Effects of taping in patellofemoral pain syndrome: A systematic review.

BACKGROUND: Patellofemoral pain syndrome (PPS) is defined as a condition in the patellofemoral joint that can present with pain, functional deficit, crepitus, and instability. Its etiology appears to lie in excessive loading of the patellofemoral joint due to mispositioning of the patella. The application of taping has recently increased, to manage PPS. However, the level of scientific evidence in this sense is unknown. OBJECTIVE: To determine the effect of different types of taping in subjects with PPS. METHODS: A bibliographic search was carried out in January and February 2021 in Scopus, Web of Science, PubMed, Medline, SPORTDiscus, PEDro and CINAHL. RESULTS: A total of 13 studies were included for qualitative analysis. The mean score on the PEDro scale was 5.30 points. Most of the articles reflect a decrease in pain after the taping intervention, while variables such as functionality, muscle activity and biomechanical modification do not show positive effects. CONCLUSION: Taping appears to have positive effects on pain in subjects with PPS. However, the evidence is contradictory with the rest of the variables studied.

Consecuencias neurobiológicas del abuso sexual en la infancia: revisión de literatura / Neurobiological consequences of child sexual abuse: literature review / Consequências neurobiológicas do abuso sexual infantil: revisão da literatura

RESUMEN Objetivo: Describir las consecuencias neurobiológicas en ninos, ninas y adolescentes con antecedente de abuso sexual infantil (ASI). Metodologia: Se realizó una revisión de literatura entre los años 2015 al 2020 en tres bases de datos (Pubmed, Scopus, Scielo), utilizando las palabras clave: abuso sexual infantil, neurobiologia. Se recopiló información acerca de los tipos de alteraciones neurobiológicas (estructurales, funcionales, endocrinos, psicológicos, inmunológicos y genéticos) en ninos, ninas y adolescentes con antecedente de ASI. Se excluyeron articulos cuyo titulo o resumen no incluyeran los temas de esta revisión. Resultados: Se seleccionaron 99 estudios asociados a las consecuencias neurobiológicas del ASI, con las consecuentes alteraciones estructurales, funcionales, endocrinas, inmunológicos y genéticos que afectan a un importante número de victimas. Conclusiones: Diversos autores han encontrado una relación entre la exposición al ASI y los cambios neurobiológicos, visibilizando asi, el impacto que esto ocasiona en la salud de las victimas, por tal, se hace importante promover intervenciones tempranas y tratamiento adecuado por las múltiples consecuencias que genera, algunas irreversibles.

ABSTRACT Objective: To describe the neurobiological consequences in children and adolescents with a history of child sexual abuse (CSA). Methodology: A literature review was carried out between the years 2015 and 2020 in three databases (Pubmed, Scopus, Scielo), using the keywords: child sexual abuse, neurobiology Information was collected about the types of neurobiological alterations (structural, functional, endocrine, psychological, immunological and genetic) in children and adolescents with a history of CSA. Articles whose title or abstract did not include the topics of this review were excluded. Results: 99 studies associated with the neurobiological consequences of CSA were selected, with the consequent structural, functional, endocrine, immunological and genetic alterations that affect a significant number of victims. Conclusions: Various authors have found a relationship between exposure to CSA and neurobiological changes, thus making visible the impact that this causes on the health of the victims, therefore, it is important to promote early interventions and adequate treatment due to the multiple consequences that generates, some irreversible.

RESUMO Objetivo: Descrever as conseqüências neurobiológicas em crianças e adolescentes com histórico de abuso sexual infantil (CSA). Metodologia: Entre 2015 e 2020 foi realizada uma revisão bibliográfica em três bancos de dados (Pubmed, Scopus, Scielo), utilizando as palavras-chave: abuso sexual infantil, neurobiologia. Foram coletadas informações sobre os tipos de alterações neurobiológicas (estruturais, funcionais, endócrinas, psicológicas, imunológicas e genéticas) em crianças e adolescentes com histórico de CSA. Foram excluidos os artigos cujo titulo ou resumo não incluia os tópicos desta revisão. Resultados: Foram selecionados 99 estudos associados às conseqüências neurobiológicas da CSA, com conseqüentes alterações estruturais, funcionais, endócrinas, imunológicas e genéticas que afetam um número significativo de vitimas. Conclusões: Vários autores encontraram uma relação entre a exposição à CSA e as mudanças neurobiológicas, tornando assim visivel o impacto que isso tem na saúde das vitimas, por isso é importante promover intervenções precoces e tratamento adequado para as múltiplas conseqüências que ela gera, algumas das quais são irreversiveis.

