Incapacidad relacionada con el dolor lumbar crónico: prevalencia y factores asociados

A incapacidade relacionada à dor lombar crônica (DLC) é um fenômeno complexo e multifatorial. O objetivo desse estudo foi identificar a prevalência e os fatores associados à incapacidade em pacientes com dor lombar crônica. Estudo transversal com amostra composta por 177 pacientes com DLC, de três serviços de saúde; que responderam ao formulário com dados demográficos, ao Inventário de Depressão de Beck, às Escalas Oswestry Disability Index, de autoeficácia para dor crônica, Tampa de Cinesiofobia e de Fadiga de Piper. A prevalência de incapacidade foi de 65% (IC95%: 57,5 - 72,0) e era de moderada a grave em 80,7% dos pacientes. O modelo de regressão múltipla identificou três fatores independentemente associados à incapacidade: ausência de trabalho remunerado, autoeficácia baixa e depressão. Os fatores associados à incapacidade identificados são modificáveis. Intervenções como recolocação no trabalho, tratamento para a depressão e reconceitualização da crença de autoeficácia podem ter um impacto importante na prevenção e redução de incapacidade.La discapacidad relacionada con el dolor lumbar crónico (DLC) es complejo y multifactorial. El objetivo fue identificar la prevalencia y factores asociados a la discapacidad en pacientes con DLC. Estudio transversal con 177 pacientes de tres servicios de salud; que respondieron al formulario con los datos demográficos, Inventario de Depresión de Beck, Escala de discapacidad de Oswestry, autoeficacia para el dolor crónico, Tampa kinesiophobia and Piper fatiga. La prevalencia de la discapacidad fue del 65% (IC 95%: 57,5 a 72,0) y de moderada a severa en 80,7% de los pacientes. El modelo de regresión se identificó tres factores independientemente asociados con la discapacidad: la falta de trabajo, baja autoeficacia y la depresión. Los factores identificados son modificables. Intervenciones como el trabajo de sustitución, el tratamiento de la depresión y la reconceptualización de la creencia de la autoeficacia puede tener un impacto importante en la prevención y reducción de la discapacidad.Disability related to chronic low back pain (CLBP) is a complex and multidimensional phenomenon. The aim of the study was to identify the prevalence of disability and factors associated with disability outcome in 177 CLBP adults. Respondents were recruited from three health care service centers and answered questions from: Demographic Identification Form, Oswestry Disability Index, Chronic Pain Self-efficacy Scale, Tampa Scale Kinesiophobia, Beck Depression Inventory, and the Revised Piper Fatigue Scale. The prevalence of disability among the respondents was 65% (95% CI: 57.5 - 72.0), and disability was moderate to severe in 80.7% of them. The multiple regression model identified three factors as independently associated with disability: work situation, low self-efficacy and depression. The factors identified to be associated with disability are modifiable. Interventions such as work relocation, depression treatment and re-conceptualization of self-efficacy may have an important impact in preventing and reducing disability in chronic low back pain patients

Amateur Female Athletes Perform the Running Split of a Triathlon Race at Higher Relative Intensity than the Male Athletes: A Cross-Sectional Study

Maximal oxygen uptake (V˙O2max), ventilatory threshold (VT) and respiratory compensation point (RCP) can be used to monitor the training intensity and the race strategy, and the elucidation of the specificities existing between the sexes can be interesting for coaches and athletes. The aim of the study was to compare ventilatory threshold (VT), respiratory compensation point (RCP), and the percentage of the maximal aerobic speed (MAS) that can be maintained in a triathlon race between sexes. Forty-one triathletes (22 men and 19 women), 42.1 ± 8.4 (26 to 60) years old, that raced the same Olympic triathlon underwent a cardiorespiratory maximal treadmill test to assess their VT, RPC, and MAS, and race speed. The maximal oxygen uptake (V˙O2max) (54.0 ± 5.1 vs. 49.8 ± 7.7 mL/kg/min, p < 0.001) and MAS (17 ± 2 vs. 15 ± 2 km/h, p = 0.001) were significantly higher in male than in female athletes. Conversely, there were no sex differences according to the percentage of V˙O2max reached at VT (74.4 ± 4.9 vs. 76.1 ± 5.4%, p = 0.298) and RCP (89.9 ± 3.6 vs. 90.6 ± 4.0%, p = 0.560). The mean speed during the race did not differ between sexes (12.1 ± 1.7 km/h and 11.7 ± 1.8 km/h, p = 0.506, respectively). Finally, men performed the running split at a lower percentage of speed at RCP than women (84.0 ± 8.7 vs. 91.2 ± 7.0%, respectively, p = 0.005). Therefore, male and female athletes accomplished the running split in an Olympic triathlon distance at distinct relative intensities, as female athletes run at a higher RCP percentage

Estratégias de neuromodulação para o tratamento da depressão maior: desafios e recomendações de uma força-tarefa

The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). METHOD: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. RESULTS: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. DISCUSSION: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.O uso de técnicas de neuromodulação para o tratamento do transtorno depressivo maior (TDM) tem despertado um renovado interesse nos últimos anos com o desenvolvimento de outras intervenções não-farmacólogicas além da eletroconvulsoterapia (ECT), como a estimulação magnética transcraniana (EMT), a estimulação transcraniana por corrente continua (ETCC), a estimulação cerebral profunda (DBS) e a estimulação de nervo vago (VNS). MÉTODO: Nós organizamos um grupo de trabalho com vários pesquisadores para discutir os avanços recentes e os principais desafios para o uso da neuromodulação no tratamento do TDM. RESULTADOS: O estado-da-arte da neuromodulação foi revisado e discutido em quatro seções: [1] epidemiologia e fisiopatologia do TDM; [2] uma revisão das técnicas de neuromodulação; [3] o uso das técnicas de neuromodulação na depressão que ocorre associada ou em virtude de condições não-psiquiátricas; [4] os principais desafios da pesquisa na neuromodulação e alternativas para superá-los. DISCUSSÃO: ECT é o tratamento de primeira linha para depressão grave. EMT e ETCC são estratégias com um perfil benigno de efeitos adversos; contudo, enquanto os efeitos da EMT são comparáveis ao das drogas antidepressivas para o tratamento da TDM, a eficácia da ETCC ainda precisa ser estabelecida por mais pesquisas clínicas. DBS e VNS são intervenções invasivas com um papel possível para a depressão refratária. Em resumo, TDM é uma condição crônica, incapacitante e de alta prevalência; portanto na prática clínica todas as opções de tratamento possíveis, incluindo as farmacológicas e não-farmacológicas, devem ser consideradas.University of São Paulo Department and Institute of PsychiatryHospital 9 de Julho Pain Center and Functional NeurosurgeryUniversity of Paulo Department of Physical Medicine and RehabilitationUniversity of Brasília Laboratory of Neurosciences and BehaviorColumbia UniversityFederal University of Minas Gerais Faculty of Medicine Department of Internal Medicine (Neurology Unit)Centro Brasileiro de Estimulação MagnéticaFederal University of São Paulo Department of PsychiatryUniversity MackenzieSpaulding Rehabilitation Hospital Laboratory of NeuromodulationHarvard Medical SchoolBerenson-Allen Center for Noninvasive Brain StimulationHarvard Medical School Beth Israel Deaconess Medical CenterUNIFESP, Department of PsychiatrySciEL

Comparative analysis of Amputee Soccer players and coach perception of intensity training

We investigate if there are agreement and differences between the training intensity and load prescribed by the coach and those perceived by Amputee Soccer (AS) players. Eleven AS players and the team coach participated in the study. Before each session, we registered the coach Rating Perceived Exertion (RPE) intended (not disclosed to the players). Immediately after the training session, the players responded to the same version of RPE individually. The load was quantified through the session-RPE (s-RPE) (RPE x minutes). In sessions 1 and 2, the coach overestimated the training RPE (p &lt; 0.05; Effect size [ES] = 0.2 and 0.3), whereas in sessions 4 and 5 the values were underestimated (p &lt; 0.05; ES = 0.3). In the case of s-RPE, the overestimation of RPE occurred in session 1 (p = 0.02; ES = 0.9), whereas in sessions 4 and 5 (p &lt; 0.05; ES = 1.8 and 0.9) the coach underestimated the load values. We conclude that the training load planned by the coach is different and disagrees with the perception of the AS players in most of the training sessions.We investigate if there are agreement and differences between the training intensity and load prescribed by the coach and those perceived by Amputee Soccer (AS) players. Eleven AS players and the team coach participated in the study. Before each session, we registered the coach Rating Perceived Exertion (RPE) intended (not disclosed to the players). Immediately after the training session, the players responded to the same version of RPE individually. The load was quantified through the session-RPE (s-RPE) (RPE x minutes). In sessions 1 and 2, the coach overestimated the training RPE (p &lt; 0.05; Effect size [ES] = 0.2 and 0.3), whereas in sessions 4 and 5 the values were underestimated (p &lt; 0.05; ES = 0.3). In the case of s-RPE, the overestimation of RPE occurred in session 1 (p = 0.02; ES = 0.9), whereas in sessions 4 and 5 (p &lt; 0.05; ES = 1.8 and 0.9) the coach underestimated the load values. We conclude that the training load planned by the coach is different and disagrees with the perception of the AS players in most of the training sessions

VEGETAÇÃO ARBÓREO-ARBUSTIVA DO PARQUE ESTADUAL NASCENTES DO PARANAPANEMA, SERRA DE PARANAPIACABA, CAPÃO BONITO, SP, BRASIL

O continuum ecológico da Serra de Paranapiacaba constitui uma das áreas mais conservadas entre os remanescentes de Floresta Atlântica no Brasil. Este trabalho apresenta a vegetação do Parque Estadual Nascentes do Paranapanema – PENAP, composta por fitofisionomias de Florestas Ombrófila Densa, sendo que 79,50% do seu território (17.704,15 ha) estão representados pela formação Montana e 3,24% (721,52 ha), Altomontana; 12,01% (2.674,50 ha) por Floresta Ombrófila Aberta com bambus; 0,40% (89,90 ha) por Refúgio montano (Campo de altitude) com perturbação e 3,86% (861,02 ha) por vegetação secundária. Ao todo foram amostradas 204 espécies arbóreo-arbustivas em sua maioria, pertencentes a 66 famílias e 127 gêneros, com 21 espécies ameaçadas de extinção em nível estadual, nacional ou global, com destaque para o carvalho brasileiro Euplassa cantareirae classificada como presumivelmente extinta para São Paulo e em perigo para o Brasil. O PENAP é uma área protegida importante para a conservação da biodiversidade, por abrigar remanescentes florestais bem preservados, fitofisionomias raras como florestas altomontanas que são pouco representadas no Sistema de Unidades de Conservação do estado de São Paulo, por possuir riqueza de espécies, ainda que sua flora esteja subamostrada quando comparada com a flora regional conhecida, sendo assim uma lacuna do conhecimento a ser sanada com realização de pesquisas. Além disso, o parque por ser contíguo a outras Unidades de Conservação, amplia o continuum de áreas protegidas da Serra de Paranapiacaba, reduzindo efeitos de borda e proporcionando a perspectiva de manutenção a longo prazo do habitat para espécies silvestres

CARACTERIZAÇÃO EPIDEMIOLÓGICA DOS PACIENTES ATENDIDOS NO CENTRO DE TRATAMENTO DE QUEIMADOS DO AMAPÁ

Burns are injuries caused by heat sources, usually restricted to the skin. Its degree of importance and severity varies according to its origin, and can be classified in different ways, be it by depth of this lesion, extension or causative agent. The aim of this study was to quantify the burn cases of patients treated at the Hospital de Emergências (HE) in the State of Amapá, in the municipality of Macapá, Brazil, from the period of 2012 to 2015. The data collection was done by means of documentary, by the analysis of records and HE records. The records were analyzed for sex, age, causes, burned body surface area, degree of burn, hospitalization time, causative agent and mortality. The study was submitted and approved by the Brazilian Research Ethics Committee (CAAE: 66761717.8.0000.0003). Of the 1460 records analyzed, there was a predominance of men (54.04%); prevalence of burns in the group of individuals from 0 to 18 years old (44.52%); predominance of second degree lesions (38.97%); discharge on the same day of hospitalization (70.41%); 0 and 10% of the body area reached (73%); and overheated liquids were the most prevalent agents (53.9%). The facts seem to point to a lack of orientation about PPE and care in work practice. Parental care and guidance at home could help prevent accidents with overheated fluids.Keywords: Burns; Epidemiology; Emergency Hospital.Queimaduras são lesões causadas por fontes de calor, geralmente restritas à pele. Seu grau de importância e gravidade varia de acordo com sua origem, podendo ser classificada de diferentes maneiras, seja ela por profundidade desta lesão, por extensão ou por agente causador. Este estudo teve como objetivo quantificar os casos de queimaduras dos pacientes atendidos no Hospital de Emergências (HE) do Estado do Amapá, no município de Macapá, no período de 2012 a 2015. Os registros coletados foram analisados quanto ao sexo, idade, causas, superfície corporal queimada, grau de queimadura, tempo de internação, agente causador e mortalidade. O estudo foi submetido e aprovado pelo Comitê de Ética em Pesquisa (CAAE:66761717.8.0000.0003). Dos 1460 registros analisados houve predominância do masculino (54,04%); prevalência de queimaduras no grupo de indivíduos de 0 a 18 anos (44,52%); predomínio de lesões de segundo grau (38,97%); alta no mesmo dia da internação (70,41%); 0 e 10% da área corpórea atingida (73%); e o líquidos superaquecidos foram os agentes mais prevalentes (53,9%).Os fatos parecem apontar para uma falta de orientação acerca dos EPIs e cuidados na prática laboral. O cuidado e orientação parental, em casa, poderia ajudar na prevenção de acidentes com líquidos superaquecidos.Palavras-chave: Queimaduras, Epidemiologia, Hospital de Emergência

Search for coherent elastic neutrino-nucleus scattering at a nuclear reactor with CONNIE 2019 data

The Coherent Neutrino-Nucleus Interaction Experiment (CONNIE) is taking data at the Angra 2 nuclear reactor with the aim of detecting the coherent elastic scattering of reactor antineutrinos with silicon nuclei using charge-coupled devices (CCDs). In 2019 the experiment operated with a hardware binning applied to the readout stage, leading to lower levels of readout noise and improving the detection threshold down to 50 eV. The results of the analysis of 2019 data are reported here, corresponding to the detector array of 8 CCDs with a fiducial mass of 36.2 g and a total exposure of 2.2 kg-days. The difference between the reactor-on and reactor-off spectra shows no excess at low energies and yields upper limits at 95% confidence level for the neutrino interaction rates. In the lowest-energy range, 50-180 eV, the expected limit stands at 34 (39) times the standard model prediction, while the observed limit is 66 (75) times the standard model prediction with Sarkis (Chavarria) quenching factors.Comment: 23 pages, 14 figure

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others