Abstract Background Currently, studies using video games as an intervention to improve cognitive functions in the elderly are on the rise. Objective To investigate and evaluate the effects of cognitive interventions using video games on cognition in healthy elderly people published in the last ten years. Methods A systematic review involving a qualitative analysis carried out between July and September 2021 on the SciELO, LILACS and MEDLINE databases.. Results A total of 262 articles were identified in the initial search. After exclusion of duplicates, analysis of titles/abstracts and of the full text, a final total of 9 studies were included in the review. The objectives of the studies included investigating the effects on cognition of cognitive training (CT) programs using video games compared to programs using entertainment games or to low-intensity CT games. Despite the growing number of studies, many of them were focused on cognitive rehabilitation in elderly people with some degree of cognitive impairment, and few involved training among healthy elderly people.

Resumo Antecedentes Atualmente, estão em alta estudos que utilizam video games para melhorar as funções cognitivas em idosos. Objetivo Investigar e avaliar os efeitos de intervenções cognitivas com video games na cognição de idosos saudáveis publicadas nos últimos dez anos. Métodos Estudo de revisão sistemática com análise qualitativa realizado entre julho e setembro de 2021, das bases de dados SciELO, LILACS e MEDLINE. Resultados Foram identificados 262 estudos na busca inicial. Após a exclusão de estudos duplicados, análise dos títulos e resumos, e análise integral dos estudos, nove estudos foram incluídos na revisão. Os objetivos de alguns estudos incluíam investigar os efeitos na cognição de programas de treino cognitivo (TC) com video games comparados aos de programas com jogos de entretenimento ou com jogos com baixa intensidade de TC. Apesar do crescente número de estudos, muitos centravam-se na reabilitação cognitiva em idosos com algum comprometimento cognitivo e poucos realizaram o treino em idosos saudáveis. Conclusão Pelos estudos analisados, as intervenções de TC com video games apresentaram melhorias significativas na velocidade de processamento (VP) e na memória operacional (MO); por outro lado, não foram observadas melhorias nas funções executivas.

Abstract Background Computerized cognitive training programs may have benefited the self-assessment of memory, quality of life, and mood among older adults during the coronavirus disease 2019 (COVID-19) pandemic. Objective To determine the subjective impacts of computerized cognitive training on mood, frequency of forgetfulness, memory complaints, and quality of life in the elderly using an online platform. Methods In total, 66 elderly participants of USP 60 +, a program for the elderly offered by Universidade de São Paulo, who voluntarily enrolled in the study were selected and randomized with an allocation ratio of 1:1 into 2 groups: the training group (n = 33) and the control group (n = 33). After signing the free and informed consent form, they answered a protocol which included a sociodemographic questionnaire, the Memory Complaints Questionnaire (MAC-Q), the McNair and Kahn’s Frequency of Forgetfulness Scale, the Geriatric Depression Scale (GDS-15), the Geriatric Anxiety Inventory (GAI), and the Control, Autonomy, Self-Realization, and Pleasure (CASP-19) questionnaire. The training cognitive game platform aimed to stimulate various cognitive aspects, including memory, attention, language, executive functions (reasoning, logical thinking), and visual and spatial skills. Results The participants of the training group showed a reduction in the MAC-Q, MacNair and Kahn, and GAI scores in the pre- and posttest comparison. Significant differences were identified between the groups regarding the total scores of the MAC-Q in the post-test, which was also evidenced by the logistic regression. Conclusion Participation in a computerized cognitive intervention promoted reductions in memory complaints, frequency of forgetfulness, and anxiety symptoms, in addition to improving self-reported quality of life.

Resumo Antecedentes Programas informatizados de treinamento cognitivo podem ter beneficiado a autoavaliação da memória, a qualidade de vida e o humor entre os idosos durante a pandemia de doença do coronavírus 2019 (coronavirus disease 2019, COVID-19, em inglês). Objetivo Determinar os impactos subjetivos do treinamento cognitivo computadorizado no humor, na frequência de esquecimento, nas queixas de memória, e na qualidade de vida em idosos utilizando uma plataforma online. Métodos Ao todo, 66 idosos participantes do programa USP 60 +, oferecido à terceira idade pela Universidade de São Paulo, e inscritos voluntariamente no estudo, foram selecionados e randomizados em uma razão de 1:1 em 2 grupos: grupo treinamento (n = 33) e grupo controle (n = 33). Após assinarem o termo de consentimento livre e esclarecido, os participantes responderam a um protocolo que incluía um questionário sociodemográfico, o Questionário de Queixas de Memória (Memory Complaints Questionnaire, MAC-Q), A Escala de Frequência de Esquecimento de McNair e Kahn, a Escala de Depressão Geriátrica (Geriatric Depression Scale, GDS-15), o Inventário de Ansiedade Geriátrica (Geriatric Anxiety Inventory, GAI), e –o questionário de Controle, Autonomia, Autorrealização e Prazer (Control, Autonomy, Self-Realization, and Pleasure, CASP-19). A plataforma de jogos cognitivos de treinamento visou estimular diversos aspectos cognitivos, incluindo memória, atenção, linguagem, funções executivas (raciocínio, raciocínio lógico) e habilidades visuais e espaciais. Resultados Na comparação pré e pós-teste, os participantes do grupo de treinamento apresentaram redução nas pontuações do MAC-Q, da escala McNair e Kahn e do GAI. Diferenças significativas entre os grupos quanto às pontuações totais da escala MAC-Q no pós-teste também foram evidenciadas pela regressão logística. Conclusão A participação em uma intervenção cognitiva computadorizada promoveu reduções nas queixas de memória, frequência de esquecimento e sintomas de ansiedade, além de melhorar a qualidade de vida autorrelatada.

Abstract This paper provides an in-depth analysis of the evolving landscape of international politics, the challenges this scenario presents for the field of International Relations (IR) and the pivotal role played by Revista Brasileira de Política Internacional (RBPI) in shaping both academic knowledge and policy frameworks. The study aims to achieve two primary objectives. First, to contextualize the significant shifts in international politics in the last few years, such as the rise of China and the impact of the COVID-19 pandemic, while advocating for interdisciplinary approaches and highlighting the contributions of Latin American, particularly Brazilian, scholars to global academic debates. Second, to trace the history, evolution, and international impact of RBPI since its inception in 1958, emphasizing its role in leveraging the standards of academic publishing in Brazil and Latin America, fostering international collaborations, and influencing policy decisions. The paper proposes that RBPI serves as an indispensable platform for advancing rigorous academic inquiry and offers a more inclusive perspective on international relations, thereby having a lasting impact on both the academic and policy landscapes globally.

Abstract The present study aimed was to evaluate the spatial variability of weed species by means of phytosociological parameters and their correlations with the physical-chemical soil properties, under semiarid climate conditions. Weed phytosociology and soil characterization were carried out in two areas one newly deforested area covering 8.86 ha, and one experimental agricultural area covering 24.7 ha; both in the semi-arid region of Brazil. Weed and soil were sampled by following georeferenced grids in each area. Biomass and the total number of weed individuals, as well as soil properties, were mapped by the ordinary Kriging method. The predominant herbaceous plants in the newly deforested area were Hexasepalum teres and Digitaria insularis. The weed species that predominated in the agricultural area were Cyperus rotundus L., Euphorbia heterophylla L. and Herissantia Crispa (L.) Brizicky; the latter species outstanding for dry biomass (873.5g). Spatial dependence was observed for the predominant species, except for Digitaria insularis. The spatial distribution of these weeds was conditioned by soil K+ contents in both areas, and by sand content for the experimental agricultural area. Therefore, these two soil attributes resulted key factors for weed infestation in this semi-arid region.

ABSTRACT. Dementias secondary to cardiovascular diseases are the second cause of neurogenerative diseases. These conditions can be prevented by controlling risk factors, and it is necessary to observe the relationship between chronic diseases. Objective: to know the influence of chronic non-communicable diseases on cognition and depressive symptoms in the elderly, amid the COVID-19 pandemic. Methods: 578 older adults were evaluated using a sociodemographic questionnaire, the Brazilian Telephone version of the Mini Mental State Examination (Braztel-MMSE), the Geriatric Depression Scale (GDS-15) and an open questionnaire related to NCDs. Results: the association of Non-Communicable Diseases (NCD) with age, depressive symptoms and schooling was confirmed. Conclusion: no association with cognitive decline was evident due to the relationship of high schooling of participants and control of NCDs.

RESUMO. As demências secundárias às doenças cardiovasculares são a segunda causa de doenças neurodegenerativas. Essas condições podem ser prevenidas pelo controle de fatores de risco, sendo necessário observar a relação entre doenças crônicas. Objetivo: Conhecer a influência das doenças crônicas não transmissíveis (DCNT) na cognição e nos sintomas depressivos em pessoas idosas, em meio à pandemia da COVID-19. Métodos: Foram avaliados 578 idosos utilizando um questionário sociodemográfico, o Brazilian telephone version of the Mini Mental State Examination (Braztel-MMSE), a Escala de Depressão Geriátrica (GDS-15) e um questionário aberto relacionado às DCNT. Resultados: Foi confirmada a associação das DCNT crônicas com idade, sintomas depressivos e escolaridade. Conclusão: Nenhuma associação com declínio cognitivo foi evidente em razão da relação da alta escolaridade dos participantes com o controle das DCNT.

RESUMO. O treino da memória operacional (WM) com idosos pode gerar benefícios em sua cognição. Entretanto, há escassez de revisões da literatura sobre o tema. Objetivo: Investigar e avaliar, na literatura, os efeitos do treino da WM na cognição de idosos saudáveis, em intervenções individuais e grupais. Métodos: Estudo de revisão sistemática realizado entre março e junho de 2021, utilizando-se as bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval System Online (MEDLINE). Resultados: Foram identificados e analisados 47 estudos, 40 apenas com idosos, e sete comparativos entre idosos e adultos mais jovens, que realizaram treino individual ou em grupo com foco nos efeitos na WM. Conclusões: Os trabalhos analisados mostraram que ambos os tipos de intervenções podem contribuir para a manutenção e/ou melhoria da cognição de pessoas idosas, aproveitando sua plasticidade cerebral e, portanto, para a promoção de sua saúde mental e para a prevenção de problemas cognitivos que podem interferir em sua qualidade de vida.

ABSTRACT. The working memory (WM) training in older adults can benefit their cognition. However, there is a dearth of literature reviews on the subject. Objective: This study aimed to investigate and evaluate the effects of WM training on the cognition of healthy older adults, in individual and group interventions reported in the literature. Methods: This is a systematic review involving a qualitative analysis of publications on the SciELO, LILACS, and MEDLINE databases carried out between March and June 2021. Results: A total of 47 studies were identified and analyzed, comprising 40 in older adults only and 7 comparing older and younger adults, investigating individual or group WM training or other types of intervention focused on WM effects. Conclusions: Both individual and group intervention contributed to the maintenance and/or improvement of cognition in older adults exploiting brain plasticity to promote mental health and prevent cognitive problems that can negatively impact quality of life of this group.

Abstract The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women’s ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women’s ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.

Resumo Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.

Resumo Esta investigação teve como objetivo caracterizar as mulheres que realizaram o pré-natal no Brasil segundo raça/cor e variáveis sociodemográficas e verificar associação entre os indicadores de processo do cuidado no pré-natal e a raça/cor das mulheres. Estudo transversal de base populacional empreendido com dados da Pesquisa Nacional de Saúde de 2013. Realizou-se análise bivariada mediante modelo de regressão logística multinível, estimando-se as odds ratio para medir a associação entre os indicadores de processo do cuidado pré-natal adequado e raça/cor das mulheres e verificando os respectivos intervalos de confiança de 95%. Os achados evidenciaram que mulheres negras possuem menor chance de iniciar o pré-natal antes das 12 semanas de gestação, ter seis ou mais consultas, realizar teste de HIV, exame VDRL e receber orientações referentes aos cuidados na gestação e parto. Identificamos desigualdades na atenção à saúde das mulheres brasileiras atendidas no pré-natal relacionadas à raça/cor e a outras características sociodemográficas. Conclui-se que ser negra e ocupar lugares sociais desfavoráveis acarretam desvantagens para as mulheres quanto ao acesso a um pré-natal considerado adequado segundo os critérios estabelecidos pelo Ministério da Saúde do Brasil.

Abstract The study aimed to characterize women that attended prenatal care in Brazil according to ethnicity/skin color and sociodemographic variables and to verify the association between the indicators of the prenatal care process and the women’s ethnicity/skin color. This was a population based, cross-sectional study carried out with data from the National Health Survey of 2013. A bivariate analysis was performed using the multilevel logistic regression model, estimating the odds ratio and the respective 95% confidence intervals to test the association between the indicators of the adequate prenatal care process and the women’s ethnicity/skin color. The findings showed that black women have a lower chance of starting prenatal care before 12 weeks of gestation, having 6 or more consultations, performing the HIV test, performing the VDRL exam or receiving advice related to care during gestation and childbirth. Inequalities were identified in the healthcare of Brazilian women during prenatal care, related to ethnicity/skin color and other sociodemographic characteristics. It was concluded that being of black ethnicity and living in a socially disadvantaged area entails disadvantages for women regarding access to a prenatal care considered to be adequate according to the criteria established by the Brazilian Ministry of Health.

RESUMO. Estudos mostram que o envelhecimento é acompanhado por perdas nas funções cognitivas, e que as intervenções podem gerar um aumento no desempenho e/ou apoiar a manutenção de habilidades cognitivas em idosos. Objetivo: Realizar uma revisão sistemática de pesquisas com longa duração que ofereceram treino cognitivo (CT) em idosos sem demência e/ou com comprometimento cognitivo leve (MCI). Métodos: Revisão sistemática de estudos controlados, publicados em periódicos científicos a partir de 2000, com duração ≥6 meses, CT na intervenção, participantes ≥60 anos, saudáveis ou com MCI, avaliações por testes cognitivos e/ou neuropsicológicos. Resultados: Foram selecionados 32 estudos, sendo dez protocolos de pesquisa, 14 com idosos sem MCI e/ou sem demência e oito com idosos com MCI ou risco de demência. Conclusões: Foram relatados benefícios no desempenho cognitivo, incluindo habilidades motoras, de idosos que participaram de CT, com ou sem sessões de reforço, incluindo ou não intervenções multimodais.

ABSTRACT. Studies show that aging is accompanied by losses in cognitive functions and that interventions can increase performance and/or support the maintenance of cognitive skills in the elderly. Objective: The objective of this study was to carry out a systematic review of long-term studies involving cognitive training (CT) in older adults without dementia and/or with mild cognitive impairment (MCI). Methods: A systematic review of controlled studies was published in scientific journals from 2000 onward, with duration ≥6 months, CT intervention, cognitively normal (CN) or MCI participants aged ≥60 years, and assessments using cognitive and/or neuropsychological tests. Results: A total of 32 studies were reviewed, comprising 10 on study protocols, 14 in CN older adults (no MCI and/or dementia), and 8 in older adults with MCI or at risk for dementia. Conclusions: The studies reported improvements in cognitive performance for some motor abilities, among older participants of CT with or without booster sessions, including multimodal interventions or otherwise.

Abstract Introduction Coronavirus disease 2019 (COVID-19) has claimed millions of lives. Adequate protection of the professionals involved in patient care is essential in the battle against this disease. However, there is much uncertainty involving safety-relarted topics that are of particular interest to the rhinologist in the context of COVID-19. Objective To evaluate the current evidence regarding three safety-related topics: mask and respirator use, performance of nasal endoscopic procedures, and use of topical nasal and intranasal medications (saline irrigation and nasal corticosteroids). Methods A literature review was performed on the PubMed, Scopus, and Cochrane databases, with standardized search queries for each of the three topics of interest. Results In total, 13 articles on mask use, 6 articles on the safety of nasal corticosteroids, 6 articles on the safety of nasal endoscopic procedures, and 1 article on nasal irrigation with saline solution were included in the final analysis. Conclusion N95 respirators are essential for the adequate protection of otolaryngologists. If reuse is necessary, physical methods of sterilization must be employed. No evidence was found to contraindicate the use of nasal corticosteroids, whether acute (in the management of sinonasal inflammatory conditions) or continued (in patients who use them chronically). Nasal irrigation with saline solution apparently does not increase the risk in the context of COVID-19. Nasal endoscopic procedures should only be performed after testing the patient for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the surgical team must wear full personal protective equipment to prevent aerosol exposure.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the perception of the aesthetic result of breast reconstruction surgery from the perspective of plastic surgeons compared with physicians who are not specialists in plastic surgery. METHODS: Twenty patients who underwent breast reconstruction after mastectomy had their aesthetic results evaluated by 16 plastic surgeons and 16 nonplastic physicians, yielding a total of 620 ratings (320 ratings from plastic surgeons and 320 ratings from other specialists). For all analyses, the level of rejection adopted for the null hypothesis was 5% (p-value <0.05). RESULTS: Significant differences were observed between the two groups. On average, medical professionals who specialized in plastic surgery always obtained higher scores than other physicians. However, no significant differences were found in the assessment of the aesthetic outcome of breast reconstruction according to the sex of the rating medical professional for any of the assessments considered in this study. A strong positive linear correlation between the time since training in the medical specialty of plastic surgery (r=0.750, p=0.001) and the mean aesthetic outcome score was observed in this study. CONCLUSION: Plastic surgeons assessed the aesthetic results of breast reconstruction more positively than nonplastic physicians.

RESUMO. O treino da memória operacional (WM) com idosos pode gerar benefícios em sua cognição. Entretanto, há escassez de revisões da literatura sobre o tema. Objetivo: Investigar e avaliar, na literatura, os efeitos do treino da WM na cognição de idosos saudáveis, em intervenções individuais e grupais. Métodos: Estudo de revisão sistemática realizado entre março e junho de 2021, utilizando-se as bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval System Online (MEDLINE). Resultados: Foram identificados e analisados 47 estudos, 40 apenas com idosos, e sete comparativos entre idosos e adultos mais jovens, que realizaram treino individual ou em grupo com foco nos efeitos na WM. Conclusões: Os trabalhos analisados mostraram que ambos os tipos de intervenções podem contribuir para a manutenção e/ou melhoria da cognição de pessoas idosas, aproveitando sua plasticidade cerebral e, portanto, para a promoção de sua saúde mental e para a prevenção de problemas cognitivos que podem interferir em sua qualidade de vida.

ABSTRACT. The working memory (WM) training in older adults can benefit their cognition. However, there is a dearth of literature reviews on the subject. Objective: This study aimed to investigate and evaluate the effects of WM training on the cognition of healthy older adults, in individual and group interventions reported in the literature. Methods: This is a systematic review involving a qualitative analysis of publications on the SciELO, LILACS, and MEDLINE databases carried out between March and June 2021. Results: A total of 47 studies were identified and analyzed, comprising 40 in older adults only and 7 comparing older and younger adults, investigating individual or group WM training or other types of intervention focused on WM effects. Conclusions: Both individual and group intervention contributed to the maintenance and/or improvement of cognition in older adults exploiting brain plasticity to promote mental health and prevent cognitive problems that can negatively impact quality of life of this group.

RESUMO A oftalmologia fornece um campo vasto de conhecimentos necessários à medicina legal e às perícias médicas. O presente artigo objetivou revisar as informações na perícia criminal e cível, as repercussões da morte e os achados post-mortem que o exame ocular pode fornecer. Demonstrou-se que a perícia ocular é complexa e multifacetada, fornecendo ferramentas importantes para a classificação das lesões corporais, verificação da capacidade laboral, investigação da causa mortis e estimativa do tempo de morte.

ABSTRACT Ophthalmology provides a vast field of knowledge necessary for forensic medicine and medical expertise. The present article aimed to review the information on criminal and civil medical expertise, the repercussions of death, and the postmortem findings that the eye examination can provide. Ocular expertise has been shown to be complex and multifaceted, providing important tools to classify bodily injuries, verify work capacity, investigate the cause of death, and estimate the time of death.

RESUMO Nos últimos anos, foram encontrados poucos estudos relatando os benefícios das intervenções cognitivas e educativas à qualidade de vida, ao bem-estar psicológico e contra os sintomas depressivos. Objetivo: Investigar os impactos de intervenções educativas e cognitivas nas variáveis de bem-estar psicológico, qualidade de vida e humor de adultos maduros e idosos sem demência e/ou com comprometimento cognitivo leve. Métodos: A pesquisa de revisão sistemática ocorreu entre setembro e outubro de 2020 e, para a seleção dos estudos, foram utilizadas as bases de dados: Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), PubMed e Medical Literature Analysis and Retrieval System Online (MEDLINE). Foram selecionados os seguintes termos para a busca: “idos*” AND “treino cognitivo” AND “bem-estar psicológico” AND “qualidade de vida” e seus correspondentes em inglês e espanhol. Resultados: De 241 artigos contendo as palavras-chave, 26 estudos primários foram selecionados para esta revisão. Deles, 18 demonstraram melhora significativa na qualidade de vida, no bem-estar psicológico ou na cognição. Conclusões: Os estudos analisados evidenciaram efeitos positivos das intervenções educacionais e cognitivas para a qualidade de vida, para o bem-estar psicológico e contra os sintomas depressivos de idosos e adultos maduros sem demência e depressão.

