Abstract Objective: To analyze the tendency of alcoholic beverage consumption among adolescents and young adults at school age according to their sexes. Methods: This is a trend research study in public schools of the municipality of Petrolina, between 2014 and 2016, with 3146 students aged between 12 and 24 years old. The instrument was constituted by socio-economic inquiry and the Youth Risk Behavior Survey. Trends were assessed using the Centers for Disease Control and Prevention recommended approach. The analyses were conducted using logistic regression, with a statistical significance of 0.05. Results: Close to 56% of the adolescents had already tried some alcoholic beverage, most of which had contact after 13 years of age. The prevalence of binge drinking ranged between 17% and 25%. The percentage of girls who tried alcohol before 13 years old remained similar over the three years (p = 0.943). The prevalence of this behavior was stabilized at around 20%. There was a trend to decrease in the prevalence of boys who reported having tried alcohol before 13 years old (p = 0.014). The percentage of boys who reported involvement in binge drinking in the past 30 days remained stable at around 20% over the years (p = 0.951 ). The girls’ data revealed a significant decrease in binge drinking (p = 0.019). Conclusions: The general analysis suggests a trend towards stabilization of consumption among boys, and an increase among girls.

ABSTRACT Objective: to trace the clinical and epidemiological profile of penile cancer in Rio Grande do Norte/Brazil and relate them to data published in the literature. Methods: a cross-sectional study was conducted with 94 patients diagnosed with penile cancer in 2011-2018, treated at the Liga Norte Riograndense Contra o Cancer. Results: all patients were diagnosed with squamous cell carcinoma, mainly aged over 50 years, from the states interior, brown, illiterate, or with incomplete primary education. At diagnosis, 68% of patients were classified as having tumors =T2, and 30% had lymph node involvement. Distant metastases were detected in 2.1% of patients at diagnosis. Most patients received the diagnosis in the initial phase of the disease, but 20.2% were diagnosed in stage IV. Partial penectomy was the most performed surgery, and 10% of patients relapsed, mainly in the lymph nodes (87.5%). The mean follow-up of the patients was 18 months, with an estimated overall survival at five years of 59.1%. However, 25% of patients were followed up for up to 3 months, losing follow-up. Conclusion: the State of Rio Grande do Norte has a high incidence of penile cancer with a high frequency of locally advanced tumors at diagnosis and in younger patients younger than 50. Furthermore, socioeconomic factors interfere with early diagnosis and hinder access to specialized services.

RESUMO Objetivo: traçar o perfil clínico e epidemiológico do câncer de pênis no Rio Grande do Norte/Brazil e relacioná-los com dados publicados na literatura. Métodos: realizou-se estudo transversal de 94 pacientes diagnosticados com câncer de pênis no período de 2011-2018, tratados na Liga Norte Riograndense Contra o Câncer. Resultados: todos os pacientes foram diagnosticados com carcinoma espinocelular, principalmente com idade acima dos 50 anos, provenientes do interior do estado, pardos, analfabetos ou com ensino fundamental incompleto. Ao diagnóstico, 68% dos pacientes foram classificados com tumores =T2 e 30% possuiam envolvimento linfonodal. Metástases à distância foram detectadas em 2,1% dos pacientes ao diagnóstico. A maioria dos pacientes recebeu o diagnóstico na fase inicial da doença, mas 20,2% foram diagnosticados em estádio IV. Penectomia parcial foi a cirurgia mais realizada e 10% dos pacientes recidivaram, principalmente para linfonodos (87,5%). A média de seguimento dos pacientes foi de 18 meses, apresentando estimativa de sobrevida global em 5 anos de 59,1%. No entanto, 25% dos pacientes foram acompanhados por até 3 meses, perdendo o seguimento. Conclusão: o Estado do Rio Grande do Norte apresenta elevada incidência de câncer de pênis com alta frequência de tumores localmente avançados ao diagnóstico, assim como em pacientes mais jovens, menores que 50 anos de idade. Outrossim, o fator socioeconômico interfere no diagnóstico precoce e dificulta o acesso a serviços especializados. .

RESUMO Objetivo: avaliar a concordância do tempo máximo de fonação (TMF) com a Capacidade Vital, intra e interexaminador, por meio da técnica de contagem numérica em uma única respiração (TC) e do fonema /a/ sustentado e da capacidade vital lenta (CVL). Métodos: trata-se de um estudo de concordância realizado em três grupos de indivíduos saudáveis, cada grupo com 30 voluntários, alocados de acordo a idade. A CVL foi mensurada por meio do espirômetro, enquanto o TMF foi avaliado pela emissão do fonema/a/ e da TC. Os dados foram analisados pelo programa SPSS versão 20.0. Inicialmente utilizou-se estatística descritiva e para concordância dos dados foi utilizado o coeficiente de correlação intraclasse (CCI). Resultados: os Coeficientes de Correlação Intraclasse (CCI) intraexaminadores foram considerados excelentes, com resultados significantes acima de 0,92 para a CVL e maiores que 0.79 para a TC e fonema/a/. Em relação à avaliação interexaminadores, os CCIs também foram significantes tanto para a CVL com valores maiores que 0,96 quanto para a TC e o fonema/a/ com valores maiores que 0,85. O erro inerente a técnica foi avaliada por meio do erro padrão da medida para as analises intra e interexaminadores com valores que variaram de 1,79 a 3,29 para fonema/a/, 3,20 a 6,58 para TC e 65,05 a 206,73 para CVLml. Conclusão: as técnicas de fonação com o fonema /a/ e TC, assim como a CVL, demonstraram uma excelente concordância intra e interexaminadores.

ABSTRACT Purpose: to evaluate the reliability of the maximum phonation time (MPT) and Vital Capacity intra and inter-examiner, by means of the single-breath counting test (CT) and the sustained /a/ phoneme, and the slow vital capacity (SVC). Methods: a reliability study carried out in three groups of healthy individuals, each group with 30 volunteers, allocated according to age. SVC was measured using a spirometer, while the MPT was assessed by the phoneme /a/ and CT. The data were analyzed using SPSS version 20.0. Initially, descriptive statistics were used and for data reliability, the intraclass correlation coefficient (ICC). Results: the Intraclass Correlation Coefficients (ICC) were considered excellent, with significant results above 0.92 for SVC and greater than 0.79 for CT and phoneme /a/. Regarding the inter-examiner evaluation, the ICCs were also significant for both SVC with values greater than 0.96, and for CT and the phoneme /a/ with values greater than 0.85. The error inherent in the technique was assessed using the standard error of the measurement for intra and inter-examiner analyses with values ranging from 1.79 to 3.29 for phoneme /a/, 3.20 to 6.58 for CT and 65, 05 to 206.73 for SVCml. Conclusion: phonation techniques with the phoneme /a/ and CT, as well as SVC, have an excellent reliability, due to intra and inter-examiner agreement measures.

RESUMO Introdução: A cirurgia transanal robótica (RTS,Robotic Transanal Surgery) é análoga da TAMIS (cirurgia minimamente invasiva transanal) e representa um novo foco para o avanço das plataformas transanais. A cirurgia transanal robótica é algumas vezes chamada de TAMIS robótica. Embora limitada a apenas alguns centros em todo o mundo, a experiência com a cirurgia transanal robótica tem sido encorajadora. A maioria das pesquisas com cirurgia transanal robótica tem se concentrado na excisão local da neoplasia retal, embora procedimentos mais complexos, como a proctectomia transanal, sejam possíveis utilizando a abordagem robótica. Este artigo relata a técnica cirúrgica de R-TAMIS realizada no Instituto Nacional do Câncer (INCA, Rio de Janeiro). Métodos: paciente de 71 anos, sexo feminino, com doença cardiológica (insuficiência cardíaca), com neoplasia retal de 1,5 cm a 4 cm da borda anal em posição anterolateral direita. A biópsia revelou tumor neuroendócrino. Uma colonoscopia completa não revelou evidências de lesões sincrônicas. A investigação incluiu ultrassonografia endorretal em 3D e ressonância magnética, que demonstrou que a lesão era uT1uN0. A paciente foi aconselhada sobre as opções cirúrgicas – excisão localversus ressecção anterior baixa. Devido à condição cardiológica, optou-se por proceder à excisão local com cirurgia transanal robótica. Conclusão: A TAMIS robótica é um procedimento cirúrgico seguro e eficaz para casos altamente selecionados de neoplasia retal. Ela melhora a ergonomia do cirurgião e facilita a remoção do tumor e a sutura na abordagem transanal.

ABSTRACT Introduction: Robotic transanal surgery (RTS) is the analog of TAMIS and represents a new focus for the advancement of transanal platforms robotic transanal surgery is sometimes referred to as robotic TAMIS. Though limited to only a few centers world-wide, experience with robotic transanal surgery has been encouraging. Most research with robotic transanal surgery has concentrated on local excision of rectal neoplasia, although more complex procedures such as transanal proctectomy are possible using the robotic approach. This article reports the surgical technique of R-TAMIS performed in the Brazilian National Cancer Institute (INCA, Rio de Janeiro). Methods: 71-year-old, female with cardiologic disease (heart failure), with a 1.5 cm rectal neoplasm at 4 cm from the anal verge in the right anterolateral position. Biopsy revealed neuroendocrine tumor. A compete colonoscopy revealed no evidence of synchronous lesions. Work-up included 3D endorectal ultrasonography and magnetic resonance imaging, which demonstrated the lesion to be uT1uN0. The patient was counseled about surgical options − local excision versus low anterior resection. Due to the cardiologic condition, the patient was elected to proceed with local excision with robotic transanal surgery. Conclusion: Robotic TAMIS is a safe and effective operative procedure for high selected cases of rectal neoplasm. It enhances surgeon ergonomics and facilitates tumor removal and suture in the transanal approach.

Resumo Objetivos: Determinar a prevalência de uso atual do tabaco e sua associação com fatores sociodemográficos e comportamentos de risco entre adolescentes e jovens escolares, segundo o sexo. Métodos: A amostra foi composta por estudantes da rede estadual entre 12 e 24 anos, que responderam a versão brasileira do questionário Youth Risk Behavior Survey. Os dados foram analisados no SPSS (versão 20.0), por meio da Regressão de Poisson para avaliar a Razão de Prevalência (RP) das variáveis independentes em relação ao desfecho. Foi adotado p < 0,05. Resultados: A análise final foi composta por 1.275 adolescentes, dos quais 716 (56,2%) eram meninas e 559 (43,8%) meninos. A prevalência de consumo atual do tabaco foi de 6,6% entre as meninas e 9,7% entre os meninos. No sexo feminino, consumir álcool nos últimos 30 dias (3,91 [1,54-9,94]) e ter 14 anos ou menos (0,50 [0,26-0,96]) influenciaram o uso atual de tabaco. No sexo masculino, o uso de tabaco nos últimos 30 dias foi influenciado pelo consumo atual de álcool (2,92 [1,21-7,08]) e envolvimento em luta corporal nos últimos 12 meses (2,32 [1,32-4,09]). Conclusão: Embora a prevalência de consumo atual do tabaco tenha sido baixa em ambos os sexos, a população estudada ainda exibe risco, pois o envolvimento em luta corporal no sexo masculino e o consumo atual de álcool em ambos os sexos aumentaram a probabilidade da população se envolver com uso atual do tabaco.

Abstract Objectives: To determine the prevalence of current tobacco use and its association with sociodemographic factors and risk behaviors among adolescents and young students, according to gender. Methods: The sample consisted of students from the state public school network aged between 12 and 24 years, who answered the Brazilian version of the Youth Risk Behavior Survey questionnaire. The data were analyzed in SPSS software (v. 20.0), using Poisson regression to evaluate the prevalence ratio (PR) of the independent variables in relation to the outcome. p < 0.05 was established as the significance level. Results: The final analysis consisted of 1275 adolescents, of whom 716 (56.2%) were girls and 559 (43.8%) were boys. The prevalence of current tobacco use was 6.6% among girls and 9.7% among boys. In females, consuming alcohol in the last 30 days (3.91 [1.54-9.94]) and being 14 years old or younger (0.50 [0.26-0.96]) influenced current tobacco use. In the male gender, tobacco use in the last 30 days was influenced by current alcohol consumption (2.92 [1.21-7.08]) and involvement in physical fighting in the last 12 months (2.32 [1.32-4.09]). Conclusion: Although the prevalence of current tobacco use was low in both genders, the assessed population still presents a risk, since male involvement in physical fighting and current consumption of alcohol in both genders increased the probability of this population becoming regular tobacco users.

Abstract Aims: To verify the effects of flexibility training conducted at different intensities in young adults. Methods: Twenty-one (21) young adults of both genders with no history of surgery, fracture, and/or rheumatic diseases in the lower limbs and hip, were randomly assigned to low intensity (LI) or high intensity (HI) stretching groups. Two researchers were assigned to evaluate the active knee extension range of motion (ROM) of the volunteers and two other researchers were responsible for the training program. The training consisted of a single exercise for the hamstring muscles (biceps femoris, semimembranosus, semitendinosus). Each session consisted of three repetitions of passive static stretching, maintained for the 60s each, with 30s interval between them, and performed three times a week for four weeks. The stretching intensity was based on the Numerical Verbal Scale, the LI group maintained the intensity between 1 and 2, while the HI group between 9 and 10. Three ROM evaluations were performed pre-intervention, after the 6th session and at the end of the 12th session. Results: No difference was observed between the groups that underwent either high- or low-intensity programs. Both groups achieved gains in flexibility after four weeks of training. Conclusions: The study demonstrated that both high- and low-intensity stretching exercises are effective for ROM and there were no differences between them. Therefore, the intensity can be defined by the preference of the therapist or patient.

Abstract Aim: Resistance exercise (RE) is a widely accepted strategy to counteract the effects of aging and chronic diseases on health-related outcomes. Studies have been suggested that RE improves brain and cognitive health. RE with unstable devices (REI) is a neuromotor complexity strategy with the potential to improve strength, power, and balance in onder adults, however, their effects on neurocognitive function in individuals at risk of cognitive decline are poorly understood. Thus, we describe the REI study protocol, a randomized clinical trial design to assess the effects of 12-weeks of REI and RE on neurocognitive functions in older adults with subjective cognitive complaints. Methods: The sample will consist of individuals (aged 65 or older) with subjective cognitive complaints, who will be randomized in one of three experimental groups: control, RE or REI. Participants of the RE group will receive 12-weeks of progressive resistance training (seven exercises structured into 3 sets of 10-15 repetitions maximum, three times per week). Participants of the REI group will receive the same RE protocol performed on unstable devices that promote progressive instability. The control group received a health education program. The primary outcome is a composite score of neurocognitive functions. Secondary outcomes include each separately neurocognitive domain, functional performance, balance, falls-related parameters, cardiovascular and mood variables. The study results will provide information to design a future and larger preventive trial on populations at risk of cognitive decline and dementia, which is imperative in public health terms. Trial registration: Brazilian registry of clinical trials number RBR-4kqs22.

Resumo Objetivo Determinar a prevalência de comportamentos de risco e sua associação com sobrepeso e obesidade em adolescentes escolares. Métodos Trata-se de estudo transversal, realizado em escolas públicas com adolescentes de 12 a 17 anos. Foi utilizado o questionário Youth Risk Behavior Survey. Os percentis do índice de massa corporal foram obtidos utilizando as tabelas do Centers for Disease Control and Prevention. Possíveis associações foram avaliadas usando o teste do χ2 e um modelo de regressão logística binária. Foram calculados os valores de odds ratio e o IC95%. Resultados Foram avaliados 1.169 estudantes, e 33,9% reportaram ter tido relação sexual. Desse grupo, 33% não utilizaram preservativo na última relação sexual, e 32,7% relataram ter tido quatro ou mais parceiros na vida. Considerando o estado nutricional, 15,3% apresentavam sobrepeso ou obesidade. Em relação ao não uso de preservativo, somente foi observada associação com o número de parceiros sexuais na vida (OR: 0,50; IC95%: 0,28-0,88). O número de parceiros sexuais na vida apresentou associação com o sexo masculino (OR: 9,17; IC95%: 4,16-20,22), idade da primeira relação sexual inferior a 13 anos (OR: 2,51; IC95%: 1,23-5,13) e uso de álcool ou drogas antes da última relação sexual (OR: 6,16; IC95%: 2,14-17,73). Conclusão As taxas de comportamento sexual de risco foram altas, e não foi observada sua associação com sobrepeso e obesidade.

Abstract Objective To determine the prevalence of risky sexual behavior and its association with overweight and obesity among adolescent students. Methods This is a cross-sectional study, conducted in public schools with adolescents aged 12 to 17 years. We used the questionnaire Youth Risk Behavior Survey. The body mass index percentiles were calculated by means of table from the Center for Control and Prevention of Diseases. Possible associations were assessed using the χ2 test and binary logistic regression model. The odds ratio and 95%CI were calculated. Results We evaluated 1,169 students, and 33.9% reported having had sexual intercourse. Of those, 33% did not use a condom during their last intercourse, and 32.7% had had four or more sexual partners thus far. Regarding nutritional status, 15.3% were overweight or obese. In relation to the non-use of condoms, we observed only an association with the number of lifetime sexual partners (OR: 0.50; 95%CI: 0.28-0.88). The number of lifetime sexual partners was associated with males (OR: 9.17; 95%CI: 4.16-20.22), sexual debut age at 13 years or less (OR: 2.51; 95%CI: 1.23-5.13) and drinking alcohol or using drugs before the last intercourse (OR: 6.16; 95%CI: 2.14-17.73). Conclusion Risky sexual behavior rates were high and no association was found between risky sexual behaviors and overweight and obesity.

RESUMO Objetivo: identificar a acurácia do teste de contagem em uma única respiração para determinar a capacidade vital lenta em pacientes hospitalizados e avaliar sua repetibilidade entre o mesmo examinador. Métodos: estudo de diagnóstico em que a escolha das técnicas foi aleatoriamente atribuída. A área sob a curva (característica de operação do receptor) foi calculada a partir da capacidade vital lenta (20ml/kg) para avaliar as melhores características psicométricas do teste de contagem em uma única respiração para este ponto de corte. A repetibilidade observada pelo mesmo examinador foi avaliada usando o coeficiente de correlação intraclasse. Resultados: foram analisados (característica de operação do receptor/capacidade vital lenta=20ml/Kg), foi encontrado o valor de 21 em teste de contagem em uma única respiração com uma sensibilidade de 94,44% e especificidade de 76,62% (área abaixo da curva=0,93, p<0,005). O valor do coeficiente de correlação intraclasse para o teste de contagem foi 0,976 com p>0,005. Conclusão: o teste de contagem em uma única respiração foi uma técnica válida, repetitiva e pode ser uma importante opção de rastreamento para avaliação da função pulmonar na ausência de equipamentos específicos. Essa técnica abre perspectivas no que se refere à substituição da medição da capacidade vital lenta em hospitais que não possuem equipamento espirométrico ou em pacientes que apresentam uma doença contagiosa com risco de contaminação e propagação de doença de um paciente para outro.

ABSTRACT Purpose: to identify the accuracy of the single-breath counting test to determine slow vital capacity in hospitalized patients and to evaluate the repeatability of the same examiner. Methods: a diagnostic study and the choice of techniques were randomly assigned. The area under the curve (receiver operating characteristic) was calculated from the slow vital capacity (20ml/kg) to evaluate the best psychometric characteristics of single-breath counting Test for this cutoff point. Repeatability observed by the same examiner was assessed using the Intraclass Correlation Coefficient. Results: 516 patients hospitalized for various diseases were analyzed. In the curve analysis (receiver operating characteristic/slow vital capacity=20ml/Kg), the value of 21 in single-breath counting test with a sensitivity of 94.44% and specificity of 76.62% (area under the curve =0.93, p<0.005) was found. The intraclass correlation coefficient value for the single-breath counting test was 0.976 with p>0.005. Conclusion: the single-breath counting test was a valid and repetitive technique, and may be an important screening option for assessment of lung function in the absence of specific equipment. This technique opens perspectives to replace slow vital capacity measurement in hospitals, which lack spirometric equipment, or in patients who may have a contagious disease, which has a risk of contamination and spread of disease from one patient to another.

ABSTRACT The quality of sesame (Sesamum indicum L.) seeds is directly influenced by their physical characteristics, which are seldom studied notwithstanding their extreme importance in the entire production chain. Therefore, the objective of this study was to quantify the physical properties of two types of sesame seeds, collected at three points in the plant with different maturation levels, measured with digital caliper, and to evaluate the feasibility of using a digital image to determine their physical characteristics. The seeds were initially evaluated for water content and mass of 1000 seeds, and later with the data of the characteristic dimensions A (length), B (width), and C (thickness), obtained by a caliper and digital images, we determined their sphericity, circularity, projected area, and geometric diameter. We observed that water content did not affect the physical properties of the cream (CNPA G4) and black sesame cultivars. In addition, seeds of the black cultivar presented higher results than the seeds of the cream cultivar for the mass of 1000 seeds (2.7 ± 0.08 g), sphericity (58.8 ± 0.47%), projected area (4.03 ± 0.12 mm2), and geometric diameter (1.65 ± 0.03 mm). Seed batches harvested after 70% maturation had the highest mass of 1000 seeds (2.7 ± 0.12 g). The results of the physical analyses of sesame seeds performed with caliper and digital image are equivalent, which shows that digital images can be used as tools to obtain the physical properties of seeds.

Abstract Fungal infections have become a concern for health professionals, and the emergence of resistant strains has been reported for all known classes of antifungal drugs. Among the fungi causing disease, we highlight those that belong to the genus Aspergillus. For these reasons, the search for new antifungals is important. This study examines the effects of a coumarin derivative, 4-acetatecoumarin (Cou-UMB16) both alone and together with antifungal drugs, and its mode of action against Aspergillus spp. Cou-UMB16 was tested to evaluate its effects on mycelia growth, and germination of Aspergillus spp. fungal conidia. We investigated its possible action on cell walls, on the cell membrane, and also the capacity of this coumarin derivative to enhance the activity of antifungal drugs. Our results suggest that Cou-UMB16 inhibits Aspergillus spp. virulence factors (mycelia growth and germination of conidia) and affects the structure of the fungal cell wall. When applying Cou-UMB16 in combination with azoles, both synergistic and additive effects were observed. This study concludes that Cou-UMB16 inhibits mycelial growth and spore germination, and that the activity is due to its action on the fungal cell wall, and that Cou-UMB16 could act as an antifungal modifier.

RESUMO JUSTIFICATIVA E OBJETIVOS: A discinese escapular tem sido associada a lesões e dor no ombro, no entanto essa relação em adolescentes atletas ainda não é bem definida. O objetivo deste estudo foi avaliar a prevalência de discinese escapular em adolescentes atletas amadores e sua associação com a dor e medidas de função no ombro. MÉTODOS: 178 adolescentes do sexo masculino (14,58±2,16 anos) participaram do estudo. Os sujeitos responderam ao questionário Quick Disability Arm Shoulder Hand. Também foram avaliados massa corporal, estatura, rotação interna do ombro e Closed Kinetic Chain Upper Extremity Stability. Para avaliação da discinese escapular, utilizou-se o método visual dinâmico. A regressão logística binária foi utilizada para analisar a associação entre discinese e as demais variáveis. A comparação entre os grupos com e sem discinese foi feita pelo teste te Mann-Whitney, sendo aceito significância estatística quando p<0,05. RESULTADOS: A prevalência de discinese foi de 56,7% e essa condição não teve associação com dor no ombro. Atletas mais jovens têm 159% mais chances de apresentar discinese, enquanto aqueles que treinam mais de uma hora por dia, durante três vezes por semana, têm 77% mais chances de ter o mesmo desfecho. Nenhuma diferença na função do ombro foi encontrada. CONCLUSÃO: A discinese escapular não está associada à dor e não altera medidas de função no ombro em adolescentes atletas. Modalidade, idade e volume de treinamento parecem induzir mudanças na movimentação escapular.

