Effects of exercise on human energy metabolism in high temperature and high humidity environment / Efeitos do exercício sobre o metabolismo energético humano em ambientes de alta temperatura e umidade / Efectos del ejercicio sobre el metabolismo energético humano en ambientes de alta temperatura y humedad

ABSTRACT Introduction Many exercise enthusiasts have started participating in sports in the high-temperature environment in recent years due to the increasing popularity of these sports habits. However, their scientific studies still have a gap in their safety and effectiveness. Objective Measure the energy supply characteristics of fat and sugar oxidation during exercise in different high-temperature and humidity environments. Methods 20 healthy adult subjects were exposed to fixed-intensity exercise for 20 minutes at 30-33 oC, 20% relative humidity (RH), and 50% RH, respectively. Results Under the silent exposure condition, compared with RH 20% and RH 50% under high temperature, sugar oxidation was significantly increased (P<0.01), while fat oxidation was significantly reduced (P<0.01), and total energy consumption was significantly increased (P<0.01). Under the condition of 65% VO2 max exercise, compared with RH 20% and RH 50% at high temperatures, the amount of sugar oxidation was significantly reduced (P<0.05), and the total energy consumption was significantly reduced (P<0.05). Conclusion Under 65% exercise under VO2 max in the high temperature and humidity-controlled environment, the high temperature and medium humidity (RH 50%) environment consumes more energy, and there is a greater amount of sugar oxidation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução Muitos entusiastas do exercício físico começaram a participar de esportes no ambiente de altas temperaturas nos últimos anos devido a crescente popularidade desses hábitos esportivos, embora seus estudos científicos ainda apresentem uma lacuna sobre sua segurança e efetividade. Objetivo Comparar as características do fornecimento de energia de oxidação de gordura e açúcar durante o exercício em ambientes de alta temperatura e umidade diferentes. Métodos Um total de 20 sujeitos adultos saudáveis foram expostos a exercícios de intensidade fixa durante 20 minutos a 30-33 oC, 20% de umidade relativa (RH) e 50% de RH, respectivamente. Resultados Sob a condição de exposição silenciosa, comparado com RH 20% e RH 50% sob alta temperatura, a oxidação do açúcar foi significativamente aumentada (P<0,01), enquanto a oxidação da gordura foi significativamente reduzida (P<0,01), e o consumo total de energia foi significativamente incrementado (P<0,01). Sob a condição de 65% de exercício de VO2max, comparado com RH 20% e RH 50% a altas temperaturas, a quantidade de oxidação do açúcar foi significativamente reduzida (P<0,05), e o consumo total de energia foi significativamente reduzido (P<0,05). Conclusão Sob a condição de 65% de exercício sob VO2max, no ambiente de alta temperatura e umidade controlados, o ambiente de alta temperatura e umidade média (RH 50%) consome mais energia, havendo uma maior quantidade de oxidação de açúcar. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción En los últimos años, muchos aficionados al ejercicio han comenzado a practicar deportes en el entorno de altas temperaturas debido a la creciente popularidad de estos hábitos deportivos, aunque sus estudios científicos aún presentan lagunas sobre su seguridad y eficacia. Objetivo Comparar las características de suministro energético de la oxidación de grasas y azúcares durante el ejercicio en diferentes entornos de alta temperatura y humedad. Métodos Un total de 20 sujetos adultos sanos fueron expuestos a ejercicio de intensidad fija durante 20 minutos a 30-33 oC, 20% de humedad relativa (HR) y 50% de HR, respectivamente. Resultados Bajo la condición de exposición silenciosa, en comparación con RH 20% y RH 50% bajo alta temperatura, la oxidación de azúcar se incrementó significativamente (P<0.01), mientras que la oxidación de grasa se redujo significativamente (P<0.01), y el consumo total de energía se incrementó significativamente (P<0.01). Bajo la condición de ejercicio VO2max 65%, en comparación con RH 20% y RH 50% a alta temperatura, la cantidad de oxidación de azúcar se redujo significativamente (P<0,05), y el consumo total de energía se redujo significativamente (P<0,05). Conclusión Bajo la condición de 65% de ejercicio bajo VO2max en el ambiente controlado de alta temperatura y humedad, el ambiente de alta temperatura y humedad media (RH50%) consume más energía y hay una mayor cantidad de oxidación de azúcar. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Corneal confocal microscopy detects small-fiber neuropathy in patients with amyotrophic lateral sclerosis / 中华内科杂志

Objective:To investigate small fiber neuropathy in patients with amyotrophic lateral sclerosis (ALS) by corneal confocal microscopy.Methods:A total of 57 ALS patients were consecutively enrolled in Department of Neurology between June 2015 and February 2016, including 37 men and 20 women with mean age 24-80 (52±11)?years. There were 30 controls including 21 men and 9 women with mean age 23-76 (55±13) years. All subjects underwent corneal confocal microscopy (CCM), contact heat evoked potential (CHEP) and skin sympathetic reflection (SSR) to quantify small nerve fiber pathology. Four parameters, such as nerve fiber length (NFL), nerve branch density (NBD), nerve fiber density (NFD) and nerve fiber tortuosity (NFT) were assessed by corneal confocal microscopy. All statistical calculations were conducted using SPSS version 12.0.Results:Compared with control group, corneal nerve fiber length (NFL),nerve fiber density (NFD) were significantly decreased [(12.2±4.4)mm/mm 2 vs.(15.1±4.5) mm/mm 2, P=0.028;(50.8±24.0)/mm 2 vs. (68.3±16.4)/mm 2, P=0.002],and nerve fiber tortuosity (NFT) were significantly increased [(2.6±1.0)level vs.(1.0±0.5)level, P<0.01)] in SFN group, while nerve branch density (NBD) were comparable ( P=0.700).The course of disease is correlated with NFT ( r=0.25, P=0.030). Conclusions:CCM is a new sensitive noninvasive clinical technique that detects early small fiber nerve damage in patients with ALS.

