Agriculture impairs stream ecosystem functioning in a tropical catchment.

The expansion of agriculture is particularly worrying in tropical regions of the world, where native forests are being replaced by crops at alarming rates, with severe consequences for biodiversity and ecosystems. However, there is little information about the potential effects of agriculture on the functioning of tropical streams, which is essential if we are to assess the condition and ecological integrity of these ecosystems. We conducted a litter decomposition experiment in streams within a tropical catchment, which were subjected to different degrees of agricultural influence: low (protected area, PA), medium (buffer area, BA) and high (agricultural area, AA). We quantified decomposition rates of litter enclosed within coarse-mesh and fine-mesh bags, which allowed the distinction of microbial and detritivore-mediated decomposition pathways. We used litter of three riparian species representing a gradient in litter quality (Alnus acuminata > Ficus insipida > Quercus bumelioides), and examined detritivore assemblages through the contents of litterbags and benthic samples. We found that the increasing agricultural influence promoted microbial decomposition, probably due to nutrient-mediated stimulation; and inhibited detritivore-mediated and total decomposition because of reduced detritivore numbers, most likely caused by pesticides and sedimentation. Effects were evident for Alnus and Ficus, but not for Quercus, which was barely decomposed across the gradient. Our study provides key evidence about the impact of agriculture on tropical stream ecosystem functioning, which is associated to changes in stream assemblages and may have far-reaching repercussions for global biochemical cycles.

Hemophagocytic syndrome in patients living with HIV: a retrospective study.

Various infectious diseases can hyper-stimulate the immune system, causing hemophagocytic syndrome (HPS). Little is known regarding the accuracy of diagnostic criteria and epidemiological triggering factors in the acquired immunodeficiency syndrome (AIDS) setting. We investigated the major infectious disease triggers of HPS in patients living with human immunodeficiency virus (HIV)/AIDS and determined the accuracy of bone marrow aspiration (BMA). The inclusion criteria were (i) confirmed HIV diagnosis, (ii) bone marrow aspiration, and (iii) a minimum of four HPS criteria. Patients were further classified into those with four presumed HPS criteria, or ≥ 5 confirmed criteria. The disease triggers, accuracy of bone marrow aspiration, and prognosis markers were examined. Presumed HPS was observed in 15/36 patients (41%), and confirmed HPS in 58% (n = 21). The major etiological triggers were infection with Mycobacterium (34%), Cytomegalovirus (14%), Cryptococcus neoformans (11%), and hematological or tumoral disease (11%). BMA demonstrated 93% specificity on screening diagnosis (odds ratio [OR] 12.7, 95% confidence interval [CI] 1.4-115.1, P = 0.01). Ferritin > 5000 ng/mL correlated with probability of death in univariate analysis (OR 6.00, 95% CI 1.33-27.05, P = 0.02). Ferritin performance as test of death probability presented area under the curve as 0.74 (95% CI 0.56-0.91, P = 0.016). However, neither cluster of differentiation for lymphocyte count nor HIV viral load correlated with patient deaths. Mycobacterium spp. and Cytomegalovirus were the main factors triggering HPS, followed by Cryptococcus neoformans, and hematological and tumoral diseases. High ferritin levels were associated with increased death probability. High specificity was noted with BMA.

Quality of life and characteristics of diabetic patients. / Qualidade de vida e características dos pacientes diabéticos.

This study aimed to assess the association between quality of life and clinical and sociodemographic variables in type 2 diabetes patients, after they had started treatment in Primary and Specialized Health Care. This is an analytical cross-sectional study with a sampling of diabetic patients from Primary (n = 385) and Specialized (n = 385) Health Care. The dependent variable, quality of life, was evaluated by the Diabetes Quality of Life Measure - Brazil. Clinical and sociodemographic data were collected. Bivariate analysis by chi square test tested the association between the dependent variable with the independent ones. Next, we performed an analysis of multiple logistic regression. In Specialized Health Care, individuals who practice physical activity had less chance of having worse quality of life and those with less time of diagnosis presented higher chance of worse quality of life. In Primary Health Care, those who performed diets and presented glycated hemoglobin ≤ 7% had less chance of having worse quality of life. Women presented higher chances of worse quality of life than men. We concluded that with exception to the time of diagnosis and sex, other variables that influenced quality of life of diabetics were modifiable factors (glycated hemoglobin, alimentary diet and physical activity).

Qualidade de vida e características dos pacientes diabéticos / Quality of life and characteristics of diabetic patients

Resumo Este estudo objetivou avaliar a associação entre qualidade de vida e variáveis clínicas e sociodemográficas em pacientes diabéticos tipo 2, após iniciarem tratamento na Atenção Primária e Especializada. Trata-se de um estudo transversal analítico com amostra de pacientes diabéticos provenientes da Atenção Primária (n = 385) e Especializada (n = 385). A variável dependente, qualidade de vida, foi avaliada pelo Diabetes Quality of Life Measure - Brasil. Foram coletados dados clínicos e sociodemográficos. Análise bivariada pelo teste qui-quadrado testou a associação entre a variável dependente com as independentes. Em seguida, realizou-se análise de regressão logística múltipla. Na Atenção Especializada, os indivíduos que realizaram atividade física tiveram menos chance de ter pior qualidade de vida e aqueles com menor tempo de diagnóstico apresentaram mais chance de pior qualidade de vida. Na Atenção Primária, os que realizaram dieta e que apresentaram hemoglobina glicada ≤ 7% tiveram menos chance de ter pior qualidade de vida. Já os do sexo feminino apresentaram mais chance de pior qualidade de vida do que os do masculino. Conclui-se que com exceção do tempo de diagnóstico e sexo, as demais variáveis que influenciaram na qualidade de vida dos diabéticos foram fatores modificáveis.

Abstract This study aimed to assess the association between quality of life and clinical and sociodemographic variables in type 2 diabetes patients, after they had started treatment in Primary and Specialized Health Care. This is an analytical cross-sectional study with a sampling of diabetic patients from Primary (n = 385) and Specialized (n = 385) Health Care. The dependent variable, quality of life, was evaluated by the Diabetes Quality of Life Measure - Brazil. Clinical and sociodemographic data were collected. Bivariate analysis by chi square test tested the association between the dependent variable with the independent ones. Next, we performed an analysis of multiple logistic regression. In Specialized Health Care, individuals who practice physical activity had less chance of having worse quality of life and those with less time of diagnosis presented higher chance of worse quality of life. In Primary Health Care, those who performed diets and presented glycated hemoglobin ≤ 7% had less chance of having worse quality of life. Women presented higher chances of worse quality of life than men. We concluded that with exception to the time of diagnosis and sex, other variables that influenced quality of life of diabetics were modifiable factors (glycated hemoglobin, alimentary diet and physical activity).

[Sleep quality in aged patients with peripheral vascular diseases]. / Qualidade do sono em pacientes idosos com patologias vasculares periféricas.

Peripheral vascular diseases (PVD) are prevalent among the elderly, and, due to their chronic character, result in poor quality of life and poor sleep quality. This study aimed at evaluating sleep quality of elderly people diagnosed with PVD who undergo clinical ambulatory treatment in a university hospital in Campinas, in the State of São Paulo. Subjects (n=50, aged 74 +/- 8 years old) answered the Pittsburgh Sleep Quality Index (PSQI) and provided basic demographic data and PVD history (35 subjects had arterial blockage in lower limbs). Results showed that 34 subjects presented bad sleep quality; sleep length was 5.8 (+/- 2.3) hours, and, according to 23 subjects, night sleep was frequently disturbed by pain (thrice a week or more). Eighteen subjects took analgesics; four took sleep medicines. Findings may have important implications for nurses working with PVD patients, stressing the need to take into account consequences of PVD on sleep disturbances when planning their interventions.

Qualidade do sono em pacientes idosos com patologias vasculares periféricas / Sleep quality in aged patients with peripheral vascular diseases

Patologias vasculares periféricas freqüentemente acometem idosos e, sendo crônicas, interferem na qualidade de vida desses indivíduos, inclusive no sono. Portanto, este estudo objetivou avaliar a qualidade do sono de idosos com patologias vasculares periféricas em acompanhamento ambulatorial no Hospital das Clínicas da Universidade Estadual de Campinas. Os voluntários (n=50, idade média de 74 8 anos) responderam ao Índice de Qualidade de Sono de Pittsburgh (PSQI), forneceram dados sociodemográficos e sobre a vasculopatia (35 idosos apresentavam obstrução arterial em membros inferiores). Verificou-se que 34 idosos apresentavam sono de má qualidade. A duração do sono era de 5,8 ( 2,3) horas e, segundo 23 idosos, as dores perturbavam o sono noturno freqüentemente (três vezes na semana ou mais). Somente 18 idosos usavam analgésicos e quatro, medicamentos para dormir. Os achados podem subsidiar o enfermeiro na implementação de medidas para melhorar esse quadro e promover a qualidade de vida das pessoas acometidas.

Peripheral vascular diseases (PVD) are prevalent among the elderly, and, due to their chronic character, result in poor quality of life and poor sleep quality. This study aimed at evaluating sleep quality of elderly people diagnosed with PVD who undergo clinical ambulatory treatment in a university hospital in Campinas, in the State of São Paulo. Subjects (n=50, aged 74 8 years old) answered the Pittsburgh Sleep Quality Index (PSQI) and provided basic demographic data and PVD history (35 subjects had arterial blockage in lower limbs). Results showed that 34 subjects presented bad sleep quality; sleep length was 5.8 ( 2.3) hours, and, according to 23 subjects, night sleep was frequently disturbed by pain (thrice a week or more). Eighteen subjects took analgesics; four took sleep medicines. Findings may have important implications for nurses working with PVD patients, stressing the need to take into account consequences of PVD on sleep disturbances when planning their interventions.

Las patologías vasculares periféricas frecuentemente acometen a las personas de la tercera edad y, siendo crónicas, interfieren en la calidad de vida de esos individuos, inclusive en el sueño. Por tanto, en este estudio se tuvo por objetivo evaluar la calidad del sueño de personas de la tercera edad con patologías vasculares periféricas en tratamiento ambulatorio en el Hospital de las Clínicas de la Universidad Estatal de Campinas. Los voluntarios (n=50, edad media de 74 8 años) respondieron al Índice de Calidad de Sueño de Pittsburgh (PSQI), proporcionaron sus datos sociodemográficos y sobre la vasculopatía (35 personas de la tercera edad presentaban obstrucción arterial en miembros inferiores). Se verificó que 34 personas de la tercera edad presentaban sueño de mala calidad. La duración del sueño era de 5,8 ( 2,3) horas y, según 23 de los participantes, los dolores perturbaban su sueño nocturno frecuentemente (tres veces en la semana o más). Sólo 18 de ellos usaban analgésicos y cuatro, medicamentos para dormir. Los hallazgos pueden ayudar al enfermero en la implementación de medidas para mejorar ese cuadro y promover la calidad de vida de las personas acometidas.

Análise ergonômica das posturas que envolvem a coluna vertebral no trabalho da equipe de enfermagem / An ergonomic analysis of the postures that involve the spine in nursing team work

Pesquisa descritiva de estudo de caso baseada em Fialho e Santos para desenvolver análise ergonômica numa situação de trabalho. Visa analisar as posturas que envolvem a coluna vertebral durante o desenvolvimento do trabalho da equipe de enfermagem numa Clínica médico-cirúrgica. A análise revela que os equipamentos, estrutura física do setor e a biomecânica corporal dos funcionários, colaboram na adoção de posturas inadequadas, que associadas a sua jornada de trabalho e ao tempo de serviço, podem causar deformidades na estrutura vertebral e para-vertebral. Concluiu-se que a equipe de enfermagem adota posturas de inclinação cervical, torácica, lombar e de rotação que com o passar do tempo levam a desgaste das estruturas vertebrais, ocasionando muitas vezes dor. Recomenda-se que seja promovido um programa de terapia ocupacional para diminuir o risco de deformações da coluna vertebral e obter a satisfação no trabalho que se refletirá na produtividade destes profissionais...

This is a descriptive research of a case study based on Fialho and Santos to develop an ergonomic analysis in an occupational situation. The aim of this work is to analyze postures involving the spine during the day-to-day work of the nursing team at a medical-surgical Clinic. The analysis reveals that the equipment, physical infrastructure of the department and bodily biomechanics of the staff all combine to produce inadequate postures, which when associated with their working day and length of service could cause deformities of the vertebral and Paravertebral structure. It was concluded that the nursing team adopts postures of cervical, thoracic and lumbar inclination and rotation, which over time, leads to erosion of the vertebral structures, often causing pain. It recommends the promotion of a program of occupational therapy to lower the risk of deformities of the spine and obtain satisfaction at work, which will be reflected in the productivity of these professionals...

Investigación descriptiva sobre estudio de caso, basada en los estudios de Fialho y Santos para desarrollar un análisis ergonómico en una situación de trabajo. Su objetivo es analizar las posturas que afectan la columna vertebral durante el desarrollo del trabajo de un equipo de enfermería en una Clínica médica. El análisis reveló que los equipos, la estructura física del sector y la biomecánica corporal de los empleados, son factores que colaboran para la adopción de posturas inadecuadas, que asociadas a la jornada de trabajo y al tiempo de servicio de los empleados, pueden causar deformidades en la estructura vertebral y en la paravertebral. Se concluye que el equipo de enfermería adopta posturas de inclinación cervical, torácica, lumbar y de rotación, que con el pasar del tiempo producen el desgaste de las estructuras vertebrales, ocasionando muchas veces dolor. Se recomienda que sea desarrollado un programa de terapia ocupacional para disminuir el riesgo de deformaciones de la columna vertebral, y así, obtener satisfacción en el trabajo, el cual se reflejará en la productividad de estos profesionales...