Escoliose idiopática do adolescente - classificação e manejo terapêutico / Adolescent idiopathic scoliosis - classification and therapeutic management

A escoliose idiopática do adolescente (EIA) é definida como a alteração do eixo normal da coluna em pacientes com idade superior aos 10 anos e que não atingiram a maturidade musculoesquelética. Quanto à sua etiologia, embora os mecanismos fisiopatológicos da EIA sejam desconhecidos, aventa-se a possibilidade da relação entre predisposição genética e a gênese da doença. Uma vez que, aproximadamente 30% dos portadores possuem algum membro familiar também acometido por essa afecção e, particularmente em casos em que ambos os pais são portadores de escoliose, os filhos têm uma probabilidade 50 vezes maior de desenvolvê-la. A respeito da investigação inicial, deve-se realizar uma anamnese completa e um exame físico adequado, respeitando sempre a sensibilidade e privacidade do adolescente. Ademais, a avaliação é pautada em manobras semiológicas, como o Teste de Adams, que fornece indicadores necessários para continuar a investigação diagnóstica. Em relação ao quadro clínico, existe a possibilidade da ocorrência do desvio da coluna para os 3 eixos dimensionais, além da ocorrência da rotação vertebral. Frente a isso, as classificações de curvatura propostas por King e Lenke são de relevância para o estabelecimento da melhor conduta terapêutica, sendo ela conservadora e, em casos reservados, a abordagem cirúrgica pode ser instituída, atenuando a progressão da moléstia

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Emprego das aberrações cromossômicas instáveis e micronúcleos no biomonitoramento individual : estudo comparativo

A biodosimetria é baseada na investigação de efeitos biológicos radioinduzidos objetivando relacioná-los com a dose absorvida. A quantificação de aberrações cromossômicas instáveis e de micronúcleos, em linfócitos do sangue periférico, são os dois métodos comumente utilizados em biodosimetria. Neste contexto, o objetivo desta pesquisa foi o de comparar estes métodos para o biomonitoramento de profissionais de saúde ocupacionalmente expostos à radiação. Em paralelo, a técnica de bandeamento C foi empregada no controle de qualidade das análises de aberrações cromossômicas instáveis. Para tanto, foram coletadas amostras de sangue periférico de profissionais de saúde em três hospitais de Recife, e as culturas de linfócitos foram realizadas com base na técnica de citogenética clássica. Foi constatado que a análise de micronúcleos é mais rápida que a de aberrações cromossômicas instáveis, o que sugere sua utilização numa avaliação preliminar em casos de suspeita de exposição à radiação ionizante. A técnica de bandeamento C foi eficiente, como teste confirmatório, na identificação de dicêntricos e anéis durante as análises de aberrações cromossômicas instáveis, podendo ser aplicada no controle de qualidade em biodosimetria. A comparação entre as condições individuais de trabalho com as freqüências de aberrações instáveis e micronúcleos, obtidas das análises citogenéticas, resultaram na mudança de comportamento dos profissionais envolvidos nesta pesquisa, no que se refere a uma melhor observância das normas de radioproteçã

Bioindicators in radiation protection

Biodosimetry is the evaluation of absorbed dose using bioindicators. Among chromosomal aberrations, scoring of dicentrics from peripheral human blood has been used as gold standard for biodosimetry, although in case of large scale incidents its use presents some drawbacks. Advances in technology have led to new investigations allowing or permitting the use of new methods which not only improve this "classical" biodosimetry but permits the design of other bioindicators making possible faster analyses, particularly in events where many persons may have been exposed. This report presents an overview of some recent studies developed by the "Grupo de Estudos em Radioproteção e Radioecologia - GERAR", Nuclear Energy Department of UFPE - Brazil, involving biodosimetry

Non-linear dynamics of chromosome condensation induced by colcemid

This study investigated the dynamical process of chromosome condensation after colcemid treatment. Two pairs of human chromosomes, #2 and #3, were highlighted for the accurate identification by fluorescence in situ hybridization (FISH). A computerized image analysis system was used to measure the lengths of the two pairs of chromosomes averaged over 50 metaphases of different cultures with colcemid (0.5 µg/mL) added either at 3 or 48 h of a total 72 h culture period. For determining whether the process of chromosome condensation was chaotic or random, the algorithm of Detrended Fluctuation Analysis (DFA) was used. In order to evaluate the power of the method, the data were shuffled and DFA was performed again. It was found that colcemid prolonged treatment induced a significantly greater chromosome condensation (p<0.05), and the dynamics of this process was determined by the DFA and showed to be chaotic, with scaling exponents with range values 0.5< &#945;<1.0. When the data were shuffled, the scaling exponent &#945;reduced around to 0.5, which was characteristic of random events. These findings reinforced the idea that colcemid could interfere in some manner with the structure of chromosomes and the dynamics of chromosome condensation was non-linear

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation