Pioneer of Cardiothoracic Surgery - Luiz Tavares da Silva

ABSTRACT Luis Tavares revolutionized cardiac surgery, always bringing the most modern instruments and equipment from his travels to England - surgical forceps, scissors, scalpels, etc. He always insisted that he was not just a thoracic surgeon, for his work extended over a wide field and created three important cardiac surgery centers which promoted a great development of cardiology. He carried out the first open heart surgery (atrial septal defect) employing extracorporeal circulation and closure of a ventricular septal defect with deep surface hypothermia of north and northeast Brazil. He promoted an intense scientific exchange program between Recife and England, resulting in significant advances in medicine, and participated directly in the creation of HEMOPE), leading to radical changes and improvements in blood therapy in the whole country. The PROCAPE, inaugurated in 2006, was the result of the cardiac center created by him in early 1970 at Hospital Oswaldo Cruz and can be considered the second largest public-university cardiology center in Brazil. He is thus widely regarded as an outstanding name in medicine in the 20th century and one of the fathers of modern cardiac surgery in Brazil.

Relação entre o perfil sociodemográfico e a competência motora de crianças / Relationship between the sociodemographic profile and motor competence of children

Resumo Objetivo Verificar as relações estabelecidas entre os fatores individuais e ambientais na competência motora de crianças de 06 a 10 anos de idade. Método Trata-se de um estudo de caráter quantitativo, sustentado na estatística descritiva e inferencial. Os seguintes instrumentos de coleta foram utilizados: Teste de Proficiência Motora de Bruininks-Oseretsky e Home Observation for Measurement of the Environment - Middle Childhood. Resultados As análises indicaram a influência dos constructos ambientais no desenvolvimento e manutenção da competência motora das crianças, elucidando o fato de que o ambiente domiciliar adequado é um fator de proteção para o desenvolvimento dessa competência. Crianças residentes em casas adequadas apresentaram em média 66% mais chances de terem competência motora. Outro fato evidenciado deu-se em razão da disparidade no nível de competência motora entre os sexos, com destaque para o fato de que meninas com idade entre 9 e 10 anos que residem em domicílios classificados como não adequados localizados na região central da cidade e que estudam em escolas públicas apresentaram valores de competência motora abaixo do esperado para sua idade. Conclusão O perfil sociodemográfico de crianças que apresentaram as melhores chances para uma proficiência motora mais alta foi de meninos com idade entre 6 e 7 anos que residem em domicílios classificados como adequados localizados em bairros e que estudam em escolas privadas.

Abstract Objective To verify the relationships established between individual and environmental factors in the motor competence of children aged 06 to 10 years. Method This is a quantitative study supported by descriptive and inferential statistics. The following collection instruments were used: Bruininks-Oseretsky Motor Proficiency Test and Home Observation for Measurement of the Environment - Middle Childhood. Results The analyses indicated the influence of environmental constructs on the development and maintenance of children's motor competence, elucidating the fact that the appropriate home environment is a protective factor for the development of this competence. Children residing in adequate homes were 66% more likely to have motor competence on average. Another fact highlighted was due to the disparity in the level of motor competence between the sexes, with emphasis on the fact that girls aged 9-10 years who live in households classified as unsuitable, located in the central region of the city, studying in public schools presented motor competence values below the expected for their age. Conclusion The sociodemographic profile of children who presented the best chances for higher motor proficiency included boys aged 6-7 years old, living in households classified as adequate, located in neighborhoods outside the central region, and studying in private schools.

Influence of sex on the exposure to isoniazid in patients with pulmonary tuberculosis

ABSTRACT Isoniazid is a key component of tuberculosis treatment. Adequate exposure is a determinant for therapeutic success; however, considerable inter- and intraindividual variations in drug plasma levels can lead to unfavorable outcomes. While some predictors of isoniazid levels are well-known, others, such as sex, yield controversial results, requiring further investigation to optimize exposure. This study investigates whether the sex of patients influences the dose administered and the concentrations of isoniazid in plasma. Levels of isoniazid were associated with the N-acetyltransferase 2 phenotypes. A total of 76 male and 58 female patients were included. Isoniazid was measured by high-performance liquid chromatography, and N-acetyltransferase 2 phenotypes were assessed using molecular techniques. The results show that the dose administered, expressed in mg/kg, was higher in females, but the plasma levels were similar between both sexes. Among patients, 46.2%, 38.8%, and 15% were slow, intermediate, and fast acetylators, respectively. As expected, isoniazid levels were associated with the acetylation phenotypes, with higher concentrations in the slow acetylators. Thus, sex-related difference in isoniazid levels is due to the body weight of patients, and the optimized dose regimen based on patient weight and acetylator phenotypes can improve the treatment outcomes.

Concentrations of total, bioavailable, and free 25OHD in individuals with and without primary hyperparathyroidism and their correlations to DXA and trabecular bone score

ABSTRACT Objective: This study aimed to investigate the association between 25OHD (total, bioavailable and free) with bone mass and microarchitecture among primary hyperparathyroidism (PHPT) patients and controls. Subjects and methods: Sixty-four patients in the preoperative period of PHPT and 63 matched controls, who had not taken vitamin D in the last three months. To calculate the bioavailable and free 25OHD, the genetic variants of the vitamin D-binding protein (DBP) were determined. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry (DXA). The distributions of total, bioavailable and free 25OHD and their correlation with TBS and DXA were evaluated. Results: PHPT showed BMD and TBS values lower than CTRL in all locations (p < 0.05). There were no statistical differences in the levels of free, bioavailable and total 25OHD between the PHPT and CTRL groups [mean, min-max: 3.4 (1.4-8.6) vs. 3.1 (1.0-9.8) pg/mL, 1.51 (0.43-3.58) vs. 1.41 (0.38-3.48) ng/mL, 22.6 (11.0-39.9) vs. 20.6 (8.9-35.3) ng/dL, respectively; (p > 0.05). The distribution of DBP haplotypes was similar between groups. DXA showed no correlation with any form of 25OHD in both groups. TBS presented a weak correlation with the total 25OHD in PHPT (r = 0.28; p = 0.02) and a moderate correlation with the total, free and bioavailable 25OHD in CTRL (r = 0.42; r = 0.42; r = 0.43; respectively, p < 0.01). Conclusion: The concentrations of total, free and bioavailable 25OHD were similar in both the PHPT and control groups. 25OHD concentrations correlated positively with TBS and not with DXA, especially in controls, suggesting that this method may be more sensitive to assessing the consequences of vitamin D deficiency on bone quality in individuals without PHPT.

Resilience, self-efficacy and motivation as positive psychological characteristics of student and professional dancers / Resiliência, autoeficácia e motivação como características psicológicas positivas de bailarinos alunos e profissionais

ABSTRACT This study aimed at assessing the following psychological variables: resilience, self-efficacy and motivation. A total of 135 dancers participated in the study, that is, 112 students from the Brazilian dance school known as Escola de Dança do Teatro Guaíra, 15 professional dancers from the school referred to as Balé Teatro Guaíra, and 08 professional dancers from the school named G2 Cia de Dança. The evaluation of the psychological variables was carried out by using four questionnaires: Resilience Scale (RS), General Self-Efficacy Scale (GSE), Self-Efficacy Scale for Dancers (SESD), and Sport Motivation Scale-II (SMS-II). The Hierarchical Cluster Analysis with the Ward's method and Mann-Whitney test were used for assessing the data. The results showed that students and professionals have similar levels of motivation, but divergent ones regarding friendship, personal fulfilment, satisfaction, meaning of life and self-confidence, ability to adapt to situations of resilience, and psychological self-efficacy. The Cluster Analysis enabled the researchers to organize the group of student dancers with similar characteristics into three clusters, that is, 'predominant', 'intermediate' and 'minority', whereas the group of professional dancers was divided into two groups, 'minor and 'major''. It was concluded that both student dancers and professional ones showed high values of resilience, self-efficacy and motivation. These results highlight that dance has an important role in the construction of a positive psychological profile.

RESUMO Esta pesquisa analisou as seguintes variáveis psicológicas: resiliência, autoeficácia e motivação. Um total de 135 bailarinos participou do estudo, isto é, 112 alunos da Escola de Dança do Teatro Guaíra, 15 bailarinos profissionais do Balé Teatro Guaíra e 08 bailarinos profissionais do G2 Cia de Dança. A avaliação das variáveis psicológicas foi realizada por meio de quatro questionários: Escala de Resiliência (ES), Escala de Autoeficácia Geral Percebida (EAGP), Escala de Autoeficácia para Bailarinos (AEBAI) e Escala de Motivação para o Esporte II (SMS-II). Para análise de dados utilizou-se a Análise de Clusters hierárquica com o Método de Ward e o Teste de Mann-Whitney. Os resultados mostraram que alunos e profissionais possuem níveis semelhantes para a motivação, todavia distintos com relação às categorias de amizade, realização pessoal, satisfação, significado de vida e autoconfiança, capacidade de adaptação a situações da resiliência e autoeficácia psicológica. A Análise de Clusters possibilitou organizar o grupo de bailarinos alunos com características semelhantes em três clusters, isto é, "predominante", "intermediário" e "minoritário", enquanto que o grupo de bailarinos profissionais foi dividido em dois grupos, isto é, "menor" e "maior". Concluiu-se que tanto bailarinos alunos e profissionais da dança apresentaram altos índices de resiliência, autoeficácia e motivação. Estes resultados permitem afirmar que a dança têm um papel importante na construção de um perfil psicológico positivo.

Psychometric properties of the Movement Assessment Battery for Children (MABC-2): an analysis based on the Item Response Theory / A falta capacidade discriminatória em tarefas motoras do Movement Assessment Battery for Children ­ 2: O que a Teoria de Resposta ao Item revela?

Introduction: the American Psychiatric Association reveals that 6% of school-age children have developmental coordination disorder. Objective: this study aimed at assessing the suitability of the tasks proposed by the MABC-2 motor assessment instrument based on the psychometric properties of such an instrument and the analysis of the Item Response Theory. Methods: 582 children ranging in age from 3 to 5 years old of both sexes participated in the study. The motor tasks suitability for children was verified by using the Gradual Response Model, and applying the Maximum Likelihood Estimation method. Results: the motor task 'bicycle trail' showed a lower discriminatory power and was removed from the analysis. Considering the 'Aiming & Catching' dimension, 'Threading Beads' was the motor task with the highest degree of difficulty. Regarding balance, the 'One Leg Balance' task was classified as having a high degree of difficulty; on the other hand, the motor tasks 'Jumping on mats' and 'Catching Beanbag' required below average motor performance levels, that is, they are tasks with low discrimination capacity. The results showed that the low discriminative capacity of some MABC-2 items regarding this study sample makes it difficult to correctly classify the child's general motor performance level.Conclusion: the findings show that there is a need to review the suitability of the MABC-2 motor tasks in order to equate the difficulty and discriminatory capacity of the tasks so that standardization more appropriate to the reality of children from different populations is established.Keywords: psychometric properties, motor tasks, motor performance.

Introdução: a American Psychiatric Association revela que 6% das crianças em idade escolar apresentavam desordem coordenativa desenvolvimental. Objetivo: analisar a adequabilidade das tarefas propostas no instrumento de avaliação motora MABC-2 a partir da análise da teoria de resposta ao item.Método: participaram do estudo 582 crianças de 3 a 5 anos de idade, de ambos os sexos. A adequabilidade das tarefas motoras às crianças foi verificada por meio do modelo de resposta gradual, com método de estimação de máxima verossimilhança. Resultados: os resultados evidenciaram a existência de apenas dois fatores, sendo que as tarefas relativas ao "Equilíbrio" e "Lançar e "Receber", das dimensões propostas no modelo original foi agrupado em uma dimensão. Além disso, a tarefa motora "Caminho da bicicleta" não apresentou bom ajuste ao modelo, sendo eliminada das análises. Com isto, o modelo final apresentou bons índices de ajuste, e os parâmetros relacionados à tarefa indicaram a falta de equivalência de dificuldade e capacidade discriminatória entre as tarefas motoras do instrumento.Conclusão: os achados indicam que existe a necessidade de rever a adequabilidade das tarefas motoras do MABC-2 no sentido de equiparar a dificuldade e a capacidade discriminatória das tarefas a fim de criar uma padronização mais adequada a realidade de crianças de diferentes populações.

Movement assessment battery for children-second edition: theoretical adequacy of a motor assessment instrument / Movement assessment battery for children-second edition: adequação teórica do modelo do instrumento de avaliação motora

ABSTRACT Objective: To investigate the adequacy of the theoretical model of the Movement Assessment Battery for Children-Second Edition (MABC-2) instrument. Methods: 582 children, of both sexes, aged between 3 and 5 years and residents in the city of Maringá (state of Paraná, Southern Brazil) participated in the study. Data were collected from May/2014 to June/2015 and analyzed using descriptive and inferential statistics. Results: The evidence obtained from exploratory factor analysis indicated the presence of two factors, which was the option that best fitted the explanatory model. Hence, it was necessary to regroup the motor tasks of the dimensions "Aiming & catching" and "Balance" into only one dimension. It is noteworthy that the "Bicycle trail" motor task did not fit the model, as it presented a low and negative factor load in the analyzed dimensions. In the confirmatory factor analysis, adequate adjustment indices were observed for the tested model, which confirmed the non-classification of the "Bicycle trail" motor task in the original dimension. Conclusions: After removing the "Bicycle trail" motor task, the adjusted two-factor model seems to be the most appropriate to assess the motor performance of children participating in the study.

RESUMO Objetivo: Investigar a adequabilidade do modelo teórico do instrumento de avaliação motora Movement Assessment Battery for Children-Second Edition. Métodos: Participaram do estudo 582 crianças, de ambos os sexos com idade entre 3 e 5 anos da cidade de Maringá, Paraná, no período de maio/2014 a junho/2015. Para analisar os dados, utilizou-se a estatística descritiva e inferencial. Resultados: As evidências obtidas por meio da análise fatorial exploratória indicaram a presença de dois fatores. Essa opção foi a que melhor se ajustou ao modelo explicativo. Com isso, foi necessário reagrupar as tarefas motoras das dimensões "lançar e receber" e "equilíbrio" em apenas uma dimensão. Destaca-se que a tarefa motora "caminho da bicicleta" não se adequou ao modelo, pois apresentou carga fatorial baixa e negativa nas dimensões analisadas. Na análise fatorial confirmatória, observaram-se índices de ajustamento adequados para o modelo testado, a qual confirmou o não enquadramento da tarefa motora "caminho da bicicleta" na dimensão original. Conclusões: Após a retirada da tarefa motora "caminho da bicicleta", o modelo ajustado de dois fatores parece ser o mais adequado para avaliar o desempenho motor das crianças participantes do estudo.

Parâmetros de dificuldade e discriminação das tarefas motoras do instrumento KTK: uma análise a partir da teoria de resposta ao item / Difficulty and discrimination parameters of the KTK instrument motor tasks: an analysis from item response theory

RESUMO Nas últimas décadas o uso da Teoria de Resposta ao Item (TRI) tem sido implementada devido à complexidade dos cálculos estatísticos que permite analisar com profundidade testes educacionais, questionários e listas de itens aplicados em diferentes áreas como a psicometria, ranking esportivo e pedagogia. A partir dessa premissa este estudo teve como objetivo verificar a adequabilidade das tarefas motoras do KTK analisando o grau de dificuldade e parâmetro de discriminação de cada tarefa motora. Participaram do estudo 385 crianças de 5 a 14 anos. O instrumento avaliado foi o KTK (Körperkoordinationstest für Kinder), composto por quatro tarefas motoras: trave de equilíbrio, saltos monopedais, saltos laterais e transposição de plataformas. As análises foram conduzidas a partir dos dados brutos adquiridos em cada tarefa motora. A fim de verificar a estrutura fatorial da matriz teórica subjacente ao teste, foi realizada uma análise fatorial exploratória seguida da análise fatorial confirmatória. Os parâmetros de dificuldade e discriminação de cada tarefa motora foram analisados a partir do modelo de resposta gradual, fundamentado na teoria de resposta ao item (TRI). Os resultados corroboram com a estrutura fatorial sugerida na versão original do KTK, apresentando apenas um fator, chamado de coordenação motora. Os indicadores da Análise Fatorial Confirmatória (AFC) foram aceitáveis, indicando boa qualidade do modelo ajustado para a amostra. Conclui-se que a análise de TRI evidenciou diferenças nos parâmetros de dificuldade e de discriminação entre as tarefas motoras do KTK, demonstrando a importância de considerar uma ponderação na criação de tabelas normativas de avaliações motoras.

ABSTRACT In the last decades, the use of Item Response Theory (IRT) has been implemented due to the complexity of statistical calculations that allows for in-depth analysis of educational tests, questionnaires and lists of items applied in different areas such as psychometry, sports ranking and pedagogy. Based on this premise, this study aimed to verify the suitability of the KTK motor tasks analyzing the degree of difficulty and discrimination parameters of each motor task. A total of 385 children aged 5 to 14 years participated in the study. The instrument evaluated was the KTK (Körperkoordinationstest für Kinder), consisting of four motor tasks: balance beam, single-pedal jumps, side jumps and platform transposition. Analyzes were conducted from the raw data acquired in each motor task. In order to verify the factor structure of the theoretical matrix underlying the test, an exploratory factor analysis was performed, followed by a confirmatory factor analysis. The difficulty and discrimination parameters of each motor task were analyzed using the gradual response model, based on the Item Response Theory (IRT). The results corroborate the factor structure suggested in the original version of the KTK, presenting only one factor, called motor coordination. The AFC indicators were acceptable, indicating good quality of the model adjusted for the sample. It is concluded that the IRT analysis evidenced differences in the parameters of difficulty and discrimination between the KTK motor tasks, demonstrating the importance of considering a weighting in the creation of normative tables of motor assessments.

Tratamento de efluentes: remoção de detergente utilizando processo Fenton com ultrassom e prego reutilizado / Effluent treatment: detergent removal using Fenton ultrasound process and reused nail

RESUMO Diferentes metodologias são descritas na literatura para tratamento de efluentes industriais. Entretanto, a maioria dos processos não são totalmente eficientes quando o efluente apresenta baixo conteúdo de partícula coloidal suspensa e alta concentração de matéria orgânica e detergentes. Entre os métodos que são estudados para eliminar detergente e matéria orgânica de efluentes industriais, o processo Fenton é uma estratégia atraente. No presente estudo, foi aplicada uma metodologia para remoção de detergente de efluentes líquidos utilizando processo Fenton com ultrassom e prego reutilizado. A otimização de parâmetros para tratamento do efluente foi realizada por meio das análises de pH, detergente, cor, turbidez, demanda química de oxigênio, demanda bioquímica de oxigênio, óleos e graxas, e sólidos suspensos. Os melhores resultados foram obtidos em pH 3,5, com 90 mg L−1 de peróxido de hidrogênio e um prego de ferro (2,7g) tanto para o processo Fenton como para o Fenton com ultrassom. Nessas condições, os valores de remoção de detergente foram de 99,4%. Em pH 2,5, 4,5 e 5,5, os valores obtidos para remoção de detergente foram menores, 75,2, 89,5, 68,4%, respectivamente. Resultados semelhantes foram obtidos para cor, turbidez, demanda química de oxigênio e demanda bioquímica de oxigênio. A reutilização dos pregos mostrou que a eficiência média na remoção de detergente até o quarto ciclo foi acima de 90%, e, a partir do quinto ciclo, observou-se uma diminuição gradativa, sendo a diferença entre o primeiro e o sexto ciclo em torno de 10%.

ABSTRACT Different methodologies are described in the literature for the industrial effluents treatment. However, most processes are not fully efficient when the effluent has low suspended colloidal particle content and high concentration of organic matter and detergents. Among the methods that are studied to eliminate detergent and organic matter from industrial effluents, the Fenton process is an attractive strategy. In the present study, a more sustainable methodology was applied to remove detergent and organic matter from liquid effluents using Fenton process with ultrasound and recycled nail. The optimization of parameters for effluent treatment was carried out through the analysis of pH, detergents, color, turbidity, chemical oxygen demand, biochemical oxygen demand, oils and greases, and suspended solids. The best results were obtained at pH 3.5, with 90 mg L−1 of hydrogen peroxide and an iron nail (2.7 g) both for the Fenton process and Fenton with ultrasound. Under these conditions, detergent removal values were 99.4%. At pH 2.5, 4.5, and 5.5, the values obtained for detergent removal were lower, 75.2, 89.5, and 68.4%, respectively. Similar results were obtained for color, turbidity, chemical oxygen demand, and biochemical oxygen demand. The reuse of the nails showed that the average detergent removal efficiency up to the fourth cycle was above 90%, and, from the fifth cycle, a gradual decrease was observed, with the difference between the first and sixth cycles being around 10%.

Descripción del nido de Phyllotis andium (Cricetidae: Phyllotini) en un matorral seco interandino en Ecuador / Nest description of Phyllotis andium (Cricetidae: Phyllotini) in a inter Andean dry scrub in Ecuador

Resumen En este trabajo describimos la estructura del nido de Phyllotis andium Thomas, 1912 en un matorral seco interandino al sur de la provincia del Azuay en Ecuador y el uso de un pasto introducido en su fabricación. Se presentan también observaciones sobre sociabilidad y abundancia de esta especie. Estos datos proporcionan nueva información sobre las relaciones intraespecíficas de estos roedores y su historia natural.

Abstract In this work, we describe the structure of the nest of Phyllotis andium Thomas, 1912 in an inter-Andean dry scrub in the south of the Azuay province in Ecuador, and the use of an introduced grass in their manufacture. Observations on sociability and abundance of this species are also presented. These data provide new information on the intraspecific relationships of these rodents and their natural history.

