The impact of astrocytic NF-κB on healthy and Alzheimer's disease brains.

Astrocytes play a role in healthy cognitive function and Alzheimer's disease (AD). The transcriptional factor nuclear factor-κB (NF-κB) drives astrocyte diversity, but the mechanisms are not fully understood. By combining studies in human brains and animal models and selectively manipulating NF-κB function in astrocytes, we deepened the understanding of the role of astrocytic NF-κB in brain health and AD. In silico analysis of bulk and cell-specific transcriptomic data revealed the association of NF-κB and astrocytes in AD. Confocal studies validated the higher level of p50 NF-κB and phosphorylated-p65 NF-κB in glial fibrillary acidic protein (GFAP)+-astrocytes in AD versus non-AD subjects. In the healthy mouse brain, chronic activation of astrocytic NF-κB disturbed the proteomic milieu, causing a loss of mitochondrial-associated proteins and the rise of inflammatory-related proteins. Sustained NF-κB signaling also led to microglial reactivity, production of pro-inflammatory mediators, and buildup of senescence-related protein p16INK4A in neurons. However, in an AD mouse model, NF-κB inhibition accelerated ß-amyloid and tau accumulation. Molecular biology studies revealed that astrocytic NF-κB activation drives the increase in GFAP and inflammatory proteins and aquaporin-4, a glymphatic system protein that assists in mitigating AD. Our investigation uncovered fundamental mechanisms by which NF-κB enables astrocytes' neuroprotective and neurotoxic responses in the brain.

Epidemiology of pediatriac scoliosis in a tertiary hospital in recife-pe / Epidemiologia da escoliose pediátrica em hospital terciário em recife-pe / Epidemiología de la escoliosis pediátrica en hospital terciario en recife-pe

ABSTRACT: Objective: The present study aims to outline the epidemiological parameters of patients with scoliosis between the ages of 0 and 18 years old, who were evaluated at the Getúlio Vargas Hospital in Recife-PE. Methods: The participants completed a demographic questionnaire, followed by clinical evaluation, including Cobb angle measurement, clinical photographic registration and quality of life questionnaires. Results: The sample consisted of 103 patients, mostly females, with a mean age of 13.86 years, from the interior of the state, diagnosed with adolescent idiopathic scoliosis classified as Lenke 1. Neuromuscular and congenital scoliosis were less common. The quality-of-life questionnaire showed a significant difference in self-image perception among patients with idiopathic scoliosis, those who had a curve measuring under 50 degrees had better scores than those who had greater angles. Patients with larger curves scored lower on all questionnaire items, but there was no significant difference when compared to the other group. Conclusion: It was shown that the main epidemiological parameters in the pediatric population with scoliosis are girls, mean age 13 years, coming from the interior of the state being idiopathic scoliosis, the most common, classified as Lenke 1. Neuromuscular scoliosis was the main type of deformity following the idiopathic; cerebral palsy being the most common etiology. Level of evidence IV; Prognostic Studies Investigating the effect of a Patient characteristic on the outcome of Disease.

RESUMO: Objetivo: Traçar o perfil epidemiológico dos pacientes portadores de escoliose entre as idades de 0 até 18 anos no Hospital Getúlio Vargas em Recife-PE. Métodos: Estudo transversal em que os participantes foram submetidos a um questionário demográfico, em seguida tiveram seu perfil clínico avaliado com a medição do ângulo de Cobb, realização de fotografias clínicas e aplicação de questionários de qualidade de vida. Resultados: A amostra foi construída com 103 pacientes, em sua maioria do gênero feminino, com idade média de 13,68 anos, provenientes do interior do estado, com diagnóstico de escoliose idiopática do adolescente classificadas como Lenke 1. Escoliose neuromuscular e congênita estiveram presentes em menor número. O questionário de qualidade de vida aplicado mostrou que houve diferença significativa na percepção da autoimagem de pacientes com escoliose idiopática que tinham curvas menores que 50 graus em relação aos que tinham maior deformidade. Aqueles com curvas de maior valor angular apresentavam menor pontuação em todos os quesitos do questionário, sugerindo pior qualidade de vida, mas não houve diferença significativa. Conclusão: Conclui-se que, o perfil epidemiológico dos pacientes portadores de escoliose pediátrica é formado por meninas com escoliose idiopática, com média de idade de 13 anos, provenientes do interior do estado, tendo diagnóstico de escoliose idiopática classificada como Lenke 1. Dos demais tipos de escoliose, o mais prevalente foi a escoliose neuromuscular secundária à paralisia cerebral. Nível de Evidência IV; Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

RESUMEN: Objetivos: Describir el perfil epidemiológico de los pacientes diagnosticados con escoliosis de 0 a 18 años que son evaluados en el Hospital Getúlio Vargas en Recife-PE. Métodos: Los participantes fueron sometidos a una encuesta demográfica y luego a una evaluación clínica que incluyó la toma de fotos, la medición de ángulo de Cobb y un cuestionario de calidad de vida. Resultados: La muestra fue constituida por 103 individuos, la mayoría de género femenino, con edad media de 13,68 años, que provenían del interior del estado y que fueron diagnosticadas con escoliosis idiopática del adolescente, clasificada en Lenke 1. La escoliosis neuromuscular y congénita estuvieron presentes en un número más pequeño. El cuestionario de calidad de vida mostró que hubo una diferencia significativa en la percepción de autoimagen de los pacientes con escoliosis idiopática con curvas menores a 50 grados cuando se compararon con los que tenían curvas más grandes. Los pacientes con curvas mayores tenían menos puntos en todas las preguntas del cuestionario, pero sin diferencia significativa. Conclusión: Se concluyó que el perfil epidemiológico de los pacientes con escoliosis pediátrica era formado por niñas con escoliosis idiopática, con edad media de 13 años, que provenían del interior del estado, clasificadas como Lenke 1. De los demás tipos de escoliosis, la neuromuscular secundaria a parálisis cerebral fue la más común. Nivel de evidencia IV; Estudios pronósticos - Investigación del efecto de características de un paciente sobre el desenlace de la enfermedad.

Odontologia hospitalar: uma análise crítica sobre a inserção do cirurgião dentista na atenção terciária no estado do Rio Grande do Sul, Brasil / Hospital dentistry: a critical analysis of the role of the dental surgeon in tertiary care in the state of Rio Grande do Sul, Brazil

Objetivo: analisar a inserção do cirurgião dentista na atenção terciária no estado do Rio Grande do Sul, Brasil. Método: estudo descritivo ecológico, com uso de dados secundários registrados pelo Cadastro Nacional de Estabelecimentos de Saúde no ano de 2023. A coleta de dados foi realizada em duas etapas. Na primeira etapa também foram coletados os dados do CNES referentes à presença do cirurgião dentista, tipo de vínculo contratual e especialidades ofertadas pelos serviços. Já na segunda etapa os dados coletados foram referentes aos indicadores sociodemográficos dos profissionais com habilitação em odontologia hospitalar utilizando as informações disponibilizadas pelo Sistema WSCFO do Conselho Federal de Odontologia. A análise dos dados foi realizada com o suporte do software TabWin, versão 3.6, e do software estatístico R v. 4.2.3. Os dados foram analisados por meio de análise descritiva. Resultados: apenas 6,11% das instituições são certificadas e consideradas Hospitais de Ensino. A maioria dos estabelecimentos (87,14%) oferece atendimento pelo SUS. Quanto à presença de cirurgiões dentistas nos estabelecimentos, 64,63% dos estabelecimentos relataram tê-los, enquanto 35,37% não possuem esse profissional em sua equipe. Neste estudo, constatamos que uma correlação positiva do cirurgião dentista com o número de leitos de UTI adulto e ao maior porte do hospital. Conclusão: observa-se que ainda há necessidade de estruturação da atenção terciária no Estado do Rio Grande do Sul, no que se refere à odontologia hospitalar. Há poucos os cirurgiões dentistas com uma carga horária dedicada exclusivamente ao atendimento hospitalar clínico a beira leito.(AU)

Objective: To analyze the inclusion of dental surgeons in tertiary care in the state of Rio Grande do Sul, Brazil. Method: a descriptive ecological study using secondary data recorded by the National Register of Health Establishments in 2023. Data was collected in two stages. In the first stage, data was also collected from the CNES regarding the presence of a dental surgeon, the type of contractual relationship and the specialties offered by the services. In the second stage, data was collected on the sociodemographic indicators of professionals qualified in hospital dentistry using the information provided by the WSCFO System of the Federal Council of Dentistry. The data was analyzed using TabWin software, version 3.6, and R v. 4.2.3 statistical software. The data was analyzed using descriptive analysis. Results: only 6.11% of institutions are certified and considered Teaching Hospitals. The majority of establishments (87.14%) provide care through the SUS. As for the presence of dental surgeons in the establishments, 64.63% of the establishments reported having them, while 35.37% did not have this professional on their team. In this study, we found a positive correlation between the number of adult ICU beds and the size of the hospital. Conclusion: There is still a need to structure tertiary care in the state of Rio Grande do Sul, in terms of hospital dentistry. There are few dental surgeons with a workload dedicated exclusively to bedside clinical hospital care.(AU)

Evaluation of the mechanical properties of different materials for manufacturing occlusal splints.

This study aimed to compare the mechanical properties of various occlusal plate materials by analyzing surface roughness, Knoop microhardness, flexural strength, and modulus of elasticity. Fifty samples were prepared and classified as SC (self-curing acrylic resin), WB (heat-cured acrylic resin), ME (acrylic resin polymerized by microwave energy), P (resin print), and M (polymethylmethacrylate polymer block for computer-aided design/computer-aided manufacturing). The data were analyzed using a one-way analysis of variance and Tukey's honestly significant difference test. Surface roughness was the same in all groups. The surface hardness of group M was statistically superior. The samples from groups P and M had higher flexural strength than other samples. The modulus of elasticity of group SC was statistically lower than that of other groups. The mechanical properties of the materials used to make the occlusal plates differed, and group M achieved the best results in all analyses. Therefore, clinicians must consider the material used to manufacture long-lasting and efficient occlusal splints.

Retinal pathological features and proteome signatures of Alzheimer's disease.

Alzheimer's disease (AD) pathologies were discovered in the accessible neurosensory retina. However, their exact nature and topographical distribution, particularly in the early stages of functional impairment, and how they relate to disease progression in the brain remain largely unknown. To better understand the pathological features of AD in the retina, we conducted an extensive histopathological and biochemical investigation of postmortem retina and brain tissues from 86 human donors. Quantitative examination of superior and inferior temporal retinas from mild cognitive impairment (MCI) and AD patients compared to those with normal cognition (NC) revealed significant increases in amyloid ß-protein (Aß42) forms and novel intraneuronal Aß oligomers (AßOi), which were closely associated with exacerbated retinal macrogliosis, microgliosis, and tissue atrophy. These pathologies were unevenly distributed across retinal layers and geometrical areas, with the inner layers and peripheral subregions exhibiting most pronounced accumulations in the MCI and AD versus NC retinas. While microgliosis was increased in the retina of these patients, the proportion of microglial cells engaging in Aß uptake was reduced. Female AD patients exhibited higher levels of retinal microgliosis than males. Notably, retinal Aß42, S100 calcium-binding protein B+ macrogliosis, and atrophy correlated with severity of brain Aß pathology, tauopathy, and atrophy, and most retinal pathologies reflected Braak staging. All retinal biomarkers correlated with the cognitive scores, with retinal Aß42, far-peripheral AßOi and microgliosis displaying the strongest correlations. Proteomic analysis of AD retinas revealed activation of specific inflammatory and neurodegenerative processes and inhibition of oxidative phosphorylation/mitochondrial, and photoreceptor-related pathways. This study identifies and maps retinopathy in MCI and AD patients, demonstrating the quantitative relationship with brain pathology and cognition, and may lead to reliable retinal biomarkers for noninvasive retinal screening and monitoring of AD.

Deletion of MyD88 in astrocytes prevents ß-amyloid-induced neuropathology in mice.

As the understanding of immune responses in Alzheimer's disease (AD) is in its early phases, there remains an urgency to identify the cellular and molecular processes driving chronic inflammation. In AD, a subpopulation of astrocytes acquires a neurotoxic phenotype which prompts them to lose typical physiological features. While the underlying molecular mechanisms are still unknown, evidence suggests that myeloid differentiation primary response 88 (MyD88) adaptor protein may play a role in coordinating these cells' immune responses in AD. Herein, we combined studies in human postmortem samples with a conditional genetic knockout mouse model to investigate the link between MyD88 and astrocytes in AD. In silico analyses of bulk and cell-specific transcriptomic data from human postmortem brains demonstrated an upregulation of MyD88 expression in astrocytes in AD versus non-AD individuals. Proteomic studies revealed an increase in glial fibrillary acidic protein in multiple brain regions of AD subjects. These studies also showed that although overall MyD88 steady-state levels were unaffected by AD, this protein was enriched in astrocytes near amyloid plaques and neurofibrillary tangles. Functional studies in mice indicated that the deletion of astrocytic MyD88 protected animals from the acute synaptic toxicity and cognitive impairment caused by the intracerebroventricular administration of ß-amyloid (Aß). Lastly, unbiased proteomic analysis revealed that loss of astrocytic MyD88 resulted in altered astrocyte reactivity, lower levels of immune-related proteins, and higher expression of synaptic-related proteins in response to Aß. Our studies provide evidence of the pivotal role played by MyD88 in the regulation of astrocytes response to AD.

Prevalence of self-reported symptoms of temporomandibular disorders and associated factors in the period of distance learning.

OBJECTIVE: Assess the prevalence of self-reported TMD symptoms and anxiety and check the quality of sleep and life during the distance learning period in university students at the University of Brasilia (UnB). MATERIALS AND METHODS: The participants were students from the Health Sciences College and Medicine College at UnB. Self-administered questionnaires were used to evaluate symptoms of TMD, quality of life, and sleep quality. One-way analysis of variance, followed by Bonferroni test, and Kruskal-Wallis test, followed by Dunn's test, were performed (P < 0.05). For qualitative data analysis, the chi-square test was applied (P < 0.05). RESULTS: Total 156 students were included; prevalence of TMD, anxiety, sleep disturbance, and poor sleep quality was 73.1%, 84%, 12.8%, and 62.8%, respectively. A greater prevalence of painful TMD was observed in students with severe anxiety (P = 0.007). Students with symptoms of painful TMD, severe anxiety, and sleep disorders had statistically worse quality of life. CONCLUSIONS: The implementation of distance learning in health courses to replace classroom teaching during the COVID-19 pandemic has impacted TMD prevalence, anxiety, quality of life, and sleep quality. CLINICAL RELEVANCE: Psychological factors are directly associated with TMD symptoms and quality of life, TMD conditions are related to quality of life as well. COVID-19 pandemic and the distance learning in health courses are new situations that can lead to a great impact on mental health and in consequence to TMD conditions and quality of life.

Evaluation of the mechanical properties of different materials for manufacturing occlusal splints

Abstract This study aimed to compare the mechanical properties of various occlusal plate materials by analyzing surface roughness, Knoop microhardness, flexural strength, and modulus of elasticity. Fifty samples were prepared and classified as SC (self-curing acrylic resin), WB (heat-cured acrylic resin), ME (acrylic resin polymerized by microwave energy), P (resin print), and M (polymethylmethacrylate polymer block for computer-aided design/computer-aided manufacturing). The data were analyzed using a one-way analysis of variance and Tukey's honestly significant difference test. Surface roughness was the same in all groups. The surface hardness of group M was statistically superior. The samples from groups P and M had higher flexural strength than other samples. The modulus of elasticity of group SC was statistically lower than that of other groups. The mechanical properties of the materials used to make the occlusal plates differed, and group M achieved the best results in all analyses. Therefore, clinicians must consider the material used to manufacture long-lasting and efficient occlusal splints.

