Analysis of muscle mass by computed tomography in patients with head and neck cancer: a prospective study / Análise da massa muscular por tomografia computadorizada em pacientes com câncer de cabeça e pescoço: um estudo prospectivo

Abstract Objective: To evaluate the preoperative muscle mass of patients with head and neck cancer (HNC) with computed tomography (CT), comparing the results obtained through analysis of cross-sectional areas at the level of the third lumbar vertebra (L3) with those obtained through analysis of cross-sectional areas at the levels of the third cervical and fourth thoracic vertebrae (C3 and T4, respectively). Materials and Methods: A total of 63 patients with HNC were evaluated preoperatively. Using CT, we assessed muscle mass at L3, as well as at C3 and T4. Results: Most (73.0%) of the patients had low muscle mass at L3, whereas 50.8% had a normal body mass index. The cross-sectional area at L3 correlated strongly with those at C3 and T4 (r = 0.831 and r = 0.763, respectively; p < 0.001 for both). In addition, the muscle mass index at L3 correlated strongly with those at C3 and T4 (r = 0.781 and r = 0.715, respectively; p < 0.001 for both). Conclusion: Low muscle mass appears to be highly prevalent in patients with HNC. Measurements at C3 and T4 could represent alternative means of assessing muscle mass in such patients.

Resumo Objetivo: Avaliar e comparar a massa muscular de pacientes com câncer de cabeça e pescoço (CCP) durante o período pré-operatório com tomografia computadorizada (TC), por meio da análise das áreas transversais no nível da terceira vértebra lombar (L3) em comparação com níveis cervical (C3) e torácico (T4). Materiais e Métodos: Sessenta e três pacientes com CCP foram avaliados no pré-operatório. A TC foi utilizada para avaliar a massa muscular de L3, assim como as secções transversais de C3 e T4. Resultados: A maioria dos pacientes (73,0%) tinha baixa massa muscular analisada pela TC de L3, mas índice de massa corpórea normal (50,8%). Também foi observada forte correlação entre as áreas e o índice de massa muscular (IMM) de L3 com C3 (área: r = 0,831, p < 0,001; IMM: r = 0,781, p < 0,001) e T4 (área: r = 0,763, p < 0,001; IMM: r = 0,715, p < 0,001). Conclusão: A baixa massa muscular é altamente prevalente em pacientes com CCP. As análises de TC em C3 e T4 podem representar opção para avaliar a massa muscular em pacientes com CCP.

Phenotypic plasticity in Copaifera langsdorffii Desf. in different forest fragments in São Paulo state, Brazil.

Forest fragments are susceptible to environmental shifts and this demands high phenotypic plasticity of the species growing in these areas. In this context, the objective of the present work was to study the phenotypic plasticity of copaíba (Copaifera langsdorffii Desf.) based on morphological and anatomical metrics of the leaflets of plants from six forest fragments. The leaflets of C. langsdorffii individuals of the different fragments did not show qualitative differences, nonetheless, they demonstrated quantitative plasticity. Stomatal density (p = 0.017), specific leaf area (p = 0.009), palisade parenchyma (p = 0.008) and relative water content (p = 0.002), indicated a high luminous, water and nutritional influence on the development of leaflets. Based on the dry mass of the leaflets and the thickness of the palisade parenchyma, the principal component analysis explained 57.43% of the differences found between the variables. The data presented here provides evidence of the phenotypic plasticity of C. langsdorffii which, although occurring in similar soils, showed significant quantitative differences in its morphoanatomical characters.

Preoperative evaluation of sarcopenia in patients with colorectal cancer: a prospective study.

OBJECTIVE: Colorectal cancer is the third most diagnosed malignant neoplasm in the world and the fourth leading cause of cancer mortality. The loss of muscle mass in oncological patients is the main aspect of cancer-related malnutrition. Associations between sarcopenia and poor outcomes, such as high postoperative mortality, chemotherapy toxicity, and reduced survival, have been recently described. The aim of this study was to prospectively assess the prevalence of preoperative sarcopenia in patients with colorectal cancer using validated methods to evaluate muscle strength, muscle mass, and physical performance. METHODOLOGY: This study included patients with colorectal cancer undergoing oncological staging at a Cancer Center in Brazil from May 2019 to March 2020 who had images from abdominal computed tomography available for analysis of body composition. The muscle strength test, physical performance, referred fatigue, and clinical and nutritional data were evaluated. RESULTS: A total of 31 patients were included, and most were diagnosed with colon cancer (77.4%) and clinical stage II in 41.9% of cases. The prevalence of probable sarcopenia was 22.6%; of these patients, sarcopenia was confirmed in 19.4%, and ultimately, 9.7% of the sample was classified as severe sarcopenia. We did not find a significant association between the presence of sarcopenia in our sample and age, sex, tumor staging, nutritional characteristics, referred patient fatigue, or postoperative complications. CONCLUSION: Considering the criteria established by the EWGSOP, the prevalence of preoperative sarcopenia in colorectal cancer patients was 19.4%.

