Orientações de enfermagem para pessoas com estomia intestinal em cenário extra hospitalar: scoping review / Nursing guidelines for people with intestinal ostomy in extra-hospital scenario: scoping review / Directrices de enfermería para personas con ostomía intestinal en escenario extrahospitalario: scoping review

RESUMO Objetivo: mapear na literatura as orientações de enfermagem para pessoas com estomias intestinais na atenção primária à saúde e centros de referência. Método: scoping review desenvolvida em abril e maio de 2022, em bases nacionais e internacionais e fontes de literatura cinzenta. Utilizou-se os descritores: Ostomia; Colostomia; Ileostomia; Educação em Saúde; Atenção Primária; Serviços de Saúde e suas traduções no inglês. Seguiu-se as etapas recomendadas pelo Joana Briggs Institute e registrou-se na plataforma Open Science Framework. Resultados: foram identificados 2242 estudos, sendo 17 selecionados para composição amostral. As orientações versaram predominantemente sobre autocuidado com estomia e pele periestomal, escolha de equipamentos coletores e adjuvantes e aspectos sobre aceitação e adaptação. Conclusão: Identificou-se na literatura as principais orientações de enfermagem dirigidas às pessoas com estomia. O estudo contribui para prática em Enfermagem diante do raciocínio das necessidades e dos cuidados qualificados a serem dispensados à pessoa com estomia na integralidade da atenção.

ABSTRACT Objective: to map in the literature the nursing guidelines for people with intestinal ostomies in primary health care and referral centers. Method: scoping review developed in April and May 2022, in national and international bases and gray literature sources. The descriptors were used: Ostomy; Colostomy; Ileostomy; Health Education; Primary Attention; Health Services and their English translations. Followed the steps recommended by the Joana Briggs Institute and registered on the Open Science Framework platform. Results: were identified 2242 studies, 17 of which were selected for sample composition. The guidelines focused predominantly on self-care with ostomy and peristomal skin, choice of collector and adjuvant equipment, and aspects of acceptance and adaptation. Conclusion: the main nursing guidelines for people with ostomy were identified in the literature. The study contributes to nursing practice in view of the reasoning of the needs and qualified care to be provided to the person with an ostomy in the integrality of care.

RESUMEN Objetivo: mapear en la literatura las directrices de enfermería para personas con ostomías intestinales en la atención primaria de salud y centros de referencia. Método: Scoping Review desarrollado en abril y mayo de 2022, en bases nacionales e internacionales y fuentes de literatura gris. Se utilizaron los descriptores: ostomía; colostomía; ileostomía; Educación en salud; atención primaria; servicios de salud y sus traducciones al inglés. Se siguieron las etapas recomendadas por el Instituto Joana Briggs y se hizo el registro en la plataforma Open Science Framework. Resultados: se identificaron 2242 estudios, de los cuales 17 fueron seleccionados para composición de la muestra. Las orientaciones se centraron predominantemente en el autocuidado con ostomía y piel periestomal, elección de equipos colectores y adyuvantes, y aspectos de aceptación y adaptación. Conclusión: Se identificaron en la literatura las principales orientaciones de enfermería para personas con ostomía. El estudio contribuye a la práctica de enfermería en vista del razonamiento de las necesidades y cuidados calificados a ser prestados a la persona con ostomía en la integralidad del cuidado.

Effects of Harvest Time and Hydrodistillation Time on Yield, Composition, and Antioxidant Activity of Mint Essential Oil.

In this study, we assessed the effects of different harvest times (9 a.m., 1 p.m., and 5 p.m.) and hydrodistillation times (60, 90, and 120 min) on the yield, chemical composition, and antioxidant activity of the spearmint (Mentha spicata L.) essential oil (EO) sourced from the Amazon region. EO yield was ≥1.55% and was not significantly influenced (p ≥ 0.05) by the different harvest times and hydrodistillation times. Thirty-one different organic compounds were identified, of which menthol (91.56-95.68%), menthone (0.6-2.72%), and isomenthone (0.55-1.46%) were the major constituents. The highest menthol content in the EO was obtained from samples collected at 9 a.m., with a hydrodistillation time of 60-90 min, compared to other harvest and hydrodistillation times. This suggests that exposure to sun and light, which is greater at harvest times of 1 p.m. and 5 p.m., decreased the menthol content and altered the chemical composition of Mentha EO. Furthermore, the sample harvested at 9 a.m. and hydrodistilled for 60 min showed the highest antioxidant activity (61.67 equivalent mg of Trolox per g of EO), indicating that antioxidant activity is strongly affected by light exposure and the contact duration of the sample with boiling water during hydrodistillation.

Stability and Antioxidant Activity of Pouteria macrophylla Fruit Extract, a Natural Source of Gallic Acid.

Pouteria macrophylla (cutite) fruits are rich in phenolic acids, resulting in antioxidant and skin depigmenting activity. The aim of this study, then, is to evaluate the cutite extract stability under three variations of light, time, and temperature using a Box-Behnken experimental design to analyze through the surface response the variations of the total phenolic content (TPC), antioxidant activity (AA), and gallic acid content (GA). A colorimetric assay was also performed, and a decrease in the darkening index was noticed due to the high phenolic coloration in the presence of light, indicating less degradation to extract stability. The experimental planning showed variations in all responses, and second-order polynomial models were calculated and considered predictable, as well as the effects were significant. The TPC exhibited a variation in less concentrated samples (0.5% p/v) at higher temperatures (90 °C). In contrast, the temperature was the only influential variable for AA, where only higher temperatures (60-90 °C) were able to destabilize the fruit extract. Differently, GA showed only the concentration as the influential variable, exhibiting that neither temperature nor time of exposure could affect the gallic acid content stability of P. macrophylla extract. For this, P. macrophylla extract was shown to be highly stable, providing a great perspective on cosmetic application.

Effectiveness of a course on family health in the knowledge of doctors of the Mais Médicos program.

OBJECTIVE: The aim of this study was to analyze the effectiveness of the distance education course in family health in the knowledge of physicians from the Mais Médicos program. METHOD: This is a quantitative, quasi-experimental study, without a pretest and posttest control group, carried out from August 2019 to September 2021. In all modules, physicians responded to a pretest and posttest to verify their knowledge of the subject. RESULTS: There was a statistically significant difference in all modules with higher average scores in the posttests; the modules with the greatest emphasis are child health care: growth and development; approach to cancer in primary health care; and family health strategy and territorialization. CONCLUSION: The effectiveness of the distance education course was verified, as evidenced by the significant improvement of knowledge in all the modules studied.

Effectiveness of a course on family health in the knowledge of doctors of the Mais Médicos program

SUMMARY OBJECTIVE: The aim of this study was to analyze the effectiveness of the distance education course in family health in the knowledge of physicians from the Mais Médicos program. METHOD: This is a quantitative, quasi-experimental study, without a pretest and posttest control group, carried out from August 2019 to September 2021. In all modules, physicians responded to a pretest and posttest to verify their knowledge of the subject. RESULTS: There was a statistically significant difference in all modules with higher average scores in the posttests; the modules with the greatest emphasis are child health care: growth and development; approach to cancer in primary health care; and family health strategy and territorialization. CONCLUSION: The effectiveness of the distance education course was verified, as evidenced by the significant improvement of knowledge in all the modules studied.

Acute effect of different loads on muscle performance and perceived exertion in young women / Efecto agudo de distintas cargas sobre el desempeño muscular y el esfuerzo percibido en mujeres jóvenes / Efeito agudo de diferentes cargas no desempenho muscular e esforço percebido em mulheres jovens

ABSTRACT Introduction: Load reduction using the repetition maximum (RM) method may be necessary to promote higher numbers of repetitions, and consequently, higher total volume, time under tension, and perceived exertion ratings. Objective: To compare the effects of different leg press exercise loads on number of repetitions, total volume, time under tension, and perceived exertion. Methods: Eighteen women university students (23.9 ± 3.8 years) performed two experimental sessions with 90% and 100% of 10-12 RM in a balanced crossover design. Results: The number of repetitions of the second and third sets, the total volume, and time under tension at 90% of 10-12 RM was statistically higher than at 100% of 10-12 RM ( p < 0.05). The perceived exertion of the first and second sets and the training load (perceived exertion x duration of sessions) were higher at 100% of the 10-12 RM session ( p < 0.05). Conclusion: A small reduction in load results in a greater number of repetitions, total volume, and time under tension. The session with the higher load appeared to induce higher perceived exertion and training load. Thus, scientists and coaches might consider lower loads to maximize the number of repetitions, total volume, and time under tension, which may cause greater long-term muscular adaptations. Level of evidence II; Comparative prospective study.

RESUMEN Introducción: La reducción de la carga por el método de las repeticiones máximas (RM) puede ser necesaria para promover un mayor número de repeticiones y, consecuentemente, un mayor volumen total, tiempo bajo tensión y calificaciones del esfuerzo percibido. Objetivo: Comparar los efectos de diferentes cargas del ejercicio de prensa de piernas sobre el número de repeticiones, volumen, tiempo bajo tensión y esfuerzo percibido. Métodos: Dieciocho estudiantes universitarios (23,9 ± 3,8 años) realizaron dos sesiones experimentales con el 90% y el 100% de 10-12 RM en un diseño trasversal equilibrado. Resultados: El número de repeticiones de la segunda y tercera serie, el volumen total y el tiempo bajo tensión al 90% de 10-12 RM fue estadísticamente mayor que al 100% de 10-12 RM (p < 0,05). El esfuerzo percibido de la primera y segunda serie y la carga de entrenamiento (esfuerzo percibido x duración de las sesiones) fueron superiores en la sesión realizada al 100% de 10-12 RM (p < 0,05). Conclusión: Una pequeña reducción de la carga da lugar a un mayor número de repeticiones, volumen total y tiempo bajo tensión. La sesión con mayor carga indujo un mayor esfuerzo percibido y carga de entrenamiento. Por lo tanto, los científicos y entrenadores pueden considerar cargas más bajas para maximizar el número de repeticiones, el volumen total y el tiempo bajo tensión, lo que puede causar mayores adaptaciones musculares a largo plazo. Nivel de evidencia II; Estudio prospectivo comparativo.

RESUMO Introdução: A redução da carga pelo método das repetições máximas (RM) pode ser necessária para promover maior número de repetições e, consequentemente, maior volume total, tempo sob tensão e classificações do esforço percebido. Objetivo: Comparar os efeitos de diferentes cargas do exercício leg press no número de repetições, volume total, tempo sob tensão e percepção de esforço. Métodos: Dezoito universitárias (23,9 ± 3,8 anos) realizaram duas sessões experimentais com 90% e 100% de 10-12 RM em desenho transversal balanceado. Resultados: O número de repetições da segunda e terceira séries, volume total e tempo sob tensão a 90% de 10-12 RM foi estatisticamente maior do que a 100% de 10-12 RM (p < 0,05). A percepção do esforço da primeira e segunda séries e a carga de treinamento (percepção do esforço x duração das sessões) foram maiores na sessão realizada com 100% de 10-12 RM (p < 0,05). Conclusão: Uma pequena redução da carga resulta em maior número de repetições, volume total e tempo sob tensão. A sessão com maior carga induziu maior percepção do esforço e carga de treinamento. Assim, cientistas e treinadores podem considerar cargas menores para maximizar o número de repetições, o volume total e o tempo sob tensão, o que pode causar maiores adaptações musculares a longo prazo. Nível de evidência II; Estudo prospectivo comparativo.

Simulação virtual sobre amamentação e lesões mamilo-areolares: desenvolvimento e validação de protótipo / Simulación virtual sobre lactancia y lesiones en el pezón y areola: elaboración y validación de prototipo / Virtual simulation on breastfeeding and nipple-areolar lesions: prototype development and validation

Resumo Objetivo Construir e validar conteúdo e aparência do protótipo do Serious game "AleitaGame" sobre amamentação e lesões mamilo-areolares. Métodos Trata-se de um estudo realizado em três etapas, sendo elas: seleção do conteúdo através de uma Scoping Review, desenvolvimento de software educativo embasado no método de Benitti, Seara e Schlindwen, e um estudo metodológico para a validação de conteúdo, aspectos técnicos e pedagógicos, realizada com seis juízes especialistas na temática. A análise descritiva foi utilizada nesse estudo, bem como o Índice de Validade de Conteúdo para o instrumento de avaliação do conteúdo. Resultados O conteúdo dos casos clínicos e dos cenários simulados foi construído a partir de 115 estudos e foi validado por seis juízes em relação ao conteúdo e os aspectos técnico-pedagógicos, sendo esses os únicos que apresentaram sugestões no design e feedback do game. A versão final do serious game contém diferentes recursos de mídia e gamificação para uma interação com o tema que trata da técnica de amamentação como causa de lesão mamilo-areolar em lactantes. Conclusão O protótipo do "AleitaGame" foi validado por juízes especialistas e está adequado para a etapa final de desenvolvimento do software educativo.

Resumen Objetivo Elaborar y validar el contenido y la apariencia del prototipo del serious game "AleitaGame" sobre lactancia y lesiones en el pezón y areola. Métodos Se trata de un estudio realizado en tres etapas, a saber: selección de contenido a través de una Scoping Review, desarrollo del software educativo basado en el método de Benitti, Seara y Schlindwen, y un estudio metodológico para la validación del contenido, aspectos técnicos y pedagógicos, realizada con seis jueces especialistas en el tema. En este estudio se utilizó el análisis descriptivo, así como también el Índice de Validez de Contenido para el instrumento de evaluación de contenido. Resultados El contenido de los casos clínicos y de los escenarios simulados fue elaborado a partir de 115 estudios y validado por seis jueces con relación al contenido y a los aspectos técnico-pedagógicos, que fueron los únicos que presentaron sugerencias sobre el diseño y feedback del juego. La versión final del serious game contiene diferentes recursos multimedia y de gamificación para interactuar con el tema que trata sobre la técnica de lactancia como causa de lesiones en el pezón y areola en lactantes. Conclusión El prototipo de "AleitaGame" fue validado por jueces especialistas y está preparado para la etapa final de desarrollo del software educativo.

Abstract Objective To develop and validate the content and appearance of the prototype of the Serious game "AleitaGame" on breastfeeding and nipple-areolar lesions. Methods This is a study carried out in three stages, namely: content selection through a Scoping Review, development of educational software based on the Benitti, Seara and Schlindwen approach, and a methodological study for content validation, technical and pedagogical aspects, carried out with six expert judges on the subject. Descriptive analysis was used in this study, as well as the Content Validity Index for the content assessment instrument. Results The content of the clinical cases and the simulated scenarios was built from a total of 115 studies and was validated by six judges in relation to the content and the technical-pedagogical aspects, the only ones who presented suggestions in the design and feedback of the game. The final version of the serious game contains different media and gamification resources for an interaction with the theme that deals with the breastfeeding technique as a cause of nipple-areolar lesion in lactating women. Conclusion The "AleitaGame" prototype was validated by expert judges and is suitable for the final stage of educational software development.

Hearing health of adults and the elderly: effectiveness of remote educational actions for Community Health Agents / Saúde auditiva de adultos e idosos: efetividade de ações educativas na modalidade remota para agentes comunitários de saúde

ABSTRACT Purpose: to assess the evolution of educational actions on hearing health, in the remote format, for Community Health Agents from Santa Maria, RS, Brazil, and to identify if there is a relationship between the level of knowledge acquired and the variables age, length of service and education. Methods: a quantitative and interventional research, carried out with 44 Community Health Agents, who participated in three meetings, via Google Meet. In the first, data on the professionals' knowledge were collected and, in the second and third meetings, there was training on 1) hearing, 2) hearing health and disorders, 3) organization of the Hearing Health Service, 4) use/hygiene of hearing aids and 5) importance of users' follow-up at the service, and the collection of knowledge acquired on these topics. Such collection took place through Quizzes, elaborated in Google Forms. The statistical tests Chi-square and Two-sample Test of Proportions were used to statistically analyze the data, with a significance of 5%. Results: there was a difference in the rate of correct answers in the post-training Quiz and the acquisition of knowledge was more evident when compared to the performances "worse" and "mistake" in themes 1, 2, 3 and 4. No relationship was found between the level of knowledge acquired and the studied variables. Conclusion: the educational actions proved to be effective and the level of knowledge acquired on the topics is not related to the studied variables.

RESUMO Objetivo: verificar a efetividade de ações educativas sobre saúde auditiva, no formato remoto, para agentes comunitários de saúde de Santa Maria/RS e identificar se há relação entre o nível de conhecimento adquirido e as variáveis idade, tempo de função e escolaridade. Métodos: pesquisa quantitativa e intervencionista, realizada com 44 agentes comunitários de saúde, que participaram de três encontros, via Google Meet. No primeiro, foram coletados dados acerca do conhecimento prévio dos profissionais e, no segundo e terceiro encontros, ocorreu a capacitação sobre 1) audição, 2) saúde/alterações auditivas, 3) organização do Serviço de Saúde Auditiva, 4) uso/higienização das próteses auditivas e 5) importância do retorno dos usuários ao serviço, e a coleta do conhecimento adquirido acerca destes temas. Tais coletas deram-se por meio de Quizzes, elaborados no Google Forms. Os dados foram submetidos aos testes estatísticos Igualdade de Duas Proporções e Qui-quadrado, adotando-se significância de 5%. Resultados: constatou-se diferença no índice de acertos no Quiz pós-capacitação e a aquisição do conhecimento foi mais evidente quando comparada aos desempenhos "piora" e "erro" nos temas 1, 2, 3 e 4. Não foi encontrada relação entre o nível de conhecimento adquirido e as variáveis estudadas. Conclusão: as ações educativas mostraram-se efetivas e o nível de conhecimento adquirido sobre os temas abordados não está relacionado às variáveis estudadas.

Poor Agreement between Responses to the International Physical Activity Questionnaire and Objective ActiGraph® Data among Persons with Major Depressive or Bipolar Disorders.

The purpose of this research was to investigate the degree of agreement between data from the International Physical Activity Questionnaire-Short Form (IPAQ) and accelerometer (ActiGraph®) readings for physical activity (PA), classified as moderate, vigorous, and moderate-vigorous PA, and sedentary behavior (SB) in participants with major depressive or bipolar disorder. Following a cross-sectional observational design (n = 30), participants used an accelerometer for 4 to 7 days (minimum of 10 h per day) and answered the IPAQ (for the same period as accelerometer use). Our results suggest significant differences (p < 0.05) when comparing the ActiGraph® and IPAQ data: for moderate PA, 155 min vs. 25 min per week; for moderate-vigorous PA, 157 min vs. 50 min per week; and for SB, 8 h vs. 3 h per day. Spearman's correlation coefficients (ActiGraph® and IPAQ) were low for moderate PA, vigorous PA, and moderate-vigorous PA (rho = 0.03 to 0.13). The Bland-Altman plot showed a bias of -75 min for moderate PA, 9 min for vigorous PA, -66 min for moderate-vigorous PA, and -5 h for SB. Considering the differences observed and the objectivity of the ActiGraph® measurements, whenever possible, we recommend ActiGraph® measurements of PA and SB for these clinical groups.

Seasonal dynamics of Amblyomma sculptum: a review.

BACKGROUND: Amblyomma sculptum is a hard tick that is associated with domestic animals and the transmission of Brazilian spotted fever. This association has motivated several field studies on this ixodid tick within its distribution area in South America. Thorough knowledge of the seasonal dynamics of A. sculptum in different ecological scenarios is required in order to better understand the biological characteristics of this tick and develop techniques for the control and prevention of diseases transmitted by this vector. In this article, we systematically review the seasonal dynamics of A. sculptum and tick collection methodology. METHODS: A systematic search of the Scopus, Web of Science, PubMed and Scielo databases was carried out for articles (including dissertations and theses) on the population dynamics of A. sculptum. The inclusion criterion was the report of seasonal dynamic studies on A. sculptum through surveys carried out for at least 1 year with, as methodology, tick collection in the environment and/or tick count/collection on A. sculptum primary hosts (horses or capybaras). Studies carried out before the reclassification of Amblyomma cajennense sensu lato in 2014, which referred to Amblyomma cajennense in areas where it is currently known that only A. sculptum occurs, were also included. Articles meeting the inclusion criterion, but not available in online databases, were also added based on the authors' experience on the subject. Sixteen articles and one thesis were selected for inclusion in this systematic review. RESULTS: Most of the studies were carried out in the southeastern region of Brazil, with a few also carried out in the northeast, center-west and south of Brazil and northwest of Argentina. Five techniques/methods were applied across these studies: CO2 traps, dragging, flagging, visual searches and tick counting on animals, used alone or in combination. CONCLUSION: Seasonal dynamics of A. sculptum was found to be similar in almost all of the areas studied, with larvae predominating during the autumn, nymphs in the winter and adults in the spring and summer.

ASIA syndrome: Adverse reaction or autoimmunity?

Introduction: Adjuvant-Induced Autoimmune / Auto-inflammatory Syndrome (ASIA) is an immune-mediated condition by the exposure of material previously considered inert, such as silicone, aluminum salts, mineral oils, hyaluronic acid and metallic implants. In addition to a genetic component, there is a risk of development of an undifferentiated connective tissue disease, which varies clinically and laboratorially depending on the adjuvant material used. Patients and methods: This paper addresses two cases reported, in caucasian subjects, born and residents in Madeira Island, Portugal. In this article are described two different histological patterns occurring in ASIA patients, due to mammoplasty with silicone. Conclusion: Although ASIA does not meet the diagnostic requirements for connective tissue disease, there is a close relationship with the development of autoimmune conditions. These cases aim to alert the medical community to the existence of this entity, encourage the notification of situations arising from exposure to adjuvants and investigate the presence of a genetic predisposition and a suggestive histological pattern in excisional biopsies of satellite adenomegalies.

Evaluation of targets for Strongyloides genus specific molecular diagnosis in experimental strongyloidiasis.

Strongyloides venezuelensis has been used in different experimental studies, such as those aimed at the evaluation of diagnostic techniques for human strongyloidiasis, mainly the molecular diagnosis. In this study, three regions (genus, 18S and 28S targets) of Strongyloides ribosomal DNA were evaluated for the molecular diagnosis of experimental strongyloidiasis. Rats were infected subcutaneously with 400 or 4000 S. venezuelensis infective larvae (400iL3 and 4000iL3), and kept for 35 days. Fecal samples were collected daily to count eggs per gram of feces (EPG) and to perform the polymerase chain reaction (PCR). Egg count started on the 5th day post-infection (pi) and ended on days 33 and 34 pi, in 400iL3 and 4000iL3 groups, respectively. Based in EPG, fecal samples were selected from days 2, 5, 8, 11, 15, 23 and 35 pi for DNA extraction; PCR (genus, 18S and 28S); and sequencing. The PCR-28S products showed higher values of identity (95-100%) in the database with the Strongyloides sequences. Therefore, it is possible to reinforce the application of PCR-28S in the diagnosis of experimental and human strongyloidiasis.

Rhipicephalus microplus seasonal dynamic in a Cerrado biome, Brazil: An update data considering the global warming.

The present study evaluated over two years the seasonal dynamics of Rhipicephalus microplus in a Cerrado biome of midwestern Brazil (Goiânia, Goiás) and correlated the current climatic conditions (environmental temperature, insolation, rainfall, relative humitidy and saturation deficit of the atmosphere) of this site with 30 years ago. In addition, the data collected in the present research were compared with climatic conditions data and R. microplus population dynamics conducted by our group in other regions (Formiga, Minas Gerais and Jaboticabal, São Paulo) within the same biome. For the parasitic phase dynamics, R. microplus females (4.5-8.0 mm) counts were performed on tick natural infested cows kept in Panicum maximum paddocks. To verify the larvae dynamics on pasture the flannel dragg technique on natural infested pasture was performed, and the height of the grass was measured. Five peaks of engorged R. microplus females on animals and larvae infestations on pastures were observed. Being three and two peaks during the rainy and dry season of the year, respectively. Insolation (r = 0.8758; P = 0.00009; R²â€¯= 0.7670), rainfall (r = -0.8572; P = 0.0002; R²â€¯= 0.7348), maximum environmental temperature in summer (r = 0.9999; P < 0.0087; R²â€¯= 0.9988) and the saturation deficit of the atmosphere in autumn (r = -0.9789; P = 0.0211; R²â€¯= 0.9582) influenced the seasonal dynamics of R. microplus larvae on pastures. While the forage height did not influence the number of larvae found on pasture (r = 0.1545; P = 0.7682; R²â€¯= 0.0239). The comparison between the climatic data of the last 30 years with the current climatological data (2012 to 2019) in the state of Goiás, and the comparison with R. microplus population dynamics from other two locations in the same biome indicated that the increase of the environmental temperature due to the global warming possibly is a determining factor which increase the number of one or up two tick annual peaks. In addition, this climatic variable was responsible for increase the population density of ticks on pastures and animals observed in July/winter of the present study, in comparison to other regions with the same biome, as discussed in this work.

Heart Dissemination: A Clinical Case of Melanoma.

Introduction. Primitive malignant heart tumours are rare, specific cases. The presence of cardiac metastases, often in the pericardium, besides indicating disseminated oncological disease, represents a diagnostic challenge since they tend to be asymptomatic. Malignant cutaneous melanoma (MCM) is the neoplasm that most often affects the heart. Patients and Methods. The authors describe a case report of a 59-year-old female patient with a history of non-insulin-treated diabetes mellitus, arterial hypertension, dyslipidemia, and remitting cutaneous malignant melanoma who underwent skin excision, lymphadenectomy, and adjuvant chemotherapy in 1996. In April 2014, she resorted to emergency service due to epigastric pain and progressive tiredness. Due to the persistence of the complaints, abdominal ultrasound was performed, which showed a large pericardial effusion, corroborated later by teleradiography and echocardiography. The patient underwent pericardiocentesis, which isolated neoplastic cells. A computed tomography study of the chest, abdomen, and pelvis revealed bilateral and pericardial pleural effusion, as well as alterations suggestive of pericardial and pulmonary metastasis. Later, fine-needle aspiration puncture of the left posterior cervical nodule confirmed histologically malignant melanoma metastasis. Discussion. Given the natural history of melanoma that when metastasized has an overall survival of 15-20% for 5 years, its metastatic spread may occur several years after its surgical excision. Thus, patients with a history of melanoma and heart failure who develop new cardiac symptoms of unknown aetiology should undergo imaging studies such as echocardiography, computed tomography, and magnetic resonance imaging.

Bem-estar mental de enfermeiros em um hospital de urgência e emergência / Mental well-being of nurses at an urgency and emergency hospital / Bienestar mental de enfermeros en un hospital de urgencia y emergencia

OBJETIVO: identificar a autopercepção dos enfermeiros acerca dos fatores que interferem em seu bem-estar mental durante o processo de trabalho em um hospital de urgência e emergência. MÉTODO: estudo de campo com abordagem qualitativa realizado por intermédio de entrevistas com enfermeiros(as) das alas vermelhas (trauma e clínica) de um hospital referência, localizado no Estado de Alagoas. RESULTADOS: existem diversos fatores que afetam, de forma positiva ou negativa, o bem-estar mental de enfermeiros que trabalham em hospitais de urgência e emergência. O processo de adoecimento mental do trabalhador é singular, complexo e dinâmico, além de ser multifatorial, desta forma, mesmo com diversos fatores negativos encontrados no ambiente de trabalho, os fatores positivos podem se sobressair e minimizar as interferências insalubres sofridas pelos profissionais. CONCLUSÃO: é importante que ocorra uma sensibilização das instituições e enfermeiros sobre o tema, que ainda é negligenciado, para que sejam construídas estratégias, compatíveis com a realidade de cada local, que possam proporcionar qualidade de vida e bem-estar mental no trabalho.

OBJECTIVE: to identify nurses' self-perception about the factors that interfere with their mental well-being during the work process in an urgency and emergency hospital. METHOD: a field study with a qualitative approach conducted by means of interviews with nurses in the red wards (trauma and clinic) of a reference hospital, located in the state of Alagoas. RESULTS: there are several factors that positively or negatively affect the mental well-being of nurses, who work in urgency and emergency hospitals. The worker's mental illness process is unique, complex, and dynamic, in addition to being multifactorial. Thus, even with several negative factors found in the workplace, the positive factors can stand out and minimize the unhealthy interferences suffered by professionals. CONCLUSION: it is important that nurses and institutions are sensitive about this topic, which is still neglected, so that strategies compatible with the reality of each location and which can provide quality of life and mental well-being at work are built.

OBJETIVO: identificar la autopercepción en el personal de enfermería sobre los factores que interfieren en su bienestar mental durante el proceso laboral en un hospital de urgencias y emergencias. MÉTODO: se lleva a cabo un estudio de campo con enfoque cualitativo mediante entrevistas con enfermeras de las alas de riesgo (trauma y clínica) de un hospital de referencia en el Estado de Alagoas. RESULTADOS: el bienestar mental del personal de enfermería que trabaja en hospitales de urgencias y emergencias se ve afectado positiva o negativamente por diversos factores. Dada la condición de unicidad, complejidad y dinamismo del proceso de enfermedad mental del trabajador de la salud; ante su esencia multifactorial, que incluye los varios factores negativos presentes en el entorno laboral, es posible que se pongan de relieve los factores positivos y se reduzcan, por tanto, las interferencias insanas que sufren los profesiones. CONCLUSIÓN: es importante concienciar a las instituciones y a los enfermeros sobre el tema, que continua desatendido, con miras al desarrollo de estrategias alineadas con la realidad de cada local a fin de ofrecer calidad de vida y bienestar mental en el trabajo.

Acute Iatrogenic Agranulocytosis: A Rare and Dire Case of an Adverse Drug Reaction to Be Aware.

BACKGROUND: Iatrogenic agranulocytosis (IA), by nonchemotherapeutic drugs, is a rare adverse event, resulting in a neutrophil count under 0.5 × 109 cells/L with fever or other suggestive signs of infection. METHODS: This paper discusses the possible mechanisms responsible for agranulocytosis induced by nonchemotherapeutic drugs. It also describes three cases as well as potential ways to handle such iatrogenic situations. CONCLUSION: Neutropenia under 0.1 × 109 cells/L predispose patients to potentially fatal infections. Empiric broad-spectrum antibiotic and hematopoietic growth factors may be helpful in shortening hospitalization and prevent further infectious complications. Not all drugs associated with IA require frequent hematological monitoring, except medications such as clozapine, ticlopidine, and antithyroids.

Acaricidal activity of (E)-cinnamaldehyde and α-bisabolol on populations of Rhipicephalus microplus (Acari: Ixodidae) with different resistance profiles.

This study aimed to investigate the acaricidal activity of (E)-cinnamaldehyde and α-bisabolol on populations of Rhipicephalus microplus with different resistance profiles. The adult immersion test (AIT) was used to characterize the susceptibility of tick populations (50 field populations) to synthetic acaricides: deltamethrin, amitraz, and chlorfenvinphos. The larval packet test (LPT) was used to determine the LC50 values for (E)-cinnamaldehyde (populations 1-25) and α-bisabolol (populations 26-50) at the concentrations of 0.31, 0.62, 1.25, 2.0, 2.5, 5.0 and 10.0 mg/mL. The susceptible strain Porto Alegre (POA) was used as a reference for calculating the resistance ratio (RR). In the AIT, deltamethrin did not show efficacy >95 % for any of the populations, whereas amitraz and chlorfenvinphos have presented efficacy >95 % for three (6 %) and 15 (30 %) populations, respectively. In the LPT, the LC50 values of (E)-cinnamaldehyde and α-bisabolol varied from 0.23 to 2.36 mg/mL and 1.57-3.01 mg/mL, respectively. The RR50 for (E)-cinnamaldehyde showed 20 (80 %) populations with values <1.0 and no population with values>1.5. As for α-bisabolol, only two (8%) populations have presented RR50 <1.0, whereas three (12 %) populations showed incipient resistance to this sesquiterpene (RR50 between 1.5 and 2.0). The results indicate that all studied tick populations showed low susceptibility to at least one of the commercial acaricides tested. In addition, comparison between the LC50 values of (E)-cinnamaldehyde and α-bisabolol for the field populations and the susceptible strain POA suggests that there is no cross-resistance of (E)-cinnamaldehyde and α-bisabolol for the tick populations evaluated, and that the differences in the LC50 values are due to population variations.

Xylella fastidiosa subsp. pauca Strains Fb7 and 9a5c from Citrus Display Differential Behavior, Secretome, and Plant Virulence.

Xylella fastidiosa colonizes the xylem of various cultivated and native plants worldwide. Citrus production in Brazil has been seriously affected, and major commercial varieties remain susceptible to Citrus Variegated Chlorosis (CVC). Collective cellular behaviors such as biofilm formation influence virulence and insect transmission of X. fastidiosa. The reference strain 9a5c produces a robust biofilm compared to Fb7 that remains mostly planktonic, and both were isolated from symptomatic citrus trees. This work deepens our understanding of these distinct behaviors at the molecular level, by comparing the cellular and secreted proteomes of these two CVC strains. Out of 1017 identified proteins, 128 showed differential abundance between the two strains. Different protein families were represented such as proteases, hemolysin-like proteins, and lipase/esterases, among others. Here we show that the lipase/esterase LesA is among the most abundant secreted proteins of CVC strains as well, and demonstrate its functionality by complementary activity assays. More severe symptoms were observed in Nicotiana tabacum inoculated with strain Fb7 compared to 9a5c. Our results support that systemic symptom development can be accelerated by strains that invest less in biofilm formation and more in plant colonization. This has potential application in modulating the bacterial-plant interaction and reducing disease severity.

