Carvacrol-Loaded Nanoemulsion Promotes Tocolytic and Anti-Dysmenorrhea Effects in Rodents.

INTRODUCTION: Carvacrol is a phenolic constituent of essential oils that has antinociceptive, anti-inflammatory, and antioxidant activities. METHOD: This study aimed to evaluate the in vitro spasmolytic and in vivo anti-dysmenorrhea potential of a nanoemulsion-containing carvacrol (nanoCARV). RESULTS: In isolated rat uterus, nanoCARV reduced spontaneous contractions (pEC50 = 3.91 ± 0.25) and relaxed preparations pre-contracted with oxytocin (pEC50 = 3.78 ± 0.2), carbachol (pEC50 = 4.15 ± 0.4), prostaglandin F2α (pEC50 = 3.00 ± 0.36), and KCl (pEC50 = 3.98 ± 0.32). The investigation of the mechanism of action revealed significant differences (p < 0.05) between the pEC50 values of nanoCARV in the absence or presence of aminophylline or tetraethylammonium. In a primary dysmenorrhea model, treatment with nanoCARV reduced the number of oxytocin-induced abdominal writhes. CONCLUSIONS: These data indicate that the anti-dysmenorrhea effect of nanoCARV may be related to the relaxation of uterine smooth muscle, with participation of the cAMP signaling pathway and potassium channels.

Desmistificando a coleta citopatológica: uma forma de prevenir o câncer de colo do útero / Demystifying cytopathological collection: a way to prevent cervical cancer

Objetivo: Relatar uma ação de Educação em Saúde sobre a prevenção do câncer de colo uterino por meio da citologia. Método: Trata-se de um relato de experiência vivenciado por uma enfermeira durante uma ação a dez mulheres sobre a importância da coleta citopatológica para prevenção desse câncer. Foi realizada em maio de 2023, em uma unidade básica de saúde e dividida em três momentos: no primeiro, foi realizado um Brainstorm, no segundo um pré-teste utilizando uma dinâmica e o terceiro momento foi o pós-teste. Resultado: Foi evidenciado que as mulheres não tinham entendimento correto sobre a coleta citopatológica, as etapas do exame, ou seja, o conhecimento era insuficiente e não se sentiam preparadas para falar sobre o assunto. Conclusão: A ação permitiu um maior conhecimento das usuárias e das suas necessidades de entendimento e esclarecimentos sobre a coleta citopatológica, levando em consideração a sua importância no rastreio precoce de câncer de colo do útero.(AU)

Objective: To report a Health Education action on the prevention of cervical cancer through cytology. Method: This is an experience report lived by a nurse during an action with ten women on the importance of cytopathological collection for the prevention of this cancer. It was carried out in May 2023, in a basic health unit and divided into three moments: in the first, a Brainstorm was performed, in the second, a pre-test using a dynamic and the third moment was the post-test. Result: It was evidenced that the women did not have a correct understanding of the cytopathological collection, the examination steps, that is, the knowledge was insufficient and they did not feel prepared to talk about the subject. Conclusion: The action allowed for a greater knowledge of the users and their needs for understanding and clarification about the cytopathological collection, taking into account its importance in the early screening of cervical cancer.(AU)

Objetivo: Relatar un programa de educación sanitaria sobre la prevención del cáncer de cuello de útero mediante la citología. Método: Este es un informe de la experiencia de una enfermera durante una acción con diez mujeres sobre la importancia de la recolección citopatológica para prevenir este cáncer. Tuvo lugar en mayo de 2023 en una unidad básica de salud y se dividió en tres etapas: la primera fue una lluvia de ideas, la segunda fue un pre-test mediante dinámicas y la tercera fue el post-test. Resultados: Quedó claro que las mujeres no tenían una comprensión correcta de la colecta citopatológica y de las etapas del examen, o sea, sus conocimientos eran insuficientes y no se sentían preparadas para hablar del tema. Conclusión: La acción permitió una mayor concienciación de las usuarias y su necesidad de comprensión y aclaración sobre la colecta citopatológica, teniendo en cuenta su importancia en el cribado precoz del cáncer de cuello uterino.(AU)

Five-Year Outcomes With Pembrolizumab Versus Chemotherapy as First-Line Therapy in Patients With Non-Small-Cell Lung Cancer and Programmed Death Ligand-1 Tumor Proportion Score ≥ 1% in the KEYNOTE-042 Study.

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.We report 5-year results from the phase III KEYNOTE-042 study (ClinicalTrials.gov identifier: NCT02220894). Eligible patients with locally advanced/metastatic non-small-cell lung cancer (NSCLC) without EGFR/ALK alterations and with programmed death ligand-1 (PD-L1) tumor proportion score (TPS) ≥ 1% received pembrolizumab 200 mg once every 3 weeks for 35 cycles or chemotherapy (carboplatin + paclitaxel or pemetrexed) for 4-6 cycles with optional maintenance pemetrexed. Primary end points were overall survival (OS) in PD-L1 TPS ≥ 50%, ≥ 20%, and ≥ 1% groups. Patients who completed 35 cycles of pembrolizumab with ≥ stable disease could begin second-course pembrolizumab upon progression. One thousand two hundred seventy-four patients were randomly assigned (pembrolizumab, n = 637; chemotherapy, n = 637). Median follow-up time was 61.1 (range, 50.0-76.3) months. OS outcomes favored pembrolizumab (v chemotherapy) regardless of PD-L1 TPS (hazard ratio [95% CI] for TPS ≥ 50%, 0.68 [0.57 to 0.81]; TPS ≥ 20%, 0.75 [0.64 to 0.87]; TPS ≥ 1%, 0.79 [0.70 to 0.89]), with estimated 5-year OS rates with pembrolizumab of 21.9%, 19.4%, and 16.6%, respectively. No new toxicities were identified. Objective response rate was 84.3% among 102 patients who completed 35 cycles of pembrolizumab and 15.2% among 33 patients who received second-course pembrolizumab. First-line pembrolizumab monotherapy continued to show durable clinical benefit versus chemotherapy after 5 years of follow-up in PD-L1-positive, locally advanced/metastatic NSCLC without EGFR/ALK alterations and remains a standard of care.

Mixed laryngocele mimicking thyroid nodule.

Laryngocele is defined as a dilation of the laryngeal saccule forming an air sac. Some differential diagnoses for laryngocele have been reported. The aim of the present paper was to describe a case of a patient referred for the evaluation a suspected thyroid nodule that was subsequently diagnosed as a mixed laryngocele. A 31-year-old male with no clinical manifestations was referred by an endocrinologist to undergo Doppler ultrasonography and fine-needle aspiration biopsy due to a preliminary ultrasonographic diagnosis of a nodule apparently in the thyroid. The diagnosis of laryngocele was raised considering the cytopathological analysis and imaging exam. Computed tomography of the neck confirmed this hypothesis. The patient was counseled to consult a surgeon, but, up to the end of this report, continued asymptomatic and in follow-up. We report a mixed laryngocele with different clinical behavior, showing that laryngocele may appear to be another entity and drawing the attention of clinicians to imaging similarities.

Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis.

