ABSTRACT BACKGROUND: Carpal tunnel syndrome (CTS) is a common condition greatly affects patients’ quality of life and ability to work. Systematic reviews provide useful information for treatment and health decisions. OBJECTIVE: This study aimed to assess the methodological quality of previously published systematic reviews on the treatment of CTS. DESIGN AND SETTING: Overview of systematic reviews conducted at the Brazilian public higher education institution, São Paulo, Brazil METHODS: We searched the MEDLINE and Cochrane Library database for systematic reviews investigating the treatment of CTS in adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and measurement tool to assess systematic reviews (AMSTAR) were applied by two independent examiners. RESULTS: Fifty-five studies were included. Considering the stratification within the AMSTAR measurement tool, we found that more than 76% of the analyzed studies were “low” or “very low”. PRISMA scores were higher when meta-analysis was present (15.61 versus 10.40; P = 0.008), while AMSTAR scores were higher when studies performed meta-analysis (8.43 versus 5.59; P = 0.009) or when they included randomized controlled trials (7.95 versus 6.06; P = 0.043). The intra-observer correlation demonstrated perfect agreement (> 0.8), a Spearman’s correlation coefficient of 0.829, and an ICC of0.857. The inter-observer correlation indicated that AMSTAR was more reliable than PRISMA. CONCLUSION: Overall, systematic reviews of the treatment of CTS are of poor quality. Reviews with better-quality conducted meta-analysis and included randomized controlled trials. AMSTAR is a better tool than PRISMA because it has a better performance and should be recommended in future studies. REGISTRATION NUMBER IN PROSPERO: CRD42020172328 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020172328)

SUMMARY OBJECTIVE: The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery. METHODS: A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019. RESULTS: A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications. CONCLUSION: Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary.

ABSTRACT. This study aimed to observe the attractiveness efficiency of trap boxes installed in collective shelters of stingless bee colonies (Melipona flavolineata, Melipona fasciculata and Scaptotrigona aff. depilis), as an alternative method for non-chemical control of tracuá carpenter ants (Camponotus atriceps). The study was conducted at Embrapa Amazônia Oriental, in Belém, Pará, Brazil, from March to August 2015. The results showed that the efficiency of this technique depended on the presence of bee colonies and on the bee species in the collective shelter. Overall, an efficiency of 40.6% was found in the capture of C. atriceps individuals, which rose to 75% considering only collective shelters of M. fasciculata colonies, and to 87.5% for collective shelters of M. flavolineata. Trap boxes installed in collective shelters of S. depilis did not attract any C. atriceps group or individuals. The use of trap boxes in collective shelters of stingless bee colonies of the genus Melipona (M. flavolineata and M. fasciculata) is an efficient alternative method of non-chemical control of tracuá carpenter ants (C. atriceps).

ABSTRACT BACKGROUND: Carpal tunnel syndrome (CTS) is a common condition greatly affects patients’ quality of life and ability to work. Systematic reviews provide useful information for treatment and health decisions. OBJECTIVE: This study aimed to assess the methodological quality of previously published systematic reviews on the treatment of CTS. DESIGN AND SETTING: Overview of systematic reviews conducted at the Brazilian public higher education institution, São Paulo, Brazil METHODS: We searched the MEDLINE and Cochrane Library database for systematic reviews investigating the treatment of CTS in adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and measurement tool to assess systematic reviews (AMSTAR) were applied by two independent examiners. RESULTS: Fifty-five studies were included. Considering the stratification within the AMSTAR measurement tool, we found that more than 76% of the analyzed studies were “low” or “very low”. PRISMA scores were higher when meta-analysis was present (15.61 versus 10.40; P = 0.008), while AMSTAR scores were higher when studies performed meta-analysis (8.43 versus 5.59; P = 0.009) or when they included randomized controlled trials (7.95 versus 6.06; P = 0.043). The intra-observer correlation demonstrated perfect agreement (> 0.8), a Spearman’s correlation coefficient of 0.829, and an ICC of0.857. The inter-observer correlation indicated that AMSTAR was more reliable than PRISMA. CONCLUSION: Overall, systematic reviews of the treatment of CTS are of poor quality. Reviews with better-quality conducted meta-analysis and included randomized controlled trials. AMSTAR is a better tool than PRISMA because it has a better performance and should be recommended in future studies. REGISTRATION NUMBER IN PROSPERO: CRD42020172328 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020172328)

