Efeitos agudos da estimulação elétrica nervosa transcutânea na reabilitação de pacientes após artroplastia total de joelho

Introdução: A artroplastia total de joelho (ATJ) consiste em uma cirurgia de substituição de tal articulação por uma prótese, e é realizada, principalmente, em casos de acometimento do joelho por osteoartrose. No pós-operatório de ATJ, a dor é intensa e limita a mobilidade dos pacientes, sendo a analgesia um dos objetivos do tratamento fisioterapêutico. Uma das alternativas disponíveis para o manejo da dor é a estimulação elétrica nervosa transcutânea (TENS), caracterizada pela aplicação de uma corrente elétrica pulsada através de eletrodos posicionados sobre a pele. Objetivo: Avaliar os efeitos agudos da TENS associada à fisioterapia convencional comparados com a fisioterapia convencional sobre o nível de dor, a amplitude de movimento (ADM) do joelho e a administração de medicamentos analgésicos na reabilitação de pacientes após ATJ. Métodos: Foram incluídos pacientes com idade entre 40 e 90 anos, submetidos à ATJ no Hospital de Clínicas de Porto Alegre, entre maio e setembro de 2016. A amostra foi dividida aleatoriamente em grupo experimental (GE), que realizou fisioterapia convencional associada à aplicação da TENS, e em grupo controle (GC), que realizou apenas fisioterapia convencional, ambos no primeiro dia de pós-operatório. A TENS foi aplicada com frequência=100Hz, duração de pulso=100μs, intensidade no limiar sensorial, durante 30 minutos, com eletrodos posicionados paralelamente à coluna lombar, sobre as raízes nervosas de L3, L4 e L5 Foram realizadas avaliações acerca do nível de dor através da escala visual analógica, da ADM do joelho operado através do aparelho de movimento passivo contínuo (CPM) e da administração de medicamentos analgésicos através dos registros presentes nos prontuários. Resultados: Foram incluídos 26 pacientes, 13 no GE (idade média de 67,8±7,4 anos, 10 do sexo feminino), e 13 no GC (idade média de 66,5±7,4 anos, 13 do sexo feminino). Foi observada uma diminuição significativa do nível de dor após a aplicação da TENS comparada ao momento basal no GE (p=0,000), mesmo comportamento observado no GC (p=0,000). Porém, não houve diferença entre os grupos (p=0,334). Em ambos os grupos houve um aumento significativo da ADM de flexão do joelho após 30 minutos de utilização do aparelho de CPM comparado aos 15 minutos de utilização do aparelho (p=0,000). Porém, não houve diferença entre os grupos (p=0,916). Quanto à administração de morfina durante as 24 horas seguintes às intervenções, não houve diferença entre os grupos (p=0,695). Conclusão: A TENS associada à fisioterapia convencional, aplicada no primeiro dia de pós-operatório, não promoveu efeitos adicionais em pacientes após ATJ em relação ao nível de dor, à ADM do joelho e à administração de morfina, comparada com somente a fisioterapia convencional.Introduction: Transcutaneous electrical nerve stimulation (TENS) is an alternative to relieve pain after total knee arthroplasty (TKA). Objective: To evaluate the acute effects of TENS associated with conventional physiotherapy compared to conventional physiotherapy on pain level, range of motion (ROM) and administration of analgesic drugs in patients after TKA. Methods: Patients submitted to TKA were included in Clínicas’ Hospital of Porto Alegre. The sample was randomly divided into experimental group (EG), who received conventional physiotherapy and TENS, and control group (CG), who received only conventional physiotherapy, both on the first postoperative day. TENS was applied with frequency=100Hz, pulse duration=100μs, sensorial threshold intensity, for 30 minutes, with electrodes parallel to the lumbar spine. Pain level, knee ROM and administration of analgesic drugs were evaluated. Results: Twenty-six patients were included, 13 per group. Pain level decreased significantly after TENS application compared to baseline in EG (p=0,000), same behavior observed in CG (p=0,000), but with no difference between them (p=0,334). Knee flexion ROM increased significantly after 30 minutes using the continuous passive movement device, compared to 15 minutes, in both groups (p=0,000), but with no difference between them (p=0,916). Administration of morphine in 24 hours after interventions did not differ between the groups (p=0,695). Conclusion: TENS associated with conventional physiotherapy, applied on the first postoperative day of TKA, did not promote additional effects on pain level, knee ROM and administration of morphine compared to conventional physiotherapy alone

Poslijeoperacijsko smanjivanje debljine donorske rožnične lamele nakon konvencionalne stražnje slojevite transplantacijske rožnice

The purpose of this study was to evaluate postoperative deturgescence of lamellar donor graft after conventional Descemet’s stripping automated endothelial keratoplasty (DSAEK). It was a prospective study that included 55 eyes of patients (mean age 70.9±9.4 years; female 61.8%, male 38.2%). Preoperative thickness of lamella was compared with postoperative thickness six months after surgery. Central lamellar graft thickness decreased from 142±27 µm preoperatively to 124±20 µm 6 months postoperatively (p<0.01). After performing conventional DSAEK corneal transplantation, surgeons should expect deturgescence of corneal graft and reduction in thickness of lamellae by about 12% of initial thickness according to our results. We found this information important for better planning of surgical procedures and knowing what to expect after surgery, as well as for better cooperation with eye banks when ordering pre-cut corneal tissue.Svrha ovoga istraživanja bila je procjena poslijeoperacijske deturgescencije donorske rožnične lamele nakon konvencionalne stražnje slojevite transplantacije rožnice (engl. Descemet’s stripping automated endothelial keratoplasty). U ovu prospektivnu studiju bilo je uključeno 55 očiju bolesnika (srednja dob 70,9±9,4 godina; žene 61,8%; muškarci 38,2%). Prijeoperacijska debljina lamele uspoređena je s poslijeoperacijskom debljinom šest mjeseci nakon transplantacije. Centralna debljina donorske lamele smanjila se s prijeoperacijskih 142±27 µm na 124±20 µm šest mjeseci nakon operacije (p<0,01). Prema rezultatima očekivano stanjivanje donorske rožnične lamele nakon konvencionalne stražnje slojevite transplantacije iznosilo je u prosjeku 12% od početne debljine. Smatramo da je taj podatak važan zbog boljeg planiranja operacijskog zahvata stražnje slojevite transplantacije rožnice i preciznijeg naručivanja rožničnog tkiva iz očne banke

Differential Diagnostic Performance of Rose Bengal Score Test in Sjøgren’s Syndrome Patients

Aim of the study was to evaluate the diagnostic performance of the Rose Bengal score test for Sjøgren’s syndrome (SS), and to explore differences between other tests and examinations. All participants were examined, including (but not limited to) unstimulated (UWS) and stimulated (SWS) whole saliva, labial gland biopsy (LGB or focus score), ophthalmologic questionnaire (ocular surface disease index OSDI) and objective tests: Schirmer test 1 (Sch.1), Schirmer test 2 (Sch.2), Tear Break-up Time (TBUT) test and Rose Bengal score (RBS). Data were analyzed using Mann Whitney U-test, Receiver Operating Characteristic analysis, with specificity and sensitivity calculations and Spearman’s correlation test. ROC curves showed a poor diagnostic performance of TBUT and OSDI. Sch.1, Sch.2 and LGB all exhibited a high diagnostic performance. RBS exhibited the best performance (sensitivity 100,00; specificity 100,00; AUC 1,000). Study reveals the scarce reliability of TBUT, OSDI and Sch.1, and emphasizes RBS as the test of choice in the SS diagnosis

Differential Diagnostic Performance of Rose Bengal Score Test in Sjøgren’s Syndrome Patients

Aim of the study was to evaluate the diagnostic performance of the Rose Bengal score test for Sjøgren’s syndrome (SS), and to explore differences between other tests and examinations. All participants were examined, including (but not limited to) unstimulated (UWS) and stimulated (SWS) whole saliva, labial gland biopsy (LGB or focus score), ophthalmologic questionnaire (ocular surface disease index OSDI) and objective tests: Schirmer test 1 (Sch.1), Schirmer test 2 (Sch.2), Tear Break-up Time (TBUT) test and Rose Bengal score (RBS). Data were analyzed using Mann Whitney U-test, Receiver Operating Characteristic analysis, with specificity and sensitivity calculations and Spearman’s correlation test. ROC curves showed a poor diagnostic performance of TBUT and OSDI. Sch.1, Sch.2 and LGB all exhibited a high diagnostic performance. RBS exhibited the best performance (sensitivity 100,00; specificity 100,00; AUC 1,000). Study reveals the scarce reliability of TBUT, OSDI and Sch.1, and emphasizes RBS as the test of choice in the SS diagnosis

The Omicron lineages BA.1 and BA.2 (Betacoronavirus SARS-CoV-2) have repeatedly entered Brazil through a single dispersal hub

Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation

Comparison of NO2 vertical profiles from satellite and ground based measurements over Antarctica

The Intercomparison of nitrogen dioxide (NO2) vertical profiles, derived from the satellite based HALogen Occultation Experiment (HALOE) measurements and from the ground based UV-VIS spectrometer GASCOD (Gas Analyzer Spectrometer Correlating Optical Differences) observations at the Mario Zucchelli Station (MZS), in Antarctica, are done for the first time. It is shown here that both datasets are in good agreement showing the same features in terms of magnitude, profile structure, and temporal variations

Phylogeography of the common vampire bat (Desmodus rotundus): Marked population structure, Neotropical Pleistocene vicariance and incongruence between nuclear and mtDNA markers

Background: The common vampire bat Desmodus rotundus is an excellent model organism for studying ecological vicariance in the Neotropics due to its broad geographic range and its preference for forested areas as roosting sites. With the objective of testing for Pleistocene ecological vicariance, we sequenced a mitocondrial DNA (mtDNA) marker and two nuclear markers (RAG2 and DRB) to try to understand how Pleistocene glaciations affected the distribution of intraspecific lineages in this bat. Results: Five reciprocally monophyletic clades were evident in the mitochondrial gene tree, and in most cases with high bootstrap support: Central America (CA), Amazon and Cerrado (AMC), Pantanal (PAN), Northern Atlantic Forest (NAF) and Southern Atlantic Forest (SAF). The Atlantic forest clades formed a monophyletic clade with high bootstrap support, creating an east/west division for this species in South America. On the one hand, all coalescent and non-coalescent estimates point to a Pleistocene time of divergence between the clades. On the other hand, the nuclear markers showed extensive sharing of haplotypes between distant localities, a result compatible with male-biased gene flow. In order to test if the disparity between the mitochondrial and nuclear markers was due to the difference in mutation rate and effective size, we performed a coalescent simulation to examine the feasibility that, given the time of separation between the observed lineages, even with a gene flow rate close to zero, there would not be reciprocal monophyly for a neutral nuclear marker. We used the observed values of theta and an estimated mutation rate for the nuclear marker gene to perform 1000 iterations of the simulation. The results of this simulation were inconclusive: the number of iterations with and without reciprocal monophyly of one or more clades are similar. Conclusions: We therefore conclude that the pattern exhibited by the common vampire bat, with marked geographical structure for a mitochondrial marker and no phylogeographic structure for nuclear markers is compatible with a historical scenario of complete isolation of refuge-like populations during the Pleistocene. The results on demographic history on this species is compatible with the Carnaval-Moritz model of Pleistocene vicariance, with demographic expansions in the southern Atlantic forest.FAPESP grants number 03/01583 -3 and 04/08682-4CAPES grant number BEX4687/06-

Solid lipid nanoparticles vs. nanostructured lipid carriers: a comparative review

Solid–lipid nanoparticles and nanostructured lipid carriers are delivery systems for the delivery of drugs and other bioactives used in diagnosis, therapy, and treatment procedures. These nanocarriers may enhance the solubility and permeability of drugs, increase their bioavailability, and extend the residence time in the body, combining low toxicity with a targeted delivery. Nanostructured lipid carriers are the second generation of lipid nanoparticles differing from solid lipid nanoparticles in their composition matrix. The use of a liquid lipid together with a solid lipid in nanostructured lipid carrier allows it to load a higher amount of drug, enhance drug release properties, and increase its stability. Therefore, a direct comparison between solid lipid nanoparticles and nanostructured lipid carriers is needed. This review aims to describe solid lipid nanoparticles and nanostructured lipid carriers as drug delivery systems, comparing both, while systematically elucidating their production methodologies, physicochemical characterization, and in vitro and in vivo performance. In addition, the toxicity concerns of these systems are focused on.LA/P/0101/2020, LA/P/0140/2020info:eu-repo/semantics/publishedVersio