We studied 2351 participants with COVID-19, 1177 (50%) reported previous dengue infection. Those without previous dengue had a higher risk of death (hazard ratio: 0.44; 95% CI: 0.22 to 0.89; p = 0.023) in 60-day follow-up. These findings raise the possibility that dengue might induce immunological protection against SARS COV-2.
Diabetic sensorimotor polyneuropathy (DSPN) affects approximately 10% of the subjects newly diagnosed 1,2,3 as type 2 diabetes and this percentage can increase by duration, lack of glycemic and cardiovascular complications 3,4,5 . When appropriately treated by restoration of glycemic control 3 , the progression of the DSPN can be delayed and the diabetic ulcers and amputations reduced 3,6 . However, the neuropathy is still the major cause of diabetic foot presenting damaged nerve fibers and this secondary complication affects more than 50% among the subjects diagnosed ABSTRACTSince 1994, the University of Michigan Diabetes Research and Training Center proposed an instrument to measure neuropathies not yet adapted to use in Brazil. Then, this study aimed to adapt cross-culturally the Michigan Neuropathy Screening Instrument (MNSI) into Brazilian Portuguese, verifying its reliability. Thirty diabetic patients were initially evaluated with the adapted version after completed the essential steps to accomplish the cross-cultural adaptation. Twenty-two of them completed the procedures to repeat the measured scores after day 1 (trial 0). The repeated measurements were tested at days 2 or 3 (trial 1) by another rater (inter-rater reliability) and retested at day 20 (trial 2) by one of the attended raters (inter-test reliability). There were not great semantics, linguistics or cultural differences between two versions and excellent reliability was confirmed by intra-class correlation coefficient above 0.840. It was concluded that MNSI in the Brazilian version is reliable and it is ready to use.Keywords: diagnosis; monitoring; diabetic neuropathies. RESUMODesde 1994, o Centro de Treinamento e Pesquisa em Diabetes da Universidade de Michigan propôs um instrumento não ainda adaptado para uso no Brasil para mensurar neuropatias. O objetivo deste estudo foi adaptar transculturalmente o Michigan Neuropathy Screening Instrument (MNSI) para o Português brasileiro, verificando sua confiabilidade. Trinta pacientes diabéticos foram inicialmente avaliados pela versão adaptada depois de completados os passos essenciais para finalizar a adaptação transcultural. Vinte e dois deles completaram os procedimentos para repetir os escores medidos depois do dia 1 (ensaio 0). As medidas repetidas foram testadas nos dias 2 ou 3 (ensaio 1) por outro examinador (confiabilidade interexaminador) e retestadas no dia 20 (ensaio 2) por um dos examinadores participantes (confiabilidade interteste). Não existiam diferenças semânticas, linguísticas ou culturais entre as duas versões e excelente confiabilidade foi confirmada pelo coeficiente de correlação intra-classe acima de 0,840. Conclui-se que o MNSI na versão brasileira é confiável e está pronto para uso.Palavras-chave: diagnóstico; monitoramento; neuropatias diabéticas.
Introduction: Muscle strength has shown different responses to the cooling of neuromuscular tissue and its behavior is still unclear. Objective: To verify the behavior of maximum grip strength before and after forearm cooling. Methods: The cooling intervention consisted of immersing the forearm up to the elbow in water cooled to 10° C. Grip strength was assessed using a dynamometer prior to cooling, immediately after immersion, and at 5, 10 and 30 minutes of forearm exposure to ambient temperature (recovery phase) concomitantly to measurement of skin surface temperature. The sample consisted of 30 healthy individuals. Results: Grip strength decreased significantly (p < 0.05) between the period prior to cooling and all the time intervals following immersion in ice water. There was also a gradual increase in grip strength during the recovery phase, with significant differences (p < 0.05) between the mean immediately after immersion and means at 5, 15 and 30 minutes after exposure to ambient temperature. Conclusion: The results indicate that immersion in ice water (10ºC) for 15 minutes significantly reduced (p < 0.05) grip strength for up to 30 minutes after forearm cooling. Strength also recovered progressively after removal of the cold stimulus. Further research is needed to obtain definitive results regarding the effects of cooling on muscle strength in healthy individuals.
Traumatismo intracraniano no Brasil: Prevalência, internações e morbimortalidade por macrorregiões Intracranial trauma in Brazil: Prevalence, hospitalizations and morbidity and mortality by macro-regions RESUMO Introdução: O traumatismo intracraniano compreende um grupo de lesões que frequentemente ocorrem por consequência do trauma. São causa importante de morbimortalidade em todas as faixas etárias. Objetivos: Demonstrar a prevalência de internações e taxas de morbimortalidade por traumatismo intracraniano nas macrorregiões brasileiras. Metodologia: Trata-se de um estudo descritivo transversal que usou os dados do SIH (Sistema de Informação Hospitalar) disponíveis no DATASUS. Coletou-se as informações sobre internações hospitalares por traumatismo intracraniano (TIC) entre os anos de 2015 e 2019. A estatística descritiva dos dados foi realizada por meio do programa Excel. Resultados e Discussão: Observou-se a maior prevalência de internações por traumatismo nas regiões de maior densidade populacional do país. O estado do Paraná foi o terceiro estado com mais internações por TIC apesar de não ser o terceiro estado em densidade populacional do país. As faixas etárias com maior prevalência de internação por traumatismo são entre 20 e 50 anos de idade e a taxa de mortalidade por TIC é mais proeminente nos idosos acima de 80 anos. Considerações Finais: O presente estudo observou que a prevalência de internações segue alta em todo o país, sendo motivo de grandes investimentos, desde a abordagem inicial até o gasto com reabilitação desses indivíduos, demonstrando que essas lesões, potencialmente preveníveis, são um problema de saúde pública.
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