RESUMO Objetivo Analisar os dados clínicos e sociodemográficos das fraturas acetabulares em um hospital quaternário brasileiro e comparar com dados relatados na literatura. Métodos: Estudo epidemiológico, descritivo, analítico transversal, em que foram analisados 87 pacientes com fraturas acetabulares no Hospital São Paulo (UNIFESP/EPM) entre 2005 e 2016. Variáveis demográficas como idade, sexo, profissão, escolaridade e cor foram pesquisadas. As fraturas acetabulares foram classificadas conforme o grupo AO/OTA e conforme Judet e Letournel. A terapêutica, o tempo de internação e de espera para cirurgia bem como as complicações foram analisadas. Foram feitas associações entre as diversas variáveis obtidas. Resultados: A média de idade dos pacientes vítimas de fraturas do acetábulo foi de 39,8 anos (DP 13,1 anos). Houve predomínio das fraturas da parede posterior (34,5%) e dupla coluna (14,9%). Os pacientes ficaram, em média, 14,4 dias internados. Mais de 90% dos pacientes foram submetidos à abordagem cirúrgica. Um quarto dos pacientes tiveram complicações, sendo a principal, infecção (12,6%). Conclusões: Foi obtida uma amostra etária unimodal com predomínio de pacientes do sexo masculino, brancos e economicamente ativos. Houve um predomínio das fraturas da parede posterior. Mais de 90% dos pacientes foram operados antes dos 14 dias de internação. Constatou-se uma associação estatisticamente significante entre complicações e tempo excedido de permanência hospitalar. Nível de evidência II, Estudo retrospectivo.

ABSTRACT Objective: Analyze the clinical and sociodemographic data on acetabular fractures in a Brazilian quaternary care hospital and compare with data reported in the literature. Methods: A descriptive, analytical cross-sectional epidemiological study analyzing 87 patients with acetabular fractures at Hospital São Paulo (UNIFESP/EPM) between 2005 and 2016. Demographic variables such as age, sex, occupation, educational level and color were investigated. Acetabular fractures were classified according to the AO/OTA group and Judet and Letournel classification. Therapeutic approach, hospital length of stay and waiting time for surgery as well as complications were analyzed. Associations were established among the various variables obtained. Results: The mean age of patients with acetabulum fractures was 39.8 years (SD 13.1 years). There was a predominance of posterior wall (34.5%) and dual-column (14.9%) fractures. The average hospital length of stay was 14.4 days. More than 90% of patients underwent a surgical procedure. One-fourth of patients had complications, the main one being infection (12.6%). Conclusions: Unimodal age distribution was obtained with a predominance of white male economically active patients. There was a predominance of posterior wall fractures. More than 90% of patients underwent surgery before they had been in hospital for 14 days. A statistically significant association was found between complications and exceeded length of hospital stay. Level of evidence II, Retrospective study.

Resumo Objetivos Comparar o tempo médio de retorno dos atletas ao esporte após lesão muscular aguda da coxa com hematoma que foi ou não puncionado. Métodos Estudolongitudinal de intervenção clínica, controlado e não randomizado, com participação de 20 atletas amadores e profissionais com lesão muscular aguda do tipo parcial moderada ou (sub)total na região da coxa, segundo a classificação do Consenso de Munique. Nove atletas foram incluídos no grupo intervenção e 11 no grupo controle. Os atletas do grupo intervenção foramsubmetidos a punção do hematoma e fisioterapia e os do grupo controle, apenas a fisioterapia. A variável tempo de retorno ao esporte foi analisada como teste deMann-Whitney e o nível de significância usado foi 95% (p < 0,05). Resultados A população estudada foi composta principalmente por homens, dos quais oito eram praticantes de esportes no nível amador. Três mulheres, das quais duas eram amadoras, foram incluídas no estudo. A média de idade dos participantes foi de 34,70 ± 12,79 anos. Houve 13 indivíduos com lesões na região posterior da coxa, cinco comlesões na região anterior e dois com lesões na região adutora. Considerando todas as lesões, o tempo médio de retorno ao esporte foi de 48,50 ± 27,50 dias no grupo intervenção. Já no grupo controle, esse intervalo foi de 102,09 ± 52,02 dias (p = 0,022). Conclusão No presente estudo, a punção do hematoma muscular mostrou-se efetiva em abreviar o tempo de retorno ao esporte dos atletas com lesões musculares parciais moderadas e (sub)totais associadas a hematomas. Abstract Objectives To correlate the mean time of return of athletes to sport after acute injury of the thigh muscle with hematoma that was punctured or not.

Abstract Objectives To correlate the mean time of return of athletes to sport after acute injury of the thigh muscle with hematoma that was punctured or not. Methods Study based on clinical intervention, controlled and non-randomized with 20 amateur and professional athletes, divided into moderate and total or subtotal thighs lesions, according with the Munich Consensus Statement. Nine athletes were included in the intervention group and 11 athletes in the control group. In the intervention group, the athletes were submitted to a puncture of the hematoma, associated to physical therapy; the control group did only physical therapy. The variable mean time of return to sport was analyzed using the Mann-Whitney test and a significance level of 5% (p < 0.05; 95% confidence interval [CI]) was established. Results The mean group was composed mostly of men, eight of them were amateur athletes. There were three women, two of whom were amateur athletes. The average age of participants was 34.70 ± 12.79 years. There were 13 patients with posterior thigh lesions, 5 with anterior lesions and two with adductor lesions. Considering all injuries, the mean time of return to sport was of 48.50 ± 27.50 days in the intervention group. In the control group, this period was of 102.09 ± 52.02 days, showing a statistically significant difference between them (p = 0.022). Conclusion In the present study, hematoma drainage in athletes with moderate and total or subtotal muscle injuries associated with hematomas decreased their return time to sport.

ABSTRACT BACKGROUND: Hierarchy of evidence is an important measurement for assessing quality of literature. Information regarding quality of evidence within the Brazilian hand surgery setting is sparse, especially regarding whether research has improved in either quality or quantity. This study aimed to identify and classify hand surgery studies published in the two most important Brazilian orthopedics journals based on hierarchy of evidence, with comparisons with previously published data. DESIGN AND SETTING: Bibliometric analysis study performed in a federal university. METHODS: Two independent researchers conducted an electronic database search for hand surgery studies published between 2010 and 2016 in Acta Ortopédica Brasileira and Revista Brasileira de Ortopedia. Eligible studies were subsequently classified according to methodological design, based on the Haynes pyramid model (HP) and the JBJS/AAOS levels of evidence and grades of recommendations (LOR). Qualitative and quantitative data were gathered regarding all studies. Previous data were considered to assess whether the proportion of high-quality studies had improved over time (2000-2009 versus 2010-2016). RESULTS: The final analysis included 123 studies, mostly originating from the southeastern region (78.8%) and private institutions (65%), with self-funding (91.8%). Methodological assessment showed that 15.4% were classified as level I/II using HP and 16.4% using LOR. No significant difference in proportions of high-quality studies was found between the two periods of time assessed (5% versus 12%; P = 0.13). CONCLUSION: Approximately 15% of hand surgery studies published in two major Brazilian journals were likely to be classified as high-quality through two different systems. Moreover, no trend towards quality-of-evidence improvement was found over the last 15 years.

RESUMO Este trabalho teve como objetivo isolar bactérias esporulantes a partir do mel de Melipona sp. em ambiente de caatinga e avaliar o seu potencial antagonista com vistas à aplicação na medicina e produção animal. As amostras de méis foram coletadas no município de Serra Talhada-PE, onde o mel foi retirado de quatro colméias diferentes (em triplicata), totalizando 12 amostras que amostras foram diluídas (10-1 a 10-5) e submetidas a 80 ºC por 20 minutos e resfriadas a 5 ºC para indução de esporos e eliminação de células vegetativas. Em seguida, as diluições foram semeadas em Agar Nutriente e incubadas a 30 º por 72 horas para contagem das unidades formadoras de colônias (UFC). Antes do tratamento térmico foram realizados testes para verificar a presença de fungos filamentosos, leveduras e coliformes totais e termotolerantes. As diluições foram semeadas em Agar Malte e Agar Sabouraud e incubadas a 30 ºC por 14 dias. Coliformes totais e termotolerantes foram quantificados pelo método do número mais provável (NMP). Foram obtidos sete isolados (I) de bactérias esporulantes (Bacillus), porém apenas quatro mostraram algum potencial antagonista. O isolado I-5 apresentou o maior potencial antagonista, inibindo o crescimento de Escherichia coli, Klebsiella sp., Pseudomonas aeruginosa, Salmonella sp. e Staphylococcus aureus. Apenas Sarcina sp. não foi inibida. Não foram encontrados fungos filamentosos, leveduras ou coliformes nas amostras. O mel de Melipona sp. é uma fonte de bactérias esporulantes resistentes a elevadas temperaturas e com potencial antagonista a micro-organismos contaminantes e apresenta boa qualidade microbiológica.

ABSTRACT The aim of this study was to isolate sporogenic bacteria from the honey of stingless bees Melipona sp., in dry forest, and to evaluate their antagonistic potential for medicinal employment purposes and animal production. The honey samples were collected in Serra Talhada-PE, where honey was taken from four different hives (in triplicate), totaling 12 samples. The samples were diluted and subjected to 80 ºC for 20 minutes to eliminate vegetative cells. The dilutions were plated onto nutrient agar and incubated at 30 ºC for 72 hours. Then the colony forming units (CFU) were quantified. The samples were also plated onto malt agar and Sabouraud agar, and incubated at 30 ºC for 14 days for the growth of yeast and molds. Total and fecal coliforms were quantified by the most probable number method (MPN). Seven isolates (I) of sporogenic bacteria (Bacillus) were obtained, however only four showed probiotic potential. Isolate I-5 showed the greatest probiotic potential and inhibited the growth of Escherichia coli, Klebsiella sp., Pseudomonas aeruginosa, Salmonella sp., and Staphylococcus aureus. The growth of the Sarcina sp. was not inhibited by any isolate. No yeast, molds or coliforms were found. The Melipona sp. honey is a source of spore-forming bacteria and is antagonistic to microorganisms that contaminate honey. It has good microbiological quality.

Com o objetivo de avaliar os potenciais produtivo e genético de clones de batata-doce, visando à seleção de materiais genéticos mais produtivos, com caracteres que facilitem o manejo, foi desenvolvido um experimento, no ano de 2007, composto por nove clones e duas variedades, no delineamento em blocos casualizados, com três repetições. Avaliaram-se seis características da parte aérea e quatro das raízes. O clone 6 obteve a maior produtividade de raiz comercial, com 12,08 t ha-1. Os clones 8, 14 e a variedade Rainha Prata apresentaram as maiores produtividades de fitomassa da parte aérea, com 5,42; 5,17 e 5,83 t ha-1, respectivamente. O clone 11, além de produzir 9,08 t ha-1 de raiz comercial e 4,02 t ha-1 de fitomassa da parte aérea, apresentou também comprimento e diâmetro do entrenó favoráveis às práticas de manejo. As produtividades de raiz comercial e as de fitomassa da parte aérea além do comprimento do entrenó apresentaram as maiores σ2G e σ2E, CV G, h² e índice de variação (b) favoráveis para se obter ganhos genéticos satisfatórios com a seleção. Dessa forma, os clones 6 e 11 apresentam características interessantes a serem exploradas por técnicas seletivas nas futuras etapas de melhoramento dessa cultura.

