"Mãos de Conforto" (Hands of Comfort): A novel non-pharmacological intervention to ease agitation in elderly persons with dementia.

Behavioral symptoms associated with dementia, such as agitation, are frequent and associated with well-known negative consequences for patients, their carers, and their environment. Pharmacological treatments for agitation using sedatives and antipsychotics are known to have several undesirable side effects and modest efficacy. Non-pharmacological alternatives are recommended as first-line options for agitation in persons with dementia with few side effects, but there is limited evidence of efficacy. We developed a novel and simple non-pharmacological alternative for agitation in dementia residents based on a Brazilian intervention using warm water surgical gloves used in patients with COVID-19 in intensive care units during the pandemic. We coined it "Mãos de Conforto" - Hands of Comfort. We report a series of 7 cases in 3 residents with dementia who whore Hands of Comfort.

Adult Colocolic Intussusception: A Rare Case of Intestinal Obstruction.

Intussusception occurs when a part of the intestine slides into its distal adjacent portion and is a surgical emergency. Adult colocolic intussusception is rare, but it is a severe condition and is usually associated with a presence of a tumoral process. We present the case of a frail male patient admitted to our emergency department with abdominal pain, prostration, and dyspnea. The patient was diagnosed with colocolic intussusception and was submitted to a subtotal colectomy and ileostomy. Patients with colocolic intussusception usually present with chronic abdominal pain and signs of intestinal obstruction. Abdominal CT scan facilitates the diagnosis, but most cases are only diagnosed intraoperatively. Given the high probability of colon cancer, the treatment involves an oncological resection of the intestinal segment. Colocolic intussusception is a rare cause of intestinal obstruction in adults where a high suspicion index is of paramount importance, especially considering that most of the diagnoses are made at surgery.

Abdominal Cocoon Syndrome: A Rare Cause of Intestinal Obstruction.

Abdominal cocoon syndrome, also known as Sclerosing Encapsulating Peritonitis, is characterized by a fibro-collagenous membrane that involves abdominal viscera and it's a rare cause of intestinal obstruction. We present here two cases. Two male patients, 29 and 75 years old, were admitted to our emergency department with abdominal pain, vomiting, tender and painful abdomen but without changes in intestinal transit or peritoneal reaction. They were treated surgically and diagnosed with abdominal cocoon syndrome. Patients with abdominal cocoon syndrome usually present with recurrent episodes of intestinal obstruction, which result from the compression of the bowel within the constricting cocoon. Most of the time, this clinical picture resolves with conservative measures, delaying the diagnosis. The definitive treatment consists of excision of the membrane with lysis of adhesions, which is usually reserved for more severe cases of obstruction. This is a rare disease, where a high suspicion index is of paramount importance, especially considering that most of the diagnoses are made at the surgery.

Cell growth arrest by nucleotides, nucleosides and bases as a tool for improved production of recombinant proteins.

Arresting cell growth and thus decreasing cell division potentially lessens the chance for genetic drift in the cell population; this would be of utmost importance for the consistent production of biopharmaceuticals during long periods. The drawback of the addition of well-known synchronizing agents, such as chemotherapeutics, is that they cause a disproportionate accumulation of cellular constituents, leading to cell death. The use of compounds that are naturally synthesized by the cell, as is the case of nucleotides, nucleosides, and bases (Nt/Ns/B), is shown in this work to be a promising tool. The addition of purines and pyrimidines was tested using a CHO cell line producing the secreted form of the human placental alkaline phosphatase enzyme (SEAP). From the chemical alternatives tested, AMP was the most promising compound for protein production improvement; it reduced cell growth and maintained the culture with high cell viability for long periods, while increasing SEAP specific productivity 3-fold. The use of CHO and BHK mammalian cells producing Factor VII and the use of a insect cell line (Sf9) showed that the effect of AMP addition seems to be independent of the r-protein and cell line. With the addition of AMP, accumulation of cells at the S phase was accompanied by an increase of the protein specific productivity. Addition of known synchronizing drugs (aphidicolin and doxorubicin) and application of environmental cell growth arrest strategies (depletion of nutrients and byproduct accumulation) showed also to effectively arrest CHO cell growth. A careful look onto cell cycle distribution in the different scenarios created, shows whether it is important to consider r-protein expression dependency upon cell cycle in process optimization and operation strategies.