A cadeira de rodas e seus componentes essenciais para a locomoção de pessoas com tetraplegia por lesão da medula espinhal

Objetivo: Compreender quais itens são essenciais à cadeira de rodas (CR) na perspectiva da pessoa tetraplégica por lesão da medula espinhal (LME). Método: O estudo qualitativo foi com entrevista semi-estruturada e análise de discurso, bem como, checklist da CR em uso e do Sistema Único de Saúde (SUS). Resultados: No total foram dez entrevistados: nove homens e uma mulher, média de idade de 42,3 anos (± 9,23), dois advogados, um economista e demais aposentados. As causas da LME foram acidente automobilístico (60%), mergulho em águas rasas (30%) e atropelamento (10%), respectivamente. O tempo de lesão foi em média 16,3 anos (± 7,14) e todos realizavam fisioterapia. Os números de CR, até a adequada, foram duas a cinco e todos praticavam esporte adaptado ou lazer com CR. O checklist apontou itens insuficientes na CR do SUS e da análise dos discursos resultaram em quatro categorias: Itens, materiais e condições necessárias; A conquista da funcionalidade; Vantagens e desvantagens da CR; e Sentimentos vivenciados. A CR é essencial para a locomoção das pessoas com tetraplegia e conhecer modelos, experimentar e ter orientações sobre os itens adequados são importantes para a aquisição. Os itens adequados facilitam a aceitação, melhor adaptação, locomoção e autonomia. Conclusão: A cadeira do SUS mostrou-se insuficiente, o que leva ao abandono. A adquirida por funcionalidade, com itens essenciais, o que responde a individualidade e ao gosto do usuário, mostrou-se útil e adequada apesar de seu elevado custo.Objective: This study sought to understand which items are essential to the wheelchair from the perspective of a person with quadriplegic spinal cord injury (SCI). Method: The study was qualitative with semi-structured interviews and discourse analysis, as well as a checklist of the wheelchair being used and the wheelchair provided by the government’s Unified Health System (SUS). Results: The causes of SCI were motor vehicle accidents (60%), diving into shallow waters (30%) and being struck by a vehicle (10%), respectively and the injury time averaged 16.3 years (± 7.14). All of the subjects were in physiotherapy. The number of wheelchairs tested before finding the proper one were two to five and some participants practiced adapted sports with the wheelchair. The checklist showed that the government wheelchair had insufficient items and the discourse analysis resulted in four categories: Items, materials, and conditions; Learning functionality; Advantages and disadvantages of the wheelchair; and Feelings experienced. The wheelchair is essential to acquiring mobility for people with quadriplegia and trying out different models and getting orientation on the items are important for their acquisition. Suitable items facilitate acceptance, better adaptation, mobility and enable autonomy. Conclusion: The wheelchair from the government’s health system was insufficient, leading to its being abandoned, and wheelchairs acquired for their functionality, with essential items, responsive to the user’s individuality and taste proved to be useful and appropriate, despite their high cost

Estudo sobre as características da dor em pacientes com lesão medular

Além da perda da funcionalidade após a lesão medular (LM), a dor é tida como uma das principais complicações mais incapacitantes e vivenciadas no processo de reabilitação, mesmo com o avanço significativo na compreensão da fisiopatologia e tratamento da dor, a abordagem desse sintoma ainda é precária na lesão medular. Objetivo: Descrever as características do quadro álgico nessa população e associar a dor com o tipo de lesão, interferência nas atividades de vida diária (AVD’s) e o seu aparecimento. Método: Trata-se de estudo transversal com um roteiro de entrevista semiestruturado aplicado a 77 pacientes. Foram calculadas a média e desvio padrão, frequências absolutas e relativas, para a associação entre as variáveis qualitativas foi utilizado teste Qui-quadrado (χ²). Resultados: A idade foi de 38,26 ± 12,43 anos, sendo 84,4% homens e 80,5% de paraplégicos. Trinta e um foram por acidente automobilístico e 29 por ferimento de arma de fogo, sendo 61,0% com lesão medular completa. Quanto à dor, 44,2% relataram dor severa e 29,8% a moderada, em 50,6% não sentiam dor acima da lesão e 58,4% sentiam-na abaixo. Trinta e nove relataram sentir dor em queimação, 40,0% relataram que a dor surgiu no primeiro ano após a LM. A intensidade da dor foi de 5,44 ± 3,18 pontos, sendo 5,20 ± 3,07 nos homens, 6,75 ± 3,54 nas mulheres, 4,13 ± 3,18 nos tetraplégicos e 5,76 ± 3,12 nos paraplégicos. Para 27 pacientes a dor piorou permanecendo na mesma posição, para 22 melhorou realizando fisioterapia e para 21 com a mudança de posição. Para 68,8% a dor não interferiu nas AVD’s. Vinte e oito utilizaram medicação analgésica. Houve associação significativa de que a presença de dor abaixo da lesão interfere nas AVD’s (p = 0,04) e surge no primeiro ano após a lesão acima e abaixo da lesão (p = 0,05 e p = 0,01), respectivamente. Conclusão: A dor foi prevalente nos lesados medulares, mais evidenciada nas mulheres e na maioria surgiu no primeiro ano após a lesão e interfere AVD’s. A fisioterapia e a mudança de posição diminuíram a dor. Portanto, as orientações e intervenções por parte da equipe multiprofissional devem ser imediatas após a lesão, pois a prevenção ou diminuição desta complicação refletirá na melhoria da qualidade de vida e na readaptação do paciente à sua vida familiar e social.Aside from the loss of functionality after a spinal cord injury (SCI) pain is considered one of the most disabling complications experienced in the rehabilitation process, even with the significant advances in understanding the physiopathology and treatment of the pain, the approach to this symptom is still precarious in spinal cord injury. Objective: To describe the characteristics of pain in this population and to associate the pain between variables such as the type of injury, the interference in the daily living activities (DLA), and its onset. Method: It is a descriptive cross-sectional study and was conducted on 77 patients with spinal cord injuries; the survey was applied using a semi-structured interview. Mean and standard deviation and absolute and relative frequencies were calculated, and for the association between qualitative variables we used the Chisquare test (χ²). Results: The mean age was 38.26 ± 12.43 years, 84.4% of which were men, and 80.5% were paraplegics. Thirty-one were caused by motor vehicle crashes and twenty-nine were by gunshot; 61% of them were fully disabled. As for the pain, 44.2% reported severe pain and 29.8% moderate, 50.6% felt no pain above the lesion, but 58.4% felt it below. Thirty-nine patients reported feeling burning pain, 40% reported that the pain came in the first year after SCI. Pain intensity was 5.44 ± 3.18 points, with 5.20 ± 3.07 in men and 6.75 ± 3.54 in women; for tetraplegic individuals it was 4.13 ± 3.18 and with 5.76 ± 3.12 in the paraplegics. For 27 patients the pain worsened if they remained in the same position, improved to 22 by performing physiotherapy, and to 21 with a change in position. For 68.8% of the patients the pain did not interfere with their DLAs. Twenty-eight used analgesics. It was significantly mentioned that the presence of pain below the lesion interferes with the DLAs (p = 0.04) and appears in the first year after injury above and below the lesion (p = 0.05 and p = 0.01), respectively. Conclusion: Pain was prevalent in those with injured spinal cords, more evident in women, and for the majority arose in the first year after injury and interferes with their DLA. Physiotherapy and a change of position decreased the pain. Therefore, orientations and interventions by the multidisciplinary team should be immediate after the injury, because the prevention or reduction of this complication will lead to an improved quality of life and the re-adaptation of the patient to their family and social life

Efeito da tração manual sobre o comprimento da coluna cervical em indivíduos assintomáticos: estudo randomizado controlado

THE Objectives of the study were to measure the length of the cervical spine when submitted to manual traction and to verify changes in the cervical spine after 10 consecutive sessions. In this randomized controlled study 64 participants were submitted to two radiological procedures: one before and another during traction. The distances between the anterior and posterior vertebrae edges of C2 the C7 were measured and compared. In the first stage it was shown that measures of the anterior distance was 8.40 to 8.50 cm (POs objetivos do estudo foram o de mensurar o comprimento da coluna cervical quando submetida à tração manual, e o de verificar as alterações da cervical após um período de 10 sessões consecutivas. Trata-se de estudo randomizado controlado, no qual 64 participantes foram submetidos a dois procedimentos radiológicos, antes e durante a tração. As distâncias das bordas anteriores e posteriores do corpo vertebral C2 até as do corpo vertebral de C7 foram mensuradas e comparadas. Na primeira etapa as medidas das bordas anteriores foi de 8,40 para 8,50 cm (

Sexual profile and adaptations of men after spinal cord injury

Lesão medular (LM) consiste em qualquer tipo de lesão nos elementos neurais do canal medular, acarretando inúmeros comprometimentos, sendo a alteração nos padrões da resposta sexual um deles, condicionada por fatores físicos, psíquicos e sociais. Em função destas alterações, os pacientes necessitam realizar adaptações sexuais para manterem a atividade sexual. Objetivo: Verificar o perfil e adaptações sexuais de homens após a LM e associar o diagnóstico neurofuncional com frequência sexual, ereção, uso de adaptação, tipo de adaptação, e a utilização de adaptação com frequência e satisfação sexual após a lesão. Método: Trata-se de um estudo transversal com 36 homens lesados medulares que foram entrevistados por meio do questionário (QSH-LM). Resultados: Média de idade é 36,64 anos com prevalência decorrente de acidente de trânsito, de paraplegia e de lesão medular completa. Após a LM, 52,8% estão casados, 75,5% mantém atividade sexual sendo que 44,4% têm menos de 1 relação sexual/semana, 80,6% estão satisfeitos sexualmente, 50,0% têm ereção, 38,9% ejaculação e 44,4% orgasmo. Quanto ao uso de adaptação para ter/manter a ereção, 61,1% utilizam, sendo 25,5% por não conseguirem manter a ereção e 22% optam pelo anel peniano. Houve associação significativa de que paraplégicos utilizam adaptações com mais frequência e preferem o anel peniano e pacientes que utilizam adaptação sexual tem maior frequência sexual e estão satisfeitos sexualmente (p = 0,02). Conclusão: Através deste trabalho podem-se conhecer o perfil sexual dos pacientes após a LM e as adaptações sexuais mais utilizadas, resultados que subsidiam informações que poderão auxiliar os profissionais de saúde a acompanharem e orientarem de maneira adequada os seus pacientes.Spinal cord injury (SCI) refers to any type of injury to the neural elements of the spinal canal, resulting in countless damages, one of them being the change in patterns of sexual response, conditioned by physical, psychological, and social aspects. Due to these changes, patients need to make adjustments to maintain sexual activity. Objective: To verify the sexual profile and adaptations of men after SCI and to associate the neurofunctional diagnosis with sexual frequency, erection, use and type of adaptation, and the use of adaptation with sexual frequency and sexual satisfaction. Method: Cross-sectional study with 36 men with spinal cord injuries. They were interviewed with the (QSH-LM) questionnaire. Results: The mean age was 36.64 years old with the majority of injuries stemming from traffic accidents, resulting in paraplegia or complete injury. After the SCI, 52.8% of the subjects remained married, 75.5% maintained sexual activity, whereas 44.4% have less than one intercourse/week, 80.6% are sexually satisfied, 50% have erection, 38.9% ejaculation, and 44.4% orgasm. Regarding the use of adaptations to achieve and maintain an erection, 61.1% of the subjects use them, 25.5% because they fail to maintain an erection and 22% have opted for the penis ring. There was a significant association between paraplegics who use adjustments more frequently and prefer the penis ring and patients who use sexual adaptations having greater sexual frequency and being sexually satisfied (p = 0.02). Conclusion: Through this work it is possible to know the sexual profile of patients after SCI and the most used sexual adaptations. These results support the information that might assist healthcare professionals to monitor and guide their patients properly

Development and validation of HERWIG 7 tunes from CMS underlying-event measurements

This paper presents new sets of parameters (“tunes”) for the underlying-event model of the HERWIG7 event generator. These parameters control the description of multiple-parton interactions (MPI) and colour reconnection in HERWIG7, and are obtained from a fit to minimum-bias data collected by the CMS experiment at s=0.9, 7, and 13Te. The tunes are based on the NNPDF 3.1 next-to-next-to-leading-order parton distribution function (PDF) set for the parton shower, and either a leading-order or next-to-next-to-leading-order PDF set for the simulation of MPI and the beam remnants. Predictions utilizing the tunes are produced for event shape observables in electron-positron collisions, and for minimum-bias, inclusive jet, top quark pair, and Z and W boson events in proton-proton collisions, and are compared with data. Each of the new tunes describes the data at a reasonable level, and the tunes using a leading-order PDF for the simulation of MPI provide the best description of the dat

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| < 0.03 at 95% confidence level. [Figure not available: see fulltext.

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Measurement of prompt open-charm production cross sections in proton-proton collisions at root s=13 TeV

The production cross sections for prompt open-charm mesons in proton-proton collisions at a center-of-mass energy of 13TeV are reported. The measurement is performed using a data sample collected by the CMS experiment corresponding to an integrated luminosity of 29 nb(-1). The differential production cross sections of the D*(+/-), D-+/-, and D-0 ((D) over bar (0)) mesons are presented in ranges of transverse momentum and pseudorapidity 4 < p(T) < 100 GeV and vertical bar eta vertical bar < 2.1, respectively. The results are compared to several theoretical calculations and to previous measurements.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV