Factors associated with burnout in military police officers in a city in Paraná.

OBJECTIVE: to analyze the association between burnout and sociodemographic, work factors, lifestyle habits and health conditions of military police officers in a municipality in the state of Paraná, Brazil. METHOD: cross-sectional research with 131 military police officers. Data were analyzed using the Statistical Package for the Social Sciences software and the R program. Chi-square, Fisher's exact and Poisson Generalized Linear Model tests were used. RESULTS: most participants (65.6%) had a high level of burnout. In relation to protective factors, those who carried out leisure activities had a 33.6% chance of not developing burnout. Conjugality was also a protective factor. Not practicing physical activity and leisure activities are factors that can contribute to the occurrence of burnout. CONCLUSIONS: important factors and high rates of burnout were observed in the police officers investigated. It is necessary to implement public health policies to reduce burnout with attention focused on this professional category.

Association of PARP1 Expression Levels and Clinical Parameters in Different Leukemic Subtypes With BCR::ABL1 p190+ Translocation.

Background/Aim: Although the reciprocal translocation t(9;22)(q34;q11) is a hallmark of chronic myeloid leukemia (CML), it is also present in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Depending on the gene's breakpoint, it is possible to obtain three isoforms, among which p190 stands out for the poor prognosis it induces whenever it appears. Due to the genomic instability induced by BCR::ABL1, it is proposed to expand the applicability of poly-ADP-ribose polymerase-1 (PARP1) and its inhibitors in hematological neoplasms. Materials and Methods: We measured the expression levels of PARP1 by quantitative real-time PCR (qPCR) using TaqMan®, correlating its expression with BCR::ABL1 p190+, to evaluate its influence in the clinic of adult patients. Results: We found that PARP1 is expressed differently in ALL, AML and CML and that p190 transcripts do not follow a linear pattern in these populations. We also found that PARP1 expression is not correlated with age, white blood cell and the amount of p190 transcripts. Conclusion: Despite the lack of statistical correlation between the variables analyzed, the role of PARP1 in BCR::ABL1 leukemia cannot be ruled out, given the instability profile promoted by this translocation. Finally, further studies involving a larger sample of patients are needed, as well as investigations into other molecular pathways that may impact on the pathogenesis of different BCR::ABL1 leukemic subtypes.

Occupational nursing during disasters from the perspective of holistic theory.

Disasters are defined as unpredictable and complex situations. This theoretical-reflective study, conducted from August 2020 to December 2020, reflected on occupational nursing during disasters in light of Myra Levine's holistic theory. The first principle of her model is to conserve human energy, focusing on vital sign measurement; the second, conservation of structural integrity, focuses on multiple injuries; the third, conservation of personal integrity, focuses on relationships; while the fourth, conservation of social integrity, involves public and private dimensions beyond an individual level. Levine's conservation model is of special utility in disaster situations, since it is rooted in occupational nursing care, working toward effective adaptation of nursing processes for individuals and families, aiming to achieve professional autonomy and quality care for patients, their families, and society.

Os desastres caracterizam-se como situações imprevisíveis e complexas. Este artigo objetivou refletir sobre a ótica da enfermagem do trabalho em desastres, fundamentada na teoria holística de Myra Estrin Levine. Trata-se de um estudo teóricoreflexivo desenvolvido no período de agosto a dezembro de 2020. Na teoria holística, o primeiro princípio é a conservação da energia do ser humano, com foco na medida dos sinais vitais. Já a conservação da integridade estrutural foca nas experiências múltiplas com lesões. A conservação da integridade pessoal se refere aos relacionamentos para definirem a si mesmos. Por fim, a conservação da integridade social, por sua vez, envolve a definição do ser que vai além do indivíduo e possui dimensões pública e particular. O modelo holístico de Myra Estrin Levine contribui em especial com a temática de desastres, tendo em vista que, ancorada no cuidado de enfermagem no contexto ocupacional, baseia-se em trabalhar de forma didática a adaptação eficaz do processo de enfermagem aos indivíduos e às famílias, além de contribuir com o processo de enfermagem, visando alcançar a autonomia profissional e a boa qualidade da assistência prestada ao cliente, à família e à sociedade.

Renal ischemia/reperfusion induces prominent progressive kidney disease in diabetic mice.

Acute kidney injury (AKI) is a public health concern associated with high rates of mortality, even in milder cases. One of the reasons for the difficulty in managing AKI in patients is due to its association with pre-existing comorbidities, such as diabetes. In fact, diabetes increases the susceptibility to develop more severe AKI after renal ischemia. However, the long-term effects of this association are not known. Thus, an experimental model was designed to evaluate the chronic effects of renal ischemia/reperfusion (IR) in streptozotocin (STZ)-treated mice. We focused on the glomerular and tubulointerstitial damage, as well as kidney function and metabolic profile. It was found that pre-existing diabetes may potentiate progressive kidney disease after AKI, mainly by exacerbating proinflammatory and sustaining fibrotic responses and altering renal glucose metabolism. To our knowledge, this is the first report that highlights the long-term effects of renal IR on diabetes. The findings of this study can support the management of AKI in clinical practice.NEW & NOTEWORTHY This study demonstrated that early diabetes potentiates progressive kidney disease after ischemia/reperfusion (IR)-induced acute kidney injury, mainly by exacerbating pro-inflammatory and sustaining fibrotic responses and altering renal glucose metabolism. Thus, these findings will contribute to the therapeutic support of patients with type 1 diabetes with eventual renal IR intervention in clinical practice.

Molecular and Clinical Insights in the Increasing Detection of BCR::ABL1 p190+ in Adult Acute Myeloid Leukemia Patients.

BACKGROUND/AIM: Acute myeloid leukemia (AML) is a myeloproliferative neoplasm marked by abnormal clonal expansion of hematopoietic progenitor cells, displaying karyotypic aberrations and genetic mutations as prognostic indicators. The World Health Organization (WHO) and the European LeukemiaNet guidelines categorize BCR::ABL1 p190+ AML as high risk. This study explored the identification of the increased incidence of BCR::ABL1 p190+ in our AML population. PATIENTS AND METHODS: This study included 96 AML patients stratified according to WHO guidelines. Subsequently, patients were screened for genetic abnormalities, such as BCR::ABL1 p 190+, PML::RARA, RUNX1::RUNX1T1, and CBFB::MYH11 by quantitative reverse transcription polymerase chain reaction (RT-qPCR) analysis. RESULTS: Among 96 AML patients, 36 displayed BCR::ABL1 p190+, overcoming the expected global incidence. Age variations (19 to 78 years) showed no significant laboratory differences between BCR::ABL1 p190+ and non-BCR::ABL p190+ cases. The overall survival analysis revealed no statistically significant differences among the patients (p=0.786). CONCLUSION: The analyzed population presented a higher frequency of BCR::ABL1 p190+ detection in adult AML patients when compared to what is described in the worldwide literature. Therefore, more studies are needed to establish the reason why this incidence is higher and what the best treatment approach should be in these cases.

Reliability and Validity of the Spanish Version of the Brief-BESTest in Stroke Patients.

Background: Balance disorders and postural control treatments play an important role in fall prevention. The Brief-BESTest is a short-scale employed to evaluate balance and fall risk in different populations. Balance assessment is a fundamental element in patients with Acquired Brain Injury rehabilitation since postural alteration is one of the most frequent sequelae. The objective was to validate the Spanish version of the Brief-BESTest questionnaire in the stroke population. Methods: Subjects of both sexes aged over 18 years with a diagnosis of acute/chronic stroke were included. The BESTest, Mini-BESTest, Brief-BESTest, Berg Balance Scale, and Timed Up & Go Test were used to assess balance. The scales were implemented once. Cronbach's alpha coefficient was used to assess the internal consistency and confirmatory factorial analysis was employed to assess validity. Results: A total of 44 patients with a mean age of 65.35 years (SD = 10.665) participated. Cronbach's alpha coefficient showed a high internal consistency with a value of 0.839. In the criterion validity, there was a high positive correlation between the Brief-BESTest and BESTest (r = 0.879), Mini-BESTest (r = 0.808), and Berg Balance Scale (r = 0.711). Conclusion: The Spanish version of the Brief-BESTest scale is valid and reliable, showing adequate psychometric properties for balance assessment in patients with acute or chronic stroke.

Association of CD38+ Immunophenotyping Biomarker With a Better Prognosis in Elderly Acute Myeloid Leukemia Patients.

BACKGROUND/AIM: The relevance of cytogenetic markers as prognostic risk factors has been demonstrated in a vast number of studies, with many prognostication tools utilizing these factors to determine treatment approaches. Patients aged above 60 years represent an important subgroup of acute myeloid leukemia (AML) patients, especially because they usually exhibit a poorer cytogenetic landscape and are less suitable for intensive treatments. The importance of evaluating prognostic parameters in AML, especially in low-income countries, prompted an investigation into CD38 expression and its effects. PATIENTS AND METHODS: Medical records of AML patients aged above 60 years from three hospitals in Brazil's northwest region were analyzed. A total of 67 patients were evaluated in terms of overall survival and factors predicting worse outcomes. The risk stratification was performed based on the European LeukemiaNet 2022 guidelines. The analysis of immunophenotyping markers was conducted using multi-parametric flow cytometry. RESULTS: The overall survival of CD38-positive AML patients was higher than that of patients with CD38-negative AML, with survival rates of 15.6 months versus 4 months, respectively (p-value=0.026). The impact of CD38 positivity was relevant also in multivariable Cox proportional hazards regression, demonstrating a positive effect on overall survival, with a hazard ratio of 0.33 (95%CI=0.13-0.79; p-value=0.014). CONCLUSION: Expression of CD38 in patients with AML was associated with better overall survival and serves as a relevant predictor of improved outcome in patients aged above 60 years.

Corrigendum: Quality of life and quality of education among physiotherapy students in Europe.

[This corrects the article DOI: 10.3389/fmed.2024.1344028.].

Antifibrotic treatment adherence, efficacy and outcomes for patients with idiopathic pulmonary fibrosis in Spain: a real-world evidence study.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a rare disorder associated with increased mortality and morbidity. There are currently two drugs approved for IPF but their safety and efficacy profile in real-world settings in Spain is not well understood. METHODS: An observational, multicentre, prospective study was carried out among patients with IPF who started treatment with pirfenidone or nintedanib from 2015 to 2021. Data regarding clinical characteristics, drug adherence, safety profiles and clinical outcomes between these two drugs were collected. RESULTS: 232 patients were included in the analysis. There were no meaningful differences between both groups at baseline. Patients who started pirfenidone showed a decreased risk for treatment withdrawal compared with those starting nintedanib (HR 0.65 (95% CI 0.46 to 0.94; p=0.002)). Time to first adverse event and all-cause mortality was similar between study groups. Risk factors for withdrawal were female sex, diarrhoea and photosensitivity. CONCLUSIONS: in this real-world study, both pirfenidone and nintedanib showed similar efficacy profiles. Pirfenidone was associated with less treatment discontinuations due to side effects.

Upper Limb Electromyographic Responses to Motor Imagery and Action Observation in Acquired Brain Injury.

Acquired Brain Injuries are one of the leading causes of mortality and disability worldwide. One of the most frequent sequelae is motor impairment of the upper limbs, which affects people's functionality and quality of life. Following the discovery of mirror neurons, new techniques were developed based on the mechanisms of neuronal plasticity, such as motor imagery (MI) and action observation (AO). We propose a protocol using electromyographic recordings of forearm muscles in people who have suffered a stroke during an MI task and an AO task. Three different experimental conditions will be studied during the electromyographic recordings: control recording, recording during MI, and recording during AO. Understanding the muscle activation in each technique will allow us to develop future protocols and intervention plans, improving the quality of care for people who have suffered a stroke.

Quality of life and quality of education among physiotherapy students in Europe.

Background: The study of physiotherapy is challenging and can affect the students' well-being and quality of life. The aim of this study was to describe and compare factors that could affect well-being among students across Europe. Methods: In this descriptive cross-sectional study using an online questionnaire survey, students of bachelor's physiotherapy programs from 23 European faculties, from 8 countries, were interviewed on mental health and stress burden, sleep quality, dietary habits, and physical activity. Results: Although 75% of students rated their quality of life positively and 47% were satisfied with their mental health, 65% showed higher levels of stress and 51% described impaired sleep quality. The minimum physical activity of 150 min weekly was described by 79% of students, within which 67% engaged in strengthening twice a week. Students with a higher stress load/worse psychological health also showed worse sleep quality and lower amount of physical activity, women were significantly worse off. In terms of physical activity and sleep quality, students from Finland and Kosovo achieved the best results, while students from Italy, Greece, and Portugal achieved the worst. Students from Italy indicated the greatest dissatisfaction with the organisation of the study system and communication with teachers, while in Kosovo students rated the communication and study organisation the highest. All students had a problem with adhering to nutritional habits. Students from Italy and Spain, with the lowest body mass indexes and weight averages, were closest to the nutrition recommendations. Conclusion: We demonstrated that physiotherapy students are burdened with stress, suffer from sleep disorders, and do not follow the recommendations regarding nutrition nor physical activity. There are significant differences between universities and countries in some aspects.

Human Neutrophils Couple Nitric Oxide Production and Extracellular Trap Formation in Allergic Asthma.

Rationale: Nitric oxide (NO) is increased in the airways and serum of patients with allergic asthma, suggesting an important role in asthma. NO production has been widely attributed to the canonical inducible NO synthase. Much effort has been made to inhibit this enzyme, with two outcomes: no asthma improvement and partial NO reduction, suggesting the involvement of an inducible NO synthase-independent source. Objectives: Neutrophils produce NO under inflammatory conditions, and their role in asthma has been overlooked. The present study analyzes their possible role as sources of NO. Methods: Our hypothesis was tested in 99 allergic patients with intermittent bronchial asthma and 26 healthy donors. NO production by blood and sputum neutrophils in response to allergens, anti-IgE, and anti-IgE receptor antibodies was assessed by Griess reagent, flow cytometry, and confocal microscopy. The formation of extracellular traps (ETs) as a possible consequence of NO production was quantified by Western blot and confocal microscopy, and reactive oxygen species were assessed with luminol-enhanced chemiluminescence. Measurements and Main Results: Among blood and sputum granulocytes from patients with allergic asthma, only neutrophils produce NO by an IgE-dependent mechanism. This production is independent of NO synthase, but dependent on a reaction between L-arginine and reactive oxygen species from NOX2 (NADPH oxidase). NO and ETosis are induced in parallel, and NO amplifies ET formation, which is a key mediator in asthma. Conclusions: Our findings reveal a novel role of neutrophils as the unique allergen/IgE-dependent NO source in allergic asthma, enhancing ET formation. These results suggest that NO produced by neutrophils needs further consideration in the treatment of allergic asthma.

Podocytes from hypertensive and obese mice acquire an inflammatory, senescent, and aged phenotype.

Patients with hypertension or obesity can develop glomerular dysfunction characterized by injury and depletion of podocytes. To better understand the molecular processes involved, young mice were treated with either deoxycorticosterone acetate (DOCA) or fed a high-fat diet (HFD) to induce hypertension or obesity, respectively. The transcriptional changes associated with these phenotypes were measured by unbiased bulk mRNA sequencing of isolated podocytes from experimental models and their respective controls. Key findings were validated by immunostaining. In addition to a decrease in canonical proteins and reduced podocyte number, podocytes from both hypertensive and obese mice exhibited a sterile inflammatory phenotype characterized by increases in NLR family pyrin domain containing 3 (NLRP3) inflammasome, protein cell death-1, and Toll-like receptor pathways. Finally, although the mice were young, podocytes in both models exhibited increased expression of senescence and aging genes, including genes consistent with a senescence-associated secretory phenotype. However, there were differences between the hypertension- and obesity-associated senescence phenotypes. Both show stress-induced podocyte senescence characterized by increased p21 and p53. Moreover, in hypertensive mice, this is superimposed upon age-associated podocyte senescence characterized by increased p16 and p19. These results suggest that senescence, aging, and inflammation are critical aspects of the podocyte phenotype in experimental hypertension and obesity in mice.NEW & NOTEWORTHY Hypertension and obesity can lead to glomerular dysfunction in patients, causing podocyte injury and depletion. Here, young mice given deoxycorticosterone acetate or a high-fat diet to induce hypertension or obesity, respectively. mRNA sequencing of isolated podocytes showed transcriptional changes consistent with senescence, a senescent-associated secretory phenotype, and aging, which was confirmed by immunostaining. Ongoing studies are determining the mechanistic roles of the accelerated aging podocyte phenotype in experimental hypertension and obesity.

Validation of Endogenous Control Genes by Real-Time Quantitative Reverse Transcriptase Polymerase Chain Reaction for Acute Leukemia Gene Expression Studies.

Reference genes are used as internal reaction controls for gene expression analysis, and for this reason, they are considered reliable and must meet several important criteria. In view of the absence of studies regarding the best reference gene for the analysis of acute leukemia patients, a panel of genes commonly used as endogenous controls was selected from the literature for stability analysis: Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), Abelson murine leukemia viral oncogene human homolog 1 (ABL), Hypoxanthine phosphoribosyl-transferase 1 (HPRT1), Ribosomal protein lateral stalk subunit P0 (RPLP0), ß-actin (ACTB) and TATA box binding protein (TBP). The stability of candidate reference genes was analyzed according to three statistical methods of assessment, namely, NormFinder, GeNorm and R software (version 4.0.3). From this study's analysis, it was possible to identify that the endogenous set composed of ACTB, ABL, TBP and RPLP0 demonstrated good performances and stable expressions between the analyzed groups. In addition to that, the GAPDH and HPRT genes could not be classified as good reference genes, considering that they presented a high standard deviation and great variability between groups, indicating low stability. Given these findings, this study suggests the main endogenous gene set for use as a control/reference for the gene expression in peripheral blood and bone marrow samples from patients with acute leukemias is composed of the ACTB, ABL, TBP and RPLP0 genes. Researchers may choose two to three of these housekeeping genes to perform data normalization.

Brown spiders (Loxosceles) are taking hold in Pernambuco, Brazil: a case series, 2018-2022.

OBJECTIVE: To describe accidents involving brown spider (genus Loxosceles) bites notified by the Pernambuco Poison Information and Care Center (CIATox-PE), Brazil, from January 2018 to December 2022. METHODS: This was a case series study of brown spider bites notified by the CIATox-PE. RESULTS: The study included 22 cases with median age of 35 years, the majority being female (13); the cases occurred in rural and urban areas (12 versus 10), at night (10); Petrolina was the municipality with the highest number of notifications (6); spider bites occurred mainly in the lower (11) and upper (9) limbs, almost exclusively inside households (21); specific serum therapy was not indicated for 8 cases because the time for its effectiveness had already elapsed. CONCLUSION: Loxoscelism cases occurred more frequently in females, in both rural and urban areas and mainly at home, with delays in seeking medical care. MAIN RESULTS: The 22 cases described represent an alert for the presence of a venomous species not reported in previous studies in Pernambuco. The severity of cases may be associated with delays in seeking medical care, especially due to the population's lack of information. IMPLICATIONS FOR SERVICES: Identify the presence of brown spiders in households in the region and the potential severity of poisonings. Alert health professionals to recognize the clinical picture with a view to appropriate early treatment. PERSPECTIVES: Develop research on poisoning by venomous animals and educational actions alerting the population to prevent these accidents and updating health professionals on care.

Tumor pseudopapilar sólido de páncreas, una neoplasia inusual / Solid Pseudopapillary Tumor of the Pancreas, an Unusual Neoplasm

Presentación del caso. Se trata de una mujer de 26 años que presentó dolor en epigastrio e hipocondrio izquierdo, con aumento del perímetro abdominal y pérdida de 5 kg de peso corporal. En el examen físico se detectó una masa de gran tamaño en el epigastrio, con bordes regulares, ligeramente dolorosa al tacto y no móvil. Los estudios de imagen revelaron una neoplasia mixta en el cuerpo y cola pancreática. Intervención terapéutica. Se practicó una esplenopancreatectomía corpo-caudal, con extirpación completa del tumor. Evolución clínica. La paciente recibió cuidados especializados y vigilancia estrecha posquirúrgica en la unidad de cuidados intensivos, sin presentar complicaciones relevantes. Tras el alta hospitalaria, la paciente refirió un buen estado general en los controles de seguimiento, que incluyeron una tomografía realizada a los 12 meses, donde no se evidenciaron restos o recidivas tumorales

Case presentation. A 26-year-old woman who presented with pain in the epigastrium and left hypochondrium, with increased abdominal perimeter and loss of 5 kg of body weight. Physical examination revealed a large mass in the epigastrium, with regular borders, slightly painful to the touch and non-mobile. Imaging studies revealed a mixed neoplasm in the pancreatic body and tail. Treatment. A corpo-caudal splenopancreatectomy was performed, with complete removal of the tumor. Outcome. The patient received specialized care and close postoperative surveillance in the intensive care unit, with no relevant complications. After hospital discharge, the patient reported a good general condition in the follow-up controls, which included a computed tomography scan performed after 12 months, where no tumor remnants or recurrences were evidenced

Podocyte injury at young age causes premature senescence and worsens glomerular aging.

As life expectancy continues to rise, age-related diseases are becoming more prevalent. For example, proteinuric glomerular diseases typified by podocyte injury have worse outcomes in the elderly compared with young patients. However, the reasons are not well understood. We hypothesized that injury to nonaged podocytes induces senescence, which in turn augments their aging processes. In primary cultured human podocytes, injury induced by a cytopathic antipodocyte antibody, adriamycin, or puromycin aminonucleoside increased the senescence-related genes CDKN2A (p16INK4a/p14ARF), CDKN2D (p19INK4d), and CDKN1A (p21). Podocyte injury in human kidney organoids was accompanied by increased expression of CDKN2A, CDKN2D, and CDKN1A. In young mice, experimental focal segmental glomerulosclerosis (FSGS) induced by adriamycin and antipodocyte antibody increased the glomerular expression of p16, p21, and senescence-associated ß-galactosidase (SA-ß-gal). To assess the long-term effects of early podocyte injury-induced senescence, we temporally followed young mice with experimental FSGS through adulthood (12 m of age) and middle age (18 m of age). p16 and Sudan black staining were higher at middle age in mice with earlier FSGS compared with age-matched mice that did not get FSGS when young. This was accompanied by lower podocyte density, reduced canonical podocyte protein expression, and increased glomerular scarring. These results are consistent with injury-induced senescence in young podocytes, leading to increased senescence of podocytes by middle age accompanied by lower podocyte lifespan and health span.NEW & NOTEWORTHY Glomerular function is decreased by aging. However, little is known about the molecular mechanisms involved in age-related glomerular changes and which factors could contribute to a worse glomerular aging process. Here, we reported that podocyte injury in young mice and culture podocytes induced senescence, a marker of aging, and accelerates glomerular aging when compared with healthy aging mice.

Brown spiders (Loxosceles) are taking hold in Pernambuco, Brazil: a case series, 2018-2022 / Las arañas marrones (Loxosceles) están instalándose en Pernambuco, Brasil: serie de casos, 2018-2022 / As aranhas-marrons (Loxosceles) estão se estabelecendo em Pernambuco: série de casos, 2018-2022

ABSTRACT Objective To describe accidents involving brown spider (genus Loxosceles) bites notified by the Pernambuco Poison Information and Care Center (CIATox-PE), Brazil, from January 2018 to December 2022. Methods This was a case series study of brown spider bites notified by the CIATox-PE. Results The study included 22 cases with median age of 35 years, the majority being female (13); the cases occurred in rural and urban areas (12 versus 10), at night (10); Petrolina was the municipality with the highest number of notifications (6); spider bites occurred mainly in the lower (11) and upper (9) limbs, almost exclusively inside households (21); specific serum therapy was not indicated for 8 cases because the time for its effectiveness had already elapsed. Conclusion Loxoscelism cases occurred more frequently in females, in both rural and urban areas and mainly at home, with delays in seeking medical care.

RESUMEN Objetivo Describir accidentes causados ​​por arañas pardas (género Loxosceles) notificados por el Centro de Información de Asistencia Toxicológica de Pernambuco (CIATox-PE), Brasil, de enero de 2018 a diciembre de 2022. Métodos Reporte de 22 casos notificados de CIATox-PE. Resultados Casos con media de idade de 35 años, predominio femenino (13); los casos ocurrieron en área rural/urbana (12 versus 10), por la noche (10); Petrolina fue el municipio con más notificaciones (6); las picaduras fueron principalmente en los miembros inferiores (11) y superiores (9), casi exclusivamente en el interior de las viviendas (21); en 8 de los casos no se indicó sueroterapia específica por haber superado el tiempo de efecto. Conclusión Los casos de loxoscelismo ocurrieron con mayor frecuencia en el sexo femenino, en áreas rurales y urbanas, y principalmente en el hogar, con demoras en la búsqueda de atención médica.

RESUMO Objetivo Descrever os acidentes por picada de aranhas-marrons (gênero Loxosceles), notificados no Centro de Informação de Assistência Toxicológica de Pernambuco (CIATox-PE), Brasil, no período de 2018 a 2022. Métodos Estudo de série, sobre casos notificados no CIATox-PE. Resultados Foram incluídos 22 casos com mediana de idade de 35 anos e houve predomínio do sexo feminino (13); os casos ocorreram nas zonas rural e urbana (12 versus 10), durante a noite (10), e Petrolina foi o município com mais notificações (6); as picadas ocorreram, principalmente, nos membros inferiores (11) e superiores (9), quase exclusivamente dentro das residências (21); para 8 acidentados, não se prescreveu soroterapia específica por terem ultrapassado o tempo de efetividade. Conclusão Os casos de loxoscelismo ocorreram com maior frequência no sexo feminino, nas zonas rural e urbana indiferentemente, quase todos foram intradomiciliares e houve demora na procura por atendimento médico.

Factors associated with Burnout Syndrome in police officers: a scoping review / Factores asociados al Síndrome de Burnout en policías: revisión de alcance / Fatores associados à Síndrome de Burnout em policiais: revisão de escopo

ABSTRACT Objectives: to synthesize research on factors associated with Burnout Syndrome (BS) in police officers. Methods: a scoping review was conducted without temporal or language restrictions. Data were exported to EndNote to remove duplicates and then imported into the Rayyan app for organization, article selection, and data extraction. Results: a total of 4559 publications were identified, with 50 studies included in the review. Research conducted in Brazil and the United States predominated. Certain occupational factors were found to be more closely linked to police officers compared to other professions, including law enforcement, frequency of interaction with suspects and criminals, rank, dissatisfaction with the organization, and civilian confrontations. Conclusions: certain aspects of the police profession contribute to BS, even in countries with better working conditions in public security. It is recommended to prioritize health promotion initiatives for these professionals.

RESUMEN Objetivos: sintetizar los estudios que abordan los factores asociados al síndrome de burnout (SB) en policías. Métodos: revisión de alcance, sin restricción temporal y de idiomas con exportación a EndNote, eliminación de duplicados y exportación a la aplicación Rayyan para organización, selección de artículos y extracción de datos. Resultados: se identificaron 4559 publicaciones con inclusión de 50 estudios. Hubo predominio de investigaciones realizadas en Brasil y Estados Unidos. Algunos factores laborales estuvieron más relacionados con los policías en comparación con otras profesiones, como la aplicación de la ley, la frecuencia de interacción con sospechosos y criminales, ser cabo, insatisfacción con la corporación y enfrentamientos con civiles. Conclusiones: ciertos aspectos laborales contribuyen al SB, incluso en países con mejores condiciones laborales en Seguridad Pública. Se recomienda priorizar acciones de promoción de la salud para estos profesionales.

RESUMO Objetivos: sintetizar os estudos que abordam os fatores associados à síndrome de burnout (SB) em policiais. Métodos: revisão de escopo, sem restrição temporal e de idiomas, com exportação para o EndNote, suprimindo os duplicados, e exportados para o aplicativo Rayyan, para organização, seleção dos artigos e extração dos dados. Resultados: foram identificadas 4559 publicações, com inclusão de 50 estudos. Houve predominância de pesquisas realizadas no Brasil e nos Estados Unidos. Alguns fatores laborais foram mais relacionados aos policiais quando comparados com outras profissões, como a aplicação da lei, frequência de interação com suspeitos e criminosos, ser cabo, insatisfação com a corporação e confrontos com civis. Conclusões: certos aspectos laborais contribuem para a SB, mesmo em países com melhores condições de trabalho na Segurança Pública. Recomenda-se priorizar ações de promoção da saúde para esses profissionais.

Estereología en placentas procedentes de gestaciones gemelares / Stereology in placentas from twin pregnancies

Introducción: La disfunción placentaria origina complicaciones fetales; de manera más frecuente, la restricción del crecimiento intrauterino y la preclampsia. Objetivo: Identificar el patrón estereológico en placentas gemelares, y su relación con la corionicidad y el peso del recién nacido. Métodos: Se realizó un estudio descriptivo en una muestra de 16 gestantes gemelares, 25 placentas y 32 recién nacidos. Se estudiaron las variables peso del recién nacido, número de vellosidades, superficie vellositaria total, área vellositaria, área de nodos, densidad óptica de fibrina en la superficie vellositaria y densidad óptica de fibrina alrededor del vaso. Resultados: Existió relación directa entre el número de vellosidades y la superficie vellositaria total. En las placentas monocoriónicas hubo predominio de recién nacidos bajo peso. Se percibe una diferencia en los resultados de área, según el tipo placentario y la región topográfica. En las placentas monocoriales se observó mayor área, tanto de la vellosidad placentaria como en los nodos sincitiales, siendo el área de la vellosidad mayor en la periferia placentaria, y el área de nodos sincitiales en la región 4 cm del cordón umbilical. Conclusiones: La estereología microscópica a nivel pericordón, a 4 cm del cordón y en la periferia del disco placentario, arrojó diferencias significativas para el área de la vellosidad y la densidad óptica de fibrina en la superficie de la vellosidad. Los valores promedio para el área de nodos sincitiales y la densidad óptica de fibrina alrededor del vaso no mostraron diferencias estadísticamente significativas. Es la corionicidad un predictor del bajo peso al nacer(AU)

Introduction: Placental dysfunction causes fetal complications; more frequently, intrauterine growth restriction and preeclampsia. Objective: To identify the stereological pattern in twin placentas, and its relationship with chorionicity and weight of the newborn. Methods: A descriptive study was carried out in a sample of 16 women with twin pregnancy, 25 placentas and 32 newborns. The variables weight of the newborn, number of villi, total villous surface, villous area, node area, optical density of fibrin on the villous surface and optical density of fibrin around the vessel were studied. Results: There was a direct relationship between the number of villi and the total villous surface. In monochorionic placentas there was a predominance of low birth weight newborns. A difference is observed in the area results according to the placental type and the topographic region. In monochorionic placentas, a greater area was observed, both in the placental villus and in the syncytial nodes, with the villus area being greater in the placental periphery and the area of syncytial nodes in the region 4 cm from the umbilical cord. Conclusions: Microscopic stereology at the perichordal level, 4 cm from the cord and at the periphery of the placental disc showed significant differences for the villus area and fibrin optical density on the villus surface. The average values for the area of syncytial nodes and the optical density of fibrin around the vessel did not show statistically significant differences. Chorionicity is a predictor of low birth weight(AU)