Magnetic solid phase extraction as a nonchromatographic method for the quantification of ultratrace inorganic arsenic in rice by inductively coupled plasma-optical emission spectrometry (ICP OES).

An alternative analytical method was developed for the quantification of inorganic arsenic (iAs) in rice by ICP OES. Iron nanoparticles modified with an organophosphorus compound were used as the solid phase for MSPE of iAs from the plant matrix. The MSPE procedure was performed using 4 mL of a buffer solution with pH 4.0, 20 mg of the nanomaterial, and a 15-min extraction time. The total As (tAs) by ICP OES was also quantified using the same MSPE procedure after solubilization of the samples by a block digester. The accuracy of tAs and iAs quantification was verified using CRM NIST 1568b (97 % and 101 % recovery, respectively). The precision (RSD < 15 %) and LOD and LOQ (1.08 and 3.70 µg kg-1, respectively) of the proposed method were satisfactory. The rice samples had tAs contents between 0.090 and 0.295 mg kg-1 and iAs mass fractions between 0.055 and 0.109 mg kg-1.

Social and health indicators in an academic community: enteroparasites, nutritional, allergic and clinical aspects / Indicadores sociais e de saúde em uma comunidade acadêmica: enteroparasitos, aspectos nutricionais, alérgicos e clínicos

Objective: this study aimed to associate enteroparasitic infection with nutritional, allergic, and clinical repercussions and the sociodemographic aspects in an academic community in Santo Antônio de Jesus, Bahia, Brazil. Methods: the cross-sectional research was carried out between February 2018 and March 2020, with 121 participants. Spontaneous sedimentation and Rugai techniques were used for the parasitological diagnosis of fecal samples. Allergies and clinical issues and the sociodemographic aspects were studied via a questionnaire, and the nutritional status was obtained from the assessment of body mass index and arm and abdominal circumferences. Results: there was 38.2% positivity for intestinal parasites; 65.9% for female participants; with the majority of eutrophic, between 18-27 years old; heteronormative, and single. Besides, the Endolimax nana (78.7%) and Giardia duodenalis (21.3%) were the predominant species. Statistical significance was found between obesity rates and the presence of intestinal parasites and those with allergic aspects. Nervousness, headache, and back and abdominal pains were the most common symptoms. Conclusions: this study contributes to obtaining data on epidemiological and public health surveys in the Bahian territory, providing a reference for other researchers. The statistical association of these with nutritional and allergic aspects can support future research on this population.

Objetivo: este estudo teve como objetivo associar a infecção enteroparasitária com aspectos nutricionais, alérgicos, clínicos e sociodemográficos em uma comunidade acadêmica do município de Santo Antônio de Jesus, Bahia, Brasil. Método: a pesquisa transversal foi realizada entre fevereiro de 2018 e março de 2020, com 121 participantes. As técnicas de sedimentação espontânea e Rugai foram utilizadas para o diagnóstico parasitológico de amostras fecais. Alergias, questões clínicas e aspectos sociodemográficos foram estudados por meio de um questionário, e o estado nutricional foi obtido por meio da avaliação do índice de massa corporal e das circunferências braquial e abdominal. Resultados: houve 38,2% de positividade para parasitos intestinais; 65,9% para participantes do sexo feminino; com a maioria eutrófica, entre 18-27 anos; heteronormativa e sigle. Além disso, Endolimax nana (78,7%) e Giardia duodenalis (21,3%) foram as espécies predominantes. Foi encontrada significância estatística entre as taxas de obesidade e presença de parasitos intestinais e com aspectos alérgicos. Nervosismo, dor de cabeça, dores nas costas e abdominais foram os sintomas mais comuns. Conclusões: este estudo contribui para a obtenção de dados sobre inquéritos epidemiológicos e de saúde pública no território baiano, servindo de referência para outras pesquisas. A associação estatística destes com aspectos nutricionais e alérgicos pode subsidiar futuras pesquisas nesta população.

Impact of serum vitamin D levels on periodontal healing outcomes: A preliminary cohort study.

OBJECTIVE: To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis. METHODS: Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and 6 months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyse the data (p ≤ 0.05). RESULTS: The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥30 ng/ml than those with <30 ng/ml (CI = -0.23-0.42, p = 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites of gingival bleeding on probing at the final evaluation (OR = 0.58, 95% CI = 0.17-1.99, p = 0.39). CONCLUSION: Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.

Produção e uso de filtros de água com carvão ativado derivado de matérias sustentáveis / Production and use of water filters with activated carbon derived from sustainable materials

Objetivo: avaliar a eficiência de filtros de tratamento de água, usando carvão ativado de diferentes fontes de resíduo de biomassa. Métodos: trata-se de um estudo experimental, descritivo, de caráter quantitativo, realizado no Centro Universitário Católica de Quixadá, Ceará-Brasil, durante o período de janeiro a junho de 2018. Foram preparados filtros de carvão ativados e, posteriomente, sua eficiência no tratamento de água foi avaliada. Resíduos de descarte de madeira, a entrecasca do coco verde, a casca do fruto do caju e do colmo de bambu foram usados como fonte de matéria-prima. O filtro de tratamento de água foi montado, usando o método coluna de cromatografia, adicionando areia e algodão como outros meios filtrantes. Parâmentros físico-químicos foram utilizados na avaliação da eficiência dos filtros construídos. Resultados: a análise de componente principal selecionou dois componentes da qualidade de água, explicando 80,081% da variância total. O coeficiente de correlação cofenética de r=0.9572 indica que o dendograma estimado foi bom, considerando os parâmetros de qualidade da água. Entre os filtros, o bambu apresentou-se como melhor resposta entre filtros testados, sendo responsável pela redução de diversos fatores como cor, turbidez, dureza total e sódio. Conclusão: os fitros de carvão ativado derivado do descarte de madeira e da entrecasca do fruto do caju obtiveram pouca influência na melhoria da qualidade da água, em relação à amostra controle.

Objective: to evaluate the efficiency of water treatment filters using activated carbon from different sources of biomass residue. Methods: this is a descriptive experimental study of a quantitative nature carried out at the Centro Universitário Católica de Quixadá, Ceará-Brazil, during the period from January to June 2018. Activated carbon filters were prepared, and subsequently, their efficiency in water treatment was evaluated. Wood waste, green coconut husk, cashew nut shell, and bamboo stem were used as a source of raw material. The water treatment filter was assembled using the column chromatography method by adding sand and cotton as other filter media. Physicochemical parameters were used to evaluate the efficiency of the built filters. Results: principal component analysis selected two water quality components, explaining 80.081% of the total variance. The cophenetic correlation coefficient of r=0.9572 indicates that the estimated dendrogram was good, considering the water quality parameters. Among the filters, bamboo showed the best response among the filters tested, being responsible for the reduction of several factors such as color, turbidity, total hardness, and sodium. Conclusion: activated carbon filters derived from discarded wood and cashew nut shells had little influence on improving water quality compared to the control sample.

Implant Osseointegration in Grafted Autogenous Bone Blocks Fixed with Screws and Cyanoacrylate-Based Adhesive: Histomorphometric and Micro-CT Analyses.

PURPOSE: To evaluate implant osseointegration in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Also, grafted bone fixed either with an adhesive or screw was evaluated. MATERIALS AND METHODS: Two surgical defects in the parietal region of rabbits (n = 12) were performed in each animal. Autogenous bone blocks obtained were fixed anteriorly with a screw or cyanoacrylate-based adhesive. After 30 and 45 days of grafting procedures, implants were placed in bone blocks. Histomorphometric and microcomputed tomography (micro-CT) analyses of the implant area were performed at 30 days after implant surgery in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric analyses of bone-grafted areas were performed at 60 and 75 days in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric evaluations were carried out in implant and grafted bone areas. The micro-CT parameters evaluated were bone-to-implant contact, bone area fraction occupancy, bone volume fraction, trabecular thickness, trabecular separation, and trabecular number. RESULTS: No differences were observed in the micro-CT parameters for the screw and adhesive groups in all experimental periods. However, an increased quantity of immature bone volume was observed on the adhesive group in the grafted area after 75 days. The grafted area in the screw group (75 days) presented a decrease in the volume density of the immature bone compared with the screw group (60 days). There were no differences in both groups and experimental periods in soft tissue in the grafted area. CONCLUSION: No differences were observed in the osseointegration of implants placed in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Therefore, osseointegration in autogenous bone fixed with cyanoacrylate-based adhesive is viable.

Women Representation in Surgical Specialties: Reflections about Gender Equity after the 34th Brazilian Surgical Conference.

In September 2021, the 34th Brazilian Surgical Conference hosted the "Panel: Women in Surgery" - the only session in the event solely composed of female speakers. Although gender inequities in surgery are well recognized in the international literature, the panel portrayed how distant we are from the desired equity in our country. In addition, the session emphasized the need to broaden the debate and identify the mechanisms for greater inclusion and maintenance of women in the surgical career. In this editorial, we provide a historical overview of gender disparities in the Brazilian surgical ecosystem, highlight the contributing factors to a reduced number of female surgeons, and how the structure of medical societies may influence the rise of women to leadership positions. Accordingly, we discuss the benefits of gender diversity for surgeons, patients, and institutions. Furthermore, we analyze the representation of women in the Brazilian College of Surgeons since its foundation and in the scientific sessions at the conference, demonstrating that more initiatives are required to encourage female representation in the college. Finally, we propose a series of recommendations to foster engagement and contribute to the prosperity of women surgeons in Brazil.

Global Surgery at the National Landscape: Perspectives after the XXXIV Brazilian Congress of Surgery.

The XXXIV Brazilian Congress of Surgery included Global Surgery for the first time in its scientific program. Global Surgery is any action in research, clinical practice, and policy-making that aims to improve access and quality of care in surgical specialties. In 2015, The Lancet Commission on Global Surgery highlighted that five billion people lack safe, timely, and affordable surgical care. Even more critical, nine of ten people cannot access essential surgical care in low and middle-income countries, where a third of the worldwide population resides, and only 6% of global surgical procedures are performed. Although Brazilian researchers and institutions have been contributing to lay the movement's foundations since 2014, Global Surgery remains a barely debated subject in the country. It is urgent to expand the field and break paradigms regarding the surgeons' role in public health in Brazil. Accomplishing these standards requires a joint effort to strategically allocate resources and identify collaboration opportunities, including those from medical societies and regulatory bodies. As members of the International Student Surgical Network of Brazil - a nonprofit organization by and for students, residents, and young physicians focused on Global Surgery - we review why investing in surgery is cost-effective to strengthen health systems, reduce morbimortality, and lead to economic development. Additionally, we highlight and propose key recommendations to foster the field at the national level.

One-class classification of special agroforestry Brazilian coffee using NIR spectrometry and chemometric tools.

The near-infrared spectrometry combined with the one-class classification method was applied as quality control of the agroforestry-grown specialty coffee. A total of 34 samples were analyzed in this study. Spectral data were obtained using a NIR portable and different pre-treatment strategies for baseline correction were evaluated. Unsupervised pattern recognition (PCA and HCA) techniques were performed. The construction of the classification model was carried out using the dd-SIMCA algorithm with 19 samples acquired directly from producers that are recognized for the best quality control of the specialty type coffee. In order to test the model, 15 samples of non-specialty type, obtained in local markets, were evaluated. The classification model with the highest correct classification rate (CCR) scored 100% and 87% in the validation and test groups, respectively. The results demonstrated that the application of this strategy was successful in verifying the authenticity of specialty type agroforestry-grown coffee samples.

Global Surgery at the National Landscape: Perspectives after the XXXIV Brazilian Congress of Surgery / Cirurgia Global no Cenário Nacional: Perspectivas após o 34º Congresso Brasileiro de Cirurgia

ABSTRACT The XXXIV Brazilian Congress of Surgery included Global Surgery for the first time in its scientific program. Global Surgery is any action in research, clinical practice, and policy-making that aims to improve access and quality of care in surgical specialties. In 2015, The Lancet Commission on Global Surgery highlighted that five billion people lack safe, timely, and affordable surgical care. Even more critical, nine of ten people cannot access essential surgical care in low and middle-income countries, where a third of the worldwide population resides, and only 6% of global surgical procedures are performed. Although Brazilian researchers and institutions have been contributing to lay the movement's foundations since 2014, Global Surgery remains a barely debated subject in the country. It is urgent to expand the field and break paradigms regarding the surgeons' role in public health in Brazil. Accomplishing these standards requires a joint effort to strategically allocate resources and identify collaboration opportunities, including those from medical societies and regulatory bodies. As members of the International Student Surgical Network of Brazil - a nonprofit organization by and for students, residents, and young physicians focused on Global Surgery - we review why investing in surgery is cost-effective to strengthen health systems, reduce morbimortality, and lead to economic development. Additionally, we highlight and propose key recommendations to foster the field at the national level.

RESUMO O 34° Congresso Brasileiro de Cirurgia incluiu Cirurgia Global pela primeira vez em seu programa científico. Cirurgia Global é qualquer ação em pesquisa, prática clínica e políticas em saúde que visa melhorar o acesso e a qualidade do atendimento em especialidades cirúrgicas. Em 2015, a Comissão da The Lancet em Cirurgia Global destacou que cinco bilhões de pessoas carecem de assistência cirúrgica segura, oportuna e acessível. Ainda mais crítico, nove em cada dez pessoas não têm acesso a cuidados cirúrgicos essenciais em países de baixa e média renda, onde um terço da população mundial reside e apenas 6% dos procedimentos cirúrgicos globais são realizados. Embora pesquisadores e instituições brasileiras tenham contribuído para lançar as bases internacionais e nacionais do movimento desde 2014, a Cirurgia Global ainda é um assunto pouco debatido no país. Assim, faz-se urgente expandir essa área de conhecimento e quebrar paradigmas quanto ao papel do cirurgião na saúde pública no Brasil. Isso requer um esforço conjunto para alocar recursos de forma estratégica bem como para identificar oportunidades de colaboração, incluindo as sociedades médicas e os órgãos reguladores. Como membros da International Student Surgical Network of Brazil - organização sem fins lucrativos feita por e para estudantes, residentes e jovens médicos com foco na Cirurgia Global - revisamos por que investir em Cirurgia é uma medida custo-efetiva para fortalecer os sistemas de saúde, reduzir a morbimortalidade e promover o desenvolvimento econômico. Além disso, destacamos e propomos recomendações-chave para fomentar a Cirurgia Global a nível nacional.

Women Representation in Surgical Specialties: Reflections about Gender Equity after the 34th Brazilian Surgical Conference / Representatividade das Mulheres nas Especialidades Cirúrgicas: Reflexões sobre Equidade de Gênero após o 34º Congresso Brasileiro de Cirurgia

ABSTRACT In September 2021, the 34th Brazilian Surgical Conference hosted the "Panel: Women in Surgery" - the only session in the event solely composed of female speakers. Although gender inequities in surgery are well recognized in the international literature, the panel portrayed how distant we are from the desired equity in our country. In addition, the session emphasized the need to broaden the debate and identify the mechanisms for greater inclusion and maintenance of women in the surgical career. In this editorial, we provide a historical overview of gender disparities in the Brazilian surgical ecosystem, highlight the contributing factors to a reduced number of female surgeons, and how the structure of medical societies may influence the rise of women to leadership positions. Accordingly, we discuss the benefits of gender diversity for surgeons, patients, and institutions. Furthermore, we analyze the representation of women in the Brazilian College of Surgeons since its foundation and in the scientific sessions at the conference, demonstrating that more initiatives are required to encourage female representation in the college. Finally, we propose a series of recommendations to foster engagement and contribute to the prosperity of women surgeons in Brazil.