Impacto del cambio climático en la salud / The impact of climate change on health

Climate changes evidenced by an increase in our planet's mean temperature, changes in rainfall, increased sea level and extreme weather conditions, favor air and soil contamination, ocean acidification, droughts, floods, heat waves and forest fires, which affect the health and wellbeing of exposed populations. These changes will exert negative effects on respiratory and cardiovascular systems, nutritional status, burden of infectious diseases, especially vector-borne infections, and human mental health. Moreover, environmental damages, such as loss of biodiversity, ecological collapse and deterioration of socioeconomic factors such as agricultural and fishery production, and the loss of habitable land, will impulse massive migrations. This article summarizes the impact that climate change is expected to have on respiratory, cardiovascular and infectious diseases and its repercussions on people of extreme ages. It is imperative to achieve the immediate commitment of worldwide national governments to control green-house gas emissions. The appropriate technology does exist, but political will is urgently needed to accomplish this goal.

Estresse por calor na Atenção Primária à Saúde: uma revisão clínica / Heat stress in Primary Health Care: A clinical review / Estrés por calor en la Atención Primaria a la Salud: una revisión clínica

Introdução: A exposição nociva ao calor ganha mais relevância com a progressão do aquecimento global antropogênico e a Atenção Primária à Saúde (APS) tem um papel crescente nesse cenário. No Brasil, as ondas de calor entre 2014 e 2015 duraram mais tempo que nos anos prévios, além disso, entre 2000-2015 a associação entre temperatura e hospitalizações variou de acordo com a duração da exposição ao calor. Nesse contexto, o objetivo desta revisão é realizar uma atualização sobre manejo clínico de patologias relacionadas ao calor na APS. Metodologia: Realizou-se a busca na base de dados ACCESSS, que utiliza a pirâmide 5.0 da assistência à saúde baseada em evidências. Foram identificados 103 sumários sintetizados para referência clínica com as palavras "Heat stress", "Heat Stroke", "Heat Wave" e "Heat Exhaustion", mas apenas três entravam no escopo deste estudo. Resultados e Discussão: O estresse pelo calor é uma condição comum, negligenciada e evitável que afeta diversos pacientes, iniciando-se com uma má adaptação ao calor que se não for corrigida pode gerar uma cascata de eventos inflamatórios. O estresse pelo calor é caracterizado por sintomas inespecíficos, como mal-estar, cefaleia e náusea. O tratamento envolve o resfriamento do paciente e monitoramento, garantindo hidratação adequada. A exaustão pelo calor, se não tratada, pode evoluir para insolação, uma doença grave que pode levar ao coma e morte, envolvendo disfunção do sistema nervoso central - necessitando de um tratamento mais agressivo além do resfriamento

Introduction: The nocive exposure to heat gets more attention with anthropogenic global warming, and Primary Health Care (PHC) has a growing role in this scenario. In Brazil heat waves between 2014 and 2015 lasted longer than in previous years. Further, in addition between 2000-2015 the association between temperature and hospitalizations varied according to the duration of heat exposure. Therefore, the aim of this review is to perform an update on clinical management of heat related pathologies in PHC. Methodology: The ACCESSS database was searched using the evidence-based health care pyramid 5.0, where we identified 103 synthesized summaries for clinical reference with words "Heat stress", "Heat Stroke", "Heat Wave" and "Heat Exhaustion", but only three fell within the scope of this study. Results and Discussion: Heat stress is a common, neglected and preventable condition that affects several patients, it starts with a poor adaptation to heat that if it is not adjusted it can generate a cascade of inflammatory events. Heat stress is characterized by nonspecific symptoms such as malaise, headache and nausea. The treatment involves patient monitoring and cooling, ensuring adequate hydration. Heat exhaustion, if untreated, can progress to heatstroke, a serious illness that can lead to coma and death, involving central nervous system dysfunction - requiring more aggressive treatment than cooling.

Introducción: La exposición nociva al calor gana más destaque con la progresión del calentamiento global antropogénico, y la Atención Primaria a la Salud tienen un papiel cresciente en este escenario. En Brasil las olas de calor entre 2014 y 2015 duraron más tiempo que en los años previos, además entre 2000-2015 la asociación entre temperatura y hospitalizaciones ha variado de acuerdo con la duración de la exposición al calor. En este contexto, el objetivo de esta revisión es realizar una actualización sobre manejo clínico de patologías relacionadas al calor en la APS. Metodología: Se realizó la búsqueda en la base de datos ACCESSS, que utiliza la pirámide 5.0 de la asistencia a la salud basada en evidencias. Se han identificado 103 sumarios sintetizados para referencia clínica con las palabras "Heat stress", "Heat Stroke", "Heat Wave" y "Heat Exhaustion", pero sólo tres son considerados en el ámbito de este estudio. Resultados y Discusión: El estrés por el calor es una condición común, descuidada y evitable que afecta a varios pacientes, iniciándose con una mala adaptación al calor que si no se corrige puede generar una cascada de eventos inflamatorios. El estrés por el calor se caracteriza por síntomas inespecíficos, como malestar, cefalea y náuseas. El tratamiento implica el enfriamiento del paciente y el monitoreo, garantizando la hidratación adecuada. El agotamiento por el calor, si no se trata, puede evolucionar hacia la insolación, una enfermedad grave que puede llevar al coma y a la muerte, involucrando disfunción del sistema nervioso central - necesitando un tratamiento más agresivo además del enfriamiento.

