Suture versus tacks in minimally invasive transabdominal preperitoneal inguinal repair: a meta-analysis of randomized controlled trials.

INTRODUCTION: There is uncertainty regarding the method of mesh fixation and peritoneal closure during transabdominal preperitoneal (TAPP) repair for inguinal hernias, with no definitive guidelines to guide surgeon choice. METHODS: MEDLINE, Cochrane, Central Register of Clinical Trials, and Web of Science were searched for RCTs published until November 2023. Risk ratios (RRs) and mean differences (MD) with 95% confidence intervals (CIs) were pooled with a random-effects model. Statistical significance was defined as p < 0.05. Heterogeneity was assessed using the Cochran Q test and I2 statistics, with p values inferior to 0.10 and I2 > 25% considered significant. Statistical analyses were conducted using Review Manager version 5.4 and RStudio version 4.1.2 (R Foundation for Statistical Computing). RESULTS: Eight randomized controlled trials (RCTs) were included, comprising 624 patients, of whom 309 (49.5%) patients were submitted to TAPP with the use of tacks, and 315 (50.5%) received suture fixation. The use of tacker fixation was associated with a significant increase in postoperative pain at 24 h (MD 0.79 [VAS score]; 95% CI 0.38 to 1.19; p < 0.0002; I2 = 87%) and one week (MD 0.42 [VAS score]; 95% CI 0.05 to 0.79; p < 0.03, I2 = 84%). The use of tacks was associated with shorter operative time (MD-25.80 [min]; 95% - 34.31- - 17.28; P < 0.00001; I2 = 94%). No significant differences were found in overall complications, chronic pain, seromas, hematomas, and urinary retention rates. CONCLUSION: In patients who underwent TAPP hernia repair, tacks are associated with decreased operative time but increased postoperative pain at 24 h and one week.

Do Narcisismo das Pequenas Diferenças ao Gozo Narcísico / From the Narcissism of Small Differences to Narcissistic Jouissance / Del Narcisismo de las Pequeñas Diferencias al Goce Narcisista

A proposta desse ensaio é retomar a incursão de Freud, a partir da Primeira Guerra Mundial, na fonte do sofrimento que vem das relações entre os humanos, indicando a novidade que significou o conceito de narcisismo das pequenas diferenças na apreensão dos movimentos coletivos que declaram uma inócua expressão de hostilidade ao outro, ou os que promulgam ações destrutivas e mortíferas contra o outro eleito como seu inimigo absoluto. Com o advento da pulsão de morte, Freud redimensiona o conceito de narcisismo das pequenas diferenças e introduz a ideia de que a satisfação das pulsões que atingem a mais cega fúria de destruição, está conectada a um gozo [Genuß] narcísico. Esse gozo, na leitura de Lacan, é um mal porque comporta um mal à alteridade. É com esse legado que nos propomos pensar a extensão da psicanálise ao discurso decolonial e outros discursos contra hegemônicos, através do diálogo interdisciplinar, na leitura das linguagens de ódio que enfrentamos em nossa época.

The purpose of this essay is to resume Freud's incursion, from the First World War, on the source of the suffering that comes from the relationships between humans, indicating the novelty that meant the concept of narcissism of small differences in the apprehension of collective movements that declare an innocuous expression of hostility to the other, or those who enact destructive and deadly actions against the other chosen as their absolute enemy. With the advent of the death drive, Freud re-dimensions the concept of narcissism of small differences and introduces the idea that the satisfaction of drives that reach the blindest fury of destruction is connected to a narcissistic jouissance [Genuß]. This jouissance, in Lacan's reading, is an evil because it entails an evil to alterity. It is with this legacy that we propose to think about the extension of psychoanalysis to the decolonial discourse and other counter-hegemonic discourses, through interdisciplinary dialogue, in the reading of the languages of hate that we face in our time.

El propósito de este ensayo es retomar la incursión de Freud, desde la Primera Guerra Mundial, sobre el origen del sufrimiento que proviene de las relaciones entre los humanos, señalando la novedad que significó el concepto de narcisismo de las pequeñas diferencias en la aprehensión de los movimientos colectivos que declaran una expresión inocua de hostilidad hacia el otro, o los que ejecutan acciones destructivas y mortíferas contra el otro elegido como su enemigo absoluto. Con el advenimiento de la pulsión de muerte, Freud redimensiona el concepto de narcisismo de las pequeñas diferencias e introduce la idea de que la satisfacción de las pulsiones que alcanzan la más ciega furia de destrucción está ligada a un goce narcisista [Genuß]. Este goce, en la lectura de Lacan, es un mal porque implica un mal a la alteridad.Es con este legado que nos proponemos pensar la extensión del psicoanálisis al discurso decolonial y otros discursos contrahegemónicos, a través del diálogo interdisciplinario, en la lectura de los lenguajes de odio que enfrentamos en nuestro tiempo.

Factors that Affect Performance of Clinical Breast Examination and Mammography Screening among Brazilian Women.

BACKGROUND: In the Brazilian health system, community health facilities consist of multidisciplinary teams that focus on family health, whereas health centers treat mainly illnesses of registered patients. In the present study we compared socio-economic factors and performance of mammography screening (MS) and clinical breast exam (CBE),  respectively, among women who used both types of public health service centers. METHODS: The present study included 180 women aged ≥40 years, who used different health service centers within the same municipal district. Of all 180 women, 110 (41.1%) and 70 (38.9%) used a health center and a community health facility. Logistic regression analysis was performed to calculate odds ratios (ORs) and confidence intervals (CIs) of variables. RESULTS: Regression modeling indicated that women who used the community health facility, performed annual MS 9.52 (OR= 0.105; 95%CI: 0.03- 0.36) times more often (p <0.001). In this model retirement and gynecological service use ≤ each second year, increased annual MS performance 8.16 (95%CI: 1.55- 54.32) and 7.78 (95%CI: 2.54- 23.79) times (p <0.001; p <0.001). Among 113 (62.8%) women who reported strong fear of MS, the chance of its performance was 35.71 (OR= 0.028; 95%CI: 0.02- 0.32) times decreased (p= 0.05). In a second model use of gynecological service ≤ each second year, increased chance of annual CBE performance 7.92 (95%CI: 3.25- 19.29) times (p <0.001). Women who used the community health facility performed annual and bi-annual CBE 2.90 (OR= 0.345; 95%CI: 0.14- 0.86) and 2.97 (OR= 0.337; 95%CI: 0.12- 0.92) times more often, compared to women who used the health center (p =0.030). CONCLUSIONS: Performance of MS and CBE varied both considerable among women who used different types of health service centers. Gynecological service use, fear and socioeconomic variables, additionally influenced regular performance of MS and CBE.

Airway-delivered short-chain fatty acid acetate boosts antiviral immunity during rhinovirus infection.

BACKGROUND: Microbiota are recognized to play a major role in regulation of immunity through release of immunomodulatory metabolites such as short-chain fatty acids (SCFAs). Rhinoviruses (RVs) induce upper respiratory tract illnesses and precipitate exacerbations of asthma and chronic obstructive pulmonary disease through poorly understood mechanisms. Local interactions between SCFAs and antiviral immune responses in the respiratory tract have not been previously investigated. OBJECTIVE: We sought to investigate whether pulmonary metabolite manipulation through lung-delivered administration of SCFAs can modulate antiviral immunity to RV infection. METHODS: We studied the effects of intranasal administration of the SCFAs acetate, butyrate, and propionate on basal expression of antiviral signatures, and of acetate in a mouse model of RV infection and in RV-infected lung epithelial cell lines. We additionally assessed the effects of acetate, butyrate, and propionate on RV infection in differentiated human primary bronchial epithelial cells. RESULTS: Intranasal acetate administration induced basal upregulation of IFN-ß, an effect not observed with other SCFAs. Butyrate induced RIG-I expression. Intranasal acetate treatment of mice increased interferon-stimulated gene and IFN-λ expression during RV infection and reduced lung virus loads at 8 hours postinfection. Acetate ameliorated virus-induced proinflammatory responses with attenuated pulmonary mucin and IL-6 expression observed at day 4 and 6 postinfection. This interferon-enhancing effect of acetate was confirmed in human bronchial and alveolar epithelial cell lines. In differentiated primary bronchial epithelial cells, butyrate treatment better modulated IFN-ß and IFN-λ gene expression during RV infection. CONCLUSIONS: SCFAs augment antiviral immunity and reduce virus load and proinflammatory responses during RV infection.

Strain Magnitude Assessed at Rest and During Stress Echocardiography in Patients with Normal Coronary Flow Reserve

Abstract Background Coronary flow and myocardial contractile performance assessed by strain magnitude increase during a dobutamine stress echocardiogram (DSE). Normal coronary flow reserve (CFR) can be attained upon completion of a DSE at age-predicted maximum heart rate (HR) (HRmax = 220 - age)] or submaximal HR [(0.85) HRmax] or before completion (early CFR). Objective To ascertain the association between delta strain and HR in patients with early normal CFR. Methods This prospective study included patients whose normal CFR was obtained before the DSE was completed. Percentage of resting HR (%HRrest) = [(HRrest ÷ HRmax) 100]% and %HR CFR = [(HR at the time of CFR attainment) ÷ (HRmax) 100]% were recorded. Strain was assessed in the left ventricular region of interest, and delta strain was calculated as the difference between the measures obtained at HRrest and after the DSE was completed. Strain agreement analysis for HRrest, %HRrest, and %HR CFR was performed using the kappa coefficient. The Shapiro-Wilk test was used to assess data normality, and the Mann-Whitney test was used to compare the groups. A p-value < 0.05 was considered statistically significant. Results Strain measured -23.3% ± 4.3% at baseline and -31.1% ± 4.9% during the DSE. In delta strain > 8 absolute points, the ROC curves showed an area under the curve of 0.874 ± 0.07 for %HRrest (p = 0.001) and an area under the curve of 0.862 ± 0.07 for %HR CFR (p = 0.001). In delta strain > 8 points, %HRrest ≤ 42.6% of HRmax and %HR CFR ≤ 62.5% of HRmax showed an accuracy of 82.9% and 79.8%, respectively. Conclusion In this study, lower HRrest and HR at the time of CFR attainment had a good association with better myocardial contractile performance, according to the change in strain magnitude.

Melatonin Pretreatment Protects Against Status epilepticus, Glutamate Transport, and Oxidative Stress Induced by Kainic Acid in Zebrafish.

Status epilepticus (SE) develops from abnormal electrical discharges, resulting in neuronal damage. Current treatments include antiepileptic drugs. However, the most common drugs used to treat seizures may sometimes be ineffective and have many side effects. Melatonin is an endogenous physiological hormone that is considered an alternative treatment for neurological disorders because of its free radical scavenging property. Thus, this study aimed to determine the effects of melatonin pretreatment on SE by inducing glutamatergic hyperstimulation in zebrafish. Seizures were induced in zebrafish using kainic acid (KA), a glutamate analog, and the seizure intensity was recorded for 60 min. Melatonin treatment for 7 days showed a decrease in seizure intensity (28%), latency to reach score 5 (14 min), and duration of SE (29%). In addition, melatonin treatment attenuated glutamate transporter levels, which significantly decreased in the zebrafish brain after 12 h of KA-induced seizures. Melatonin treatment reduced the increase in oxidative stress by reactive oxygen species formation through thiobarbituric acid reactive substances and 2',7'-dichiorofluorescin, induced by KA-seizure. An imbalance of antioxidant enzyme activities such as superoxide dismutase and catalase was influenced by melatonin and KA-induced seizures. Our study indicates that melatonin promotes a neuroprotective response against the epileptic profile in zebrafish. These effects could be related to the modulation of glutamatergic neurotransmission, recovery of glutamate uptake, and oxidative stress parameters in the zebrafish brain.

Fatores de risco o para desenvolvimento de lesão por pressão em idosos: revisão integrativa / Risk factors for the development of pressure injury in the elderly: integrative review / Factores de riesgo para el desarrollo de lesiones por presión en los ancianos: revisión integrativa

Objetivo: analisar a produção científica acerca da prevenção de lesões por pressão em idosos, identificando os fatores predisponentes para o seu surgimento. Método: revisão integrativa realizada no mês de setembro de 2019, nas bases de dados LILACS, MEDLINE, CINAHL, Scopus e Web of Science. Resultados: quinze artigos foram selecionados, de um universo de 618 publicações, com predomínio de estudos transversais e internacionais. A análise identificou que a idade avançada, presença de comorbidades, má nutrição, imobilidade, tempo prolongado de internação configuram-se como fatores de risco. Conclusão: torna-se cada vez mais clara a importância de prevenir a lesão por pressão, observando as condições clínicas, identificando os fatores de risco, realizando intervenção precoce a fim de que seja minimizada sua incidência melhorando com isso a qualidade de vida do idoso.

Objective: to analyze the scientific production on the prevention of pressure injuries in the elderly, identifying the predisposing factors for its emergence. Method: integrative review carried out in September 2019, in the LILACS, MEDLINE, CINAHL, Scopus and Web of Science databases. Results: fifteen articles were selected from a universe of 618 publications with predominance of cross-sectional and international studies. The analysis identifyied advanced age, presence of comorbidities, malnutrition, immobility, prolonged hospital stay are risk factors. Conclusion: it becomes increasingly clear the importance of preventing pressure injuries, observing the clinical conditions, identifying risk factors, performing early intervention in order to minimize its incidence, thereby improving the quality of life of the elderly

Objetivo: analizar la producción científica sobre la prevención de las lesiones por presión en el adulto mayor, identificando los factores predisponentes para su aparición. Método: revisión integradora realizó en septiembre de 2019, en las bases de datos LILACS, MEDLINE, CINAHL, Scopus y Web of Science. Resultados: quince artículos fueron seleccionados de un universo de 618 publicaciones, con predominio de estudios transversales y internacionales. El análisis identificó que la edad avanzada, la presencia de comorbilidades, la desnutrición, la inmovilidad, la estancia hospitalaria prolongada son factores de riesgo. Conclusión: se hace cada vez más evidente la importancia de prevenir las lesiones por presión, observar las condiciones clínicas, identificar los factores de riesgo, realizar una intervención temprana para minimizar su incidencia, mejorando así la calidad de vida de los ancianos.

Biocidal Activity of a Nanoemulsion Containing Essential Oil from Protium heptaphyllum Resin against Aedes aegypti (Diptera: Culicidae).

This work aimed to prepare a nanoemulsion containing the essential oil of the Protium heptaphyllum resin and evaluate its biocidal activities against the different stages of development of the Aedes aegypti mosquito. Ovicide, pupicide, adulticide and repellency assays were performed. The main constituents were p-cymene (27.70%) and α-pinene (22.31%). The developed nanoemulsion showed kinetic stability and monomodal distribution at a hydrophilic-lipophilic balance of 14 with a droplet size of 115.56 ± 1.68 nn and a zeta potential of -29.63 ± 3.46 mV. The nanoemulsion showed insecticidal action with LC50 0.404 µg·mL-1 for the ovicidal effect. In the pupicidal test, at the concentration of 160 µg·mL-1, 100% mortality was reached after 24 h. For adulticidal activity, a diagnostic concentration of 200 µg·mL-1 (120 min) was determined. In the repellency test, a concentration of 200 µg·mL-1 during the 180 min of the test showed a protection index of 77.67%. In conclusion, the nanobiotechnological product derived from the essential oil of P. heptaphyllum resin can be considered as a promising colloid that can be used to control infectious disease vectors through a wide range of possible modes of applications, probably as this bioactive delivery system may allow the optimal effect of the P. heptaphyllum terpenes in aqueous media and may also induce satisfactory delivery to air interfaces.

Gerenciamento de enfermagem no ambiente hospitalar e os desafios para o exercício profissional / Nursing management in the hospital environment and the challenges for the professional practice

Objetivo:analisar o gerenciamento de enfermagem no contexto do exercício profissional do enfermeiro em um ambiente hospitalar. Método:estudo qualitativo realizado junto a 19 enfermeiros de um hospital de referência em urgência e emergência, no interior da Paraíba, Brasil. Utilizou-se como técnica de coleta de dados entrevistas semiestruturadas submetidas à análise de conteúdo na modalidade temática proposta por Bardin. Resultados: elaborou-se três categorias gerais:O gerenciamento em Enfermagem àluz da Lei do Exercício Profissional; Dimensionamento da equipe e a valorização do trabalho em enfermagem; e Educação permanente. Identificou-se dificuldades enfrentadas pelos enfermeiros no seu processo de trabalho ligadas ao dimensionamento inadequado dos profissionais de enfermagem. Conclusão:o gerenciamento no ambiente hospitalar incide no exercício profissional do enfermeiro e se apresenta como fenômeno e multifacetado, imbricado numa tessitura de relações políticas, éticas, legais, institucionais, profissionais e humanas com reflexos sobre o processo cuidar em enfermagem

Objective: to analyze Nursing management in the context of the nurses' professional practice in a hospital environment. Method:a qualitative study carried out with 19nurses from a reference hospital in Urgency and Emergency care from the inland of Paraíba, Brazil. Semi-structured interviews submitted to content analysis in the thematic modality proposed by Bardin were used as data collection technique. Results: three general categories were elaborated, namely: Nursing management in light of the Law of Professional Practice; Team sizing and appreciation of the Nursing work; and Permanent Education. Difficulties faced by the nurses in their work process were identified, linked to inadequate sizing of Nursing professionals. Conclusion:managementin the hospital environment focuses on the nurses' professional practice and presents itself as a multifaceted phenomenon, imbricated in a structure of political, ethical, legal, institutional, professional and human relationships with reflections on the care process in Nursing.

Development of nano-emulsions based on Ayapana triplinervis essential oil for the control of Aedes aegypti larvae.

Ayapana triplinervis is a plant species used in traditional medicine and in mystical-religious rituals by traditional communities in the Amazon. The aim of this study are to develop a nano-emulsion containing essential oil from A. triplinervis morphotypes, to evaluate larvicidal activity against Aedes aegypti and acute oral toxicity in Swiss albino mice (Mus musculus). The essential oils were extracted by steam dragging, identified by gas chromatography coupled to mass spectrometry, and nano-emulsions were prepared using the low energy method. Phytochemical analyses indicated the major compounds, expressed as area percentage, ß-Caryophyllene (45.93%) and Thymohydroquinone Dimethyl Ether (32.93%) in morphotype A; and Thymohydroquinone Dimethyl Ether (84.53%) was found in morphotype B. Morphotype A essential oil nano-emulsion showed a particle size of 101.400 ± 0.971 nm (polydispersity index = 0.124 ± 0.009 and zeta potential = -19.300 ± 0.787 mV). Morphotype B essential oil nano-emulsion had a particle size of 104.567 ± 0.416 nm (polydispersity index = 0.168 ± 0.016 and zeta potential = -27.700 ± 1.307 mV). Histomorphological analyses showed the presence of inflammatory cells in the liver of animals treated with morphotype A essential oil nano-emulsion (MAEON) and morphotype B essential oil nano-emulsion (MBEON). Congestion and the presence of transudate with leukocyte infiltration in the lung of animals treated with MAEON were observed. The nano-emulsions containing essential oils of A. triplinervis morphotypes showed an effective nanobiotechnological product in the chemical control of A. aegypti larvae with minimal toxicological action for non-target mammals.

Gallic Acid Reverses Neurochemical Changes Induced by Prolonged Ethanol Exposure in the Zebrafish Brain.

Gallic acid (GA) is a polyphenolic compound that has attracted significant interest due to its antioxidant action through free radical elimination and metal chelation. Ethanol is a highly soluble psychoactive substance, and its toxicity is associated with oxidative stress. In this context, the purpose of the present study was to investigate the effect of GA on neurochemical changes in zebrafish brains exposed to ethanol. GA was first analyzed in isolation by treating the animals at concentrations of 5, 10, and 20 mg/L for 24 h and 48 h. The results revealed that the group exposed to 20 mg/L over a 24/48 h period exhibited increases in thiobarbituric acid reactive substance (TBA-RS) levels and 2',7'-dichlorofluorescein (DCFH) oxidation, demonstrating a pro-oxidant profile. Moreover, decrease in acetylcholinesterase (AChE) enzyme activity was observed. To investigate the effects of GA after ethanol exposure, the animals were divided into four groups: control; those exposed to 0.5% ethanol for 7 days; those exposed to 0.5% ethanol for 7 days and treated with GA at 5 and 10 mg/L on day 8. Treatment with GA at 5 and 10 mg/L reversed impairment of choline acetyltransferase activity and the damage to TBA-RS levels, DCFH oxidation, and superoxide dismutase activity induced by ethanol. Results of the present study suggest that GA treatment (20 mg/L) appeared to disrupt oxidative parameters in the zebrafish brain. GA treatment at 5 and 10 mg/L reversed alterations to the cholinergic system induced by prolonged exposure to ethanol in the zebrafish brain, probably through an antioxidant mechanism.

Análise da Segurança e Exequibilidade do Ecocardiograma sob Estresse com Dobutamina em Dez Mil e Seis Exames de uma População Geral / Analysis of the Safety and Feasibility of Dobutamine Stress Echocardiography in Ten Thousand and Six Tests of a General Population

Fundamento: Durante o ecocardiograma sob estresse com dobutamina, podem ocorrer efeitos adversos e exames inconclusivos. Objetivo: Avaliar em uma grande população geral a segurança e a exequibilidade do ecocardiograma sob estresse com dobutamina. Métodos: Estudo de 10.006 ecocardiogramas sob estresse com dobutamina realizados no período de julho de 1996 a setembro de 2007. A dobutamina foi administrada em quatro estágios (10, 20, 30 e 40 µcg.kg-1.min-1) para pesquisa de isquemia miocárdica e iniciada com 5 µcg.kg- ¹.min-1 apenas na análise de viabilidade miocárdica. A atropina foi iniciada conforme os protocolos vigentes. Foram verificados dados clínicos, hemodinâmicos e efeitos adversos associados ao ecocardiograma sob estresse com dobutamina. Resultados: Durante os ecocardiogramas sob estresse com dobutamina, ocorreu angina típica (8,9%), pico hipertensivo (1,7%), ectopias ventriculares isoladas (31%), taquiarritmia supraventricular (1,89%), fibrilação atrial (0,76%) e taquicardia ventricular não sustentada (0,6%). Os efeitos adversos citados foram mais frequentes nos pacientes com ecocardiogramas sob estresse com dobutamina positivos para isquemia. A desaceleração sinusal paradoxal (0,16%) não ocorreu em ecocardiogramas sob estresse com dobutamina positivo. As três complicações graves ocorreram em ecocardiogramas sob estresse com dobutamina positivos para isquemia. Foram dois casos (0,02%) com fibrilação ventricular e um caso de síndrome coronariana aguda (0,01%). Não houve caso de taquicardia ventricular sustentada, ruptura cardíaca, assistolia ou óbito. Comparados aos exames concluídos, nos inconclusivos, os pacientes usaram menos atropina (81,5% versus 49,9%; p< 0,001) e mais betabloqueador (4,7% versus 19%; p< 0,001), apresentando mais pico hipertensivo (1,1% versus 14,2%; p = 0,0001) e taquicardia ventricular não sustentada (0,5% versus 2,2%; p< 0,001). Conclusão: O ecocardiograma sob estresse com dobutamina realizado de forma apropriada é seguro e apresenta elevada exequibilidade.

Background: Adverse effects and inconclusive results may occur on dobutamine stress echocardiography. Objective: To assess the safety and feasibility of dobutamine stress echocardiography in a large general population. Methods: A total of 10,006 dobutamine stress echocardiographies were performed between July 1996 and September 2007. Dobutamine was administered in four stages (10, 20, 30, and 40 µcg·kg-1·min-1) to research myocardial ischemia starting with 5 µcg·kg- ¹·min-1 to analyze myocardial viability. Atropine administration was initiated according to current protocols. Clinical, hemodynamic, and adverse effect data associated with dobutamine stress echocardiography findings were verified. Results: Typical angina (8.9%), hypertensive peak (1.7%), isolated ventricular ectopias (31%), supraventricular tachyarrhythmia (1.89%), atrial

Os fios de Caracol: mulheres em danças de si / Snail Threads: women dancing their own / Hilos de Caracol: mujeres en danzas de sí

O presente trabalho tem como proposta a composição de um corpo-escrita por meio de narrativas de mulheres que dançam, ensaiando outros modos de existência a partir dos seus corpos generificados, femininos. O campo de pesquisa emergiu do encontro entre uma pesquisadora e dançarina e mulheres num espetáculo dançado, no qual o signo mulher nos apequena e performamos para multiplicar e profanar gestos, língua, sentidos. Tomando como pista metodológica a cartografia, entendemos a atividade de pesquisa como um acompanhamento de processos em curso, de derivas subjetivas. Seguimos, então, a partir desse campo, a invenção de um corpo que se revolve na sua própria história diante das marcas que lhe foram impostas e o constituem. Numa dança de si, amplia sensibilidades, transmuta e se produz no ilocalizável. Nessa experimentação, arte e clínica aparecem articuladas e emergindo de um plano comum.

The present work proposes the composition of a body-writing through narratives of women who dance, rehearsing other modes of existence from their gendered, feminine bodies. The research field emerged from the encounter between a researcher and dancer and women in a dance show where the sign woman is small and we perform to multiply and desecrate gestures, language, senses. Taking cartography as a methodological clue, we understand the research activity as an accompaniment of ongoing processes, of subjective drifts. We followed, then, from that field, the invention of a body that revolves in its own history in the face of the marks that were imposed on it and constitute it; in a dance of itself, it broadens sensibilities, transmutes and is produced in the illocalizable. In this experimentation, art and clinic appear articulated and emerging from a common plan.

El presente trabajo propone la composición de una escritura corporal a través de narraciones de mujeres que bailan, ensayando otros modos de existencia a partir de sus cuerpos femeninos y de género. El campo de investigación surgió del encuentro entre un investigador y bailarín y mujeres en un espectáculo de danza donde la mujer de los signos es pequeña y actuamos para multiplicar y profanar gestos, lenguaje, sentidos. Tomando la cartografía como una pista metodológica, entendemos la actividad de investigación como un acompañamiento de procesos en curso, de desviaciones subjetivas. Seguimos, entonces, desde ese campo, la invención de un cuerpo que gira en su propia historia frente a las marcas que se le impusieron y constituyen; en un baile de uno mismo, amplía sensibilidades, transmuta y se produce en lo ilocalizable. En esta experimentación, el arte y la clínica aparecen articulados y emergen de un plan común.

Evaluation of larvicidal potential against larvae of Aedes aegypti (Linnaeus, 1762) and of the antimicrobial activity of essential oil obtained from the leaves of Origanum majorana L.

This study evaluated the larvicidal activity of Origanum majorana Linnaeus essential oil, identified the chemical composition, evaluated the antimicrobial, cytotoxic and antioxidant potential. The larvicidal activity was evaluated against larvae of the third stage of Aedes aegypti Linaeus, whereas the chemical composition was identified by gas chromatography coupled to mass spectrometer, the antimicrobial activity was carried out against the bacteria Pseudomonas aeruginosa, Escherichia coli and Staphylococcus auereus, the antioxidant activity was evaluated from of 2.2-diphenyl-1-picryl-hydrazila sequestration and Artemia salina Leach cytotoxicity. Regarding to the results, the larvicidal activity showed that O. majorana L. essential oil caused high mortality in A. aegypti L. larvae. In the chromatographic analysis, the main component found in O. majorana L. essential oil was pulegone (57.05%), followed by the other components verbenone (16.92%), trans-p-menthan-2-one (8.57%), iso-menthone (5.58%), piperitone (2.83%), 3-octanol (2.35%) and isopulegol (1.47%). The antimicrobial activity showed that E. coli and P. aeruginosa bacteria were more sensitive to oil than S. aureus, which was resistant at all concentrations. Essential oil did not present antioxidant activity, but it has high cytotoxic activity against A. salina L.

Saúde bucal de universitários internacionais: da importância ao conhecimento e condutas frente às patologias orais / Oral health of international undergraduates: from importance to knowledge and conducts toward oral pathologies / Salud bucal de universitarios internacionales: de la importancia al conocimiento y conductas frente a las patologías orales

Objetivo: Investigar a importância da saúde bucal e a frequência e os meios utilizados na higienização da cavidade oral, assim como o conhecimento e as condutas de universitários frente às doenças bucais. Método: Estudo descritivo e qualitativo desenvolvido com universitários de diferentes nacionalidades. Os dados foram coletados pela aplicação de questionário. Resultados: Para os participantes, a importância da saúde bucal estava vinculada à prevenção de doenças, à estética, à autoestima e à saúde geral. Quanto à frequência e aos meios utilizados na escovação, todos higienizavam a cavidade oral diariamente e a maioria utilizava escova e creme dental. Eles associavam as doenças orais à dor, ao sangramento, aos problemas dentários e à falta de escovação. Além do dentista, buscavam o médico e o enfermeiro para resolução de problemas odontológicos. Conclusão: Apesar de reconhecerem a importância da saúde oral, o conhecimento dos universitários sobre as patologias bucais foi escasso e muito limitado

Objective: To investigate the importance of oral health and the frequency and means used to clean the oral cavity, as well as the knowledge and behavior of undergraduates regarding oral diseases. Method: Descriptive and qualitative study developed with undergraduates of different nationalities. The data were collected by the application of a questionnaire. Results: For the participants, the importance of oral health was linked to disease prevention, aesthetics, self-esteem and general health. As for the frequency and means used in brushing, they all cleaned the oral cavity daily and most of them used toothbrush and toothpaste. They associated oral diseases with pain, bleeding, dental problems and lack of brushing. Besides the dentist, they sought the doctor and the nurse to solve dental problems. Conclusion: Although they recognize the importance of oral health, the knowledge of undergraduates about oral pathologies was scarce and very limited

Objetivo: Investigar la importância de la salud bucal y la frecuencia y los medios utilizados en la higienizacíon de la cavidade oral, así como el conocimiento y las conductas de universitarios frente a las enfermidades bucales. Método: Estudio descriptivo y cualitativo desarrollado com universitarios de diferentes nacionalidades. Los datos fueron recolectados por la aplicación de cuestionario. Resultados: Para los participantes, la importancia de la salud bucal estaba vinculada a la prevención de enfermidades, a la estética, a la autoestima ya la salud general. Em cuanto a la frequencia y los medios utilizados en el cepillado, todos higienizaban la cavidad oral diariamente y la mayoría utilizaba cepillo y crema dental. Ellos asociaban las enfermedades orales al dolor, al sangrado, a los problemas dentales ya la falta de cepillado. Además del dentista, buscaban al médico y al enfermero para la resolucíon de problemas odontológicos. Conclusión: A pesar de reconocer la importancia de la salud oral, el conocimiento de los universitarios sobre las patologías buçales fue escaso y muy limitad

Perfil sociodemográfico e econômico e comportamento sexual de brasileiros e estrangeiros recém-ingressos em uma universidade pública / Sexual behavior, sociodemographic and economic profile of both first-year brazilian and international students at a public university / Perfil sociodemográfico y económico y comportamiento sexual de brasileños y extranjeros recien-ingresaron una universidad pública

Objetivo: Caracterizar, comparar e associar o perfil sociodemográfico e econômico, bem como o comportamento sexual e o conhecimento e presença de Infecções Sexualmente Transmissíveis (IST) entre universitários brasileiros e estrangeiros recém-ingressos a uma universidade pública. Métodos: Pesquisa exploratória, descritiva e quantitativa, conduzida com 131 estudantes. Resultados: Houve o predomínio de participantes do sexo masculino, brasileiros e guineenses, solteiros, com parceria eventual e renda familiar de até um salário mínimo. Mais da metade dos participantes brasileiros e estrangeiros tinha iniciado a vida sexual antes dos 18 anos e tinha tido, no mínimo, 2 parceiros. A maior parte dos estudantes sabia o conceito de IST e não tinha contraído qualquer uma delas. Foi observada associação entre ser estrangeiro, ter tido a 1ª relação sexual e conhecer IST. Conclusão: Percebe-se que a realidade dos universitários estrangeiros se assemelha à realidade dos brasileiros, sendo ambos vulneráveis às IST

Objective: To characterize, compare and associate the sociodemographic and economic profile, as well as the sexual behavior and the knowledge and presence of Sexually Transmissible Infections (STI) among Brazilian university students and foreigners recently admitted to an public university. Method: Exploratory, descriptive and quantitative research was conducted with 131 students. Results: There was a predominance of male participants, Brazilian and Guinean, single, with eventual partnership and family income of up to one minimum wage. More than half of the Brazilian and foreign participants had started their sexual life before the age of 18 and had had at least 2 partners. Most students knew the concept of STI and hadn't contracted any of them. An association was observed between being a foreigner, having had the first intercourse and knowing STI. Conclusion: It's perceived that the reality of foreign university students is similar to the reality of Brazilians

Objetivo: Caracterizar, comparar y asociar el perfil sociodemográfico y económico, así como el comportamiento sexual y el conocimiento y presencia de Infecciones Sexualmente Transmisibles (IST) entre universitarios brasileños y extranjeros recién ingresados a uma universidad pública. Métodos: Investigación exploratoria, descriptiva y cuantitativa, conducida con 131 estudiantes. Resultados: Hubo el predominio de participantes del sexo masculino, brasileños y guineanos, solteros, con asociación eventual y renta familiar de hasta un salario mínimo. Más de la mitad de los participantes brasileños y extranjeros había iniciado la vida sexual antes de los 18 años y había tenido al menos 2 socios. La mayoría de los estudiantes sabía el concepto de IST y no había contraído ninguna de ellas. Se observó asociación entre ser extranjero, haber tenido la 1ª relación sexual y conocer IST. Conclusión: La realidade de los universitarios extranjeros se asemeja a la realidad de los brasileños, siendo ambos vulnerables a las IST

Relato de caso de síndrome de Hikikomori em Portugal: uma síndrome primária ou expressão de outra perturbação mental? / Case report of Hikikomori syndrome in Portugal: a primary syndrome or the expression of another mental disorder?

RESUMO O fenómeno hikikomori, forma de isolamento social grave e prolongado, constitui um desafio diagnóstico. A nível conceptual, alguns autores diferenciam o hikikomori em primário e secundário. Este último conceito é utilizado quando está presente comorbilidade que, pelo menos parcialmente, explique a síndrome, enquanto na ausência de diagnóstico psiquiátrico denomina- se "hikikomori primário". Os autores apresentam um caso clínico português com as mesmas características sociodemográficas e clínicas descritas no Japão. Esse caso ilustra que o hikikomori pode potencialmente ser explicado por uma perturbação psiquiátrica subjacente, nem sempre clara à apresentação, e a importância da avaliação cuidadosa e continuada no tempo, por forma a conseguir o esclarecimento diagnóstico e intervenção terapêutica adequada.

ABSTRACT Diagnosing hikikomori, a form of severe and prolonged social withdrawal, is challenging. Conceptually speaking, some authors differentiate "primary" and "secondary" hikikomori. The latter term has been used when there is co-morbidity that at least partially explains the syndrome, whereas in the absence of a psychiatric diagnosis it is called "primary hikikomori". The authors present a Portuguese case report with the same sociodemographic and clinical characteristics described in Japan. This case illustrates that hikikomori can potentially be explained by an underlying psychiatric disorder that is not always clear at the presentation and the importance of careful and continuous assessment, in order to achieve diagnostic clarification and adequate therapeutic intervention.

Ocorrência de lesões por pressão em unidade de terapia intensiva de um hospital universitário / Occurrence of pressure injuries in the intensive therapy unit of a university hospital / Ocurrencia de lesión por presión en la unidad de cuidados intensivos de un hospital universitario

As lesões por pressão (LPP) representam importantes causas de morbimortalidade a nível mundial. Assim, objetivou-se identificar a ocorrência e características das LPP bem como, o perfil do paciente acometido. Trata-se de uma pesquisa descritiva, longitudinal e quantitativa, realizada em uma unidade de terapia intensiva adulto. A população foi constituída de registros de internações em prontuários no período de maio a dezembro de 2014 e a coleta de dados foi realizada em agosto de 2014 a janeiro de 2015. Identificou-se uma ocorrência de 22,07% com predomínio de lesões em mulheres idosas, com distúrbios respiratórios e presença de co-morbidades. Sete pacientes já apresentavam a lesão na admissão e 10 desenvolveram na UTI. A maioria das lesões estava no estágio II e na região sacral e, em relação ao desfecho clínico, 52,94% deles evoluiu para o óbito. O estudo evidenciou a importância da capacitação profissional como estratégia para reduzir a incidência dessas lesões.(AU)

Pressure lesions (LPP) represent important causes of morbidity and mortality worldwide. Thus, the objective was to identify the occurrence and characteristics of LPP in critically ill patients. This is a descriptive, longitudinal and quantitative study performed in an adult intensive care unit (ICU). The population was composed of records of hospitalizations in medical records from May to December 2014 and the data collection was performed in August 2014 to January 2015. An occurrence of 22.07% was identified with a predominance of lesions in women elderly, with respiratory disorders and presence of comorbidities. Seven patients already had the lesion on admission and 10 developed in the ICU. The majority of the lesions were in stage II and in the sacral region and, in relation to the clinical outcome, 52.94% of them evolved to death. The study evidenced the importance of professional training as a strategy to reduce the incidence of LPP in the unit.(AU)

Las lesiones por presión (LPP) representan importantes causas de morbimortalidad a nivel mundial. Así, se objetivó identificar la ocurrencia y características de las LPP en el paciente gravemente enfermo. Se trata de una investigación descriptiva, longitudinal y cuantitativa, realizada en una unidad de terapia intensiva adulto (UTI). La población fue constituida de registros de internaciones en prontuarios en el período de mayo a diciembre de 2014 y la recolección de datos fue realizada en agosto de 2014 a enero de 2015. Se identificó una ocurrencia del 22,07% con predominio de lesiones en mujeres ancianos, con disturbios respiratorios y presencia de comorbilidades. Siete pacientes ya presentaban la lesión en la admisión y 10 desarrollaron en la UTI. La mayoría de las lesiones estaban en la etapa II y en la región sacral y, en relación al desenlace clínico, el 52,94% de ellos evolucionó hacia el óbito. El estudio evidenció la importancia de la capacitación profesional como estrategia para reducir la incidencia de la UPP en la unidad.(AU)

Chemical Characterization, Antioxidant, Cytotoxic and Microbiological Activities of the Essential Oil of Leaf of Tithonia Diversifolia (Hemsl) A. Gray (Asteraceae).

The present study aimed to evaluate the chemical composition, antioxidant potential, and the cytotoxic and antimicrobial activity of the essential oil of the plant species Tithonia diversifolia (Hemsl) A. Gray. The essential oil obtained was used to identify the chemical compounds present through the techniques of GC-MS and NMR. The antioxidant potential was calculated by the sequestration method of 2,2-diphenyl-1-picrylhydrazyl. For cytotoxic activity, the larval mortality of Artemia salina was evaluated. The main chemical constituents identified are αpinene (9.9%), Limonene (5.40%), (Z)-ß-ocimene (4.02%), p-cymen-8-ol (3.0%), Piperitone (11.72%), (E)-nerolidol (3.78%) and Spathulenol (10.8%). In the evaluation of the antimicrobial activity, bacterial strains of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were used. The results showed that the bacterium E. coli were more susceptible to the presence of the essential oil, presenting minimal inhibitory concentration at the concentrations that were exposed. The essential oil presented antioxidant activity of 54.6% at the concentration of 5 mg·mL-1 and provided a CI50 of 4.30. It was observed that the essential oil of this species was highly toxic against A. salina lavas, as its cytotoxic activity showed an LC50 of 3.11. Thus, it is concluded that T. diversifolia oils are effective in inhibiting bacterial growth and reducing oxidative stress.