Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture.

The aim of the present study was to evaluate the Mini Nutritional Assessment (MNA), the Nutritional Risk Screening (NRS) 2002 and the American Society of Anesthesiologists Physical Status Score (ASA) as predictors of gait status and mortality 6 months after hip fracture. A total of eighty-eight consecutive patients over the age of 65 years with hip fracture admitted to an orthopaedic unit were prospectively evaluated. Within the first 72 h of admission, each patient's characteristics were recorded, and the MNA, the NRS 2002 and the ASA were performed. Gait status and mortality were evaluated 6 months after hip fracture. Of the total patients, two were excluded because of pathological fractures. The remaining eighty-six patients (aged 80·2 (sd 7·3) years) were studied. Among these patients 76·7 % were female, 69·8 % walked with or without support and 12·8 % died 6 months after the fracture. In a multivariate analysis, only the MNA was associated with gait status 6 months after hip fracture (OR 0·773, 95 % CI 0·663, 0·901; P= 0·001). In the Cox regression model, only the MNA was associated with mortality 6 months after hip fracture (hazard ratio 0·869, 95 % CI 0·757, 0·998; P= 0·04). In conclusion, the MNA best predicts gait status and mortality 6 months after hip fracture. These results suggest that the MNA should be included in the clinical stratification of patients with hip fracture to identify and treat malnutrition in order to improve the outcomes.

Social, Genetics and Histopathological Factors Related to Titin (TTN) Gene Mutation and Survival in Women with Ovarian Serous Cystadenocarcinoma: Bioinformatics Analysis.

Several factors may increase the risk of development of ovarian cancer. In this study, we investigated the relationship between social, genetic, and histopathologic factors in women with ovarian serous cystadenocarcinoma and titin (TTN) mutations, whether the TTN gene mutation may be a predictor, and its impact on mortality and survival in these patients. A total of 585 samples from patients with ovarian serous cystadenocarcinoma were collected from The Cancer Genome Atlas and PanCancer Atlas through the cBioPortal for analysis of social, genetic, and histopathological factors. Logistic regression was used to investigate whether TTN mutation could be a predictor, and the Kaplan-Meier method was applied to analyze survival time. TTN mutation frequency did not differ between age at diagnosis, tumor stage, and race, and was related to increased Buffa hypoxia score (p = 0.004), mutation count (p < 0.0001), Winter hypoxia Score (p = 0.030), nonsynonymous tumor mutation burden (TMB) (p < 0.0001), and reduced microsatellite instability sensor score (p = 0.010). The number of mutations (p < 0.0001) and winter hypoxia score (p = 0.008) were positively associated with TTN mutations, and nonsynonymous TMB (p < 0.0001) proved to be a predictor. Mutated TTN affects the score of genetic variables involved in cancer cell metabolism in ovarian cystadenocarcinoma.

Efficacy of topical permethrin as repellent against Aedes aegypti's bites.

Mosquitoes are the most important vectors of infectious diseases and their bites are related to several adverse skin reactions. Permethrin impregnated clothes are an efficient strategy against arthropods' bites; however, its topical efficacy as a repellent has not been well established. We studied the response to permethrin lotion 5 percent and N,N-Diethyl-meta-toluamide (DEET) spray 50 percent applied to the unprotected forearms of 10 volunteers. Each arm was exposed to 20 female mosquitoes of Aedes aegypti. We performed 71 bilateral comparative measurements evaluating the timing for the first bites. The average times for the arm without the product, with permethrin 5 percent, and with DEET 50 percent were: 7.9 seconds, 336.2 seconds and 7512.1 seconds. The results showed a significant difference between repellency times between either product and unprotected controls. In addition, there was a significant difference in time to first bite between permethrin and DEET treated arms (p<0.01). Permethrin affords some repellent activity against Aedes aegypti bites in this experimental setting. However, permethrin's profile of repellency was significantly inferior to that of DEET.

Chiral Derivatives of Xanthones: Investigation of the Effect of Enantioselectivity on Inhibition of Cyclooxygenases (COX-1 and COX-2) and Binding Interaction with Human Serum Albumin.

Searching of new enantiomerically pure chiral derivatives of xanthones (CDXs) with potential pharmacological properties, particularly those with anti-inflammatory activity, has remained an area of interest of our group. Herein, we describe in silico studies and in vitro inhibitory assays of cyclooxygenases (COX-1 and COX-2) for different enantiomeric pairs of CDXs. The evaluation of the inhibitory activities was performed by using the COX Inhibitor Screening Assay Kit. Docking simulations between the small molecules (CDXs; known ligands and decoys) and the enzyme targets were undertaken with AutoDock Vina embedded in PyRx-Virtual Screening Tool software. All the CDXs evaluated exhibited COX-1 and COX-2 inhibition potential as predicted. Considering that the (S)-(-)-enantiomer of the nonsteroidal anti-inflammatory drug ketoprofen preferentially binds to albumin, resulting in lower free plasma concentration than (R)-(+)-enantiomer, protein binding affinity for CDXs was also evaluated by spectrofluorimetry as well as in in silico. For some CDXs enantioselectivity was observed.

Panorama retrospectivo na visão de enfermeiros do programa de capacitação profissional - trainee num hospital privado / Panorama retrospectivo en la vista de enfermeras del programa de formación profesional - trainee de hospital privado / Retrospective overview in the view of nurses of the professional training program - trainee of a private hospital

Objetivo: Descrever de forma retrospectiva o panorama, na visão dos enfermeiros, do Programa de Capacitação Profissional ­ Trainee do Hospital Santa Teresa, Petrópolis, Rio de Janeiro. Métodos: Estudo retrospectivo, descritivo e exploratório com abordagem qualitativa e quantitativa com o uso de formulário aplicado a 12 enfermeiros para avaliar o panorama do Programa de Capacitação Profissional ­ Trainee, ocorrido entre dezembro de 2016 a dezembro de 2017. Resultados: A idade média dos participantes foi de 29,9 anos, predominância do sexo feminino 83,33%, Concordância geral sobre a estrutura do programa teve 73,60% positiva, negativa de 11,10% e neutra de 15,30%. O principal benefício citado foi o crescimento profissional e o entendimento do funcionamento hospitalar. Os desafios foram o medo/ansiedade, adaptação e a falta de conhecimento e acolhimento pelas equipes nos setores. Conclusão: O treinamento e a capacitação estruturados são capazes de produzir mudanças nos indivíduos ao criar e melhorar habilidades, conhecimentos, atitudes ou comportamento.(AU)

Objective: To describe retrospectively the overview from the perspective of nurses in the Professional Training Program - Trainee at Santa Teresa Hospital, Petrópolis, Rio de Janeiro. Method: An retrospective, descriptive and exploratory study with a qualitative and quantitative approach using a form from 12 nurses to assess the overview of the Professional Training Program ­ Trainee, that occurred between december of 2016 to december of 2017. Results: The average age from participants was 29.9 years, with a female predominance of 83.33%. General agreement on the structure of the program was 73.60% positive, 11.10% negative and 15.30% neutral. The main benefit cited was the professional growth and the acknowledge of hospital functioning. The challenges were fear/anxiety, adaptation and lack of knowledge and acceptance by others professionals. Conclusion: Structured training and qualification are capable of producing changes when create and improve skills, knowledge, attitudes or behavior.(AU)

Objetivo: Describir el panorama retrospectivamente de la perspectiva de enfermeros en el Programa de Formación Profesional - Trainee del Hospital Santa Teresa, Petrópolis, Rio de Janeiro. Método: Estudio retrospectivo, descriptivo y exploratorio con abordaje cualitativo y cuantitativo, utilizando un formulario aplicado a 12 enfermeros para evaluar el panorama del Programa de Formación Profesional ­ Trainee, que ocurrió entre diciembre de 2016 a diciembre de 2017. Resultados: La edad promedio de los participantes fue 29,9 años, predominio femenino 83,33%. La concordancia general sobre la estructura del programa fue 73,60% positiva, 11,10% negativa y 15,30% neutral. El principal beneficio citado fue el crecimiento profesional y la comprensión del funcionamiento del hospital. Los retos fueron miedo/ansiedad, adaptación y desconocimiento y aceptación por parte de los equipos de los sectores. Conclusión: La formación estructurada y el desarrollo de capacidades son capaces de generar cambios en las personas creando y mejorando habilidades, conocimientos, actitudes o comportamientos.(AU)

Does VDAC insert into membranes in random orientation?

It is widely accepted that voltage-dependent anion-selective channel (VDAC) inserts into planar lipid bilayers in a random orientation. This is in contrast to the well-documented oriented insertion of various channel-forming proteins. Because of the potential importance of this issue, we have examined the orientation of VDAC inserted in membranes. The time constants of the VDAC-current relaxation in response to applied positive and negative voltage pulses were used to characterize the channel orientation. We have found that VDAC channels can be separated into two groups according to differences in the time constant ratio. The difference in time constant ratio between the two main groups of VDAC channels was quantitative, and not qualitative as would be expected for opposite topologies. This finding allows us to hypothesize that both groups of VDAC channels possess a qualitatively similar asymmetry with respect to the localization of voltage-gated domains and, consequently, with respect to its entire molecular structure. The probability of having each type of VDAC channel conformation is predetermined by the protein structure in aqueous solution. A striking resemblance between asymmetry in voltage sensitivity at the single-channel and multi-channel levels was also demonstrated. The first inserted channel seems to direct subsequent insertions of channels with a similar conformation.

Probing the volume changes during voltage gating of Porin 31BM channel with nonelectrolyte polymers.

To probe the volume changes of the voltage-dependent anion-selective channel (VDAC), the nonelectrolyte exclusion technique was taken because it is one of the few existing methods that may define quite accurately the rough geometry of lumen of ion channels (in membranes) for which there is no structural data.Here, we corroborate the data from our previous study [FEBS Lett. 416 (1997) 187] that the gross structural features of VDAC in its highest conductance state are asymmetric with respect to the plane of the membrane, and state that this asymmetry is not dependent on sign of voltage applied. Hence, the plasticity of VDAC does not play a role in the determination of lumen geometry at this state and the asymmetry is an internal property of the channel. We also show that the apparent diameter of the cis segment of the pore decreases slightly from 2 to 1.8 nm when the channel's conductance decreases from its high to low state. However, the trans funnel segment undergoes a more marked change in polymer accessible volume. Specifically, its larger diameter decreases from approximately 4 to 2.4 nm. Supposing the channel's total length is 4.6 nm, the apparent change in channel volume during this transition is estimated to be about 10 nm(3), i.e. about 40% of the channel's volume in the high conductance state.

Treatment of osteochondral injuries with platelet gel.

OBJECTIVES: Treatments for injured articular cartilage have not advanced to the point that efficient regeneration is possible. However, there has been an increase in the use of platelet-rich plasma for the treatment of several orthopedic disorders, including chondral injuries. Our hypothesis is that the treatment of chondral injuries with platelet gel results in higher-quality repair tissue after 180 days compared with chondral injuries not treated with gel. METHODS: A controlled experimental laboratory study was performed on 30 male rabbits to evaluate osteochondral injury repair after treatment with or without platelet gel. Osteochondral injuries were surgically induced in both knees of each rabbit at the medial femoral condyle. The left knee injury was filled with the platelet gel, and the right knee was not treated. Microscopic analysis of both knee samples was performed after 180 days using a histological grading scale. RESULTS: The only histological evaluation criterion that was not significantly different between treatments was metachromasia. The group that was treated with platelet gel exhibited superior results in all other criteria (cell morphology, surface regularity, chondral thickness and repair tissue integration) and in the total score. CONCLUSION: The repair tissue was histologically superior after 180 days in the study group treated with platelet gel compared with the group of untreated injuries.

Amiloidose pulmonar com apresentação traqueobrônquica: relato de caso clínico / Pulmonary amyloidosis with tracheobronchial presentation: clinical case report

Introdução: Amiloidose é o termo utilizado para designar doenças que fazem deposição extracelular de proteínas fibrilares patológicas em órgãos e tecidos, podendo ser sistêmica ou restrita a um único órgão. As manifestações clínicas são diversas, como cardiomiopatia, falência renal, esplenomegalia, problemas intestinais, neuropatias, problemas pulmonares, entre outros. Objetivo: relatar um caso clínico de paciente com amiloidose traqueobrônquica. Metodologia: revisão de bibliografias em comparação ao relato de caso, o qual foi descrito a partir de dados retirados do prontuário e de exames complementares da paciente. Caso clínico: paciente do sexo feminino, 70 anos, procurou assistência médica por dorsalgia, apresentando também chiado, tosse seca, dispneia paroxística noturna e ortopneia. Realizou-se investigação diagnóstica durante a internação, na qual biópsia da mucosa traqueobrônquica e coleta de lavado alveolar foram positivos para o teste Vermelho Congo, o que confirmou o diagnóstico de amiloidose. A paciente, então, foi encaminhada para terapia de ablação a laser. Conclusão: portanto, diante de um paciente com quadro clínico inespecífico e suspeita diagnóstica principal de amiloidose pulmonar, é imprescindível investigar e descartar diagnósticos diferenciais como neoplasia ou discrasia de células plasmáticas. Para isso, é necessário que haja alta precisão na análise dos exames de imagem, de modo a sugerir esse diagnóstico, o qual deve ser confirmado através da fibrobroncoscopia com biópsia de tecido brônquico, que através da coloração Vermelho do Congo, evidenciará presença de substância amorfa e birrefringente, compatível com substância amiloide [au]

Introduction: Amyloidosis is the term used to describe diseases that cause extracellular deposition of pathological fibrillar proteins in organs and tissues, which can be systemic or restricted to a single organ. The clinical manifestations are diverse, such as cardiomyopathy, renal failure, splenomegaly, intestinal problems, neuropathies, lung problems, among others. Objective: to report a clinical case of a patient with pulmonary amioloidosis. Methodology: review of bibliographies in comparison to the case report, which was described based on data taken from the patient's record and complementary exams. Clinical case: a seventy-year-old female patient sought medical assistance because of back pain, also presenting wheezing, dry cough, paroxysmal nocturnal dyspnea and orthopnea. Diagnostic investigation was carried out during hospitalization, in which biopsy of the tracheobronchial mucosa and collection of alveolar lavage were positive for the Congo Red test,wich confirmed the amyloidosis diagnosis. The patient was then referred for laser ablation therapy.Conclusion: hence, in a patient with a nonspecific clinical presentation and main diagnostic suspicion of pulmonary amyloidosis, it is essential to investigate and rule out differential diagnoses such as malignancy or plasma cell dyscrasia. Therefore, it is necessary to use high precision in the analysis of image exams in order to suggest this diagnosis, which should be confirmed through fibrobronchoscopy with bronchial tissue biopsy, that through the Congo Red dye, will show the presence of amorphous and birefringent substance, compatible with amyloid substance [au]

Effect of flavonoids on 2'-deoxyguanosine and DNA oxidation caused by singlet molecular oxygen.

Antioxidant potential is generally investigated by assaying the ability of a compound to protect biological systems from free radicals. However, non-radical reactive oxygen species can also be harmful. Singlet molecular oxygen ((1)O(2)) is generated by energy transfer to molecular oxygen. The resulting (1)O(2) is able to oxidize the nucleoside 2'-deoxyguanosine (dGuo), which leads to the formation of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) and spiroiminodihydantoin 2'-deoxyribonucleoside diastereomers (dSp) in an aqueous solution. The main objective of the present study was to verify whether the presence of flavonoids (flavone, apigenin, quercetin, morin and catechin) at different concentrations could protect dGuo from (1)O(2) damage. Of the tested flavonoids, flavone possessed antioxidant activity, as determined by a decrease in the formation of both products. Apigenin, morin, quercetin and catechin all increased the formation of 8-oxodGuo at a concentration of 100 microM. The quantification of plasmid strand breaks after treatment with formamidopyrimidine-DNA glycosylase showed that flavone protected and quercetin and catechin enhanced DNA oxidation. Our results show that compounds, such as flavonoids, may affect the product distribution of (1)O(2)-mediated oxidation of dGuo, and, in particular, high concentrations of flavonoids with hydroxyl groups in their structure lead to an increase in the formation of the mutagenic lesion 8-oxodGuo.

Treatment of osteochondral injuries with platelet gel

OBJECTIVES: Treatments for injured articular cartilage have not advanced to the point that efficient regeneration is possible. However, there has been an increase in the use of platelet-rich plasma for the treatment of several orthopedic disorders, including chondral injuries. Our hypothesis is that the treatment of chondral injuries with platelet gel results in higher-quality repair tissue after 180 days compared with chondral injuries not treated with gel. METHODS: A controlled experimental laboratory study was performed on 30 male rabbits to evaluate osteochondral injury repair after treatment with or without platelet gel. Osteochondral injuries were surgically induced in both knees of each rabbit at the medial femoral condyle. The left knee injury was filled with the platelet gel, and the right knee was not treated. Microscopic analysis of both knee samples was performed after 180 days using a histological grading scale. RESULTS: The only histological evaluation criterion that was not significantly different between treatments was metachromasia. The group that was treated with platelet gel exhibited superior results in all other criteria (cell morphology, surface regularity, chondral thickness and repair tissue integration) and in the total score. CONCLUSION: The repair tissue was histologically superior after 180 days in the study group treated with platelet gel compared with the group of untreated injuries. .

Eficácia de um agente cimentante e antisséptico no controle bacteriano nas conexões dos implantes / Efficacy of a cementing and antiseptic agent in preventing contamination and bacterial flow at the dental implant connection

Objetivo: avaliar a eficácia de um antisséptico de longa duração no controle microbiano dos espaços entre o implante e o parafuso de cobertura (PC), pela contagem das unidades formadoras de colônias (UFCs) no ato da reabertura. Material e métodos: foram selecionados 70 sítios em 17 pacientes, para instalação de implantes dentais, e divididos aleatoriamente em dois grupos. No grupo experimental (n=35), o antisséptico foi aplicado na rosca do PC, imediatamente antes de sua instalação. No grupo-controle, a instalação do PC foi feita sem o antisséptico. A reabertura foi realizada após seis meses e os PCs foram removidos e armazenados em frascos assépticos contendo solução salina. Cada amostra foi centrifugada, diluída seriadamente até 10-10, semeada e encubada em microaerofi lia para a cultura de UFCs. Após a contagem, as análises estatísticas comparativas foram feitas pelo teste de Kruskal-Wallis (p < 0,05). Resultados: o grupo-controle apresentou média de 7,18 x 107 UFC/ml, enquanto no experimental a média foi de 2,12 x 105 UFC/ml. O crescimento bacteriano foi significativamente menor no grupo experimental (p=0,0003). Conclusão: o antisséptico reduziu signifi cativamente o crescimento bacteriano entre implante e parafuso de cobertura, tendo sido eficaz no controle microbiano destes espaços.

Objective: to evaluate the effi cacy of a long-term antiseptic in bacterial control of the spaces between the implant and the cover screw (PC), by counting colony-forming units (UFC) at the time of the re-entry surgery. Material and methods: seventy sites for implant placement were selected in 17 patients referred for dental implants, and divided randomly into two groups. In the experimental group (n=35), the antiseptic was applied on the thread of the PC immediately before installation. In the control group, the PC was installed with no antiseptic. The re-entry was performed after six months, the PCs removed and stored in asseptic recipients containing saline solution. Each sample was centrifuged, diluted serially up to 10-10, seeded and incubated in microaerophilic conditions for CFU culture. After counting, statistical comparative analyzes were performed by Kruskal-Wallis test (p < 0.05). Results: the control group had a mean of 7.18 x 107 CFU/mL, while the experimental average was 2.12 x 105 CFU/mL. Bacterial growth was significantly lower in the experimental group (p=0.0003). Conclusion: the antiseptic reduced, significantly, the bacterial contamination in the spaces between the implant and the cover screw, being effective in the microbial control of those spaces.

Manifestações mucocutâneas da dengue / Mucocutaneous manifestations of dengue

Dengue é doença viral sistêmica que ocorre de forma epidêmica em áreas tropicais e subtropicais da Asia, Américas e Africa. O vírus da dengue pertence ao gênero Flavivirus e à família Flaviviridae (arbovírus do grupo B). Aedes aegypti é o principal vetor e verdadeiro reservatório. A febre na dengue clássica persiste por período de dois a cinco dias com cefaléia intensa, mialgia, artralgia e dor retro-orbital. Alterações cutâneas incluem diversos achados como erupção morbiliforme que pode ser pruriginosa e que gera descamação residual, algumas manifestações hemorrágicas discretas como epistaxe, petéquias e sangramento gengival. Extravasamento capilar de plasma é responsável pela hemoconcentração e trombocitopenia observadas e que caracterizam a dengue hemorrágica. Manifestações cutâneas da dengue hemorrágica incluem lesões hemorrágicas disseminadas como petéquias e equimoses, mas também instabilidade hemodinâmica com pulso filiforme, pressão arterial convergente, extremidades frias, confusão mental e choque.

Dengue fever is a systemic viral disease that occurs epidemically in tropical and subtropical regions of Asia, Americas and Africa. The dengue virus belongs to the genus Flavivirus of the family Flaviviridae (group B arbovirus). Aedes aegypti is the major vector and the true reservoir for the virus. Classic dengue fever lasts for two-five days, with severe headache, intense myalgia, arthralgia and retro-orbital pain. Cutaneous alterations include several findings such as a diffuse morbilliform rash that may be pruritic and heals with desquamation, and minor bleeding phenomena such as epistaxis, petechiae, and gingival bleeding. Diffuse capillary leakage of plasma is responsible for the hemoconcentration and thrombocytopenia that characterize dengue hemorrhagic fever. Cutaneous manifestations of dengue hemorrhagic fever include many disseminated hemorrhagic lesions such as petechiae and ecchymoses, but also hemodynamic instability with filiform pulse, narrowing of pulse pressure, cold extremities, mental confusion, and shock.

Parecer técnico para subsidiar decisão da justiça eleitoral nas eleições 2020 N°153/2020 / Technical opinion to support electoral justice decision in the 2020 elections N° 153/2020

Medidas de prevenção e controle da disseminação do SARS-CoV-2 (Covid-19) para as eleições de 22020.

Acompanhamento farmacoterapeutico em indivfduos hipertensos de um centro de convivência para idosos de Campo Grande/MS / Pharmacotherapeutic follow-up in hypertensive individuals at a community center for the elderly in Campo Grande/MS

O uso de medicamentos e uma questão relevante a todas as faixas etárias, as pesquisas sobre o assunto têm se dedicado, com frequência, ao paciente idoso, em decorrência das peculiaridades desse grupo etário. As doenças crônicas são frequentes na terceira idade, o que acarreta grande consumo de variados tipos de medicamentos. Dentre elas destacam-se a hipertensão arterial, pois reduz a expectativa de vida e se constitui no principal precursor das doenças cardiovasculares. A metodologia utilizada baseou-se num "follow up" (seguimento) de 27 pacientes com diagnóstico de hipertensão, cadastrados num centro de convivência para idosos em Campo Grande. 0 objetivo foi realizar o acompanhamento farmacoterapêutico destes usuários hipertensos para minimizar e/ou corrigir os principais problemas relacionados a medicamentos, por meio de visitas periódicas em domicílios. As intervenções foram feitas em sua maioria baseadas em orientações e observações sobre a adequação do medicamento ao paciente. A intervenção farmacêutica de uma forma geral se mostrou necessária e apresentou resultados positivos.

The consumption of drugs is a relevant matter in all ages. The researches about this subject have recently been directed to the elderly people because of the caractheristics of this group. T he cronic diseases are much frequent in the elderly, what involves a large consumption of drugs. Among them the hypertension has great importance because reduces life expectancy and leads to heart diseases. The methodo logy was based on follow up 27 patients with the diagnosis o f hypertens ion from aelderly centre in Campo Grande city. The aim of this study as to follow the therapeutic given to the elderly patientswith hypertension, through periodic home visits, in order to minimize and/or correcting the pr ob lem s related to its use. T he intervent ions were made based on orientations and observations about the adequacy of the patient to the used drug. The pharmacist intervention has become important during the drug therapy and has presented positive results.

Hemorragia digestiva aguda: análise clínica / Acute gastrointestinal bleeding: clinical analysis

Säo analisados 109 casos de Hemorragia Digestiva Aguda com predomínio para o sangramento alto (82,5%). A resoluçäo do processo se deu em 24 horas em 53,1% dos pacientes. A perda sangüínea foi considerada leve em 62,3%, mas anemia esteve presente em 68,8%. Ulcera péptica e cirrose hepática contribuíram como causa de base em 20,7%. Evoluçäo favorável em 92,6%