Hands Free 3.c Technique - Step by Step Maximizes the Duration of Sublingual Microcirculatory Image - A Prognosis to Monitor Microcirculation in Patients with Covid-19 and Sepsis

ABSTRACT: The sublingual area is the most used site to assess microcirculation in critically ill patients at bedside. The prerequisite for microcirculation evaluation, using HVM imaging (Handheld Vital Microscopy), is to ensure measurements free of image artifacts, confirming an adequate analysis of blood flow. However, this would only be possible with standardizati on in the process of image capture. Currently, with the Hands On technique, the recommended capture time is 4 to 20 seconds, which is already considered laborious. In this study, the Hands Free 3.C technique proposes an alternative that maximizes the image period of sublingual microcirculation (as suggested by the Second Consensus) for more than 12 minutes, and thus opening the way for future research aiming at therapeutic maneuvers in critically ill patients such as COVID -19 and sepsis.

RESUMEN: El área sublingual es el sitio más utilizado para evaluar la microcirculación junto a la cama en pacientes críticamente enfermos. El requisito previo para la evaluación de la microcirculación, utilizando imágenes HVM (Microscopía Vital Portátil), es asegurar mediciones libres de artefactos de imagen, confirmando un análisis adecuado del flujo sanguíneo. Sin embargo, esto solo sería posible con la estandarización en el proceso de captura de imágenes. Actualmente, con la técnica Hands On, el tiempo de captura recomendado es de 4 a 20 segundos, lo que ya se considera laborioso. En este estudio, la técnica Hands Free 3.C propone una alternativa que maximiza el período de imagen de la microcirculación sublingual (como sugiere el Segundo Consenso) durante más de 12 minutos, y abre así el camino a futuras investigaciones encaminadas a maniobras terapéuticas en pacientes con enfermedades graves como COVID -19 y sepsis.

No association between vitamin D status and COVID-19 infection in São Paulo, Brazil

ABSTRACT In recent years the immunomodulatory actions of vitamin D, a steroid hormone, have been extensively studied. In 2020, due to the COVID-19 pandemic, the question arose as to 25(OH)D status would be related to susceptibility to SARS-CoV-2 infection, since several studies pointed out a higher prevalence and severity of the disease in populations with low levels of 25(OH)D. Thus, we investigated the 25(OH)D levels in adults "Detected" positive for SARS CoV-2 by RT-PCR (reverse transcriptase polymerase chain reaction) test, and in negative controls, "not Detected", using the Fleury Group's examination database, in Sao Paulo, Brazil. Of a total of 14.692 people with recent assessments of 25(OH)D and RT-PCR tests for COVID-19, 2.345 were positive and 11.585 were negative for the infection. The groups did not differ in the percentage of men and women, or in the age distribution. There were no differences in the distribution of 25(OH)D between the two groups (p = 0.08); mean 25(OH)D of 28.8 ± 21.4 ng/mL and 29.6 ± 18.1 ng/mL, respectively. In the specific population studied, clinical, environmental, socioeconomic and cultural factors should have greater relevance than 25(OH)D in determining the susceptibility to COVID-19.

Hands Free Technique: New Tool Possibility for Image Capture of Sublingual Microcirculation with Handheld Vital Microscopy - HVM

ABSTRACT: New microcirculatory imaging techniques allowed direct observation of microcirculation at the bedside. This study presents a new device that assists the operator with the unprecedented Hands Free technique. To this end, a replica of Handheld Vital Microscopy was developed to simulate the method of capturing the image in the sublingual area, the most used site to assess microcirculation in critically ill patients. We achieved a reduction in the displacement of micros cope replica with a Hands Free method. The immediate consequence is an increase in the stability of HVM replica by 75 times, or more, over the current 4 seconds, during its contact with the sublingual tissue. The device also offers better control of th e pressure of the tip of the HVM replica over the sublingual area. The results demonstrated that the Hands Free technique, operating in the same sublingual area for 900 seconds, should allow for future research aimed at therapeutic maneuvers in patients with serious illnesses.

RESUMEN: Las nuevas técnicas de imagen microcirculatoria permitieron la observación directa de la microcirculación junto a la cama del paciente. Este estudio sin precedentes presenta un nuevo dispositivo que ayuda al operador con la técnica manos libres. Con este fin, se desarrolló una réplica de la Microscopía Vital Portátil para simular el método de captura de la imagen en el área sublingual, el sitio más utilizado para evaluar la microcirculación en pacientes críticos. Logramos una reducción en el desplazamiento de la réplica del microscopio con el método de manos libres. La consecuencia inmediata es un aumento en la estabilidad de la réplica de HVM en 75 veces, o más, durante los 4 segundos actuales, durante su contacto con el tejido sublingual. El dispositivo también ofrece un mejor control de la presión de la punta de la réplica de HVM sobre el área sublingual. Los resultados demostraron que la técnica de manos libres, que opera en la misma área sublingual durante 900 segundos, debería permitir futuras investigaciones destinadas a maniobras terapéuticas en pacientes con enfermedades graves.

Nutritional determinants as potential contributors to anemia in children and adolescents with malaria by P. vivax / Determinantes nutricionais como potenciais contribuintes para anemia em crianças e adolescentes com malária por P. vivax / Determinantes nutricionales como posibles contribuyentes para la anemia en niños y adolescentes con malaria por P. Vivax

Background and Objectives: Nutrition, in addition to its physiological function, plays an important role in the recovery of individuals with malaria, a disease that still represents a serious public health problem in the world. The objective of this study was to assess nutritional determinants in the frequency of food intake and the occurrence of anemia in children and adolescents with P. vivax malaria. Methods: A cross-sectional analytical study was carried out between 2014 and 2015 in the Marajo Island. The hemoglobin level was measured by the colorimetric enzymatic reaction and a questionnaire of food intake frequency was used to assess the consumption of different types of food. Results: A total of 67 patients met the inclusion criteria, from which 62.7% were children and 37.3% were adolescents. There was a high consumption of ultra-processed foods in both age groups. Anemia occurred in 52.2% of patients, and in most of them it was moderate. There was no significant association between anemia and sex, age group or parasitemia at admission. However a significant association was found between anemia and the ingestion of ultra-processed foods. Conclusion: The ingestion of ultra-processed foods contributes to anemia in children and adolescent with malaria by P. vivax.(AU)

Justificativa e Objetivos: A nutrição, além de sua função fisiológica, desempenha um papel importante na recuperação de indivíduos com malária, uma doença que ainda representa um grave problema de saúde pública no mundo. O objetivo deste estudo é avaliar os determinantes nutricionais na frequência da ingestão alimentar e a ocorrência de anemia em crianças e adolescentes com malária por P. vivax. Métodos: Estudo transversal analítico, realizado entre 2014 e 2015 na ilha do Marajó. O nível de hemoglobina foi medido pela reação enzimática colorimétrica e um questionário de frequência de ingestão alimentar foi utilizado para avaliar o consumo de alimentos. Resultados: Um total de 67 pacientes atendeu aos critérios de inclusão do estudo, dos quais 62,7% eram crianças e 37,3% adolescentes. Houve alto consumo de alimentos ultraprocessados em ambas as faixas etárias. A anemia foi detectada em 52,2% dos pacientes e, na maioria deles, foi moderada. Não houve associação significativa entre anemia e sexo, faixa etária ou parasitemia na admissão. No entanto, encontramos uma associação significativa entre presença de anemia e ingestão de alimentos ultraprocessados. Conclusão: A ingestão de alimentos ultraprocessados contribui para a anemia em crianças e adolescentes com malária por P. vivax.(AU)

Justificación y objetivos: La nutrición, además de su función fisiológica, juega un papel importante en la recuperación de las personas con malaria, una enfermedad que todavía representa un importante problema de salud pública en el mundo. El objetivo de este estudio es evaluar los determinantes nutricionales en la frecuencia del consumo de alimentos y la ocurrencia de anemia en niños y adolescentes con malaria por P. vivax. Métodos: se realizó un estudio analítico transversal entre 2014 y 2015, en la Isla de Marajó. El nivel de hemoglobina fue evaluado por ensayos enzimáticos colorimétricos y se utilizó un cuestionario de frecuencia de consumo de alimentos para evaluar el consumo. Resultados: Un total de 67 pacientes cumplió los criterios de inclusión en el estudio, de los cuales el 62,7% eran niños y el 37,3% adolescentes. Se registró un alto consumo de alimentos ultraprocesados en niños y adolescentes. La anemia se detectó en el 52,2% de los pacientes, de carácter moderada principalmente. No se encontró una asociación significativa entre anemia y sexo, grupo de edad o parasitemia al ingreso. Sin embargo, se encontró una asociación significativa entre la anemia y la ingestión de alimentos ultraprocesados. Conclusión: La ingesta de alimentos ultraprocesados se asocia con la presencia de anemia en niños y adolescentes con malaria por P. vivax.(AU)

Football society players over the age of 55: how stressful can a match be?

This study aimed atassessingthe physical activitylevel, heart rate and the salivary cortisol level of football society players.The sample consisted of 19 male mastersfootballplayerswith an average age of 56.7±3.9 years. The long form of the International Physical Activity Questionnaire (IPAQ)andPolar®heart rate monitors were usedas instruments, in additionto Salivette® tubes to measure salivary cortisol. Data analysis was performed by using the repeated measuresAnalysis of Variance (ANOVA) with Bonferroni post hoctest,and Spearman's Rank Correlation Coefficient. The results showed that the salivary cortisol concentration indicated an index of 1.97 ng/ml at the beginning of the match;40 minutes after that thesevalues increased to 8.00 ng/ml,and 60 minutesafter the match had started they reached 8.40 ng/ml. Considering the post-match moment, a moderate and positive correlation between the salivary cortisol concentration and heart rate (averageand maximum) wasseen. In conclusion,the physical effort expended during football Society practice needs to be monitored due to the high heart rate and high increase in the salivary cortisol concentrationofthis age group.

Características pessoais e do ambiente associadas com transtorno do desenvolvimento da coordenação / Personal and environmental characteristics associated with coordination development disorder

RESUMO Identificar a associação entre características pessoais e ambientais de crianças com provável transtorno do desenvolvimento da coordenação (TDC). Participaram 42 pais, 32 professores e 42 pré-escolares (3,4±0,5 anos). Como instrumentos foram utilizados o Movement Assessment Battery for Children 2 (MABC-2), o Teste de Maturidade Mental Columbia (EMMC), o Questionário da Associação Brasileira de Empresas de Pesquisas (ABEP), o Strengths and Difficulties Questionnaire (SDQ), o Swanson Nolan and Pelham IV Scale (SNAP-IV), o Questionário de percepção de pais/responsáveis sobre habilidades motoras, acadêmicas, emocionais e comportamentais e o Early Years Movement Skills Checklist. Na análise foi utilizado o teste Shapiro Wilk e Regressão Logística Binária (p<0,05). Os resultados demostraram diferença estatisticamente significativa para as seguintes características associadas às crianças com persistência de TDC: 1) características pessoais: o peso ao nascer, a idade de sentar, o desenvolvimento cognitivo, os problemas de linguagem e os problemas de conduta; 2) características ambientais da família: a união estável dos pais, a melhor qualidade do ambiente domiciliar; 3) no ambiente escolar o nível de escolaridade do professor. Conclui-se que as crianças que nasceram com maior peso, que apresentaram desenvolvimento cognitivo superior, vivem com pais em união estável, que possuem professor de sala especialista e apresentaram menores chances de persistir no TDC.

ABSTRACT Identify the associtation among personal and environmental characteristics on the motor development of children with probable developmental coordination disorder (DCD). The participants were 42 parents, 32 teachers and 42 preschoolers' (3.4±0.5years). As measurement instruments: The Movement Assessment Battery for Children 2 (MABC2), the Columbia Mental Maturity test (EMMC), the Questionnaire of the Brazilian Association of Research Companies (ABEP), the Strengths and Difficulties Questionnaire (SDQ), the Swanson Nolan and Pelham IV Scale (SNAP-IV), Structured Questionnaire for parents on motor, academic, emotional and behavioral skills and Early Years Movement Skills Checklist were used. For data analysis, the Shapiro Wilk test and Binary Logistic Regression were used, adopting p <0.05. Results shown statistically significant difference for the personal characteristics associated with children with persistence DCD: 1) birth weight, age to sit, cognitive development, language problems and conduct problems; 2) For home characteristics: quality of the home environment and the parents' stable union were taken into account; 3) For day care center, the education of the classroom teacher was considered. In conclusion, children who were born with greater weight, who had higher cognitive development, live with parents in a stable relationship and who have a specialized classroom teacher were less likely to persist in DCD.

Comparação do desempenho motor de crianças entre escolas públicas de tempo parcial e integral / Comparison of motor performance of children between part-time and full time public schools

O ensino em tempo integral vem sendo implantado gradativamente nas escolas públicas brasileiras nas últimas décadas, o que vem estimulando pesquisas sobre seus efeitos em diferentes aspectos educacionais. O objetivo deste estudo foi comparar o desempenho motor de crianças matriculadas em escolas públicas de tempo parcial e integral. Foram avaliadas 159 crianças, com idades entre 7 e 8 anos, sendo 84 (52,8%) do sexo masculino, das quais 77 (48,4%) estavam matriculadas no ensino em tempo parcial e 82 (51,6%) no ensino em tempo integral, todas no 3º ano do ensino fundamental de quatro escolas públicas municipais na cidade de Maringá-PR. O Test of Gross Motor Development-2 (TGMD-2) foi utilizado como instrumento de medida para avaliar o desempenho motor das crianças. Para análise dos dados quantitativos foi utilizada estatística descritiva, o teste de normalidade Kolgomorov-Smirnov, e o Teste U de Mann Whitney para as comparações das variáveis de desempenho motor. Adotou-se nível de significância de p<0,05. Evidenciou-se que a maioria das crianças avaliadas demonstrou um nível de desenvolvimento motor abaixo da média referenciada para a idade. Não houve diferença significativa no desempenho motor quando comparadas crianças de escolas públicas de tempo parcial e integral, tampouco houve diferença entre os sexos. Desta forma, concluiu-se que o turno escolar extra e suas atividades complementares não exerceram influência capaz de favorecer o desenvolvimento motor das crianças matriculadas em escolas públicas de tempo integral. Ou ainda, indicando que o contexto escolar não é exclusivamente determinante para o desenvolvimento motor das crianças, haja vista que elas estão inseridas também em outros contextos extraescolar.(AU)

: Full-time education has been gradually implemented in Brazilian public schools in recent decades, which has been stimulating research on its effects in different educational aspects. The aim of this study was to compare the motor performance of children enrolled in part-time and full-time public schools. Were assessment 159 children, aged between 7 and 8 years, 84 (52.8%) males, of which 77 (48.4%) were enrolled in partial education and 82 (51.6%) in full-time education, all in the 3rd. year of the elementary school from four municipal public schools in the city of Maringá-PR. The Test of Gross Motor Development-2 (TGMD-2) was used as a measurement instrument to assess the motor performance of chlidren. For the analysis of the quantitative data we used descriptive statistics, the Kolgomorov-Smirnov normality test, and the Mann-Whitney U test for the comparisons of motor performance variables. A significance level of p≤0.05 was adopted. It was evidenced that the majority of the children evaluated demonstrated a level of motor development below the age-referenced average. There was no significant difference in motor performance when compared to children from public schools of part-time and full time, nor was there a difference between the sexes. Thus, it was concluded that the extra school shift and its complementary activities did not exert an influence capable of favoring the motor development of children enrolled in full-time public schools. Or, indicating that the school context is not exclusively determinant for the motor development of the children, since they are also inserted in other contexts outof-school.(AU)

Acompanhamento longitudinal das alterações no transtorno do desenvolvimento da coordenação em crianças pré-escolares / Longitudinal study changes in coordination development disorder in preschool children

Resumo Objetivo Acompanhar, ao longo de 24 meses, as alterações entre o diagnóstico de Desenvolvimento Motor Típico (DM) e o provável Transtorno do Desenvolvimento da Coordenação (pTDC) em pré-escolares. Método Foram elaborados dois designs de coleta: 1) Design longitudinal de 12 meses (Long-1), constituído por 201 crianças, com idade inicial média de 3,6±0,5 anos; 2) Design longitudinal de 24 meses (Long-2), composto por 27 crianças, com idade inicial média de 3,6±0,1 anos. Como instrumento de avaliação, foi utilizado o Movement Assessment Battery for Children 2 (MABC-2). Os dados foram analisados usando os testes Kolmogorov-Smirnov, Shapiro-Wilk, Wilcoxon e Friedman, adotando p<0,05. Resultados Os resultados do DM no Long-1 revelaram alta prevalência do pTDC de 24,4% na avaliação inicial e 19,4% após 12 meses. No DM, observou-se aumento na destreza manual e diminuição na habilidade de lançar e receber após 12 meses. Nas tarefas de destreza manual, as meninas foram superiores aos meninos após 12 meses, sendo os meninos superiores na tarefa de lançar e receber nas duas avaliações. Os resultados do DM no Long-2 evidenciaram prevalência de 18,5% de pTDC na primeira avaliação, de 7,4% após 12 meses e 22,2% após 24 meses. Ocorreu aumento do escore na destreza manual ao longo dos 24 meses, no entanto, ocorreu declínio nas tarefas de equilíbrio entre as 3 avaliações. Conclusão O desenvolvimento motor típico e o provável Transtorno do Desenvolvimento da Coordenação não apresentaram constância e consistência entre as avaliações motoras ao longo de 24 meses, demonstrando oscilação na classificação de provável transtorno de desenvolvimento da coordenação e/ou do desenvolvimento motor típico.

Abstract Objective To follow changes in the diagnosis of Typical Motor Development (MD) and the probable Coordination development disorder (pCDD) diagnostics in preschoolers for 24 months. Method Two data collection designs were elaborated: 1) Longitudinal design of 12 months (Long-1) consisting of 201 children, with an average initial age of 3.6 ± 0.5 years old; 2) Longitudinal design of 24 months (Long-2) composed of 27 children, with an average initial age of 3.6±0.5 years old. The assessment tool used was the Movement Assessment Battery for Children 2 (MABC-2). For data analysis, the Kolmogorov-Smirnov, Shapiro-Wilk, Wilcoxon, and Friedman tests were used, adopting p <0.05. Results The results of MD in Long-1 revealed a high prevalence of probable pCDD with 24.4% in the 1st evaluation and 19.4% in the 2nd evaluation. In the MD, we observed a manual dexterity improvement and a reduced ability to throw and receive during the 12 months. In manual dexterity tasks, girls were better than boys in the 2nd evaluation, and for the task of throwing and receiving boys were better at two of the evaluations. The results of MD in Long-2 showed a prevalence of 18.5% of pTDC in the first evaluation, 7.4% after 12 months, and 22.2% after 24 months. There was an increase in the score in manual dexterity over the 24 months, however, there was a decline in the balance tasks between the 3 assessments. Conclusion It is concluded that the typical DM and the probable DCD did not show constant and consistent development during motor evaluations over 24 months, showing oscillation in the classification of probable coordination development disorder and/or typical motor development.

Low Cost Equipment with Compressor System and Balanced Pressure to Protect the Professional Dentist Against Contaminated Aerosol During COVID-19 Pandemic / Equipo de Bajo Costo con Sistema de Compresor y Presión Equilibrada para Proteger al Dentista Profesional Contra el Aerosol Contaminado Durante la Pandemia COVID-19

ABSTRACT: During the current coronavirus epidemic, personal protective equipment has become a vital issue. Depending on the procedure, the generation of aerosols increases the risk of infection for healthcare professionals. However, in dentistry, there is a high risk of contamination from blood or tissue fluids, generated in surgical procedures with ultrason ic and high-speed cutting devices. Thus, the creation of a prototype with a functional respiratory protection system offers filtered air at the entrance and exit of the circuit, also benefiting the patient. This experimental and unprecedented air purification system has 99.9 % high efficiency filters, positive and negative pressure control and also generates an internal balance of air flow; its purpose is to maintain the facial seal of the snorkel mask. The results showed that this air purificat ion system could be an option in environments contaminated by aerosol caused by rotary intruments in dentistry.

RESUMEN: Durante la actual epidemia de coronavirus, el equipo de protección personal se ha convertido en un problema vital. Dependiendo del procedimiento, la generación de aerosoles aumenta el riesgo de infección para los profesionales de la salud. Sin embargo, en odontología, existe un alto riesgo de contaminación por sangre o fluidos tisulares, generados en procedimientos quirúrgicos con dispositivos de corte ultrasónicos y de alta velocidad. Por lo tanto, la creación de un prototipo con un sistema funcional de protección respiratoria ofrece aire filtrado a la entrada y salida del circuito, lo que también beneficia al paciente. Este sistema de purificación de aire experimental y sin precedentes tiene 99.9 % de filtros de alta eficiencia, control de presión positiva y negativa y también genera un equilibrio interno del flujo de aire; Su propósito es mantener el sello facial de la máscara de snorkel. Los resultados mostraron que este sistema de purificación de aire podría ser una opción en ambientes contaminados por aerosoles causados por instrumentos rotativos en odontología.

Can diabetes mellitus modify the plasma concentrations of rifampicin in patients under treatment for tuberculosis?

Abstract Rifampicin is a key component of treatment for tuberculosis and its efficacy is determined by the blood levels attained after therapeutic doses. However, there is a high variability of rifampicin blood levels that is related to both the patient and the formulation used. To date, the effect of diabetes mellitus on the plasma levels of rifampicin was low exploited, which could be relevant either by the significant increase of the comorbidity worldwide as by the probable influence of diabetes on the rifampicin exposure. The study aims to evaluate whether diabetes mellitus contribute to the variation of the maximum concentration of rifampicin in patients with tuberculosis treated with a daily dose of 10 mg/kg. Rifampicin and glycated hemoglobin were measured by high-performance liquid chromatography, and blood glucose by spectrophotometry. A total of 62 male patients were included in the study, and 26 presented diabetes mellitus. Rifampicin plasma levels in 2-h plasma samples collected at day 61 ranged from 3 µg/mL to 14.2 µg/mL. Drugs levels were similar between diabetic and non-diabetic patients and were not correlated with blood glucose and glycated hemoglobin. Moreover, a high percentage of patients in both groups presented low levels of rifampicin.