Preoperative evaluation of sarcopenia in patients with colorectal cancer: a prospective study

SUMMARY OBJECTIVE: Colorectal cancer is the third most diagnosed malignant neoplasm in the world and the fourth leading cause of cancer mortality. The loss of muscle mass in oncological patients is the main aspect of cancer-related malnutrition. Associations between sarcopenia and poor outcomes, such as high postoperative mortality, chemotherapy toxicity, and reduced survival, have been recently described. The aim of this study was to prospectively assess the prevalence of preoperative sarcopenia in patients with colorectal cancer using validated methods to evaluate muscle strength, muscle mass, and physical performance. METHODOLOGY: This study included patients with colorectal cancer undergoing oncological staging at a Cancer Center in Brazil from May 2019 to March 2020 who had images from abdominal computed tomography available for analysis of body composition. The muscle strength test, physical performance, referred fatigue, and clinical and nutritional data were evaluated. RESULTS: A total of 31 patients were included, and most were diagnosed with colon cancer (77.4%) and clinical stage II in 41.9% of cases. The prevalence of probable sarcopenia was 22.6%; of these patients, sarcopenia was confirmed in 19.4%, and ultimately, 9.7% of the sample was classified as severe sarcopenia. We did not find a significant association between the presence of sarcopenia in our sample and age, sex, tumor staging, nutritional characteristics, referred patient fatigue, or postoperative complications. CONCLUSION: Considering the criteria established by the EWGSOP, the prevalence of preoperative sarcopenia in colorectal cancer patients was 19.4%.

Analysis of muscle mass by computed tomography in patients with head and neck cancer: a prospective study.

Objective: To evaluate the preoperative muscle mass of patients with head and neck cancer (HNC) with computed tomography (CT), comparing the results obtained through analysis of cross-sectional areas at the level of the third lumbar vertebra (L3) with those obtained through analysis of cross-sectional areas at the levels of the third cervical and fourth thoracic vertebrae (C3 and T4, respectively). Materials and Methods: A total of 63 patients with HNC were evaluated preoperatively. Using CT, we assessed muscle mass at L3, as well as at C3 and T4. Results: Most (73.0%) of the patients had low muscle mass at L3, whereas 50.8% had a normal body mass index. The cross-sectional area at L3 correlated strongly with those at C3 and T4 (r = 0.831 and r = 0.763, respectively; p < 0.001 for both). In addition, the muscle mass index at L3 correlated strongly with those at C3 and T4 (r = 0.781 and r = 0.715, respectively; p < 0.001 for both). Conclusion: Low muscle mass appears to be highly prevalent in patients with HNC. Measurements at C3 and T4 could represent alternative means of assessing muscle mass in such patients.

Objetivo: Avaliar e comparar a massa muscular de pacientes com câncer de cabeça e pescoço (CCP) durante o período pré-operatório com tomografia computadorizada (TC), por meio da análise das áreas transversais no nível da terceira vértebra lombar (L3) em comparação com níveis cervical (C3) e torácico (T4). Materiais e Métodos: Sessenta e três pacientes com CCP foram avaliados no pré-operatório. A TC foi utilizada para avaliar a massa muscular de L3, assim como as secções transversais de C3 e T4. Resultados: A maioria dos pacientes (73,0%) tinha baixa massa muscular analisada pela TC de L3, mas índice de massa corpórea normal (50,8%). Também foi observada forte correlação entre as áreas e o índice de massa muscular (IMM) de L3 com C3 (área: r = 0,831, p < 0,001; IMM: r = 0,781, p < 0,001) e T4 (área: r = 0,763, p < 0,001; IMM: r = 0,715, p < 0,001). Conclusão: A baixa massa muscular é altamente prevalente em pacientes com CCP. As análises de TC em C3 e T4 podem representar opção para avaliar a massa muscular em pacientes com CCP.

Computed tomography assessment of body composition in patients with nonmetastatic breast cancer: what are the best prognostic markers?

Objective: To correlate body composition measures, based on computed tomography (CT) analysis of muscle mass and adipose tissue, with disease-free survival in breast cancer patients. Materials and Methods: This single-center retrospective study included 262 female patients with nonmetastatic breast cancer. Body composition was assessed on a pretreatment CT scan (at the L3 level). The analysis included quantification of the areas of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle mass, as well as of the mean skeletal muscle density. The VAT/SAT ratio, skeletal mass index (SMI), and skeletal muscle gauge (SMG) were calculated. Results: Of the 262 patients evaluated, 175 (66.8%) were classified as overweight or obese on the basis of their body mass index. We observed low SMI in 35 patients (13.4%) and elevated VAT in 123 (46.9%). Disease-free survival was significantly shorter in the patients who underwent neoadjuvant chemotherapy (p = 0.044), in those with a low SMI (p = 0.006), in those with low SMG (p = 0.013), and in those with a low VAT/SAT ratio (p = 0.050). In a multivariate analysis, only SMG, the VAT/SAT ratio, and having undergone neoadjuvant chemotherapy retained their statistical significance. Conclusion: Our results confirm that low SMG and the VAT/SAT ratio can be used as imaging biomarkers to assess prognosis in patients with nonmetastatic breast cancer.

Objetivo: Correlacionar medidas de composição corporal baseadas na análise por tomografia computadorizada (TC) da massa muscular e tecido adiposo com a sobrevida livre de doença em pacientes com câncer de mama. Materiais e Métodos: Estudo retrospectivo unicêntrico que incluiu 262 mulheres com câncer de mama não metastático. Avaliação da composição corporal foi realizada na TC pré-tratamento (nível de L3), incluindo tecido adiposo subcutâneo (SAT) e tecido adiposo visceral (VAT), massa muscular esquelética e densidade do músculo esquelético. A relação VAT/SAT, o índice de massa esquelética (SMI) e o produto do músculo esquelético (SMG) foram calculados. Resultados: De acordo com o índice de massa corporal, 175 (66,8%) pacientes foram classificadas com sobrepeso ou obesidade. Baixo SMI foi observado em 35 (13,4%) pacientes e VAT elevado, em 123 (46,9%). Houve uma redução significativa na sobrevida livre de doença nas pacientes que realizaram quimioterapia neoadjuvante (p = 0,044), nas com baixo SMI (p = 0,006), baixo SMG (p = 0,013) e baixa relação VAT/SAT (p = 0,050). Na análise multivariada, apenas SMG, relação VAT/SAT e quimioterapia neoadjuvante confirmaram significância estatística. Conclusão: Nossos resultados confirmaram que SMG e relação VAT/SAT baixos podem ser usados como importantes biomarcadores de imagem para avaliar o prognóstico em pacientes com câncer de mama não metastático.

Computed tomography assessment of body composition in patients with nonmetastatic breast cancer: what are the best prognostic markers? / Avaliação da composição corporal por tomografia computadorizada em pacientes com câncer de mama não metastático: quais os melhores marcadores de prognóstico?

Abstract Objective: To correlate body composition measures, based on computed tomography (CT) analysis of muscle mass and adipose tissue, with disease-free survival in breast cancer patients. Materials and Methods: This single-center retrospective study included 262 female patients with nonmetastatic breast cancer. Body composition was assessed on a pretreatment CT scan (at the L3 level). The analysis included quantification of the areas of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle mass, as well as of the mean skeletal muscle density. The VAT/SAT ratio, skeletal mass index (SMI), and skeletal muscle gauge (SMG) were calculated. Results: Of the 262 patients evaluated, 175 (66.8%) were classified as overweight or obese on the basis of their body mass index. We observed low SMI in 35 patients (13.4%) and elevated VAT in 123 (46.9%). Disease-free survival was significantly shorter in the patients who underwent neoadjuvant chemotherapy (p = 0.044), in those with a low SMI (p = 0.006), in those with low SMG (p = 0.013), and in those with a low VAT/SAT ratio (p = 0.050). In a multivariate analysis, only SMG, the VAT/SAT ratio, and having undergone neoadjuvant chemotherapy retained their statistical significance. Conclusion: Our results confirm that low SMG and the VAT/SAT ratio can be used as imaging biomarkers to assess prognosis in patients with nonmetastatic breast cancer.

Resumo Objetivo: Correlacionar medidas de composição corporal baseadas na análise por tomografia computadorizada (TC) da massa muscular e tecido adiposo com a sobrevida livre de doença em pacientes com câncer de mama. Materiais e Métodos: Estudo retrospectivo unicêntrico que incluiu 262 mulheres com câncer de mama não metastático. Avaliação da composição corporal foi realizada na TC pré-tratamento (nível de L3), incluindo tecido adiposo subcutâneo (SAT) e tecido adiposo visceral (VAT), massa muscular esquelética e densidade do músculo esquelético. A relação VAT/SAT, o índice de massa esquelética (SMI) e o produto do músculo esquelético (SMG) foram calculados. Resultados: De acordo com o índice de massa corporal, 175 (66,8%) pacientes foram classificadas com sobrepeso ou obesidade. Baixo SMI foi observado em 35 (13,4%) pacientes e VAT elevado, em 123 (46,9%). Houve uma redução significativa na sobrevida livre de doença nas pacientes que realizaram quimioterapia neoadjuvante (p = 0,044), nas com baixo SMI (p = 0,006), baixo SMG (p = 0,013) e baixa relação VAT/SAT (p = 0,050). Na análise multivariada, apenas SMG, relação VAT/SAT e quimioterapia neoadjuvante confirmaram significância estatística. Conclusão: Nossos resultados confirmaram que SMG e relação VAT/SAT baixos podem ser usados como importantes biomarcadores de imagem para avaliar o prognóstico em pacientes com câncer de mama não metastático.

Análise dos materiais didáticos utilizados por radiologistas e residentes de radiologia brasileiros: mudança de paradigma.

Objetivo: Identificar o perfil de utilização dos recursos didáticos pelos médicos radiologistas e residentes em radiologia e diagnóstico por imagem brasileiros. Materiais e Métodos: Estudo observacional, transversal e descritivo, realizado por meio de questionário eletrônico contendo perguntas referentes ao perfil do médico, formação, local de atuação, perfil de acesso a recursos educacionais e tipos de recursos mais utilizados. Resultados: Responderam ao questionário 265 médicos com idade média de 38,2 anos, sendo a maioria radiologistas formados (170; 64,2%), do sexo masculino (166; 62,6%), trabalhando em instituições privadas (174; 65,7%), sem vínculo acadêmico (167; 63,0%), atuando principalmente nas áreas de ultrassonografia (212; 80,0%) e tomografia computadorizada (206; 77,7%). A carga horária média de estudo semanal foi de 9,6 horas (mediana: 6 horas), sendo maior no grupo dos médicos que estão em formação e nos que atuam em instituições públicas e acadêmicas. Quanto ao recurso para o acesso do material de estudo, observou-se uma tendência pela maior utilização do computador (65,3%). A maioria dos respondentes optou por acessar materiais didáticos sem custo (61,9%), sendo os sites da web, livros e revistas eletrônicas os mais pesquisados. Conclusão: Os radiologistas brasileiros utilizam recursos eletrônicos e digitais como principais materiais didáticos, sendo os sites da web, livros e revistas eletrônicas as fontes mais utilizadas.

Food promoted on an online food delivery platform in a Brazilian metropolis during the COVID-19 pandemic: a longitudinal analysis.

OBJECTIVE: To analyse food advertised on an online food delivery (OFD) platform during 16 weeks of the COVID-19 pandemic in Brazil. DESIGN: Longitudinal study. We randomly selected foods advertised on the OFD app's home page, classifying the food items into water; natural juices and smoothies; vegetables; fruits; traditional meals and pasta; ultra-processed beverages; ice cream and candies, and salty packaged snacks; sandwiches; savoury snacks; and pizza. We also registered the marketing strategies used to promote the food items, such as photos, discounts, 'combo deals', and messages on healthiness, value for the money, tastiness, and pleasure. SETTING: Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: 1,593 food items. RESULTS: In general, the OFD platform most commonly promoted traditional meals and pasta, ultra-processed beverages, and sandwiches-these food groups were offered 20-25% of the time during the 16 weeks. There were no promotions for water during the whole period, and the least common promotions were those for natural juices and smoothies, vegetables, and fruits (<5%). The most common food promotion strategies were photos (>80%) and discounts (>95%), while approximately 30% of the offers featured combo deals. Messages on tastiness, pleasure, and value for the money varied from 15% to 40%. CONCLUSION: Although the OFD platform offered traditional meals and pasta, most of the foods and beverages advertised were unhealthy and promoted with persuasive strategies. This finding highlights a growing public health concern: an increase in unhealthy eating patterns during the pandemic.

Análise dos materiais didáticos utilizados por radiologistas e residentes de radiologia brasileiros: mudança de paradigma / Analysis of the use of educational materials by radiologists and radiology residents in Brazil: paradigm shift

Resumo Objetivo: Identificar o perfil de utilização dos recursos didáticos pelos médicos radiologistas e residentes em radiologia e diagnóstico por imagem brasileiros. Materiais e Métodos: Estudo observacional, transversal e descritivo, realizado por meio de questionário eletrônico contendo perguntas referentes ao perfil do médico, formação, local de atuação, perfil de acesso a recursos educacionais e tipos de recursos mais utilizados. Resultados: Responderam ao questionário 265 médicos com idade média de 38,2 anos, sendo a maioria radiologistas formados (170; 64,2%), do sexo masculino (166; 62,6%), trabalhando em instituições privadas (174; 65,7%), sem vínculo acadêmico (167; 63,0%), atuando principalmente nas áreas de ultrassonografia (212; 80,0%) e tomografia computadorizada (206; 77,7%). A carga horária média de estudo semanal foi de 9,6 horas (mediana: 6 horas), sendo maior no grupo dos médicos que estão em formação e nos que atuam em instituições públicas e acadêmicas. Quanto ao recurso para o acesso do material de estudo, observou-se uma tendência pela maior utilização do computador (65,3%). A maioria dos respondentes optou por acessar materiais didáticos sem custo (61,9%), sendo os sites da web, livros e revistas eletrônicas os mais pesquisados. Conclusão: Os radiologistas brasileiros utilizam recursos eletrônicos e digitais como principais materiais didáticos, sendo os sites da web, livros e revistas eletrônicas as fontes mais utilizadas.

Abstract Objective: To profile the use of educational materials by radiologists and radiology residents in Brazil. Materials and Methods: This was a cross-sectional, descriptive, observational study in which an electronic questionnaire was sent via email to physicians working in the field of radiology. The questionnaire contained questions regarding the profile, education, and place of work of the physicians, as well as their access to educational resources and the types of educational materials they used most. Results: The questionnaire was completed by 265 physicians. The mean age of the respondents was 38.2 years. Of the 265 respondents, 212 (80.0%) worked with ultrasound, 206 (77.7%) worked with computed tomography, 170 (64.2%) were board-certified, 166 (62.6%) were male, 174 (65.7%) worked at private facilities, and 167 (63.0%) had no academic affiliation. The mean weekly total study time was 9.6 h (median, 6 h), being higher among physicians in training, among those who worked at public facilities, and among those who worked at teaching hospitals. Regarding the device employed in order to access educational materials, there was a trend toward greater use of computers, which were employed by 65.3%. The majority of the respondents (61.9%) chose to access educational materials that were free of charge, the most common sources being websites, eBooks, and online journals. Conclusion: Electronic and digital resources are the main means of access to educational materials used by radiologists in Brazil, the most commonly used resources being web sites, eBooks, and online journals.

As resistências culturais enfrentadas pela mulher no âmbito das modalidades de lutas / Cultural resistances faced by women in the context of the modalities of struggles

O presente estudo qualitativo teve como objetivo compreender barreiras sociais enfrentadas pelas mulheres praticantes de lutas (artes marciais ou esportes de combate). Este estudo traz artigos acadêmicos, exemplos e fragmentos de textos de conhecimento público que mostram parte do processo histórico que uma mulher enfrenta quando pratica luta. Foi elaborada uma revisão de literatura acerca do tema para encontrar a existência das barreiras sociais e quais são elas. Como consequência, esse artigo é capaz de transmitir superações das mulheres tanto no âmbito das modalidades de lutas quanto no âmbito social.Como resultado, foi identificado alguns fatores e a existência de 5 barreiras sociais: a distinção de gênero, cultura da feminilidade, as mídias, exploração da erotização da mulher e a exclusão social da mesma. Tais barreiras são encontradas estruturadas na sociedade. E, mesmo diante disso, a mulher vem conquistando espaço na sociedade em geral e na área das lutas em particular.

This qualitative study aimed to understand social barriers faced by women who practice fighting (martial arts or combat sports). It brings some academic articles, examples and public known texts which shows parts of a historical process woman goes through when fight practicing. A literature review was elaborated upon the theme to find possible social barriers and what would they be. As consequence, this article was able to transmit overcoming examples of women in both contexts: of fighting modalities and within public spaces.As an outcome, this study found five mainly social barriers, which are: the distinction of gender, culture of femininity, the media, the erotization of women's bodies and behaviors and their social exclusion. Such barriers were found pervaded throughout our society culture. And, even before that, women have been conquering and exhibiting female empowerment within our society and in the context of fights (martial arts and combat sports).

El presente estudio cualitativo tuvo como objetivo comprender las barreras sociales que enfrentan las mujeres que luchan (artes marciales o deportes de combate). Este estudio trae artículos académicos, ejemplos y fragmentos de textos de conocimiento público que muestran parte del proceso histórico que enfrenta una mujer cuando practica pelear. Se preparó una revisión de la literatura sobre el tema para descubrir la existencia de barreras sociales y cuáles son. Como consecuencia, este artículo es capaz de transmitir la superación de las mujeres tanto en el ámbito de las modalidades de lucha como en el ámbito social.Como resultado, se identificaron algunos factores y la existencia de 5 barreras sociales: la distinción de género, la cultura de la feminidad, los medios de comunicación, la explotación de la erotización de las mujeres y la exclusión social. Dichas barreras se encuentran estructuradas en la sociedad. E incluso con eso en mente, las mujeres han ido ganando espacio en la sociedad en general y en el área de las luchas en particular.

Digital food environment of a Brazilian metropolis: food availability and marketing strategies used by delivery apps.

OBJECTIVE: Food delivery apps represent an important and emerging dimension of the digital food environment. This study aimed to examine food availability and the use of marketing strategies by two food delivery apps in a Brazilian metropolis. DESIGN: An exploratory study was conducted in the city of Belo Horizonte, Minas Gerais. Food groups were identified and the use of price discounts and photos by the apps was observed. SETTING: Eighteen neighbourhoods and the ten best rated restaurants in each app. PARTICIPANTS: Three hundred sixty-two commercial food establishments. RESULTS: The proportion of ultra-processed beverages on offer in the apps (78·45 %) was much higher in comparison with water (48·89 %), natural juices or smoothies (27·07 %). Ultra-processed ready-to-eat meals represented almost 70 % of the food offered in the establishments' menus, while traditional meals and vegetables represented just over 30 % of the offering. Ice cream, candies and salty packaged snacks were nine times more frequently presented than fruits. The use of photos and price discounts prevailed predominantly among ultra-processed beverages, sandwiches and ice cream, candies and salty packaged snacks. These marketing strategies were least used for promoting fruits and vegetables. CONCLUSIONS: Restaurants registered on food delivery apps offered a significant amount of ultra-processed foods with price discounts and photos in comparison with unprocessed and minimally processed foods.