Perfil clínico-epidemiológico de pacientes classificados com o discriminador sepse possível no departamento de emergência / Perfil clínico-epidemiológico de los pacientes clasificados con el posible discriminador de sepsis en el servicio de urgencias / Clinical-epidemiological profile of patients classified with the possible sepsis discriminator in the emergency department

Objetivo: descrever o perfil clínico-epidemiológico de pacientes classificados com o discriminador "sepse possível" do Sistema Manchester de Classificação de Risco em um departamento de emergência terciário. Método: estudo observacional retrospectivo, realizado no período de janeiro de 2018 a dezembro de 2019. A amostra foi composta por 1522 pacientes. A coleta de dados foi realizada em dados de prontuário eletrônico. A análise foi realizada com o uso de estatística descritiva. Resultados: O sexo feminino foi majoritário (50,6%), com idade média de 63,7 anos (±15,48). A maioria dos atendimentos foi por demanda espontânea (74,1%), com tempos médios de espera para CR e tempo de CR de 3/4 e 4/3 minutos, em 2018 e 2019, respectivamente. Conclusão: É necessário associar o protocolo de classificação de risco, já instituído, outros mecanismos a fim de aprimorar o entendimento e o fluxo assistencial acerca de pacientes potencialmente sépticos.(AU)

Objective: The present study aims to describe the clinical profile of patients classified with the discriminator "possible sepsis" of the Manchester Risk Classification System in a terciary emergency department. Method: Retrospective observational study, carried out from January 2018 to December 2019. The sample composed of 1522 patients. Data collection was performed using electronic medical records. Analysis performed using descriptive statistics. Results: Females were the majority (50.6%), with a mean age of 63.7 years (±15.48). Most attendances were by spontaneous demand (74.1%), with average waiting times for risk classification and risk classification time of 3/4 and 4/3 minutes, in 2018 and 2019, respectively. Conclusion: It is necessary to associate the risk classification protocol, already in place, with other mechanisms in order to improve the understanding and care flow about potentially septic patients.(AU)

Objetivo: describir el perfil clínico-epidemiológico de los pacientes clasificados con el discriminador "posible sepsis" del Manchester Risk Classification System en un servicio de urgencias de tercer nivel. Método: estudio observacional retrospectivo, realizado de enero de 2018 a diciembre de 2019. La muestra estuvo compuesta por 1522 pacientes. La recolección de datos se realizó mediante historias clínicas electrónicas. El análisis se realizó mediante estadística descriptiva. Resultados: el sexo femenino fue mayoritario (50,6%), con una edad media de 63,7 años (±15,48). La mayoría de las atenciones fueron por demanda espontánea (74,1%), con tiempos promedio de espera para clasificación de riesgo y tiempo de clasificación de riesgo de 3/4 y 4/3 minutos, en 2018 y 2019, respectivamente. Conclusión: Es necesario asociar el protocolo de clasificación de riesgo, ya existente, con otros mecanismos para mejorar la comprensión y el flujo de atención sobre pacientes potencialmente sépticos.(AU)

Construção de tecnologias educativas no ensino de reanimação cardiopulmonar para educadores do ensino fundamental / Construcción de tecnologías educativas en la enseñanza de la reanimación cardiopulmonar para educadores de educación primaria / Construction of educational technologies in cardiopulmonary resuscitation teaching for elementary school educators

Objetivo: relatar a experiência sobre a produção e a divulgação de uma tecnologia, em forma de cartilha educativa, para orientar educadores que atuam no ensino fundamental, sobre as ações de primeiros socorros que devem ser tomadas frente à uma parada cardiorrespiratória. Método: trata-se de um estudo descritivo, tipo relato de experiência. O desenvolvimento do projeto ocorreu no primeiro semestre de 2021, respeitando as etapas metodológicas sugeridas por Sabino para a construção de cartilhas educativas. Resultado: desenvolveu-se uma cartilha educativa intitulada "Suporte Básico de Vida para Educadores do Ensino Fundamental", contendo 28 páginas, com dimensão de 297x210mm, editoradas com auxílio do software Adobe InDesign. Conclusão: a cartilha educativa pode tornar-se uma ferramenta válida a ser utilizada pelos educadores, com o objetivo de informar, reforçar conhecimentos e formar multiplicadores para reanimação cardiorrespiratória, reduzindo a morbimortalidade por causas externas na infância e na adolescência.(AU)

Objective: to report the experience on the production and dissemination of a technology, in the form of an educational booklet, to guide educators who work in elementary school, on the first aid actions that must be taken in the event of a cardiorespiratory arrest. Method: this is a descriptive, experience report type study. The development of the project took place in the first half of 2021, respecting the methodological steps suggested by Sabino for the construction of educational booklets. Result: an educational booklet entitled "Basic Life Support for Elementary School Educators" was developed, containing 28 pages, measuring 297x210mm, edited with the help of Adobe InDesign software. Conclusion: the educational booklet can become a valid tool to be used by educators, with the objective of informing, reinforcing knowledge and training multipliers for cardiorespiratory resuscitation, reducing morbidity and mortality from external causes in childhood and adolescence.(AU)

Objetivo: relatar la experiencia sobre la producción y difusión de una tecnología, en forma de cartilla educativa, para orientar a los educadores que actúan en la enseñanza básica, sobre las acciones de primeros auxilios que se deben tomar en caso de parada cardiorrespiratoria. Método: se trata de un estudio descriptivo, tipo relato de experiencia. El desarrollo del proyecto se dio en el primer semestre de 2021, respetando los pasos metodológicos sugeridos por Sabino para la construcción de cartillas educativas. Resultado: se elaboró un cuadernillo educativo titulado "Soporte Vital Básico para Educadores de Enseñanza Básica", de 28 páginas, de 297x210 mm, editado con la ayuda del software Adobe InDesign. Conclusión: la cartilla educativa puede convertirse en una herramienta válida para ser utilizada por los educadores, con el objetivo de informar, reforzar conocimientos y multiplicadores de formación para la reanimación cardiorrespiratoria, reduciendo la morbimortalidad por causas externas en la infancia y la adolescencia(AU)

Traumatic brain injury alterations in the functional connectome are associated with neuroinflammation but not tau in a P30IL tauopathy mouse model.

INTRODUCTION: Traumatic Brain Injury (TBI) is often associated with long-term cognitive deficits and altered brain networks which have been linked with accumulation of neurofibrillary tau tangles and neuroinflammation. In this work, we investigated the changes in the brain post-TBI in an Alzheimer's disease pR5 tauopathy model and evaluated the contribution of tauopathy and neuroinflammation to connectivity alterations using resting-state functional Magnetic Resonance Imaging (rs-fMRI). METHOD: 26 P301L tau transgenic mice of 8-9 months of age (21-35 g) expressing the human tau isoform carrying the pathogenic P301L mutation were used for the study. Animals were assessed at day 1 and 7 post-injury/craniotomy and were randomly divided into four groups. All animals underwent an MRI scan on a 9.4T Bruker system where rsfMRI was acquired. Following imaging, brains were stained with pSer (396 + 404), glial fibrillary acidic protein (GFAP), and ionised calcium-binding adaptor molecule-1 (Iba-1). Group-information-guided Independent Component Analysis (GIG-ICA) and region-of-interest (ROI)-based network connectivity approaches were applied. Principal Component Regression was applied to predict connectivity network strength from the corresponding ROIs. RESULTS: TBI mice showed decreased functional connectivity in the dentate gyrus, thalamus, and other areas compared to sham animals at day 1 post-injury with the majority of changes resolving at day 7. Principal Component Regression showed only the contralateral CA1 network strength was correlated with the CA1's astrocyte and microglia cell density and the ipsilateral thalamus network strength was correlated with the ipsilateral thalamus' astrocyte and microglia cell density. CONCLUSION: We present the first report on the temporal alterations in functional connectivity in a P30IL mouse model following TBI. Connectivity between key regions known to be affected in Alzheimer's disease were short-term and reversible following injury. Connectivity strength in CA1 and thalamus showed significant correlation with astrocyte and microglial cell density but not tau density.

Simplified prosthetic rehabilitation of a patient with partial finger amputation after a firearm injury.

OBJECTIVE: This study reports a clinical case of rehabilitation of a patient who had her left little finger amputated at the mesial phalanx because of a gunshot wound. The finger prosthesis was custom- made using a silicone. CASE DESCRIPTION: This study presents a clinical case of a female patient who had her left little finger amputated at the mesial phalanx because of a gunshot wound in 2016. The patient was attended at a reference center in maxillofacial rehabilitation in the city of Brasilia, Distrito Federal, Brazil, for the manufacture of a finger prosthesis. After molding, a finger waxing was obtained using the right little finger as a template. The waxing was later adjusted on the plaster model of the affected stump. The prosthesis was manufactured with silicone and intrinsically stained with a makeup powder. A water-based adhesive and a ring were used to generate a slight compression so that the prosthesis was retained on the stump. OUTCOMES: The rehabilitation showed satisfactory levels of stability, retention, and aesthetics, and it was usable and clinically acceptable, as observed in a follow-up appointment in February 2020. CONCLUSIONS: The complete or partial reestablishment of functions performed by important structures, such as the fingers, is essential to increase the quality of life of individuals, improving their performance of daily activities. In addition, reporting on this public health problem allows scientific advancement in the area.

Anatomical study of the ideal positioning of the s2 iliac screw / Estudo anatômico do posicionamento ideal do parafuso s2 ilíaco / Estudio anatómico de la posición ideal del tornillo s2 ilíaco

ABSTRACT Objective: To evaluate the morphometry of the pelvis to determine the safe trajectory for the insertion of the S2-iliac screw, and to correlate it with studies reported in the literature for other populations. Method: The computed tomography (CT) pelvic exams of 36 Brazilian patients without congenital malformations, tumors, pelvic ring fractures or dysplasias were selected from the database of a radiological clinic. To define the ideal trajectory of the S2-iliac screw, the following variables were measured: 1- maximum sacroiliac screw length; 2- thickness of the iliac dipole for planning the choice of screw dimensions (length and diameter); 3 - distance between the insertion point of the iliac S2 screw and the posterior sacral cortex; 4 - angulation for insertion of the screw in the mediolateral direction, representing the angle formed between the "iliac line" and the anatomical sagittal plane; 5- Angulation for insertion of the screw in the craniocaudal direction. The Pearson's chi squared and student's t tests were used for statistical analysis. Results: The sample consisted of 36 patients, 50% (18/36) of whom were women. The mean age was 63.7 years, ranging from 23 to 96 years. All the pelvic morphometric variables analyzed presented values similar to those described in the literature for other populations. Conclusion: Prior evaluation of the tomography exams was important for preoperative planning, and there was a statistically significant difference between the sexes only in relation to the variables left craniocaudal and length of the left internal table. Level of evidence III; Observational cross-sectional study.

RESUMO Objetivo: Avaliar a morfometria da pelve para determinar a trajetória de segurança de introdução do parafuso S2-ilíaco e correlacionar com estudos relatados na literatura para outras populações. Métodos: A partir do banco de dados de uma clínica radiológica, foram selecionados 36 exames de tomografia computadorizada (TC) da pelve de pacientes brasileiros sem achados de malformações congênitas, tumorações, fraturas do anel pélvico ou displasias. Para definição da trajetória ideal do parafuso S2-ilíaco foram mensuradas as seguintes variáveis: 1 - comprimento máximo do parafuso sacro-ilíaco; 2 - espessura da díploe ilíaca para planejar a escolha das dimensões do parafuso (comprimento e diâmetro); 3 - distância entre o ponto de inserção do parafuso S2-ilíaco e a cortical posterior do sacro; 4 - angulação para inserção do parafuso no sentido médio-lateral, representando o ângulo formado entre a "reta ilíaca" e o plano sagital anatômico; 5 - angulação para inserção do parafuso no sentido craniocaudal. Para análise estatística foram usados os testes Qui-quadrado de Pearson e t de Student. Resultados: A amostra foi constituída de 36 pacientes, sendo 50% (18/36) mulheres. A média de idade foi de 63,7 anos, variando de 23 a 96 anos. Todas as variáveis morfométricas pélvicas analisadas apresentaram valores semelhantes aos descritos na literatura para outras populações. Conclusões: A avaliação prévia dos exames de tomografia foi importante para o planejamento pré-operatório, assim como a diferença estatisticamente significante entre os sexos somente com relação às variáveis craniocaudal esquerda e comprimento da tábua interna esquerda. Nível de evidência III; Estudo observacional de corte transversal.

RESUMEN Objetivo: Evaluar la morfometría de la pelvis para determinar la trayectoria de seguridad de introducción del tornillo S2-ilíaco y correlacionarla con estudios relatados en la literatura para otras poblaciones. Método: A partir de la base de datos de una clínica radiológica, se seleccionaron 36 exámenes de tomografía computarizada (TC) de la pelvis de pacientes brasileños sin hallazgos de malformaciones congénitas, tumores, fracturas del anillo pélvico o displasias. Para definir la trayectoria ideal del tornillo S2-ilíaco, se midieron las siguientes variables: 1- longitud máxima del tornillo sacro-ilíaco; 2- espesor del díploe ilíaco: para planificar la elección de las dimensiones del tornillo (longitud y diámetro); 3- distancia entre el punto de inserción del tornillo S2ilíaco y la cortical posterior del sacro; 4- angulación para inserción del tornillo en el sentido medio-lateral, que representa el ángulo formado entre la "recta ilíaca" y el plano sagital anatómico; 5- angulación para inserción del tornillo en el sentido craneocaudal. Para el análisis estadístico se utilizaron las pruebas Chi-cuadrado de Pearson y t de Student. Resultados: La muestra fue constituida de 36 pacientes, siendo 50% (18/36) mujeres. La edad promedio fue de 63,7 años, variando de 23 a 96 años. Todas las variables morfométricas pélvicas analizadas presentaron valores similares a los descritos en la literatura para otras poblaciones. Conclusiones: Fue importante la evaluación previa de los exámenes de tomografía para la planificación preoperatoria; así como la diferencia estadísticamente significativa entre géneros sólo en relación a las variables craneocaudal izquierda y longitud de la tabla interna izquierda. Nivel de evidencia III; Estudio observacional de corte transversal.

Laser in wounds: knowledge translation to an effective and innovative nursing practice.

OBJECTIVE: To describe the knowledge translation obtained through research of low-level laser therapy to wound treatment in the clinical practice. METHODS: Experience report about implementation strategies of this new technology in a university hospital, being an extension course the main one, developed between May and December 2019. RESULTS: The course was carried out by researchers in partnership with clinical nurses to 13 nurses from different areas with previous experience in wound care. Were taught 30 theoretical-practical class hours, part of them supervised in a real clinical setting, besides case studies. From that, an exclusive nursing consultation schedule of laser therapy was created at the outpatient and its use was also improved to patients admitted in several units of the hospital. FINAL CONSIDERATIONS: The knowledge translation developed about laser therapy allowed its implementation as a technology in wound treatment, qualifying the professional practice and benefiting the treatment of patients with wounds.

Reproducibility of the classification of proximal humeral ossification in idiopathic scoliosis / Reprodutibilidade da classificação da ossificação do úmero proximal na escoliose idiopática / Reproducibilidad de la clasificación de la osificación del húmero proximal en la escoliosis idiopática

ABSTRACT Objective To evaluate the intra- and interobserver reproducibility of the classification of proximal humeral ossification in patients with idiopathic scoliosis. Methods Observational, descriptive, cross-sectional study. Radiographs (anteroposterior) of 29 patients diagnosed with idiopathic scoliosis were chosen and investigated at the Spine Surgery Outpatient Clinic of the Department of Orthopedics and Traumatology of the Hospital Getúlio Vargas, Recife, Pernambuco. These radiographs were evaluated and classified by 9 spinal orthopedic surgeons at two moments, with a minimum interval of 30 days, for analysis of the intraobserver and interobserver reproducibility of the classification of proximal humeral ossification used as a predictor of peak growth velocity. Results Intraobserver reproducibility achieved moderate to substantial concordance with the kappa index. In the analysis of interobserver reproducibility using the Fleiss' kappa method, a reasonable to moderate concordance was observed, except for in stage 5, in which concordance ranged from substantial to almost perfect. Conclusion In this study, the reproducibility of the Li classification in most of the stages was reasonable to moderate for the interobserver assessment and moderate to substantial for the intraobserver assessment, which differs from the current literature. Level of evidence III; Diagnostic studies - Investigation of a diagnostic test.

RESUMO Objetivo Avaliar a reprodutibilidade intra e interobservadores da classificação de ossificação do úmero proximal em pacientes portadores de escoliose idiopática. Métodos Estudo observacional, descritivo e transversal. Foram selecionadas radiografias (anteroposteriores) de 29 pacientes com diagnóstico de escoliose idiopática acompanhados no Ambulatório de Cirurgia da Coluna do Departamento de Ortopedia do Hospital Getúlio Vargas, Recife, Pernambuco. Essas radiografias foram avaliadas e classificadas por nove cirurgiões ortopedistas de coluna em dois momentos, com intervalo mínimo de 30 dias, para análise da reprodutibilidade intraobservador e interobservador da classificação de ossificação do úmero proximal utilizada como preditor do pico de velocidade de crescimento. Resultados A reprodutibilidade intraobservador com o índice Kappa atingiu concordância moderada a substancial. Já na análise da reprodutibilidade interobservador com o método de kappa de Fleiss constatou-se concordância de razoável a moderada, exceto no estágio 5, no qual a concordância variou de substancial a quase perfeita. Conclusões Neste estudo, a reprodutibilidade da classificação de Li, na maioria dos estágios foi razoável a moderada na avaliação interobservador e moderada à substancial na avaliação intraobservador, o que diverge da literatura atual. Nível de evidência III; Estudos diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Objetivo Evaluar la reproducibilidad intra e interobservador de la clasificación de osificación del húmero proximal en pacientes con escoliosis idiopática. Métodos Estudio observacional, descriptivo y transversal. Se seleccionaron radiografías (anteroposteriores) de 29 pacientes con diagnóstico de escoliosis idiopática en la Clínica de Cuidados Ambulatorios de Cirugía de Columna del Departamento de Ortopedia del Hospital Getúlio Vargas, Recife, Pernambuco. Estas radiografías fueron evaluadas y clasificadas por nueve cirujanos ortopedistas de columna, en dos momentos, con un intervalo mínimo de 30 días, para analizar la reproducibilidad intraobservador e interobservador de la clasificación de osificación del húmero proximal utilizada como predictor de la velocidad máxima de crecimiento. Resultados La reproducibilidad intraobservador con el índice Kappa alcanzó concordancia de moderada a sustancial de la reproducibilidad intraobservador. En el análisis de la reproducibilidad interobservador con el método de kappa de Fleiss, se encontró concordancia de razonable a moderada, excepto en la etapa 5, en que la concordancia varió de sustancial a casi perfecta. Conclusiones En este estudio, la reproducibilidad de la clasificación de Li en la mayoría de las etapas fue de razonable a moderada en la evaluación interobservador y de moderada a sustancial en la evaluación intraobservador, lo que difiere de la literatura actual. Nivel de Evidencia III; Estudios de Diagnóstico - Investigación de una prueba de diagnóstico.

Diffusion Tensor Imaging Detects Acute Pathology-Specific Changes in the P301L Tauopathy Mouse Model Following Traumatic Brain Injury.

Traumatic brain injury (TBI) has been linked with tauopathy. However, imaging methods that can non-invasively detect tau-protein abnormalities following TBI need further investigation. This study aimed to investigate the potential of diffusion tensor imaging (DTI) to detect tauopathy following TBI in P301L mutant-tau-transgenic-pR5-mice. A total of 24 9-month-old pR5 mice were randomly assigned to sham and TBI groups. Controlled cortical injuries/craniotomies were performed for TBI/sham groups followed by DTI data acquisition on days 1 and 7 post-injury. DTI data were analyzed by using voxelwise analysis and track-based spatial statistics for gray matter and white matter. Further, immunohistochemistry was performed for total-tau and phosphorylated-tau, astrocytes, and microglia. To detect the association of DTI with these pathological markers, a correlation analysis was performed between DTI and histology findings. At day 1 post-TBI, DTI revealed a widespread reduction in fractional anisotropy (FA) and axial diffusivity (AxD) in the TBI group compared to shams. On day 7, further reduction in FA, AxD, and mean diffusivity and increased radial diffusivity were observed. FA was significantly increased in the amygdala and cortex. Correlation results showed that in the ipsilateral hemisphere FA reduction was associated with increased phosphorylated-tau and glial-immunoreactivity, whereas in the contralateral regions, the FA increase was associated with increased immunostaining for astrocytes. This study is the first to exploit DTI to investigate the effect of TBI in tau-transgenic mice. We show that alterations in the DTI signal were associated with glial activity following TBI and would most likely reflect changes that co-occur with/without phosphorylated-tau. In addition, FA may be a promising measure to identify discrete pathological processes such as increased astroglia activation, tau-hyperphosphorylation or both in the brain following TBI.

