Effect of a specially formulated diet on progression of heart enlargement in dogs with subclinical degenerative mitral valve disease.

BACKGROUND: Previous studies in dogs with degenerative mitral valve disease (DMVD) have identified altered myocardial energy metabolism and oxidation, which might contribute to cardiac hypertrophy. Diets rich in medium chain fatty acids and antioxidants are a potential means of treatment. A previous clinical study found significantly smaller left atrial diameter (LAD) and left atrium-to-aorta diameter ratio (LA : Ao) in dogs with subclinical DMVD fed a specially formulated diet vs control diet for 6 months. HYPOTHESIS/OBJECTIVES: A specially formulated diet will slow or arrest left heart enlargement in dogs with subclinical DMVD over 365 days. ANIMALS: One hundred twenty-seven dogs with unmedicated subclinical DMVD; 101 dogs in the per protocol cohort. METHODS: Randomized double-blinded controlled multicenter clinical trial. RESULTS: The study's primary composite outcome measure was the sum of percentage change in LAD and left ventricular internal dimension at end-diastole (LVIDd) at day 365. In the per protocol cohort, the outcome measure increased by 8.0% (95% confidence interval [CI], 2.9%-13.1%) in dogs receiving the test diet vs 8.8% (95% CI, 5.1%-12.5%) in dogs receiving control diet (P = .79). Neither component of the primary outcome measure was significantly different between groups (LAD, P = .65; LVIDd, P = .92). No difference was found in mitral valve E wave velocity (P = .36) or the proportion of dogs withdrawn from the study because of worsening DMVD and heart enlargement (P = .41). CONCLUSIONS AND CLINICAL IMPORTANCE: Feeding a specially formulated diet for 365 days was not associated with a significantly different rate of change of left heart size in dogs with subclinical DMVD as compared to control.

Intranasal Insulin for the Treatment of Persistent Post-COVID-19 Olfactory Dysfunction.

OBJECTIVE: To investigate if intranasal insulin could be a treatment option for those suffering from recalcitrant olfactory dysfunction due to COVID-19. STUDY DESIGN: Prospective interventional cohort with a single group. SETTING: Sixteen volunteers with anosmia, severe hyposmia, or moderate hyposmia for more than 60 days as sequelae of severe acute respiratory syndrome coronavirus 2 infections were selected for the study. All volunteers reported that standard therapies, such as corticosteroids, have failed to improve their olfactory function. METHODS: Olfactory function was assessed by the Chemosensory Clinical Research Center test of olfaction (COT) before and after the intervention. Changes in qualitative, quantitative, and global COT scores were investigated. The insulin therapy session consisted of placing into each olfactory cleft 2 pieces of gelatin sponge soaked with neutral protamine Hagedorn (NPH) insulin, 40 IU on each side. The procedure was repeated twice a week for 1 month. Glycaemic blood level was measured before and after each session. RESULTS: The qualitative COT score rose 1.53 points, p = .0001, 95% confidence interval (CI) (-2.12 to -0.94). The quantitative COT score increased by 2.00 points, p = .0002, 95% CI (-3.59 to -1.41). Global COT score had an improvement of 2.01 points, p = .00003, 95% CI (-2.7 to -1.3). Glycaemic blood level dropped on average 10.4 mg/dL, p < .00003, 95% CI (8.1-12.8). CONCLUSION: Our results suggest that the administration of NPH insulin into the olfactory cleft yields a rapid improvement in the sense of smell of patients suffering from persistent post-COVID-19 olfactory dysfunction. Moreover, the procedure seems to be safe and tolerable.

Yeast Cell Wall Compounds on The Formation of Fermentation Products and Fecal Microbiota in Cats: An In Vivo and In Vitro Approach.

The effects of yeast cell wall compounds (YCWs) being added to cat food on hindgut fermentation metabolites and fecal microbiota were assessed in in vivo Experiment 1 (Exp. 1) and in vitro Experiments 2 and 3 (Exp. 2 and 3). In Exp. 1, the cats' diets were supplemented with two dietary concentrations (46.2 and 92.4 ppm) of YCWs (YCW-15 and YCW-30, respectively), and a negative control diet with no compound in three groups (six cats per group) was used to assess the fecal score, pH, digestibility, fermentation products, and microbiota. In Exp. 2, feces from the cats that were not supplemented with YCWs (control) were used as an inoculum. A blend of pectin, amino acids, and cellulose was used as a substrate, and the YCW compound was added at two levels (5 and 10 mg). In Exp. 3, feces from cats fed YCWs were used as an inoculum to test three different substrates (pectin, amino acids, and cellulose). In Exp. 2 and 3, the gas production, pH, and fermentation products (ammonia, SCFAs, and BCFAs) were assessed. YCW-30 resulted in a higher digestibility coefficient of the crude protein, organic matter (OM) (p < 0.05), and energy of the diet (p < 0.10). Regarding the fermentation products, YCW-15 showed a trend toward higher concentrations of propionate, acetate, lactate, ammonia, isobutyrate, and valerate, while YCW-30 showed a trend (p < 0.10) toward higher levels of butyrate and pH values. The bacteroidia class and the genus Prevotella were increased by using YCW-30 and the control. At the gender level, decreased (p < 0.01) Megasphaera was observed with YCW inclusion. The microbiota differed (p < 0.01) among the groups in their Shannon indexes. For beta diversity, YCW-30 showed higher indexes (p = 0.008) than the control. The microbiota metabolic profile differed in the pathway CENTFERM-PWY; it was more expressed in YCW-30 compared to the control. In Exp. 2, the YCWs showed a higher ratio (p = 0.006) of the fermentation products in the treatments with additives with a trend towards a high dose of the additive (10 mg). In Exp. 3, the effects of the substrates (p < 0.001), but not of the YCWs, on the fermentation products were observed, perhaps due to the low dietary concentrations we used. However, the marked responses of the fermentation products to the substrates validated the methodology. We could conclude that the YCWs, even at low dietary concentrations, affected fecal SCFA production, reduced the fecal pH, and modulated the fecal microbiota in the cats. These responses were more pronounced under in vitro conditions.

Vivenciar e enfrentar o preconceito do HIV no Rio de Janeiro, Brasil / Experiencing and facing HIV prejudice in Rio de Janeiro, Brazil / Viviendo y enfrentando el prejuicio del VIH en Río de Janeiro, Brasil

Objetivo: descrever como as pessoas vivenciam e enfrentam o preconceito após o diagnóstico do HIV. Método: estudo descritivo, exploratório e qualitativo com pessoas vivendo com HIV, em uso de terapia antirretroviral. Realizou-se entrevistas semiestruturadas, no ambulatório de um hospital universitário no município do Rio de Janeiro, Brasil. Aplicou a análise lexical através do software Iramuteq 0.7 alpha 2, com uso da classificação hierárquica descendente. Resultados: percebeu-seque os participantes ainda sofrem com medos e temores em revelar o diagnóstico, sendo a principal barreira para o convívio com o vírus. O entendimento sobre a cronicidadee a existência de tratamento melhoram a relação consigo mesmo. Sentem a necessidade em possuírem espaços de fala e escuta, ligado à importância de se manter um diálogo positivo acerca do HIV e reduzir a discriminação. Conclusão: a vivência das pessoas com HIV é um processo complexo, que não depende exclusivamente de cuidados clínicos, mas as instituições podem atuar de forma articulada para ações que fomentem maior conhecimento sobre o vírus e a doença, podendo somar para areduçãode preconceitos.Descritores: HIV; Discriminação Social; Acontecimentos que Mudam a Vida.

Objective: to describe how people experience and face prejudice after being diagnosed with HIV. Method: descriptive, exploratory and qualitative study with people livingwith HIV, using antiretroviral therapy. Semi-structured interviews were carried out at the outpatient clinic of a university hospital in the city of Rio de Janeiro, Brazil. The lexical analysis was applied using the Iramuteq 0.7 alpha 2 software, using the descending hierarchical classification. Results: it was noticed that the participants still suffer from fears and fears in revealing the diagnosis, being the main barrier to living with the virus. Understanding chronicity and the existence of treatment improve the relationship with oneself. They feel the need to have spaces for speaking and listening, linked to the importance of maintaining a positive dialogue about HIV and reducing discrimination. Conclusion: the experience of people with HIV is a complex process, which does not depend exclusively on clinical care, but institutions can act in an articulated way for actions that promote greater knowledge about the virus and the disease, which can add to the reduction of prejudices.

Objetivo: describir cómo las personas experimentan y enfrentan los prejuicios después de ser diagnosticados con el VIH. Método: estudio descriptivo, exploratorio y cualitativo con personas que viven con VIH, en uso de terapia antirretroviral. Las entrevistas semiestructuradas se realizaron en el ambulatorio de un hospital universitario de la ciudad de Río de Janeiro, Brasil. El análisis léxico se aplicó mediante el software Iramuteq 0.7 alpha 2, utilizando la clasificación jerárquica descendente. Resultados: se percibió que los participantes todavía sufren de miedos y temores en revelar el diagnóstico, siendo la principal barrera para vivir con el virus. Comprender la cronicidad y la existencia de tratamiento mejora la relación con uno mismo. Sienten la necesidad de tener espacios para hablar y escuchar, vinculados a la importancia de mantener un diálogo positivo sobre el VIH y reducir la discriminación.Conclusión: la experiencia de las personas con VIH es un proceso complejo, que no depende exclusivamente de la atención clínica, sino que las instituciones pueden actuar de manera articulada para acciones que promuevan un mayor conocimiento sobre el virus y la enfermedad, lo que puede contribuir a la reducción de prejuicios.

Protestantism and psychoactive drugs: implications for nursing and health / Protestantismo y drogas psicoactivas: implicaciones para la salud y la enfermería / Protestantismo e drogas psicoativas: implicações para a saúde e enfermagem

Objectives: To identify and analyze the social representations of psychoactive drugs to the protestant religious group and their implications for nursing care. Method: The data collection was carried out in the state and city of Rio de Janeiro, through the Free Evocation of Words technique. Results: The participants were 300 subjects divided into three subgroups with 100 Protestant evangelical subjects. Of them, 74.67% were female (224 participants) and 25.33%, males (76). Final thoughts: The assistance, taking into account the factors beyond spiritual, is beneficial not only for the patient, but also for the Nursing team, because it improves the spiritual awareness and understanding of the individual as a being beyond the disease.

Objetivos: Identificar y analizar las representaciones sociales de las drogas psicoactivas para el grupo religioso protestante y sus implicaciones para el cuidado de enfermería. Método: La recolección de datos se realizó en el estado y ciudad de Río de Janeiro, mediante la técnica de Evocación Libre de Palabras. Resultados: Los participantes fueron 300 sujetos divididos entres subgrupos con 100 sujetos evangélicos protestantes. De ellos, el 74,67% eran mujeres (224 participantes) y el 25,33%, hombres (76). Reflexiones finales: La asistencia, teniendo en cuenta los factores más allá de lo espiritual, es beneficiosa no solo para el paciente, sino también para el equipo de Enfermería, porque mejora la conciencia espiritual y la comprensión del individuo como un ser más allá de la enfermedad.

Objetivos: Identificar e analisar as representações sociais das drogas psicoativas para o grupo religioso protestante e suas implicações para o cuidado de enfermagem. Método: A coleta de dados foi realizada no estado e município do Rio de Janeiro, por meio da técnica de Evocação Livre de Palavras. Resultados: Participaram do estudo, 300 sujeitos divididos em grupos de 100 sujeitos para cada subgrupo de evangélicos protestantes. Dos quais 74,67% eram do gênero feminino (224 participantes) e 25,33 do gênero masculino (25,33%). Considerações Finais: A assistência levando-se em conta os fatores para além do espiritual é benéfica não apenas para o paciente, mas também para a equipe de Enfermagem, pois melhora a consciência espiritual e a compreensão do indivíduo como um ser para além da doença.

A VIVÊNCIA DO PRECONCEITO APÓS A REVELAÇÃO DA SOROPOSITIVIDADE PARA O HIV / EXPERIENCE PREJUDICE AFTER THE DISCLOSURE OF SEROPOSITIVITY FOR HIV

Este estudo teve por objeto o processo de diagnóstico da soro positividade para o HIV e por objetivos: descrever processo de revelação do diagnóstico positivo para HIV e discutir a vivência do preconceito e suas consequências para vida cotidiana. Método: Entrevistas com 49 pessoas que vivem com HIV (PVHIV). Técnica de análise de conteúdo lexical, com auxílio do software Iramuteq 0.7 alpha 2. Resultados: As condições de vida de pessoas que vivem com HIV são permeadas pelo estigma, preconceito e discriminação. A revelação do diagnóstico para a sociedade não é uma tarefa fácil e nem sempre ocorre. Após impacto inicial do diagnóstico, a vida segue com mudanças cotidianas, os sentimentos de desespero e medo são aplacados com o tempo, entretanto o preconceito persiste. Conclusão: Os resultados mostram complexo cenário de se (con) viver com o vírus e /ou com a síndrome. A descoberta do diagnóstico, aceitação, decisão sobre revelação, reunir meios de enfrentamento do preconceito e prosseguir vivendo, exige que PVHIV tenham suporte e se reprogramem para enfrentar desafios diários.

This study had as its object the process of diagnosing serum positive for HIV and its objectives: to describe the process of disclosing the positive diagnosis for HIV and to discuss the experience of prejudice and its consequences for everyday life. Method: Interviews with 49 people living with HIV (PLHIV). Lexical content analysis technique, with the aid of the Iramuteq 0.7 alpha 2 software. Results: The living conditions of people living with HIV are permeated by stigma, prejudice and discrimination. Disclosing the diagnosis to society is not an easy task and does not always occur. After the initial impact of the diagnosis, life continues with daily changes, the feelings of despair and fear are appeased over time, however prejudice persists. Conclusion: The results show a complex scenario of (con) living with the virus and / or the syndrome. The discovery of diagnosis, acceptance, decision on disclosure, gathering means to face prejudice and continue living, requires that PLHIV have support and reprogram themselves to face daily challenges.

Influence of type of starch and feeding management on glycaemic control in diabetic dogs.

The present study evaluated the effects of two diets with different starch sources and two feeding methods on the glycaemic control in dogs with diabetes mellitus. The diets had similar nutrient contents (40% starch and 16% dietary fibre), one formulated with 46% of broken rice and the other with 42% sorghum and 10% lentils (as-fed). Ten client-owned diabetic dogs were fed with each diet for 2 months, in a crossover design. Five dogs received NPH human insulin and food every 12 h (feeding method 1), and the other five received insulin every 12 h but were fed three times a day (feeding method 2). In feeding method 2, morning insulin was higher than the evening dose and dogs received the second meal after 4 to 5 h of the morning insulin and meal. Parameters evaluated included insulin dosage, 12- and 8-h glycaemic curves, complete blood count, biochemical profile and urinalysis. Glycaemic curves were analysed by ANOVA with repeated measures. Glycaemic control parameters (fasting, mean, minimum and maximum glycaemia and serum fructosamine) and glucose area under the curve (AUC) were calculated and analysed by paired t test (p < 0.05). In feeding method 1, dogs fed the sorghum-based diet presented lower mean (p = 0.04) and minimum blood glucose concentrations (p = 0.03), and a tendency to lower maximum blood glucose (p = 0.06) and glucose AUC (p = 0.08) than when fed the rice-based diet. When food was provided twice a day, the ingestion of the rice-based diet resulted in higher post-prandial glucose response than the diet with sorghum and lentil. In feeding method 2, there was no effect of diet on the assessed parameters (p > 0.05). No differences in insulin dosage were observed between groups or feeding methods (p > 0.05). Providing two meals a day followed by insulin administration associated with the sorghum- and lentil-based diet improved glycaemic control in diabetic dogs.

Representações sociais do usuário de drogas para a igreja católica: as implicações para o cuidado / Social representations of drug users for the catholic church: the implications for their care / Representaciones sociales de los usuarios de drogas para la iglesia católica: las implicaciones para su cuidado

Objetivo: Refletir sobre as representações sociais do usuário de drogas psicoativas para a Igreja Católica. Método: Trata-se de um estudo qualitativo, descritivo, tipo reflexivo. Basearam-se os critérios de inclusão em sujeitos com idade superior a 18 anos e que frequentam o grupo religioso há pelo menos seis meses, excluindo-se os participantes que não preencheram tais critérios. Adotaram-se a Teoria das Representações Sociais como referencial teórico e o Teste de Associação Livre de Palavras como instrumento de coleta de dados. Resultados: Compôs-se a amostra final do estudo por 100 participantes dos quais 34 eram do sexo feminino e 66, do sexo masculino. Percebeu-se, referente ao grau de instrução, que a maioria apresentava Ensino Médio completo (39 participantes) e, no que tange à faixa etária, 30 apresentavam idades entre 20 e 30 anos, e 26, entre 31 e 40 anos. Conclusão: Aponta-se a religião católica com maior número de fiéis no Brasil, dessa forma, entender a sua representação a respeito do usuário de drogas psicoativas visa a colaborar, de maneira direta, para a construção de ferramentas capazes de potencializar o tratamento oferecido para estes usuários não só nas comunidades terapêuticas, como também no Sistema Único de Saúde, tendo em vista que hoje se admite que o ser humano é biopsicossocialespiritual.(AU)

Objective: To reflect on the social representations of the psychoactive drug user for the Catholic Church. Method: It is a qualitative, descriptive, reflective type study. The inclusion criteria were based on subjects over 18 years of age who have been attending the religious group for at least six months, excluding those who did not meet such criteria. The Theory of Social Representations was adopted as a theoretical reference and the Free Association of Words Test as an instrument of data collection. Results: The final sample of the study was composed by 100 participants of whom 34 were female and 66 were male. It was noticed, regarding the level of education, that the majority had finished High School (39 participants) and, concerning the age group, 30 were between 20 and 30 years old, while 26 were between 31 and 40 years old. Conclusion: The Catholic religion is pointed out as having the largest number of members in Brazil; thus, understanding its representation regarding the user of psychoactive drugs aims to collaborate directly in the construction of tools capable of boosting the treatment offered to such users not only in the therapeutic communities, but also in the Unified Health System (SUS), bearing in mind that today the human being is admitted as being biopsychosocial-spiritual.(AU)

Objetivo: Reflexionar sobre las representaciones sociales del consumidor de drogas psicoactivas para la Iglesia Católica. Método: Es un estudio de tipo cualitativo, descriptivo y reflexivo. Los criterios de inclusión se basaron en sujetos mayores de 18 años que hayan asistido al grupo religioso durante al menos seis meses, excluyendo a aquellos que no cumplieron dichos criterios. Se adoptó como referencia teórica la Teoría de las Representaciones Sociales y como instrumento de recolección de datos el Test de Asociación Libre de Palabras. Resultados: La muestra final del estudio estuvo compuesta por 100 participantes de los cuales 34 eran mujeres y 66 eran hombres. Se advirtió, en cuanto al nivel de estudios, que la mayoría había terminado el Bachillerato (39 participantes) y, en cuanto al grupo de edad, 30 tenían entre 20 y 30 años, mientras que 26 tenían entre 31 y 40 años. Conclusión: Se señala que la religión católica tiene el mayor número de miembros en Brasil; así, entender su representación frente al usuario de psicofármacos tiene como objetivo colaborar directamente en la construcción de herramientas capaces de potenciar el tratamiento ofrecido a dichos usuarios no solo en las comunidades terapéuticas, sino también en el Sistema Único de Salud (SUS), teniendo en cuenta que hoy se admite al ser humano como biopsicosocial-espiritual.(AU)

Maternal Common Mental Disorders symptoms influence associated with early childhood dental caries: A cross-sectional study in a southern Brazilian city.

BACKGROUND: Maternal mental problems can interfere with the overall health and care of the child; some oral health studies have been trying to elucidate whether there is a relationship between maternal common mental disorders (CMD) and children's oral health status. AIM: The aim was to investigate the influence of mothers that present CMD symptoms on their child's dental caries status. DESIGN: This cross-sectional study was carried out in Pelotas with 530 mother/child (aged 2-5 years old) dyads recruited from an epidemiological survey in August 2015 during the national vaccination campaign. A questionnaire was used to determine mother's CMD symptoms using the Self-Reporting Questionnaire (SRQ-20) and socioeconomic/demographic variables which were used for adjustment. Dental caries examination was performed. The outcome was obtained using the dmfs (decayed, missing, filled surfaces) index, based on OMS guidelines. Poisson regression with robust variance was used to estimate the risk ratio and 95% confidence interval (CI). RESULTS: Maternal CMD was positively associated with dental caries prevalence in children; the adjusted relative risk for every 1 SRQ-20 score increase was 1.06 (95% CI 1.00-1.12). CONCLUSIONS: Our findings suggest that maternal mental health can impair children's oral health in relation to dental caries.

Explorando evidências científicas sobre ações de autocuidado em pacientes com psoríase: revisão integrativa / Exploring scientific evidence on self-care actions in patients with psoriasis: an integrative review

Objetivo: analisar artigos científicos publicados em periódicos onlineacerca das ações de autocuidado, desenvolvidas por profissionais de saúde, às pessoas com psoríase. Metodologia:Foram utilizadas buscas nas bases de dados durante o mês de agosto de 2020 ­SCOPUS, LILACS, BDENF, CINAHL, Web Science e MEDLINE (via de acesso PubMed). Foram incluídas na busca publicações em inglês, espanhol e português do período de janeiro de 2015 a julho de 2020. Resultados:A amostra final foi composta por 9 artigos em inglês. A discussão do estudo tem como base teórica a Teoria do Déficit do Autocuidado de Dorothea Orem. Foram criadas 3 categorias a partir dos fundamentos e pressupostos que esta teoria oferece.Os resultados apontaram a educação em saúde como meio indispensável para aquisição de conhecimentos e habilidades para o autocuidado. Quanto as ações de autocuidado realizadas por profissionais de saúde, destacaram-se orientações e informações sobreconhecimentos -da doença ecomorbidades, tratamento, medicação, mudanças no estilo de vida, hábitos saudáveis, manuseio das lesões cutâneas, outras. Fatores como aspectos emocionais, interações sociais, crenças, cultura, necessidades do paciente e motivação para autocuidar-se devem ser considerados.Considerações finais:O estudo possibilitou identificar e analisar evidências científicas acerca da temática. Constatou-se que parao desenvolvimento das ações de autocuidado é necessário identificar os requisitos de autocuidado do paciente, optar pela metodologia mais adequada e planejar as ações, podendo ou não seguir diretrizes padronizadas. A educação em saúde se coloca como essencial na comunicação dessas práticas, através de estratégias, utilizando-se de diferentes tecnologias em saúde.

Objective: to analyze scientific articles published in onlinejournals about self-care actions, developed by health professionals, for people with psoriasis. Methodology: Searches were used in the databases during the month of August 2020 ­SCOPUS, LILACS, BDENF, CINAHL, Web Science and MEDLINE (access via PubMed). Publications in English, Spanish and Portuguese from January 2015 to July 2020 were included in the search.Results: The final sample consisted of 9 articles in English. The discussion of the study is theoretically based on Dorothea Orem's Self-Care Deficit Theory. Three categories were created from the foundations and assumptions that this theory offers. The results indicated health education as an indispensable means for acquiring knowledge and skills for self-care. As for the self-care actions performed by health professionals, guidelines and information on knowledge about the disease and comorbidities, treatment, medication, changes in lifestyle, healthy habits, handling of skin lesions, and others stood out. Factors such as emotional aspects, social interactions, beliefs, culture, patient needs and motivation to take care of themselves must be considered.Results: The final sample consisted of 9 articles in English. The discussion of the study is theoretically based on the Deficit Theory of the Final Considerations: The study made it possible to identify and analyze scientific evidence on the subject. It was found that for the development of self-care actions it is necessary to identify the patient's self-care requirements, choose the most appropriate methodology and plan the actions, which may or may not follow standardized guidelines. Health education is essential in the communication of these practices, through strategies, using different health technologies.

Lifting frontal reverso: alternativa para o tratamento da paquidermoperiostose / Reverse frontal lifting: alternative for the treatment of pachydermoperiostosis

Introdução: Paciente com diagnóstico de paquidermoperiostose, apresentando forte manifestação cutânea, impossibilitando a correção do defeito pelas técnicas usuais de lifting facial. O lifting frontal reverso foi a técnica idealizada para o caso. É uma técnica inovadora, não havendo publicação prévia na literatura. Relato de caso: Paciente italiano, sexo masculino, 56 anos, apresentando síndrome de manifestação cutânea, em especial na região frontal da face, com pele inelástica de aspecto coriáceo, que gerava desconforto estético, ensejando um estigma sindrômico. Métodos: A técnica elaborada para este caso envolve incisão, que se inicia na raiz da hélice (ponto A), contorna o supercílio em linha sinuosa distando meio centímetro da implantação dos pelos da sobrancelha, indo até a região da glabela, curvando para a raiz do nariz e indo se encontrar com dimensões idênticas do outro lado. Do ponto A, também ascende uma linha curva inclinando-se para o sentido medial, com uma distância de 2cm. A intenção é diminuir a distância entre a área a ser tracionada e a área de incisão, a fim de obter maior tração, possibilitando assim a correção do aspecto da face em foco. Resultados: A tração caudal do retalho por incisão supraciliar possibilitou a correção do defeito em região frontal sem que houvesse alteração da linha de implantação capilar ou ascensão excessiva das sobrancelhas. Conclusão: A técnica de lifting frontal reverso foi criada para um caso específico de síndrome de paquidermoperiostose. Quando bem indicada esta técnica pode ser utilizada atingindo bons resultados.

Introduction: Patient diagnosed with pachydermoperiostosis, presenting a strong cutaneous manifestation, making it impossible to correct the defect by the usual facial lifting techniques. The reverse frontal facelift was the idealized technique for this case. It is an innovative technique, there being no previous publication in the literature. Case report: Italian male patient, 56 years old, with cutaneous manifestation syndrome, especially in the frontal region of the face, with leathery inelastic skin, which generated aesthetic discomfort, predisposing for a syndromic stigma. Methods: The technique developed for this case involves an incision, which starts at the root of the helix (point A), bypasses the eyebrow in a sinuous line distant half a centimeter from the implantation of the eyebrow hair, going to the glabella, curving towards the nasal root and going to meet identical dimensions on the other side. From point A, a curved line also leans towards the medial direction, at a distance of 2 cm. The intention is to reduce the distance between the area to be pulled and the incision area, in order to obtain more traction, thus enabling the correction of the aspect of the face in focus. Results: Caudal traction of the flap by a supraciliary incision made it possible to correct the defect in the frontal region without altering the capillary implantation line or causing excessive eyebrow rise. Conclusion: The reverse frontal lifting technique was created for a specific case of pachydermoperiostosis syndrome. When correctly indicated, this technique can be used to achieve good results.

Influence of the FIV Status and Chronic Gingivitis on Feline Oral Microbiota.

Feline chronic gingivostomatitis (FCGS) has an unclear pathogenesis with the oral microbiome and viral infections, such as feline immunodeficiency virus (FIV), thought to contribute. Although the relationship between the FIV status and FCGS is not clear, one theory is FIV-induced immune dysregulation could contribute to oral dysbiosis, promoting FCGS development. To further understand the relationship between FCGS, FIV infection, and the oral microbiome, oral cavities of forty cats fitting within 4 groups (FIV- without gingivitis, FIV+ without gingivitis, FIV- with gingivitis, FIV+ with gingivitis) were swabbed. Next generation sequencing targeting the V4 region of the 16s rRNA gene was performed for bacterial community profiling. No differences in diversity were observed, however, analysis of the data in terms of gingivitis revealed differences in the relative abundance of taxa and predicted functional output. Odoribacter spp., a bacteria associated with oral disease, was found in higher relative abundances in cats with the highest gingivitis grade. Cats with gingivitis were also found to harbor communities more involved in production of short-chain fatty acids, which have been connected with oral disease. Significant findings associated with the FIV status were few and of low impact, suggesting any connection between the FIV status and FCGS is likely not related to the oral microbiota.

Perfil dos profissionais de enfermagem que estão atuando durante a pandemia do novo Coronavírus / Perfil de los profesionales de enfermería que trabajan durante la nueva pandemia de Coronavirus / Profile of nursing professionals working during the new Coronavirus pandemic

Objetivo: identificar perfil dos profissionais de enfermagem que estão atuando durante a pandemia do novo coronavírus. Método: pesquisa quantitativa, com 128 profissionais do Estado do Rio de Janeiro, por meio de questionário online autoaplicado no período de 19 a 21 de maio de 2020. Análise de dados foi por estatística descritiva. Resultados: equipe composta por profissionais enfermeiros, jovens, do sexo feminino e sem treinamento específico para atuar junto aos casos confirmados/suspeitos do novo coronavírus. Conclusão: a identificação do perfil possibilita atentar as especificidades dessa população que está atuando durante a pandemia do novo coronavirus, de mulheres jovens, com provável necessidade de apoio nos cuidados com suas famílias, e que precisa estar mais preparada com treinamento para evitar a própria contaminação e de seus familiares, bem como ter segurança para prestar uma assistência de enfermagem com qualidade.(AU)

Objective: to identify the profile of nursing professionals who are working on the front line in the new coronavirus pandemic. Method: quantitative research, with 128 professionals from the State of Rio de Janeiro, thought a self-administered online questionnaire from May 19 to 21, 2020. Data analysis was performed using descriptive statistics. Results: team made up of professional nurses, young women and without specific training to work with confirmed/suspected cases of the new coronavirus. Conclusion: the identification of the profile makes it possible to pay attention to the specificities of this population that is working during the pandemic of the new coronavirus, of young women, with probable need of support in the care of their families, and who needs to be more prepared with training to avoid their own contamination and her family members, as well as being safe to provide quality nursing care.(AU)

Objetivo: identificar el perfil de los profesionales de enfermería que se encuentran trabajando durante la nueva pandemia de coronavirus. Metodo: investigación cuantitativa, con 128 profesionales del estado de Río de Janeiro, a través de un cuestionario en línea autoadministrado del 19 al 21 de mayo de 2020. El análisis de los datos fue por estadística descriptiva. Resultados: equipo formado por enfermeras profesionales, mujeres jóvenes y sin formación específica para trabajar con casos confirmados/sospechosos del nuevo coronavirus. Conclusión: la identificación del perfil permite prestar atención a las especificidades de esta población que se encuentra trabajando durante la pandemia del nuevo coronavirus, de mujeres jóvenes, con probable necesidad de apoyo en el cuidado de sus familias, y que necesitan estar más preparadas con capacitación para evitar su propia contaminación y de sus familiares, además de ser segura para brindar atención de enfermería de calidad.(AU)

Conviver com o vírus da imunodeficiência humana - os desafios do diagnóstico / Living with the human immunodeficiency virus - the challenges of the diagnosis

Objetivo: descrever os sentimentos e enfrentamentos do antes e depois da descoberta do diagnóstico positivo para o vírus da imunodeficiência humana. Metodologia: estudo qualitativo, descritivo. Realizado em um ambulatório especializado em pessoas que vivem com HIV, localizado na cidade do Rio de Janeiro. Os participantes do estudo foram os usuários deste ambulatório, com idade superior a 18 anos. A coleta de dados foi realizada a partir de entrevistas semiestruturadas. Técnica de análise de conteúdo lexical, com auxílio do software Iramuteq 0.7 alpha 2. Resultados: a felicidade e o prazer em viver a vida são relatados com frequência como uma situação que ficou para trás, no passado, antes do diagnóstico, e que agora a morte se apresenta de uma forma mais concreta, uma ameaça sempre à espreita. Conclusões: para alguns participantes, a vida no passado era mais feliz, o presente é depressivo e o futuro, incerto; a morte é uma preocupação presente, posteriormente a aceitação vai acontecendo, a motivação para viver reaparece principalmente quando as pessoas vivendo com o vírus da imunodeficiência humana se sentem apoiadas e acolhidas.

Objective: to describe the feelings and confrontations of the before and after of the discovery of positive diagnosis of human immunodeficiency virus. Methodology: qualitative descriptive study. Held at an outpatient clinic specialized in people living with HIV, located in the city of Rio de Janeiro. Study participants were users of this clinic aged over 18 years. Data collection was performed using semi-structured interviews. Data collection was performed through semi-structured interviews. Lexical content analysis technique, with the aid of the Iramuteq 0.7 alpha 2 software. Results: happiness and pleasure in living life are often reported as a situation that was left behind in the past, before the diagnosis, and that now death presents itself in a more concrete way, a threat always lurking. Conclusions: for some participants, life in the past was happier and the present is depressing and the future, uncertain; death is a present concern, as time passes acceptance comes about; the motivation to live reappears mainly when people living with the human immunodeficiency virus feel supported and welcomed.

Are maternal mental disorders associated with children's oral health? A systematic review.

Maternal mental problems may lead to a negative effect on children's oral health (COH). The aim of this study was to systematically review the literature to answer the question: Are maternal mental disorders (MMD) associated with COH from zero to 12 years old? Electronic searches were performed in five databases with no language restriction. Cohort, case-control, and cross-sectional studies were included. A total of 1183 references were identified, and seven studies were included. In relation to MMD studies investigated: Common Mental Disorders (n = 2), Major Depressive Disorder (MDD) (n = 2), symptoms of depression (SD) (n = 3), Alcohol-related diagnosis (n = 1), and symptoms of anxiety (n = 2). As outcome, the studies investigated dental caries (n = 5), gingivitis and periodontal diseases (n = 1), sleep bruxism (SB) (n = 1), and malocclusion (n = 1). Positive association was found between MDD and OH (SB and dental caries). There was no MMD associated with malocclusion. Alcohol-related diagnosis showed a positive association with gingivitis and periodontal diseases and no association with dental caries; anxiety had a positive association with dental caries and no association with SB. The heterogeneity of the data precluded precise conclusions to be drawn, but MMD may have influence on COH.

Fatores de estresse nos profissionais de enfermagem no combate à pandemia da COVID-19: síntese de Evidências / Stress factors in nursing professionals in combating the COVID-19 pandemic: synthesis of evidence

A síndrome respiratória aguda grave causada pelo novo coronavírus (SARS-CoV-2)foi considerada pandêmica desde marçode 2020pela Organização Mundial de Saúde. Objetivo:identificar os principais efeitos psicológicos da pandemia da COVID-19 nos profissionais de enfermagem; descrever os principais fatores capazes de gerar estresse psicológico nos professionais de enfermagem;descrever as estratégias de copingpara o combate ao estresse emocional. Método:revisão da literatura, utilizando-se5artigos indexados no PubMed e LILACS. Resultados:o aumento da carga de trabalho, medo de contaminar os familiares e de se contaminar, desinformação e raiva do governo e dos sistemas de saúde são os principais fatores capazes de gerar estresse emocional nos profissionais de enfermagem. Conclusão:é de suma importância considerar as questões psicológicas, reconhecendo e acolhendo os receios e medos dos profissionais de enfermagem criando-se assim uma esfera de estabilidade em meio à crise.(AU)

The severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2) has been considered pandemic since March2020by the World Health Organization. Objectives: to identify the main psychological effects of the COVID-19 pandemic on nursing professionals; describe the main factors capable of generating psychological stress in nursing professionals, describe the coping strategies to combat emotional stress. Methods: literature review, using 5 articles indexed in PubMed and LILACS.Results: fear of contaminating family members and of being contaminated, misinformation and anger from the government and health systems are the main factors capable of generating emotional stress in nursing professionals. Conclusion: it is extremely important to consider psychological issues, recognizing and welcoming the fears and fears of nursing professionals, thus creating a sphere of stability in the midst of the crisis.(AU)

Premature deaths by visceral leishmaniasis in Brazil investigated through a cohort study: A challenging opportunity?

BACKGROUND: Visceral Leishmaniasis (VL) is the most severe form of leishmaniasis because it can lead to death. In the Americas, 96% of cases are in Brazil, and despite efforts, the fatality rate has increased in the past years. We analyzed deaths associated to VL in Brazil and investigated the factors that could influence on the timeliness of fatal outcome with emphasis on time (tStoD). METHODOLOGY: The registered deaths by VL were sourced from the Brazilian National Notification System from 2007-2014. Through a retrospective cohort study, univariate and multivariable Cox proportional hazards model analysis were performed and investigated the factors that could influence the time (tStoD). These factors were analyzed through survival models. RESULTS: Out of the 1,589 reported deaths, the median for onset of the symptoms and the case notification date (tStoN) is 25 days (10-61), and for date of case notification and death (tNotD) is 9 days (4-17). The time (tStoN) to event investigation for HIV non-infected individuals was 1.4 (1.16-1.68) greater than the HIV positive group. At the same time peri-urban and urban area were 0.83 (0.47-1.44) and 1.33 (1.16-1.52), respectively. The explorations revealed apparent differences between the time to event investigation (both for tStoN and tNotD) and the age at the onset of the symptoms. According to the tStoN the rate of notification is 1.73 times greater in patients under 5 years old at the onset of the clinical symptoms compared to older patients. CONCLUSION: VL patients under 5 years old were diagnosed earlier and had shorter survival. It could mean that in younger population, although properly diagnosed, the fatality pattern might be related to the severity of the disease. Main host characteristics were evaluated, and age and co-infections seem to have an impact in the disease progression.

Mudanças no cotidiano de mulheres vivendo com HIV: análise ambulatorial, Rj, Brasil / Changes in the quotidian of women living with HIV: ambulatorial analysis, Rio de Janeiro state, Brazil / Cambios en el cotidiano de mujeres que viven con el VIH: análisis ambulatorio, Rj, Brasil

Objective: The study's purpose has been to scrutinize the changes in women's daily life, as well as to investigate how they stand after the diagnosis of HIV/AIDS and the introduction of Antiretroviral Therapy (ART). Methods: It is a descriptive and prospective study with a qualitative approach. Semi-structured interviews were performed with twenty-two HIV positive women, who were enrolled in the immunology ambulatory of a university hospital located in the Rio de Janeiro city. This research was approved by the Research Ethics Committee (CAAE: 45955315.0.0000.5285). Results: Most women dealt positively with the changes in their daily lives after discovering the disease, looking for a way of life with quality, although they still show some difficulties in that regard. Concerning the ART, there was struggle in its beginning; however, as the time went by the adaptations occurred mainly with the family support. Conclusion: It is essential to provide better support towards women during both HIV diagnosis and treatment, so that they can improve their coping strategies

Objetivo: Investigar as mudanças no cotidiano e analisar o enfrentamento de mulheres após o diagnóstico do HIV/AIDS e a introdução da Terapia Antirretroviral (TARV). Método: Estudo descritivo e prospectivo de natureza qualitativa. Realizadas entrevistas semiestruturadas com vinte e duas mulheres HIV positivas, matriculadas no ambulatório de imunologia de um hospital universitário do Rio de Janeiro. Aprovado pelo Comitê de Ética CAAE: 45955315.0.0000.5285. Resultados: A maioria das mulheres enfrentou positivamente as mudanças no seu cotidiano após a descoberta da doença, buscando viver com qualidade, embora ainda apresentem dificuldades na retomada de suas vidas. Com relação à TARV houve dificuldade em seu início, no entanto com o passar do tempo ocorreram adaptações principalmente com o apoio da família. Conclusão: É fundamental que haja um maior apoio as mulheres durante o diagnóstico e tratamento do HIV, para que possam elaborar melhor suas estratégias de enfrentamento

Objetivo: Investigar los cambios en la rutina y hacer un análisis del enfrentamiento de mujeres tras el diagnóstico del VIH/sida y la introducción de la Terapia Antirretroviral (TARV). Método: Estudio descriptivo y prospectivo de naturaleza cualitativa. Se realizaron entrevistas semiestructuradas con veintidós mujeres VIH positivas, matriculadas en el ambulatorio inmunológico de un hospital universitario de Río de Janeiro. Aprobado por el Comité de Ética CAAE: 45955315.0.0000.5285. Resultados: La mayoría de las mujeres enfrentó positivamente los cambios en su cotidiano después del descubrimiento de la enfermedad, buscando vivir con calidad, aunque todavía presentan dificultades en la reanudación de sus vidas. En cuanto a la TARV hubo dificultad en su inicio, sin embargo con el paso del tiempo ocurrieron adaptaciones principalmente con el apoyo de la familia. Conclusión: El apoyo a las mujeres durante el diagnóstico y tratamiento del VIH es fundamental, para que puedan elaborar sus estrategias de enfrentamiento

Male and female cats have different regional body compositions and energy requirements for weight loss and weight maintenance.

Body composition and energy requirements are different between males and females in several species, and both interfere with weight loss. The aim of this study was to compare the total and regional body composition and energy requirements in obese male (n = 8) and female (n = 8) cats, during weight loss and weight maintenance over 17 subsequent weeks after regimen. The total and regional (thoracic and pelvic limbs, and trunk) body composition was assessed by dual-energy X-ray absorptiometry (DXA). Females exhibited a higher fat mass (FM) than males (p < 0.05), and the trunk was the site with greater fat accumulation regardless of gender. A 23.0 ± 2.8% reduction in body weight was followed by a 50.3 ± 9.4% and a 37.0 ± 8.9% reduction in fat in the trunk region in males and females respectively. Lean mass (LM) mobilization was also increased in the trunk (p < 0.05), and the loss of LM was associated with a reduction in bone mass. The energy intake to achieve the same rate of weight loss was 12.9 ± 3.4% higher in males (p < 0.05). The cats exhibited a gradual increase in energy requirements to maintain their body weight after weight loss (p < 0.05). It was concluded that obese cats mainly accumulate fat in the trunk. The reduction in lean mass after the regimen also occurred in the trunk, with no modifications in the skeletal muscle mass of the limbs. Neutered male cats have higher energy requirements than neutered females, and gender should be considered during obesity management in cats.

Effects of transcranial direct current stimulation on the rehabilitation of painful shoulder following a stroke: protocol for a randomized, controlled, double-blind, clinical trial.

BACKGROUND: Shoulder pain is reported to be one of the major challenges faced in the functional recovery of patients in rehabilitation following a stroke. In such cases, transcranial direct current stimulation (tDCS) has been used as an additional therapeutic tool for improvements in central and peripheral pain. The aim of the proposed study is to evaluate the effect of tDCS when combined with upper limb physical therapy on pain intensity and functional improvement in stroke survivors with shoulder pain in the hemiplegic limb. METHODS: A randomized, placebo-controlled, double-blind, clinical trial is proposed. The volunteers will be randomly allocated to receive passive movement on the upper limb, which will be performed by the therapist for 20 min followed by either active tDCS or sham tDCS (current stimulation for 30 s) during simultaneous physical activity of the upper limb ("mini-bike") for 20 min, totaling 40 min of intervention performed in 10 consecutive sessions. The anode electrode will be positioned over the primary motor cortex with a current of 2 mA and the cathode electrode will be positioned in the supraorbital region contralateral to the anode. The primary outcome will be shoulder pain intensity, which will be measured using the visual analog scale (VAS) on three occasions: 1) pre-intervention; 2) after 10 interventions (5 weekly sessions, for 2 weeks); and 3) 30 days after the end of the interventions. The secondary outcomes will be motor performance, upper limb function, and quality of life. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-8F5MNY . Registered on June 2, 2017.