BACKGROUND: Obesity is considered a top public health concern, and its prevalence is growing every day. Thus, interventions to address this problem should be encouraged and further studied. In this regard, the aim of this review was to summarize the evidence of martial arts interventions to evaluate their effectiveness on the anthropometric and body composition parameters of overweight and obese subjects. METHODS: A systematic literature search was conducted on January 26, 2020 using the PubMed, Medline, Lilacs, Cochrane, and Scielo databases. Reference lists of eligible articles and relevant reviews have also been examined. All randomized clinical trials on martial arts that evaluated the anthropometric and body composition parameters of overweight and obese subjects were included, and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. The Downs & Black checklist was used to assess the quality of the studies. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42018086116). RESULTS: A total of 82 articles were identified from the initial search strategy. A further 2 articles were identified from the review of relevant bibliographies. Six studies encompassing 258 participants who were overweight or obese were included. Four studies reported Tai Chi practice, one study reported Kung Fu exercise, and another study reported martial arts exercise. The examined meta-analyses did not reveal significant benefits from martial arts practice over control groups after the experiment period for body mass index (- 1.34 kg/m2; 95% CI: - 2.72, 0.05), waist circumference (1.41 cm; 95% CI: - 0.72, 3.54) and percentage of body fat (- 0.75%; 95% CI: - 5.58, 4.08). CONCLUSION: The scarcity, heterogeneity, short intervention time, small sample size, and significant methodological limitations of the available studies do not allow to conclude whether martial arts are effective in the anthropometric and body composition parameters of overweight and obese individuals. This study highlights the need for more research to assess the benefits of martial arts for overweight and obese individuals.

Mass spectrometry imaging as a potential technique for diagnostic of Huanglongbing disease using fast and simple sample preparation.

Huanglongbing (HLB) is a disease of worldwide incidence that affects orange trees, among other commercial varieties, implicating in great losses to the citrus industry. The disease is transmitted through Diaphorina citri vector, which inoculates Candidatus Liberibacter spp. in the plant sap. HLB disease lead to blotchy mottle and fruit deformation, among other characteristic symptoms, which induce fruit drop and affect negatively the juice quality. Nowadays, the disease is controlled by eradication of sick, symptomatic plants, coupled with psyllid control. Polymerase chain reaction (PCR) is the technique most used to diagnose the disease; however, this methodology involves high cost and extensive sample preparation. Mass spectrometry imaging (MSI) technique is a fast and easily handled sample analysis that, in the case of Huanglongbing allows the detection of increased concentration of metabolites associated to the disease, including quinic acid, phenylalanine, nobiletin and sucrose. The metabolites abieta-8,11,13-trien-18-oic acid, suggested by global natural product social molecular networking (GNPS) analysis, and 4-acetyl-1-methylcyclohexene showed a higher distribution in symptomatic leaves and have been directly associated to HLB disease. Desorption electrospray ionization coupled to mass spectrometry imaging (DESI-MSI) allows the rapid and efficient detection of biomarkers in sweet oranges infected with Candidatus Liberibacter asiaticus and can be developed into a real-time, fast-diagnostic technique.

Inexpensive and nonconventional fabrication of microfluidic devices in PMMA based on a soft-embossing protocol.

This study describes an inexpensive and nonconventional soft-embossing protocol to produce microfluidic devices in poly(methyl methacrylate) (PMMA). The desirable microfluidic structure was photo-patterned in a poly(vinyl acetate) (PVAc) film deposited on glass substrate to produce a low-relief master. Then, this template was used to generate a high-relief pattern in stiffened PDMS by increasing of curing agent /monomer ratio (1:5) followed by thermal aging in a laboratory oven (200°C for 24 h). The stiffened PDMS masters were used to replicate microfluidic devices in PMMA based on soft embossing at 220-230°C and thermal sealing at 140°C. Both embossing and sealing stages were performed by using binder clips. The proposed protocol has ensured the replication of microfluidic devices in PMMA with great fidelity (>94%). Examples of MCE devices, droplet generator devices and spot test array were successfully demonstrated. For testing MCE devices, a mixture containing inorganic cations was selected as model and the achieved analytical performance did not reveal significant difference from commercial PMMA devices. Water droplets were successfully generated in an oil phase at rate of ca. 60 droplets/min (fixing the continuous phase flow rate at 100 µL/h) with size of ca. 322 ± 6 µm. Glucose colorimetric assay was performed on spot test devices and good detectability level (5 µmol/L) was achieved. The obtained results for two artificial serum samples revealed good agreement with the certified concentrations. Based on the fabrication simplicity and great analytical performance, the proposed soft-embossing protocol may emerge as promising approach for manufacturing PMMA devices.

Fabrication of microwell plates and microfluidic devices in polyester films using a cutting printer.

This study reports, for the first time, the possibility to manufacture analytical devices on polyester substrates using a cutting printer. The protocol involves the design of a layout in a graphical software, the cut into polyester films and the lamination against one or multiple polyester films coated with a thermosensitive layer. The feasibility of the proposed approach was demonstrated through the fabrication of 96-microwell plates, 3D microfluidic mixing and distance-based microfluidic devices. The printer has enabled cutting microchannels wider than 300 µm on polyester films and a thickness of 250 µm. Urea and glucose assays were performed on microwell plates aiming for their quantification in artificial urine and serum samples. The presented results revealed good agreement with the expected values. The complexation reaction between Fe2+ and o-phenanthroline was selected as model to investigate the feasibility of the 3D mixing device. Absorbance measurements were recorded for the reaction product performed in both on and off-chip modes. Considering the achieved data, the on-chip mixing exhibited similar behavior when compared to off-chip reaction, thus demonstrating to be efficient to perform mixtures due to the turbulence generated inside three-dimensional channels. Lastly, a distance-based device was designed to detect H2O2 based on the displacement of a dye plug promoted by the oxygen generation using a copper-modified paper sheet. The distance-based peroxymeter revealed a linear behavior in the concentration range between 1 and 5% (v/v) and a LOD equal to 0.5% (65.2 mM). Based on the results herein reported, the proposed method represents a simple and alternative protocol to produce microdevices, using affordable and inexpensive raw materials, within 10 min, and at a cost lower than US$ 0.10 per unit.

The long noncoding RNA KIAA0125 is upregulated in ameloblastomas.

Ameloblastoma and adenomatoid odontogenic tumor (AOT) are jaw tumors derived from the teeth forming apparatus. While ameloblastoma is a destructive, debilitating lesion, with conventional surgical treatment leading to facial deformity and morbodities, AOT shows indolent clinical behavior. The underlying molecular mechanisms associated with their biological behavior are unknown. The use of high-density whole-genome microarray analysis in ameloblastomas and AOT revealed high frequency of genomic gain at 14q32.33, which encompasses the long noncoding RNA (lncRNA) gene KIAA0125. In the present study, we aimed to investigate the expression profile of KIAA0125 in these tumors. Thirteen samples were included (five solid/multicystic ameloblastomas, four AOT, and four dental follicles). The relative quantification of KIAA0125 expression was obtained by qPCR and interactions of KIAA0125 were in silico predicted. We detected higher levels of KIAA0125 transcripts in the ameloblastoma group compared to dental follicles (p = 0.042). The expression levels of KIAA0125 in AOT were not different from that of dental follicles. KIAA0125 was predicted to interact with 41 miRNA families. Four miRNAs of these families have been previously reported differentially expressed in ameloblastoma, being miR-135a-5p, miR-204-5p and miR-205-5p upregulated, and miR-150-5p downregulated. The lncRNA KIAA0125 is likely involved in the ameloblastoma pathobiology. LncRNAs hold strong promise as therapeutic targets and experimental validation of this lncRNA functions may lead to tailored therapies targeting KIAA0125 in extensive and recurrent ameloblastoma cases.

Relationships between physical activity, quality of life, and age in women attending social groups for the elderly / Relações entre atividade física, qualidade de vida e idade em mulheres que frequentam grupos sociais de idosos

AIMS: To analyze factors associated with physical activity levels among older women attending social groups for the elderly. METHODS: A cross-sectional study was conducted with elderly women enrolled in the Municipal Social Development Foundation in the city of Tubarão, in south Brazil. Sociodemographic and health status variables were evaluated through questionnaires administered during interviews, and by anthropometric evaluation. The level of physical activity was assessed using the Modified Baecke Questionnaire for the Elderly. Quality of life was assessed using the World Health Organization Quality of Life Assessment for older adults. RESULTS: Out of 306 elderly women included in the study, 214 (69.9%) were defined as physically inactive and 92 (30.1%) were active. The proportion of physically active participants between 60-69 years of age was 52.2%, between 70-79 years was 40.2% and equal or more than 80 years was 7.6% (p=0.011). No other sociodemographic or anthropometric characteristics were associated with physical activity. In the non-adjusted analysis there was association between physical activity and better quality of life, as well as with fewer diseases. There was a weak negative correlation between physical activity and number of diseases (correlation coefficient=0.215) and a weak positive correlation between physical activity and quality of life scores (correlation coefficient=0.284). In the adjusted analysis, physical activity remained as a protection factor for loss of quality of life: prevalence ratio=0.88 (95% confidence interval=0.81-0.96), p=0.003. CONCLUSIONS: The study concluded that physical activity in elderly women was associated with better quality of life, even when adjusted for age

OBJETIVOS: Analisar os fatores associados aos níveis de atividade física em mulheres idosas que frequentam grupos sociais para idosos. MÉTODOS: Estudo transversal, realizado com mulheres idosas cadastradas na Fundação Municipal de Desenvolvimento Social, na cidade de Tubarão, no sul do Brasil. As variáveis sociodemográficas e de estado de saúde foram avaliadas por meio de questionários aplicados durante as entrevistas e por avaliação antropométrica. O nível de atividade física foi avaliado pelo Questionário Baecke Modificado para Idosos. A qualidade de vida foi avaliada pelo questionário World Health Organization Quality of Life assessment for older adults. RESULTADOS: Das 306 idosas incluídas no estudo, 214 (69,9%) foram definidas como fisicamente inativas e 92 (30,1%) como ativas. A proporção de participantes fisicamente ativas entre 60-69 anos de idade foi de 52,2%, entre 70-79 anos foi de 40,2% e igual ou maior que 80 anos foi de 7,6% (p=0,011). Nenhuma outra característica sociodemográfica ou antropométrica foi associada à atividade física. Na análise não ajustada houve associação entre atividade física e melhor qualidade de vida, assim como com menos doenças. Houve correlação negativa fraca entre atividade física e número de doenças (coeficiente de correlação= ­0.215) e positiva fraca entre atividade física e nível de qualidade de vida (coeficiente de correlação=0.284). Na análise ajustada, a atividade física permaneceu como fator de proteção para perda de qualidade de vida: razão de prevalência=0,88 (intervalo de confiança 95%=0,81-0,96), p=0,003. CONCLUSÕES: O estudo concluiu que a atividade física em mulheres idosas foi associada à melhor qualidade de vida, mesmo na análise ajustada por idade.

Uncovering the Formation of Color Gradients for Glucose Colorimetric Assays on Microfluidic Paper-Based Analytical Devices by Mass Spectrometry Imaging.

This study describes the use of mass spectrometry imaging with matrix-assisted laser desorption/ionization (MALDI) and desorption electrospray ionization (DESI) to understand the color gradient generation commonly seen in microfluidic paper-based analytical devices (µPADs). The formation of color gradients significantly impacts assay sensitivity and reproducibility with µPADs but the mechanism for formation is poorly understood. The glucose enzymatic assay using potassium iodide (KI) as a chromogenic agent was selected to investigate the color gradient generated across a detection spot. Colorimetric measurements revealed that the relative standard deviation for the recorded pixel intensities ranged between 34 and 40%, compromising the analytical reliability. While a variety of hypotheses have been generated to explain this phenomenon, few studies have attempted to elucidate the mechanisms associated with its formation. Mass spectrometry imaging using MALDI and DESI was applied to understand the nonuniform color distribution on the detection zone. MALDI experiments were first explored to monitor the spatial distribution of the glucose oxidase and horseradish peroxidase mixture, before and after lateral flow assay with and without KI. MALDI(+)-TOF data revealed uniform enzyme distribution on the detection spots. On the other hand, after the complete assay DESI(-) measurements revealed a heterogeneous shape indicating the presence of iodide and triiodide ions at the zone edge. The reaction product (I3-) is transported by lateral flow toward the zone edge, generating the color gradient. Mass spectrometry imaging has been used for the first time to prove that color gradient forms as result of the mobility small molecules and not the enzyme distribution on µPAD surface.

