Acompanhamento da liga de cirurgia plastica no uso de lipoenxerto em reparação de cicatriz de excisão de sarcoma em membro inferior / Follow-up of the plastic surgery alloy in the use of lipostening in the repair of a sarcoma excision scar in a lower member

Este trabalho tem como objetivo relatar um caso que foi acompanhado pelos os membros da equipe executora do projeto de extensão Liga de Cirurgia Plástica e descrever o quadro clínico do paciente com deformação pós-cirúrgica de sarcoma de partes moles e mostrar a lipoenxertia como forma de tratamento estético da lesão. Descrever também, a importância da intervenção para a melhoria da qualidade de vida do paciente, e assim mostrando a eficácia do tratamento estético da lesão

Avaliação da resposta imune de cães submetidos à vacinação contra cinomose associada ao estímulo pela acupuntura

A acupuntura é um dos métodos mais antigos da Medicina Tradicional Chinesa (MTC) que consiste na técnica de estímulo cutâneo com agulhas em locais pré-determinados (os acupontos), para prevenir ou tratar doenças, sendo usada na imunomodulação, onde atua na atividade hemodinâmica, aumentando a população e atividade das células Natural Killers, CD4+, CD8+, dentre outras. Por este motivo, acupuntura vem sendo utilizada como terapia complementar no tratamento de algumas doenças infecciosas, como a cinomose canina que é uma das doenças infecciosas mais importantes dos caninos, sendo endêmica no Brasil, altamente contagiosa, levando a quadro neurológico e morte. Os animais acometidos geralmente são os que não foram primovacinados. Este trabalho objetivou avaliar a resposta humoral de cães a partir da administração de diferentes doses de vacina contra cinomose associada aos estímulos nos acupontos IG4 (Hegu), VG14 (Dahzui) e E36 (Zusanli), e foi desenvolvido no Hospital Veterinário do Departamento de Medicina Veterinária da Universidade Federal Rural de Pernambuco. Foram realizadas imunizações em 18 cães, com idades variadas, distribuídas aleatoriamente em cinco grupos, sendo eles: Grupo I (G1) – três animais que receberam a dose usual de vacina, no total de 1 mL, por via subcutânea na região do hipocôndrio direito; Grupo II (G2) – dois animais que receberam 1mL da dose usual de vacina, por via subcutânea na região do hipocôndrio direito e estímulos nos acupontos IG4, VG14 e E36. Grupo III (G3) - quatro animais que receberam no total de 1 mL de NaCl, por via subcutânea na região do hipocôndrio direito e estímulo nos acupontos IG4, VG14 e E36. Grupo IV (G4) - cinco animais que receberam 0,2 mL da dose vacinal, por via subcutânea, na região do hipocôndrio direito e estímulo nos acupontos IG4, VG14 e E36. Grupo V (G5) - dois animais que receberam 0,2 mL da dose vacinal por via subcutânea na região do hipocôndrio direito. A avaliação hematológica foi realizada antes de administração de qualquer protocolo experimental (D0) e 12 (D12) dias após a administração dos protocolos. Os parâmetros avaliados foram o perfil hematológico e titulação de anticorpos anti-CDV. Os resultados obtidos demonstraram que a estimulação pela acupuntura elevou o título de anticorpos contra cinomose dos cães, em todos os grupos experimentais, até mesmo aqueles que não foram revacinados, mas que apresentavam um título médio anticorpos, demonstrando a real atividade imunoestimulante da acupuntura. Além disso, os parâmetros leucométricos demonstraram uma melhora na condição geral das defesas dos animais, uma vez que, em média, houve maior equilíbrio desses parâmetros após o uso da acupuntura. De acordo com nossos resultados, podemos concluir que a acupuntura pode se tornar uma técnica promissora no estímulo imunológico pré-vacinal de cães

Seagrass and submerged aquatic vegetation (VAS) habitats off the Coast of Brazil: state of knowledge, conservation and main threats

Seagrass meadows are among the most threatened ecosystems on earth, raising concerns about the equilibrium of coastal ecosystems and the sustainability of local fisheries. The present review evaluated the current status of the research on seagrasses and submerged aquatic vegetation (SAV) habitats off the coast of Brazil in terms of plant responses to environmental conditions, changes in distribution and abundance, and the possible role of climate change and variability. Despite an increase in the number of studies, the communication of the results is still relatively limited and is mainly addressed to a national or regional public; thus, South American seagrasses are rarely included or cited in global reviews and models. The scarcity of large-scale and long-term studies allowing the detection of changes in the structure, abundance and composition of seagrass habitats and associated species still hinders the investigation of such communities with respect to the potential effects of climate change. Seagrass meadows and SAV occur all along the Brazilian coast, with species distribution and abundance being strongly influenced by regional oceanography, coastal water masses, river runoff and coastal geomorphology. Based on these geomorphological, hydrological and ecological features, we characterised the distribution of seagrass habitats and abundances within the major coastal compartments. The current conservation status of Brazilian seagrasses and SAV is critical. The unsustainable exploitation and occupation of coastal areas and the multifold anthropogenic footprints left during the last 100 years led to the loss and degradation of shoreline habitats potentially suitable for seagrass occupation. Knowledge of the prevailing patterns and processes governing seagrass structure and functioning along the Brazilian coast is necessary for the global discussion on climate change. Our review is a first and much-needed step toward a more integrated and inclusive approach to understanding the diversity of coastal plant formations along the Southwestern Atlantic coast as well as a regional alert the projected or predicted effects of global changes on the goods and services provided by regional seagrasses and SAV

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. Funding: UK Medical Research Council, US National Institutes of Health. © 2014 Elsevier Ltd

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

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

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe