The futility of being selfish in vaccine distribution

The SIR (Susceptible-Infected-Recovered) model is employed in a network with community structure to investigate the benefit of sharing vaccine across communities. The network studied comprises two communities, one of which controls vaccine budget and may share it with the other. Different scenarios are considered regarding the connectivity between communities, infection rates and the fraction of the population that is not vaccinated. Properties of the SIR model facilitates the use of Dynamic Message Passing to infer the state of each node. Our results show a large set of sharing strategies in which the sharing community benefits from the reduced global infection rates with no detrimental impact on its local infection rate

Desempenho da válvula de pressão fixa com antissifão SPHERA® no tratamento da hidrocefalia e na prevenção da ocorrência de hiperdrenagem

Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA® in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index &gt;50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H2O after tap test (40 mL), 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT) evidence of hypo or overdrainage, and no immediate early or late significant complications

Transorbital stab penetrating brain injury. Report of a case

INTRODUCTION: Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head injuries. In this paper the Authors describe a case of patient victim of transorbital stab with brain injury with good recovery and review the literature about cranial stab wound. CASE REPORT: A 23-year-old man was involved in an altercation which resulted in the patient sustaining wounds to the head, with penetrating in left transorbital, affecting the eye. At arrival to the first trauma center the patient was conscient and complete responsive with 15 points in Glasgow Coma Scale, and motor deficit grade III. CT scan demonstrated left periventricular brain hematoma and supraorbital fracture. A four-vessel cerebral angiogram demonstrated no anormality. In this evolution patient presented good neurologic outcome. CONCLUSION: In patients conscients with no surgical lesion like our patient, the hospital discharge must occurr after the angiogram have excluded intracranial vascular lesion

Efficacy of ketoprofen lysine salt and paracetamol/acetaminophen to reduce pain during rapid maxillary expansion: A randomized controlled clinical trial

Background: Rapid maxillary expansion (RME) is an orthopaedic procedure indicated for a wide variety of clinical conditions. Aim: The aim of the study was to compare the effects of ketoprofen lysine salt (KLS) vs paracetamol/acetaminophen (P) on pain perception during RME. Design: One hundred and fifty‐one subjects (mean age 8.6 year) were enrolled in this prospective controlled clinical trial according to inclusion criteria: prepuberal stage of development, negative posterior transverse interarch discrepancy, non‐ concurrent use of other drugs. First phase: n.40 allocated to Group 1 used 40 mg of KLS, n.40 to Group 2 used 250 mg of P, n.36 to Group 3 as control group. Second phase: n.35 allocated to Group 4 used 40 mg ketoprofen lysine salt once a day for the first 3 days of activation. Pain experience was reported on a numeric rating scale (0‐4) and a 100‐mm visual analogue scale. Pain perception was tested with the Mann‐Whitney test (P &lt; 0.05). Results: Pain perception was higher during the first 3 days of activation and it was described as mild to moderate. Group 1 experienced significantly less pain during the fourth, fifth, and sixth day (P &lt; 0.05) compared with Group 2. Patients of the Group 4 reported significantly lower pain during the whole period of RME activation (P &lt; 0.05). Conclusions: The perceived higher pain was reported during the second and third day of expansion. The analgesic effect of KLS is more effective than P during the fourth, fifth, and sixth day. The use of KLS during the first 3 days of activation seems to be able reducing pain during the whole active phase