Aptidão física relacionada à saúde de escolares brasileiros praticantes de karatê / Health-related physical fitness in brazilian schoolchildren practioners of karate

A aptidão física se mostra importante em qualquer fase da vida, mas na infância e na adolescência possui um papel fundamental. Diante disso, o objetivo do presente estudo foi analisar a aptidão física relacionada à saúde de escolares brasileiros praticantes de karatê e comparar as diferenças entre os sexos. Realizou-se estudo epidemiológico transversal, de base escolar, com alunos da rede pública e privada do município de Tubarão (SC), praticantes de karatê. A aptidão física relacionada à saúde foi avaliada mediante a realização dos testes motores sentar e alcançar, abdominal modificado em um minuto e, corrida/caminhada de nove minutos. O índice de massa corporal foi utilizado para classificação nutricional e o somatório das espessuras de dobras cutâneas tricipital e panturrilha medial foi utilizado como indicador de gordura corporal. Todos os critérios e as classificações utilizados foram recomendados pelo Physical Best. Foi adotado significância de p<0,05. A classificação obtida através do índice de massa corporal indica que 77,8% dos meninos e 69,6% das meninas encontram-se com estado nutricional adequado. Na avaliação da gordura corporal, 50% dos meninos e 74,7% das meninas possuem quantidade adequada. Nos testes motores, alcançaram os critérios estabelecidos 48,1% dos meninos e 63,3% das meninas no sentar-e-alcançar; 45,4% e 30,4%, respectivamente, no abdominal modificado em um minuto, e 22,2% e 48,1%, respectivamente, na corrida/caminhada de nove minutos. Em conclusão, os resultados indicam que a prática regular de karatê possa contribuir para o desenvolvimento de melhores índices de aptidão física relacionada à saúde de escolares.

Physical fitness shows very important at any stage of life, but in childhood and adolescence has a very important role. Therefore, the objective of the present study was to analyze the health-related physical fitness Brazilians schoolchildren who practice karate and to compare the differences between the sexes. A cross-sectional study was realized, school-based, performed with students from public and private schools of Tubarão municipality (SC), karate practitioners. The health-related physical fitness was evaluated by motor tests, sit and reach, modified sit-ups in one minute and nine minutes run/walk. The body mass index was used for nutritional classification and the sum of skinfold thicknesses of triceps and medial calf was used as indicator of body fat. All used criteria and ratings were referenced by the "Physical Best". A p-value <0.05 was considered statistically significant. The classification obtained through the body mass index indicates that 77,8% of boys and 69,6% of girls are with good nutritional status. In the assessment of body fat, 50,0% of boys and 74,7% girls have a proper amount. In motor tests, 48,1% of boys and 63,3% girls in sit-and-reach; 45,4% and 30,4% respectively, in the modified sit-ups in one minute, and 22,2% and 48,1%, respectively, in the nine minutes run/walk reached the established criteria. In conclusion, the results of this study indicate that the regular practice of karate can contribute to the development of better students of health-related physical fitness rates.

Clinical complications in renal biopsy using two different needle gauges: The impact of large hematomas, a random clinical trial study.

OBJECTIVE: To compare complications of ultrasound-guided percutaneous renal biopsy using two needle gauges (16-G and 18-G). METHODS: A total of 238 individuals with renal biopsy indication were included and randomly separated into two groups: ultrasound-guided percutaneous renal biopsy procedure carried out with a 16-G or 18-G needle. The adequacy of biopsy samples and post-procedure complications were compared between the two groups. RESULTS: The procedures carried out with a 16-G needle collected fragments with a mean of 22.1 ± 10.8 glomeruli, and those carried out with an 18-G needle had a mean of 17.5 ± 9.4 glomeruli. Patients submitted to renal biopsies with a 16-G needle had a higher likelihood of having a complication (OR5.1, 95% CI 1.7-15.4, P = 0.001). The overall mean volume of post-biopsy hematoma in patients with complications was significantly larger than those without complications (44 ± 56.1 mL vs 5.9 ± 6.6 mL; P < 0.001). CONCLUSIONS: Renal biopsies carried out by ultrasonography using an 18-G needle provide adequate histological analysis, showing a lower amount of glomeruli but with similar clinical quality as a 16-G needle. Furthermore, it is associated with a lower risk of procedure-related complications.

McKenzie Method of Mechanical Diagnosis and Therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up.

BACKGROUND: The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the exercise approaches recommended by low back pain (LBP) guidelines. We investigated the efficacy of MDT compared with placebo in patients with chronic LBP. METHODS: This was a prospectively registered, two-arm randomised placebo controlled trial, with a blinded assessor. A total of 148 patients seeking care for chronic LBP were randomly allocated to either MDT (n=74) or placebo (n=74). Patients from both groups received 10 treatment sessions over 5 weeks. Patients from both groups also received an educational booklet. Clinical outcomes were obtained at the end of treatment (5 weeks) and 3, 6 and 12 months after randomisation. Primary outcomes were pain intensity and disability at the end of treatment (5 weeks). We also conducted a subgroup analysis to identify potential treatment effect modifiers that could predict a better response to MDT treatment. RESULTS: The MDT group had greater improvements in pain intensity at the end of treatment (mean difference (MD) -1.00, 95% CI -2.09 to -0.01) but not for disability (MD -0.84, 95% CI -2.62 to 0.93). We did not detect between-group differences for any secondary outcomes, nor were any treatment effect modifiers identified. Patients did not report any adverse events. CONCLUSION: We found a small and likely not clinically relevant difference in pain intensity favouring the MDT method immediately at the end of 5 weeks of treatment but not for disability. No other difference was found for any of the primary or secondary outcomes at any follow-up times. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT02123394).

Histological and morphological evaluation of condylar cartilage of young rats in response to stimulation of mandibular protrusion / Avaliação histológica e morfológica da cartilagem condilar de ratos frente a estímulos de protrusão mandibular

The aim of this study was to evaluate the histogical and morphological aspects of the condyle in response to mandibular protrusion induced by composite resin occlusal planes. Thirty five-week-old male Wistar rats were selected and randomly divided in two groups. One group received a composite resin type of oclusal plane that induced mandibular protrusion, and the other was the control group, without treatment. Animals were euthanized after experimental time intervals of 7, 21 and 30 days. For histological analysis, thickness of the proliferative, serial and hypertrophic layers was measured, as well as each layer separately. The highest difference in cartilage thickness was observed at day 21, showing a significant increase of the proliferative layer. There were also other histomorphological changes related to occlusal plane interference. Condylar forward repositioning induced by composite occlusal planes influenced the endochondral ossification, increasing the proliferative layer.

Este estudo teve como objetivo avaliar os aspectos histológicos e morfológicos do côndilo mandibular diante da protrusão induzida por um plano inclinado fixo de resina. Para tanto, trinta ratos Wistar machos com cinco semanas de vida foram divididos aleatoriamente em dois grupos. Um grupo experimental (E) recebeu o plano inclinado fixo de resina, que induziu a mandíbula à protrusão, e o outro consistiu no grupo controle (C), sem tratamento. Os animais foram eutanasiados após 7, 21 e 30 dias de experimento. Para análise histológica, foi realizada a mensuração da espessura condilar total, incluindo as camadas proliferativa, seriada e hipertrófica, assim como cada camada separadamente. A maior espessura da cartilagem foi observada em 21 dias no grupo E, com significante aumento da camada proliferativa. Também foram verificados níveis de histodiferenciação nos demais períodos, caracterizando interferência do plano inclinado. Concluiu-se que a indução do posicionamento condilar em avanço por meio do plano inclinado fixo interferiu no processo de ossificação endocondral, aumentando a atividade da camada proliferativa.

Versatile fabrication of paper-based microfluidic devices with high chemical resistance using scholar glue and magnetic masks.

Simple methods have been developed for fabricating microfluidic paper-based analytical devices (µPADs) but few of these devices can be used with organic solvents and/or aqueous solutions containing surfactants. This study describes a simple fabrication strategy for µPADs that uses readily available scholar glue to create the hydrophobic flow barriers that are resistant to surfactants and organic solvents. Microfluidic structures were defined by magnetic masks designed with either neodymium magnets or magnetic sheets to define the patter, and structures were created by spraying an aqueous solution of glue on the paper surface. The glue-coated paper was then exposed to UV/Vis light for cross-linking to maximize chemical resistance. Examples of microzone arrays and microfluidic devices are demonstrated. µPADs fabricated with scholar glue retained their barriers when used with surfactants, organic solvents, and strong/weak acids and bases unlike common wax-printed barriers. Paper microzones and microfluidic devices were successfully used for colorimetric assays of clinically relevant analytes commonly detected in urinalysis to demonstrate the low background of the barrier material and generally applicability to sensing. The proposed fabrication method is attractive for both its ability to be used with diverse chemistries and the low cost and simplicity of the materials and process.

Adherence to Back Pain Clinical Practice Guidelines by Brazilian Physical Therapists: A Cross-sectional Study.

STUDY DESIGN: This was a cross-sectional observational study. OBJECTIVES: (i) to investigate whether Brazilian physical therapists make clinical decisions for patients with low back pain based upon clinical practice guidelines and (ii) to determine whether the physical therapists are able to recognize differential diagnoses of low back pain associated with red or yellow flags. SUMMARY OF BACKGROUND DATA: Early adherence to clinical practice guidelines may accelerate recovery and reduce the costs associated with low back pain. It is unknown whether Brazilian physical therapists follow clinical practice guidelines to make their clinical decisions in the treatment of patients with low back pain. METHODS: The sample consisted of physical therapists from two Brazilian physical therapy associations. The data were collected via electronic survey and face-to-face interviews. The survey was composed of six hypothetical clinical cases of low back pain, which served as a basis to evaluate clinical decisions and adherence to clinical practice guidelines for low back pain. The study participants had 27 possible answers for each clinical case and could choose up to five answers. The results were analyzed in three ways: full adherence, partial adherence, or no adherence to the recommendations from clinical practice guidelines. RESULTS: A total of 530 physical therapists were invited and 189 participated in the study (response rate = 35.6%). Full adherence to the guidelines was low for all six cases (rates ranging from 5%-24%). Partial adherence to the guidelines was higher when compared with full adherence (rates ranging from 32%-75%). The participants were more likely to identify differential diagnoses associated with yellow flags than with red flags. CONCLUSION: Brazilian physical therapists are not using the best available evidence in their clinical decision making for patients with low back pain. Wider dissemination of clinical practice guidelines should be urgently undertaken. LEVEL OF EVIDENCE: 2.

Does cell phone use increase the chances of parotid gland tumor development? A systematic review and meta-analysis.

BACKGROUND: Prior epidemiological studies had examined the association between cell phone use and the development of tumors in the parotid glands. However, there is no consensus about the question of whether cell phone use is associated with increased risk of tumors in the parotid glands. We performed a meta-analysis to evaluate the existing literature about the mean question and to determine their statistical significance. METHODS: Primary association studies. Papers that associated cell phone use and parotid gland tumors development were included, with no restrictions regarding publication date, language, and place of publication. Systematic literature search using PubMed, SciELO and Embase followed by meta-analysis. RESULTS AND CONCLUSION: Initial screening included 37 articles, and three were included in meta-analysis. Using three independent samples including 5087 subjects from retrospective case-control studies, cell phone use seems to be associated with greater odds (1.28, 95%- confidence interval: 1.09-1.51) to develop salivary gland tumor. Results should be read with caution due to the limited number of studies available and their retrospective design.