Abstract This randomized parallel-group control trial tested the efficacy of distraction using audiovisual eyeglasses (AVE) during dental procedures [NCT03902158]. Forty-four 6–9 year-old children with low/moderate anxiety and who needed restorative treatment or exodontia of the primary molars were randomly allocated into two groups: the AVE (experimental) and the conventional behavior management techniques (control) groups. Motion sensors were used to measure the participants’ body movements. Dental visits were video recorded, and their pain levels and behavior were assessed using the Faces, Legs, Activity, Cry, and Consolability Behavioral Pain Assessment Scale and the Venham Behavioral Scale, respectively. Anxiety was assessed via heart rate measurements. After treatment, the children scored their pain using the Faces Pain Scale. Mann-Whitney U and chi-square tests were used to compare the groups. The mean score on the behavioral scale was 0.59 in the experimental group and 0.72 in the control group under local anesthesia (p = 0.73). During the procedure, the mean score was 0.41 in the experimental group and 1.32 in the control group (p = 0.07). The mean heart rate was similar in both groups (p = 0.47), but a significant increase during treatment was observed in the control group. There was no difference between the groups in terms of pain, behavior, and self-reported pain scores (p = 0.08). Children aged 6-7 who used the AVE had fewer wrist movements (435.6) than that of children in the control group (1170.4) (p = 0.04). The AVE achieved similar results to the basic behavior management techniques, with good acceptance by the children.

RESUMO JUSTIFICATIVA E OBJETIVOS: A Síndrome da Embolia Gordurosa (SEG) pode acontecer em pacientes vítimas de politrauma (fratura de ossos longos) ou operações plásticas (lipoaspiração), comprometendo circulação, respiração e/ou sistema nervoso central. O presente relato mostra evolução de SEG grave após lipoaspiração e lipoenxertia. RELATO DO CASO: SSS, 42 anos, ASA 1, sem fatores de risco para trombose, candidata a lipoaspiração abdominal e implante de prótese mamária. Submetida à anestesia geral balanceada com monitorização básica e ventilação controlada. Após 45 minutos de procedimento, houve queda súbita e progressiva da capnometria, hipoxemia e hipotensão grave. Imediatamente foi monitorizada com PAM e cateter central, tratada com vasopressores, inotrópicos e infusão de cristaloides, obtendo estabilização do quadro. Amostra sanguínea arterial mostrou pH = 7,21; PCO2 = 51 mmHg; PO2 = 52 mmHg; BE = -8; HCO3 = 18 mEQ/l e lactato = 6,0 mmol/l. Ecocardiograma transtorácico mostrou PSAP = 55 mmHg, VD hipocontrátil e FEVE = 60%. Diagnóstico de embolia pulmonar. Após24 h de tratamento intensivo, a paciente evoluiu com anisocoria e coma com escala de glasgow 3. Realizada TC de encéfalo que evidenciou isquemia cerebral grave, hemisférica, com sinais de êmbolos de gordura em A. cerebral média D; o ecocardiograma transesofágico mostrou forame oval patente. Finalmente, após 72 h de evolução, a paciente evoluiu para morte encefálica. CONCLUSÃO: A SEG ocorre geralmente em jovens. O tratamento baseia-se principalmente na infusão de líquidos e drogas vasoativas, ventilação mecânica e correção do fator desencadeante (fixação precoce de fraturas ou suspensão da lipoaspiração). O comprometimento multiorgânico indica pior prognóstico.

ABSTRACT BACKGROUND AND OBJECTIVES: Fat embolism syndrome may occur in patients suffering from multiple trauma (long bone fractures) or plastic surgery (liposuction), compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe fat embolism syndrome after liposuction and fat grafting. CASE REPORT: SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis. Subjected to balanced general anesthesia with basic monitoring and controlled ventilation. After 45 min of procedure, there was a sudden and gradual decrease of capnometry, severe hypoxemia and hypotension. The patient was immediately monitored for MAP and central catheter, treated with vasopressors, inotropes, and crystalloid infusion, stabilizing her condition. Arterial blood sample showed pH = 7.21; PCO2 = 51 mmHg; PO2 = 52 mmHg; BE = -8; HCO3 = 18 mEq L-1, and lactate = 6.0 mmol L-1. Transthoracic echocardiogram showed PASP = 55 mmHg, hypocontractile VD and LVEF = 60%. Diagnosis of pulmonary embolism. After 24 h of intensive treatment, the patient developed anisocoria and coma (Glasgow coma scale = 3). A brain CT was performed which showed severe cerebral hemispheric ischemia with signs of fat emboli in right middle cerebral artery; transesophageal echocardiography showed a patent foramen ovale. Finally, after 72 h of evolution, the patient progressed to brain death. CONCLUSION: Fat embolism syndrome usually occurs in young people. Treatment is based mainly on the infusion of fluids and vasoactive drugs, mechanical ventilation, and triggering factor correction (early fixation of fractures or suspension of liposuction). The multiorgânico involvement indicates a worse prognosis.

Um total de 293 espécimes de Oxelytrum discicolle foram amostrados semanalmente num período de dois anos usando uma armadilha tipo "black light". O estudo foi feito em uma reserva de Mata Atlântica localizada próximo à cidade de Viçosa, Minas Gerais, Brasil. O período de pico de abundância de O. discicolle ocorreu durante a estação úmida, entre os meses de outubro e março. A análise estatística mostrou que a abundância dos indivíduos foi significantemente e positivamente correlacionada com a temperatura, mas não com a precipitação e umidade relativa. De 28 características morfológicas tomadas em cada espécime coletado, sete foram encontradas sexualmente dimórficas, entretanto, nem morfologia nem o grau de dimorfismo sexual variaram significantemente entre as estações.

A total of 293 specimens of Oxelytrum discicolle were sampled weekly over a period of two years using a black light trap. The study took place in an Atlantic Forest reserve located near Viçosa city, Minas Gerais State, Brazil. The period of peak abundance of O. discicolle occurred during the wet season between the months of October and March. Statistical analysis showed that the abundance of individuals was significantly and positively correlated with temperature, but not with rainfall or relative humidity. Of 28 morphological measurements taken on each collected specimen, seven were found to be sexually dimorphic; however, neither morphology nor the degree of sexual dimorphism varied significantly among seasons.

Estudou-se o efeito da textura do solo, relevo, espécie forrageira, idade e sistema de formação da pastagem, sobre o ataque de Atarsocoris brachiariae. Não foram observadas diferenças significativas entre as espécies de forrageiras ou tipo de relevo quanto ao ataque da praga. As maiores densidades foram observadas em solos de textura arenosa, pastagens com mais de quatro anos, sistema de formação convencional e na faixa de 20-30 cm de profundidade. O ataque foi em reboleiras, e a maior densidade ocorreu na região de transição entre a área de pastagem morta e a área em que esta apresentava desenvolvimento normal.

The effect of soil texture, landscape, grass species, age and system of pasture formation on attack intensity of Atarsocoris brachiariae Becker was studied. No differences were found among grass species or landscape on attack intensity of this bug. Higher densities of A. brachiariae were observed in sandy soils, in pastures over four years old, in those with traditional formation and between 20-30 cm underground. Attack of A. brachiariae occurred in patches specially in the transition areas between dead grass and normal growing grass.