Efeito da Estimulação Elétrica Nervosa Transcutânea no tratamento da Dismenorreia Primária / Effect of Transcutaneous Nervous Electrical Stimulation on treatment of Primary Dysmenorrhea

Objetivo: Comparar dois tipos de Estimulação Elétrica Nervosa Transcutânea (TENS), convencional e acupuntura, no tratamento da dismenorreia primária. Métodos: Participaram do estudo 24 voluntárias com quadro clínico de dismenorreia primária, com idade entre 18 e 35 anos, divididas aleatoriamente em: grupo convencional (GC n=12), tratado com TENS convencional e grupo acupuntura (GA n=12), tratado com TENS acupuntura. As participantes foram avaliadas antes, imediatamente depois e duas horas após a terapêutica através da Escala Visual Analógica de dor (EVA). Resultados: Ao analisar os dados referentes ao GC e GA, verificou-se redução significativa do quadro álgico ao se comparar os tempos antes e depois do tratamento (p≤0,01), assim como depois e duas horas após o seu término (p≤0,01), sem diferença entre os grupos. Conclusões: A TENS reduziu a dor pélvica causada pela síndrome da dismenorreia primária das participantes da pesquisa, porém, sem diferença estatística entre os grupos.

Food availability and advertising within food outlets around primary healthcare services in Brazil.

The consumer food environment is changing: an extensive variety of foods are now available in most markets, offering palatability, convenience and novelty. However, little is known about the availability and advertising of food items within food outlets, especially among developing countries. The present study examined these dimensions in 281 food outlets located around eighteen primary healthcare services in Belo Horizonte, Brazil, in 2013. These establishments were classified as large-chain supermarkets; specialised fruits and vegetable (F&V) markets; and local grocery stores, convenience stores or bakeries. Availability of F&V, availability of ultra-processed foods (UPF) and food advertising were compared across the food outlet categories by applying the χ2 test. Almost 60 % of the food outlets were specialised F&V markets, 21⋅4 % were large-chain supermarkets and 19⋅2 % were local grocery stores, convenience stores or bakeries. Almost 80 % contained at least eight types of fruits and vegetables, and 60 % contained UPF. Food advertisement was absent in 59⋅8 % of the food outlets, 19⋅6 % were advertising only F&V and 17⋅4 % were advertising only UPF. Higher F&V availability was noted inside specialised F&V markets and large-chain supermarkets than local grocery stores, convenience stores or bakeries. Advertising of F&V was more common within specialised F&V markets. However, large-chain supermarkets and local grocery stores, convenience stores or bakeries contained more frequent UPF food advertising isolated: 38⋅3 and 35⋅2 %, respectively. Therefore, the availability and advertising of food items within food outlets around primary healthcare services are different according to the type of food outlet.

Computed tomography-measured body composition: correlation with postoperative morbidity and mortality in patients with gastroesophageal cancer / Correlação entre a composição corporal medida pela tomografia computadorizada e a morbimortalidade pós-operatória em pacientes com câncer gastroesofágico

Abstract Objective: To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer. Materials and Methods: This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat. Results: Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; p = 0.040). Conclusion: Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients.

Resumo Objetivo: Investigar se medidas antropométricas e tomografia computadorizada (TC) da composição corporal podem predizer morbimortalidade pós-operatória em pacientes com câncer gástrico e/ou esofágico. Materiais e Métodos: Estudo retrospectivo que revisou prontuários médicos e TCs abdominais de pacientes com câncer gástrico e/ou esofágico que foram operados em 2015 em um centro de referência oncológico. As TCs realizadas durante a avaliação pré- operatória de rotina foram avaliadas retrospectivamente para medir a área de massa magra ao nível de L3 e gordura visceral e subcutânea. Resultados: Setenta pacientes foram incluídos no estudo. A média de idade foi 59,9 anos (faixa de 33-82 anos), e 47 desses pacientes (67,1%) eram homens. O seguimento pós-operatório médio foi 14,9 meses. Não houve associação significativa entre morbidade ou mortalidade pós-operatória e sexo, idade, tumor primário, comorbidades, tabagismo, índice de massa corpórea, diagnóstico nutricional ou área de gordura visceral. A taxa de sobrevida foi maior para pacientes com área de massa magra normal, em comparação com pacientes com baixa área de massa magra (hazard ratio = 0,116; intervalo de confiança 95% = 0,015-0,906; p = 0,040). Conclusão: Nossos dados sugerem que a área de massa magra pode ser um importante fator prognóstico em pacientes com câncer gástrico e/ou esofágico, e sua medida na TC deve ser incluída na avaliação pré-operatória de rotina, podendo fornecer informações que auxiliem no manejo clínico e nutricional desses pacientes.

Computed tomography-measured body composition: correlation with postoperative morbidity and mortality in patients with gastroesophageal cancer.

OBJECTIVE: To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer. MATERIALS AND METHODS: This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat. RESULTS: Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; p = 0.040). CONCLUSION: Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients.

Incidência de disfunções sexuais em universitárias de um Centro Universitário no estado do Rio de Janeiro / Incidence of sexual dysfunctions in university students of a University Center in the state of Rio de Janeiro

Objetivo: verificar a incidência de disfunções sexuais em universitárias de um Centro Universitário no estado do Rio de Janeiro. Métodos: foram avaliadas 50 mulheres de um Centro Universitário no estado do Rio de Janeiro, na faixa etária de 18 a 49 anos. A coleta de dados foi realizada através de dois questionários: Quociente Sexual - Versão Feminina (QS-F) e um questionário sobre o perfil das participantes. Resultados: observou- se um elevado número de mulheres que referiram ter um bom desempenho/satisfação sexual. Verificou-se que 46% das mulheres foi classificada com o perfil de desempenho sexual bom a excelente, 32% de regular a bom, 22% apresentou um desempenho/satisfação sexual desfavorável a regular, e nenhuma ruim a desfavorável ou nulo a ruim. Conclusões: os resultados podem estar relacionados à idade da maioria das entrevistadas, já que 86% destas apresentavam idade entre 19 a 29 anos. (AU)

Objective: to verify the incidence of sexual dysfunctions in university students of a University Center in the state of Rio de Janeiro. Methods: were evaluated 50 women at a University Center located in the state of Rio de Janeiro, aged 18-49 years who were randomly selected. Data collection was conducted through the two questionnaires: Sexual Quotient - Female Version ( Q S - F) and a questionnaire about the participants. Results: there was a high number of women who reported a good performance / sexual satisfaction.It was found that 46% of woman were classified with the profile of good to excelente sexual performance, 32% in fair to good, 22% showed a regular to unfavorables performance sexual satisfaction, and no bad to unfavorable or null to bad. Conclusions: the results may be related to the age of the majority of respondents, since 86% of these were aged between 19-29 years. (AU)

Mass change of a sodium bicarbonate air-polished nanocomposite exposed to cigarette smoke, coffee, and red wine / Perda de massa de nanocompósito jateado com bicarbonato de sódio e exposto à fumaça de cigarro, café e vinho tinto

Introdução: As resinas compostas estão sujeitas à desafios na cavidade oral relacionados aos hábitos dos pacientes, que podem comprometer a integridade e longevidade das restaurações. As consequências da associação do consumo de bebidas e o uso de cigarros à profilaxia profissional precisam ser estudadas. Objetivo: O objetivo desse estudo foi avaliar como o jateamento com bicarbonato de sódio afeta a mudança de massa (sorção e solubilidade) de uma resina composta exposta à fumaça de cigarro, vinho tinto e café. Material e método: Oitenta corpos-de-prova de resina composta (FiltekZ350 XT - 3M/ESPE) foram preparados e distribuídos em 8 grupos (n=10): G1 (jateamento + água destilada), G2 (jateamento + café), G3 (jateamento + vinho tinto), G4 (jateamento + fumaça de cigarro), G5 (água destilada), G6 (café), G7 (vinho tinto) e G8 (fumaça de cigarro). Os corpos-de-prova de resina composta foram pesados em três tempos diferentes para obter M1 (massa inicial), M2 (massa após 30 dias de armazenamento nas soluções testadas e exposição ao agente) e M3 (após dessecação). Os valores de sorção e solubilidade foram calculados e analisados usando ANOVA 2-fatores e teste Tukey (5%). Resultado: Os grupos experimentais tiveram maior sorção e solubilidade comparado ao grupo controle, independentemente do uso do jateamento. Não houve diferença estatística na sorção para o fator jateamento. Porém, a solubilidade foi maior nos grupos jateados. Conclusão: O jateamento com bicarbonato de sódio foi capaz de intensificar a solubilidade da resina testada, embora não tenha aumentado significativamente os valores de sorção.

Introduction: Composite resins are subject to challenges in the oral cavity that are related to patients' habits, which can compromise the restorations' integrity and longevity. Therefore, it is necessary to study how consuming beverages and smoking cigarettes affects professional prophylaxis. Objective: The aim of this study was to evaluate how the sodium bicarbonate air-polishing affects the mass change (sorption and solubility) of a composite resin exposed to cigarette smoke, red wine, or coffee solution. Material and method: Eighty composite resin samples (FiltekZ350 XT - 3M/ESPE) were prepared and distributed into 8 groups (n=10): G1 (air-polishing + distilled water), G2 (air-polishing + coffee), G3 (air-polishing + red wine), G4 (air-polishing + cigarette smoke), G5 (distilled water), G6 (coffee), G7 (red wine), or G8 (cigarette smoke). The composite resin samples were weighed in triplicate to obtain M1 (initial mass), M2 (mass after 30 days of storage in the tested solutions), and M3 (after desiccation) values. The sorption and solubility values were calculated and analyzed using 2-way ANOVA and Tukey's test (5%). Result: The experimental groups had higher sorption and solubility values than the control groups, regardless of whether air-polishing was used. There was no statistically significant difference in the sorption between the air-polished and non-air-polished groups; however, the solubility was higher in the air-polished groups. Conclusion: Air-polishing using sodium bicarbonate powder was able to intensify the solubility process of the tested resins but did not significantly increase the sorption values.

Análise do conceito resiliência na criança / Concept analysis resilience in child

Objetiva-se descrever os elementos constituintes do Conceito Resiliência na Criança. Revisão crítica da literatura como análise de conceito para a identificação dos atributos, antecedentes e consequentes do Conceito Resiliência na Criança. A exploração teórica foi alcançada nas bases de dados: American Psychological Association, Cumulative Index to Nursing & Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, e, Medical Literature Analysis and Retrieval System Online. Os descritores da Biblioteca Virtual de Saúde para acessar as publicações foram: resiliência psicológica, criança, enfermagem, com o operador booleano AND. Foram encontrados 30 artigos (70%) nas áreas médica, de enfermagem e psicologia. Os atributos do conceito contêm duas categorias: Atributos Pessoais e Atributos Externos. Os antecedentes do conceito incluem: Recursos Internos, Ambiente Doméstico e Recursos fora da família. Os consequentes compreendem: Competência comportamental, Maturidade, Bom desempenho escolar e Saúde física e mental. Conclui-se que a resiliência na criança resulta dos processos de ligação dinâmicos entre as condições adversas e a organização e integração das experiências pessoais, familiares e comunitárias, na busca da competência da criança para um desenvolvimento saudável. A resiliência não nasce com a criança, mas é adquirida no seu desenvolvimento. O conceito demanda estudos de sua manifestação na prática

The aim is to describe constituent elements of the concept Resilience in Child. A literature's critical review as concept analysis for the identification of the concept's attributes, antecedents and consequent. The theoretical exploration of conceptual attributes was achieved in the American Psychological Association, Cumulative Index to Nursing & Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and Medical Literature Analysis and Retrieval System Online. The descriptors of the Virtual Health Library to access the publications were: psychological resilience, child, nursing, with the Boolean operator AND. 30 articles (70%) were found for access in the medical, nursing and psychology's field. The concept's attributes include two categories: Personal Attributes and External Attributes. The concept's antecedents were: Internal Resources, Domestic environment and Resources outside the family. The concept's consequent consisted of: Behavioral Competence, Maturity, Academic Achievement and Physical and Mental Health. It concludes that child resilience results from the dynamic linking of adverse conditions to the organization and integration of personal, family and community experiences in the child's pursuit of healthy development. Resilience is not born with the child, but is gained in its development. The Concept demands studies of its manifestation in practice

Plants from the Brazilian Traditional Medicine: species from the books of the Polish physician Piotr Czerniewicz (Pedro Luiz Napoleão Chernoviz, 1812-1881)

Abstract The Brazilian flora is very rich in medicinal plants, and much information about the traditional use of the Brazilian plants is only available from early literature and we are facing a rapid process of loss of biodiversity. To retrieve data about useful plants registered in the books of the Polish physicist P.L.N. Chernoviz, who lived in Brazil for 15 years in the 19th century. The aim is to improve our knowledge about Brazilian plants, and to ensure the benefits of sharing it with potential users. Data about Brazilian plants were obtained from six editions of the book Formulary and Medical Guide (Formulário e Guia Médico), published in 1864, 1874, 1888, 1892, 1897 and 1920. All this information was then organized in boxes, and correlated with pharmacological studies from PubMed and Lilacs. A total of 238 species were recorded and 117 different traditional uses were registered for the plants. The most common uses were to treat general skin diseases and intermittent fevers, as purgative, diuretics and andidiarrheal. From the total, only 61 species (25.6%) have been to date subject to pharmacological studies and had their activities confirmed. Chernoviz books represent an important source of data about plants used in traditional medicine of Brazil. Their records were collected at a time when Brazil's native vegetation was still largely intact, and traditional medicine was practiced based on native plants. We argue that these plants must be prioritized in development of medicines, submitting them to clinical studies or by considering their traditionality, as established by WHO. Strategies for the protection of the traditional knowledge are also necessary.