Relationship between ultrasound measurement of quadriceps muscle and nutritional status in ICU patients in a high-complexity trauma care hospital

Introduction Muscle mass assessment of critically ill patients is essential to be part of the nutritional diagnosis in hospital care. Thus, the evaluation of more specific techniques for that purpose is needed. The present study aimed to investigate the association of quadriceps muscle thickness (QMT), measured by ultrasound (US), with the nutritional status of critically ill patients in a referral high-complexity trauma care hospital. Methods A cross-sectional observational study was conducted in the intensive care units (ICUs) in a tertiary hospital in Brazil. The sample comprised 30 critically ill trauma patients admitted between February and March 2022. The methodology involved evaluating muscle mass and comparing nutritional status through mid-upper arm circumference measurements and US assessments. Specifically, the QMT was quantified using US at a predefined site between the iliac crest and the proximal border of the patella. Results The Kruskal-Wallis test indicated variability in QMT between the nutritional status groups, with statistical significance reached after excluding the overweight group (H(2) = 7.532, p = 0.023). The moderate malnutrition group exhibited notably lower QMT. Sensitivity analyses using bootstrap and Monte Carlo methods showed moderate trends toward significance. A positive correlation was found between QMT and mid-upper arm circumference adequacy (p < 0.05), demonstrating fair to moderate correlation (rs = 0.531). Conclusion Significant changes in QMT were detected by ultrasound assessment in moderate malnutrition patients compared to patients of other nutritional statuses. Ultrasound may be a valuable technique for monitoring muscle integrity in critically ill patients

Sinusectomia maxilar via endoscópica como tratamento da rinossinusite crônica oriunda de fístula oroantral / Maxillary sinusectomy via endoscopy as treatment of chronic rhinosinusitis from oroantral fistula

O seio maxilar define-se por um espaço pneumático na maxila bilateralmente que possui volume e proximidade com os ápices de 2º pré-molares e molares superiores, possibilitando que intervenções nestes afetem sua integridade, levando a inflamação e podendo resultar em Rinossinusite Crônica (RSC).  Este estudo visa elucidar a atribuição da cirurgia endoscópica para tratamento da RSC através de um relato de caso clínico. Paciente sexo masculino, 50 anos, compareceu ao serviço de CTBMF do Hospital da Restauração – PE, com algesia em região zigomático-maxilar direita e comunicação oroantral, há sete meses, por exodontia traumática do elemento 15, já submetido à terapêuticas clínicas, sem sucesso. Diagnosticou-se ao exame físico e de imagem, RSC secundária, optando pela sinusectomia via endoscópica ântero-posterior acessando o seio maxilar direito por antrostomia maxilar na parede nasal lateral, removendo a mucosa doente e instalando um dreno de manutenção. Concomitantemente, fechou-se a comunicação bucossinusal por um retalho na mucosa vestibular maxilar recobrindo toda falha, sob anestesia geral. No pós-operatório imediato, iniciou-se antibioticoterapia, analgesia e irrigação com soro fisiológico 0,9%, pelo dreno, removido após 72 horas. A cirurgia endoscópica como tratamento da RSC mostra-se uma alternativa quando há falha terapêutica clínica, apresentando melhora da sintomatologia e qualidade de vida dos pacientes.

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements