Photobiomodulation therapy reduces postoperative pain after third molar extractions:a randomized clinical trial

To assess the efficacy of PBMT on reducing postoperative pain scores in patients submitted to third molar extractions. A randomized controlled trial (ReBEC:RBR-94BCKZ) was designed according to the SPIRIT and followed the CONSORT. Patients were randomly allocated according to control or PBMT groups. PBMT consisted of the application of GaAlAs laser (808nm;50mW) applied in six points (1.23 min;11 J/cm2) after extraction. Pain scores were assessed using the Visual Analogue Scale (VAS) in millimeters evaluated after 6 (T6), 24 (T24), and 48 (T48) hours. The Wilcoxon Mann?Whitney test was used to check for possible associations between VAS scores and treatment groups. A total of 101 third molar extractions were performed in 44 patients. The mean age was 28 years old(SD±11.54). Comparing control and intervention, PBMT group showed a significant effect on the reduction of postoperative pain at T6(mean VAS=0.9; C.I:0.63?1.16) compared to control (mean VAS=2.5;C.I:2.1?2.88)(p<0.001). The same statistically significant effect on the reduction of postoperative pain was observed at T24 (PBMT mean VAS=0.72;C.I:0.51?0.93; control mean VAS=2.86;C.I:2.40?3.31;p<0.001) and T48 (PBMT mean VAS=0.64;C.I:0.36?0.92; control mean VAS=2.86;C.I:2.37?3.34;p<0.001). PBMT significantly reduce the postoperative pain scores when assessed 6, 24, and 48 hours after third molar extractions

PERFIL CLÍNICO E EPIDEMIOLÓGICO DE GESTANTES COM DIABETES MELLITUS GESTACIONAL EM UM MUNICÍPIO DE SANTA CATARINA

To identify the clinical and epidemiological profile of pregnant women with gestational diabetes mellitus in a referral center of a southern region city of Santa Catarina. A cross-sectional study with secondary data collection and a quantitative approach, addressing pregnant women who attended a referral center in the city of Criciúma - SC. Data collection was performed through a form covering anthropometric data, comorbidities, risk factors, maternal and fetal outcomes and their determinants. The prevalence of gestational diabetes mellitus was found in 19.6% of the pregnant women. Overweight or obesity were present in 71% of those. As a tool for drug therapy, metformin was used by 20.1% of pregnant women from which 69.8% choose a cesarean operation to be performed. Early pregnancy at the diagnosis and advanced maternal age were associated with cesarean operation. In addition, the body mass index was positively associated with the intensity of the therapy used for glycemic control. The prevalence of gestational diabetes mellitus found in the sample was higher than those from the studies of the population basis in the country and worldwide. In addition to that, most of the observed pregnant women were found to have obesity, which was highly associated with the pathology genesis and the need for more aggressive therapy. However, it is a preventable and treatable condition that can be a target for great impact on public health if addressed effectively. Keywords: Hyperglycemia; Insulin; Metformin; Obesity; PregnancyIdentificar o perfil clínico e epidemiológico de gestantes com diabetes mellitus gestacional em um centro de referência de um município da região sul de Santa Catarina. Estudo transversal com coleta de dados secundários e abordagem quantitativa, abordando gestantes atendidas em um centro de referência do município de Criciúma - SC. A coleta de dados foi realizada com o auxílio de um formulário abrangendo dados antropométricos, comorbidades, fatores de risco, desfechos maternos e fetais e os seus determinantes. A prevalência de diabetes mellitus gestacional encontrada foi de 19,6%. Sobrepeso ou obesidade estavam presentes em 71,0% das gestantes. Como terapia medicamentosa, a metformina foi utilizada por 20,1% das gestantes, e a via de parto cesárea foi realizada por 69,8%. A idade gestacional precoce ao diagnóstico e a idade materna avançada foram associadas com via de parto cesárea. O índice de massa corporal foi associado positivamente com a intensidade da terapia utilizada para controle glicêmico. A prevalência de diabetes mellitus gestacional encontrada foi superior à dos estudos de base populacional no país e no mundo. A obesidade também apresentou alta prevalência nestas gestantes, sendo fortemente associada à gênese da patologia e à necessidade de terapia mais agressiva. Todavia, é uma condição passível de prevenção e tratamento, podendo ser um alvo de grande impacto na saúde pública, se abordada de uma forma eficaz. Descritores: Gestação; Hiperglicemia; Insulina; Metformina; Obesidade

