Association of a Skin Dressing Made With the Organic Part of Marine Sponges and Photobiomodulation on the Wound Healing in an Animal Model.

The present study aims to characterize and to evaluate the biological effects of a skin dressing manufactured with the organic part of the Chondrilla caribensis marine sponge (called spongin-like collagen (SC)) associated or not to photobiomodulation (PBM) on the skin wound healing of rats. Skin dressings were manufactured with SC and it was characterized using scanning electron microscopy (SEM) and a tensile assay. In order to evaluate its biological effects, an experimental model of cutaneous wounds was surgically performed. Eighteen rats were randomly distributed into three experimental groups: control group (CG): animals with skin wounds but without any treatment; marine collagen dressing group (DG): animals with skin wounds treated with marine collagen dressing; and the marine collagen dressing + PBM group (DPG): animals with skin wounds treated with marine collagen dressing and PBM. Histopathological, histomorphometric, and immunohistochemical evaluations (qualitative and semiquantitative) of COX2, TGFß, FGF, and VEGF were done. SEM demonstrates that the marine collagen dressing presented pores and interconnected fibers and adequate mechanical strength. Furthermore, in the microscopic analysis, an incomplete reepithelialization and the presence of granulation tissue with inflammatory infiltrate were observed in all experimental groups. In addition, foreign body was identified in the DG and DPG. COX2, TGFß, FGF, and VEGF immunostaining was observed predominantly in the wound area of all experimental groups, with a statistically significant difference for FGF immunostaining score of DPG in relation to CG. The marine collagen dressing presented adequate physical characteristics and its association with PBM presented favorable biological effects to the skin repair process.

Potential Effects of Essential Oil from Plinia cauliflora (Mart.) Kausel on Leishmania: In Vivo, In Vitro, and In Silico Approaches.

In the search for new chemotherapeutic alternatives for cutaneous leishmaniasis (CL), essential oils are promising due to their diverse biological potential. In this study, we aimed to investigate the chemical composition and leishmanicidal and anti-inflammatory potential of the essential oil isolated from the leaves of Plinia cauliflora (PCEO). The chemical composition of PCEO showed ß-cis-Caryophyllene (24.4%), epi-γ-Eudesmol (8%), 2-Naphthalenemethanol[decahydro-alpha] (8%), and trans-Calamenene (6.6%) as its major constituents. Our results showed that the PCEO has moderate cytotoxicity (CC50) of 137.4 and 143.7 µg/mL on mice peritoneal exudate cells (mPEC) and Vero cells, respectively. The PCEO was able to significantly decrease mPEC infection by Leishmania amazonensis and Leishmania braziliensis. The value of the inhibitory concentration (IC50) on amastigote forms was about 7.3 µg/mL (L. amazonensis) and 7.2 µg/mL (L. braziliensis). We showed that PCEO induced drastic ultrastructural changes in both species of Leishmania and had a high selectivity index (SI) > 18. The in silico ADMET analysis pointed out that PCEO can be used for the development of oral and/or topical formulation in the treatment of CL. In addition, we also demonstrated the in vivo anti-inflammatory effect, with a 95% reduction in paw edema and a decrease by at least 21.4% in migration immune cells in animals treated with 50 mg/kg of PCEO. Taken together, our results demonstrate that PCEO is a promising topical therapeutic agent against CL.

Feeding 3-nitrooxypropanol reduces methane emissions by feedlot cattle on tropical conditions.

Our objective was to evaluate the effects of feeding 3-nitrooxypropanol (3-NOP; Bovaer, DSM Nutritional Products) at two levels on methane emissions, nitrogen balance, and performance by feedlot cattle. In experiment 1, a total of 138 Nellore bulls (initial body weight, 360 ± 37.3 kg) were housed in pens (27 pens with either 4 or 5 bulls per pen) and fed a high-concentrate diet for 96 d, containing 1) no addition of 3-NOP (control), 2) inclusion of 3-NOP at 100 mg/kg dry matter (DM), and 3) inclusion of 3-NOP at 150 mg/kg DM. No adverse effects of 3-NOP were observed on DM intake (DMI), animal performance, and gain:feed (P > 0.05). In addition, there was no effect (P > 0.05) of 3-NOP on carcass characteristics (subcutaneous fat thickness and rib eye area). In experiment 2, 24 bulls (initial BW, 366 ± 39.6 kg) housed in 12 pens (2 bulls/pen) from experiment 1 were used for CH4 measurements and nitrogen balance. Irrespective of the level, 3-NOP consistently decreased (P < 0.001) animals' CH4 emissions (g/d; ~49.3%), CH4 yield (CH4/DMI; ~40.7%) and CH4 intensity (CH4/average daily gain; ~38.6%). Moreover, 3-NOP significantly reduced the gross energy intake lost as CH4 by 42.5% (P < 0.001). The N retention: N intake ratio was not affected by 3-NOP (P = 0.19). We conclude that feeding 3-NOP is an effective strategy to reduce methane emissions, with no impairment on feedlot cattle performance.

During fiber digestion in the rumen, enteric methane is produced. Methane is a potent greenhouse gas. Recently several studies have focused on developing synthetic compounds and their utilization as specific inhibitors of methanogenesis. 3-Nitrooxypropanol is a structural compound that can help to mitigate CH4 emissions. The objective of this study was to evaluate the effects of feeding 3-nitrooxypropanol (3-NOP; Bovaer, DSM Nutritional Products) at two levels on methane emissions, nitrogen balance, and performance by feedlot cattle. No effect of 3-NOP on animal performance and N balance was found. However, regarding CH4 production 3-NOP consistently decreased (P < 0.001) animals' CH4 emissions (g/d; ~49.3%), methane yield (CH4/dry matter intake; ~40.7%), and CH4 intensity (CH4/average daily gain; ~38.6%). This study provides information on the potential role of 3-NOP on reducing CH4 emissions from feedlot cattle without reducing animal performance.

Calibration Assessment of Low-Cost Carbon Dioxide Sensors Using the Extremely Randomized Trees Algorithm.

As the monitoring of carbon dioxide is an important proxy to estimate the air quality of indoor and outdoor environments, it is essential to obtain trustful data from CO2 sensors. However, the use of widely available low-cost sensors may imply lower data quality, especially regarding accuracy. This paper proposes a new approach for enhancing the accuracy of low-cost CO2 sensors using an extremely randomized trees algorithm. It also reports the results obtained from experimental data collected from sensors that were exposed to both indoor and outdoor environments. The indoor experimental set was composed of two metal oxide semiconductors (MOS) and two non-dispersive infrared (NDIR) sensors next to a reference sensor for carbon dioxide and independent sensors for air temperature and relative humidity. The outdoor experimental exposure analysis was performed using a third-party dataset which fit into our goals: the work consisted of fourteen stations using low-cost NDIR sensors geographically spread around reference stations. One calibration model was trained for each sensor unit separately, and, in the indoor experiment, it managed to reduce the mean absolute error (MAE) of NDIR sensors by up to 90%, reach very good linearity with MOS sensors in the indoor experiment (r2 value of 0.994), and reduce the MAE by up to 98% in the outdoor dataset. We have found in the outdoor dataset analysis that the exposure time of the sensor itself may be considered by the algorithm to achieve better accuracy. We also observed that even a relatively small amount of data may provide enough information to perform a useful calibration if they contain enough data variety. We conclude that the proper use of machine learning algorithms on sensor readings can be very effective to obtain higher data quality from low-cost gas sensors either indoors or outdoors, regardless of the sensor technology.

Validity of a technological rehabilitation nursing program for people undergoing knee arthroplasty / Validación del programa de enfermería tecnológica en rehabilitación de personas realizadas en artroplastia de rodilla / Validação do programa de enfermagem de reabilitação tecnológico para pessoas submetidas a artroplastia do joelho

ABSTRACT Objective: to validate a Technological Rehabilitation Nursing Program for people undergoing total knee arthroplasty. Methods: this is a qualitative study, carried out through a focus group, with 12 nurses, considered experts in the area of rehabilitation. The program was developed using digital technology, such as an application for a mobile device. Experts assessed the program structure, the content made available to people undergoing total knee arthroplasty pre-operatively and post-operatively and the follow-up and communication strategies with nurses. Results: after content validity by experts, the final version of the program integrated three thematic areas and their respective categories: Rehabilitation program (Program phases, Program operationalization, Exercise plans included in the program); Useful information (Preparation for surgery, Care to be taken during surgery recovery); and Communication channel with nurses (Talk to a rehabilitation nurse, Self-assessment of health condition and Help with decision-making). Conclusion: experts' contributions made it possible to achieve the content validity of the program and, consequently, improve patient literacy about the procedure, complication prevention and self-care; training patients to carry out exercise plans in the pre- and post-operative periods; and communication with nurses through application.

RESUMEN Objetivo: validar un Programa Tecnológico de Enfermería de Rehabilitación para personas sometidas a artroplastia total de rodilla. Métodos: estudio cualitativo, realizado a través de un focus group, con 12 enfermeros, considerados expertos en el área de rehabilitación. El programa fue desarrollado utilizando tecnología digital, como una aplicación para un dispositivo móvil. Los expertos evaluaron la estructura del programa, los contenidos puestos a disposición de las personas sometidas a artroplastia total de rodilla en el preoperatorio y postoperatorio, y las estrategias de seguimiento y comunicación con la enfermera. Resultados: luego de la validación de contenido por parte de expertos, la versión final del Programa integró tres áreas temáticas y sus respectivas categorías: Programa de rehabilitación (Fases del programa, Operacionalización del programa, Planes de ejercicio incluidos en el programa); Información útil (Preparación para la cirugía, Cuidados a tener durante la recuperación quirúrgica); y Canal de Comunicación con la Enfermera (Hablar con una enfermera de rehabilitación, Autoevaluación del estado de salud y Ayuda en la toma de decisiones). Conclusión: los aportes de los expertos permitieron lograr la validez de contenido del programa y, en consecuencia, mejorar la alfabetización de los pacientes sobre el procedimiento, la prevención de complicaciones y el autocuidado; entrenar al paciente para que lleve a cabo planes de ejercicios en los períodos pre y postoperatorios; y comunicación con la enfermera a través de la aplicación.

RESUMO Objetivo: validar um Programa de Enfermagem de Reabilitação Tecnológico para pessoas submetidas à artroplastia total do joelho. Métodos: estudo qualitativo, realizado por meio de focus group, com 12 enfermeiros, considerados peritos na área de reabilitação. O Programa foi desenvolvido com recurso de uma tecnologia digital, do tipo aplicativo para dispositivo móvel. Os peritos avaliaram a estrutura do Programa, os conteúdos disponibilizados às pessoas submetidas a artroplastia total do joelho no pré-operatório e pós-operatório e as estratégias de acompanhamento e comunicação com o enfermeiro. Resultados: após a validação de conteúdo pelos peritos, a versão final do Programa integrou três áreas temáticas e suas respectivas categorias: Programa de Reabilitação (Fases do Programa, Operacionalização do Programa, Planos de exercícios incluídos no Programa); Informação Útil (Preparação para a cirurgia, Cuidados a ter durante a recuperação cirúrgica); e Canal Comunicacional com o Enfermeiro (Fale com enfermeiro de reabilitação, Autoavaliação da condição de saúde e Ajuda na tomada de decisão). Conclusão: os contributos dos peritos permitiram alcançar a validade de conteúdo do Programa e, consequentemente, melhorar a literacia do paciente sobre o procedimento, prevenção de complicações e autocuidado; instrumentalização do paciente para a realização dos planos de exercícios nos períodos pré e pós-operatório; e a comunicação com o enfermeiro pelo aplicativo.

Delayed Diagnosis of Intestinal Tuberculosis: A Case Report.

Abdominal tuberculosis is an uncommon clinical entity, and it can involve the gastrointestinal tract but also the peritoneum, lymph nodes, and solid organs. Its prevalence is higher among individuals from endemic regions for tuberculosis. Epidemiological risk factors associated with typical symptoms and complementary exams should prompt early treatment. We describe the case of a 47-year-old man, originally from India, residing in Portugal for approximately a year. He presented to our emergency department with a three-week-long history of diarrhea, diffuse abdominal pain, more intense on the left quadrants of the abdomen, anorexia, asthenia, and loss of nearly 10% of his body weight. Abdominal and pelvic imaging showed diffuse circumferential thickening of the distal ileum and adjacent mesentery with associated lymphadenopathies. A colonoscopy confirmed the presence of an ulcerated deformative lesion of the cecum with the involvement of the terminal ileum. Initial suspicion of infectious colitis versus inflammatory bowel disease led the team to prescribe antibiotics and corticosteroid therapy, which was associated with bronchoalveolar lavage and sputum samples negative for Mycobacterium tuberculosis, delaying the diagnosis of intestinal tuberculosis. The lack of improvement after weeks of the initial medical therapy, and with histopathological examination of cervical lymphadenopathy showing the presence of granulomatous lymphadenitis with necrosis, led the medical team to start antituberculostatic therapy. The patient showed significant clinical and laboratory improvement, but after two months of adequate treatment a cavitated nodule appeared on the upper lobe of the left lung, and a Mycobacterium tuberculosis complex was identified in the bronchoalveolar lavage. Timely diagnosis and adequate treatment are essential to lower mortality rates of intestinal tuberculosis, and epidemiological risk factors have a great deal of importance on this matter and must always be taken into account.

Analysis of the Influence of Abdominal Obesity on Systemic Arterial Hypertension and on the Lipid Profile on Cardiometabolic Risk Stratification in Adult Women

Abstract Background: Obesity is a public health problem and has been associated with the development of metabolic disorders that have a strong relationship with the onset of cardiovascular diseases (CVD). Objective: The objective was to analyze the influence of abdominal obesity (AO) on systemic arterial hypertension (SAH) and on the lipid profile in cardiovascular risk stratification in adult women. Methods: Altogether, 91 women participated in the research. Lifestyle information was collected, in addition to the analysis of clinical measures of cardiovascular risk and biochemical parameters. Unpaired Student's t-test, logistic regression, and Pearson's correlation were performed for data analysis, with a value of p <0.05 considered significant. Results: The prevalence of AO was 62.6%. Logistic regression showed that AO increased the chance of developing SAH by 2.9-fold. The same behavior was observed in the TG/HDL-c lipid ratio (3.93 ± 0.3 vs. 2.16 ± 0.2), representing an 82% increase in obese women. The present study also demonstrated that the best anthropometric parameter to analyze cardiovascular risk in the studied population was the waist/height ratio (AUC = 0.707). Conclusions: It can therefore be concluded that AO plays a significant role in the development of SAH and changes in lipid values that predict increased cardiovascular risk, configuring a strong influence factor for CVD.

Perspectivas do uso de extratos de plantas amazônicas (açaí, copaíba, salva-do-marajó, pupunha e bacuri) como potenciais moduladores da fermentação ruminal: um breve panorama / Perspectives on the use of extracts from Amazonian plants and fruits (açai, copaiba, salva-do-marajo, pupunha and bacuri) as potential modulators of ruminal fermentation: a brief overview / Perspectivas del uso de extractos de plantas y frutos amazónicos (açaí, copaíba, salva-do-marajó, pupunha y bacuri) como potenciales moduladores de la fermentación ruminal: un breve panorama