ABSTRACT BACKGROUND AND OBJECTIVES: Scapular dyskinesis has been associated to shoulder injuries and pain. However, this relationship with adolescent athletes is not well established. The objective of this study was to evaluate scapular dyskinesis in young athletes and its association with pain or shoulder function. METHODS: 178 male adolescent athletes (14.58±2.16 years) were evaluated. The subjects completed the Quick Disability Arm Shoulder Hand questionnaire. Body mass, height, shoulder internal rotation and Closed Kinetic Chain Upper Extremity Stability test were measured. A dynamic visual method was applied to assess dyskinesis. Binary logistic regression was applied to analyze the association between dyskinesis and other variables. The comparison between groups with and without dyskinesis was made by the Mann-Whitney andt-test, accepting a statistical significance of p<0.05. RESULTS: The dyskinesis prevalence was 56.7% and this condition was not associated with shoulder pain. Younger athletes are 159% more likely to have dyskinesis, while those who practice more than one hour a day for three times a week are 77% more likely to have the same outcome. No difference in shoulder function was found. CONCLUSION: Scapular dyskinesis is not associated with pain and does not affect shoulder function in adolescent athletes. Sports modality, age and training volume seem to induce changes in scapula movement.

RESUMO Objetivo: demonstrar as alterações hemodinâmicas durante a colecistectomia laparoscópica em pacientes idosos com auxílio da ecocardiografia trans-esofágica Métodos: foram estudados trinta e um pacientes idosos (com 60 anos de idade ou mais), ASA I ou II, submetidos à colecistectomia laparoscópica eletiva, sob anestesia geral padronizada, com aferição de parâmetros cardiovasculares através de ecocardiograma trans-esofágico em três momentos diferentes: antes do pneumoperitônio (T1), após a insuflação do CO2 (T2) e na desinsuflação (T3). As variações da pressão arterial sistólica, diastólica e média, da frequência cardíaca, do débito e do índice cardíaco, e da fração de ejeção foram avaliadas estatisticamente. Resultados: apesar de pequenas, somente as variações da pressão arterial diastólica (PAD) e da fração de ejeção (FE) foram estatisticamente significativas. A PAD, em mmHg, nos diferentes momentos, de acordo com a média e desvio padrão, foram: T1=67,5±10,3; T2=73,6±12,4; T3=66,7±9,8. E para a FE, em porcentagem (%), nos diferentes momentos, de acordo com média e desvio padrão, foram: T1=66,7±10,4; T2=63,2±9,9; T3=68,1±8,4. Não houve correlação estatística entre as variações hemodinâmicas, a idade e número de comorbidades dos pacientes. Conclusão: a colecistectomia laparoscópica causa poucas alterações hemodinâmicas que são bem toleradas pela maioria dos pacientes idosos; o comprometimento prévio da função ventricular representa ameaça em pacientes idosos durante a cirurgia; parece haver menor efeito hemodinâmico causado pelo pneumoperitônio do que pelo posicionamento do paciente em Trendelemburg reverso durante a cirurgia.

ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery.

Psychological distress is among the main causes of the onset or worsening of pain symptoms in young sports people. The increasing participation of adolescents in various sports increases the need to verify the prevalence and association of these affective disorders such as anxiety, stress and depression with pain in the shoulder girdle and in the cervical region that are typical in sportspeople who use more frequently the upper limbs. The sample (n = 310; 14.16±2.12 years). Corlett's body diagram and the Brazilian short version of the anxiety, depression and stress scale (DASS-21) were used. Independent t-tests, chi-square and multiple logistic regression were used. The girls had a higher prevalence of anxiety/stress (62%, p = 0.02). The variables associated with anxiety/stress were female (OR = 2.16), aged 15 to 19 years (OR = 2.39) and individual modality (OR = 1.88). The variables associated with depression were age 15 to 19 years (OR = 1.74), individual modality (OR = 1.84) and pain in the shoulder girdle and cervical region (OR = 2.33).