Mortalidad por olas de calor en la ciudad de Buenos Aires, Argentina (2005-2015) / Mortality from heat waves in the city of Buenos Aires, Argentina (2005-2015) / Mortalidade por ondas de calor na cidade de Buenos Aires, Argentina (2005-2015)

Resumen: El objetivo de este trabajo es analizar la mortalidad durante las olas de calor en la ciudad de Buenos Aires, Argentina, para el período 2005-2015. Utilizamos un diseño de series temporales con modelos aditivos generalizados, vinculando mortalidad con días de ola de calor en todo el período, y con días de la ola de calor de 2013, la más prolongada desde el año 1906, controlando por variables temporales, temperatura media y humedad. Encontramos que el riesgo de muerte por causas naturales se incrementa en un 14% (RR = 1,140; IC95%: 1,108-1,173) durante las olas de calor, respecto al resto de los días del semestre cálido. El incremento se da en ambos sexos y en todos los grupos de edad, siendo más afectados los menores de 15 (RR = 1,167; IC95%: 1,019-1,335) y los mayores de 84 años (RR = 1,201; IC95%: 1,098-1,313). En la ola de calor de diciembre de 2013 aumentaron 43% (RR = 1,428; IC95%: 1,399-1,457) las muertes diarias totales, valor que sube al 51% para el grupo de mayores de 84 años (RR = 1,515; IC95%: 1,372-1,674) y al 65% (RR = 1,647; IC95%: 1,367-1,986) para las causas renales. Concluimos que las olas de calor constituyen un factor significativo de riesgo de muerte, diferente según sexo y edad, para la población de la ciudad de Buenos Aires.

Abstract: This study aimed to analyze mortality during heat waves in the city of Buenos Aires, Argentina, in 2005-2015. We used a time series design with generalized additive models, linking mortality to days of heat waves throughout the period, and to days of the heat wave in 2013, the longest wave since 1906, controlling for time variables, mean temperature, and humidity. Risk of death from natural causes increased by 14% (RR = 1.140; 95%CI: 1.108-1.173) during heat waves when compared to the other days in the hot season. The increase occurred in both sexes and in all age groups, and individuals under 15 years of age were more affected (RR = 1.167; 95%CI: 1.019-1.335) as were those over 84 years (RR = 1.201; 95%CI: 1.098-1.313). The heat wave in December 2013 showed an increase of 43% (RR = 1.428; 95%CI: 1.399-1.457) in total daily deaths, increasing to 51% in individuals over 84 years (RR = 1.515; 95%CI: 1.372-1.674) and 65% (RR = 1.647; 95%CI: 1.367-1.986) for renal causes. We conclude that heat waves pose a significant risk of death, differing according to sex and age in the population of Buenos Aires.

Resumo: O objetivo deste trabalho é analisar a mortalidade durante as ondas de calor na cidade de Buenos Aires, Argentina, no período de 2005-2015. Foi usado um desenho de séries temporais com modelos aditivos generalizados, vinculando a mortalidade com dias de onda de calor em todo o período, e com dias da onda de calor em 2013, a mais prolongada desde o ano de 1906, controlando através de variáveis temporais, temperatura media e umidade. Encontramos que o risco de morte por causas naturais teve um incremento de 14% (RR = 1,140; IC95%: 1,108-1,173) durante as ondas de calor, ao respeito do resto dos dias do semestre cálido. O incremento se produz em ambos os sexos e em todos os grupos de idade, sendo mais afetados os menores de 15 (RR = 1,167; IC95%: 1,019-1,335) e os maiores de 84 anos (RR = 1,201; IC95%: 1,098-1,313). Na onda de calor que ocorreu em dezembro de 2013 aumentaram um 43% (RR = 1,428; IC95%: 1,399-1,457) as mortes diárias totais, valor que sobe a 51% para o grupo de pessoas maiores de 84 anos (RR = 1,515; IC95%: 1,372-1,674) e a 65% (RR = 1,647; IC95%: 1,367-1,986) para as causas renais, Concluímos que as ondas de calor constituem um fator significativo de risco de morte, diferente segundo o sexo e idade, para a população da cidade de Buenos Aires.

Comparative study of the antioxidant capacity in green tea by extraction at different temperatures of four brands sold in Colombia / Estudio comparativo de la capacidad antioxidante en té verde por extracción a diferentes temperaturas de cuatro marcas vendidas en Colombia

Background: Tea (Camellia sinensis) is the most highly consumed beverage in the world in addition to water. The most common way of preparation is by immersing the tea bag in hot or cold water. In Colombia, it is a recent trend and the market is growing continuously. Objectives: The objective of this study is to compare the antioxidant characteristics of four brands of green tea sold in Colombia at room and hot-temperature in relation to the preparation conditions. Methods: Four commercial brands of green tea (Oriental®, Lipton®, Hindú®, Jaibel®) were used in an aqueous extraction at two temperatures: Cold tea extract (25°C) and hot tea extract (80°C). Total polyphenol concentration (TPC) was determined by Folin-Ciocalteu method; Total flavonoid content (TFC) was determined by spectrophotometric method and the antioxidant capacity was determined by two methods: DPPH radical capture assay, and the oxygen radical absorbance capacity (ORAC) assay. Finally, a method to quantify the catechins of the tea extracts, high performance liquid chromatography (HPLC) was applied. Results: The TPC vary between: 2.53 ­ 14.63 mg GAE/ g sample for cold tea extract and 29.34 - 55.06 mg GAE/g sample for hot tea extract. The TFC vary between: 2.67 ­ 7.08 mg CE/g per sample for the cold tea extract and 5.43­ 8.41 mg CE/ g sample for hot tea extract. A similar profile assays: for cold tea extract: 22.36 ­ 41.29 mg TE /g sample for DPPH and 22.95 ­ 46.25 mg TE/g sample for ORAC. Similarly, for hot tea extract the following ranges were: 38.50 ­ 110.01 mg TE/g sample for DPPH and 23.40- 113.60 mg TE/g sample for ORAC. In general, the values obtained in each assay for each brand were as follows: Oriental®> Lipton®> Hindú®> Jaibel®. The chromatographic profiles showed the presence of ten compounds. Conclusions: These results confirm that the aqueous extraction of green tea at 80°C leads to the formation of infusions made up of compounds with higher antioxidant capacity in comparison with extractions at room temperature.

Antecedentes: El té (Camellia sinensis) es la bebida más consumida en el mundo, además del agua. La forma más común de preparación es sumergiendo la bolsa de té en agua caliente o fría. En Colombia, es una tendencia reciente y el mercado está creciendo. Objetivos: El objetivo de este estudio es comparar las características antioxidantes de cuatro marcas de té verde vendidas en Colombia en relación con las condiciones de preparación. Métodos: Se utilizaron cuatro marcas comerciales de té verde (Oriental®, Lipton®, Hindú®, Jaibel®) mediante extracción acuosa a dos temperaturas: extracto de té frío (25°C) y extracto de té caliente (80°C). La concentración total de polifenoles (TPC) se determinó mediante el método de Folin-Ciocalteu; el contenido total de flavonoides (TFC) se determinó mediante método espectrofotométrico y la capacidad antioxidante se determinó mediante dos métodos: ensayo de captura del radical DPPH y ensayo de capacidad de absorción de radicales de oxígeno (ORAC). Finalmente, para cuantificar las catequínas de los extractos de té se aplicó cromatografía líquida de alta resolución (HPLC). Resultados: Los valores para TPC varían entre 2,53 -14,63 mg GAE/g extracto de té frío y entre 29,34 - 55,06 mg GAE/g extracto de té caliente. Los valores para TFC varían entre 2,67 - 7,08 mg de CE/g extracto de té frío y entre 5,43 - 8,41 mg de CE/g extracto de té caliente. Se observó un perfil similar en la capacidad antioxidante mediante ambos ensayos, extracto de té frío: 22,36 - 41,29 mg TE/g por DPPH y 22,95 - 46,25 mg TE/g por ORAC, extracto de té caliente: 38,50 - 110,01 mg TE/g por DPPH y 23,40- 113,60 mg TE/g por ORAC. En general, los valores obtenidos en cada ensayo respecto a cada marca se comportaron así: Oriental®> Lipton®> Hindú®> Jaibel®. Los perfiles cromatográficos mostraron la presencia de 10 compuestos. Conclusiones: Estos resultados confirman que la extracción acuosa de té verde a 80°C conduce a la formación de infusiones ricas en compuestos con capacidad antioxidante en comparación con extracciones a temperatura ambiente.

Efficacy of heated humidified high-flow nasal cannula as initial treatment for preterm infants with respiratory distress: a meta-analysis / 中华围产医学杂志

Objective To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) as the primary means of respiratory support for preterm infants with mild or moderate respiratory distress syndrome (RDS).Methods Randomized controlled trials (RCTs) about HHHFNC and/or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS were searched in PubMed,EMBASE,Cochrane library,Chinese Journal Full-text Database (CJFD),Wanfang Data base,VIP Database and China Biology Medicine disc (CBM).Meta-analysis was conducted with Review Manager 5.2 software to compare HHHFNC and CPAP groups in the outcomes ofpreterm infants with RDS,which included initial support failure,nasal trauma,pre-discharge mortality and incidences of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) before discharge.Results Eight randomized trials,including 1 400 preterm infants with RDS were included.Results of the meta-analysis demonstrated that no significant difference in the percentage of initial support failure was observed between the two groups (RR=1.22,95％CI:0.94-1.59,P=0.13),and HHHFNC was associated with decreased risk for nasal trauma (RR=0.35,95％CI:0.24-0.52,P＜0.001).There was no significant difference in the incidence of death,BPD,PDA or gas leaking before discharge between the two groups.Conclusions HHHFNC is an efficient respiratory support for preterm infants (gestational age over 28 weeks) with mild or moderate RDS.

Concurrent Two Types of Burn with Airbag in an Upper Extremity: Case Report

Automobile airbags have been shown to reduce morbidity and mortality in the event of a vehicle crash; however, new problems have been identified. Among these problems, direct injury from the airbag itself has become a serious concern. This suggests that an airbag itself may not be safe. Burn injury from airbags accounts for about 7.8% of all injuries caused by vehicle crashes. There are three types of burn injuries from airbags: Thermal, chemical, and frictional. Moreover, there are three subtypes within the category of thermal airbag burn, as identified by Tsunetuki in 2003. Herein, we review a case of an airbag burn and report a unique burn case on ‘an upper extremity’, including both thermal and frictional burns.

Heated carrier fluids in decreasing propofol injection pain: a randomized, controlled trial / 대한마취과학회지

BACKGROUND: Propofol is a commonly used intravenous drug during anesthetic induction because of its rapid onset and short duration. However, the injection pain that patients experience is so severe that they recall the induction of anesthesia as the most painful part of the perioperative period. Therefore, the objective of this study was to determine the effect of heated carrier fluids (40℃) in decreasing propofol injection pain. METHODS: A randomized, controlled clinical trial was conducted in 90 patients aged 18 to 65 who were scheduled for either elective or urgent surgery under general anesthesia classified as American Society of Anesthesiologists physical status I or II. Patients were allocated into the following 3 groups: 1) Group W (n = 30) who received 200 ml of heated carrier fluids for 20 minutes prior to propofol injection; 2) Group L (n = 30) who received 200 ml of heated carrier fluids for 20 minutes prior to 0.5 mg/kg 1%lidocaine 1 minute before propofol injection; 3) Group C (control group, n = 30) who received 200 ml of room temperature fluids prior to propofol injection. Pain was evaluated using verbal pain score (VPS). RESULTS: Group W and Group L showed significant reduction (P = 0.001) in the incidence and severity of injection pain compared to Group C. VPS scores were significantly lower in Group W and Group L compared to those of Group C. Incidence of propofol injection pain was statistically different between Group W (P = 0.005) and Group L (P = 0.037) compared to Group C, but not statistically different between Group W and Group L (P = 0.432). CONCLUSIONS: Both sole injection of heated carrier fluids and the combination of 0.5 mg/kg 1%lidocaine pretreatment effectively reduced propofol injection pain.

Laptop computer induced erythema ab igne: a new presentation of an old disease

Abstract Erythema ab igne is a condition characterized by skin changes due to chronic exposure to moderate temperature. We describe a female patient with continuous use of a laptop computer on exposed legs for 6 months and consequent development of reticulated hyperpigmentation at the area. Histopathological examination revealed epidermal atrophy, collagen fragmentation, and vacuolar changes in the basal layer, among other signs. We consider this case to be a modern cause of erythema ab igne.

Influence of a heating device and adhesive temperature on bond strength of a simplified ethanol-based adhesive system / Influência de um dispositivo de aquecimento e da temperatura do adesivo na resistência de união de um sistema adesivo à base de etanol

Introduction: Increased adhesive temperature has been reported to promote solvent evaporation, reduce viscosity, and improve monomeric permeation into dentin. Objective: The aim of this study was to determine the influence of different heating methods on the microtensile bond strength of an etch-and-rinse adhesive to dentin. Material and method: Twenty-four caries-free extracted human third molars were transversally sectioned to expose a flat dentinal surface. The samples were etched with 37% phosphoric acid gel and divided into three groups (n = 8): 1) Control - the adhesive system (Adper Single Bond 2; 3M ESPE) was applied at room temperature; 2) Warming device - the adhesive was warmed to 37°C in a custom device before application; and 3) Warm air - the adhesive was warmed to 50°C with an air jet after application on dentin. The specimens were restored with a composite resin (Filtek Z250 A2, 3M ESPE) and prepared for microtensile bond strength testing, after 24 h in water storage. The data were subjected to one-way ANOVA and Tukey's test (p < 0.05). Result: There was no significant difference among the groups (p > 0.05). The mean bond strength values in the control, the warming device, and the warm air groups were 48.5 (± 5.2), 40.35 (± 4.9), and 47.2 (± 5.3) MPa, respectively (p = 0.05). Conclusion: The different heating methods had no significant influence on the immediate microtensile bond strength of an etch-and-rinse ethanol-based adhesive to dentin.

Introdução:O aumento da temperatura do adesivo tem sido pesquisado como forma de melhorar a evaporação do solvente, reduzir a viscosidade e melhorar a permeação dos monômeros na dentina. Objetivo: Investigar a influência de diferentes métodos de aquecimento na resistência de união à dentina sob um ensaio de microtração de um adesivo de condicionamento ácido total. Material e método: Vinte e quatro terceiros molares hígidos foram seccionados transversalmente a fim de expor a superfície plana da dentina. As amostras foram condicionadas ácido fosfórico a 37% e dividido em três grupos (n=8). São eles: 1) Controle - onde o adesivo (Adper Single Bond 2, 3M ESPE) foi aplicado em temperatura normal (25°C); 2) Dispositivo de aquecimento - O adesivo foi aquecido em um dispositivo específico até alcançar a temperatura de 37°C e só então aplicado à dentina; 3) Ar quente - Usou-se jato de ar aquecido a 50°C por 10 segundos a uma distância de 10cm para facilitar a evaporação do solvente. Os espécimes foram restaurados com resina composta (Filtek Z250 A2, 3M ESPE) e preparados para o ensaio de microtração, após 24h de armazenamento em água destilada. Os dados obtidos foram submetidos para análise de variância (ANOVA) e teste de Tukey (p< 0,05). Resultado: Não houve diferença significativa entre os grupos (p> 0,05). As médias da resistência de união para o grupo controle, dispositivo de aquecimento e ar quente foram, respectivamente, 48,5 (± 5,2), 40,35 (± 4,9), e 47,2 (± 5,3). Conclusão: Os diferentes métodos de aquecimento não influenciaram significativamente na resistência de união imediata à dentina de um Sistema adesivo de condicionamento ácido total.

Effects of Sequential Application of Superficial Cold and Heat on Pain, Patient Satisfaction with Pain Control, Comfort Level and Subjective Response after Spine Surgery / 기본간호학회지

PURPOSE: The aims of the current study were to evaluate the effects of superficial cold and heat after spine surgery on pain, satisfaction with pain control and comfort level, and to identify subjective responses and adverse effects. METHODS: A prospective, single-blind, randomized controlled trial was utilized. The intervention group (n=36) received superficial cooling until the wound drain was removed and thereafter followed by superficial heating until discharge, while the control group (n=34) received only superficial cooling until wound drain was removed. Data were collected from August 4 to November 11 2014. RESULTS: There was significant difference in pain according to time within groups (F=71.87, p<.001). However, we found no difference in pain between groups. The intervention group reported higher patient satisfaction with pain control (4 vs 3, z=-2.83, p=.005) and higher comfort level (5 vs 4, z=-4.12, p<.001) than the control group. CONCLUSION: Results indicate that sequential application of superficial cold and heat is a useful method in clinical practice for management of pain after spine surgery.

Effect of different post-cure polymerization treatment on composite resin hardness / Efeito de diferentes métodos de polimerização complementar sobre a dureza de resinas compostas

Objective: To evaluate the influence of different additional polymerization methods on the microhardness of two direct composite resins. Methods: Direct Composite resins samples (Fill Magic and Opallis) and a Laboratory Composite Resin (Ceramage) were lightcured according to manufacturer instructions. Then, the direct resins were submitted to additional polymerization. Experimental groups were divided into (n = 5): group 1: Conventional Polymerization; group 2: Extra Light (80s); group 3: Autoclave; group 4: Laboratory Resin Ceramage. Vickers hardness test was carried out after a week of light-free storage in water, and results were subjected to ANOVA / Tukey statistical analysis. Results: Resin Lab Ceramage showed higher astatistically significant microhardness within all other resins in this study (p £ 0.05); Fill Magic showed no statistically significant difference between the groups tested compared to its control (p> 0.05); Opallis resin submitted to autoclave was the only method that showed a higher statistically significant difference compared to the control group (p £ 0.05). Conclusion: It concludes that hardness of a direct composite resin tested - Opallis - was increased by Autoclave post-cure polymerization, however, not enough to achieve the hardness of a laboratory composite. Furthermore, increasing lightcuring time does not produce a harder surface.

Objetivo: Avaliar a influência de diferentes métodos de polimerização complementar na microdureza de duas resinas compostas de uso direto. Métodos: As amostras foram confeccionadas com as resinas FillMagic, Opallis e Ceramage (Resina Composta Laboratorial); e fotopolimerizadas conforme recomendações do fabricante. Em seguida, as resinas de uso direto foram submetidas à polimerização complementar. Os grupos experimentais foram divididos em (n=5): grupo 1: Fotopolimerização convencional; grupo 2: Luz adicional (80s); grupo 3: Autoclave; grupo 4: Resina Laboratorial Ceramage. O ensaio de microdureza Vickers foi realizado após uma semana de armazenagem em água, em invólucros livres de luz, e os resultados foram submetidos à análise estatística ANOVA/Tukey. Resultados: A Ceramage apresentou maior valor de microdureza Vickers, com diferença significativa em relação a todas as outras resinas utilizadas neste estudo (p £ 0,05); a FillMagic não apresentou diferença significativa entre seus grupos experimentais e o seu controle (p > 0,05); na Opallis, a autoclave foi único método que apresentou diferença significativa quando comparado ao seu grupo controle (p £ 0,05). Conclusão: Conclui-se que a dureza de uma resina composta de uso direto testada - a Opallis - foi aumentada pela polimerização complementar em Autoclave, porém, não foi suficiente para atingir a dureza da resina composta laboratorial. Além disso, o aumento no tempo de fotoativação das resinas de uso direto não produz uma superfície de maior dureza.

Pre-heating mitigates composite degradation

ABSTRACT Dental composites cured at high temperatures show improved properties and higher degrees of conversion; however, there is no information available about the effect of pre-heating on material degradation. Objectives This study evaluated the effect of pre-heating on the degradation of composites, based on the analysis of radiopacity and silver penetration using scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS). Material and Methods Thirty specimens were fabricated using a metallic matrix (2x8 mm) and the composites Durafill VS (Heraeus Kulzer), Z-250 (3M/ESPE), and Z-350 (3M/ESPE), cured at 25°C (no pre-heating) or 60°C (pre-heating). Specimens were stored sequentially in the following solutions: 1) water for 7 days (60°C), plus 0.1 N sodium hydroxide (NaOH) for 14 days (60°C); 2) 50% silver nitrate (AgNO3) for 10 days (60°C). Specimens were radiographed at baseline and after each storage time, and the images were evaluated in gray scale. After the storage protocol, samples were analyzed using SEM/EDS to check the depth of silver penetration. Radiopacity and silver penetration data were analyzed using ANOVA and Tukey’s tests (α=5%). Results Radiopacity levels were as follows: Durafill VS<Z-350<Z-250 (p<0.05). The depth of silver penetration into the composites ranked as follows: Durafill VS>Z-350>Z-250 (p<0.05). After storage in water/NaOH, pre-heated specimens presented higher radiopacity values than non-pre-heated specimens (p<0.05). There was a lower penetration of silver in pre-heated specimens (p<0.05). Conclusions Pre-heating at 60°C mitigated the degradation of composites based on analysis of radiopacity and silver penetration depth.

The use of superficial heat for treatment of temporomandibular disorders: an integrative review / O emprego do calor superficial para tratamento das disfunções temporomandibulares: uma revisão integrativa

Purpose: To perform an integrative review of scientific bibliographic production on the use of superficial heat treatment for temporomandibular disorders. Research strategy : Literature review was accomplished on PubMed, LiLACS, SciELO, Bireme, Web of Science, and BBO databases. The following descriptors were used: hot temperature, hyperthermia induced, heat transference, temporomandibular joint, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, and their equivalents in Portuguese and Spanish. Selection criteria : Articles that addressed the superficial heat for the treatment of temporomandibular disorders, published in English, Spanish, or Portuguese, between 1980 and 2013. Data analysis : The following data were collected: technique of applying superficial heat, duration of application, stimulated body area, temperature of the stimulus, frequency of application, and benefits. Results : initially, 211 studies were found, but just 13 contemplated the proposed selection criteria. Data were tabulated and presented in chronological order. Conclusion: Several techniques for superficial heat application on treatment of temporomandibular disorders were found in the literature. The moist heat was the most widely used technique. Many studies suggested the application of heat for at least 20 minutes once a day. Most authors recommended the application of heat in facial and cervical regions. The heat treatment resulted in significant relief of pain, reduced muscle tension, improved function of the mandible, and increased mouth opening. .

Objetivo: Realizar revisão integrativa sobre a produção científica referente ao emprego do calor superficial para tratamento das disfunções temporomandibulares. Estratégia de pesquisa: Foi realizado levantamento na literatura nas bases de dados PubMed, LiLACS, SciELO, Bireme, Web of Science e BBO. Os termos utilizados foram: temperatura alta, transferência de calor, articulação temporomandibular, transtornos da articulação temporomandibular, síndrome da disfunção da articulação temporomandibular e seus correspondentes em inglês e espanhol. Critérios de seleção: Foram incluídos artigos que abordaram o calor superficial no tratamento das disfunções temporomandibulares, publicados em inglês, espanhol ou português, no período de 1980 a 2013. Análise dos dados: Foram considerados: técnica de aplicação de calor superficial, duração de aplicação, área corporal estimulada, temperatura do estímulo, frequência de realização e benefícios. Resultados: inicialmente, foram encontrados 211 estudos, dos quais 13 contemplaram os critérios de seleção propostos. Os dados foram tabulados e apresentados em ordem cronológica. Conclusão: Várias técnicas de aplicação de calor superficial para tratamento das disfunções temporomandibulares foram encontradas na literatura. O calor úmido foi a modalidade mais empregada. Muitos estudos sugerem a aplicação de calor por 20 minutos, e a frequência mínima foi uma vez ao dia. A maioria dos autores recomenda a aplicação do calor nas regiões facial e cervical. O tratamento com calor apresentou benefícios como alívio da dor, redução da tensão muscular, melhora das funções da mandíbula e aumento da abertura de boca. .

Influência da Irrigação na Osseointegração: Revisão da Literatura / Osseointegration Influenced by the Irrigation System: a Literature Review

O uso de implantes para a reabilitação oral é pratica comum na odontologia. Entretanto, falhas são relatadas na literatura. Para evitar o insucesso, cuidados na preparação do leito receptor dos implantes são importantes e, entre esses cuidados, o não aquecimento do osso adjacente é fundamental. A elevação da temperatura durante a osteotomia é um fator importante para o fracasso da técnica cirúrgica. O objetivo do trabalho foi revisar a literatura sobre a influência da irrigação na osseointegração. Foram realizadas buscas em bases de dados no portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), National Center for Biotechnology Information (NCBI)/U.S., National Library of Medicine (PubMed) e Google Acadêmico, no perído de 1964 a 2012. Foram selecionados 333 estudos relacionados à busca, sendo que 203 foram descartados por não abordarem de forma clara a relação entre o controle do calor gerado e o procedimento de instalação de implantes orais. Os 130 artigos remanescentes foram selecionados e 50 estudos foram incluídos. Foram identificados os fatores relacionados aos diferentes sistemas de irrigação do tipo externo e do tipo interno usados para o controle da temperatura, tanto das brocas como do tecido ósseo adjacente, durante a osteotomia para a inserção de implantes. Baseado na literatura, é imprescindível a utilização da irrigação durante a confecção dos alvéolos cirúrgicos para a inserção de implantes dentários, independentemente de serem interno ou externo, já que os estudos mostram que o desempenho de ambos é semelhante, salvo em casos específicos, como no caso de cirurgias guiadas, em que a irrigação interna parece ser mais eficiente.

The use of implants for oral rehabilitation is a common practice in dentistry, though failures are reported in literature. To avoid failure, careful preparation of the recipient site of the implants is important, and among these cares, not heating the adjacent bone is essential. Increasing temperature during osteotomy is an important factor in failure of the surgical technique. This study aimed to review the literature about the influence of irrigation on osseointegration. Searches were conducted in databases on the portal of periodicals from Coordination of Improvement of Higher Education Personnel (CAPES), National Center for Biotechnology Information (NCBI) / U.S., National Library of Medicine (PubMed) and Google Scholar, in the period from 1964 to 2012. Then, 333 studies were selected, but 203 were discarded for not clearly addressing the subject. One hundred and thirty remaining articles were selected, and 50 studies were included. The study identified the factors related to the external and internal irrigation systems used to control the temperature of drills and adjacent bone tissue during the osteotomy for the insertion of implants. Based on the literature the irrigation during the surgical preparation for the insertion of dental implants is fundamental, independently from being internal or external systems, once the performance of both is similar, except in specific cases, including guided surgery in which the internal irrigation appears to be more efficient.

Variación de la temperatura intradiscal por efecto de la terapia térmica con radiofrecuencia: Estudio en cadáveres / Intradiscal temperature variation resulting from radiofrequency thermal therapy: Cadaver study

Introducción: La discopatía es una de las causas más comunes del dolor lumbar. La nueva era de tratamientos para la degeneración discal implica el uso de tecnologías térmicas mínimamente invasivas, que permiten la remodelación del colágeno y la destrucción de nociceptores anulares. Sin embargo, es necesaria una mejor comprensión de la fisiopatología del tratamiento. El propósito de este estudio fue medir la variación de la temperatura intradiscal luego del procedimiento de termodiscoplastía. Material y métodos: Se tomó un espécimen de columna vertebral de cadáver humano, y se dividió en bloques formados por dos placas intervertebrales y un disco intacto. Se aplicó radiofrecuencia en cinco puntos y con tres intervalos de tiempo diferentes. Se midió la temperatura en cada una de las combinaciones. Las unidades se pesaron antes y después del tratamiento. Por último se expuso el disco y se midió el tensamiento alcanzado con cada aplicación de temperatura. Los datos se analizaron con el programa SPSS. Resultados: Se obtuvo una disminución del peso en promedio de 1.4 g (SD 0.599), con valores entre 0.5 y 2.6 gramos. Se encontraron temperaturas medias de 37.6 ºC en el reborde posterior del anillo y una variación de temperatura en promedio de 3.0 ºC (SD 6.407). En promedio se logró un tensamiento de 1.4 mm para todos los bloques en conjunto. Discusión: Los resultados obtenidos muestran la efectividad de la termodiscoplastía con radiofrecuencia dentro de los parámetros de seguridad. Los valores de temperatura con radiofrecuencia fueron más bajos que los encontrados en estudios comparables. El peso y el tensamiento permiten verificar el efecto de encogimiento y deshidratación del disco; este reporte constituye una eficaz herramienta para definir parámetros de tiempos para la aplicación de la tecnología.

Introduction: Disc disease is one of the most common causes of lumbar pain. The new era of treatments for degenerative disc disease involves the use of minimally-invasive thermal technologies allowing for collagen remodeling and destruction of nociceptors in the annulus. However, a better understanding of the treatment pathophysiology is needed. The purpose of this study was to measure intradiscal temperature variation after thermodiscoplasty. Material and methods: A human cadaver spine specimen was obtained and divided into blocks, each composed of two intervertebral plates and an intact disc. Radiofrequency was applied at five spots with three different time intervals. Temperature was measured in each of the combinations. Units were weighed before and after treatment. Finally, the disc was exposed and the tightening achieved with each radiofrequency application was measured. Data were analyzed with the SPSS software. Results: The mean weight reduction obtained was 1.4 g on average (SD 0.599), with values between 0.5 and 2.6 grams. Mean temperature in the posterior rim of the annulus was 37.6 ºC and mean temperature variation was 3.0 ºC (SD 6.407). Mean tightening achieved in all blocks overall was 1.4 mm. Discussion: The results obtained show the effectiveness of radiofrequency thermodiscoplasty when performed within the safety parameters. Temperature values with radiofrequency were lower than those found in comparable studies. The weight and the tightening show the effect of disc shrinking and dehydration. This report is an effective tool to define time parameters for the application of this technology.

O efeito da exposição ao calor sobre o desempenho cognitivo de idosos: um estudo controlado / The effect of heat exposure on the cognitive performance of older adults: a controlled trial

Introdução: Concomitante ao processo de envelhecimento populacional, estão ocorrendo mudanças climáticas, sendo a principal delas o aquecimento global. O envelhecimento leva a mudanças tanto nos mecanismos de termorregulação quanto no desempenho cognitivo. Embora inúmeros estudos tenham avaliado o efeito do calor sobre a cognição de adultos jovens, este é um tema praticamente inexplorado na população geriátrica. Objetivos: Avaliar o efeito da exposição ao calor sobre o desempenho cognitivo de idosos saudáveis e identificar fatores que expliquem as variações na susceptibilidade ao estresse térmico nesta população. Casuística e Métodos: 68 idosos com bom desempenho físico e cognitivo realizaram uma bateria de testes neuropsicológicos em duas condições ambientais: 24oC (controle) e 32oC (calor). Através de cinco testes selecionados da Bateria Neuropsicológica Automatizada de Testes de Cambridge (CANTAB), foram avaliados diferentes aspectos do desempenho cognitivo com foco principal em memória, atenção e velocidade de processamento. Um escore composto global de desempenho cognitivo foi criado usando a medida mais representativa de cada um desses testes. Antes e após cada uma das sessões de testes, foram aferidos o peso corporal, a temperatura axilar, a temperatura auricular, a frequência cardíaca e a pressão arterial. Por meio da análise de variância para medidas repetidas (ANOVA), verificou-se a interação entre o efeito da temperatura na cognição (avaliada pelo escore composto global) e características sociodemográficas (idade, sexo, educação, cor), frequência de exercício físico e umidade relativa registrada durante o protocolo de exposição ao calor. Adicionalmente, foi também desenvolvido um modelo de regressão linear multivariada a fim de identificar variáveis independentes que explicariam a susceptibilidade ao estresse pelo calor. Resultados: A idade média da amostra foi de 73,28 anos. 42,9% dos indivíduos relataram praticar atividade física quatro ou mais...

Introduction: Concomitantly to the process of population aging, major climate changes are taking place, among which global warming is regarded as the most important. Aging leads to changes in temperature control mechanisms and is associated with a subtle and progressive decline in cognitive functions. Although a great deal of studies have evaluated the effect of heat on the cognitive performance of young adults, to the best of our knowledge, no studies have directly investigated the effects of warm environments on the cognitive functioning of older adults. Objectives: To evaluate the effect of heat exposure on the cognitive performance of healthy older adults and to identify factors that would explain variations in susceptibility to heat stress in that population. Methods: 68 older adults with both good physical and cognitive performance were requested to take a series of neuropsychological tests under two environmental conditions: at 24oC and 32oC. Five tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered to measure different aspects of cognitive functioning while focusing on memory, attention and processing speed. A global composite score of cognitive performance was created, using the most representative measures of each one of those five tests. Before and after each session, measures of auxiliary temperature, tympanic temperature, blood pressure, heart rate, and body weight were obtained. Interaction analysis was carried out using repeated measures analysis of variance (ANOVA) in order to check whether the effect of temperature on cognition, assessed by the global composite score, was modified by sociodemographic characteristics (age, gender, education, race), frequency of physical activity or relative humidity registered during the heat protocol. In addition, a multiple linear regression model has been fitted to identify independent variables that would explain susceptibility to heat stress Results: The mean age...

The Influence of the Presence of Wheat Flour on the Antigenic Activities of Egg White Proteins

PURPOSE: It is known that ovomucoid, an egg allergen, is heat resistant and remains soluble after heating. However, a recent study showed that the antigenic activity of ovomucoid could be reduced by heating when egg white (EW) was mixed with wheat flour. This study was performed to determine the influence of wheat flour on the antigenic activities of EW proteins when EW is heated, and the influence of the duration of heat treatment. METHODS: A mixture of EW and wheat flour was kneaded for 10 minutes and then baked at 180degrees C for 10 minutes and 30 minutes. The EW without wheat flour was also heated at 180degrees C for 10 minutes and 30 minutes. The proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and IgE immunoblotting was performed with the pooled sera of 5 egg-allergic patients. The antigenic activities of ovomucoid in different EW samples were measured by inhibition enzyme-linked immunosorbent assay (ELISA). RESULTS: 1) SDS-PAGE: the intensity of the 37-50 kD bands (overlapped bands of ovomucoid and ovalbumin) decreased significantly in the mixture of EW and wheat flour baked for 30 minutes, compared with the mixture baked for 10 minutes, heated EW and raw EW. 2) IgE immunoblot: in the mixture of EW and wheat, a remarkable decrease of IgE reactivity to 37-50 kD was observed when baked for 30 minutes. 3) Inhibition ELISA: the antigenic activity of ovomucoid decreased significantly in the mixture of EW and wheat baked for 30 minutes, but not in the heated pure EW. CONCLUSIONS: This study showed that the antigenic activity of ovomucoid can be reduced by baking EW with wheat flour. The decrease in ovomucoid antigenicity in the baked mixture of EW and wheat flour was dependent on the time of heat treatment, indicating that heating should be prolonged to achieve a reduction in ovomucoid antigenic activity.

Eritromelalgia primária: relato de caso / Primary erythromelalgia: case report

Eritromelalgia é uma síndrome clínica rara, caracterizada por calor, rubor e dor intermitente nas extremidades, sendo frequente o acometimento bilateral das extremidades inferiores. O resfriamento local provoca alívio dos sintomas, enquanto aquecimento, exercícios físicos e uso de luvas e meias intensificam o desconforto. A desordem pode ser primária ou idiopática, ou secundária a distúrbios hematológicos e doenças vasculares inflamatórias e degenerativas. Relata-se o caso de um jovem de dezoito anos, com início precoce aos dois anos de idade dos sintomas de eritema, calor e dor, seguidos de descamação nas mãos e pés, em surtos, com intervalos longos de 4 a 5 anos entre as crises.

Erythromelalgia is a rare clinical syndrome characterized by heat, redness and intermittent pain in the extremities, being most frequent the bilateral development in the lower extremities. Local cooling brings relief to symptoms, while heating, physical exercises and use of stockings/socks intensify the discomfort. This condition can be primary or idiopathic or secondary to haematological disorders and vascular inflammatory and degenerative diseases. It is reported the case of an eighteen-year-old male who presented, at the early age of two, development of the symptoms of erythema ,heat and pain followed by desquamation of hands and feet, in outbreaks, with intervals 4 to 5 years long between the crises.