Resumo Na flora amazônica, incontáveis plantas possuem compostos bioativos, que potencialmente podem ser utilizados como moduladores da fermentação ruminal. Apesar da importância, poucos estudos têm sido desenvolvidos para avaliar a utilização de plantas amazônicas como aditivos alimentares naturais na nutrição de ruminantes. Assim, objetiva-se apresentar um panorama dos dados científicos da literatura sobre os efeitos do uso dos extratos de açaí, copaíba, salva-do-marajó, pupunha e bacuri na fermentação ruminal e os seus potenciais de utilização na dieta de ruminantes. O açaí (Euterpe oleracea Mart.), possui 16,08 mg/g de matéria seca de flavonoides, compostos com potente ação antimicrobiana. Estudos com suplementação do óleo de açaí tem mostrado efeitos modulatórios na fermentação ruminal e na produção de leite de ovelhas e vacas. Adicionalmente, a oleoresina de copaíba (Copaifera spp.) e a manteiga das sementes de bacuri (Platonia insignis Mart.), possuem, respectivamente, 88% e 41% de terpenos; a composição fitoquímica do óleo de salva-do-marajó (Hyptis crenata Pohl ex Benth) ainda não está completamente caracterizada, mas esta fonte está majoritariamente composta por terpenos cânfora (33,62%), 1,8-cineol (19,76%) e α-pineno (15,24%), que apresentam atividade in vitro antimicrobiana, capaz de reduzir a produção total de gás em ambiente ruminal in vitro. A pupunha, fruto da pupunheira (Bactris gasipaes Kunth.), possui 355,95 mg/kg de carotenoides, com efeito antimicrobiano in vitro contra algumas cepas bacterianas. Os achados desta revisão demonstram as potencialidades dos extratos amazônicos na maximização da produção animal, em razão dos possíveis efeitos na modulação da fermentação ruminal, sendo encorajada a realização de estudos adicionais visando uma maior exploração deles. Embora, atualmente, não existam estudos associados aos efeitos do açaí, salva-do-marajó, pupunha e bacuri na fermentação ruminal, pressupõe-se que pela sua composição fitoquímica, poderiam ter um efeito semelhante aos ionóforos na produção de ruminantes.

Abstract In the Amazonian Forest, diverse plants have bioactive compounds, which can potentially be used as modulators of ruminal fermentation. Despite the importance, few studies have been developed to evaluate the use of extracts from Amazonian plants as natural feed additives in ruminant nutrition. Thus, the objective of this study is to present a brief overview of the scientific data in the literature regarding the effects of the use of extracts of açaí, copaíba, sage-do-marajó, peach palm, and bacuri on the ruminal fermentation and their potential for use in the diet of ruminants. Açaí (Euterpe oleracea Mart.) has 16.08 mg/g of dry matter of flavonoids, compounds with potent antimicrobial activity. Studies with açaí oil supplementation have shown modulatory effects on rumen fermentation and milk production in sheep and cows. Additionally, the copaiba oleoresin (Copaifera spp.) and the bacuri (Platonia insignis Mart.) seed butter have 88% and 41% of terpenes, respectively; the phytochemical composition of marajó sage oil (Hyptis crenata Pohl ex Benth) is not completely resolved, but this source is mostly composed of the terpenes, camphor (33.62%), 1,8-cineole (19.76%) and α-pinene (15.24%), which have in vitro antimicrobial effects against different bacterial strains. The findings of this review demonstrate the potential of Amazonian extracts in maximizing animal production, due to the possible effects on the modulation of ruminal fermentation, being encouraged to carry out additional studies aiming at a greater exploration of them. Although, there are no current studies associated with the effects of açaí, sage, peach palm, and bacuri on rumen fermentation, it is inferred that, due to their phytochemical composition, they may have a similar effect to ionophores on ruminant production.

Resumen En la selva amazónica, innumerables plantas poseen compuestos bioactivos, que potencialmente pueden ser utilizados como moduladores de la fermentación ruminal. A pesar de la importancia, han sido desarrollados pocos estudios evaluando el uso de extractos de plantas amazónicas como aditivos alimentarios naturales en la nutrición de rumiantes. Así, el objetivo de este estudio es presentar un breve panorama de los datos científicos en la literatura sobre los efectos del uso de extractos de açaí, copaíba, salvia-do-marajó, chontaduro y bacuri en la fermentación ruminal y su potencial de uso en la dieta de los rumiantes. Açaí (Euterpe oleracea Mart.) tiene 16,08 mg/g de materia seca de flavonoides, compuestos con potente acción antimicrobiana. Los estudios con suplementos de aceite de açaí han demostrado efectos moduladores sobre la fermentación ruminal y la producción de leche en ovejas y vacas. Adicionalmente, la oleorresina de copaiba (Copaifera spp.) y la mantequilla de semilla de bacuri (Platonia insignis Mart.) poseen 88% y 41% de terpenos, respectivamente; la composición fitoquímica del aceite de salvia de marajó (Hyptis crenata Pohl ex Benth) no está completamente resuelta, sin embargo esta fuente está mayoritariamente compuesta de los terpenos alcanfor (33,62%), 1,8-cineol (19,76%) y α-pineno (15,24%), los cuales poseen efecto antimicrobiano in vitro frente a diferentes cepas bacterianas. Los hallazgos de esta revisión demuestran el potencial de los extractos amazónicos en la maximización de la producción animal, debido a sus posibles efectos sobre la modulación de la fermentación ruminal, siendo incentivados a realizar estudios adicionales con el objetivo de una mayor exploración de estos. Aunque actualmente no existen estudios asociados a los efectos del açaí, la salvia, el chontaduro y el bacuri en la fermentación ruminal, se supone que, por su composición fitoquímica, podrían tener un efecto similar a los ionóforos en la producción de rumiantes.

Analysis of ocular emergencies in a reference eye center in Brazil / Análise das emergências oculares em um centro de referência oftalmológica no Brasil

ABSTRACT Purpose: To determine the incidence of ocular emergencies and patient profiles in a public health eye center in Brazil. Methods: The medical record database of the Fundação Altino Ventura, Recife, Brazil was retrospectively analyzed and included all patients assisted at the ophthalmic emergency room between January 2017 and January 2018. Medical records with incomplete data and outpatient complaints were excluded. For records with multiple visits, only the initial visit was considered. Results: In 1 year, 134,788 patients (mean age at admission: 38.7 ± 22 years; range: 0-99 years) were admitted at the emergency room of the Fundação Altino Ventura. The most frequent diagnoses were conjunctivitis (52,732 cases; 37.3%), blepharitis (7,213 cases; 5.1%), and corneal/conjunctival foreign body (6,925 cases; 4.9%). Corneal/conjunctival foreign body and ocular trauma had an eight- and two-fold higher incidence in male patients, respectively (both p<0.001). Female patients presented a two-fold higher incidence of trichiasis and blepharitis than males (p<0.001). Corneal/conjunctival foreign body and ocular trauma affected more patients in a productive age (>15 years), while corneal ulcers, blepharitis, and trichiasis affected more elderly patients. All diagnostic clusters (e.g., infectious diseases, ocular trauma, foreign bodies, retinopathies, eyelid disorders, corneal diseases, glaucomatous crisis, and neuroophthalmological diseases) were more common during the spring season (p<0.001). Conclusion: The most common ocular emergencies in the present study were infectious diseases and foreign body. However, the incidence of ophthalmological emergencies was influenced by the age and sex of patients, as well as the time of the year.

RESUMO Objetivo: Determinar a incidência de emergências oculares em um centro oftalmológico de referência no Brasil. Métodos: O banco de dados de prontuários da Fundação Altino Ventura, Recife, Brasil, foi analisado retrospectivamente e incluiu pacientes atendidos, entre janeiro de 2017 e janeiro de 2018, na sala de emergência oftalmológica. Foram excluídos os prontuários com dados incompletos e com quadros ambulatoriais. Apenas o primeiro atendimento na emergência foi considerado para análise. Resultados: Em um ano, 134.788 pacientes (idade média de 38,7 ± 22 anos [0-99 anos]) foram admitidos na emergência da Fundação Altino Ventura. Os diagnósticos mais frequentes foram conjuntivite (52.732 casos [37,3%]), blefarite (7.213 casos [5,1%]) e corpo estranho na córnea/conjuntiva (6.925 casos [4,9%]). Corpo estranho na córnea/conjuntiva e trauma ocular foram cerca de 8 vezes e 2 vezes mais incidente em indivíduos do sexo masculino, respectivamente (p<0,001 em ambos). Triquíase e blefarite afetaram ~2 vezes mais pacientes do sexo feminino, respectivamente (p<0,001 em ambos). Corpo estranho na córnea/conjuntiva e trauma ocular afetaram mais pacientes em idade produtiva (>15 anos), enquanto úlcera, blefarite e triquíase da córnea afetaram mais pacientes idosos. Todos os grupamentos de diagnóstico (doenças infecciosas, trauma ocular, corpos estranhos, retinopatias, doenças das pálpebras, doenças da córnea, crise glaucomatosa e doenças neurooftalmológicas) foram mais incidentes na primavera (valor de p<0,001). Conclusão: As emergências oftalmológicas mais comuns no presente estudo foram as doenças infecciosas e o corpo estranho. Porém, a incidência das emergências oculares são fluências pela faixa etária e gênero do paciente, além da época do ano.

+Perto® programa de enfermagem de reabilitação tecnológico / +Perto® technological rehabilitation nursing program

Com o aumento da expetativa de vida e o consequente envelhecimento das populações, a prevalência da osteoartrose, sobretudo da osteoartrose do joelho, tem vindo a expandir-se, traduzindo-se num aumento da morbilidade e incapacidade. A artroplastia total do joelho é a intervenção cirúrgica capaz de devolver funcionalidade e qualidade de vida a pessoas com estadio avançado de osteoartrose do joelho. O Enfermeiro Especialista em Enfermagem de Reabilitação, considerando a exponencial utilização das novas tecnologias por parte da população em geral, é detentor de um amplo conjunto de competências que permitem responder às necessidades específicas das pessoas com osteoartrose que são submetidas a artroplastia total do joelho, desenvolvendo e implementando programas que visem a maximização da funcionalidade e promovam a literacia em saúde. Objetivo: Construção e desenvolvimento de um programa de enfermagem de reabilitação para pessoas submetidas a artroplastia total do joelho, passível de ser acoplado numa aplicação móvel, dividido em três fases: Fase 1 ­ fase de preparação, reabilitação pré-operatória; Fase 2 ­ Fase de internamento; Fase 3 ­ fase de recuperação, reabilitação pós-operatória. Metodologia: Através da metodologia investigação-ação foi possível a criação e desenvolvimento da imagem gráfica e marca e a construção do programa de reabilitação digital, acompanhado de canal comunicacional e monitorização de pessoas submetidas a artroplastia total do joelho desde o período pré-operatório até às seis semanas do pós-operatório. Resultados: O programa de enfermagem de reabilitação tecnológico contará com um módulo de planos de exercícios diários, focado na preparação e recuperação; um módulo de informação útil, com o intuito de aumentar o conhecimento e literacia em saúde, através de recomendações, estratégias e técnicas fornecidas ao longo do programa; um módulo comunicacional com a equipa de enfermagem de reabilitação e algoritmos automáticos de apoio à tomada de decisão com feedback à medida que o programa é utilizado através de resposta a questionários e formulários. A identificação precoce de sinais e sintomas permitirá a atempada deteção e monitorização de complicações pós-operatórias capazes de diminuir a taxa de infeções e reinternamentos. Conclusão: Esta nova forma de olhar sobre o mundo digital em simbiose com a saúde que o programa de enfermagem de reabilitação tecnológico vem permitir, cria valor, reduz as barreiras geográficas e aproxima a saúde das populações preparando-as para uma proveitosa transição no processo saúde/doença, tornando as pessoas doentes na peça central de uma linha orientadora que pretende projetar os cuidados de saúde para o futuro mais eficiente, humano e sustentável.

With the increase in life expectancy and the consequent aging of populations, the prevalence of osteoarthritis, especially knee osteoarthritis, has been expanding, increasing morbidity and disabilities. Total knee arthroplasty is a surgical intervention capable of restoring functionality and quality of life to people with advanced stages of knee osteoarthrosis. The Nurse Specialist in Rehabilitation Nursing, considering the exponential use of new technologies by the general population, has a wide range of skills that allow responding to the specific needs of people with osteoarthrosis who undergo total knee arthroplasty, developing and implementing programs aimed at maximizing functionality and promoting health literacy. Objective: Construction and development of a rehabilitation nursing program for people undergoing total knee arthroplasty, which can be attached to a mobile application, divided into three phases: Phase 1 ­ preparation phase, preoperative rehabilitation; Phase 2 ­ Hospitalization phase; Phase 3 ­ recovery phase, postoperative rehabilitation. Methodology: Through the action-research methodology, it was possible to create and develop the graphic image and brand and the construction of the digital rehabilitation program, accompanied by a communication channel and monitoring of people undergoing total knee arthroplasty from the preoperative period to the six weeks of postoperative period. Results: The technological rehabilitation nursing program will have a module of daily exercise plans, focused on preparation and recovery; a useful information module, to increase health knowledge and literacy, through recommendations, strategies and techniques provided throughout the program; a communication module with the rehabilitation nursing team and automatic algorithms to support decision-making with feedback as the program is used by answering questionnaires and forms. Early identification of signs and symptoms will allow timely detection and monitoring of postoperative complications capable of reducing the rate of infections and readmissions. Conclusion: This new way of looking at the digital world in symbiosis with health that the technological rehabilitation nursing program allows, creates value, reduces geographical barriers and brings health closer to populations, preparing them for a useful transition in the health process /disease, making sick people the centerpiece of a guideline that aims to design healthcare for a more efficient, humane and sustainable future.

Fish collagen for skin wound healing: a systematic review in experimental animal studies.

Collagen extracted from fishes has been appearing as an alternative for commercial porcine and bovine collagen and it has been considered interesting especially for membrane manufacturing in tissue engineering. Despite the positive in vitro effects of fish collagen membranes, there is still no understanding of all the benefits that this natural biomaterial plays in the wound healing process, due to the lack of compilation of the results obtained in animal studies. In this sense, the purpose of this study was to perform a systematic review of the literature to examine the effects of fish collagen membranes for skin wound healing in experimental models of skin wound. The search was carried out according to the orientations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the descriptors of the Medical Subject Headings (MeSH) were defined: "fish," collagen," "skin," and "in vivo". A total of 10 articles were retrieved from the databases PubMed and Scopus. After the elegibility analyses, this review covers the different origins of fish collagen reported in the different papers from the beginning of 2015 through the middle of 2021. The results were based mainly on histological analysis and macroscopic evaluation, and fish skin collagen was responsible for improving the wound healing rate and the process of reepithelization and collagen deposition. In conclusion, fish skin collagen has shown positive results in in vivo studies and may be a potential biomaterial in tissue engineering.

Arrhythmogenic Cardiomyopathy as a Late Complication of COVID-19-Induced Myocarditis.

COVID-19 has become a global health problem. So far, more than 281 million COVID-19 cases have been confirmed. The vast majority of patients diagnosed with COVID-19 infection present only with respiratory signs and symptoms. A small amount of patients, however, show signs and symptoms of cardiovascular involvement like a myocardial injury. Myocarditis is one of the possible complications, and cases of clinically suspected myocarditis have been reported in the setting of COVID-19. Herein, we present a case of inflammatory cardiomyopathy, a different type of arrhythmogenic cardiomyopathy, in a 32-year-old man, 40 days after being diagnosed with COVID-19.

Effect of an Intraorifice Barrier on Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies.

The main cause of unsuccess in endodontically treated teeth (ETT) is due to bacterial recontamination. The placement of an intraorifice barrier (IOB) has been proposed for preventing this event in cases that the restoration is in an inadequate condition, enhancing the possibilities for predictable long-term success in endodontic therapy. Objectives. To evaluate through a systematic review and meta-analysis if it would be necessary to place an IOB in ETT. Materials and Methods. The present review is in accordance with the PRISMA 2020 Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in four databases up to July 10th, 2021: MEDLINE, Scopus, Embase, and Web of Science. Eligible studies were the ones which evaluated the use of an IOB in ETT in reducing microleakage with any material of choice and with any methods employed. Only in vitro studies published in English were included. Results. A total of thirty in vitro studies were included in the qualitative synthesis, and seven of those were included in the quantitative analyses evaluating the following materials: bioceramic cement, glass-ionomer cement (GIC), and resin-based composite (RBC). Most of the included studies placed an IOB at a 3 mm depth. Reduction in microleakage was observed when an IOB was placed, regardless of the material employed (p ≤ 0.01). Among the materials, GIC and RBC performed similarly (p > 0.05), with the bioceramic subgroup being statistically superior to the GIC subgroup (p ≤ 0.05). Conclusions. Although well-designed randomized clinical trials are required, the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics as IOB seems to be the best available material for this purpose.

A Conceptual Model and Taxonomy for Collaborative Augmented Reality.