With the objective to evaluate the yield and genetic potential of sweet potato clones, aiming at the selection of more productive genetic material, with traits that facilitate tillage, an experiment was conducted in 2007, composed of nine clones and two local varieties, in a completely randomized block design with three replications. Six traits of the shoot and four traits of the storage roots were evaluated. Clone 6 had the highest marketable root yield, with 12.08 t ha-1. Clones 8, 14 and the "Rainha Prata" variety had the highest shoot phytomass yield, with 5.42, 5.17 and 5.83 t ha-1, respectively. Clone 11, in addition to producing 9.08 t ha-1 of marketable root and 4.02 t ha-1 of shoot phytomass, also featured favorable internode length and diameter for the practice of tillage. Marketable root and shoot yield and the length of internode presented the highest and favorable σ2G and σ2E, CV G, h² and variation index (b) to obtain satisfactory genetic gains from the selection. Thus, clones 6 and 11 presented interesting traits that could be exploited by selective techniques in future stages of breeding program of this culture.

OBJETIVO: avaliar a influência da idade sobre a qualidade seminal de homens com quadro de infertilidade conjugal submetidos a análises espermáticas em um serviço de reprodução humana. MÉTODOS: estudo retrospectivo, no qual foram avaliados os espermogramas de todos os homens em processo de investigação para infertilidade conjugal no período de Setembro de 2002 a Dezembro de 2004, em um serviço de reprodução assistida do nordeste do Brasil. Foram incluídos 531 indivíduos submetidos a 531 avaliações espermáticas. Foram analisados os seguintes parâmetros: volume, concentração, motilidade e morfologia espermática. O total de investigados foi dividido em grupos, de acordo com resultados obtidos de cada variável estudada. Os grupos referentes ao volume seminal foram: hipoespermia, normoespermia e hiperespermia. Os grupos referentes à concentração espermática foram: azoospermia, oligoospermia, normospermia e poliespermia. Os grupos referentes à motilidade foram: motilidade normal e astenospermia. Os grupos referentes à morfologia foram: morfologia normal e teratospermia. As médias das idades dos pacientes entre os grupos com parâmetros normais foram comparadas com as de grupos alterados, sendo utilizado o teste t. Para análise estatística, foi utilizado o programa XLSTAT (p<0,05). RESULTADOS: os indivíduos estudados tinham média de idade de 37±7,9 anos, com um volume seminal médio de 3±1,4 mL, uma concentração espermática de 61,4±66,4 espermatozóides por mL de sêmen, motilidade progressiva de 44,7±19,4% do total de espermatozóides e morfologia normal de 11,2±6,6% dos espermatozóides. As médias de idade entre os grupos foram semelhantes, exceto a média dos indivíduos com hipoespermia, que foi significativamente maior que a dos homens com normoespermia (39,6±10,3 versus 36,5±7,3, p=0,001). CONCLUSÕES: a idade interfere, de forma inversamente proporcional, sobre o volume do ejaculado, porém não exerce influência na concentração, motilidade e morfologia espermática.

PURPOSE: to evaluate the influence of age on the quality of semen in men submitted to spermatic analysis in a human reproduction service, in cases of conjugal infertility. METHODS: a retrospective study in which the spermiograms of all men in process of investigation for conjugal infertility in a service of assisted reproduction in the Northeast of Brazil were evaluated from September 2002 to December 2004. A number of 531 individuals submitted to 531 spermatic evaluations were included in the study. The following parameters have been analyzed: spermatic volume, concentration, motility and morphology. The men under investigation have been divided in groups, according to the results obtained in each of the variables studied. Seminal volume groups were divided in: hypospermia, normospermia and hyperspermia. Spermatic concentration groups were divided in: azoospermia, oligospermia, normospermia and polyspermia. Motility groups were divided in: normal motility and asthenospermia. Morphology groups were divided in: normal morphology and teratospermia. The t test has been used to compare the average age of patients in groups with normal and in groups with altered parameters. The program XLSTAT (p<0.05) has been used for the statistical analysis. RESULTS: the individuals studied presented an average of 37±7.9 years old, with an average of seminal volume of 3±1.4 mL, a spermatic concentration of 61.4±66.4 spermatozoids by mL of semen, a progressive motility of 44.7±19.4% of the total of spermatozoids and normal morphology of 11.2±6.6% of the spermatozoids. Average age among groups were similar, except for that of individuals with hypospermia, which was significantly higher than the one from men with normospermia (39.6±10.3 versus 36.5±7.3, p=0.001). CONCLUSIONS: age interferes in an inversely proportional way on the ejaculated volume, but does not influence spermatic concentration, motility and morphology.

OBJETIVOS: comparar duas diferentes técnicas de congelação e dois tipos de envase do sêmen humano durante processo de criopreservação. MÉTODOS: estudo experimental, no qual foi analisada a criopreservação de 18 amostras de sêmen de 18 voluntários. Após a adição de meio crioprotetor, "Test-yolk buffer" , as amostras de sêmen foram envasadas em palhetas com capacidade de 0,25 mL ou em criotubos de 2 mL e submetidas à criopreservação por dois métodos, um lento e outro rápido, totalizando quatro tratamentos distintos: RP (congelação pelo método rápido e envasado em palheta), RT (rápido-criotubo), LP (lento-palheta) e LT (lento-criotubo). As amostras, após 24 horas, foram descongeladas em temperatura ambiente e mantidas a 37ºC. Os dados coletados foram analisados através do teste t de Student, com p<0,05, utilizando o programa de computador SPSS for Windows® versão 11.0.0. RESULTADOS: houve redução da motilidade espermática após o processo de criopreservação. A taxa de motilidade inicial foi 58,1% e as motilidades após os diferentes métodos de criopreservação foram: 19,2% (RP), 27% (RT), 21,1% (LP) e 30,3% (LT). Houve redução significativa na morfologia normal. A taxa de morfologia normal inicial foi 14,2% e as morfologias após os diferentes métodos de criopreservação foram: 12,8% (RP), 12,6% (RT), 12,6% (LP) e 12,4% (LT). CONCLUSÕES: o método de criopreservação lento com envase em criotubo esteve associado à melhor motilidade espermática após o descongelamento. Não houve diferença entre os métodos quando avaliada a morfologia espermática.

PURPOSE: to compare two different methods of freezing and two types of human semen storage during cryopreservation process. METHODS: experimental research in which the cryopreservation of 18 semen samples from 18 volunteers was studied. Following the addition of the cryoprotectant medium, Test-yolk buffer, the semen samples were packaged into 0.25 mL straws or into 2 mL cryotubes and submitted to cryopreservation by slow or rapid methods, in four different treatments: RS (cryopreservation by rapid method and packaged in straws), RT (rapid-cryotubes), SS (slow-straws), and ST (slow-cryotubes). Samples were thawed after 24 hand then maintained at 37ºC. Data collected were analyzed by the Student t-test, with p<0.05, using the SPSS computer program for Windows®, version 11.0.0. RESULTS: the motility of spermatozoa decreased after the cryopreservation process. The initial motility rate was 58.1% and motilities after the different methods of cryopreservation were 19.2% (RS), 27% (RT), 21.1% (SS) and 30.3% (ST). There was a significant decrease of the normal morphology. The initial normal morphology was 14.2% and morphologies after the different methods of cryopreservation were 12.8% (RS), 12.6% (RT), 12.6% (SS) and 12.4% (ST). CONCLUSIONS: the slow method of cryopreservation with storage in cryotubes showed the best recovery of motile cells after freezing and thawing. There was no difference among the methods when appraised the morphology.