Repeat cytoreduction with Hyperthermic Intraperitoneal chemotherapy in patients with peritoneal disease: A 5-year retrospective analysis.

BACKGROUND: Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (CR-HIPEC) is a locorregional surgical therapy applied in patients with peritoneal-only metastatic disease of primary abdominal malignancies. Integrated in a multimodal treatment, CR-HIPEC is associated with increased overall survival. In cases of peritoneal-site only relapse, it may be carried out more than once. METHODS: Patients who received a CR-HIPEC between January 2016 and December 2020 at Instituto Português de Oncologia do Porto, Portugal were included in a unicentric, retrospective, observational study. Short- and long-term outcomes after surgery were analyzed. RESULTS: In this period, 259 CR-HIPEC were performed on 248 patients. Of these, 31 were CR-HIPEC repeats, with 6 being the third HIPEC in the same patient. Of the 31 cases, 15 (48.4 %) had an appendicular origin. Mean PCI in re-HIPEC group was 10.6 (SD ± 7.1). No significant differences in baseline characteristics between the first and re-HIPEC groups were found, except for mean PCI, higher in the 1st HIPEC group (p = 0.047). In re-HIPEC group, major complications rate (CT-CAE 3-4) was 12.9 % (n = 4), without postoperative mortality. The 1st and re-HIPEC group had similar morbidity rates and hospitalization time. With a median follow-up time of 44 months, relapse rate after repeat CR-HIPEC was 45.2 % (n = 14), with a mean overall survival (OS) of 68.7 months and 5-year OS of 78 %. CONCLUSIONS: Repeat CR-HIPEC is a safe approach with an acceptable complication rate for its complexity, associated with a survival benefit in selected patients. It should be presented as a valid therapeutic option in recurrent peritoneal disease.

Oncopig bladder cancer cells recapitulate human bladder cancer treatment responses in vitro.

Introduction: Bladder cancer is a common neoplasia of the urinary tract that holds the highest cost of lifelong treatment per patient, highlighting the need for a continuous search for new therapies for the disease. Current bladder cancer models are either imperfect in their ability to translate results to clinical practice (mouse models), or rare and not inducible (canine models). Swine models are an attractive alternative to model the disease due to their similarities with humans on several levels. The Oncopig Cancer Model has been shown to develop tumors that closely resemble human tumors. However, urothelial carcinoma has not yet been studied in this platform. Methods: We aimed to develop novel Oncopig bladder cancer cell line (BCCL) and investigate whether these urothelial swine cells mimic human bladder cancer cell line (5637 and T24) treatment-responses to cisplatin, doxorubicin, and gemcitabine in vitro. Results: Results demonstrated consistent treatment responses between Oncopig and human cells in most concentrations tested (p>0.05). Overall, Oncopig cells were more predictive of T24 than 5637 cell therapeutic responses. Microarray analysis also demonstrated similar alterations in expression of apoptotic (GADD45B and TP53INP1) and cytoskeleton-related genes (ZMYM6 and RND1) following gemcitabine exposure between 5637 (human) and Oncopig BCCL cells, indicating apoptosis may be triggered through similar signaling pathways. Molecular docking results indicated that swine and humans had similar Dg values between the chemotherapeutics and their target proteins. Discussion: Taken together, these results suggest the Oncopig could be an attractive animal to model urothelial carcinoma due to similarities in in vitro therapeutic responses compared to human cells.

Environmental Impacts of the Brazilian Egg Industry: Life Cycle Assessment of the Battery Cage Production System.