RESUMO Em setembro de 2021, o 34º Congresso Brasileiro de Cirurgia sediou o "Painel de debates: Mulheres na Cirurgia" - o único espaço do evento composto somente por mulheres. Embora a existência de iniquidades de gênero na cirurgia seja bem reconhecida na literatura internacional, esse painel retratou como estamos distantes da almejada equidade em nosso país. Além disso, a sessão enfatizou a necessidade de ampliar o debate e identificar os mecanismos para maior inclusão e retenção das mulheres na carreira cirúrgica. Neste editorial, apresentamos panorama histórico e atual das disparidades de gênero no ecossistema cirúrgico brasileiro; destacamos os fatores que contribuem para o número reduzido de cirurgiãs e, como a estrutura das sociedades médicas influencia na ascensão de mulheres para cargos de liderança. Em seguida, discutimos os benefícios da diversidade de gênero para cirurgiões, pacientes e instituições. Ademais, analisamos a representatividade feminina no Colégio Brasileiro de Cirurgiões desde a fundação e nos espaços científicos do congresso, demonstrando que mais medidas serão necessárias para incentivar maior protagonismo feminino no colégio. Finalmente, propomos uma série de recomendações para fomentar o engajamento e contribuir para a prosperidade das cirurgiãs no Brasil.

Medicinal Plants from Brazilian Cerrado Biome: Potential sources of new anti-inflammatory compounds and antitumor agents on Ehrlich carcinoma.

This work describes a pharmacological screening of Brazilian medicinal plants through their anti-inflammatory and cytotoxicity activities. Cytotoxicity activity of Mouriri elliptica and Alchornea glandulosa as well as the drugs celecoxib and doxorubicin were evaluated in cultures of peritoneal macrophages. The immune system influence of these samples was analyzed by determining production/inhibition of NO, production of tumor necrosis factor-α and production of interleukin-10. Regarding the production/inhibition of NO, there was NO production by M. elliptica and NO inhibition when the cells were exposed to A. glandulosa; Macrophages generally produce more NO, plus TNF-α and less IL-10, when associated to the tumor phenomenon, characterizing the inflammation involved in cancer. A. glandulosa showed anti-inflammatory effect, inhibited NO production and it was associated with low TNF-α production, although not as low as the macrophages associated with celecoxib and doxorubicin. These cytokines were not different in animals with tumor. Celecoxib confirms its anti-inflammatory action by markedly inhibiting NO and TNF-α, but also inhibiting IL-10 which is an anti-inflammatory cytokine. Doxorubicin inhibited NO in a higher percentage in the group of animals with tumor, although the literature reports that this drug stimulates the production of NO and this collaborates with its cytotoxic effect.

Enteric parasites and socio-epidemiological variables in na academic community

Studies linking human health to environmental conditions are essential since parasitic diseases are connected to environmental and sanitary aspects. This study identified the prevalence of enteric parasites in an academic community in the municipality of Santo Antônio de Jesus, Bahia, Brazil. The purpose was to determine the existence, or not, of links between infections and socio-epidemiological variables, such as personal hygiene habits, the presence of sewage systems and the environment. Participants answered a questionnaire and received universal collectors for fecal samples. Spontaneous sedimentation methods and Rugai were used for diagnosis. One hundred twenty-one samples were analyzed, in which a 38.8% parasite prevalence was detected as well as a 61.7% rate of monoparasitism, as well as a predominance of protozoa Endolimax nana (78.7%) and Giardia duodenalis (21.3%). Among parasitized individuals, 97.9% lived in the Recôncavo Baiano region. The following statistical significance stands out in the findings, with p<0.05: individuals who had already bathed in the local river were more likely to be parasitized than those who had not (p = 0.034) and individuals who washed their hands more frequently before meals proved to be less prone to intestinal parasitic infections (p = 0.018). Results evidenced the presence of enteric parasites in a number of participants in spite of their being university students. The socio-epidemiological variables analyzed brought to light characteristics that favor the establishment of the epidemiological infection triad, such as improper packaging of household waste on disposal and no records of regular domestic water tank cleaning.

