The practice of regional anesthesia is in a state of progressive evolution, mainly due to the advent of ultrasound as an anesthesiologist's instrument. Alternative techniques for postoperative analgesia of abdominal surgeries, such as transversus abdominis plane block, oblique subcostal transversus abdominis plane block, rectus abdominis muscle sheath block, ilioinguinal and iliohypogastric nerve block, and quadratus lumborum plane block, have proven useful, with good analgesic efficacy, especially when neuroaxial techniques (spinal anesthesia or epidural anesthesia) are not possible. This review discusses such blockades in detail, including the anatomical principles, indications, techniques, and potential complications.

RESUMO OBJETIVOS A pandemia da COVID-19 é um problema de saúde pública emergente e que tem repercussão internacional. As alterações inflamatórias fazem parte da fisiopatologia da COVID-19 e isso pode acarretar um maior risco tromboembólico em mulheres que fazem uso de contracepção e terapia hormonal da menopausa. Discutimos os principais aspectos relacionados a esse risco e propomos uma estratégia de seguimento das mulheres acometidas da COVID-19. MÉTODOS Esta revisão narrativa coletou informações de vários artigos publicados desde o início da pandemia do novo coronavírus, no que tange à sua fisiopatologia, estágios da doença e ocorrência de eventos trombóticos, bem como sobre o risco de tromboembolismo venoso em usuárias de contracepção e terapia hormonal da menopausa. RESULTADOS Este artigo consolida alguns parâmetros clínicos sobre o risco de tromboembolismo em usuárias de contracepção e terapia hormonal na menopausa, enfatizando o provável aumento desse risco em mulheres com suspeita ou confirmação do novo coronavírus, e traz uma recomendação de uma conduta mais segura. CONCLUSÃO Nesse cenário, além das fundamentais orientações de medidas preventivas, como o isolamento social e a higiene, é importante que os profissionais que trabalham na atenção à saúde feminina tenham conhecimentos da nova realidade e adotem condutas seguras, especialmente na prescrição de THM e contracepção.

SUMMARY OBJECTIVES The outbreak of coronavirus disease (COVID-19) is a public health emergency of international concern. Inflammatory changes are part of COVID-19 pathophysiology and this might generate a higher thromboembolic risk in patients using combined hormonal contraception and menopausal hormone therapy. We aimed to discuss the main aspects related to this issue and propose management strategies for women affected by COVID-19. METHODS This narrative review collected information from several articles published since the beginning of the outbreak of the new coronavirus disease about the pathophysiology, stage of the disease, the occurrence of thrombotic events, and the risk of thromboembolism in users of contraception and hormonal therapy. RESULTS This article consolidates clinical parameters about the risk of venous thromboembolism in users of contraception and menopausal hormone therapy emphasizing the probable increase of that risk in women with suspected or confirmed COVID-19 and bringing safer recommendations. CONCLUSIONS In this scenario, apart from the fundamental orientations of preventive measures, like social isolation and hygiene, it is important that all female health professionals have knowledge of the new rules and adopt safety measures, especially on the prescription of hormonal therapy and contraception.

Abstract INTRODUCTION: As highly specific molecular biology-based techniques may not be sensitive enough for the diagnosis of American tegumentary leishmaniasis (ATL), clinicians frequently rely on immunological tests before treatment initiation. Hence, the correct combination of diagnostic tests is imperative for ATL diagnosis. We aimed to evaluate the accuracy of the Montenegro (Leishmanin) skin test (MST) in polymerase chain reaction (PCR)-negative patients to accurately detect ATL. METHODS: Patients with a clinical picture compatible with ATL were divided into ATL (confirmed by lesion smear, culture indirect immunofluorescence, and/or histopathology) and no-ATL (diseases that can mimic leishmaniasis) groups. Conventional PCR for the minicircle kDNA of Leishmania was performed, and the MST was carried out for PCR-negative patients. RESULTS: Ninety-nine patients were included in this study, including 79 diagnosed with ATL (6 with mucocutaneous leishmaniasis) and 20 without ATL (no-ATL group). The MST showed a high sensitivity of 90.0% (95% confidence interval [CI] = 69.90-97.21) in PCR-negative patients that was 10% higher than the sensitivity reported in PCR-positive population (79.66%; 95% CI = 67.73-87.96). CONCLUSIONS: One of the most important reasons for PCR negativity among patients with active ATL is the presence of a strong cellular immunological response, especially in chronic and mucocutaneous leishmaniasis. This reinforces the considerable utility of the tests that detect cellular responses against Leishmania antigens such as the MST in PCR-negative patients when the performance in screening situations is questionable.

Membranes of polyamide 6 and its nanocomposites with 3 and 5% of clay were obtained by the phase inversion method using distilled water and solvent as the coagulation bath, 10 and 30% of acid was used, in order to change the membranes morphology/porosity. By XRD analysis, the obtained nanocomposites showed an exfoliated and/or partially exfoliated structure, it was also seen two characteristics peaks of the polyamide 6 phases (α and γ). For the membranes, the characteristic peak γ of the membrane disappeared, being evident the peaks α1 and α2. By SEM the PA6 membrane almost doesn't have pores in its surface, with an addition of clay had an increase in the quantity of surface pores. In the cross section of the PA6 membrane, an extremely thin selective layer, adding the clay the selective layer became thicker and a better defined porous support was obtained. From the acid in the coagulation bath the PA6 membrane continued with a few pores structure. For the nanocomposites there was an increase in size and a better uniformity of the pores. In the cross section the presence of the bath decrease the membrane filtering, also modifying a uniformity of the pores.

Layered or fibrous clay minerals are used as adsorbents because they have good performance to remove inorganic and organic species. In this work, a Brazilian fibrous clay mineral was applied to remove Remazol Yellow GR industrial dye from simple and binary systems; this was performed in the presence of lead in the latter case. The adsorption efficiency was investigated under various conditions of pH, time, temperature and dye concentration. The experimental data were fitted to the kinetic pseudo-first- and pseudo-second-order models, and the isotherms were fitted to the Langmuir and Freundlich models. The maximum adsorption capacity was 20.08 mg g-1 at pH 2, 240 minutes and 298 K, and these data were better fit by the kinetic pseudo-second-order model. The equilibrium study was fitted to the Langmuir model at 298 K and Freundlich for other temperatures and binary systems. The dye sorption in the presence of lead was decreased to 15 mg g-1. Therefore, palygorskite behaved as a promising solid for treating effluents.

INTRODUCTION: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) often have associated changes in craniofacial morphology and distribution of body fat, either alone or in combination. AIM: To correlate cephalometric and anthropometric measures with OSAHS severity by using the apnea-hypopnea index (AHI). METHOD: A retrospective cephalometry study of 93 patients with OSAHS was conducted from July 2010 to July 2012. The following measurements were evaluated: body mass index (BMI), neck circumference (NC), waist circumference (WC), hip circumference (HC), the angles formed by the cranial base and the maxilla (SNA) and the mandible (SNB), the difference between SNA and SNB (ANB), the distance from the mandibular plane to the hyoid bone (MP-H), the space between the base of the tongue and the posterior pharyngeal wall (PAS), and the distance between the posterior nasal spine and the tip of the uvula (PNS-P). Means, standard deviations, and Pearson's correlation coefficients were calculated and analyzed. RESULTS: AHI correlated significantly with BMI (r = 0.207, p = 0.047), NC (r = 0.365, p = 0.000), WC (r = 0.337, p = 0.001), PNS-P (r = 0.282, p = 0.006), and MP-H (r = 0.235, p = 0.023). CONCLUSION: Anthropometric measurements (BMI, NC, and WC) and cephalometric measurements (MP-H and PNS-P) can be used as predictors of OSAHS severity.