The Supplementation of Docosahexaenoic Acid-Concentrated Fish Oil Enhances Cognitive Function in Puppies.

Docosahexaenoic acid (DHA) has an important role in brain development and functionality. Therefore, this study aimed to evaluate the effects of DHA-concentrated fish oil on the cognitive function of puppies. Twelve 3-month-old puppies were included, blocked by breed and randomly distributed into two groups: the Control Group (CG), without supplementation, and the Experimental Group (EG), supplemented with 40 mg DHA/kg BW/day. The object discrimination test was used, with a normal stage (NS) and a reverse stage (RS), and blood samples were collected to evaluate the serum polyunsaturated fatty acid (PUFA) concentration and total antioxidant capacity (TAC) before (T0) and 30 (T1), 60 (T2) and 90 (T3) days after beginning the study. For the NS, there were effects of treatment (p = 0.0039) and time (p < 0.0001), in which the correct answer frequency in the EG was higher than the CG. The serum eicosapentaenoic acid (EPA) + HA concentrations at T1, T2 and T3 were higher than at T0 for the EG (p = 0.0159), in addition, EG showed higher serum EPA + DHA concentrations than CG at T2 (p = 0.0245). The TAC values were similar between the groups (p = 0.3211). It was concluded that the cognitive function of puppies can be enhanced with DHA-concentrated fish oil supplementation without increasing the serum lipid oxidation.

Hepatic Venous Outflow Obstruction in Adult Deceased Donor Liver Transplantation: Classic Piggyback Implantation Versus a Modified Technique that Widens the Ostium of the Recipient's Left and Middle Hepatic Veins.

BACKGROUND: The classic piggyback technique uses the union of the 3 hepatic veins to perform the cavo-caval anastomosis. However, due to the lateral localization of the right hepatic vein, the partial clamping of the vena cava in this technique significantly reduces the venous return to the right atrium. To avoid this, we adopted in 2015 a modified piggyback technique, in which we use the common trunk of the middle and left hepatic veins and also perform a lateral incision toward the right in the anterior wall of the vena cava in order to widen the final ostium of the cavo-caval anastomosis. The aim of the study was to analyze the incidence of hepatic venous outflow obstruction between those 2 techniques. METHODS: Retrospective study of liver transplant recipients undergoing venography for suspected hepatic venous outflow obstruction from January 2009 to June 2021. Patients undergoing transplantation with living donors or split grafts and pediatric cases were excluded from the study. RESULTS: From January 2009 to December 2014 and from January 2015 to June 2021, 587 (group 1) and 730 (group 2) deceased-donor liver transplants were performed with the classic and the modified piggyback techniques, respectively. The incidence of cases with suspected hepatic venous outflow obstruction in groups 1 and 2 were 1.87% (n = 11) and 0.95% (n = 7), respectively (P = 0,15). The number of confirmed patients with outflow blockage that required endovascular treatment during venography in groups 1 and 2 were 4 (0.68%) and 5 (0.68%), respectively (P = 0,31). CONCLUSIONS: This modified piggyback technique did not increase the incidence of hepatic venous outflow obstruction at our service.

Septuagenarian Donors and Recipients in Deceased Donor Liver Transplantation: A Brazilian Single Center Experience and Literature Review.

BACKGROUND: The number of elderly patients who have end-stage liver disease and require liver transplantation has dramatically increased. On the other hand, liver grafts from elderly donors have been offered more frequently for transplantation. The present study aims to analyze the results of liver transplants performed with donors and recipients aged ≥70 years. METHODS: We performed a single-center retrospective study of deceased donors liver transplants that involved recipients aged ≥7070 years or recipients who received grafts from donors aged ≥70 years from 2011 to 2021. A literature review on the results of liver transplantation in elderly recipients was also performed. RESULTS: Thirty septuagenarian recipients were included; their overall 1- and 5-years survival was 80% and 76.6%, respectively. The prevalence of recipients aged ≥70 years in our department was 2.65%. Twenty recipients received grafts form septuagenarian donors; their overall 1- and 5-years survival was 75%. The prevalence of donors aged ≥70 years in our department was 1%. In the literature review, 17 articles were analyzed. The 5-years survival of recipients aged ≥70 years ranged from 47.1% to 78.5%. CONCLUSIONS: Septuagenarian recipients and patients who received grafts from elderly brain-dead donors present adequate overall survival after liver transplantation. Optimized donor-recipient matching is paramount for achieving good outcomes. The combination of high-risk donors with septuagenarian recipients should be avoided as well as using grafts of elderly donors that present others risk factors. Thus, the age of the donor or recipient alone cannot be considered an absolute contraindication for liver transplantation.

Incidence of Donor Hepatic Artery Thrombosis in Liver Grafts Recognized During Organ Procurement and Backtable: A Rare but Treacherous Pitfall In Liver Transplantation.

INTRODUCTION: Donor hepatic artery thrombosis (dHAT) identified during liver procurement and backtable is a rare and little-reported event that can make liver transplants unfeasible. METHODS: This is a retrospective study of dHAT identified during liver grafts procurements or backtable procedures. All grafts were recovered from brain-dead donors. The demographic characteristics of the donors and the incidence of dHAT were analyzed. The data were also compared to a cohort of donors without dHAT. RESULTS: There was a total of 486 donors during the study period. The incidence of dHAT was 1.85% (n = 9). The diagnosis of dHAT was made during procurement in 5 cases (55.5%) and during the backtable in 4 (44.4%). Most donors were female (n = 5), with an average BMI of 28.14 ± 6.9 kg/m2, hypertensive (n = 5), and with stroke as cause of brain death (n = 8). The most prevalent site of dHAT was a left hepatic artery originating from the left gastric artery (n = 4). Of the 9 cases reported, 2 livers were used for transplantation, and 7 were discarded. Comparing those cases to a cohort of 260 donors without dHAT, we found a higher incidence of anatomic variations in the hepatic artery (P = .01) and of stroke as cause of brain death (P = .05). CONCLUSION: The occurrence of dHAT before liver procurement is a rare event, however it may become a treacherous pitfall if the diagnosis is late. Grafts with anatomic variations recovered from women with brain death due to stroke and with past history of hypertension seem to be at a higher risk of presenting dHAT.

Contribuições da vivência em comunidade para formação acadêmica em fisioterapia / Contributions of a community experience to academic training in physiotherapy / Contribuciones de la experiencia comunitaria a la formación académica en fisioterapia

Introdução:Durante sua formação,o fisioterapeuta é preparado para atuar em todos os níveis de atenção, não ficando restritos somente às ações reabilitadoras e curativas às quais são comumente associados.Apromoção e educação em saúde, fazemparte de suas atribuições e visam a autonomiana saúde da população.Objetivo:Relatar a experiência de acadêmicos de um curso de Fisioterapia durante a vivência no estágio supervisionado no setor de saúde na comunidade.Metodologia:Os relatos apresentados neste estudo estão vinculados à atuação de quatro discentes do curso de Fisioterapia em uma Unidade Básica de Saúde do município de Piripiri-PI, durante o período de fevereiro a março do ano de 2020. As atividades eram realizadas três vezes por semana, ficando estabelecido a divisão em três momentos (Alongamento e aferição da pressão arterial; Dinâmica; Roda de conversa), com o intuito de trazer uma melhor interação da comunidade com os acadêmicos, proporcionar ganhos de saúde aos participantes e promover um maior conhecimento sobre os temas abordados.Resultados:Essas ações realizadas durante o estágio, resultaram na construção de um vínculo entre os acadêmicos e a comunidade gerando promoção e educação para ambos os lados, bem como a desconstrução da sociedade sobre as atribuições do fisioterapeuta.Conclusões:Desta forma finda-se que o estágio na comunidade agrega ao conhecimento teórico e prático dos acadêmicos uma experiência rica, que leva ao desenvolvimento de habilidades e trabalho em equipe, assim como proporciona uma maior valorização sobre a importância da atenção primária e o papel do fisioterapeuta na equipe multidisciplinar (AU).

Introduction:During their training, the physiotherapist is prepared to work at all levels of care, not being restricted only to the rehabilitation and corrective actions to which they are commonly associated.Health promotion and education, it is part of their duties and aim at the autonomy in the health of the population.Objective:To report the experience of a physiotherapy course's academics during their supervised internship in the community health sector. Methodology:The reports presented in this study are linkedto the performance of four students of the Physiotherapy course in a Basic Health Unit in the municipality of Piripiri-PI, between February and March of 2020. The activities were carried out three times a week, the division was established in three moments (Stretching and blood pressure measurement; Dynamic; Conversation circle) to bring a better interaction between the community and academics, providing health gains to participants and promoting more excellent knowledge on the topics addressed.Results:These actions carried out during the internship resulted in the construction of a bond between academics and the community, generating promotion and education for both sides and the deconstruction of society about the physiotherapist's duties.Conclusions:Thus, it ends that the internship in the community adds to the theoretical and practical knowledge of academics a rich experience, which leads to the development of skills and teamwork, as well as providing a greater appreciation of the importance of primary care and the role of the physiotherapist. in the multidisciplinary team (AU).

Introducción: Durante su formación, el fisioterapeuta se prepara para trabajar en todos los niveles asistenciales, no limitándose únicamente a las acciones rehabilitadoras y correctoras a las que comúnmente se les asocia.La promoción y educación para la salud, forma parte de sus funciones y tiene como objetivo la autonomía en la salud de la población.Objetivo: Relatar la experiencia de los académicos de un curso de fisioterapia durante sus prácticas supervisadas en el sector de la salud comunitaria.Metodología: Los informes que se presentan en este estudio están vinculados a la actuación de cuatro estudiantes del curso de Fisioterapia en una Unidad Básica de Salud del municipio de Piripiri-PI, entre febrero y marzo de 2020. Las actividades se realizaron tres veces por semana, la división se estableció en tres momentos (Estiramiento y medición de la presión arterial; Dinámica; Círculo de conversación) para traer una mejor interacción entre la comunidad y los académicos, proporcionando ganancias de salud a los participantes y la promoción de un conocimiento más excelente sobre los temas abordados.Resultados:Estas acciones realizadas durante la pasantía resultaron en la construcción de un vínculo entre los académicos y la comunidad, generando promoción y educación para ambas partes y la deconstrucción de la sociedad sobre las funciones del fisioterapeuta. Conclusiones: Así, se concluye que la pasantía en la comunidad agrega a los conocimientos teóricos y prácticos de los académicos una rica experiencia, que lleva al desarrollo de habilidades y al trabajo en equipo, además de proporcionar una mayor valoración de la importancia de la atención primaria y del rol del fisioterapeuta. en el equipo multidisciplinario (AU).

Ansiedade em acadêmicos de enfermagem e suas complicações futuras / Anxiety in nursing academics and their future complications / Ansiedad en enfermería académica y sus futuras complicaciones

Objetivo: Conhecer quais elementos favorecem a ocorrência de ansiedade em acadêmicos de enfermagem e suas possíveis complicações. Método: Revisão integrativa da literatura nacional e internacional. A coleta foi realizada nas bases de dados indexáveis na Biblioteca Virtual em Saúde, Base de dados da literatura LatinoAmericana em Ciência da Saúde, Biblioteca de Enfermagem; Index de Psicologia, Medical Literature Analysis and Retrieval System Online e Scientific Eletronic Libary Online. Com descritores: Ansiedade, Acadêmicos, Complicações e Enfermagem. Resultados: Após a análise dos artigos selecionados, 11 artigos compuseram a amostra. Conclusão: A compreensão acerca da ansiedade em acadêmicos de enfermagem é imprescindível para que se torne possível a prevenção de futuras complicações.

Objective: To know which elements favor the occurrence of anxiety in nursing students and its possible complications. Method: Integrative review of national and international literature. The collection was carried out in the indexable databases in the Virtual Health Library, Database of the Latin American literature in Health Science, Nursing Library; Psychology Index, Medical Literature Analysis and Retrieval System Online and Scientific Eletronic Libary Online. With descriptors: Anxiety, Academics, Complications and Nursing. Results: After analyzing the selected articles, 11 articles made up the sample. Conclusion: Understanding anxiety in nursing students is essential for preventing future complications.

Objetivo: Conocer qué elementos favorecen la ocurrencia de ansiedad en estudiantes de enfermería y sus posibles complicaciones. Método: Revisión integradora de literatura nacional e internacional. La recolección se realizó en las bases de datos indexables de la Biblioteca Virtual en Salud, Base de datos de la literatura latinoamericana en Ciencias de la Salud, Biblioteca de Enfermería; Índice de psicología, Sistema de análisis y recuperación de literatura médica en línea y Biblioteca electrónica científica en línea. Con descriptores: Ansiedad, Académicos, Complicaciones y Enfermería. Resultados: Tras analizar los artículos seleccionados, 11 artículos conformaron la muestra. Conclusión: Comprender la ansiedad en los estudiantes de enfermería es fundamental para prevenir futuras complicaciones.

Evaluation of quality of life, functionality and disability in patients with systemic sclerosis in a university hospital / Avaliação da qualidade de vida, funcionalidade e deficiência em pacientes com esclerose sistêmica em um hospital universitário

INTRODUCTION: Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by progressive fibrosis of the skin and internal organs that promotes high morbidity and mortality. OBJECTIVE: To evaluate the functionality, disability and quality of life of patients with systemic sclerosis and to compare the clinical forms of the disease. METHODS: Cross-sectional, descriptive and analytical study performed at the Rheumatology Clinic of the Hospital das Clínicas of the Federal University of Pernambuco (HC-UFPE) from August 2018 to April 2019. The non-probabilistic, convenience sample consisted of 60 patients diagnosed with systemic sclerosis (SSc), followed at the Rheumatology outpatient clinic of the Hospital das Clínicas, Federal University of Pernambuco. To evaluate the outcomes, the following instruments were used: Cochin Hand Functional Scale (CHFS) for hand function; 12-Item Short-Form Health Survey (SF-12) for quality of life; and Scleroderma Health Assessment Questionnaire (SHAQ) for functionality and disability. RESULTS: The mean results for CHFS, SHAQ, SF-12 Physical Component Summary and SF-12 Mental Component Summary were 14.5 (6.0-29.75), 1.01±0.56, 35.04±8.09, 40.94±10.56, respectively. There were no significant differences in CHFS outcomes between patients with diffuse and limited forms of SSc, SHAQ and the mental component of SF-12. However, in the physical component of SF-12, a better score was found in patients with the diffuse form of the disease (p=0.04). CONCLUSION: Patients with SSc present an important impairment of hand function, quality of life and functional capacity, and those with limited cutaneous form present worse scores of the physical component in the evaluation of quality of life.

INTRODUÇÃO: A esclerose sistêmica (ES) é uma doença autoimune crônica que se caracteriza por fibrose progressiva da pele e órgãos internos, promovendo grande morbimortalidade. OBJETIVO: Avaliar a funcionalidade, incapacidade e qualidade de vida em pacientes com esclerose sistêmica e comparar as formas clínicas da doença. MÉTODOS: Estudo transversal, descritivo e analítico, realizado na Clínica de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), de agosto de 2018 a abril de 2019. A amostra não probabilística do tipo conveniência foi composta por 60 pacientes com diagnóstico de ES, acompanhados no ambulatório de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco. Para avaliar os resultados, foram utilizados os seguintes instrumentos: Escala Funcional da Mão de Cochin (CHFS) para função da mão; 12-Item Short-Form Health Survey (SF-12) para qualidade de vida; Questionário de Avaliação de Saúde da Esclerodermia (SHAQ) para funcionalidade e incapacidade. RESULTADOS: Os resultados médios para CHFS, SHAQ, SF-12 componente físico e SF-12 componente mental foram 14,5 (6,0-29,75), 1,01±0,56; 35,04±8,09; 40,94±10,56, respectivamente. Não houve diferenças significativas nos resultados do CHFS entre pacientes com formas difusas e limitadas de ES, SHAQ e o componente mental do SF-12. No entanto, no componente físico do SF-12, foi encontrado melhor escore dos pacientes com a forma difusa da doença (p=0,04). CONCLUSÃO: Pacientes com ES apresentam comprometimento importante da função da mão, qualidade de vida e capacidade funcional, e aqueles com forma cutânea limitada apresentam piores escores do componente físico na avaliação da qualidade de vida.

Intervenções fisioterapêuticas nos pacientes em cuidados paliativos / Physiotherapeutic interventions in palliative care patients

Introdução: O cuidado paliativo é uma abordagem direcionada à melhora da qualidade de vida dos indivíduos e de seus familiares, acometidos física e psicologicamente por patologias incuráveis, tendo como necessidade a atuação multidisciplinar em todas as fases da vida e em todos os níveis de atenção, e a fisioterapia é capaz de atuar de maneira direcionada aos distúrbios cinéticos funcionais. Objetivos: Identificar as intervenções fisioterapêuticas utilizadas nos pacientes em cuidados paliativos. Métodos: Trata-se de uma revisão integrativa de literatura nas bases de dados Scielo, Pubmed, Lilacs e PEDro. Resultados: Foram encontrados 367 artigos, sendo elegíveis 5 para o presente estudo, 4 relacionados a pacientes com câncer e um a pessoas vivendo com vírus da imunodeficiência humana. A maioria demonstra resultados significativos direcionados a melhora da qualidade de vida com melhora da mobilidade e da qualidade de sono, redução da fadiga, maior independência, força e resistência muscular, aumento da densidade óssea e o alcance de metas. Conclusão: A intervenção fisioterapêutica mais utilizada é no treino físico, desenvolvido a partir das necessidades individuais ligadas aos sinais, sintomas e/ou da queixa funcional do paciente. Estudos de qualidade, abordando a temática em questão para auxílio de uma prática baseada em evidências, são necessários.