Misoprostol administered sublingually at a dose of 12.5 µg versus vaginally at a dose of 25 µg for the induction of full-term labor: a randomized controlled trial.

BACKGROUND: Labor induction is defined as any procedure that stimulates uterine contractions before labor begins spontaneously. The vaginal and oral routes of administration of misoprostol are those most used for the induction of labor in routine practice, with the recommended dose being 25 µg. Nevertheless, the sublingual route may reduce the number of vaginal examinations required, increasing patient comfort and lowering the risk of maternal and fetal infection. Based on a previous systematic review, the objective of this study was to compare the frequency of tachysystole as the main outcome measure when misoprostol is administered sublingually at the dose of 12.5 µg versus vaginally at a dose of 25 µg to induce labor in a full-term pregnancy with a live fetus. METHODS: A randomized, placebo-controlled, triple-blind clinical trial was conducted at two maternity hospitals in northeastern Brazil. Two hundred patients with a full-term pregnancy, a live fetus, Bishop score ≤ 6 and an indication for induction of labor were included. Following randomization, one group received 12.5 µg misoprostol sublingually and a vaginal placebo, while the other group received a sublingual placebo and 25 µg misoprostol vaginally. The primary outcome was the frequency of tachysystole. Student's t-test, the chi-square test of association and Fisher's exact test were used, as appropriate. Risk ratios and their 95% confidence intervals were calculated. RESULTS: The frequency of tachysystole was lower in the group using 12.5 µg misoprostol sublingually compared to the group using 25 µg misoprostol vaginally (RR = 0.15; 95%CI: 0.02-0.97; p = 0.002). Failure to achieve vaginal delivery within 12 and 24 h was similar in both groups. Sublingual administration was preferred to vaginal administration by women in both groups; however, the difference was not statistically significant. CONCLUSION: The effectiveness of labor induction with low-dose sublingual misoprostol was similar to that achieved with vaginal administration of the recommended dose; however, the rate of tachysystole was lower in the sublingual group, and this route of administration may prove a safe alternative. TRIAL REGISTRATION: Registration number: NCT01406392, ClinicalTrials.gov. Date of registration: August 1, 2011.

Vocal symptoms in pediatric population: Validation of the Brazilian version of the Pediatric Vocal Symptoms Questionnaire. / Sintomas vocais na população pediátrica: Validação da versão brasileira do Questionário de Sintomas Vocais Pediátrico.

PURPOSE: To validate the Pediatric Vocal Symptoms Questionnaire (PVSQ) for Brazilian Portuguese. METHODS: The study was approved by the Ethics Committee (758,309). A total of 716 individuals participated in this research, of which 367 were children and adolescents, with and without vocal alteration, aged 6-18 years, and 349 were parents/guardians, who responded to the final version of the instrument. Among the interviewed of this version, 272 participated in the test-retest, and 32, of the sensitivity. Children and adolescents aged 6-18 years responded to the self-evaluation version of the PVSQ, and their parents/guardians to its parental version. RESULTS: The PVSQ showed acceptable reliability and reproducibility for the Brazilian population and sensitivity to vocal treatment. CONCLUSION: The PVSQ was validated for Brazilian Portuguese, being a good instrument of vocal self-evaluation, both in the parental version and in the self-evaluation version.

