White spots amidst the gold: ultrastructural and histological aspects of the chronic inflammatory response of goldfish with ichthyophthiriasis.

Ichthyophthirius multifiliis, the causative agent of white spot disease, is a ciliated protozoan parasite that infects freshwater fish and induces high mortality. Outbreaks occur both in natural and production sites. The aim of the present study was to describe the lesions caused by chronic infection by I. multifiliis in goldfish (Carassius auratus) from an ornamental fish farm, highlighting important ultrastructural aspects of this protozoan. Damaged skin and gills, collected from fish with white or ulcerative skin lesions, were routinely processed for histological analysis and transmission electron microscopy. The parasitic forms present in the skin were associated with an inflammatory infiltrate consisting of macrophages, lymphocytes and other polymorphonuclear cells. The lesions associated with the presence of the parasite were organized in the form of granulomas, with macrophages in the layers closest to the parasites. A trophont-thickened membrane and induction of granulomatous inflammation were identified in this study as mechanisms for evasion of the immune response. We concluded that the presence of I. multifiliis trophonts resulted in the formation of granulomatous inflammation, whether associated or not with pathogen lysis, suggesting that the parasite can use an inflammatory response to evade the immune response.

Prevenção de comportamentos autodestrutivo na adolescência: influência das redes sociais / Prevention of self-destructive behaviors in adolescence: influence of social networks

A comunicação entre pais e seus filhos no período da adolescência é fundamental para propor uma estrutura psicológica, na qual pode-se permitir que o adolescente desenvolva uma autoestima forte e independente. Objetivo: identificar por meio de literatura o comportamento autodestrutivo em adolescentes que utilizam redes sociais e jogos digitais de modo demasiado. Método: Trata-se de um estudo de cunho exploratório com intuito caracterizado por meio de revisão bibliográfica, realizada através do Google Acadêmico, Fio Cruz (Fundação Oswaldo Cruz), Biblioteca Virtual em Saúde (BVS), utilizando os uni termos: "COMPORTAMENTOS AUTODESTRUTIVOS NA ADOLESCENCIA", pesquisado apenas no idioma português," ordenado por "data" de 2002 até maio de 2023. Resultado: Mediante as bases pesquisadas forem elegíveis (22) artigos, (2) revistas e (1) livro após os critérios estabelecidos ficaram apenas 05 artigos. Conclusão: Cabe aos profissionais da saúde bem como a equipe de enfermagem, seja na atenção primaria ou dentro do ambiente hospitalar estarem preparados e capacitados para prestar uma assistência de qualidade, realizar o acolhimento e uma escuta terapêutica de forma mais positiva.(AU)

Communication between parents and their children during adolescence is fundamental to propose a psychological structure in which adolescents can develop a strong and independent self-esteem. Objective: to identify, through literature, self-destructive behavior in adolescents who use social networks and digital games too much. Method: This is an exploratory study with a purpose characterized by a bibliographical review, carried out through Google Scholar, Fio Cruz (Oswaldo Cruz Foundation), Virtual Health Library (VHL), using the uni terms: "SELF-DESTRUCTIVE BEHAVIORS NA ADOLESCENCIA", searched only in Portuguese," sorted by "date" from 2002 to May 2023. Result: According to the searched databases, (22) articles, (2) magazines and (1) book were eligible after the established criteria. only 05 articles. Conclusion: It is up to health professionals, as well as the nursing team, whether in primary care or within the hospital environment, to be prepared and qualified to provide quality care, embracement and therapeutic listening in a more positive way.(AU)

La comunicación entre padres e hijos durante la adolescencia es fundamental para proponer una estructura psicológica en la que los adolescentes puedan desarrollar una autoestima fuerte e independiente. Objetivo: identificar, a través de la literatura, conductas autodestructivas en adolescentes que utilizan demasiado las redes sociales y los juegos digitales. Método: Se trata de un estudio exploratorio con finalidad caracterizada por una revisión bibliográfica, realizada a través de Google Scholar, Fio Cruz (Fundación Oswaldo Cruz), Biblioteca Virtual en Salud (BVS), utilizando los términos uni: "CONDUCTAS AUTODESTRUCTIVAS EN LA ADOLESCENCIA" , buscado solo en portugués", ordenados por "fecha" de 2002 a mayo de 2023. Resultado: De acuerdo con las bases de datos buscadas, (22) artículos, (2) revistas y (1) libro fueron elegibles después de los criterios establecidos. sólo 05 artículos. Conclusión: Corresponde a los profesionales de la salud, así como al equipo de enfermería, ya sea en la atención primaria o en el ámbito hospitalario, estar preparados y calificados para brindar un cuidado de calidad, acogida y escucha terapéutica de forma más positiva.(AU)

Human archetypal pluripotent stem cells differentiate into trophoblast stem cells via endogenous BMP5/7 induction without transitioning through naive state.

Primary human trophoblast stem cells (TSCs) and TSCs derived from human pluripotent stem cells (hPSCs) can potentially model placental processes in vitro. Yet, the pluripotent states and factors involved in the differentiation of hPSCs to TSCs remain poorly understood. In this study, we demonstrate that the primed pluripotent state can generate TSCs by activating pathways such as Epidermal Growth Factor (EGF) and Wingless-related integration site (WNT), and by suppressing tumor growth factor beta (TGFß), histone deacetylases (HDAC), and Rho-associated protein kinase (ROCK) signaling pathways, all without the addition of exogenous Bone morphogenetic protein 4 (BMP4)-a condition we refer to as the TS condition. We characterized this process using temporal single-cell RNA sequencing to compare TS conditions with differentiation protocols involving BMP4 activation alone or BMP4 activation in conjunction with WNT inhibition. The TS condition consistently produced a stable, proliferative cell type that closely mimics first-trimester placental cytotrophoblasts, marked by the activation of endogenous retroviral genes and the absence of amnion expression. This was observed across multiple cell lines, including various primed induced pluripotent stem cell (iPSC) and embryonic stem cell (ESC) lines. Primed-derived TSCs can proliferate for over 30 passages and further specify into multinucleated syncytiotrophoblasts and extravillous trophoblast cells. Our research establishes that the differentiation of primed hPSCs to TSC under TS conditions triggers the induction of TMSB4X, BMP5/7, GATA3, and TFAP2A without progressing through a naive state. These findings propose that the primed hPSC state is part of a continuum of potency with the capacity to differentiate into TSCs through multiple routes.

Leg length discrepancy is not a risk factor for plantar fasciitis.

PURPOSE: Plantar fasciitis (PF) is a main source of heel pain, and only about one-third of patients have bilateral symptomatic involvement, although age, body mass index (BMI), and physical activities are known risk factors. The high prevalence of unilateral involvement is poorly understood. We aimed to assess the potential association between PF and the leg length discrepancy (LLD) in unilateral PF. METHODS: A transversal case-control study was conducted from January 2019 to December 2020, including 120 participants allocated to two groups matched by BMI and sex: cases (with a diagnosis of PF; 50 ± 13 years) and control (without foot pain; 40 ± 15 years). For both groups, a difference greater than 0.64 cm in the scanometry determined the criteria for the presence of LLD. RESULTS: The multivariate logistic regression analysis showed an independent association of PF only with age (p < 0.001), and no association with LLD. We did not observe differences in the mean discrepancy (1.37 ± 0.83 cm in the PF group in comparison with 1.13 ± 0.37 cm in the control group, [p > 0.05]) or in the prevalence of LLD between groups (48% [n = 29] in the PF group compared with 42% [n = 25] in the control group, [p > 0.05]). In the PF group, 80% of the participants reported unilateral pain. We observed a higher prevalence of pain in the shorter limb (p < 0.05). CONCLUSION: Age was the only factor associated with the diagnosis of PF when groups were matched by sex and BMI. LLD was not an independent factor associated with the diagnosis of PF. However, when PF is unilateral, the shorter limb is more affected with 70% of prevalence. LEVEL OF EVIDENCE: Level III, case-control.

Bristow-Latarjet Surgery: A Current Overview in Brazil.

Objective To provide a current overview of the Bristow-Latarjet surgery in Brazil. Materials and Methods This cross-sectional study was based on an electronic questionnaire with 26 items, which was sent to active members of the Brazilian Society of Shoulder and Elbow Surgery (Sociedade Brasileira de Cirurgia do Ombro e Cotovelo, SBCOC, in Portuguese). The questionnaire addressed training, surgical technique, complications, and postoperative management. Results We sent the questionnaire to 845 specialists from April 20 to May 12, 2021, and 310 of them answered i in full. During their specialization, most specialists participated in up to ten Bristow-Latarjet procedures. The most frequent complication was graft fracture, while the most common technical difficulty was screw positioning. In total, 50.6% and 73.9% reported having experienced intraoperative and postoperative complications respectively; 57.1% declared performing subscapularis suture; 99.7% indicated postoperative immobilization; and 61.9% considered graft consolidation fundamental. Conclusion Most specialists participated in up to ten Bristow-Latarjet procedures during the specialization, but 13.5% of them graduated without participating in the surgery. The most frequent complication was graft fracture. The most common technical difficulty was screw positioning. Most participants prefer postoperative immobilization since they believe graft consolidation is essential to resume the practiced of sports. The highest complication rate occurred with specialists who have obtained their titles 11 to 15 years ago. In Brazil, the Southeast region is the largest producer of specialists and has the highest concentration of these professionals.

Prognostic Factors and Markers in Non-Small Cell Lung Cancer: Recent Progress and Future Challenges.

Lung cancer is a highly aggressive neoplasm and, despite the development of recent therapies, tumor progression and recurrence following the initial response remains unsolved. Several questions remain unanswered about non-small cell lung cancer (NSCLC): (1) Which patients will actually benefit from therapy? (2) What are the predictive factors of response to MAbs and TKIs? (3) What are the best combination strategies with conventional treatments or new antineoplastic drugs? To answer these questions, an integrative literature review was carried out, searching articles in PUBMED, NCBI-PMC, Google Academic, and others. Here, we will examine the molecular genetics of lung cancer, emphasizing NSCLC, and delineate the primary categories of inhibitors based on their molecular targets, alongside the main treatment alternatives depending on the type of acquired resistance. We highlighted new therapies based on epigenetic information and a single-cell approach as a potential source of new biomarkers. The current and future of NSCLC management hinges upon genotyping correct prognostic markers, as well as on the evolution of precision medicine, which guarantees a tailored drug combination with precise targeting.

Comparison of methods for controlling acquiescence bias in balanced and unbalanced scales / Comparação de métodos para o controle do viés da aquiescência em escalas balanceadas e desbalanceadas / Comparación de métodos para controlar el sesgo de aquiescencia en escalas balanceadas y no balanceadas

Controlling acquiescence bias typically involves the application of positive and negative keyed items. However, little is known about the effect of balancing positive and negative items on bias control. The aim of this study was to compare three Confirmatory Factor Analysis models (without control, MIMIC, and Random Intercept) to recover the factor structure of unbalanced and balanced instruments, using simulated and real data (from an instrument that assesses Personality). By controlling for acquiescence, the results indicated that the performance of balanced scales was better than that of unbalanced scales, as well as in the absence of control for response bias, when considering balanced and unbalanced scales. Thus, this research suggests the possibility of controlling acquiescence through balanced instruments associated with the use of statistical methods in modeling.(AU)

O controle do viés de aquiescência normalmente envolve a aplicação de itens positivos e negativos. Contudo, pouco se sabe sobre o efeito do balanceamento entre itens positivos e negativos sobre o controle do viés. O objetivo deste estudo foi comparar três modelos de Análise Fatorial Confirmatória (sem controle, MIMIC e Intercepto Randômico) para recuperar a estrutura fatorial de instrumentos desbalanceados e balanceados, a partir de dados simulados e reais (procedentes de um instrumento que avalia Personalidade). Mediante o controle da aquiescência, os resultados indicaram que a performance de escalas balanceadas foi melhor do que de escalas desbalanceadas, bem como na ausência de controle desse viés de resposta, ao considerar as escalas balanceadas e desbalanceadas. Dessa maneira, esta pesquisa aponta para a possibilidade de controle de aquiescência por meio de instrumentos balanceados associada ao uso dos métodos estatísticos na modelagem.(AU)

El control del sesgo de aquiescencia involucra la aplicación de ítems positivos y negativos. Sin embargo, el efecto del equilibrio entre ítems positivos y negativos en el control del sesgo sigue siendo una pregunta abierta. En este sentido, el objetivo de este estudio fue comparar tres modelos de Análisis Factorial Confirmatorio (sin control, MIMIC e Intercepto Aleatorio) para recuperar la estructura factorial de instrumentos balanceados y desbalanceados, a partir de datos simulados y reales (a partir de un instrumento que evalúa personalidad). El control de este sesgo de respuesta indicó que el desempeño de escalas balanceadas fue mejor que el de escalas desbalanceadas, así como en la ausencia del control de la aquiescencia, al considerar escalas balanceadas y desbalanceadas. Por lo tanto, esta investigación sugiere la posibilidad de controlar este sesgo de respuesta por medio de instrumentos balanceados asociados con el uso de métodos estadísticos modelado.(AU)

Bristow-Latarjet Surgery: A Current Overview in Brazil / Cirurgia de Bristow-Latarjet: Um panorama atual do Brasil

Abstract Objective To provide a current overview of the Bristow-Latarjet surgery in Brazil. Materials and MethodsThis cross-sectional study was based on an electronic questionnaire with 26 items, which was sent to active members of the Brazilian Society of Shoulder and Elbow Surgery (Sociedade Brasileira de Cirurgia do Ombro e Cotovelo, SBCOC, in Portuguese). The questionnaire addressed training, surgical technique, complications, and postoperative management. Results We sent the questionnaire to 845 specialists from April 20 to May 12, 2021, and 310 of them answered i in full. During their specialization, most specialists participated in up to ten Bristow-Latarjet procedures. The most frequent complication was graft fracture, while the most common technical difficulty was screw positioning. In total, 50.6% and 73.9% reported having experienced intraoperative and postoperative complications respectively; 57.1% declared performing subscapularis suture; 99.7% indicated postoperative immobilization; and 61.9% considered graft consolidation fundamental. Conclusion Most specialists participated in up to ten Bristow-Latarjet procedures during the specialization, but 13.5% of them graduated without participating in the surgery. The most frequent complication was graft fracture. The most common technical difficulty was screw positioning. Most participants prefer postoperative immobilization since they believe graft consolidation is essential to resume the practiced of sports. The highest complication rate occurred with specialists who have obtained their titles 11 to 15 years ago. In Brazil, the Southeast region is the largest producer of specialists and has the highest concentration of these professionals.

Resumo Objetivo Traçar um panorama atual da cirurgia de Bristow-Latarjet no Brasil. Materiais e Métodos Estudo transversal no qual um questionário eletrônico com 26 perguntas sobre aspectos de formação, técnica cirúrgica, complicações e manejo pós-cirúrgico foi enviado a membros ativos da Sociedade Brasileira de Cirurgia do Ombro e Cotovelo (SBCOC). Resultados Entre 20 de abril e 12 de maio de 2021, o questionário foi enviado a 845 especialistas, e obteve-se 310 respostas completas. Durante a especialização, a maior parte dos especialistas participou de até dez procedimentos de Bristow-Latarjet. A complicação mais frequente foi a fratura do enxerto, e a dificuldade técnica, o posicionamento dos parafusos. Ao todo, 50,6% já tiveram complicações no intraoperatório; 73,9% já tiveram complicações no pós-operatório; 57,1% fazem a sutura do subescapular; 99,7% indicam a imobilização no pós-operatório; e 61,9% consideram a consolidação do enxerto fundamental. Conclusão A maior parte dos especialistas participou de até dez procedimentos de Bristow-Latarjet durante a especialização, mas 13,5% se formaram sem ter participado de nenhuma cirurgia. A complicação mais frequente foi a fratura do enxerto. A dificuldade técnica mais frequente foi o posicionamento dos parafusos. Imobilização no pós-operatório é a preferência da maioria dos participantes, que consideram fundamental a consolidação do enxerto para o retorno ao esporte. O maior número de complicações ocorreu com especialistas que obtiveram o título de 11 a 15 anos atrás. A região Sudeste é a maior formadora de especialistas e onde está concentrada a maior parte deles.

Modulation of Alveolar Macrophage Activity by Eugenol Attenuates Cigarette-Smoke-Induced Acute Lung Injury in Mice.

This study investigates the role of eugenol (EUG) on CS-induced acute lung injury (ALI) and how this compound is able to modulate macrophage activity. C57BL/6 mice were exposed to 12 cigarettes/day/5days and treated 15 min/day/5days with EUG. Rat alveolar macrophages (RAMs) were exposed to CSE (5%) and treated with EUG. In vivo, EUG reduced morphological changes inflammatory cells, oxidative stress markers, while, in vitro, it induced balance in the oxidative stress and reduced the pro-inflammatory cytokine release while increasing the anti-inflammatory one. These results suggest that eugenol reduced CS-induced ALI and acted as a modulator of macrophage activity.

Computational Biology Helps Understand How Polyploid Giant Cancer Cells Drive Tumor Success.

Precision and organization govern the cell cycle, ensuring normal proliferation. However, some cells may undergo abnormal cell divisions (neosis) or variations of mitotic cycles (endopolyploidy). Consequently, the formation of polyploid giant cancer cells (PGCCs), critical for tumor survival, resistance, and immortalization, can occur. Newly formed cells end up accessing numerous multicellular and unicellular programs that enable metastasis, drug resistance, tumor recurrence, and self-renewal or diverse clone formation. An integrative literature review was carried out, searching articles in several sites, including: PUBMED, NCBI-PMC, and Google Academic, published in English, indexed in referenced databases and without a publication time filter, but prioritizing articles from the last 3 years, to answer the following questions: (i) "What is the current knowledge about polyploidy in tumors?"; (ii) "What are the applications of computational studies for the understanding of cancer polyploidy?"; and (iii) "How do PGCCs contribute to tumorigenesis?"

Terminologia especializada de enfermagem para o cuidado com crianças e adolescentes com epidermólise bolhosa / Specialized nursing terminology for the care of children and adolescents with epidermolysis bullosa / Terminología especializada de enfermería para el cuidado de niños y adolescentes con epidermólisis ampollosa

RESUMO Objetivo: construir uma terminologia especializada de enfermagem para o cuidado com crianças e adolescentes com epidermólise bolhosa. Método: estudo metodológico, documental, construído entre os meses de janeiro a dezembro de 2021, em parceria com o Centro CIPE®, em João Pessoa - Brasil. Os dados foram analisados com utilização da ferramenta PorOnto e dos seguintes referenciais teóricos metodológicos: a Classificação Internacional para Prática de Enfermagem 2019/2020; e o mapeamento humano seguindo a ISO/TR 12300:2016 e o método de validação dos termos. Resultados: o processo de validação com juízes resultou em 480 termos para criança e adolescente com epidermólise bolhosa, os quais foram submetidos ao mapeamento, resultando em 207 constantes na CIPE® e 273 não constantes na CIPE®. Conclusão: evidencia-se um quantitativo maior de termos não constantes, isto pode ser justificado pela peculiaridade da doença e cuidados específicos com a criança e adolescentes. A construção da terminologia fortalece a elaboração de diagnósticos, resultados e intervenção de enfermagem.

ABSTRACT Objective: To build a specialized nursing terminology for the care of children and adolescents with epidermolysis bullosa. Method: Methodological, documentary study, built between the months of January to December 2021, in partnership with the ICNP® Center, in João Pessoa - Brazil. Data were analyzed using the PorOnto tool and the following theoretical methodological references: the International Classification for Nursing Practice 2019/2020, and human mapping following ISO/TR 12300:2016 and the term validation method. Results: The validation process with judges resulted in 480 terms for children and adolescents with epidermolysis bullosa, which were submitted to mapping, resulting in 207 constant ICNP® terms and 273 non-constant ICNP® terms. Conclusion: a higher number of non-constant terms is evidenced, which can be justified by the peculiarity of the disease and specific care with children and adolescents. The construction of terminology strengthens the development of diagnoses, outcomes, and nursing intervention.

RESUMEN Objetivo: construir una terminología especializada de enfermería para el cuidado de niños y adolescentes con epidermólisis ampollosa. Método: Estudio metodológico, documental, construido entre los meses de enero y diciembre de 2021, en colaboración con el Centro CIPE®, en João Pessoa - Brasil. Los datos fueron analizados utilizando la herramienta PorOnto y las siguientes referencias teóricas metodológicas: la Clasificación Internacional para la Práctica de Enfermería 2019/2020; y el mapeo humano siguiendo la norma ISO/TR 12300:2016 y el método de validación de términos. Resultados: El proceso de validación con jueces dio como resultado 480 términos para niños y adolescentes con epidermólisis ampollosa, que se sometieron a mapeo, dando como resultado 207 términos incluidos en la CIPE® y 273 términos no incluidos en la CIPE®. Conclusión: se evidencia una mayor cantidad de términos no constantes, lo que puede justificarse por la peculiaridad de la enfermedad y los cuidados específicos de niños y adolescentes. La construcción de la terminología refuerza la elaboración de diagnósticos, resultados e intervenciones médicas.

Serratus plane block with sedation for patients submitted to axillary dissection: a prospective case series.

Axillary dissection is a standard surgical procedure for stage III skin and soft tissue tumors and is usually performed under general anesthesia. This study aimed to investigate the feasibility of performing axillary dissection with Serratus muscle plane block plus intravenous sedation. Fifteen patients undergoing axillary dissection were prospectively recruited. The patients were evaluated during their pre-operative anesthetic appointment, during their procedure, and at post-operative days 1 and 30. The blockade was performed superficial to the Serratus muscle at the level of fourth rib. Sedation was performed using propofol, fentanyl, dexmedetomidine, and S-ketamine. None of the patients required conversion to general anesthesia. Surgeons showed a highly positive response when asked about the anesthetic technique, and most of them found the technique "indistinguishable" from general anesthesia. The median (interquartile range) pain scores at rest over all time frames was 0 (0-0). Furthermore, no patients developed nausea, hemodynamic instability, or any complications associated with the technique. The Serratus plane block associated with intravenous sedation proved feasible for axillary lymphadenectomy, however, further clinical trials should evaluate potential advantages compared to other techniques.

Cuidados de enfermagem com crianças e adolescentes com epidermólise bolhosa: revisão sistemática / Cuidados de enfermería a niños y adolescente con epidermólisis ampollosa: revisión sistemática / Nursing care for children and adolescents with epidermolysis bullosa: a systematic review

Resumo Objetivo Analisar a produção científica referente às ações/Intervenções de Enfermagem no ambiente hospitalar relacionadas ao cuidado com crianças e adolescentes com epidermólise bolhosa. Métodos Revisão sistemática, cuja busca se deu nas bases Cinahl, MEDLINE®/PubMed®, SCOPUS, LILACS e SciELO, realizada no período de setembro de 2020 a janeiro de 2021. Para a busca, foram utilizados os descritores "epidermólise bolhosa" AND "criança" AND "adolescente" AND "enfermagem", nas bases Lilacs e SciELO, e "epidermolysis bullosa" AND "children" AND "adolescent" AND, "nursing" nas demais bases em inglês. Resultados Houve maior registro de artigos publicados com base na pergunta norteadora tendo como país de origem os Estados Unidos (22%). A maioria da classificação era no nível VI (44%) da evidência científica. Ainda, 86% dos estudos envolveram pesquisas para o plano de cuidados. As evidências encontradas decorreram de opiniões de especialistas, estudos de casos e consenso. Os fatores de cuidados mais citados foram planos de cuidados voltados à pele; troca de fraldas; cuidados com as roupas e uso de coberturas antiaderentes. Conclusão As pesquisas reportaram dificuldades quanto à disponibilidade de materiais, tratamento e profissionais especializados, além das limitações dos conhecimentos na prática clínica voltada às características da epidermólise bolhosa. Dentre os cuidados, houve destaque para informação sobre a complexidade e as características da ferida como forma de antecipar as estratégias de cuidado.

Resumen Objetivo Analizar la producción científica referente a las acciones/intervenciones de enfermería en el ambiente hospitalario relacionadas con el cuidado a niños y adolescentes con epidermólisis ampollosa. Métodos Revisión sistemática, cuya búsqueda se realizó en las bases Cinahl, MEDLINE®/PubMed®, SCOPUS, LILACS y SciELO, realizada en el período de septiembre de 2020 a enero de 2021. Para la búsqueda se utilizaron los descriptores "epidermólisis ampollosa" AND "niño" AND "adolescente" AND "enfermería", en las bases Lilacs y SciELO, y "epidermolysis bullosa" AND "children" AND "adolescent" AND, "nursing" en las demás bases en inglés. Resultados Con base en la pregunta orientadora, hubo un mayor registro de artículos publicados que tenían como país de origen Estados Unidos (22 %). La mayoría de la clasificación era de nivel VI (44 %) de la evidencia científica. Además, el 86 % de los estudios incluyeron investigaciones en el plano de los cuidados. Las evidencias encontradas derivaban de opiniones de especialistas, estudios de casos y consenso. Los factores de cuidados más citados fueron planos de cuidados orientados a la piel, cambio de pañales, cuidados con la ropa y uso de coberturas antiadherentes. Conclusión Las investigaciones indicaron dificultades en cuanto a la disponibilidad de material, tratamiento y profesionales especializados, además de las limitaciones de conocimientos en la práctica clínica orientada hacia las características de la epidermólisis ampollosa. Entre los cuidados, se destacó la información sobre la complejidad y las características de la herida como forma de anticipar las estrategias de cuidado.

Abstract Objective To analyze the scientific production regarding actions/Nursing Interventions in hospital environments related to the care of children and adolescents with epidermolysis bullosa. Methods This is a systematic review, which was searched in the CINAHL, MEDLINE®/PubMed®, Scopus, LILACS and SciELO databases, carried out from September 2020 to January 2021. For the search, the descriptors "epidermólise bolhosa" AND "criança" AND "adolescente" AND "enfermagem" were used, in Portuguese, in the LILACS and SciELO databases, and "epidermolysis bullosa" AND "children" AND "adolescent" AND "nursing" in the other databases. Results There was a greater number of articles published based on the guiding question having the United States as the country of origin (22%). Most of the classification was at level VI (44%) of scientific evidence. Still, 86% of studies involved research for the care plan. The evidence found resulted from expert opinions, case studies and consensus. The most cited care factors were skin care plans, diaper changing, clothing care and non-stick coating use. Conclusion The surveys reported difficulties regarding the availability of materials, treatment and specialized professionals, in addition to limitations of knowledge in clinical practice focused on the characteristics of epidermolysis bullosa. Among the care, there was emphasis on information about the wound complexity and characteristics as a way of anticipating care strategies.

