Heterogeneity in families with ATTRV30M amyloidosis: a historical and longitudinal Portuguese case study impact for genetic counselling.

BACKGROUND: Hereditary transthyretin amyloidosis (ATTRv amyloidosis) is an inherited disease, where the study of family history holds importance. This study evaluates the changes of age-of-onset (AOO) and other age-related clinical factors within and among families affected by ATTRv amyloidosis. METHODS: We analysed information from 934 trees, focusing on family, parents, probands and siblings relationships. We focused on 1494 female and 1712 male symptomatic ATTRV30M patients. Results are presented alongside a comparison of current with historical records. Clinical and genealogical indicators identify major changes. RESULTS: Overall, analysis of familial data shows the existence of families with both early and late patients (1/6). It identifies long familial follow-up times since patient families tend to be diagnosed over several years. Finally, results show a large difference between parent-child and proband-patient relationships (20-30 years). CONCLUSIONS: This study reveals that there has been a shift in patient profile, with a recent increase in male elderly cases, especially regarding probands. It shows that symptomatic patients exhibit less variability towards siblings, when compared to other family members, namely the transmitting ancestors' age of onset. This can influence genetic counselling guidelines.

An Analysis of Seafood Recalls in the United States, 2002 Through 2022.

This review analyzes the seafood recalls registered by the United States Food and Drug Administration (USFDA) from October 2002 through March 2022. There were more than 2,400 recalls for seafood products over this 20-year period. Biological contamination was the listed root cause for about 40% of these recalls. Almost half were designated as Class I recalls, due to the high risk of the recalled seafood to cause disease or death. Independent of the recall classification, 74% of the recalls were due to violations of the Current Good Manufacturing Practices (cGMPs) regulations. The most common cause for these seafood recalls was due to undeclared allergens (34%). More than half of the undeclared allergen recalls were for undeclared milk and eggs. Recalls for Listeria monocytogenes accounted for 30% of all recalls and were all Class I. Finfish comprised 70% of the recall incidents, and salmon was the single most recalled species (22%). Improper cold smoking treatment that resulted in Listeria monocytogenes contamination was the most common reason reported for the salmon recalls. The goal of this review was to evaluate the main causes of food safety failures within the seafood manufacturing and distribution sectors. Human errors and failures to control food safety risks during the processing of food are the main driving factors for most reported recalls in the U.S. Properly applying the Hazard Analysis Critical Control Points (HACCP) approach and procedures are needed to identify the potential food safety risks. The key to reducing the risks of human error and loss of process control is the development and implementation of an effective food safety culture program at the manufacturing facility, which must require strong senior management support at corporate and enterprise levels.

Desafios e potencialidades para a estruturação e o funcionamento dos Conselhos Locais de Saúde de Porto Alegre

O objetivo deste trabalho foi identificar a presença, bem como formas de atuação e funcionamento dos Conselhos Locais de Saúde (CLS) da cidade de Porto Alegre, visto o seu fomento como meta de gestão neste município, incluída por iniciativa do Conselho Municipal de Saúde. Metodologia: Trata-se de uma pesquisa exploratória e descritiva. Primeiramente, determinou-se a quantidade de CLS ativos. Em seguida, procurou-se agendar uma entrevista semiestruturada em grupo com os CLS encontrados, utilizando um instrumento desenvolvido e validado. Foi feita a estatística descritiva com a determinação de frequências. Resultados e Discussão: Foram encontrados 56 CLS ativos e 32 entrevistas foram realizadas. Os CLS têm uma Coordenação Local instituída e presente, com reuniões ocorrendo com pautas definidas, onde são discutidos assuntos de saúde e da vida comunitária, ainda que com baixa participação da comunidade. Os CLS usam a estrutura descentralizada de conselhos bem como outros canais como sistema de justiça e representantes políticos para encaminhar as demandas. Considerações finais: A inclusão de CLS como meta de gestão mostrou um resultado positivo no aumento dos CLS. Porém se deve pensar mais em cada território e suas particularidades, com ações que diversifiquem as formas de mobilização.

Mucopolysaccharidosis Type I: The Importance of Early Diagnosis for Adequate Treatment.

Mucopolysaccharidoses are rare lysosomal storage disorders in which glycosaminoglycans accumulate in tissues, causing multiorgan dysfunction. Mucopolysaccharidosis type I is an autosomal recessive disease caused by a deficiency of the enzyme alpha-L-iduronidase, resulting in the accumulation of dermatan and heparan sulfate. Early diagnosis is crucial for early treatment and improved outcomes. We report the case of a female child with classic clinical features who was diagnosed early which allowed hematopoietic stem cell transplantation and slowed disease progression. She presented at birth with linea alba and umbilical and inguinal hernias. Since the first months of life, she had recurrent respiratory infections. At nine months, a motor delay was noticed, and at 20 months, craniosynostosis was corrected with surgery. Coarse facial features, thoracolumbar kyphosis, and hepatomegaly prompted a urinary glycosaminoglycan study at 22 months, which showed elevated levels. Alfa-L-iduronidase activity in dried blood spot testing was low, compatible with mucopolysaccharidosis type I. Molecular testing of gene IDUA, performed for genetic counseling, revealed the pathogenic variants c.1205G>A (p.Trp402Ter) and c.1598C>G (p.Pro533Arg) in compound heterozygosity. At 26 months, her development quotient was average for her age. She started enzyme replacement therapy at 29 months and underwent hematopoietic stem cell transplantation at 33 months, which softened the coarse features, reduced respiratory infections, and improved hepatomegaly. However, at age five, her development quotient was 76 (mean = 100, standard deviation = 15). This intellectual impairment might have been prevented with an earlier diagnosis and treatment.

Genomic characterisation of multiple myeloma: study of a Portuguese cohort.

Multiple myeloma (MM) genomic complexity reflects in the variable patients' clinical presentation. Genome-wide studies seem to be a reasonable alternative to identify critical genomic lesions. In the current study, we have performed the genomic characterisation of a Portuguese cohort of patients with MM by array comparative genomic hybridisation. Overall, the most frequently detected alterations were 13q deletions, gains of 1q, 19p, 15q, 5p and 7p and trisomy 9. Even though some identified genomic alterations were previously associated with a prognostic value, other abnormalities remain with unknown, but putative significance for patients' clinical practice. These genomic alterations should be further assessed as possible biomarkers.

Clinical, sonographic and anatomopathological aspects of ovarian teratoma in a heifer / Aspectos clínicos, ultrassonográficos e anatomopatológicos do teratoma ovariano em uma novilha

Teratomas rarely occur in domestic species, especially in cattle. These tumors originate in fetal life and are characterized by rapid growth, which justifies their frequent detection in young animals. This study reported a case of ovarian teratoma in a heifer. On physical examination, the main signs identified were apathy, abdominal distention and tension, empty rumen, and mushy diarrhea. During rectal palpation, a mass was identified in the pelvic region, which was suggestive of cysts on ultrasound examination. The animal underwent laparotomy, followed by euthanasia due to a poor prognosis. At necropsy, a 54 x 43 x 52 cm (length x width x thickness) tumor was observed in the right ovary with multiple cystic areas, in addition to masses associated with multiple adhesions of the intestinal loops and peritonitis. On histopathology, muscle, cartilage, bone, nervous and epithelial tissue, glands, hair with follicles, were identified in the affected ovary. There was mixed inflammation and foci of necrosis observed with a complete absence of ovarian architecture in both the ovaries. Infiltrations were identified in the lymph nodes and mesenteric vessels. Glandular ducts were seen from the serosa to the intestinal mucosa. A locally infiltrative and expansile ovarian teratoma was diagnosed accordingly. It is considered that this kind of tumor can induce abdominal distension and absence of estrus in previously healthy, non-pregnant heifers.

Os teratomas são tumores raros nas espécies domésticas, sobretudo em bovinos. Esses tumores são caracterizados por crescimento rápido e origem durante a vida fetal, o que justifica seu diagnóstico frequente em animais jovens. O presente trabalho relata um caso de teratoma ovariano em uma novilha. No exame físico, os principais sinais identificados foram apatia, distensão e tensão abdominal, rúmen vazio e diarreia pastosa. Durante a palpação retal, uma massa foi identificada na região pélvica. Ao exame ultrassonográfico, a massa era sugestiva de cistos. O animal foi submetido a laparotomia, seguido de eutanásia devido ao mau prognóstico. Na necropsia foi observado um tumor de 54 x 43 x 52 cm (comprimento x largura x espessura) no ovário direito com múltiplas áreas císticas, além de massas associadas à múltiplas aderências das alças intestinais e peritonite. Na histopatologia foram identificados no ovário acometido a presença de tecidos muscular, cartilaginoso, ósseo, nervoso e epitelial, com glândulas, pelos e folículos. Havia inflamação mista e focos de necrose com ausência completa de arquitetura ovariana em ambos os ovários. Infiltrações foram identificadas em linfonodos e vasos mesentéricos. Ductos glandulares foram vistos desde a serosa até mucosa intestinal. Diagnosticou-se um teratoma ovariano localmente infiltrativo e expansivo. Considera-se que este tumor pode induzir distensão abdominal e ausência de estro em novilhas previamente sadias e não gestantes.

Diffuse Alopecia and Thyroid Atrophy in Sheep.

Thyroid dysfunction substantially affects the quality of life due to its association with various disorders in different organs. A low intake of selenium and zinc can predispose to thyroid alterations, resulting in hypothyroidism. A deficiency of selenium and zinc causes direct and indirect skin lesions, both by the action of free radicals on the skin and by thyroid dysfunction. The aim of this study was to describe natural cases of diffuse alopecia and thyroid abnormalities in sheep with selenium and zinc deficiency. Five adult sheep presented marked and diffuse alopecia, and the residual hairs were dry and brittle. The skin was thick and crusty, with marked peeling. The triiodothyronine (T3) and thyroxine (T4) serum concentrations were below reference values for the species. Zinc and Se concentrations were low in both the serum and liver. During necropsy, cachexia associated with serous fat atrophy was observed, and the thyroid glands showed marked atrophy. Microscopically, the thyroid presented multifocal to coalescent atrophy, with atrophied and dilated follicles, macrophage infiltration, and the presence of fibrous connective tissue. The skin revealed hyperkeratosis and edema. It is concluded that thyroid atrophy, alopecia, and hyperkeratosis are associated with low serum and liver concentrations of zinc and selenium in sheep.

Ocular and oral lesions caused by Tacinga inamoena in sheep and goats in Northeast Brazil

ABSTRACT: Two outbreaks of traumatic injuries in goats and sheep associated with grazing and ingestion of the cactus Tacinga inamoena have recently been reported in the state of Paraíba, Brazil. In the first of these, which was detected in 2019 during a preliminary inspection of a herd of 70 animals, it was found that 15 showed certain ocular complications, and these animals were subjected to general physical and ophthalmic examinations. The clinical findings included excessive lacrimation, blepharitis, photophobia, corneal opacity, hyphema, corneal neovascularization, corneal ulcers, and adherence of gloquids to the bulbar conjunctiva and cornea. Large amounts of T. inamoena were found to be present in several areas in which these animals had been grazed and had been observed consuming the fruits of this plant. In the second outbreak during the following year, two sheep from a total of 100 animals were identified as having oral lesions associated with grazing in areas within which T. inamoena was growing. One of these animals was referred to a veterinary hospital, and on physical examination was found to show apathy, anorexia, a body score of 1.5, and the presence of gloquids within the fur. With respect to the oral cavity, halitosis, severe sialorrhea, extensive hemorrhagic ulcers, and painful tenderness on palpation were detected. Given the unfavorable prognosis, the sheep was subsequently euthanized. At necropsy, multifocal to coalescent plaques were detected on the upper and lower lips, oral mucosa, tongue, and hard and soft palates. These were generally elevated and firm and characterized by an irregular, ulcerated surface, sometimes crusty, with a yellow to light brown center and erythematous edges. The findings of this study highlight that the consumption of T. inamoena can cause serious oral and ophthalmic lesions in small ruminants in the northeastern semi-arid regions of Brazil, and can potentially contribute to substantial large economic losses. This problem tends to be exacerbated by the invasive behavior of T. Inamoena, particularly in areas in the process of environmental degradation.

RESUMO: Relatam-se dois surtos de lesões traumáticas associadas ao pastejo e ingestão da Tacinga inamoena por caprinos e ovinos no estado da Paraíba, Brasil. No primeiro surto observou-se durante uma inspeção preliminar do rebanho que 15 dos 70 animais apresentavam alterações oculares, os animais foram submetidos ao exame físico geral e ao exame oftálmico. Lacrimejamento excessivo, blefarite, fotofobia, opacidade de córnea, hifema, neovascularização corneana, úlceras de córnea e gloquídeos aderidos à conjuntiva bulbar e córnea foram os achados clínicos identificados. A planta estava presente em diversas áreas e em grande quantidade nas áreas de pastejo, onde os animais eram vistos ingerindo seus frutos. No segundo surto, dois ovinos de um total de 100 animais, foram identificados com lesões orais associadas ao pastejo em áreas da planta. Um deles foi encaminhado ao Hospital Veterinário. No exame físico, o animal apresentou apatia, anorexia, escore corporal 1,5, pelos opacos, eriçados e no pelame era possível identificar gloquídeos. Na cavidade oral observou-se halitose, sialorreia intensa, extensas úlceras hemorrágicas e sensibilidade dolorosa à palpação. Devido ao prognóstico desfavorável o animal foi eutanasiado. Na necropsia, placas multifocais a coalescentes, elevadas, firmes e com superfície irregular, ulcerada, por vezes crostosas, com centro amarelo a marrom-claro e bordos eritematosos, estavam presentes nos lábios superiores, inferiores, mucosa oral, língua, palatos duro e mole. T. inamoena causa sérias lesões orais e oftálmicas em pequenos ruminantes no semiárido nordestino e prejuízos econômicos de grandes dimensões, que podem ser agravados pelo comportamento invasor da T. inamoena em áreas com indícios de degradação ambiental.

Ocular and oral lesions caused by Tacinga inamoena in sheep and goats in Northeast Brazil / Lesões oculares e orais causadas por Tacinga inamoena em ovinos e caprinos no Nordeste brasileiro

Two outbreaks of traumatic injuries in goats and sheep associated with grazing and ingestion of the cactus Tacinga inamoena have recently been reported in the state of Paraíba, Brazil. In the first of these, which was detected in 2019 during a preliminary inspection of a herd of 70 animals, it was found that 15 showed certain ocular complications, and these animals were subjected to general physical and ophthalmic examinations. The clinical findings included excessive lacrimation, blepharitis, photophobia, corneal opacity, hyphema, corneal neovascularization, corneal ulcers, and adherence of gloquids to the bulbar conjunctiva and cornea. Large amounts of T. inamoena were found to be present in several areas in which these animals had been grazed and had been observed consuming the fruits of this plant. In the second outbreak during the following year, two sheep from a total of 100 animals were identified as having oral lesions associated with grazing in areas within which T. inamoena was growing. One of these animals was referred to a veterinary hospital, and on physical examination was found to show apathy, anorexia, a body score of 1.5, and the presence of gloquids within the fur. With respect to the oral cavity, halitosis, severe sialorrhea, extensive hemorrhagic ulcers, and painful tenderness on palpation were detected. Given the unfavorable prognosis, the sheep was subsequently euthanized. At necropsy, multifocal to coalescent plaques were detected on the upper and lower lips, oral mucosa, tongue, and hard and soft palates. These were generally elevated and firm and characterized by an irregular, ulcerated surface, sometimes crusty, with a yellow to light brown center and erythematous edges. The findings of this study highlight that the consumption of T. inamoena can cause serious oral and ophthalmic lesions in small ruminants in the northeastern semi-arid regions of Brazil, and can potentially contribute to substantial large economic losses. This problem tends to be exacerbated by the invasive behavior of T. Inamoena, particularly in areas in the process of environmental degradation.(AU)

Relatam-se dois surtos de lesões traumáticas associadas ao pastejo e ingestão da Tacinga inamoena por caprinos e ovinos no estado da Paraíba, Brasil. No primeiro surto observou-se durante uma inspeção preliminar do rebanho que 15 dos 70 animais apresentavam alterações oculares, os animais foram submetidos ao exame físico geral e ao exame oftálmico. Lacrimejamento excessivo, blefarite, fotofobia, opacidade de córnea, hifema, neovascularização corneana, úlceras de córnea e gloquídeos aderidos à conjuntiva bulbar e córnea foram os achados clínicos identificados. A planta estava presente em diversas áreas e em grande quantidade nas áreas de pastejo, onde os animais eram vistos ingerindo seus frutos. No segundo surto, dois ovinos de um total de 100 animais, foram identificados com lesões orais associadas ao pastejo em áreas da planta. Um deles foi encaminhado ao Hospital Veterinário. No exame físico, o animal apresentou apatia, anorexia, escore corporal 1,5, pelos opacos, eriçados e no pelame era possível identificar gloquídeos. Na cavidade oral observou-se halitose, sialorreia intensa, extensas úlceras hemorrágicas e sensibilidade dolorosa à palpação. Devido ao prognóstico desfavorável o animal foi eutanasiado. Na necropsia, placas multifocais a coalescentes, elevadas, firmes e com superfície irregular, ulcerada, por vezes crostosas, com centro amarelo a marrom-claro e bordos eritematosos, estavam presentes nos lábios superiores, inferiores, mucosa oral, língua, palatos duro e mole. T. inamoena causa sérias lesões orais e oftálmicas em pequenos ruminantes no semiárido nordestino e prejuízos econômicos de grandes dimensões, que podem ser agravados pelo comportamento invasor da T. inamoena em áreas com indícios de degradação ambiental.(AU)

Trabajadores del sexo y salud pública: intersecciones, vulnerabilidades y resistencia / Sex workers and public health: intersections, vulnerabilities and resistance

RESUMEN Desde el siglo XIX, con la sífilis y, más recientemente, con el sida, lxs trabajadorxs del sexo pasaron a ser vistos como medios de transmisión de enfermedades y como un problema de salud pública que requiere intervención. Sin embargo, las investigaciones han demostrado que, en los países occidentales, la tasa de VIH en personas involucradas con la venta de sexo es baja, con excepción de grupos específicos, como los consumidores de drogas por vía inyectable. Además, se han puesto en evidencia los riesgos a los que están sometidos lxs trabajadorxs del sexo, por vía de la estigmatización o de otras formas de violencia. En este artículo, a partir de una etnografía urbana con trabajadorxs del sexo de calle, llevada a cabo en la ciudad de Porto (Portugal) entre 2004 y 2005, discutimos las vulnerabilidades sociales, laborales y jurídicas que afectan a las personas involucradas en el comercio del sexo y cómo interfieren en su salud. Nos centraremos en las estrategias de lxs trabajadorxs del sexo para minimizar los riesgos para la salud y el discurso de resistencia en el combate a las vulnerabilidades.

ABSTRACT Since the 19th century with syphilis and most recently with AIDS, sex workers have been seen as a means for disease transmission and a public health problem that requires intervention. However, researchers have shown that in Western countries, HIV rates in people involved in commercial sex are low, except for in specific groups, such as intravenous drug users. Moreover, the risks faced by sex workers due to stigmatization and other forms of violence have been put into evidence. Based on an urban ethnography with street sex workers carried out in Porto (Portugal), between 2004 and 2005, this article discusses the social, labor, and legal vulnerabilities affecting people involved in commercial sex and how these interfere with their health. Focus is placed on the strategies used by sex workers to minimize health risks and their discourses of resistance in fighting vulnerabilities.

Dia Nacional de Lutas: pelas mídias e pelos sindicalistas trabalhistas / National Day of Fight: by media and trade unionists / Día Nacional de Lucha: por las medias y por los sindicalistas / Journée Nationale des Luttes:: par les médias et par les syndicalistes

A pesquisa teve o objetivo de compreender o evento Dia Nacional de Lutas de julho de 2013 como expressão do sindicalismo trabalhista brasileiro, a partir do olhar da mídia e dos próprios sindicalistas. Aquele evento foi programado sob o clima político criado pela onda de protestos populares do mês antecedente. Realizamos pesquisa documental de reportagens em jornais diários e mídias eletrônicas e entrevistamos dois dirigentes sindicais. Aplicamos análise de conteúdo e identificamos quatro categorias sobre a mobilização: Motivos, Organização, Resultados e Avaliação do Movimento. Acerca dos Motivos e da Organização, as divergências entre os resultados das análises referentes às reportagens e às entrevistas dos dirigentes sindicais são menores, enquanto se acentuam quando se trata dos Resultados e Avaliação do Movimento. No conjunto, os resultados indicaram que o Dia Nacional de Luta expressou um momento de empoderamento do movimento sindical, voltando-se para os interesses mais amplos de todos os cidadãos.

The research aimed to understand the event National Day of Fight in 2013, July, as the expression of Brazilian labor unionism since the perspective of media and the own trade unionists. That event was planned under the political climate that was generated by the wave of popular protests of the preceding month. We developed documental research of reports in daily newspapers and electronic media and we interviewed two trade unionists. We applied content analysis and identified four categories about the mobilization: Motives, Organization, Results and Evaluation of Movement. About the Motives and the Organization, the divergences between the results of analysis in reference to reports and to interviews are smaller, while they increase in reference to Results and Evaluation of movement. In summary, the results indicate that the National Day of Fight expressed the moment of empowerment to syndical movement, retrieving its focus on broader interests of all citizens.

La investigación tubo el objetivo de comprender el evento Día Nacional de Lucha de julio de 2013 como expresión del sindicalismo de los trabajadores brasileños, desde la mirada de la medía y de los propios sindicalistas. Aquel evento fue planteado en el clima político generado por la onda de protestos populares del mes antecedente. Desarrollamos investigación documental de periódicos y entrevistamos dos dirigentes sindicales. Aplicamos análisis de contenido e identificamos cuatro categorías acerca de la movilización: Motivos, Organización, Resultados y Evaluación del Movimiento. Acerca de los Motivos y de la Organización, las divergencias entre los resultados de los análisis referentes a los periódicos y medías electrónicas y las entrevistas de los dirigentes sindicales son menores, mientras se acentúan cuando se refieren a los Resultados y Evaluación del Movimiento. En resumen, los resultados indicaron que el Día Nacional de Lucha expresó un momento de empoderamiento del movimiento sindical, rescatando su foco en los intereses más amplios de todos ciudadanos.

L'objectif de la recherche était de comprendre l'évènement de la Journée Nationale de Lutte de juillet 2013 en tant qu'expression du syndicalisme des travailleurs brésiliens à partir du regard des médias et des syndicalistes eux-mêmes. Cet évènement a été organisé dans le cadre d'un climat politique créé par la vague de manifestations populaires du mois de juin de la même année. Nous avons effectué une étude documentée de reportages issus de quotidiens et de supports électroniques et nous avons aussi interviewé deux dirigeants syndicalistes. Nous y avons appliqué une analyse de contenu et avons identifié quatre catégories à propos de la mobilisation : Raisons, Organisation, Résultat et Evaluation du Mouvement des Raisons et de l'Organisation. Les divergences entre les résultats des analyses en lien avec les reportages et les entrevues des dirigeants syndicalistes sont moins importantes et elles s'accentuent lorsqu'il s'agit des Résultats et Evaluation du Mouvement. Dans l'ensemble, les résultats ont indiqué que la Journée Nationale de Lutte a symbolisé le moment de prise de pouvoir du mouvement syndical et une prise en compte plus élargie des intérêts de tous les citoyens.

Assessment of impairment in activities of daily living in mild cognitive impairment using an individualized scale / Avaliação do comprometimento nas atividades de vida diária no comprometimento cognitivo leve através de uma escala individualizada

ABSTRACT Mild impairment in activities of daily living (ADL) can occur in Mild Cognitive Impairment (MCI), but the nature and extent of these difficulties need to be further explored. The Canadian occupational performance measure (COPM) is one of the few individualized scales designed to identify self-perceived difficulties in ADL. The present study investigated impairments in ADL using the COPM in elderly with MCI. A total of 58 MCI patients were submitted to the COPM for studies of its validity and reliability. The COPM proved a valid and consistent instrument for evaluating ADL in elderly MCI patients. A total of 74.6% of the MCI patients reported difficulties in ADL. Of these problems, 41.2% involved self-care, 31.4% productivity and 27.4% leisure. This data further corroborates recent reports of possible functional impairment in complex ADL in MCI.

RESUMO A presença de dificuldades leves no desempenho de atividades da vida diária (AVD) pode estar presente no comprometimento cognitivo leve (CCL), mas sua natureza e extensão devem ser melhor exploradas. A medida canadense de desempenho ocupacional (COPM) é uma das poucas escalas individualizadas de autorrelato destinadas a identificar dificuldades no desempenho de AVDs. Este estudo investigou as dificuldades em AVDs através da COPM em idosos com CCL. 58 idosos com CCL foram submetidos à validação da COPM. A COPM se mostrou um instrumento válido e consistente para avaliar desempenho de AVDs em idosos com CCL. 74,6% dos idosos relatou alguma dificuldade no desempenho de AVDs, sendo 41,2% em auto-cuidado, 31,4% na produtividade e de 27,4% no lazer. Estes dados acrescentam evidências à recente literatura em que afirma que há comprometimento nas AVDs em CCL.

Percepção dos atores sobre o papel da terapia da fala nos contextos de cinema, dublagens, teatro e televisão em Portugal / Actors? perception on the role of speech therapy in cinema, dubbing, theatre and television contexts in Portugal / Percepción de los actores sobre la función de la logopedia en los contextos de cine, doblaje, teatro y televisión en Portugal

Introdução: Em alguns países tem-se verificado um aumento da parceria entre o terapeuta da fala e o ator, existindo uma expansão crescente da intervenção do terapeuta nos vários contextos profissionais do ator. Em Portugal, esta realidade é ainda pouco conhecida. Objetivo: Descrever e relacionar a percepção que os atores das diferentes áreas performativas: cinema, dublagem, teatro e televisão, têm em relação ao papel do terapeuta da fala. Material e Método: Realizou-se um estudo observacional descritivo-transversal. Recorreu-se a um questionário online para recolha de dados, numa amostra de 72 atores, proveniente de todo o país. Resultados: Nos contextos de dublagem e teatro o terapeuta da fala é considerado como extremamente importante, enquanto em cinema e televisão a classificação obtida é de importante. Apesar de os inquiridos atribuírem um grau elevado de importância à integração do terapeuta da fala nas suas equipes de trabalho, as suas áreas de intervenção ainda não são completamente conhecidas. Na opinião dos inquiridos, o terapeuta da fala pode integrar a equipe dos quatro contextos, nos seguintes aspectos: terapia vocal, orientação de aquecimento vocal e assistência contínua aos atores. Conclusão: Os atores estão receptivos ao trabalho do terapeuta da fala, embora demonstrem uma visão parcial das suas funções. A preparação dos terapeutas da fala para esta área é questionada, pelo que é necessário, desenvolver mais conhecimento sobre as suas reais competências, bem como formas de aprimoramento profissional de modo a melhor responder às necessidades dos atores, nos vários contextos.

Introduction: Speech therapists and the actors have developed straight professional relations in some countries. Therefore, a growing expansion has been observed in the speech therapist intervention in several working contexts of professional actors. In Portugal, this situation is poorly known.Objective: Describe and relate the perception of professional actors from different performance areas (cinema, dubbing, theater and television), about the role of speech therapists in their working contexts. Methods: A descriptive and cross-sectional study was conducted, using an online questionnaire to collect data in a sample of 72 actors from all regions of Portugal. Results: In the dubbing and theater contexts, speech therapists are assessed as extremely important, while in television and cinema theyare classified as important. Although respondents consider as highly important the integration of speech therapists in their working teams, they mostly reveal a partial awareness about speech therapy. In the actors? opinion, speech therapists may have a role in the four analyzed contexts, especially in the following areas: voice therapy, voice warmup guidance, and follow-up assistance. Conclusion: Actors are receptive to work with speech therapists, although they have a narrow view of their functions. Speech therapists are considered partially prepared to work with actors,so work is needed to better adapt to their vocal and professional needs, according with each working context.

Introducción: En algunos países se ha verificado un aumento en la asociación entre elterapeuta del habla y el actor, existiendo una expansión creciente de la intervención del terapeutaen los varios contextos profesionales del actor. En Portugal, esta realidad es aún poco conocida. Objetivo: Describir y relacionar la percepción que los actores de diferentes áreas escénicas: cine, doblaje, teatro y televisión, tienen con respecto al papel del terapeuta del habla.Material y método: Se realizó un estudio observacional descriptivo-transversal. Con la ayuda de un cuestionario online se pudieron recolectar datos, con una muestra total de 72 actores, provenientes de todo el país. Resultados: En los contextos de doblajes y teatro, elterapeuta del habla es considerado de extrema importancia,mientras que en el cine y televisión la clasificación obtenida es importante. Aunque los encuestados hayan atribuido un grado elevado de importancia a la integración del terapeuta del habla en sus equipos de trabajo, sus áreas de intervención no son aun completamente conocidas. En la opinión de los encuestados, el terapeuta del habla puede integrar el equipo de los cuatro contextos, en lossiguientes aspectos: terapia vocal, orientación del calentamiento vocal y apoyo continuo a los actores.Conclusión: os actores están receptivos al trabajo de los terapeutas del habla, aunque demuestren visión parcial de sus funciones. Se cuestionó el preparo de los terapeuta del habla para esta área lo que indicó que es necesario desarrollar más conocimientos sobre sus efectivas competencias, así como formasde perfeccionamiento profesional para contestar mejor a las necesidades de los actores en los varios contextos.

Is it important to repeat the positioning maneuver after the treatment for benign paroxysmal positional vertigo? / É importante realizar o reteste da manobra de posicionamento após o tratamento da vertigem postural paroxística benigna?

INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular dysfunction. OBJECTIVE: To assess whether the performance of the Dix-Hallpike maneuver after the Epley positioning maneuver has prognostic value in the evolution of unilateral ductolithiasis of posterior semicircular canal. METHODS: A prospective cohort study in monitored patients at otoneurology ambulatory with a diagnosis of BPPV; they were submitted to the therapeutic maneuver and then to a retest in order to evaluate the treatment effectiveness; all cases were reassessed one week later and the retest prognostic value was evaluated. RESULTS: A sample of 64 patients which 47 belonging to negative retest group and 17 belonging to positive retest. Performed the maneuver in all patients, the retest presented 51.85% sensitivity, 91.89% specificity, 82.35% positive predictive value and 72.34% negative predictive value. CONCLUSION: The study shows that doing the retest after repositioning maneuver of particles in BPPV is effectual, since it has high specificity. .

INTRODUÇÃO: A vertigem posicional paroxística benigna (VPPB) é a causa mais comum de disfunção vestibular periférica. OBJETIVO: Avaliar se a realização do reteste de Dix-Hallpike após a manobra de posicionamento de Epley tem valor prognóstico na evolução da vertigem posicional da ductolitíase paroxística benigna de canal semicircular posterior unilateral. MÉTODO: Estudo prospectivo do tipo coorte de pacientes em acompanhamento no ambulatório de otoneurologia com diagnóstico de VPPB; foram submetidos a manobra terapêutica e posteriormente ao reteste para avaliar a eficácia do tratamento; todos os casos foram reavaliados em uma semana e analisado o valor prognostico do reteste. RESULTADOS: Amostra de 64 pacientes, 47 do grupo reteste negativo e 17 do reteste positivo; realizada manobra de Epley em todos os pacientes. O reteste apresentou sensibilidade de 51,85%; especificidade de 91,89%; valor preditivo positivo de 82,35% e valor preditivo negativo de 72,34%. CONCLUSÃO: O estudo mostra que é válido realizar o reteste após a manobra de reposicionamento de partículas na VPPB, visto que possui alta especificidade. .

O estigma da doença mental e as residências terapêuticas no município de Volta Redonda-RJ / The stigma of mental illnesses and the therapeutic residences in the town of Volta Redonda-RJ / El estigma de la enfermedad mental y las residencias terapéuticas en la ciudad de Volta Redonda-RJ

Os objetivos desta pesquisa são caracterizar o estigma vivenciado por portadores de transtorno mental e profissionais de saúde, durante o processo de implantação das Residências Terapêuticas; e analisar a atuação da equipe de enfermagem para a transposição destes obstáculos e implantação das mesmas. É uma pesquisa qualitativa de cunho histórico-social. As fontes primárias foram constituídas de documentos escritos e seis entrevistas. O referencial teórico para análise dos resultados foi o autor Erving Goffman. Observou-se que o estigma social resultou na resistência de alguns atores sociais para implantação e permanência das Residências Terapêuticas, tanto por parte dos moradores próximos as mesmas quanto para o aluguel destes imóveis. Também se evidenciou crise de identidade profissional. Concluiu-se que o enfermeiro teve papel fundamental ao interferir no processo de estigmatização ao portador de transtorno mental e aos profissionais de saúde mental, mostrando que a mudança na forma da assistência prestada seria uma inovação.

This research aims to characterize the stigma experienced by patients with mental disorders and health professionals during the implementation process of the Therapeutic Residences, as well as to analyze the nursing staff's performance in overcoming those obstacles and implementing those Residences. A qualitative socio-historical research was undertaken. Its primary sources consisted of written documents and six interviews. The theoretical reference that supported the result analysis was the author Erving Goffman. It was observed that the social stigma resulted in some social actors' resistance against the implementation and permanence of the Therapeutic Residences, involving not only neighbors of the therapeutic residences, but also the effect on property rentals. Additionally, a professional identity crisis was observed. It was concluded that the nurse played a key role by interfering in the stigmatization process of mental disorder patients and of mental health professionals, showing that changing the form of care delivery could represent an innovation.

Los objetivos de esta investigación son caracterizar el estigma vivido por portadores de trastorno mental y profesionales de salud durante el proceso de implantación de las Residencias Terapéuticas; y analizar la actuación del equipo de enfermería para la transposición de estos obstáculos e implantación de las mismas. Se trata de una investigación cualitativa de cuño histórico y social. Las fuentes primarias fueron constituidas de documentos escritos y seis entrevistas. El referencial teórico para análisis de los resultados fue el autor Erving Goffman. Se ha observado que el estigma social resultó en la resistencia de algunos actores sociales para implantación y permanencia de las Residencias Terapéuticas, tanto por los residentes cercanos a la misma como el alquiler de estas propiedades. También se demostró crisis de identidad profesional. Se concluyó que el enfermero tuvo papel fundamental al interferir en el proceso de estigmatización al portador de trastorno mental y a los profesionales de salud mental, mostrando que el cambio en la forma de atención prestada sería una innovación.

Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

INTRODUCTION: Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC), and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA) is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA®) allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss. OBJECTIVE: To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA®. CASES REPORTS: The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA® implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA® resulted in a decreased gap postoperatively. FINAL COMMENTS: BAHA® hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome.

Supplementing long-chain n-3 polyunsaturated fatty acids in canned wild Pacific pink salmon with Alaska salmon oil.

Establishing n-3 polyunsaturated fatty acid contents in canned wild Alaska pink salmon products is challenging due to ample natural variation found in lipid content of pink salmon muscle. This study investigated the effect of adding salmon oil (SO) to canned pink salmon produced from fish exhibiting two opposite degrees of skin watermarking, bright (B) and dark (D). Specific goals of the study were to evaluate the benefits of adding SO to canned pink salmon with regard to nutritional value of the product, sensory characteristics, and the oxidative and hydrolytic stability of the lipids over thermal processing. Six groups of canned pink salmon were produced with variable levels of SO, either using bright (with 0, 1, or 2% SO) or dark (with 0, 2, or 4% SO) pink salmon. Compositional analysis revealed highest (P < 0.05) lipid content in sample B2 (8.7%) and lowest (P < 0.05) lipid content in sample D0 (3.5%). Lipid content of samples B0, B1, D2, and D4 was not significantly different (P > 0.05) ranging from 5.7% to 6.8%. Consequently, addition of SO to canned pink salmon allowed for consistent lipid content between bright and dark fish. Addition of 1% or 2% SO to canned bright pink salmon was not detrimental to the sensory properties of the product. It is recommended that canned bright pink salmon be supplemented with at least 1% SO, while supplementation with 2% SO would guarantee a minimum quantity of 1.9 g of n-3 fatty acids per 100 g of product. Addition of 4% SO to canned dark pink salmon was detrimental to product texture and taste, while supplementation with 2% SO did not negatively affect sensorial properties of the product. Accordingly, canned dark pink salmon should be supplemented with 2% SO so that a minimum n-3 fatty acids content of 1.5 g per 100 g of product.