Notes

Responses in order to and also Connection between Management of Autoimmune Cerebellar Ataxia in older adults.
To describe the use of psychotropic drugs among civil servants with registered absenteeism due to mental disorders, and to investigate associations with duration of leave of absence.

A cross-sectional study with civil servants on leave of absence due to mental disorders, between January and December 2017. Demographic, occupational and clinical variables were extracted from secondary data. Non-parametric tests were used to investigate correlations between use of psychotropic drugs and leave duration. Cluster analysis was used to investigate associations between occupational characteristics and illness profile.

Antidepressants were the most commonly used drugs (82.9%). Central tendency values for days on leave differed according to the number of psychotropic drugs used. In cluster analysis, a particular cluster (servants of intermediate age group and work experience - mean of 46 years and 15 years, respectively) stood out regarding use of antidepressants, severity of depression and frequency and duration of leave of absence.

Leave of absence due to mental disorders was associated with higher rates of psychotropic drug use. The group of servants identified in this study may be a primary target for health promotion, prevention and recovery actions at the organization.
Leave of absence due to mental disorders was associated with higher rates of psychotropic drug use. The group of servants identified in this study may be a primary target for health promotion, prevention and recovery actions at the organization.
To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners.

Seventy-two participants (42 men, 30 women; mean age 37.3±9.9 years) were enrolled in this cross-sectional study and divided into three groups AT group (ATG, n=24), healthy runners' group (HRG, n=24), and non-runners' group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer.

The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120°/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. DS-3201 The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG.

Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.
Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.
Coronary artery disease is the primary cause of death and is responsible for a high number of hospitalizations worldwide. Ventricular remodeling is associated with worse prognosis following ST-segment elevation myocardial infarction (STEMI) and is a risk factor for ventricular dysfunction and heart failure. This study aimed to identify the predictors of ventricular remodeling following STEMI. Additionally, we evaluated the clinical, laboratory, and echocardiographic characteristics of patients with anterior wall STEMI who underwent primary percutaneous intervention in the acute phase and at 6 months after the infarction.

This prospective, observational, and longitudinal study included 50 patients with anterior wall STEMI who were admitted to the coronary care unit (CCU) of a tertiary hospital in Brazil between July 2017 and August 2018. During the CCU stay, patients were evaluated daily and underwent echocardiogram within the first three days following STEMI. After six months, the patients underwent clinical evaluation and echocardiogram according to the local protocol.

Differences were noted between those who developed ventricular remodeling and those who did not in the mean±standard deviation levels of creatine phosphokinase MB isoenzyme (CKMB) peak (no remodeling group 323.7±228.2 U/L; remodeling group 522.4±201.6 U/L; p=0.008) and the median and interquartile range of E/E' ratio (no remodeling group 9.20 [8.50-11.25] and remodeling group 12.60 [10.74-14.40]; p=0.004). This difference was also observed in multivariate logistic regression.

Diastolic dysfunction and CKMB peak in the acute phase of STEMI can be predictors of ventricular remodeling following STEMI.
Diastolic dysfunction and CKMB peak in the acute phase of STEMI can be predictors of ventricular remodeling following STEMI.This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR 0.76; 95% confidence interval 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.
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