BackgroundPhotobiomodulation therapy (PBMT) when used isolated or combined with static magnetic field (PBMT-sMF) has been proven benefits on skeletal muscle increasing performance and reducing fatigue, increasing oxygen saturation, and modulating inflammatory process. However, it is unknown whether the effects observed with this therapy on respiratory muscles will be similar to the effects previously observed on skeletal muscles.ObjectiveWe aimed to investigate whether PBMT-sMF is able to decrease the length of stay in the intensive care unit (ICU) and to reduce the mortality rate of patients with severe COVID-19 requiring invasive mechanical ventilation, increasing the respiratory function and modulating the inflammatory process.MethodsWe conducted a prospectively registered, pragmatic, triple-blinded (patients, therapists and outcome assessors), randomized, placebo-controlled trial of PBMT-sMF in patients with severe COVID-19, requiring invasive mechanical ventilation, admitted to the ICU. Patients were randomly assigned to receive either PBMT-sMF (6 sites at the lower thorax – 189 J total, and 2 sites at the neck area – 63 J total) or placebo PBMT-sMF daily during all the ICU stay. The primary outcome was length of stay in the ICU defined by either discharge or death. The secondary outcomes were survival rate, muscle function of diaphragm, change in blood tests, change in mechanical ventilation parameters and change in arterial blood gas analysis.ResultsA total of 30 patients underwent randomization (with 15 assigned to PBMT-sMF and 15 to placebo) and were analyzed. The length of stay in the ICU for the placebo group was 23.06 days while for the PBMT-sMF group was 16.26. However, there was no statistically difference between groups for the length of stay in the ICU (mean difference - MD = - 6.80; 95% CI = - 18.71 to 5.11). Regarding the secondary outcomes were observed statistically differences in favor of PBMT-sMF for diaphragm thickness, fraction of inspired oxygen, partial pressure of oxygen/fraction of inspired oxygen ratio, C-reactive protein, lymphocytes count, and hemoglobin (p<0.05).ConclusionAmong patients with severe COVID-19 requiring invasive mechanical ventilation, PBMT-sMF was not statistically different than placebo to the length of stay in the ICU. However, it is important to highlight that our sample size was underpowered to detect statistical differences to the primary outcome. In contrast, PBMT-sMF increased muscle function of diaphragm, improved ventilatory parameters, decreased C-reactive protein levels and hemoglobin count, and increased lymphocytes count.

IntroduçãoConsiderada como um dos fatores de risco cardiovascular mais importantes, a hipertensão arterial sistêmica é uma condição bastante prevalente na população adulta 1 , e atinge aproximadamente de 15% a 20% da população brasileira 2 . Em muitos casos, a primeira forma de apresentação da hipertensão arterial sistêmica é a crise hipertensiva 3 . Caracterizada por um aumento rápido, intenso e inapropriado da pressão arterial, a crise hipertensiva é uma das complicações da hipertensão arterial 2,4-8 associada a uma predisposição genética ou a fatores de risco, como estresse, ingestão excessiva de sal, álcool, tabagismo, obesidade, sedentarismo, doença renal, entre outros distúrbios 9 .Cirurgiões-dentistas demonstram não ter segurança suficiente para agir corretamente em situações de crises hipertensivas, por isso, o presente estudo tem como objetivo reunir informações sobre a crise hipertensiva, diferenciando as emergências hipertensivas das urgências hipertensivas, de modo a colaborar para o melhor entendimento sobre o tema pelos cirurgiões-dentistas que ainda têm insegurança quanto às emergências médicas.

A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment.

Morphometric, anatomical and histological examinations were made in 10 species of owls of the families Tytonidae and Strigidae and compared with the eyes of other species of nocturnal birds including common potoo (Nictibiidae) and three species of nightjars (Caprimulgidae) and two diurnal species: the roadside hawk (Accipitridae) and the domestic duck (Anatidae). In owls and the common potoo the nictitating membrane is situated on the dorsal edge of the eye. In these birds, the scleral ring bears an additional, previously undescribed bone of various forms and dimensions (1.4–6.8 mm of length and 0.8–3.3 mm of width), located on the trajectory of the tendon of the pyramidal muscle which is attached to the nictitating membrane. This bone has a groove that encloses the tendon of the pyramidal muscle, preventing it from separating from the sclera during contraction, as well as diverting the trajectory of the tendon to impede it from projecting itself over the cornea. In the ferruginous pygmy owl, Nacunda nighthawk, Pauraque, scissor-tailed nightjar, roadside hawk and domestic duck the additional bone was not seen. Based on the morphofunctional characteristics of the bone, we suggest that this bone should be named the scleral sesamoid bone.

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