PERFIL EPIDEMIOLÓGICO E CONDUTA EM PACIENTES COM NÓDULOS MAMÁRIOS PALPÁVEIS

The objective is to evaluate the clinical and epidemiological profile and what were the medical conducts in patients with palpable breast nodules in the physical examination in a clinic in the south of Santa Catarina. This is a descriptive observational study, collecting secondary data, with a quantitative approach, evaluating medical records of patients with palpable nodules on physical examination at a clinic in the south of Santa Catarina. The collected data were: sociodemographic such as age and education, in addition to gynecological factors such as menarche and use of contraceptives. As a result, the mean age of the studied population was 40.13 years. The prevalence of palpable breast lumps was 5.97%; 60.8% of the women denied a family history of neoplasia; 56.7% had no breast symptoms at the time of consultation and 52.5% had two or more pregnancies. Regarding the medical management, 50.8% requested an ultrasound and 35.8% had the nodule as the main location in the upper left external quadrant of the breast. It is concluded that the clinical profile of the patients was of women with a mean age of 40.13 years, with no history of neoplasms, with no breast symptoms, with ultrasound being the most used imaging method. Based on the data from this study, it is possible to outline strategies for a preventive approach to women with a similar profile.&nbsp;O objetico é avaliar o perfil clínico, epidemiológico e quais foram as condutas médicas em pacientes com nódulos mamários palpáveis no exame físico em uma clínica no Sul de Santa Catarina. Trata-se de um estudo observacional descritivo, de coleta de dados secundários, com abordagem quantitativa, avaliando prontuários de pacientes com nódulos palpáveis no exame físico em uma clínica no Sul de Santa Catarina. Os dados coletados foram: sociodemográficos como idade e escolaridade, além de fatores ginecológicos, como menarca e uso de anticoncepcionais. Tem-se como resultados que a idade média da população estudada foi de 40,13 anos. A prevalência de nódulos mamários palpáveis foi de 5,97%; 60,8% das mulheres negavam histórico de neoplasia familiar; 56,7% não possuíam sintomas mamários no momento da consulta e 52,5% tinham duas ou mais gestações. Em relação a conduta médica, 50,8% foi solicitado ultrassonografia e 35,8% tinham como localização principal do nódulo o quadrante superior externo esquerdo da mama. Conclui-se que o perfil clínico das pacientes foi de mulheres com média de idade de 40,13 anos, sem histórico de neoplasias, com ausência de sintomas mamários, sendo o ultrassom o método de imagem mais utilizado. A partir dos dados deste estudo é possível traçar estratégias para abordagem preventiva de mulheres com perfil semelhante

Sarcopenia and risk of malnutrition as risk factors for complications from COVID-19

Objetivo: Este estudo teve como objetivo associar o risco nutricional e de sarcopenia com desfechos clínicos em pacientes idosos com COVID-19. Métodos: Trata-se de um estudo de coorte retrospectivo longitudinal. Idosos hospitalizados com diagnóstico de COVID-19 foram incluídos no estudo. O risco nutricional foi avaliado usando o Malnutrition Universal Screening Tool (MUST) e o risco de sarcopenia foi avaliado usando o SARC-F. As associações foram avaliadas por modelos logísticos multivariados. Resultados: No total, 127 pacientes (média de idade: 71,25 ±8,06 anos) foram acompanhados até o desfecho clínico. Risco de sarcopenia foi diagnosticado em 63,8% da amostra, enquanto risco nutricional foi observado em 72% deles. Além disso, 48,8% da amostra necessitoude internação em unidade de terapia intensiva (UTI), 38,6% necessitaram ventilação mecânica e 32,3% foram a óbito. Idosos com risco de sarcopenia tiveram maior chance de internação em UTI (OR: 5,62; IC 95%: 2,2-14,3), necessidade de ventilação mecânica (OR: 4,0; IC 95%: 1,5-10,2) e óbito (OR: 5,06; IC 95%: 1,7-14,2). O risco de desnutrição avaliado pelo MUST foi um importante fator de risco para óbito (OR = 30,15; IC 95%: 3,6-245,8; p&lt;0,01). Conclusão: O risco de sarcopenia foi fator de risco para óbito, internação em UTI e ventilação mecânica,enquanto o risco nutricional foi fator de risco para óbito.Purpose: This study aimed to associate nutritional and sarcopenia risk with clinical outcomes in elderly patients with COVID-19. Methods: This is a longitudinal retrospective cohort study. Hospitalized elderly individuals diagnosed with COVID-19 were included in the study. Nutritional risk was assessed using the Malnutrition Universal Screening Tool (MUST), and Sarcopenia risk was assessed using the SARC-F. Associations were assessed throughmultivariable logistic models. Results: In total, 127 patients (mean age: 71.25 ±8.06 years) were followed up until the clinical outcome. Sarcopenia risk was diagnosed in 63.8% of the sample, whereas nutritional risk was observed in 72%. Hospitalization in the intensive care unit (ICU) was required in 48.8% of the sample, 38.6% required mechanicalventilation, and 32.3% died. Elderly individuals with sarcopenia risk were more likely to be hospitalized inICUs (OR: 5.62; 95%CI: 2.2-14.3), require mechanical ventilation (OR: 4.0; 95% CI: 1.5-10.2), and die (OR: 5.06; 95% CI: 1.7-14.2). The risk of malnutrition assessed through MUST was an important risk factor for death (OR = 30.15; 95% CI: 3.6-245.8; p&lt;0.01). Conclusion: Sarcopenia risk was a risk factor for death, hospitalization in ICU, and mechanical ventilation, while nutritional risk was a risk factor for death

Considerações gerais sobre a síncope: uma abordagem clínica : General considerations about syncope: a clinical approach

O seguinte estudo objetivou descrever sobre as etiologias e o respectivo quadro clínico da síncope. A síncope é classificado como um sintoma de perda da consciência devido redução do fluxo sanguíneo cerebral, secundário a uma etiologia. Tal evento costuma ser confundido com outras condições associadas a perda de conhecimento, apesar de para se diagnosticar como síncope é necessário descartar demais alterações. A síncope é uma condição que têm como fisiopatologia o hipofluxo de sangue no cérebro, mas conta com diversas causas como a neuromediada, ortostática, cardíaca, cerebrovascular e até idiopática,&nbsp; resultam em quadros clínicos distintos e complicações, mas o mesmo desfecho. Tal evento necessita ser investigado e detectado de imediato, por história clínica, exame físico e complementares

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

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

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