To support the nuances of collaborative work, many researchers have been exploring the field of Augmented Reality (AR), aiming to assist in co-located or remote scenarios. Solutions using AR allow taking advantage from seamless integration of virtual objects and real-world objects, thus providing collaborators with a shared understanding or common ground environment. However, most of the research efforts, so far, have been devoted to experiment with technology and mature methods to support its design and development. Therefore, it is now time to understand where the field stands and how well can it address collaborative work with AR, to better characterize and evaluate the collaboration process. In this article, we perform an analysis of the different dimensions that should be taken into account when analysing the contributions of AR to the collaborative work effort. Then, we bring these dimensions forward into a conceptual framework and propose an extended human-centered taxonomy for the categorization of the main features of Collaborative AR. Our goal is to foster harmonization of perspectives for the field, which may help create a common ground for systematization and discussion. We hope to influence and improve how research in this field is reported by providing a structured list of the defining characteristics. Finally, some examples of the use of the taxonomy are presented to show how it can serve to gather information for characterizing AR-supported collaborative work, and illustrate its potential as the grounds to elicit further studies.

Burnout e metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de universidade em tríplice fronteira / Burnout and active teaching-learning methodology among medical students at a university in a triple border region

Resumo: Introdução: A metodologia de ensino-aprendizagem constitui importante fator na formação do estudante de Medicina e pode estar associada também à exposição de fatores estressantes crônicos que culminam em sofrimento mental como é observado na síndrome de burnout (SB). Objetivo: Este estudo teve como objetivos determinar a prevalência da SB e analisar suas dimensões e a relação com a metodologia ativa de ensino-aprendizagem entre estudantes de Medicina de uma universidade de tríplice fronteira. Método: Trata-se de estudo transversal realizado com 279 acadêmicos do curso de Medicina que responderam a questionários sociodemográfico, de hábitos de vida e de aspectos do processo ensino-aprendizagem, e ao Inventário de Burnout de Maslach (IBM). Verificou-se associação entre a SB e as variáveis sociodemográficas, os hábitos de vida e o processo ensino-aprendizagem, por meio do teste de qui-quadrado de Pearson, do teste exato de Fisher e do teste t de Student. Realizaram-se análise descritiva dos dados, análise bivariada e regressão logística multivariada. Resultado: A prevalência de burnout foi de 4,7%, com 26,2% de alta exaustão emocional, 37,6% de alta despersonalização e 20,4% de baixa realização profissional. Os estudantes de Medicina avaliados neste estudo possuem níveis baixos ou moderados de SB. A insatisfação com o aprendizado da metodologia ativa, a falta de compreensão do fundamento da metodologia ativa e a percepção de que a minoria/nenhum docente aplica a metodologia ativa adequadamente foram preditores importantes associados ao burnout. Conclusão: Esta investigação pode servir para que escolas médicas possam desenvolver estratégias institucionais para enfrentamento dessa realidade no sentido de reduzir o risco do desenvolvimento de SB entre os estudantes de Medicina.

Abstract: Introduction: The teaching-learning methodology is an important factor in the training of medical students and may also be associated with the exposure to chronic stressors that culminate in mental suffering, as observed in the Burnout Syndrome (BS). Objective: To determine the prevalence of Burnout Syndrome and analyze its dimensions and the relationship with the active teaching-learning methodology in medical students at university located in a triple-border region. Method: Cross-sectional study with 279 medical students who answered questionnaires on sociodemographic data, life habits, aspects of the teaching-learning process and the Maslach Burnout Inventory (IBM). There was an association between the BS and sociodemographic variables, life habits and the teaching-learning process, using Pearson's Chi-Square tests, Fisher's exact test and Student's T test. Descriptive data analysis, bivariate analysis and multivariate logistic regression were performed. Result: The prevalence of Burnout was 4.7%, with 26.2% of high Emotional Exhaustion, 37.6% of high Depersonalization and 20.4% of low Professional Achievement. The medical students evaluated in this study have low or moderate levels of BS. Dissatisfaction with the active methodology learning, the lack of understanding of the foundation of the active methodology and the perception that the minority/none of the teachers apply the active methodology adequately were important predictors associated with Burnout. Conclusion: This investigation can help medical schools to develop institutional strategies to face this reality aiming to reduce the risk of the development of BS among medical students.

Comparison of Mechanical Resistance to Maximal Torsion Stress in Original and Nonoriginal or Compatible Prosthetic Implant Screws: An In Vitro Study.

Micromovements of the implant-abutment connection influence peri-implant bone preservation. The maximal torque after a cycle of implant prosthetic screw tightening using original components of different manufacturers and replicas produced by other companies is evaluated and quantified in this study. A total of 30 Mis Seven® standard platform implants and 30 interfaces were used, and 30 standard platform screws were tested, 10 Mis®, 10 Iconekt®, and 10 Exaktus®. The screws were tightened with an MIS® torquemeter until their respective fracture, and the fracture point was measured through the equipment's load cell, CS-Dental Testing Machine®. The screws were analyzed under an Olympus® SZ61 microscope. The fracture points were recorded and compared among all samples. To compare the mean values of the fracture torques, t-tests were performed using the reference values associated with each brand and the sample results. The variable "Place of Fracture" between the original Mis® brand and the Exaktus® replica compared to the Iconekt® replica presented a statistically significant difference (p < 0.001). When analyzing the variable "Fracture Torque," although it was verified that the replica screws (Iconekt® and Exaktus®) had a lower maximum torque, 65.11 Nm and 62.89 Nm, respectively, compared to the original Mis® brand (70 Nm and 69 Nm), there were no statistically significant differences p > 0.05. Nonoriginal screws did not present different fracture resistances compared to the original Mis® brand screws. The fracture site of Iconekt® screws showed a different pattern compared to the other brands.

Efeito de um programa de acompanhamento farmacoterapêutico em pacientes com hipertensão arterial sistêmica / Effect of a pharmacotherapeutic follow-up program in patients with systemic arterial hypertension

A Hipertensão Arterial Sistêmica (HAS) é uma condição clínica multifatorial, com tratamento não-farmacológico e/ou farmacológico, que necessita de acompanhamento farmacoterapêutico para gestão da condição de saúde. O objetivo foi avaliar o impacto de um programa de acompanhamento farmacoterapêutico em pacientes com HAS, através do estudo quase-experimental, longitudinal e prospectivo. Foram avaliados 28 pacientes, 50% estavam com pressão arterial descompensada, os PRM (Problemas Relacionados à Medicamentos) identificados foram interações medicamentosas (57,1%), duplicidade farmacoterapêutica (28,8%), medicamentos potencialmente inapropriados para idosos (38,5 %) e não adesão ao tratamento (89,3%). Dos RNM (Resultado Negativos associados à Medicação) 56,2% relacionavam-se à segurança e 37,5% à efetividade. Após o acompanhamento, 56,3% dos RNM foram resolvidos, 57,1% dos pacientes aderiram ao tratamento e houve redução da Pressão Arterial Sistólica (p=0,010) e Pressão Arterial Diastólica (p=0,020). O programa mostrou-se favorável na redução da pressão arterial sistêmica e resolução dos PRM e RNM.

Systemic Arterial Hypertension (SAH) is a multifactorial clinical condition with non-pharmacological and/or pharmacological treatment that requires pharmacotherapeutic monitoring in order to manage the health condition. The objective was to evaluate the impact of a pharmacotherapeutic follow-up program of patients with SAH through a quasi-experimental, longitudinal, and prospective study. Twenty-eight patients were evaluated, 50% of which had decompensated blood pressure; the DRPs identified were drug interactions (57.1%), pharmacotherapeutic duplication (28.8%), potentially inappropriate medication use in older adults (38.5%), and non-adherence to treatment (89.3%). Of the NOM identified (Negative Outcomes associated with Medication), 56.2% were related to safety, and 37.5% to effectiveness. After the follow-up, 56.3% of the NOM were resolved, 57.1% of patients adhered to treatment, and there was a reduction in the Systolic Blood Pressure (p = 0.010) and Diastolic Blood Pressure (p = 0.020). The program proved to be efficient in reducing systemic blood pressure and resolving DRPs and NOM.

Effects of Replacing Cottonseed Meal with Corn Dried Distillers' Grain on Ruminal Parameters, Performance, and Enteric Methane Emissions in Young Nellore Bulls Reared in Tropical Pastures.

Two experiments were conducted to evaluate the effect of replacing cottonseed meal with DDG on ruminal parameters, methane (CH4) emissions (Experiment 1), and animal performance (Experiment 2) of young Nellore bulls grazing Marandu grass during the rainy season. Four supplementation strategies were used in both experiments: (1) Mineral supplementation (MS); (2) conventional multiple supplement (energy/protein) with cottonseed meal and citrus pulp (CMS); (3) CMS with 50% cottonseed meal replaced by DDG (50DDG); and (4) CMS with 100% cottonseed meal replaced by DDG (100DDG). The 50DDG condition resulted in greater intake of dry matter (p = 0.033), organic matter (OM) (p = 0.050), forage (p = 0.035), and digestible OM (p = 0.031) than 100DDG. The supplemented animals presented greater final body weight (BW) and average daily gain than the animals consuming MS (p = 0.011), and lower pH, acetate, and acetate:propionate (p < 0.05). However, the treatments had no influence on stocking rate, gain per area, and enteric CH4 emissions (p > 0.05). Replacing cottonseed meal with DDG does not result in great variations in ruminal parameters, animal performance, and enteric CH4 emissions of grazing Nellore cattle during the rearing phase in the wet season. Both protein sources in 0.3% BW supplementation can be used to intensify beef cattle production in pastures.

Comparison of Different Methods for Spongin-like Collagen Extraction from Marine Sponges (Chondrilla caribensis and Aplysina fulva): Physicochemical Properties and In Vitro Biological Analysis.

This study aimed to compare different protocols (Protocol 1: P1; Protocol 2: P2; Protocol 3: P3; Protocol 4: P4) for the extraction of spongin-like collagen (SC) from marine sponges. The SEM micrographs demonstrated a fibrillar structure for the extracts from Chondrilla caribensis and the nodular/particulate aggregates for Aplysina fulva. FTIR showed for all samples peaks similar to collagen for both species. For C. caribensis, the extracts obtained using P2, P3, and P4 protocols presented higher values of extraction yield, TPQ, and GAGs. P2 and P4 showed higher values of SC concentration and for antioxidant analysis. For A. fulva, P2, P3, and P4 provided a higher extraction yield besides an increase in the antioxidant assay. For both species, no difference was observed for Col quantification and TPQ analysis; also, higher values of GAGs were found using P2 and P4. Fibroblast proliferation observed for C. caribensis was lower for P1 on day 1 and for P2 and P3 on day 3 (for 50%) compared to the control group. There was a significant reduction in fibroblast cell proliferation for all A. fulva extracts evaluated. It can be concluded that protocols P2 and P4 were more efficient for extracting SC from C. caribensis.