Lavagem cerebral: ciência, mito e pseudociência do controle psicológico / Lavado de cerebro: ciencia, mito y pseudociencia del control psicológico / Brainwashing: science, myth, and pseudoscience of psychological control

Resumo O interesse pela possibilidade de reconfigurar a mente humana foi recorrente na história da humanidade, sob diferentes formas aliadas principalmente à religião, à guerra e à política. Somente a partir de 1950, entretanto, é que psicólogos, psiquiatras e outros pesquisadores se dedicaram com maior profundidade ao tema, popularizado pelo termo genérico de lavagem cerebral. O objetivo deste artigo é revisar as bases teórico-conceituais e metodológicas desses esforços, assim como sua manifestação atualizada na psicologia social, quando se busca a modificação de atitudes, crenças e comportamentos. São analisados criticamente os usos da lavagem cerebral para gerar mudanças significativas por técnicas de pressões psicológicas e tortura física, os mitos de sua implementação e sua (ir)reversibilidade.

Resumen El interés por la posibilidad de reconfigurar la mente humana ha sido recurrente en la historia de la humanidad, en diferentes formas, principalmente aliadas a la religión, la guerra y la política. Sin embargo, sólo después de 1950, psicólogos, psiquiatras y otros investigadores se dedicaron con mayor profundidad al tema, popularizado por el término genérico de lavado de cerebro. El objetivo de este artículo es revisar las bases teórico-conceptuales y metodológicas de estos esfuerzos, así como su manifestación actualizada en la psicología social, cuando se busca modificar actitudes, creencias y conductas. Se analizan críticamente los usos del lavado de cerebro para generar cambios significativos a través de técnicas de presión psicológica y tortura física, los mitos de su implementación y su (ir)reversibilidad.

Abstract The interest in the possibility of reconfiguring the human mind has been recurrent in the history of humanity, in different forms, mainly allied to religion, war, and politics. Only after 1950, however, did psychologists, psychiatrists, and other researchers dedicate themselves in greater depth to the topic, popularized by the generic term brainwashing. The aim of this paper is to review the theoretical-conceptual and methodological bases of these efforts, as well as their updated manifestation in social psychology, when one seeks to modify attitudes, beliefs, and behaviors. The uses of brainwashing to generate significant change through techniques of psychological pressure and physical torture, the myths of its implementation, and its (ir)reversibility, are critically analyzed.

Serratus plane block with sedation for patients submitted to axillary dissection: a prospective case series / Bloqueio do plano do músculo serrátil guiado por ultrassonografia associado à sedação venosa como técnica anestésica em cirurgia de linfadenectomia axilar: uma série de casos prospectiva

ABSTRACT Axillary dissection is a standard surgical procedure for stage III skin and soft tissue tumors and is usually performed under general anesthesia. This study aimed to investigate the feasibility of performing axillary dissection with Serratus muscle plane block plus intravenous sedation. Fifteen patients undergoing axillary dissection were prospectively recruited. The patients were evaluated during their pre-operative anesthetic appointment, during their procedure, and at post-operative days 1 and 30. The blockade was performed superficial to the Serratus muscle at the level of fourth rib. Sedation was performed using propofol, fentanyl, dexmedetomidine, and S-ketamine. None of the patients required conversion to general anesthesia. Surgeons showed a highly positive response when asked about the anesthetic technique, and most of them found the technique "indistinguishable" from general anesthesia. The median (interquartile range) pain scores at rest over all time frames was 0 (0-0). Furthermore, no patients developed nausea, hemodynamic instability, or any complications associated with the technique. The Serratus plane block associated with intravenous sedation proved feasible for axillary lymphadenectomy, however, further clinical trials should evaluate potential advantages compared to other techniques.

RESUMO A linfadenectomia axilar é um procedimento cirúrgico padrão para tratamento de tumores de pele e partes moles no estádio III e usualmente é realizada sob anestesia geral. A presente serie de casos prospectiva tem por objetivo investigar a viabilidade da realização da linfadenectomia axilar com o uso do bloqueio do plano do músculo serrátil anterior associado a sedação endovenosa. Foram incluídos 15 pacientes no estudo. Os participantes foram recrutados e avaliados durante consulta pré-anestésica ambulatorial, acompanhados durante o dia da cirurgia, no primeiro e no trigésimo dias de pós-operatório. O bloqueio foi realizado anterior ao músculo serrátil anterior ao nível da quarta costela na linha axilar média. A sedação foi realizada com o uso de propofol, fentanil, dexmedetomidina e dextrocetamina. Não houve necessidade de conversão para anestesia geral em nenhum paciente. Os cirurgiões apresentaram resposta altamente positiva quando questionados sobre a técnica anestésica, considerando na maior parte dos casos "indistinguível" da anestesia geral. A mediana (intervalo interquartil) da dor em repouso em todos os momentos avaliados foi 0 (0-0). Além disso, nenhum paciente desenvolveu náuseas, vômitos, instabilidade hemodinâmica ou qualquer complicação relacionada à técnica empregada. O bloqueio do plano do músculo Serrátil anterior associado a sedação venosa se mostrou viável para execução de linfadenectomia axilar, entretanto ensaios clínicos adicionais são necessários para avaliar potenciais vantagens em comparação com outras técnicas.

Prazer com o sofrimento alheio: adaptação da Escala Reduzida de Impulso Sádico (ERIS) / Pleasure with the suffering of others: adaptation of the Reduced Sadistic Impulse Scale (ERIS)

O sadismo retrata comportamentos de agressão, indiferença e prazer ao causar sofrimento em outros indivíduos. Ainda não existe consenso na literatura psiquiátrica sobre se deve ser considerado um transtorno ou apenas um aspecto subclínico. O objetivo deste estudo foi adaptar para o português brasileiro a Short Sadistic Impulse Scale (SSIS), bem como buscar evidências de validade baseadas na estrutura interna. Compuseram a amostra 478 participantes, de 18 a 63 anos (M = 23,05; DP = 6,22), que responderam a um questionário demográfico e à escala traduzida. Na primeira etapa, realizou-se o processo de adaptação cultural e, na segunda, buscou-se evidências de validade. Modelagens por equações estruturais exploratórias indicaram que a Escala Reduzida de Impulso Sádico (ERIS) manteve a unidimensionalidade original. Mulheres apresentaram maior sadismo. A ERIS se mostra adequada para aplicações na população geral e capaz de captar as especificidades do sadismo

Construindo escalas de autorrelato: o que fazer? / Developing self-report scales: what to do? / Construcción de escalas de autoinforme: ¿qué hacer?

Escalas de autorrelato são comuns no cotidiano de pesquisadores, porém detalhes, que às vezes parecem de pouca importância, acabam sendo desconsiderados. Autorrelato são caracterizados pela pessoa de interesse ser a própria fonte de informação do pesquisador, assim a forma em que as possibilidades de resposta são apresentadas é de suma importância. Os formatos de resposta mais comuns são tipo Likert e as escolhas forçadas que vem ganhando popularidade nos últimos anos. Neste artigo são apresentados os elementos necessários que devem ser observados quando se constrói ou se escolhe escalas que possuam esses dois formatos de resposta. São discutidos também a quantidade de itens ou blocos necessários, as opções de resposta, polaridade dos itens, sistema de correção, bem como ao final são indicadas boas práticas na construção de itens para ambos os formatos. Dessa forma, pretende-se contribuir para a Psicologia, em especial a área de construção de instrumentos de autorrelato.(AU)

Self-report scales are common in the daily lives of researchers, however, details, which sometimes seem of little importance, can end up being disregarded. Self-reports are characterized by the person of interest being the researcher's own source of information, therefore the way in which the response possibilities are presented is of paramount importance. The most common response formats are Likert type and forced choice, which have been gaining popularity in recent years. This article presents the elements that must be observed when developing or choosing scales that have these two response formats. Also discussed are the number of items or blocks needed, the answer options, item polarity, the correction system, and good practices in the construction of items for both formats. The intention is to contribute to Psychology, especially the area of construction of self-report instruments.(AU)

Las escalas de autoinforme son habituales en el día a día de los investigadores, pero los detalles, que a veces parecen de poca importancia, acaban siendo desestimados. Los autoinformes se caracterizan porque la persona de interés es la propia fuente de información del investigador, por lo que la forma en que se presentan las posibilidades de respuesta es de suma importancia. Los formatos de respuesta más comunes son tipo Likert y las elecciones forzadas, que han ido ganando popularidad en los últimos años. Este artículo presenta los elementos necesarios que se deben observar al momento de construir o elegir escalas que tengan estos dos formatos de respuesta. También se discute la cantidad de ítems o bloques necesarios, las opciones de respuesta, la polaridad de los ítems, el sistema de corrección, así como las buenas prácticas en la construcción de ítems para ambos formatos. De esta forma, se pretende contribuir a la Psicología, especialmente al área de construcción de instrumentos de autoinforme.(AU)

Milk kefir therapy improves the skeletal response to resistance exercise in rats submitted to glucocorticoid-induced osteoporosis.

Glucocorticoid-induced osteoporosis (GIO) has emerged as a challenge after long-term glucocorticoids (GCs) administration. Exercise has been an important non-pharmacological option, while medications modulate bone remodeling despite adverse effects. In this way, milk Kefir (MK) therapy stands out as a safe alternative to improve bone metabolism. Our study aimed to investigate the effect of MK associated to resistance exercise on bone loss in rats with GIO. For this, sixty male Wistar rats were divided into 2 groups: normal (N) and subjected to GIO, which was subdivided into 4 groups: control (C), milk kefir therapy (K), Exercise (Ex), and Exercise+K (ExK). GIO was induced by dexamethasone (7 mg/kg - i.m.; 1×/wk, 5 wk). MK was administered daily (1×/day; 0.7 ml/animal) and the climb exercise with load was performed 3×/wk; both for 16 wk. Femur was collected for assessment of bone microarchitecture, quality and metabolism. GIO markedly reduced trabecular bone volume density (BV/TV) (-35 %), trabecular thickness (Tb.Th) (-33 %), mineral content of femur (-26 %) as well as bone collagen content (-56 %). Bone strength and its biomechanical properties given by flexural strength (-81 %), fracture load (-80 %), and the number of osteocytes (-84 %) were lowered after GIO. GCs reduced osteoblast number and function while increased osteoclast number, altering bone remodeling (p < 0.05). On the other hand, ExK significantly improved bone microarchitecture and quality, marked by fractal dimension increase (+38 %), cortical volume (+34 %), BV/TV (+34 %), Tb.Th (+33 %), mineral content and collagen maturity, while reduced the space between trabecula (-34 %). The Ex and ExK increased the number of osteocytes (p < 0.05) and they were able to reverse the lower osteoblast number. Both treatments used alone significantly enhanced bone biomechanical properties, but the ExK showed a more significant improvement. ExK ameliorated bone strength and biomechanics (p < 0.05) and stimulated bone formation and modulated bone remodeling (p < 0.05). MK and exercise administered isolated or in association increased the percentage of collagen bone filling after GIO (p < 0.05), but only ExK improved collagen maturity. Our results showed that MK associated to resistance exercise enhanced bone microarchitecture, quality and metabolism, being therefore an interesting tool to improve skeletal response during GIO.

A New Multi-Color FISH Assay for Brush Biopsy-Based Detection of Chromosomal Aneuploidy in Oral (Pre)Cancer in Patients with Fanconi Anemia.

BACKGROUND: Fanconi anemia (FA) is a rare inherited DNA instability disorder with a remarkably elevated risk of oral squamous cell carcinoma. These cancers can be detected with oral brush biopsy-based cytology even at early stages. This study aims to determine the diagnostic accuracy of a new multi-color fluorescent in situ hybridization (FISH) assay consisting of probes for CCND1, TERC, MYC and centromere of chromosome 6, as well as a 9p21 FISH assay consisting of probes for CDKN2A and centromere of chromosome 9 for the detection of oral (pre) malignant lesions in FA. METHODS: (I) Cutoffs for the dichotomization of positive or negative multi-color FISH results are determined and (II) retrospectively validated by using archived oral brush biopsy specimens from individuals with Fanconi anemia. In addition, the specimens for cutoff determination were re-hybridized with the 9p21 FISH assay. RESULTS: A cutoff of six or more chromosomal aneuploid cells for a positive FISH result was determined in the cutoff study on 160 biopsy specimens. The validating of this cutoff on 152 specimens showed at best a sensitivity of 87% and a specificity of 82.9%. CONCLUSION: Multi-color FISH is a sufficient tool to detect chromosomal aneuploidy in oral (pre) malignant lesions of individuals with Fanconi anemia. However, some false positive results may hamper the application as an adjuvant method to oral brush biopsy-based cytology in an oral cancer surveillance program.

Tríade Sombria baseada em um modelo de virtudes da psicologia positiva / Dark Triad based on a virtue model of positive psychology / Tríada Oscura basada en un modelo de virtudes de la psicología positiva

A partir de investigações recentes entre variáveis consideradas socialmente desejáveis, como as forças de caráter e virtudes, deu-se início a propostas que visam a analisar como essas características se comportam quando utilizadas de maneira extrema. Um conjunto de traços conhecido por suas características extremas e antagonistas são as variáveis da tríade sombria (maquiavelismo, narcisismo e psicopatia). Este estudo teve como objetivo analisar, a partir de um modelo multivariado, a contribuição das virtudes na explicação da tríade sombria. Participaram 284 adultos, com idades entre 18 a 65 anos (M = 29,06; DP = 9,73); respondendo a Escala de Forças de Caráter e o Short Dark Triad. A partir do modelo restrito de path analysis, os resultados indicaram que as virtudes interpessoais, de coragem, de humanidade e de autorregulação explicaram as dimensões sombrias. Quando sub ou superutilizadas, as virtudes podem atuar como possíveis preditoras de comportamentos socialmente indesejáveis, vide a tríade sombria.(AU)

Based on recent investigations of variables considered socially desirable, such as character strengths and virtues, proposals have been initiated that aim to analyze how these characteristics behave when underused or overused. A set of traits known for their extreme and antagonistic characteristics are the variables of the Dark Triad (Machiavellianism, narcissism and psychopathy). This study aimed to analyze, from a multivariate model, the contribution of virtues in explaining the Dark Triad. Participants were 284 adults, aged 18 to 65 years (M = 29.06; SD = 9.73); who responded to the Escala de Forças de Caráter and the Short Dark Triad. Based on the restricted path analysis model, the results indicated that the interpersonal virtues, courage, humanity and self-regulation explained the dark dimensions. When underused or overused, virtues can act as possible predictors of socially undesirable behaviors, such as the Dark Triad.(AU)

Con base en recientes investigaciones entre variables consideradas socialmente deseables, como las fortalezas de carácter y virtudes, se han iniciado propuestas para analizar cómo se comportan estas características cuando se utilizan de forma extrema. Un conjunto de rasgos conocidos por sus características extremas y antagónicas son las variables de la tríada oscura (Maquiavelismo, narcisismo y psicopatía). Este estudio tuvo como objetivo analizar la contribución de las virtudes en la explicación de la tríada oscura, a partir de un modelo multivariante. Participaron 284 adultos, de entre 18 y 65 años (M = 29.06; DS = 9.73); respondiendo a la Escala de Forças de Caráter y la Short Dark Triad. A partir del modelo de path analysis los resultados indican que las virtudes interpersonales, de valor, de humanidad y de autorregulación explican las dimensiones oscuras. Cuando se infrautilizan o se sobreutilizan, las virtudes pueden actuar como posibles predictores de comportamientos socialmente indeseables, véase la tríada oscura.(AU)