Identifying morphologically similar triatomine species is key to Chagas' disease vector control and surveillance, but remains challenging when only qualitative phenotypic data are available. We investigated whether morphometric and ecological variation can provide additional criteria for species delimitation by combining geometric morphometrics and ecological niche modelling to characterize two near-sibling triatomine species, Triatoma sordida and Triatoma garciabesi (Reduviidae: Triatominae). We analysed size and shape variation in 231 wings and 123 heads from one T. garciabesi and three T. sordida populations. Predicted distribution maps (21 climatic variables, 324 vector occurrence points) were produced using the Maxent method. Multivariate analyses summarized morphological and ecological variation. Wings and heads of T. sordida were significantly larger and more elongated than those of T. garciabesi. Discriminant analyses separated the species, with a partial overlap between Argentinean populations. The predicted distribution of T. garciabesi included northwest Argentina (mainly arid Chaco), whereas that of T. sordida included northeast Argentina (humid Chaco) and the Brazilian Cerrado and Caatinga ecoregions. Clear ecological niche differences were observed, with T. garciabesi occupying colder and drier areas than T. sordida. Our results show how morphometric variation and niche divergence can be used to enhance operational criteria for the delimitation of phenotypically similar triatomine species.

Objective: To evaluate the accuracy of the scores of Tokuhashi and Tomita and the actual survival of patients with vertebral metastases. Methods: A retrospective assessment of 45 patients with spinal metastases. Thirty-one patients underwent surgical treatment and adjuvant therapy and 14 received conservative treatment (chemotherapy/radiotherapy) or palliative/supportive, depending on the scores of Tokuhashi and Tomita. Results: In the study, 80% of patients were female and the mean age was 57.8 years (SD=11.3 years). The most frequent primary tumors were breast and prostate (68.9%). The accuracy of Tokuhashi scale was 53.4% and the Tomita, 64.5%. The concentration of Tomita range of correct classification was in the category of survival > 12 months (57.8%), while the Tokuhashi scale presented some adjustment in the other categories, < 6 months (15.6%) and 6 to 12 months (2.2%). The histological type of the primary tumor was the only variable that statistically influenced the survival time of patients (p<0.001), and patients with lung or liver tumor (most aggressive) presented a risk of death 9.89 times higher than patients with primary tumors of breast or prostate (less aggressive) (95% CI: 3.10 to 31.57). Conclusion: The Tokuhashi and Tomita scores showed good accuracy with respect to the actual survival of patients with tumor metastasis in the spine.Keywords: Spine; Neoplasms; Metastasis. RESUMO

ObjectiveTo evaluate the intraobserver and interobserver reproducibility of Hawkins' classification for fractures of the neck of the talus.Methods20 random cases of fracture of the talus were selected, to be defined according to the classification of types by eight orthopedic surgeons, 13 orthopedic residents and 15 radiology residents.ResultsUsing the statistical test of Landis and Koch, measurements of 0.627 and 0.668 were obtained in the first and second evaluations, respectively. These values define a satisfactory agreement for Hawkins' classification.ConclusionWe conclude that this classification is reproducible between observers, with better values for the more experienced observers. Level of Evidence I, Study Diagnostic - Investigating a diagnostic test.

Objective: To analyze the cervical sagittal parameters of patients with rheumatoid arthritis (RA) and compare them with the parameters obtained from healthy patients in a sample of the Brazilian population. Methods: Epidemiological data were collected and 72 radiographs of the cervical spine in the sagittal plane were evaluated by measuring the cervical sagittal parameters COG-C7 (distance measured between the center of gravity of the head and the C7 plumb line -cranial offset), C2-C7 lordosis (vertebrae from C2 to C7), T1S (T1 slope), TIA (thoracic inlet angle) and NT (neck tilt). Statistical analysis was performed using the Student’s t and chi-square tests. Results: The TIA and NT values in the RA group were 88.8° ± 12.6° and 54.5° ± 9.3°, respectively, while for the control group, they were 77.7° ± 7.9° and 50.5° ± 7.7°, respectively, the RA group values being statistically higher than the control group values (p <0.001 and p = 0.050, respectively). The values obtained for COG-C7, C2-C7 lordosis and T1S for the RA group were 9.4 ± 16.4mm, 25° ± 22.4° and 2.6° ± 10.1°, respectively, while for the control group they were 11.8 ± 17.6mm, 26.8° ± 12.5° and 30.9° ± 8.4°, respectively. Conclusions: Patients with RA present changes in the thoracic inlet parameters as compared to the control group, with a statistically significant increase in the TIA and NT values, outlining a characteristic compensatory pattern for maintaining cervical sagittal balance. Level of evidence III; Controlled cross-sectional study.

Objective: To evaluate the existence of a possible significant correlation between the quality of life of outpatients with osteoporosis and the Spinal Deformity Index (SDI), a radiographic method for semiquantitative assessment of the spine that enables the identification of prevalent and incident fractures. Methods: A cross-sectional observational study carried out with female patients, Caucasians, over 50 years of age, with a densitometric diagnosis of osteoporosis and in an outpatient follow-up, who were submitted to the Oswestry Disability Index (ODI) and SF-36 questionnaires to measure the direct and indirect damage of vertebral fragility fractures on quality of life. The scores obtained in these questionnaires were correlated with the SDI scores, calculated from the radiographs of the lumbar and thoracic spine. Results: 48 patients completed the study, with a mean age of 69.6±6.7 years, mean body mass index (BMI) of 25.4±3.4 kg/m2, mean ODI of 25.1±17.9%, mean SF- 36 of 428.7±192.4 and mean SDI of 4.3±3. For the statistical analysis, Spearman's coefficient was used (p ≤ 0.05). Conclusion: There is no statistically significant correlation between the SDI and the scores obtained on the ODI and SF-36 quality of life questionnaires. Level of evidence: III. Study of non-consecutive patients, without gold standard, applied uniformly.

Aim: To conduct a systematic review of the literature to identify risk factors associated with 30-day readmission of patients submitted to anterior or posterior access cervical spine surgery. Methods: The databases used to select the papers were PubMed, Web of Science, and Cochrane, using the following search strategy: patient AND readmission AND (30 day OR “thirty day” OR 30-day OR thirty-day) AND (spine AND cervical). Results: Initially, 179 papers that satisfied the established search stringwere selected. After reading the titles and abstracts, 46 were excluded from the sample for not effectively discussing the theme proposed for this review. Of the 133 remaining papers, 109 were also excluded after a detailed reading of their content, leaving 24 that were included in the sample for the meta-analysis. Conclusions: The average readmission rate in the studies evaluated was 4.85%. Only the occurrence of infections, as well as the presence of patients classified by the American Society of Anesthesiology (ASA) assessment system with scores greater than III, were causal factors that influenced the readmission of patients. No significant differences were noted when comparing the anterior and posterior surgical access routes. Level of evidence II; Systematic Review of Level II or Level I Studies with discrepant results.