuízos aos cofres públicos. Objetivo: Verificar a prevalência de internações e óbitos por DM, HAS e obesidade na população de Salvador. Metodologia: trata-se de um estudo descritivo, com base em dados do Departamento de Informação e Informática do SUS (DATASUS), sobre internações e óbitos ocorridos no período de janeiro a novembro de 2019, no município de Salvador (BA). A coleta dos dados eletrônicos foi realizada no mês de janeiro de 2020 e eles foram apresentados em forma de prevalência. Resultado: das internações registradas em Salvador, 0,63% foram associadas a DM, 0,03% à obesidade e 0,85% a HAS como causa principal. Em relação aos óbitos, 0,80% foram associados a DM e 0,56% a HAS. Não foram registrados óbitos associados à obesidade como causa principal, nesse período. Conclusão: houve maior prevalência de mulheres e idosos nas internações e óbitos por HAS e DM. O uso dos dados do DATASUS foi de extrema importância para a identificação do perfil de morbidade hospitalar. No entanto, a fim de garantir a consistência e a qualidade dos dados, é necessária uma padronização no modo de coleta.

Introduction: chronic non-communicable diseases (NCDs) are considered to be one of the biggest global public health problems today. Among them, diabetes mellitus (DM), systemic arterial hypertension (SAH) and obesity can be highlighted. NCDs cause health problems and high rates of hospitalization and deaths, when observed in isolation. In addition, when associated, they tend to increase the degree of morbidity, causing great damage to public coffers. Objective: to verify the prevalence of hospitalizations and deaths due to DM, SAH and obesity in the population of Salvador. Methods: this is a descriptive study, based on data from the Department of Information and Informatics of SUS (DATASUS), on hospitalizations and deaths from January to November 2019, in the city of Salvador (BA). The collection of electronic data was carried out in January 2020 and they were presented as prevalence. Results ­ Of the hospitalizations registered in Salvador, 0.63% were associated with DM, 0.03% with obesity and 0.85% with SAH as the main cause. Regarding deaths, 0.80% was associated with DM and 0.56% with SAH. There were no deaths associated with obesity as the main cause during this period. Conclusion: there was a higher prevalence of women and the elderly in hospitalizations and deaths due to SAH and DM. The use of DATASUS data was extremely important for the identification of the hospital morbidity profile. However, in order to guarantee the consistency and quality of the data, it is necessary to standardize the mode of collection.

Effects of neural mobilization on individuals with chronic low back pain / Efeito da mobilização neural em indivíduos com dor lombar crônica

ABSTRACT BACKGROUND AND OBJECTIVES: The objective of this study was to evaluate the effect of neural mobilization technique on individuals with chronic low back pain, as well as analyze possible changes in pain, motor behavior and on cytokine quantification before and after treatment. METHODS: Sixteen individuals with mean age of 30.45±10.32 years old were evaluated. The technique consisted of a total of 10 interventions, with a total duration of 10 minutes, divided into four series of 2 minutes each, with a 30-second interval between each series. The following outcomes were evaluated: pain intensity using the visual analog scale; mobility of the lumbar spine with the third finger to the ground test and hip goniometry; concentration of cytokines in serum with the multiplex technique; and quality of life with the Oswestry Disability Index, the Roland-Morris Disability Questionnaire and the World Health Organization Quality of Life Questionnaire-bref. RESULTS: Results showed a reduction in pain intensity of approximately 70% between the assessments (p<0.001). Improvements in lumbar mobility of approximately 25.5% on the third finger to the ground test (p<0.04) and improvement in the hip joint angles (p<0.04) were also observed. A difference in cytokine concentrations, both pro-inflammatory (p<0.009) and anti-inflammatory (p<0.03), was also observed between the assessments. CONCLUSION: The technique was able to reduce pain intensity and consequently increase the mobility of the volunteers. Additionally, a difference in cytokine concentration at the end of the treatment and an improvement in the individuals quality of life were observed.

RESUMO JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi avaliar o efeito da técnica de mobilização neural em indivíduos com lombalgia crônica, assim como possíveis alterações na dor, no comportamento motor e na quantificação de citocinas antes e após o tratamento. MÉTODOS: Foram avaliados 16 indivíduos com idade média de 30,45±10,32 anos. A técnica consistiu em um total de 10 intervenções, com duração total de 10 minutos, divididas em quatro séries de 2 minutos cada, com intervalo de 30 segundos entre cada série. Os desfechos a seguir foram avaliados: intensidade da dor utilizando a escala analógica visual; mobilidade da coluna lombar com o terceiro dedo ao solo e goniometria do quadril; concentração de citocinas no soro com a técnica multiplex; e qualidade de vida com o Oswestry Disability Index, Roland-Morris Disability Questionnaire and the World Health Organization Quality of Life Questionnaire-bref. RESULTADOS: Os presentes resultados demonstraram uma redução na intensidade da dor de aproximadamente 70% entre as avaliações (p<0,001). Foram observadas melhoras na mobilidade lombar de aproximadamente 25,5% no teste do terceiro dedo ao solo (p<0,04) e nos ângulos da articulação do quadril (p<0,04). Também foi observada entre as avaliações diferença nas concentrações de citocinas, tanto pró-inflamatórias (p<0,009) quanto anti-inflamatórias (p<0,03). CONCLUSÃO: A técnica foi capaz de reduzir a intensidade da dor e consequentemente aumentar a mobilidade dos voluntários. Além disso, foi observada uma diferença na concentração de citocinas no final do tratamento e uma melhoria na qualidade de vida dos indivíduos.

Guidelines for therapy of patients with chronic myeloproliferative neoplasms during the novel coronavirus SARS-CoV2 pandemic

ABSTRACT The novel coronavirus has swept across the world in 2020 and ushered a new era. In the current scenario, it is not clear how patients with myeloproliferative neoplasms (including chronic myelogenous leukemia) should be managed, considering the risk of therapy, the need for social distancing and the risk of untimely therapy discontinuation of delay. This guideline aims to give providers a sense of direction in order to better take care of patients and prioritize care.