OBJETIVO: Validar o Questionário de Sintomas Vocais Pediátrico (QSV-P) para o português brasileiro. MÉTODO: Aprovado pelo Comitê de Ética (758.309). Participaram desta pesquisa 716 indivíduos, dos quais 367 eram crianças e adolescentes, com e sem alteração vocal, entre 6 e 18 anos, e 349 eram pais/responsáveis, que responderam à versão final do instrumento. Entre os respondentes dessa versão, 272 participaram do teste-reteste, e 32, da sensibilidade. As crianças e os adolescentes entre 6 e 18 anos responderam à versão de autoavaliação do QSV-P, e seus pais/responsáveis, à versão parental do QSV-P. RESULTADOS: O QSV-P apresentou confiabilidade e reprodutibilidade aceitáveis para a população brasileira e sensibilidade ao tratamento vocal. CONCLUSÃO: O QSV-P foi validado para o português brasileiro, sendo um bom instrumento de autoavaliação vocal, tanto na versão parental quanto na versão autoavaliativa.

Acetaminophen in low doses for closure of the ductus arteriosus of the premature.

OBJECTIVE: The objective of the study is to report the experience with acetaminophen in low doses as an alternative to the treatment of the ductus arteriosus of the preterm newborn. MATERIALS AND METHODS: Retrospective study including preterm newborns with patent ductus arteriosus who received oral acetaminophen because treatment with indomethacin had failed or is contraindicated. A dosage consisted of a first dose of 25 mg/kg and maintenance doses of 30 mg/kg/day, for 3 to 7 days. A second cycle was administered in cases of reopening of the ductus arteriosus. The rates of ductal closure and surgery were calculated. Patients were categorized into responder and nonresponder groups for acetaminophen, and the average values of ductal diameter, weight, gestational age, and postnatal age were compared. RESULTS: Eighty-seven preterm newborns, with a postnatal age from 3 to 27 days, with average values of ductus arteriosus equal to 2.5 ± 0.8 mm/kg, gestational age 27.2 ± 1.9 weeks, and birth weight 888.9 ± 241 g, received acetaminophen for 3 to 7 days. A second cycle was administered in 15 preterm newborns. The ductus closure rate, after one or two cycles, was 74.7%, and the recommendations for surgical closure were progressively reduced from 50% in the 1st year to 6.2% in the past year. Lower ductal closure rate occurred in the group of newborns with the lowest average weight (P = 0.018), the highest average ductal diameter (P = 0.002), and the lowest average gestational age (P = 0.09). Postnatal age at the start of acetaminophen use was shown to be irrelevant regarding the treatment (P = 0.591). CONCLUSIONS: Acetaminophen in low doses showed to be an effective alternative for the closure of the ductus arteriosus for preterm newborns in whom treatment with indomethacin or ibuprofen failed or was contraindicated.

Qualitative and quantitative scintigraphy in sialorrhea before and after botulinum toxin injection.

OBJECTIVES/HYPOTHESIS: Sialorrhea is excessive saliva production and its usual escape of from the oral cavity. The use of botulinum toxin has been preconized, but its effectiveness until now has been unreliably measured. Our objective was to qualitatively and quantitatively determine the effectiveness of botulinum toxin injection in the reduction of saliva production by the parotid gland. STUDY DESIGN: Outcomes research. METHODS: Patients with moderate-to-critical sialorrhea had one of the parotid glands injected with 50 U of botulinum toxin, leaving the other as the control. Fifteen days after the toxin injection, they underwent scintigraphic analyses with intravenous injection of 10 mCi (37 MBq) of Tc-99 m (sodium pertechnetate). After this, the noninjected gland was treated for therapeutic complementation. RESULTS: The glands injected with botulinum toxin showed uptake reduction in 100% of patients. The uptake reduction in counts per second varied from 8% to 36%. The Wilcoxon paired test comparing the control glands with those injected showed a significant difference for the action of botulinum toxin (P = .0039). CONCLUSIONS: The scintigraphic study of parotid glands shows that botulinum toxin is effective in reducing sodium pertechnetate uptake. LEVEL OF EVIDENCE: 2c Laryngoscope, 129:2521-2526, 2019.