Compositional and structural analysis of engineered stones and inorganic particles in silicotic nodules of exposed workers.

BACKGROUND: Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very high and this is the key factor, it has been postulated that other constituents in engineered stones can influence the aggressiveness of the disease. Different samples of engineered stone countertops (fabricated by workers during the years prior to their diagnoses), as well as seven lung samples from exposed patients, were analyzed by multiple techniques. RESULTS: The different countertops were composed of SiO2 in percentages between 87.9 and 99.6%, with variable relationships of quartz and cristobalite depending on the sample. The most abundant metals were Al, Na, Fe, Ca and Ti. The most frequent volatile organic compounds were styrene, toluene and m-xylene, and among the polycyclic aromatic hydrocarbons, phenanthrene and naphthalene were detected in all samples. Patients were all males, between 26 and 46 years-old (average age: 36) at the moment of the diagnosis. They were exposed to the engineered stone an average time of 14 years. At diagnosis, only one patient had progressive massive fibrosis. After a follow-up period of 8 ± 3 years, four patients presented progressive massive fibrosis. Samples obtained from lung biopsies most frequently showed well or ill-defined nodules, composed of histiocytic cells and fibroblasts without central hyalinization. All tissue samples showed high proportion of Si and Al at the center of the nodules, becoming sparser at the periphery. Al to Si content ratios turned out to be higher than 1 in two of the studied cases. Correlation between Si and Al was very high (r = 0.93). CONCLUSION: Some of the volatile organic compounds, polycyclic aromatic hydrocarbons and metals detected in the studied countertop samples have been described as causative of lung inflammation and respiratory disease. Among inorganic constituents, aluminum has been a relevant component within the silicotic nodule, reaching atomic concentrations even higher than silicon in some cases. Such concentrations, both for silicon and aluminum showed a decreasing tendency from the center of the nodule towards its frontier.

The diagnostic value of pleural fluid homocysteine in malignant pleural effusion.

BACKGROUND: Pleural fluid homocysteine (HCY) can be useful for diagnosis of malignant pleural effusion (MPE). There are no published studies comparing the diagnostic accuracy of HCY with other tumour markers in pleural fluid for diagnosis of MPE. The aim was to compare the accuracy of HCY with that of carcinoembryonic antigen (CEA), cancer antigen (CA) 15.3, CA19.9 and CA125 in pleural fluid and to develop a probabilistic model using these biomarkers to differentiate benign (BPE) from MPE. METHODS: Patients with pleural effusion were randomly included. HCY, CEA, CA15.3, CEA19.9 and CA125 were quantified in pleural fluid. Patients were classified into two groups: MPE or BPE. By applying logistic regression analysis, a multivariate probabilistic model was developed using pleural fluid biomarkers. The diagnostic accuracy was determined by receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). RESULTS: Population of study comprised 133 patients (72 males and 61 females) aged between 1 and 96 years (median = 70 years), 81 BPE and 52 MPE. The logistic regression analysis included HCY (p<0.0001) and CEA (p = 0.0022) in the probabilistic model and excluded the other tumour markers. The probabilistic model was: HCY+CEA = Probability(%) = 100×(1+e-z)-1, where Z = 0.5471×[HCY]+0.3846×[CEA]-8.2671. The AUCs were 0.606, 0.703, 0.778, 0.800, 0.846 and 0.948 for CA125, CA19.9, CEA, CA15.3, HCY and HCY+CEA, respectively. CONCLUSIONS: Pleural fluid HCY has higher accuracy for diagnosis of MPE than CEA, CA15.3, CA19.9 and CA125. The combination of HCY and CEA concentrations in pleural fluid significantly improves the diagnostic accuracy of the test.