Brazil stands as one of the world's leading producers of animal protein, ranking sixth in global egg production. However, estimated growth in production demand, along with environmental impacts, represents a potential threat to the sustainability of the food system. Methods for assessing and quantifying the environmental impacts generated by Brazilian egg production remain scarce, lacking current reports on comparative effects or guiding standards. The objective of this study was to conduct a life cycle assessment from cradle to farm gate, adhering to ISO 14040 and 14044 standards, for the battery cage egg production systems and associated products in Brazil, with the aim of supporting and promoting sustainability improvements in the Brazilian egg industry. The entire life cycle modeling and process sustainability analysis were executed using the openLCA software, integrated with the Ecoinvent database. Emissions related to egg production yielded results of 65.06 kg SO2 eq., 27.74 kg N eq., 3086.71 kg CO2 eq., 75,152.66 CTUe, 2.75 × 10-5 CFC-11 eq., and 10,044.68 kg MJ eq. per ton of eggs produced. These findings can serve as comparative benchmarks for future studies and for analyzing data across different egg production systems in Brazil.

Unexpected pancreatic mixed neuroendocrine-nonneuroendocrine neoplasms (MiNEN)-reflection on a case report.

The authors present a case involving a 51-year-old male who was diagnosed with a 4-cm mass in the body of the pancreas, initially suspected to be a ductal adenocarcinoma due to an elevated Ca 19.9 during routine analysis. Subsequent imaging studies confirmed a resectable disease without suspicious lymph nodes or distant metastasis, leading to the proposal of surgery. The patient underwent a laparoscopic distal splenopancreatectomy, which was uneventful. The histopathological examination revealed a 3.7-cm pancreatic mixed neuroendocrine neoplasia (MiNEN) with a predominant high-grade ductal adenocarcinoma component and a concurrent high-grade neuroendocrine carcinoma, with negative margins. Two lymph node metastases were identified, each representing metastasis of one of the components. The tumor was classified as pT2N1M0. Currently, the patient is undergoing chemotherapy with FOLFIRINOX. This case prompts reflection on the optimal treatment strategy for pancreatic MiNEN and raises the question of how the preoperative diagnosis could influence the patient's outcome.

Toward Producing Biopolyethylene/Babassu Fiber Biocomposites with Improved Mechanical and Thermomechanical Properties.

The development of polymeric biocomposites containing natural fibers has grown over the years due to the properties achieved and its eco-friendly nature. Thus, biocomposites involving a polymer from a renewable source (Biopolyethylene (BioPE)) and babassu fibers (BFs), compatibilized with polyethylene grafted with maleic anhydride (MA) and acrylic acid (AA) (PE-g-MA and PE-g-AA, respectively) were obtained using melt mixing and injection molded into tensile, impact, and HDT specimens. Babassu fiber was characterized with Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TGA), and scanning electron microscopy (SEM). The biocomposites were characterized using torque rheometry, TGA, tensile strength, impact strength, thermomechanical properties, Shore D hardness, and SEM. The data indicate that the torque during the processing of compatibilized biocomposites was higher than that of BioPE/BF biocomposites, which was taken as an indication of a possible reaction between the functional groups. Compatibilization led to a substantial improvement in the elastic modulus, tensile strength, HDT, and VST and a decrease in Shore D hardness. These results were justified with SEM micrographs, which showed babassu fibers better adhered to the surface of the biopolyethylene matrix, as well as an encapsulation of these fibers. The system investigated is environmentally sustainable, and the results are promising for the technology of polymeric composites.

Mycobacterium bovis BCG expressing the proteins CP40 or CP09720 of Corynebacterium pseudotuberculosis promotes protection in mice after challenge.

In this study, we assessed the survival and immune response of mice vaccinated with recombinant Mycobacterium bovis BCG Pasteur that expressed the CP40 or CP09720 proteins after the mice were challenged with a C. pseudotuberculosis MIC-6 virulent strain. Six groups of mice (n = 10 mice per group) were immunised with a sterile 0.9% saline solution (G1), 106 CFU of M. bovis BCG Pasteur (G2), 106 CFU of M. bovis BCG/cp40 (G3), 106 CFU of M. bovis BCG/cp09720 (G4), M. bovis BCG/cp40 boosted with rCP40 (G5), and M. bovis BCG/cp09720 boosted with rCP09720 (G6). The highest survival rate of 90% was observed in the G5 group, followed by 80% in the G6 group and 70% in the G3 and G4 groups. Moreover, a significantly greater induction of IFN-γ and IL-10 was found in the G3 group and higher IL-17 levels were recorded in the G5 group compared to their levels in the control group (G1) (p < 0.05). A specific humoral immune response (total IgG) was found in the G5 and G6 groups on day 42 compared to the level of response in the G1 group. These results indicated that the vector vaccine elicited significantly greater survival of mice in all experimental groups after a strong virulent challenge and induced a strong immune response.

Health professionals' recommendations on the use of fluoride varnish for caries prevention in preschool children.

BACKGROUND: Fluoride varnish (FV) is widely recommended for caries prevention in preschool children, despite its anticaries benefits being uncertain and modest. Dentists often report using clinical practice guidelines (CPGs) as a source of scientific information. AIM: To identify and analyze recommendations for clinical practice on the use of FV for caries prevention in preschool children and to assess the methodological quality of the CPG on this topic. DESIGN: Two researchers independently used 12 search strategies and searched the first five pages of Google Search™ and three guideline databases for recommendations freely available to health professionals on the use of FV for caries prevention in preschoolers. Then, they retrieved and recorded recommendations that met the eligibility criteria and extracted the data. A third researcher resolved disagreements. Each included CPG was appraised using the AGREE II instrument. RESULTS: Twenty-nine documents were included. Recommendations varied according to age, patients' caries risk, and application frequency. Of the six CPGs, only one scored above 70% in the AGREE II overall assessment. CONCLUSION: Recommendations on the use of FV lacked scientific evidence, and CPGs were of poor quality. Application of FV is widely recommended despite recent evidence showing an uncertain, modest, and possibly not clinically relevant anticaries benefit. Dentists should be aware that it is necessary to critically appraise CPGs since they may be of poor quality.

Accidental Diagnosis of Isolated Persistent Left Superior Vena Cava After an Elective Central Venous Access Procedure for Chronic Hemodialysis: Clinical Implications and Precautions From a Case Report.

Persistent left superior vena cava (PLSVC) is the most frequent thoracic venous anatomical variant in the general population. Isolated PLSVC, without formation of the right superior vena cava, is described in 10% of cases of PLSVC only. While it can be associated with congenital heart disease, arrhythmias, and premature death, adult patients with PLSVC are mostly asymptomatic, and the diagnosis is usually accidental. We present the case of a 72-year-old male with end-stage renal disease who was started on urgent hemodialysis through a temporary non-tunneled femoral central venous catheter (CVC) in the SLED (slow low-efficiency dialysis) modality and later remained dependent on hemodialysis. At this stage, placement of a tunneled CVC in the right internal jugular vein was necessary and fluoroscopy guidance was not available. There were no complications during the procedure, but postoperative conventional chest radiography revealed an inadequate positioning of the CVC tip in the left hemithorax, crossing the midline. Subsequently, the diagnosis of PLSVC was obtained by performing a thoracic angio-CT scan, confirming CVC tip positioning inside the PLSVC, and also excluded the presence of cardiac defects or additional anatomical variations of the great vessels of the thorax. Early evaluation for the creation of autologous vascular access was started under our care, and there were no mechanical or other complications associated with hemodialysis sessions during early follow-up after discharge.

Professional burnout and patient safety culture in Primary Health Care.

OBJECTIVES: to analyze the association between the risk of occupational exhaustion (burnout) and safety culture in Primary Health Care. METHODS: ross-sectional study conducted in 18 Primary Health Care Units in the Northeast of Brazil. Three questionnaires were used: sociodemographic, Maslach Burnout Inventory, and the Medical Office Survey on Patient Safety Culture. The study was approved by the Research Ethics Committee. RESULTS: seventy-eight healthcare workers participated, of which 64.1% presented a reduced risk of burnout; and 11.5%, a high risk (p=0.000). The following were identified as weakened dimensions of safety culture: Work pressure and pace; Owner, managing partners, leadership support; Overall ratings on quality; and Overall rating on patient safety. CONCLUSIONS: an association was found between low risk of developing burnout syndrome and positive evaluation of safety culture.

Air velocity spatial variability in open Compost-Bedded Pack Barn system with positive pressure ventilation.

In Compost-Bedded Pack Barn (CBP) systems, air velocity is linked with the thermal comfort of housed dairy cattle and bedding quality and, therefore, assessing ventilation efficiency is essential. In this context, the objective of this study was to evaluate and characterize dependence and spatial distribution of air velocity at the 1.5 m height (vair,M) and at bedding level (vair,B) in an open CBP system with positive pressure ventilation. The study was conducted in 2021, in a facility located in the Zona da Mata region, Minas Gerais, Brazil. The facility area was divided into a mesh composed of 55 equidistant points, where vair,M and vair,B data were collected in the morning (09:00 a.m.) and afternoon (03:00 p.m.) periods, during three weeks in Brazilian winter. Geostatistics techniques were used to assess dependence and spatial distribution. In both periods evaluated, there were a strong occurrence of spatial dependence and non-uniform vair,M and vair,B distributions. The vair,M and vair,B values were lower than recommended (1.8 m∙s-1) in more than 65.0% of the area. Adequate ventilation levels were observed only in the first 20.0 m of the facility, from Southeast to Northwest, because of the fan lines present.

Perfil de mulheres atendidas em hospital de alta complexidade devido a agressão por queimadura pelo parceiro / Profile of women attended at a high complexity hospital due to assumption due to burning by the partner / Perfil de mujeres atendidas a un hospital de alta complejidad por asunción por quemaduras por parte de la pareja

Objetivo: Descrever o perfil dos atendimentos a mulheres que foram agredidas pelo parceiro íntimo e sofreram queimaduras em hospital de referência em trauma, urgência e emergência do Estado de Minas Gerais. Método: estudo transversal, que analisou prontuários de 19 mulheres vítimas de agressão por queimadura realizadas pelo parceiro íntimo em um hospital de referência em trauma, urgência e emergência no período de 2016 a 2019. Resultados: A maioria das vítimas era parda, casada, com filhos, trabalhava informalmente e foi agredida na residência. O atendimento incluiu prioridade muito urgente/laranja, queimaduras graves de 2º grau, internação, procedimentos cirúrgicos, complicações e acompanhamento ambulatorial pós-alta. Conclusão: Os resultados indicam atendimentos de alta complexidade, o que implica necessidade de os serviços de saúde estabelecerem mecanismos de rastreamento e investigação da violência contra a mulher, bem como preparo da equipe, prevenindo agravamentos e oferecendo suporte adequado

Objective: To describe the epidemiological profile of women who suffered assault due to burns by their intimate partner and were treated at a referral hospital for trauma emergencies in the State of Minas Gerais, Brazil. Method: This cross-sectional study analyzed the medical records of 19 women who were victims of assault due to burns by their intimate partner from 2016 to 2019in a referral hospital for trauma emergencies in Minas Gerais. Results: Most victims were Brown, married, with children, worked informally, and were assaulted at home. Care included very urgent/orange priority treatment, severe second-degree burns, hospitalization, surgical procedures, complications, and post-discharge outpatient follow-up. Conclusion: Health services must establish mechanisms to track and investigate violence against women, preventing the worsening of their condition and offering adequate support. Professionals must be prepared at all levels of care and use surveillance and promotion strategies

Describir el perfil de atención a mujeres que sufrieron agresión por quemaduras por parte de su pareja íntima, atendidas en un hospital de referencia para trauma, urgencia y emergencia en el estado de Minas Gerais (Brasil). Método: estudio transversal, que analizó las historias clínicas de 19 mujeres víctimas de agresión por quemaduras por parte de su pareja íntima atendidas en un hospital de referencia de trauma, urgencia y emergencia en Minas Gerais, en el periodo de 2016 a 2019. Resultados: La mayoría de las víctimas eran pardas, casadas, con hijos, trabajaban informalmente y fueron agredidas en su casa. La atención incluyó prioridad muy urgente/naranja, quemaduras graves de segundo grado, hospitalización, procedimientos quirúrgicos, complicaciones y seguimiento ambulatorio posterior al alta. Conclusión: Los resultados muestran una atención de alta complejidad, lo que requiere que los servicios de salud establezcan mecanismos para el seguimiento e investigación de la violencia contra la mujer, así como una mejor preparación de los profesionales para prevenir los agravamientos y ofrecer una adecuada asistencia

Life Cycle Assessment Project for the Brazilian Egg Industry.

Brazil is among the ten largest egg producers in the world. The domestic consumption of Brazilian eggs is 99.6%, the rest being exported to more than 82 countries, with an expectation of growth in the foreign market. The Brazilian egg industry has evolved considerably in recent decades, incorporating new technologies and smart practices. However, there is no assessment of how production could become more sustainable over the years. The LCA (Life Cycle Assessment) approach aims to recognize the polluting potential, identify the environmental impacts generated and reduce these impacts throughout production. On a global scale, researchers approach LCA as a constructive and quantitative technique, and there is great interest in implementing an LCA for the Brazilian egg production sector. With the aim of introducing the LCA methodology to the Brazilian egg industry, this review presents the concept and accounting structure of LCA through LCI (Life Cycle Inventory) and LCIA (Life Cycle Impact Assessment), based on the ISO 14040 and 14044:2006 standards, to quantify the environmental performance of production and identify areas for future improvement, thus promoting the environmental footprint of the Brazilian egg industry.

Bioprospection of the trichomonacidal activity of lipid extracts derived from marine macroalgae Gigartina skottsbergii.

Algal extracts are sources of bioactive substances with applications in the development of novel alternative drugs against several diseases, including trichomoniasis sexually transmitted infection caused by Trichomonas vaginalis. Factors such as clinical failures and resistant strains limit the success of the existing drugs available for treating this disease. Therefore, searching for viable alternatives to these drugs is essential for the treatment of this disease. The present study was conducted for, in vitro and in silico characterization of extracts obtained from marine macroalgae Gigartina skottsbergii at stages gametophidic, cystocarpic, and tetrasporophidic. In addition, antiparasitic activity of these extracts against the ATCC 30236 isolate of T. vaginalis, their cytotoxicity, and gene expression of trophozoites after treatment were evaluated. The minimum inhibitory concentration and 50% inhibition concentration were determined for each extract. Results: In vitro analysis of the extracts' anti-T. vaginalis activity revealed an inhibitory effect of 100%, 89.61%, and 86.95% for Gigartina skottsbergii at stages gametophidic, cystocarpic, and tetrasporophidic, respectively, at 100 µg/mL. In silico analysis revealed the interactions between constituents of the extracts and enzymes from T. vaginalis, with significant free energy values obtained for the binding. None of the extract concentrations exhibited cytotoxic effects on VERO cell line compared to control, while cytotoxicity on HMVII vaginal epithelial cells line was observed at 100 µg/mL (30% inhibition). Gene expression analysis revealed differences in the expression profile of T. vaginalis enzymes between the extract-treated and control groups. According to these results, Gigartina skottsbergii extracts exhibited satisfactory antiparasitic activity.

Komagataella pastoris KM71H Mitigates Depressive-Like Phenotype, Preserving Intestinal Barrier Integrity and Modulating the Gut Microbiota in Mice.

The role of intestinal microbiota in the genesis of mental health has received considerable attention in recent years, given that probiotics are considered promising therapeutic agents against major depressive disorder. Komagataella pastoris KM71H is a yeast with probiotic properties and antidepressant-like effects in animal models of depression. Hence, we evaluated the antidepressant-like effects of K. pastoris KM71H in a model of antibiotic-induced intestinal dysbiosis in male Swiss mice. The mice received clindamycin (200 µg, intraperitoneal) and, after 24 h, were treated with K. pastoris KM71H at a dose of 8 log CFU/animal by intragastric administration (ig) or PBS (vehicle, ig) for 14 consecutive days. Afterward, the animals were subjected to behavioral tests and biochemical analyses. Our results showed that K. pastoris KM71H administration decreased the immobility time in the tail suspension test and increased grooming activity duration in the splash test in antibiotic-treated mice, thereby characterizing its antidepressant-like effect. We observed that these effects of K. pastoris KM71H were accompanied by the modulation of the intestinal microbiota, preservation of intestinal barrier integrity, and restoration of the mRNA levels of occludin, zonula occludens-1, zonula occludens-2, and toll-like receptor-4 in the small intestine, and interleukin-1ß in the hippocampi of mice. Our findings provide solid evidence to support the development of K. pastoris KM71H as a new probiotic with antidepressant-like effects.

Intranasal administration of interleukin-4 ameliorates depression-like behavior and biochemical alterations in mouse submitted to the chronic unpredictable mild stress: modulation of neuroinflammation and oxidative stress.

Physical and psychological stress modulates the hypothalamic pituitary adrenal (HPA) axis, and the redox and inflammatory systems. Impairments in these systems have been extensively reported in major depression (MD) patients. Therefore, our study aimed to investigate the effects of the intranasal administration of interleukin-4 (IL-4) in mice with depressive-like behavior induced by chronic unpredictable mild stress (CUMS) for 28 days. On the 28th day, mice received IL-4 intranasally (1 ng/mouse) or vehicle (sterile saline), and after 30 min, they were submitted to behavioral tests or euthanasia for blood collection and removal of the adrenal glands, axillary lymph nodes, spleen, thymus, prefrontal cortices (PFC), and hippocampi (HC). A single administration of IL-4 reversed CUMS-induced depression-like behavior in the tail suspension test and splash test, without evoking locomotor changes. IL-4 administration reduced the plasma levels of corticosterone and the increased weight of suprarenal glands in stressed mice. Moreover, IL-4 restored the expression of nuclear factor erythroid 2-related factor 2 (NRF2), nuclear factor kappa B (NF-kB), interleukin 1 beta (IL-1ß), IL-4, brain derived neurotrophic factor (BDNF), and indoleamine 2,3-dioxygenase (IDO) in the PFC and HC and modulated oxidative stress markers in these brain structures in stressed mice. Our results showed for the first time the antidepressant-like effect of IL-4 through the modulation of neuroinflammation and oxidative stress. The potential effect of IL-4 administered intranasally arises as an innovative strategy for MD treatment.

Spatial Distribution of Bedding Attributes in an Open Compost-Bedded Pack Barn System with Positive Pressure Ventilation in Brazilian Winter Conditions.

The objective of this study was to characterize the dependence and spatial distribution of bedding attributes in an open compost-bedded pack barn (CBP) system with positive pressure ventilation during the winter period in Brazil. The study was conducted in July 2021, in the Zona da Mata region, Minas Gerais, Brazil. The bedding area (shavings and wood sawdust) was divided into a mesh with 44 equidistant points. At each point, the bedding temperature at the surface (tB-sur) and at a depth of 0.2 m (tB-20) and the air velocity at bedding level (vair,B) were measured, and bedding samples were collected. The bedding samples were used to determine the moisture level and pH at the surface (MB-sur e pHB-sur) and at a depth of 0.2 m (MB-20 and pHB-20). The spatial behavior of the variables was evaluated using geostatistics techniques. For all variables, the occurrence of strong spatial dependence was verified. Through the maps, it was observed that tB-sur, tB-20, MB-sur, MB-20, and vair,B showed high spatial variability, whereas pHB-sur and pHB-20 demonstrated low variation. On the surface, values of tB-sur < 20 °C and MB-sur > 60% were observed. At the subsurface, there was a predominance of tB-20 < 40 °C, MB-20 > 60%, and pH > 9, which are indications of low bedding composting activity.

Potential for Ammonia Generation and Emission in Broiler Production Facilities in Brazil.

Air quality is one of the main factors that must be guaranteed in animal production. However, the measurement of pollutants is still a problem in several countries because the available methods are costly and do not always apply to the reality of the constructive typology adopted, as in countries with a hot climate, which adopt predominantly open facilities. Thus, the objective of the present study was to develop predictive models for the potential generation and emission of ammonia in the production of broiler chickens with different types of litter, different reuse cycles and under different climatic conditions. Samples of poultry litter from thirty commercial aviaries submitted to different air temperatures were analyzed. The experiment was conducted and analyzed in a completely randomized design, following a factorial scheme. Models were developed to predict the potential for generation and emission of ammonia, which can be applied in facilities with ambient conditions of air temperature between 25 and 40 °C and with wood shaving bed with up to four reuse cycles and coffee husks bed with up to six reuse cycles. The developed and validated models showed high accuracy indicating that they can be used to estimate the potential for ammonia generation and emission.

Reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay as a rapid molecular diagnostic tool for COVID-19 in healthcare workers.

In December 2019, the Chinese Center for Disease Control (CDC of China) reported an outbreak of pneumonia in the city of Wuhan (Hubei province, China) that haunted the world, resulting in a global pandemic. This outbreak was caused by a betacoronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several of these cases have been observed in healthcare professionals working in hospitals and providing care on the pandemic's frontline. In the present study, nasopharyngeal swab samples of healthcare workers were used to assess the performance of the reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay and subsequently compared with the real-time reverse-transcription quantitative PCR (RT-qPCR) method. Thus, in this study, we validated a method for detecting SARS-CoV-2 based on RT-LAMP that can be used to diagnose these workers. The methodology used was based on analyzing the sensitivity, specificity, evaluation of the detection limit, and cross-reaction with other respiratory viruses. The agreement was estimated using a dispersion diagram designed using the Bland-Altman method. A total of 100 clinical specimens of nasopharyngeal swabs were collected from symptomatic and asymptomatic healthcare workers in Pelotas, Brazil, during the SARS-CoV-2 outbreak. RT-LAMP assay, it was possible to detect SARS-CoV-2 in 96.7% of the healthcare professionals tested using the E gene and N gene primers approximately and 100% for the gene of human ß-actin. The observed agreement was considered excellent for the primer set of the E and N genes (k = 0.957 and k = 0.896), respectively. The sensitivity of the RT-LAMP assay was positive for the primer set of the E gene, detected to approximately 2 copies per reaction. For the primer set of the N gene, the assay was possible to verify an LoD of approximately 253 copies per reaction. After executing the RT-LAMP assay, no positive reactions were observed for any of the virus respiratory tested. Therefore, we conclude that RT-LAMP is effective for rapid molecular diagnosis during the COVID-19 outbreak period in healthcare professionals.

Foot wound risk and quality of life of people with type 2 diabetes are related to self-care / O risco de feridas nos pés e a qualidade de vida de pessoas com diabetes tipo 2 estão relacionados a prática do autocuidado

INTRODUCTION: Adherence to self-care has been identified as a means of preventing diabetic foot wounds, positively influencing the clinical outcomes and quality of life of patients. The adherence to this strategy is divergent in different populations. It is essential to determine the self-care practices that are associated with diabetic foot ulcers and the quality of life in adults with diabetes. OBJECTIVE: To understand self-care practices and explore their relationship with the foot wound risk and quality of life of persons with type 2 diabetes in a city in northeastern Brazil. METHODS: A descriptive exploratory study was conducted with a sample of 300 individuals with type 2 diabetes. Data were collected using a sociodemographic questionnaire, classification of foot wound risk, the Summary of Diabetes Self-Care Activities, and SF-36. RESULTS: Adherence to self-care was low for physical exercise, self-monitoring of blood glucose, and foot care. The diet and the use of medication had better adherence by the participants. Foot wound risk was related to no adherence to diet (OR 2.2 95% CI 1.32-3.38), physical activity (OR 0.49 95% CI 0.25-0.95), and blood glucose checking (OR 5.31 95% CI 1.58-17.78). Quality of life was associated with physical activity (OR 0.35 95% CI 0.16-0.74). CONCLUSION: It can be concluded that is a relationship between self-care practices adherence, risk of foot wounds, and quality of life.

INTRODUÇÃO: A adesão ao autocuidado tem sido apontado como meio de prevenção de feridas no pé diabético, influenciando positivamente nos desfechos clínicos e na qualidade de vida dos pacientes. A adesão a esta estratégia é divergente em diferentes populações. É essencial determinar as práticas de autocuidado que estão associadas às feridas do pé diabético e à qualidade de vida em adultos com diabetes. OBJETIVO: Conhecer as prática de autocuidado e explorar sua relação com o risco de feridas nos pés e a qualidade de vida de pessoas com diabetes tipo 2 em uma cidade do nordeste do Brasil. MÉTODOS: Foi realizado um estudo exploratório descritivo com uma amostra de 300 pessoas com diabetes tipo 2. Os dados foram coletados por meio de questionário sociodemográfico, classificação de risco de feridas nos pés, resumo das atividades de autocuidado com a diabetes e sf-36. RESULTADOS: A adesão ao autocuidado foi baixa para exercícios físicos, automonitorização da glicemia e cuidados com os pés. A dieta e o uso de medicamentos apresentaram melhor adesão pelos participantes. O risco de ferimento no pé foi relacionado à não adesão a dieta (OR 2,2 IC 95% 1,32-3,38), atividade física (OR 0,49 IC 95% 0,25-0,95) e verificação da glicemia (OR 5,31 IC 95% 1,58-17,78). A qualidade de vida foi associada à atividade física (OR 0,35 IC 95% 0,16-0,74). CONCLUSÃO: Pode-se concluir que existe relação entre a adesão ao autocuidado, risco de feridas nos pés e qualidade de vida.

Causal validation of the risk for corneal injury in critically ill adults.

BACKGROUND: The validity of a nursing diagnosis depends on a continuous investigation process in different populations to provide clinical evidence. The risk for corneal injury nursing diagnosis was approved in 2013 and only reviewed in 2017, demonstrating the need to perform a clinical validation to improve it. AIM: To perform a causal validation of the risk for corneal injury nursing diagnosis in critically ill adults. STUDY DESIGN: A prospective cohort study was performed in two intensive critical care units in Northern Brazil with adults aged over 18 years without corneal injury at admission. The patients were evaluated for 10 days, using a data collection tool composed of risk factors for the risk for corneal injury nursing diagnosis. The independent variables were described through absolute and relative frequency. The accuracy measures and risk factors were identified through Cox regression, considering a 95% confidence interval. RESULTS: The nurses assessed 209 critically ill adults and identified that 76.0% of them presented the risk for corneal injury nursing diagnosis, with 16.3% developing a corneal injury, all having previously presented the risk for corneal injury nursing diagnosis. The risk factors identified were eyeball exposure (hazard ratio: 1.78; 95% CI: 1.27-2.51), Glasgow score < 6 (hazard ratio: 1.73; 95% CI: 1.15-2.60) and periorbital oedema (hazard ratio: 1.43; 95% CI: 1.03-1.99), with these factors showing high specificity, and the mechanical ventilation variable, showing high sensitivity, with ROC curve of .86. CONCLUSION: Eyeball exposure, Glasgow score < 6 and periorbital oedema are the risk factors of the risk for corneal injury nursing diagnosis, in critically ill adults. These risk factors guide nursing interventions. This causal validation can improve the risk for corneal injury nursing diagnosis levels of evidence in the NANDA International Taxonomy. RELEVANCE TO CLINICAL PRACTICE: It is necessary to guide nursing interventions for critically ill adults with lowered level of consciousness and corneal exposure for the prevention of corneal injury.