Propiedades psicométricas del cuestionario de gratitud (gq-6) para Brasil / Psychometric Properties of the Gratitude Questionnaire (gq-6) to Brazil / Propriedades psicométricas do questionário de gratidão (gq-6) para o Brasi

Este estudio tuvo como objetivo adaptar el Cuestio-nario de Gratitud (gq-6) a la población brasileña. La muestra estuvo constituida por 1 850 participantes con una edad media de 25.13 años (dt = 5.36), 50 % mujeres y 50 % hombres, con representación de todos los estados brasileños. Se realizó análisis factorial exploratorio (afe) y análisis factorial confirmatorio (afc), y correlaciones entre gratitud (gq-6) y satisfac-ción con la vida (swls), optimismo (lot-r), esperanza (ahs), felicidad (shs), afectos positivos y negativos (panas), y personalidad (bfi). Los resultados de efay cfa indicaron una solución unidimensional con los elementos que soportan cargas (λ > 0.39) en el factor y un ajuste aceptable para la solución de un factor (χ2(9) = 59, p < 0.001; cfi= 0.956, rmsea= 0.078). Las correlaciones indican una asociación con variables externas relevantes. Se concluye que el cuestionario presenta evidencia de validez y confiabilidad para su uso en investigación en el contexto brasileño

This study aimed to evaluate the psychometric properties of the Gratitude Questionnaire (gq-6) to the Brazilian population. The sample consisted of 1 850 participants with a mean age of 25.13 years (sd = 5.36), 50 % female and 50 % male and the sample represents all Brazilian states. Exploratory factor analysis (efa) and confirmato-ry factor analysis (cfa) were run, along with correlations between gratitude (gq-6) and life satisfaction (swls), optimism (lot-r), hope (ahs), happiness (shs), positive and negative affects (panas), and personality (bfi). The efa and cfa results indicated a one-dimensional solu-tion with the items loading satisfactorily (λ > 0.39) in the factor and acceptable fit for the one-factor solution (χ2 (9) = 59, p < 0.001; cfi= 0.956, rmsea= 0.078). Correlations indicate relevant relationships with exter-nal variables. In conclusion, the questionnaire shows evidence of validity and reliability for research use in the Brazilian context

Este estudo investigou as propriedades psicométricas do Questionário de Gratidão (gq-6) na população bra-sileira. Participaram 1 850 respondentes com média de idade de 25.13 anos (dp= 5.36), sendo 50 % do sexo feminino e 50 % do sexo masculino e com representação de todos os estados brasileiros. Foram rodadas análi-ses fatoriais exploratória (efa) e fatorial confirmatória (cfa), e correlações entre gratidão (gq-6) e satisfação com a vida (swls), otimismo (lo-r), esperança (ahs), felicidade subjetiva (shs), afetos positivos e negativos (panas) e personalidade (bfi). Os resultados da efa e da cfa indicaram uma solução unidimensional com os itens carregando com cargas adequadas (λ > 0.39) no fator e ajuste aceitável para a solução unifatorial (χ2 (9) = 59, p < 0.001; cfi= 0.956, rmsea = 0.078). As correlações indicaram relações com variáveis externas relevantes. Conclui-se que a escala apresenta evidências de validade e fidedignidade para uso em pesquisa no Brasil.

Thermodynamic evaluation of viscosity behavior for CaO-SiO2-Al2O3-MgO slag systems examined at the temperatures range from 1500 to 1700 °C.

This work showed an application of computational tools to understand systematically the behavior of viscosity on CSAM systems relevant to industrial uses. Consequently in this study, the viscosity experimental data obtained from the literature were compared with the thermodynamic calculated results via the software FactSage v.7.3 for melts in CaO-SiO2-Al2O3-MgO slag system with the range of compositions slags cover 0-100 wt% CaO, 0-100 wt% SiO2, 0-100 wt% Al2O3 and 0-15 wt% MgO at temperature ranges of 1500-1700 °C. Using open-source software in Python, the results of viscosity, liquid, and solid fraction of the slag, as a function of composition and temperature, are represented by multiple color maps and by iso-viscosity contours. The results of the viscosity values indicated that the effect of all the oxides in the CSAM slag system follows the well-known behavior trend observed in the literature. Viscosities of the slag were found to increase with increasing SiO2 contents and decrease with increasing basicities (high CaO). The increase in Al2O3 content increases the viscosity values. An increase of 0-15% MgO depolymerized the slag melt and decreases the viscosity. However, above 5% MgO content occur a decrease in the liquid zone (single phase) and a liquid fraction (two-phase region) of the slag. For a constant MgO concentration, the increase in temperature generates an expansion of low-viscosity zones associated with an increase in the liquid phase of the slag. From the comparison between the calculated and experimental viscosities data keeps up within 30% average relative deviation (Δ), the predictions are considered acceptable for viscosity in the CSAM slag system at high temperatures.

Lethality and mortality of COVID-19 in an important industrial center in Latin America, region of Grande ABC, São Paulo, Brazil / Letalidade e mortalidade da COVID-19 em importante pólo industrial da américa latina, região do Grande ABC, São Paulo

INTRODUCTION: the new coronavirus (COVID-19) disease has been causing economic and health system impacts worldwide, triggering humanitarian crises in vulnerable regions, marked by high mortality rates of the disease. Brazil has been suffering an increase in the number of cases, characteristic of the formation of a second wave, with great epidemiological differences observed in the most diverse regions of the country. Many studies illustrate the behaviour of COVID-19 in the state of São Paulo, but there are gaps in the scientific literature on the epidemiology of COVID-19 in municipalities of the São Paulo metropolitan region that constitute an important industrial pole in Latin America, such as the region of Grande ABC. OBJECTIVE: to evaluate mortality and lethality trends of COVID-19 during the period March 2020 to July 2021, in municipalities on region of Grande ABC, metropolitan region of São Paulo, Brazil, divided into two periods (March to November 2020 and December to July 2021. METHODS: we conducted an ecological time series study with population data from the Brazilian Ministry of Health. We collected the number of cases and deaths confirmed for COVID-19 in the municipalities that make up the region of Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo, and São Caetano do Sul) from March 2020 to July 2021. Prais-Winsten linear regression was performed, and the percentage of daily change was calculated. Differences were considered significant when p<0.05. RESULTS: in region of Grande ABC, in the period analysed, 217,264 cases and 10,004 deaths of COVID-19 were recorded. Although the mortality rate remained stationary during the first wave (March to November 2020) and the second wave (December 2020 to July 2021); lethality transitioned from decreasing during the first wave to increasing during the second wave, with rates varying according to municipality. CONCLUSION: trend analyses in incidence, mortality, and lethality rates assist in understanding the behaviour of the COVID-19 Pandemic in the region known as Grande ABC. Efforts must be maintained throughout the region to control the Pandemic.

INTRODUÇÃO: a doença do novo coronavírus (COVID-19) vem ocasionando impactos econômicos e nos sistemas de saúde mundiais, desencadeando crises humanitárias em regiões vulneráveis, marcadas por elevadas taxas de mortalidade da doença. O Brasil vem sofrendo por um aumento no número de casos, característicos da formação de uma segunda onda, com grandes diferenças epidemiológicas observadas nas mais diversas regiões do país. Muitos estudos ilustram o comportamento da COVID-19 no estado de São Paulo, mas há lacunas na literatura científica sobre a epidemiologia da COVID-19 em municípios da região metropolitana de São Paulo que constituem importante polo industrial da América latina, como por exemplo a região do Grande ABC. OBJETIVO: avaliar as tendências de mortalidade e letalidade da COVID-19 durante o período de março de 2020 a julho de 2021, em municípios do Grande ABC, região metropolitana de São Paulo, Brasil, dividindo em dois períodos (março a novembro de 2020 a dezembro a julho de 2021. MÉTODO: foi realizado um estudo ecológico de series temporais com dados populacionais oriundo do Ministério da Saúde do Brasil. Foram coletados o número de casos e óbitos confirmados para COVID-19 nos municípios que compõe a região do Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo e São Caetano do Sul) no período de março de 2020 a julho de 2021. Foi realizado a regressão linear de Prais-Winsten, e calculado o percentual de mudança diária. Foram consideradas diferenças significativas, quando p<0,05. RESULTADOS: na região do Grande ABC, no período analisado, foram registrados 217.264 casos e 10.004 óbitos de COVID-19. Apesar da taxa de mortalidade ter se mantido estacionária durante a primeira onda (março a novembro de 2020) e a segunda onda (dezembro de 2020 a julho de 2021); a letalidade transitou de decrescente durante a primeira onda para crescente durante a segunda onda, com índices variando segundo o município. CONCLUSÃO: as análises de tendência nas taxas de incidência, mortalidade e letalidade auxiliam na compreensão do comportamento da Pandemia da COVID-19 na região conhecida como Grande ABC. Esforços devem ser mantidos em toda à região para o controle da Pandemia.

Orientações de cuidados em domicílio aos familiares e cuidadores de pacientes em cuidados paliativos / Home care guidelines for family members and caregivers of patients in palliative care

Objetivo:relatar a experiência de dois graduandosde enfermagem no oferecimento de orientações a familiares de pacientes internados sob cuidados paliativos no período que antecede a alta hospitalar, por meio de uma cartilha educativa. Método:estudo descritivo, do tipo relato de experiência, de um projeto de extensão que previa as orientações de cuidados domiciliares a familiares de pacientes internados sob cuidados paliativos após a alta hospitalar. Resultados:Dúvidas acerca dos cuidados, medo e ansiedade foram sentimentos constantes manifestados pelos familiares e cuidadores, permitindo aos alunos, mais do que oferecer orientações, interagir com compaixão, humanidade e zelo, fazendo com que a proposta do projeto extrapolasse os aspectos técnicos. Conclusão:O desenvolvimento do projeto resultou em ganhos para os pacientes e seus familiares e aos alunos envolvidos. Os alunos puderam aprimorar seu conhecimento na área dos cuidados paliativos, além de desenvolver habilidades de observação sistematizada e comunicação. A universidade deve investir em atividades de extensão capazes de contribuir com a comunidade e, ao mesmo tempo, garantir o engajamento do aluno e aprimoramento de seus conhecimentos, habilidades e atitudes frente ao cuidar em enfermagem

Objective: to report the experience of two nursing students in offering guidance to family members of patients hospitalized under palliative care in the period before hospital discharge, through an educational booklet.Method: descriptive study, of the experience report type, of an extension project that provided home care guidelines for family members of patients hospitalized under palliative care after hospital discharge.Results: Doubts about care, fear and anxiety were constant feelings expressed by family members and caregivers, allowing students, more than offering guidance, to interact with compassion, humanity and zeal, making the project proposal extrapolate the technical aspects.Conclusion: The development of the project resulted in gains for the patients and their families and the students involved. Students were able to improve their knowledge in the field of palliative care, in addition to developing systematic observationand communication skills. The university must invest in extension activities capable of contributing to the community and, at the same time, guaranteeing student engagement and improving their knowledge, skills and attitudes towards nursing care

Analysis of Diabetes Mellitus-Related Amputations in the State of Espírito Santo, Brazil.

Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes-SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.

Impact of Emergency Medical System Transportation in ST-segment Elevation Myocardial Infarction: A Nationwide Retrospective Study.

INTRODUCTION: Emergency medical system transportation has been shown to reduce treatment times in ST-segment elevation myocardial infarction. The authors studied the Portuguese National Registry of Acute Coronary Syndromes to determine the nationwide impact of the emergency medical system transportation in the treatment of ST-segment elevation myocardial infarction. MATERIAL AND METHODS: A multicentric, nationwide, retrospective study of ST-segment elevation myocardial infarction patients inserted in the National Registry from 2010 to 2017 was performed. The patients were divided into: Group I, composed of patients transported by emergency medical system, and Group II, patients arriving to the Emergency department by other means. RESULTS: Of the 5702 patients studied, 25.9% were transported via emergency medical system. Rates of emergency medical system activation increased by 17% in the last 7 years. The emergency medical system provided a higher rate of transport to a percutaneous coronary intervention capable centre, of Emergency department bypass, of on-site fibrinolysis, and ensured a 59-minute reduction of the median reperfusion time (p < 0.001). There was no difference in in-hospital mortality. DISCUSSION: In this nationwide cohort, emergency medical system transportation is associated with a reduction in reperfusion times. It provides a higher amount of salvaged myocardium and reduces the incidence of acute heart failure. However, emergency medical system use did not result in lower in-hospital mortality, probably due to confounding factors of higher disease severity and comorbidity. CONCLUSION: The benefits associated with emergency medical system based transportation of patients with ST-segment elevation myocardial infarction do not translate into lower in-hospital mortality.

Introdução: O transporte através de sistemas de emergência médica reduz os tempos de tratamento no enfarte agudo do miocárdio com elevação do segmento ST. Os autores estudaram o Registo Nacional de Síndromes Coronários Agudos para avaliar o impacto nacional do transporte através de sistema de emergência médica no tratamento do enfarte agudo do miocárdio com elevação do segmento ST. Material e Métodos: Foi realizado um estudo retrospetivo, multicêntrico de doentes com enfarte agudo do miocárdio com elevação do segmento ST inseridos no Registo Nacional desde 2010 até 2017. Os doentes foram divididos em Grupo I, representando doentes transportados por viaturas de emergência médica e Grupo II, doentes que chegaram ao Serviço de Urgência por outros meios. Resultados: Do total de 5702 doentes, 25,6% foram transportados por viaturas de emergência médica. Registou-se um aumento no uso de viaturas de emergência médica de 17% nos últimos sete anos. Os sistemas de emergência médica garantiram uma maior taxa de transporte para centros capazes de realizar intervenção coronária percutânea, de bypass do Serviço de Urgência e de fibrinólise no local. O transporte através de viaturas de emergência médica conseguiu uma redução da mediana do atraso para a reperfusão de 59 minutos (p < 0,001). Não houve diferença na mortalidade intra-hospitalar. Discussão: Nesta amostra nacional, é evidente que os sistemas de emergência médica reduziram significativamente os tempos de reperfusão, associando-se a uma menor incidência de insuficiência cardíaca aguda pós-enfarte. No entanto, esse benefício não resultou numa menor mortalidade intra-hospitalar, provavelmente devido ao facto dessa população representar um subgrupo de doentes com doença mais grave e mais comorbilidades. Conclusão: Os benefícios associados ao uso de sistemas de emergência médica no transporte de doentes com enfarte agudo do miocárdio com elevação do segmento ST não se traduziram numa menor mortalidade intra-hospitalar.

Organomineral Fertilizer as Source of P and K for Sugarcane.

Sugarcane (Saccharum spp) crop has high social, economic and environmental importance for several regions throughout the world. However, the increasing demand for efficiency and optimization of agricultural resources generates uncertainties regarding high mineral fertilizer consumption. Thereby, organomineral fertilizers are to reduce the conventional sources consumption. Thus, this study was carried out to evaluate the agronomic and economic sugarcane performancies and the residual effect of P and K under mineral and organomineral fertilization. Growth and technological parameters, leaf and soil nutrients concentration in surface and subsurface layers were analyzed from sugarcane planting (plant cane) until the first ratoon. Agronomic and economic sugarcane efficiency were evaluated. At the first ratoon, resin-extractable P provided by mineral and organomineral fertilizers were, respectively, 15 and 11 mg kg-1 in the 0.0-0.2 m, and 28 and 31 mg kg-1 in 0.2-0.4 m layer. However, exchangeable K in the 0.0-0.2 m layer was 1.88 and 1.58 mmolc kg-1 for mineral and organomineral fertilizers, respectively. The yield gains over the control reached with mineral and organomineral fertilizers were, respectively, 10.99 and 17 Mg ha-1 at the lowest fertilizer rate; and 29.25 and 61.3 Mg ha-1 at the highest fertilizer rate. Agronomic and economic organomineral fertilizer efficiencies are more pronounced in plant cane. Summing two harvests, the organomineral is 7% more profitable than mineral fertilizer.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon.

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.

A new coumarin derivative, 4-acetatecoumarin, with antifungal activity and association study against Aspergillus spp

Abstract Fungal infections have become a concern for health professionals, and the emergence of resistant strains has been reported for all known classes of antifungal drugs. Among the fungi causing disease, we highlight those that belong to the genus Aspergillus. For these reasons, the search for new antifungals is important. This study examines the effects of a coumarin derivative, 4-acetatecoumarin (Cou-UMB16) both alone and together with antifungal drugs, and its mode of action against Aspergillus spp. Cou-UMB16 was tested to evaluate its effects on mycelia growth, and germination of Aspergillus spp. fungal conidia. We investigated its possible action on cell walls, on the cell membrane, and also the capacity of this coumarin derivative to enhance the activity of antifungal drugs. Our results suggest that Cou-UMB16 inhibits Aspergillus spp. virulence factors (mycelia growth and germination of conidia) and affects the structure of the fungal cell wall. When applying Cou-UMB16 in combination with azoles, both synergistic and additive effects were observed. This study concludes that Cou-UMB16 inhibits mycelial growth and spore germination, and that the activity is due to its action on the fungal cell wall, and that Cou-UMB16 could act as an antifungal modifier.

Levels of MMP-9 in patients with intracranial aneurysm: Relation with risk factors, size and clinical presentation.

BACKGROUND: Intracranial aneurysms are arterial anomalies affecting 2% to 3% of the general population in the world and these ruptures are associated with a high mortality. Some risk factors, such as age, gender, smoking, alcohol, hypertension and familial history are associated with the number of aneurysms and their size. In addition, inflammatory processes within the blood vessels of the brain can activate matrix metalloproteinase-9 (MMP-9), which degrades various components of the extracellular matrix, such as elastin. Thereby, this work has aimed at evaluating the relationship between plasma MMP-9 levels and the risk factors that are associated with intracranial aneurysm, as well as investigating the aneurysm statuses (ruptured and unruptured) and comparing them with the control volunteers. METHODS: Between August 2014 to June 2016, blood samples were collected from 282 patients (204 ruptured and 78 unruptured saccular intracranial aneurysms) and 286 control volunteers. The MMP-9 plasma levels were measured by ELISA. Statistical analyzes were performed with SPSS software when using parametric or nonparametric tests, after the normality tests. RESULTS: Higher levels of MMP-9 were found in the aneurysm groups as a whole and when they were stratified by rupture status, then compared with the control group (p < 0.0001). When stratifying them by diameter, those smaller than 7 mm presented high levels of MMP-9 (p < 0.0001), especially in the ruptured ones. As for risk factors, hypertension and smoking were the most important. However, hypertension was mostly associated with the ruptured aneurysms (p < 0.0001). CONCLUSIONS: High levels of MMP-9 were found in smaller ruptured and unruptured intracranial aneurysms (<7 mm) with strongest statistical associations than other sizes, especially when associated with smoking and hypertension.

A new coumarin derivative, 4-acetatecoumarin, with antifungal activity and association study against Aspergillus spp.

Fungal infections have become a concern for health professionals, and the emergence of resistant strains has been reported for all known classes of antifungal drugs. Among the fungi causing disease, we highlight those that belong to the genus Aspergillus. For these reasons, the search for new antifungals is important. This study examines the effects of a coumarin derivative, 4-acetatecoumarin (Cou-UMB16) both alone and together with antifungal drugs, and its mode of action against Aspergillus spp. Cou-UMB16 was tested to evaluate its effects on mycelia growth, and germination of Aspergillus spp. fungal conidia. We investigated its possible action on cell walls, on the cell membrane, and also the capacity of this coumarin derivative to enhance the activity of antifungal drugs. Our results suggest that Cou-UMB16 inhibits Aspergillus spp. virulence factors (mycelia growth and germination of conidia) and affects the structure of the fungal cell wall. When applying Cou-UMB16 in combination with azoles, both synergistic and additive effects were observed. This study concludes that Cou-UMB16 inhibits mycelial growth and spore germination, and that the activity is due to its action on the fungal cell wall, and that Cou-UMB16 could act as an antifungal modifier.

Postoperative care and long-term follow-up after a rostral mandibulectomy to treat an ossifying fibroma in a horse / Cuidados pós-operatórios e acompanhamento a longo prazo após mandibulectomia rostral no tratamento de fibroma ossificante em um equino

ABSTRACT: Ossifying fibroma is a disfiguring benign neoplasia of the jaw that affects young animals of several species, including horses. The present report described the postoperative care and long-term follow-up after a rostral mandibulectomy (RM) that was performed to treat an ossifying fibroma in a horse. A 3-year-old crossbred horse presented a hard, well-defined, 14.5×10.0×9.5cm ulcerated mass attached to the rostral mandible. Radiographic findings were compatible with a nonaggressive mandibular bone deformity (benign neoplasia). Histological features confirmed the diagnosis of the ossifying fibroma. After the RM, the horse slowly adapted to the new feeding conditions and was discharged when it fully recovered and was capable of feeding on the paddock and drinking water on its own on day 60. This slow adaptation was crucial for post-surgical recovery and required hard labor to manage the feeding and hydration by nasogastric tube during the hospital stay.

RESUMO: Fibroma ossificante é uma neoplasia benigna desfigurante da mandíbula, que afeta animais jovens de várias espécies, incluindo equinos. O presente relato descreve os cuidados pós-operatórios e o acompanhamento a longo prazo após mandibulectomia rostral (MR) no tratamento de um fibroma ossificante em um equino. Um cavalo mestiço de três anos de idade apresentou massa ulcerada, dura, bem definida, medindo 14,5x10x9,5cm, contígua à mandíbula rostral. Os achados radiográficos foram compatíveis com uma deformidade óssea mandibular não agressiva (neoplasia benigna). As características histológicas confirmaram o diagnóstico de fibroma ossificante. Após a MR, o equino adaptou-se lentamente às novas condições de alimentação e recebeu alta clínica totalmente recuperado, sendo capaz de se alimentar em piquetes e beber água por conta própria, no 60o dia. Esta lenta adaptação foi crucial para recuperação pós-cirúrgica e exigiu trabalho árduo no manejo da alimentação e hidratação por meio de sonda nasogástrica durante o período de internação hospitalar.

Physicochemical characterization and label comparison among diet yogurts sold in the city of Limoeiro do Norte - CE

Abstract This work aimed at analyzing labels (based on the current legislation) and confirm the nutritional information given on the label of five brands of diet yogurt. The physicochemical analyses carried out were: moisture, minerals, proteins, lipids, reducing carbohydrates in lactose, non-reducing carbohydrates in sucrose, total carbohydrates, acidity and pH. All brands of diet yogurt had mandatory nutritional information on their label. As for content, only brands B and C are compliant with the current legal demands. The numbers found in the analyses for protein and carbohydrates were higher than the percentages shown on the labels in all brands. There were no numbers for lipids. Despite the differences found on the labels, all brands of diet yogurt are in accordance with the Identity and Quality Standards for Fermented Milk as for protein, acidity and fat content. There was a significant difference in the complementary analyses for moisture, minerals and acidity. Nevertheless, the numbers assigned to carbohydrates and protein were lower than the actual values determined in lab and, in some brands, carbohydrates were three times higher. Thus, despite presenting all the necessary information on the label, the companies are not concerned about showing the correct nutritional data to consumers.

Cancer complaints: The profile of patients from the emergency department of a Brazilian oncology teaching hospital.

Background: With the increase in prevalence of cancer in our society, we aim to clarify through primary data use what drives emergency department (ED) utilization among patients with cancer. Methods: This is a cross-sectional study. A direct survey was applied to cancer patients over 277 visits in 2015. Variables including chief complaint for current and last visit, frequency of visits, primary tumor site, and demographics were collected. Results: Pain was the most common complaint, responsible for 40% of visits, followed by constitutional symptoms (17%), and gastrointestinal complaints (11%). Abdominal pain was the single most noted pain type, with 18.4%, and had the highest rate of recurrence. It was followed by back pain, dyspnea, asthenia and fever, accounting for 8.5%, 8.5%, 8.1% and 7%, respectively. Cervical cancer represented 14.8% of patients, followed by breast (11.6%) and lung (7.6%) cancers. The majority of patients visited the emergency department less than once a month. Conclusion: The drivers of emergency department utilization among patients with cancer found through primary use data mostly confirm findings from larger studies with secondary use data. Our research underscores the burden of pain to patients with cancer, as it is the most common complaint leading to ED visits, and generally requires multiple visits. Abdominal pain was more likely to recur than other complaints. Patients could benefit from focused outpatient pain management, and from more research and education targeting cancer-related pain.

Long-Term Follow-Up of Anterior Pituitary Deficiency after Aneurysmal Subarachnoid Hemorrhage: Prospective Cohort.

OBJECTIVE: The aim of this study was to evaluate the prevalence of hypopituitarism in the acute stage after aneurysmal subarachnoid hemorrhage (SAH) as well at the chronic stage, at least 1 year after bleeding, to assess its implications and correlation with clinical features of the studied population. PATIENTS AND METHODS: This was a prospective cohort study that evaluated patients admitted between December 2009 and May 2011 with a diagnosis of SAH secondary to cerebral aneurysm rupture. Clinical and endocrine assessment was performed during the acute stage after hospital admission and before treatment at a mean of 7.5 days (SD ± 3.8) following SAH, and also at the follow-up visit at a mean of 25.5 months (range: 12-55 months) after the bleeding. RESULTS: Out of the 119 patients initially assessed, 92 were enrolled for acute stage, 82 underwent hormonal levels analysis, and 68 (82.9%) were followed up in both acute and chronic phases. The mean age and median age were lower among patients with dysfunction in the acute phase compared to those without dysfunction (P < .05). The prevalence of dysfunction in the acute phase was higher among patients with hydrocephalus on admission computed tomography (57.9%) than among those without it (P < .05). At chronic phase, there was an association between dysfunction and Hunt & Hess scale score greater than 2 (P < .05). CONCLUSIONS: We believe that there is not enough literature evidence to incorporate routine endocrinological evaluation for patient victims of SAH, but we should always keep this differential diagnosis in mind when conducting long-term assessments of this population.

Development of a water-in-oil-in-water multiple emulsion system integrating biomimetic aqueous-core lipid nanodroplets for protein entity stabilization. Part II: process and product characterization.

The aqueous-core enclosed in lipid nanoballoons integrating multiple emulsions of the type water-in-oil-in-water mimic, at least in theory, the environment within viable cells, thus being suitable for housing hydrophilic protein entities such as bioactive proteins, peptides and bacteriophage particles. This study reports a complete physicochemical characterization of optimized biomimetic aqueous-core lipid nanoballoons housing hydrophilic (BSA) protein entities, evolved from a statistical 23×31 factorial design study (three variables at two levels and one variable at three levels) that was the subject of the first paper of a series of three, aiming at complete stabilization of the three-dimensional structure of protein entities attempted via housing the said molecular entities within biomimetic aqueous-core lipid nanoballoons integrating a multiple (W/O/W) emulsion. The statistical factorial design followed led to the production of an optimum W/O/W multiple emulsion possessing quite homogeneous particles with an average hydrodynamic size of (186.2 ± 2.6) nm and average Zeta potential of (-36.5 ± 0.9) mV, and exhibiting a polydispersity index of 0.206 ± 0.014. Additionally, the results obtained for the diffusion coefficient of the lipid nanoballoons integrating the optimized W/O/W multiple emulsion were comparable and of the same order of magnitude (10-12 m2 s-1) as those published by other authors since, typically, diffusion coefficients for molecules range from 10-10 to 10-7 m2 s-1, but diffusion coefficients for nanoparticles are typically of the order of magnitude of 10-12 m2 s-1.

Neurosurgical Videos on YouTube / Vídeos Neurocirúrgicos no YouTube

Introduction Videos can become valuable teaching tools and YouTube is a useful tool to disseminate information. It was created in February, 2005; since then, there has been a rapid expansion of YouTube videos on several subjects. Neurosurgery is not an exception in this trend, and several channels on the topic are available at the YouTube website. Methods We analyzed many articles related to the theme in several medicine specialties. In this study, we balance the pros and cons of this new technology, to foster a discussion of these changes, as well as to explain how to create and get the most fromit. We also list some interesting channels and their features as examples and suggestions. Results YouTube should be the main platform for supporting instructional videos, although it is important to be cautious at this time, as the platform still lacks good quality videos. Conclusion This technology could turn into a very important tool for learning and teaching neurosurgery. Educational institutions should guide an effort for better quality videos and broader content coverage, which could also achieve superior training at no cost.

Introdução Vídeos podem tornar-se ferramentas de ensino valiosas e o YouTube é uma plataforma muito útil para a disseminação da informação. Desde sua criação em fevereiro de 2005, houve grande expansão na quantidade dos vídeos de vários conteúdos e a neurocirurgia não está fora dessa onda, muitos canais relacionados podem ser encontrados no YouTube. Métodos Analisamos artigos relacionados ao tema em várias especialidades médicas. Balanceamos prós e contras dessa nova tecnologia, estimulamos a discussão dessas mudanças e ainda explicamos como criar e ter máximo proveito. Alguns canais interessantes são também listas como exemplos e sugestões. Resultados O YouTube deve ser a principal plataforma para vídeos instrucionais, mas nesse momento o conteúdo deve ser tomado com cuidado, uma vez que há ainda escassez de vídeos de boa qualidade. Conclusão Essa tecnologia pode tornar-se importante ferramenta na aprendizagem e ensino da neurocirurgia. Um esforço para vídeos de boa qualidade e maior abrangência de conteúdo deveria ser guiado por instituições de ensino, que também podem conseguir treinamentos melhores e mais baratos.

Lateralization of the Subthalamic Nucleus with Age in Parkinson's Disease.

Age-related changes in subthalamic nucleus (STN) position have not been well characterized in patients with Parkinson's disease (PD). We report a systematic retrospective analysis of age-related changes in radiographic and final deep brain stimulator (DBS) STN coordinates in PD patients. The charts of 134 PD patients (97 males, 28-84 years) representing 255 STN were reviewed. Multiple linear regression, stepwise regression, and relative importance of regressors analysis was performed to determine the significance of the relationship between STN position and age. Across all subjects, both radiographic STN localization and final DBS position within the STN showed a lateralization of the STN target with age (R2=0.1096,p=6.9×10-8 and R2=0.0433,p=8.7×10-4, respectively). Lateralization with age was observed regardless of MR field strength (1.5T and 3.0T) (R2=0.0946,p=7.6×10-6 and R2=0.2687,p=9.2×10-5, respectively). No other consistent or clinically significant age-related changes were identified. Multiple linear regression revealed that the third ventricle width and age are statistically significant predictors of radiographic STN lateralization (R2 = 0.2404, p = 1.51×10-5 and p = .00784 respectively). Step-wise regression demonstrated that age is a non-redundant predictor of STN lateralization relative to third ventricle width. Similar to healthy controls, STN position appears to shift laterally with age in PD. This highlights limitations of indirect targeting and atlas-based stereotactic surgery and argues for reliance on patient specific anatomy since factors such as age and 3rd ventricular width can contribute to patient-specific variability in STN localization.