Evidence of the Zanclean megaflood in the eastern Mediterranean Basin.

The Messinian salinity crisis (MSC) - the most abrupt, global-scale environmental change since the end of the Cretaceous - is widely associated with partial desiccation of the Mediterranean Sea. A major open question is the way normal marine conditions were abruptly restored at the end of the MSC. Here we use geological and geophysical data to identify an extensive, buried and chaotic sedimentary body deposited in the western Ionian Basin after the massive Messinian salts and before the Plio-Quaternary open-marine sedimentary sequence. We show that this body is consistent with the passage of a megaflood from the western to the eastern Mediterranean Sea via a south-eastern Sicilian gateway. Our findings provide evidence for a large amplitude drawdown in the Ionian Basin during the MSC, support the scenario of a Mediterranean-wide catastrophic flood at the end of the MSC, and suggest that the identified sedimentary body is the largest known megaflood deposit on Earth.

Síndrome de apneas del sueño: revisión de 25 años de experiencia / Sleep apnea syndrome: review of 25 years of experience / Síndrome da apnéia do sono: revisão de 25 anos de experiência

El conocimiento científico y clínico sobre los trastornos respiratorios del sueño se ha desarrollado de manera acelerada en las últimas décadas. El objetivo de este estudio es presentar la experiencia adquirida en nuestro país, en el diagnóstico y tratamiento del síndrome de apneas del sueño de tipo obstructivo, durante el desarrollo de una nueva disciplina en el ámbito de la neumología. Se revisaron los registros de 3109 pacientes; 447 con historias clínicas electrónicas y cuestionarios para cuantificación de síntomas y 1779 polisomnografías de pacientes con apneas de tipo obstructivo. Se presenta la evolución de la referencia de pacientes, las características demográficas (en especial el aumento de la prevalencia en jóvenes) y los hallazgos clínicos más frecuentes. Se destacan los factores de riesgo relevantes: obesidad y su relación con la severidad, enfermedades endocrinas y desplazamiento cefálico de fluidos. Se destaca el modo de acceso y la adherencia al tratamiento. La implementación de unidades clínicas de sueño permitió la referencia de pacientes para el diagnóstico y el tratamiento, dando lugar a una nueva disciplina de la neumología. La prevalencia de las apneas obstructivas del sueño es muy elevada, con progresivo y sostenido incremento. El tratamiento con aplicación de presión nasal no invasiva es factible. Aunque con distintos grados de accesibilidad y adherencia, ha permitido la corrección del trastorno respiratorio del sueño más relevante.

Scientific and clinical knowledge on sleep-disordered breathing has developed at an accelerated pace in the last decades. The objective of this study is to present the experience gained in our country in the diagnosis and treatment of obstructive sleep apnea syndrome during the development of a new discipline in the field of pneumology. Clinical records of 3109 patients were reviewed; 447 with electronic medical records and questionnaires for quantification of symptoms and 1779 polysomnographies of patients with obstructive apneas. The time evolution of the patient referral, the demographic characteristics (especially the increase in the prevalence in young people) and the most frequent clinical findings are presented. We highlight the relevant risk factors: obesity and its relationship with severity, endocrine diseases and cephalic fluid displacement. Access mode and adherence to treatment are highlighted. The implementation of sleep clinics allowed the referral of patients for diagnosis and treatment, giving rise to a new discipline of pneumology. The prevalence of obstructive sleep apnea is high, with progressive and sustained increase. Treatment with non-invasive nasal pressure application is feasible. Although with different degrees of accessibility and adherence, it has allowed the correction of the most relevant respiratory sleep disorder

O conhecimento científico e clínico sobre os transtornos respiratórios do sono desenvolveu-se rapidamente nas últimas décadas. O objetivo deste estudo é apresentar a experiência adquirida em nosso país no diagnóstico e tratamento da síndrome da apneia obstrutiva do sono durante o desenvolvimento de uma nova disciplina no campo da pneumologia. Os registros de 3109 pacientes foram revisados; 447 com registros médicos eletrônicos e questionários para quantificação de sintomas e 1779 polissonografias de pacientes com apnéia obstrutiva. Apresentamos a evolução da referência do paciente, as características demográficas (especialmente o aumento da prevalência em jovens) e os achados clínicos mais freqüentes. Destacamos os fatores de risco relevantes: obesidade e sua relação com severidade, doenças endócrinas e deslocamento do cefálico de fluídos. O modo de acesso e a adesão ao tratamento são destacados. A implementação de unidades de sono clínicas permitiu a referência de pacientes para diagnóstico e tratamento, dando origem a uma nova disciplina de pneumologia. A prevalência da apneia obstrutiva do sono é muito alta, com aumento progressivo e sustentado. O tratamento com pressão nasal não invasiva é viável. Embora com diferentes graus de acessibilidade e adesão, permitiu a correção do transtorno do sono respiratório mais relevante.

Oxigenoterapia domiciliaria en la hipertensión pulmonar y patologias no respiratorias autores / No disponible

No disponible

Pérola de esmalte: epidemiologia, morfopatogênese e relevância na clínica odontológica / Enamel pearl: epidemiology, morphopathogenesis and relevance in dental clinic

Introdução: Distúrbios da odontogênese geram anomalias dentárias com relevância diagnóstica e terapêutica. Objetivo: O presente artigo teve como objetivos fazer uma revisão sistemática sobre a pérola de esmalte e discutir seu processo formativo, bem como a sua significância na clínica odontológica. Material e Método: Três bancos de dados eletrônicos (Pubmed, Cochrane e Biblioteca Virtual em Saúde) foram usados para recuperar artigos científicos dos últimos 30 anos, usando o descritor enamel pearls. Resultado: O Brasil ocupa posição de destaque nas publicações temáticas existentes (18%). A etiopatogênese desta anomalia ainda permanece obscura, sendo necessários mais estudos acerca da contribuição de fatores envolvidos com amelogênese ectópica e cementogênese deficiente in situ. Dados epidemiológicos apontam uma frequência variável na população brasileira (0,8 a 8%) e mundial (0,2 a 6,2%), sendo os molares os dentes mais acometidos. Análise morfológica das pérolas de esmalte mostra que esta anomalia de forma e volume pode ser de dois tipos: simples (pérola verdadeira externa ou interna) ou composta (esmalte-dentina ou esmalte-dentina-polpa). É importante o diagnóstico clínico-radiológico diferencial de pérolas de esmalte para permitir o tratamento odontológico adequado, que inclui a ameloplastia como conduta eficaz para minimizar o acúmulo de biofilme oral e a exarcerbação da doença periodontal. Conclusão: Faz-se necessária a publicação de pesquisas pormenorizadas sobre pérolas de esmalte, a fim de gerar evidências científicas no fazer profissional da Odontologia.

Introduction: Disturbances in odontogenesis generate dental anomalies with diagnostic and therapeutic relevance. Objective: The aim of this article was to do the systemic review about pearl enamel, and discuss their formation process and its significance in clinical dentistry. Material and Method: Three electronic databases (Pubmed, Cochrane and Biblioteca Virtual em Saúde) were used to retrieve scientific articles in the last 30 years, using the descriptor enamel pearls. Result: Brazil occupies a prominent position in existing thematic publications (18%). Etiopathogenesis of this dental anomaly remains obscure, and more researches are needed regarding factors involved in ectopic amelogenesis and deficient cementogenesis in situ. Epidemiological data show variable frequency in the Brazilian population (0.8-8%) and in the global population (0,2-6,2%), with a higher incidence in the molars. Morphological analysis of enamel pearls shows that this shape and volume anomaly can be of two types: simple (external or internal true pearl) or compound (enamel-dentine or enamel-dentine-pulp). It is important the clinical and imaginological differential diagnosis of enamel pearls to allow adequate dental treatment that include enameloplasty as an effective conduct to minimize oral biofilm accumulation and worsening of periodontal disease. Conclusion: It is necessary to publish detailed researches about enamel pearls in order to generate scientific evidence in dental practice.

Estudio prospectivo de 221 neumonías adquiridas en la comunidad seguidas de forma ambulatoria. Etiología y evolución clinicorradiológica / Prospective study of 221 community acquired pneumonias followed up in an outpatient clinic. Etiology and clinical-radiological progression

FUNDAMENTO: Se estudiaron de forma prospectiva las neumonías adquiridas en la comunidad seguidas en una consulta neumológica extrahospitalaria, con objeto de determinar la etiología, las características clinicorradiológicas y su evolución con unas pautas de actuación y tratamiento protocolizadas. PACIENTES Y MÉTODO: Se realizaron protocolos de evaluación clínica, diagnóstico etiológico por serología (en la primera visita y a las tres semanas) y, en los casos necesarios, por fibrobroncoscopia (cepillo microbiológico protegido), así como protocolos de evolución clínica y radiológica (hasta tres revisiones) tras pautas de tratamiento empírico previamente establecidos. RESULTADOS: Se incluyó inicialmente a 240 pacientes, siendo seguidos un total de 221 casos. Obtuvimos el diagnóstico etiológico en 86 pacientes (39 por ciento), siendo el germen más frecuente Coxiella burnetii (12,2 por ciento), seguido de Mycoplasma pneumoniae y Legionella pneumophila. Se diagnosticaron dos casos de Sptreptococcus pneumoniae. La forma de presentación radiológica más frecuente fue la condensación alveolar (86 por ciento). Se emplearon como tratamiento empírico inicial macrólidos (71 por ciento) o cefalosporinas de segunda generación (22 por ciento). La evolución clínica y radiológica fue satisfactoria en la mayoría de los pacientes, siendo necesario el ingreso hospitalario en dos casos (< 1 por ciento del total). CONCLUSIONES: En las neumonías adquiridas en la comunidad en régimen ambulatorio encontramos un elevado número de gérmenes 'atípicos'. En pacientes ambulatorios creemos apropiado el tratamiento empírico con macrólidos o cefalosporinas de segunda generación (AU)

Neurosida: Estudio descriptivo, clinico-paraclinico de 50 pacientes infectados por el VIH / Neurological AIDS: a descriptive, clinical-paraclinical study of 50 patients infected with HIV

Es conocido el elevado neurotropismo del virus de la inmunodeficiencia humana (VIH), tanto en sus manifestaciones clinico-patologicas como paraclinicas. Dichas manifestaciones pueden ser la consecuencia de la agresion directa del virus sobre el SNC y periferico o proporcionar alteraciones inmunitarias que faciliten la aparicion de infecciones o neoplasias. Existen aspectos controvertidos en esta patologia. Con el proposito de aportar informacion acerca de estos aspectos, mas especificamente sobre la patologia por agresion directa del VIH, se estudiaron 50 pacientes infectados con el virus, 27 en estado II - III del CDC, y 23 en estadio IV, realizando un estudio transversal, clinico paraclinico, (EEG, Potenciales evocados multimodales, Estudio electrico periferico, TAC y estudio del LCR citobioquimico e inmunoproteico), comparando posteriormente los hallazgos obtenidos. El estudio ha evidenciado la afectacion precoz del sistema nervioso en la enfermedad, tanto en el area clinica , neuropsicologica, y estudio del LCR (citobioquimico e inmunoproteico), como en los potenciales evocados auditivos y el estudio electrico periferico. Se constata asimismo un deterioro progresivo en el SNC y periferico en las pruebas relacionadas segun los estudios clinicos existiendo una correlacion casi paralela entre el estudio neuropsicologico, el estudio electrico periferico, la TAC y el EEG