Laser in wounds: knowledge translation to an effective and innovative nursing practice / Láser em heridas: translación del conocimiento para uma práctica efectiva e inovadora en enfermería / Laser em feridas: translação do conhecimento para uma prática efetiva e inovadora na enfermagem

ABSTRACT Objective To describe the knowledge translation obtained through research of low-level laser therapy to wound treatment in the clinical practice. Methods Experience report about implementation strategies of this new technology in a university hospital, being an extension course the main one, developed between May and December 2019. Results The course was carried out by researchers in partnership with clinical nurses to 13 nurses from different areas with previous experience in wound care. Were taught 30 theoretical-practical class hours, part of them supervised in a real clinical setting, besides case studies. From that, an exclusive nursing consultation schedule of laser therapy was created at the outpatient and its use was also improved to patients admitted in several units of the hospital. Final considerations The knowledge translation developed about laser therapy allowed its implementation as a technology in wound treatment, qualifying the professional practice and benefiting the treatment of patients with wounds.

RESUMEN Objetivo Describir la traslación del conocimiento obtenido en investigación de la terapia con láser de baja potencia para el tratamiento de heridas en la práctica clínica. Métodos Relato de experiencia sobre estrategias para la implementación de esta nueva tecnología en un hospital universitario, con un curso de extensión desarrollado entre mayo y diciembre/2019. Resultados El curso fue realizado por investigadores en alianza con enfermeras especializadas para 13 enfermeros de diferentes áreas y experiencias en el cuidado con heridas. Fueran dados 30 horas de clases teórico-prácticas supervisadas en un entorno clínico real y estudios de casos. En consecuencia de esto, se creó consultas de enfermería de terapia láser, así como un aumento de esta terapia para los pacientes hospitalizados. Consideraciones finales La transferencia de conocimiento sobre la terapia con láser permitió la implantación de esta tecnología en el tratamiento de heridas, con práctica profesional calificada y beneficio el tratamiento de pacientes con heridas.

RESUMO Objetivo Descrever a translação do conhecimento obtido em pesquisa sobre terapia a laser de baixa potência para o tratamento de feridas na prática clínica. Métodos Relato de experiência sobre estratégias de implementação dessa nova tecnologia em um hospital universitário, sendo um curso de extensão a principal delas, desenvolvido entre maio e dezembro/2019. Resultados O curso foi realizado por pesquisadores em parceria com enfermeiros assistenciais para 13 enfermeiros de diferentes áreas e experiências no cuidado a pacientes com feridas. Foram ministradas 30 horas de aulas teórico-práticas, parte das mesmas supervisionadas em cenário clínico real, além de estudos de caso. A partir disso, foi criada uma agenda de consulta de enfermagem de laserterapia no ambulatório, bem como incrementado essa terapia em pacientes hospitalizados. Considerações finais A translação do conhecimento sobre laserterapia permitiu a implantação dessa tecnologia no tratamento de feridas, qualificando a prática profissional e beneficiando o tratamento de pacientes com feridas.

Prevalence of symptoms of temporomandibular disorders, oral behaviors, anxiety, and depression in Dentistry students during the period of social isolation due to COVID-19.

OBJECTIVE: Temporomandibular dysfunction (TMD), anxiety, and depression are disorders that, due to the current lifestyle, are affecting an increasing portion of the population. Investigating the prevalence of the symptoms of these disorders during the quarantine due to the coronavirus 2019 pandemic (COVID-19) is important to outline clinical strategies for patient care. This study assessed the prevalence of TMD symptoms, anxiety, depression, and oral behaviors and their associations during the social isolation due to COVID-19. METHODOLOGY: Questionnaires were used to assess TMD symptoms in accordance with the Diagnostic Criteria for Temporomandibular Disorders: clinical protocol and assessment instruments, a questionnaire to verify oral behaviors and Hospital Anxiety and Depression Scale to assess symptoms of anxiety and depression in students of dentistry at the Faculty of Health Sciences of the University of Brasília in May 2020. Qualitative data were subjected to descriptive statistics and chi-squared analysis (p<0.05). The relationship between quantitative and qualitative data was evaluated using Spearman's rho correlation (p<0.05). RESULTS: There was a high prevalence of TMD symptoms, anxiety, and depression in the participants, resulting in association between gender and anxiety symptoms (p=0.029). There was a positive correlation between oral behaviors and TMD symptoms (r=0.364; p<0.001), between oral behaviors and anxiety symptoms (r=0.312; p=0.001), and between oral behaviors and symptoms of depression (r=0.216; p=0.021). CONCLUSION: Social isolation due to the COVID-19 pandemic has an impact on the prevalence of TMD symptoms, anxiety, and depression.