O uso de oficina pedagógica na mediação de conflitos causados por estereótipos de gênero e sexualidade na escola: reflexões a partir de um relato de experiência / The use of pedagogical workshop in the mediation of conflicts caused by gender stereotypes and sexuality in school: reflections based on an experience report / El uso de taller pedagógico en la mediación de conflictos causados por estereotipos de género y sexualidad en la escuela: reflexiones a partir de un relato de experiencia

A educação escolar tem considerável atuação na formação de subjetividades e, nesse âmbito, o trabalho educativo opera na manutenção-transformação de atitudes pautadas em preconceitos e estereótipos de gênero e sexualidade. Essas atitudes encontram-se presentes no cotidiano das escolas e, não raro, são motivadoras de conflitos nas relações entre os sujeitos que ali se encontram. Apostando no importante papel que a escola tem para a desconstrução de preconceitos e rótulos, apresentamos o relato de experiência de um licenciando em História, que usou de oficina pedagógica como ferramenta para mediação de conflitos causados por estereótipos de gênero e sexualidade. A partir da experiência reflexiva desse estudante, em diálogo com a teoria queer e com autores que discutem a resolução de conflitos e a aplicação de oficinas pedagógicas, indicamos como os conflitos interpessoais podem ser oportunidades importantes para o aprendizado de atitudes e valores democráticos e para a formação ética dos estudantes, assim como demonstramos que oficinas pedagógicas se apresentam como ferramentas bastante adequadas para esse trabalho.

School education has a considerable role in the formation of subjectivities, and in this context educational work operates in the maintenance-transformation of attitudes based on prejudices and stereotypes of gender and sexuality. These attitudes are present in the daily life of schools and, not infrequently, are motivators of conflicts in the relationships between their subjects. Supported on the important role that school has for deconstructing prejudices and labels, we present the experience report of a graduate student in history, who used a pedagogical workshop as a tool to mediate conflicts caused by gender and sexuality stereotypes. Based on this student's reflective experience, in dialogue with queer theory and with authors who discuss conflict resolution and the application of pedagogical workshops, we indicate how interpersonal conflicts can be important opportunities for learning democratic attitudes and values and for ethical training of students, as well as demonstrating that pedagogical workshops present themselves as quite adequate tools for this work.

La educación escolar tiene un papel considerable en la formación de subjetividades, y, en este contexto, el trabajo educativo opera en el mantenimiento-transformación de actitudes basadas en prejuicios y estereotipos de género y sexualidad. Estas actitudes están presentes en la vida diaria de las escuelas y, con poca frecuencia, son motivadoras de conflictos en las relaciones entre los sujetos que están allí. Apostando por el importante papel que tiene la escuela para deconstruir prejuicios y etiquetas, presentamos el informe de experiencia de un estudiante graduado en historia, que utilizó un taller pedagógico como una herramienta para mediar conflictos causados por estereotipos de género y sexualidad. Con base en la experiencia reflexiva de este estudiante, en diálogo con la teoría queer y con los autores que discuten la resolución de conflictos y la aplicación de talleres pedagógicos, indicamos cómo los conflictos interpersonales pueden ser oportunidades importantes para aprender actitudes y valores democráticos y para formación ética de los estudiantes, así como demostrar que los talleres pedagógicos se presentan como herramientas bastante adecuadas para este trabajo.

Antimicrobial activity of Epsilon-Poly-L-lysine against phytopathogenic bacteria.

Antimicrobial peptides (AMPs) are components of immune defense in many organisms, including plants. They combat pathogens due to their antiviral, antifungal and antibacterial properties, and are considered potential therapeutic agents. An example of AMP is Epsilon-Poly-L-lysine (EPL), a polypeptide formed by ~ 25 lysine residues with known antimicrobial activity against several human microbial pathogens. EPL presents some advantages such as good water solubility, thermal stability, biodegradability, and low toxicity, being a candidate for the control of phytopathogens. Our aim was to evaluate the antimicrobial activity of EPL against four phytobacterial species spanning different classes within the Gram-negative phylum Proteobacteria: Agrobacterium tumefaciens (syn. Rhizobium radiobacter), Ralstonia solanacearum, Xanthomonas citri subsp. citri (X. citri), and Xanthomonas euvesicatoria. The minimum inhibitory concentration (MIC) of the peptide ranged from 80 µg/ml for X. citri to 600 µg/ml for R. solanacearum and X. euvesicatoria. Two hours of MIC exposure led to pathogen death due to cell lysis and was enough for pathogen clearance. The protective and curative effects of EPL were demonstrated on tomato plants inoculated with X. euvesicatoria. Plants showed less disease severity when sprayed with EPL solution, making it a promising natural product for the control of plant diseases caused by diverse Proteobacteria.