ABSTRACT Few recently published studies investigating the benefits of educational and cognitive interventions on quality of life (QoL), psychological well-being, and depressive symptoms are available. Objective: The aim of this study was to investigate the effects of educational and cognitive interventions on psychological well-being, QoL, and mood in mature and older adults without dementia and/or with mild cognitive impairment (MCI). Methods: The systematic review took place from September to October 2020 and the following databases were used to select the studies: SciELO, LILACS, PubMed, and Medline. The search terms used were idos* AND “treino cognitivo” AND “bem-estar psicológico” AND “qualidade de vida” and their corresponding translations in English and Spanish. Results: Of the 241 articles retrieved, 26 primary studies were included in the review. Of these, 18 showed improvement in QoL, psychological well-being, or cognition. Conclusions: The studies reported beneficial effects of educational and cognitive interventions for QoL, psychological well-being, and depressive symptoms of mature and older adults without dementia or depression.

Resumo Objetivo Avaliar, por meio de ensaio biomecânico, a carga máxima, a energia, e o deslocamento necessários para a ocorrência de fratura em modelos sintéticos de fêmures após a retirada de parafusos acanulados e a realização de técnica de reforço com polimetilmetacrilato (PMMA) em diferentes posições combinadas. Métodos Foram utilizados 25 ossos sintéticos divididos em 4 grupos: o grupo controle (GC), com 10 modelos sem perfuração, e os grupos teste (A, B e C), com 5 modelos cada. Os grupos de teste foram fixados com parafusos acanulados pela técnica de Asnis, e tiveram a síntese removida e o preenchimento de dois dos orifícios formados por técnica de reforço com PMMA. A análise biomecânica foi realizada simulando queda sobre o grande trocânter utilizando máquina servo-hidráulica. Resultados Todos os corpos de prova do GC e dos grupos A, B e C apresentaram fratura baso-cervical do colo femoral, exceto um modelo do grupo B, que apresentou fratura longitudinal. Foi utilizada uma média de 5,4 mL de PMMA no reforço dos grupos com preenchimento. Segundo a análise de variância (analysis of variance, ANOVA) e o teste de comparações múltiplas de Tukey, no nível de 5%, observou-se que o GC apresentou diferença significativa em relação aos grupos A e C nos seguintes parâmetros: carga máxima, energia até a fratura, e deslocamento. Conclusão Observou-se que os grupos A e C, quando comparados ao GC, apresenta- ram diferenças significativas na observação do deslocamento, da carga máxima, e da energia até a fratura.

Abstract Objective To evaluate, through a biomechanical assay, the maximum load, energy, and displacement necessary for the occurrence of fractures in synthetic models of femurs after the removal of cannulated screws and the performance of a reinforcement technique with polymethylmethacrylate (PMMA) in different combined positions. Methods In total, 25 synthetic bones were used, and they were divided into 4 groups: the control group (CG), with 10 models without perforation, and the test groups (A, B and C), with 5 models each. The test groups were fixed with cannulated screws using the Asnis technique, and they had the synthesis removed, and two of the holes formed by the reinforcement techniquewith PMMAwere filled. The biomechanical analysis was performed simulating a fall on the large trochanter using a servo-hydraulic machine. Results All specimens of the CG and of groups A, B and C presented basal-cervical fracture of the femoralneck, except for a singlemodel in groupB,which presenteda longitudinal fracture. An average of 5.4mL of PMMAwere used to reinforce the groupswith filling. According to the analysis of variance (ANOVA) and the Tukey multiple comparison test, at the level of 5%,weobservedthat theCGpresented significant differences inrelation to groupsAandCin the following parameters: maximum load, energy up to the fracture, and displacement. Conclusion We observed that groups A and C, when compared to the CG, showed significant differences in the observation of displacement, maximum load, and energy until the fracture.