Noninvasive assessment of liver fibrosis can predict clinical outcomes at late follow-up after a sustained virological response in HCV patients?

OBJECTIVES: The primary objective was to evaluate Liver-Related Events (LREs), including hepatic decompensation (ascites, hemorrhagic varices and encephalopathy) and Hepatocellular Carcinoma (HCC), as well as changes in liver stiffness during the follow-up period among patients who achieved a Sustained Virological Response (SVR) after treatment for chronic Hepatitis C Virus (HCV) infection. METHODS: A total of 218 patients with HCV were treated, and those who achieved an SVR were followed up for 3-years. Transient Elastography (TE) using FibroScan® was performed at various time points: before treatment, at the end of treatment, at 6-months post-treatment, at 1-year post-treatment, at 2-years post-treatment, and at 3-years post-treatment. RESULTS: At 6-months post-treatment, a Liver Stiffness Measurement (LSM) cutoff of > 19 KPa was identified, leading to a 14.5-fold increase in the hazard of negative outcomes, including decompensation and/or HCC. The analysis of relative changes in liver stiffness between pre-treatment and 6-months posttreatment revealed that a reduction in LSM of -10 % was associated with a -12 % decrease in the hazard of decompensation and/or HCC, with this trend continuing as the LSM reduction reached -40 %, resulting in a -41 % hazard of decompensation and/or HCC. Conversely, an increase in the relative change during this period, such as an LSM increase of +10 %, led to a + 14 % increase in the hazard of decompensation. In cases where this relative change in LSM was +50 %, the hazard of decompensation increased to +92. CONCLUSION: Transient elastography using FibroScan® can be a good tool for monitoring HCV patients with SVR after treatment to predict LREs in the long term.

Mental health in Brazil in times of neoliberalism and pandemic: retrogression and resistance.

This study analyzes aspects of mental health in Brazil as an active political field involving a range of social segments and actors from opposing fields in a context of advancing neoliberalism and pandemic. The analysis begins in 2016, when fiscal austerity entered the national agenda, and proceeds through the pandemic until the present day, when both phenomena continue to prevail, even if the intensity of the pandemic is now reduced. In the ambit of mental health, the national policy based on the principles of the psychiatric reform has suffered severe setbacks. Nonetheless, despite state-sponsored efforts to discourage social control and public participation, important sectors of society are engaged in active resistance.

Assessment of functional mobility and gait during a timed up and go test in adults with total blindness.

BACKGROUND: The loss of vision leads to behavioral and motor adaptations that do not necessarily translate to good functioning with regards to daily tasks. AIM: To investigate differences in functional mobility in adults with total blindness, and analyze differences in spatiotemporal gait variables with and without the use of a cane, and wearing shoes or barefoot. METHODS: We used an inertial measurement unit to assess the spatiotemporal parameters of the gait and functional mobility in seven subjects with total blindness and four sighted participants during the timed up and go test (TUG) test performed under conditions: barefoot/shod; and with/without a cane (blind subjects). RESULTS: Significant differences between groups were found in total TUG test time and in the sub-phases when the blind subjects executed the TUG barefoot and without a cane (p < .01). Other differences were found in trunk movement during sit-to-stand, and stand-to-sit where blind subjects when without cane and barefoot, they had a greater range of motion than sighted subjects (p < .01). Also, BMI has a moderate to strong influence in the execution of the TUG in blind subjects (p < .05) CONCLUSION: This study showed that, when using a gait-assistance device and wearing shoes, blind subjects have similar functional mobility and gait as sighted subjects, suggesting that an external haptic reference can compensate for the lack of vision. Knowledge of these differences can provide a better understanding of the adaptive behavior in this population, thereby assisting in minimizing the occurrence of trauma and falls.

Assessment of Neurotoxic Effects of Oxycodone and Naloxone in SH-SY5Y Cell Line.

Opioid drugs have analgesic properties used to treat chronic and post-surgical pain due to descending pain modulation. The use of opioids is often associated with adverse effects or clinical issues. This study aimed to evaluate the toxicity of opioids by exposing the neuroblastoma cell line (SH-SY5Y) to 0, 1, 10, and 100 µM oxycodone and naloxone for 24 h. Analyses were carried out to evaluate cell cytotoxicity, identification of cell death, DNA damage, superoxide dismutase (SOD), glutathione S-transferase (GST), and acetylcholinesterase (AChE) activities, in addition to molecular docking. Oxycodone and naloxone exposure did not alter the SH-SY5Y cell viability. The exposure to 100 µM oxycodone and naloxone significantly increased the cells' DNA damage score compared to the control group. Naloxone exposure significantly inhibited AChE, GST, and SOD activities, while oxycodone did not alter these enzymes' activities. Molecular docking showed that naloxone and oxycodone interact with different amino acids in the studied enzymes, which may explain the differences in enzymatic inhibition. Naloxone altered the antioxidant defenses of SH-SY5Y cells, which may have caused DNA damage 24 h after the exposure. On the other hand, more studies are necessary to explain how oxycodone causes DNA damage.

Dysphagia Days as an Assessment of Clinical Treatment Outcome in Eosinophilic Esophagitis.

INTRODUCTION: The aim of this study was to evaluate Dysphagia Days as a measure of symptom improvement in patients with eosinophilic esophagitis from the HEROES study. METHODS: Dysphagia Days, defined as a yes answer to the following question: During any meal today, did food go down slowly or get stuck in your throat or chest? was assessed for cendakimab vs placebo. RESULTS: A statistically significant reduction in the mean number of Dysphagia Days experienced was observed with cendakimab 360 mg vs placebo at week 16 (-4.67 vs -1.83; P = 0.0115); an even greater improvement was observed in steroid-refractory patients vs placebo (-4.48 vs -0.04; P = 0.0079). DISCUSSION: Dysphagia Days represents a relevant clinical end point to capture dysphagia-related symptoms.

Telehealth Adoption in an Outpatient Oncology Ward: A Best Practice Implementation Project.

Telehealth is increasingly taking place to support the transition of care and self-management of people living with cancer in outpatient oncology settings. Despite its recognised value, the scientific evidence points to disparities with regard to implementation of telehealth that might compromise the equity of access. Following the Joanna Briggs Institute (JBI) implementation approach, this project aims to promote the implementation of best practice recommendations for telehealth adoption in an outpatient oncology setting. Assisted by the Practical Application of Clinical Evidence System (PACES), the implementation process comprises three phases of (i) a baseline audit, (ii) feedback to the healthcare team and establishment of implementation strategies with the Getting Research into Practice (GRiP) tool, and (iii) a follow-up audit. The project is expected to allow the identification of barriers and facilitators for the implementation of telehealth in outpatient oncology and develop a strategy plan for its adoption, with the involvement of end-users and stakeholders. The successful adoption of telehealth according to the best available evidence will likely enhance equity of access to healthcare and quality of care at a distance.

Non-Alcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma: Immunohistochemical Assessment of Markers of Cancer Cell Metabolism.

INTRODUCTION: Hepatocellular carcinoma (HCC) has been associated to non-alcoholic fatty liver disease (NAFLD). We sought to investigate the immunoexpression of several glycolytic metabolism-associated markers in patients with HCC associated to NAFLD and associate these factors to their clinical-pathological characteristics. METHODS: We evaluated 35 HCC specimens from 21 patients diagnosed with non-alcoholic steatohepatitis (NASH) undergoing liver resection (12 patients), liver transplantation (8 patients), or both (1 patient). Histological features, clinical aspects, demographic and biochemical data, as well as the immunohistochemical reactivity for monocarboxylate transporters 1, 2, and 4; their chaperone CD147; carbonic anhydrase IX; and glucose transporter-1 (GLUT1) were assessed. RESULTS: Metabolic-associated cirrhosis was present in 12 of the 21 patients (8 child A and 4 child B scores). From 9 patients without cirrhosis, 3 presented NASH F3 and 6 NASH F2. Sixteen (76%) had diabetes mellitus, 17 (81%) arterial hypertension, and 19 (90%) body mass index above 25 kg/m2; 8 (38%) had dyslipidemia. From 35 nodules, steatosis was found in 26, ballooning in 31 nodules, 25 of them diagnosed as steatohepatitic subtype of HCC. MCT4 immunoexpression was associated with extensive intratumoral fibrosis, advanced clinical stages, and shorter overall survival. GLUT1 was noticeable in nodules with extensive intratumoral steatosis, higher intratumoral fibrosis, and advanced clinical stages. Immunohistochemical expression of the metabolic biomarkers MCT4 and GLUT1 was higher in patients with Barcelona-clinic liver cancer B or C. GLUT1 correlated with higher degree of steatosis, marked ballooning, intratumoral fibrosis, and higher parenchymal necroinflammatory activity. CONCLUSION: Our data indicate that the expression of the glycolytic phenotype of metabolic markers, especially GLUT1 and MCT4, correlates with a more severe course of HCC occurring in NASH patients.

Genotoxicity assessment in two Amazonian estuaries using the Plagioscion squamosissimus as a biomonitor.

Genotoxicity studies in coastal ecosystems have been a priority in Environmental Risk Assessment (ERA). This research aimed to study the genotoxicity by the micronucleus test and comet assay in two Brazilian Amazon estuaries (anthropized and control) using Plagioscion squamosissimus as a biomonitor. Blood samples were collected from 54 specimens. No significant genotoxic effects were detected in the cells analyzed, although the highest occurrence (MN and DNA damages) was observed in anthropized site. The percentage of genomic damage differed between the sites studied, being always higher in anthropizes site as well. Of the nucleoids analyzed in this site, on average, 28 ± 14.42% of the cells were classified in the highest damage class. The fish analyzed in the present study are direct influenced of xenobiont agents capable of producing damage to the genetic material of aquatic organisms in both sites and, consequently, may bring consequences still little reported in studies of morphophysiological alterations in humans.

Software para análise do dimensionamento de pessoal de enfermagem validado em obstetrícia / Software for analyzing nursing staff sizing validated in obstetrics

Trata-se do relatório de pesquisa da dissertação apresentada ao Programa de Pós-Graduação em Prática do Cuidado em Saúde da Universidade Federal do Paraná (UFPR), inserida na linha de pesquisa Processo de Cuidar em Saúde e Enfermagem com o tema: software para análise do dimensionamento de enfermagem validado nos setores de obstetrícia como tecnologia auxiliar da gestão do cuidado, no qual o objetivo foi desenvolver e validar um software para análise do dimensionamento de pessoal de enfermagem. Método: pesquisa metodológica aplicada, de produção tecnológica de engenharia de software segundo o referencial teórico de Pressmann (2011) e Sommerville (2003) fundamentado na Resolução Cofen 543/ 2017 e para validação de conteúdo de enfermagem adaptado de Sperandio (2008), Pereira (2011), Jensen (2012) e Friedrich (2019); avaliação de qualidade técnica, de usabilidade e de informática pelo Modelo do Processo de Avaliação (MPA) segundo a Norma Brasileira International Organization for Standardization/ International Eletrotechnical Comission (NBR ISO/ IEC); ISO/IEC 14598-6 2004, ISO/ IEC 25010: 2011 e ISO/ IEC 25000: 2014. O cenário do estudo é a maternidade/ serviço obstétrico do Complexo Hospital de Clínicas da UFPR, um hospital de grande porte e referência para atendimento de alto risco em obstetrícia. O desenvolvimento metodológico contou com a eleição dos descritores e pesquisa da literatura pertinente em bases de dados científica, seguiu o esboço, prototipagem, programação e arte final das telas (interfaces) do software conjuntamente a um profissional de informática (programador) e após a validação do produto junto a dezesseis juízes especialistas, sendo oito da enfermagem e oito da informática. Resultados: na avaliação da qualidade de sistemas, dos juízes especialistas de enfermagem a característica de adequação funcional recebeu o percentual de 81,25% dos valores pontuados, a de compatibilidade de 87,50%, a de segurança de 100%, a de confiabilidade de 75%, a usabilidade 79,68% e eficiência e desempenho 100%. Os juízes especialistas de informática avaliaram pontuando os valores da característica de adequação funcional em 90%, de compatibilidade em 70,83%, de segurança em 100%, de confiabilidade em 87,55, de usabilidade em 82,81%, de eficiência e desempenho em 100%, de manutenibilidade em 71,87% e portabilidade em 68,75%. Conclusão: a pesquisa culminou com o desenvolvimento do software DIMENF para análise do dimensionamento de pessoal de enfermagem, como produto dessa dissertação. O DIMENF servirá como ferramenta prática, que contempla dados agrupados do dimensionamento de pessoal das diferentes áreas hospitalares, seja de internação, apoio, diagnóstico, centro cirúrgico ou ambulatorial, de forma a auxiliar a gestão do cuidado e permitir ao enfermeiro adequar as necessidades de recursos humanos de enfermagem às necessidades assistenciais dos usuários dos serviços de saúde, tanto para garantir a segurança do paciente e qualidade assistencial, quanto para oferecer adequadas condições de trabalho aos profissionais de enfermagem.

This is the research report of the dissertation presented to the Postgraduate Program in Health Care Practice at the Federal University of Paraná (UFPR), inserted in the line of research Process of Caring for Health and Nursing with the theme: software for analysis of nursing sizing validated in the obstetrics sectors as an auxiliary technology for care management, without the objective of developing and validating software for analyzing the sizing of nursing staff. Method: applied methodological research, of technological production of software engineering according to the theoretical framework of Pressmann (2011) and Sommerville (2003) based on Resolution Cofen 543/2017 and for validation of nursing content adapted from Sperandio (2008), Pereira (2011), Jensen (2012) and Friedrich (2019); evaluation of technical quality, usability and information technology by the Evaluation Process Model (MPA) according to the Brazilian Standard International Organization for Standardization/ International Electrotechnical Commission (NBR ISO/ IEC); ISO/ IEC 14598-6 2004, ISO/ IEC 25010: 2011 and ISO/ IEC 25000: 2014. The scenario of the study is the maternity / obstetric service of the Hospital de Clínicas Complex of UFPR, a large hospital and a reference for the care of high risk in obstetrics. The methodological development included the selection of descriptors and research of the relevant literature in scientific databases, followed the outline, prototyping, programming and final art of the screens (interfaces) of the software together with a computer professional (programmer) and after validation of the product with sixteen expert judges, eight from nursing and eight from information technology. Results: when assessing the quality of systems, from the expert nursing judges, the characteristic of functional adequacy received the percentage of 81.25% of the scored values, the compatibility of 87.50%, the safety of 100%, the reliability 75%, usability 79.68% and efficiency and performance 100%. The IT experts judged by scoring the values of the characteristic of functional adequacy at 90%, compatibility at 70.83%, security at 100%, reliability at 87.55, usability at 82.81%, efficiency and performance at 100%, maintainability at 71.87% and portability at 68.75%. Conclusion: the research culminated in the development of the DIMENF software for analyzing the dimensioning of nursing staff, as a product of this dissertation. The DIMENF will serve as a practical tool, which includes grouped data on the dimensioning of personnel from different hospital areas, whether inpatient, support, diagnosis, surgical or outpatient centers, in order to assist the management of care and allow nurses to adapt resource needs. Nursing staff to the care needs of users of health services, both to ensure patient safety and care quality, and to provide adequate working conditions for nursing professionals.

Factors associated with quality of life in patients with Chagas disease: SaMi-Trop project.

TRIAL REGISTRATION: NCT02646943.

Risk Score for Predicting 2-Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi-Trop Cohort Study.

Background Risk stratification of Chagas disease patients in the limited-resource setting would be helpful in crafting management strategies. We developed a score to predict 2-year mortality in patients with Chagas cardiomyopathy from remote endemic areas. Methods and Results This study enrolled 1551 patients with Chagas cardiomyopathy from Minas Gerais State, Brazil, from the SaMi-Trop cohort (The São Paulo-Minas Gerais Tropical Medicine Research Center). Clinical evaluation, ECG, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) were performed. A Cox proportional hazards model was used to develop a prediction model based on the key predictors. The end point was all-cause mortality. The patients were classified into 3 risk categories at baseline (low, <2%; intermediate, ≥2% to 10%; high, ≥10%). External validation was performed by applying the score to an independent population with Chagas disease. After 2 years of follow-up, 110 patients died, with an overall mortality rate of 3.505 deaths per 100 person-years. Based on the nomogram, the independent predictors of mortality were assigned points: age (10 points per decade), New York Heart Association functional class higher than I (15 points), heart rate ≥80 beats/min (20 points), QRS duration ≥150 ms (15 points), and abnormal NT-proBNP adjusted by age (55 points). The observed mortality rates in the low-, intermediate-, and high-risk groups were 0%, 3.6%, and 32.7%, respectively, in the derivation cohort and 3.2%, 8.7%, and 19.1%, respectively, in the validation cohort. The discrimination of the score was good in the development cohort (C statistic: 0.82), and validation cohort (C statistic: 0.71). Conclusions In a large population of patients with Chagas cardiomyopathy, a combination of risk factors accurately predicted early mortality. This helpful simple score could be used in remote areas with limited technological resources.

Use of wearable inertial sensors for the assessment of spatiotemporal gait variables in children: A systematic review

Abstract Aim: The present study aimed to perform a literature review on the use of wearable inertial sensors for gait analysis of children in clinical practice. Methods: Searches were performed in the MEDLINE, EMBASE, Cochrane Library, and PEDro databases for studies involving children or adolescents submitted to gait analysis with the use of wearable inertial sensors. No restrictions were imposed regarding the date of publication or language. Results: Three hundred twenty articles were retrieved, 14 of which met the eligibility criteria and were selected for the present systematic review. Two independent reviewers assessed the risk of bias and study quality using the ROBINS-I and AXIS scale. The studies included in the present review reported multiple outcomes of kinematic gait assessments calculated from the signals provided by the wearable sensors, performed in a hospital setting, outpatient clinic, and a familiar environment, with several types of pediatric conditions. Conclusion: The findings suggest that wearable sensors are effective for the evaluation of quantitative gait variables in children with different pediatric conditions, enabling an objective analysis that should prove useful in the processes of clinical diagnosis and rehabilitation. However, given the relatively small number of studies published on this topic, it is difficult to make strong recommendations regarding the most appropriate equipment, sensor placement, and outcomes for assessing gait in children.

18F-FDG PET/CT AS AN ASSESSMENT TOOL OF HEPATOCELLULAR CARCINOMA SECONDARY TO NON-ALCOHOLIC FATTY LIVER DISEASE DEVELOPMENT IN EXPERIMENTAL MODEL.

BACKGROUND: Hepatocellular carcinoma (HCC) can be the last step of non-alcoholic fatty liver disease (NAFLD) evolution. Experimental models are crucial to elucidate the pathogenesis of HCC secondary to NAFLD. The 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays an important role in evaluating HCC development and progression. OBJECTIVE: To standardize the imaging method of PET/CT with 18F-FDG as an evaluation tool of the experimental model of HCC secondary to NAFLD. METHODS: Ten male Sprague-Dawley rats were fed with choline-deficient high-fat diet and diethylnitrosamine (DEN) in the drinking water for 16 weeks and then received 1 mL of saline solution (0.9%) daily by gavage for three weeks. At the 16th and 19th weeks, abdominal ultrasonography (USG) was performed. 18F-FDG PET/CT images were obtained before the beginning of experiment (week 0) and at the end (week 19). Histological and immunohistochemically analysis were also performed. RESULTS: The USG results showed a homogeneous group at the 16th week with an average of 4.6±2.74 nodules per animal. At the 19th week, PET/CT findings demonstrated an average of 8.5±3.7 nodules per animal. The mean values of SUVmed and SUVmax were 2.186±0.1698 and 3.8±1.74, respectively. The average number of nodules per animal in the histological analysis was 5.5±1.5. From all nodules, 4.6% were classified as well-differentiated HCC and 81.8% were classified as poorly-differentiated HCC. CONCLUSION: 18F-FDG PET/CT was able to evaluate the development of HCC in an experimental model of NAFLD non-invasively. From the standardization of PET/CT in this model, it is possible to use this tool in future studies to monitor, in vivo and non-invasively, the progression of HCC.

Avaliação do comportamento de consumidores quanto ao consumo e cuidados com produtos de origem animal no município de Maceió, Alagoas / Consumer behavior evaluation on consumption and care of products of animal origin in the municipality of Maceió, Alagoas

Com o objetivo de avaliar o comportamento de consumidores quanto ao consumo e cuidados com os produtos de origem animal foi aplicado um questionário a 197 consumidores divididos em 2 grupos (parte alta e baixa da cidade). Não houve diferença significativa entre os grupos estudados, quanto aos cuidados, porém ambos apresentaram o hábito de consumir leite in naturae queijos crus, e não notificam as inconformidades observadas em estabelecimentos especializados em serviços de alimentação. As duas populações possuem o conhecimento básico sobre os cuidados necessários para uma alimentação segura, mas ainda há necessidade de uma educação sanitária e participação da população na área de Vigilância Sanitária. A cartilha entregue aos participantes introduziu a educação sanitária como forma de iniciar o interesse dos mesmos nessa área.

Avaliação do conhecimento de consumidores sobre saúde pública e importância do médico veterinário / Assessment of consumer knowledge on public health and importance of the veterinary doctor

Com o objetivo de avaliar os consumidores, quanto ao nível de conhecimento destes sobre a saúde pública foi aplicado um questionário a 197 consumidores. Os consumidores foram questionados aos sobre dois pontos se procuravam o médico em casos de intoxicação ou toxinfecção alimentar e se sabiam a importância do médico veterinário. Foi possível observar que a minoria dos consumidores possui o hábito de notificar a ocorrência de doenças de origem alimentar e que a maioria destes tem conhecimento sobre a importância da atuação do Médico Veterinário na Saúde Pública. Sendo importante a realização de educação sanitária sobre a relevância da participação da população sobre a melhoria da saúde pública. A cartilha entregue aos participantes introduziu a educação sanitária como forma de iniciar o interesse dos mesmos nessa área.

PET/CT com 18F-FDG como ferramenta de avaliação do desenvolvimento de carcinoma hepatocelular secundário a doença hepática gordurosa não alcoólica em modelo experimental / 18f-fdg pet/ct as an assessment tool of hepatocellular carcinoma secondary to non-alcoholic fatty liver disease development in experimental model

ABSTRACT BACKGROUND: Hepatocellular carcinoma (HCC) can be the last step of non-alcoholic fatty liver disease (NAFLD) evolution. Experimental models are crucial to elucidate the pathogenesis of HCC secondary to NAFLD. The 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays an important role in evaluating HCC development and progression. OBJECTIVE: To standardize the imaging method of PET/CT with 18F-FDG as an evaluation tool of the experimental model of HCC secondary to NAFLD. METHODS: Ten male Sprague-Dawley rats were fed with choline-deficient high-fat diet and diethylnitrosamine (DEN) in the drinking water for 16 weeks and then received 1 mL of saline solution (0.9%) daily by gavage for three weeks. At the 16th and 19th weeks, abdominal ultrasonography (USG) was performed. 18F-FDG PET/CT images were obtained before the beginning of experiment (week 0) and at the end (week 19). Histological and immunohistochemically analysis were also performed. RESULTS: The USG results showed a homogeneous group at the 16th week with an average of 4.6±2.74 nodules per animal. At the 19th week, PET/CT findings demonstrated an average of 8.5±3.7 nodules per animal. The mean values of SUVmed and SUVmax were 2.186±0.1698 and 3.8±1.74, respectively. The average number of nodules per animal in the histological analysis was 5.5±1.5. From all nodules, 4.6% were classified as well-differentiated HCC and 81.8% were classified as poorly-differentiated HCC. CONCLUSION: 18F-FDG PET/CT was able to evaluate the development of HCC in an experimental model of NAFLD non-invasively. From the standardization of PET/CT in this model, it is possible to use this tool in future studies to monitor, in vivo and non-invasively, the progression of HCC.

RESUMO BACKGROUND: O carcinoma hepatocelular (CHC) pode ser a última fase da doença hepática gordurosa não alcoólica (DHGNA). Modelos experimentais são cruciais para elucidação da patogênese do CHC secundário a DHGNA. A tomografia por emissão de pósitrons/tomografia computadorizada (PET/TC) com 2-desoxi-2-(18F)fluoro-D-glicose (18F-FDG) desempenha um importante papel na avaliação do desenvolvimento e progressão do CHC. OBJETIVO: Padronizar a metodologia de imagem por PET/TC com 18F-FDG como uma ferramenta de avaliação do modelo experimental de CHC secundário a DHGNA. MÉTODOS: Dez ratos Sprague-Dawley machos foram alimentados com dieta hiperlipídica deficiente em colina associada a dietilnitrosamina (DEN) na água de beber por 16 semanas e depois receberam 1 mL de solução salina (0,9%) por gavagem diariamente por três semanas. Nas 16ª e 19ª semanas, foi realizada a ultrassonografia abdominal. As imagens do PET/TC com 18F-FDG foram obtidas antes do início do experimento (semana 0) e no final (semana 19). Análises histológica e imunohistoquímica também foram realizadas. RESULTADOS: Os resultados da ultrassonografia demonstraram um grupo homogêneo na 16ª semana com uma média de 4,6±2,74 nódulos por animal. Na 19ª semana, os achados do PET/CT demonstraram uma média de 8,5±3,7 nódulos por animal. Os valores médios de SUVmed e SUVmáx foram 2,186±0,1698 e 3,8±1,74, respectivamente. A média do número de nódulos na análise histológica foi de 5,5±1,5. De todos os nódulos, 4,6% foram classificados como bem diferenciados e 81,8% foram classificados como CHC pouco diferenciado. CONCLUSÃO: O PET/TC com 18F-FDG foi capaz de avaliar o desenvolvimento do CHC secundário a DHGNA de forma não invasiva. A partir da padronização do PET/CT neste modelo, faz-se possível a utilização desta ferramenta em futuros estudos para monitorar, in vivo e de forma não invasiva, a progressão do CHC.

Productivity of CNPq Researchers from Different Fields in Biomedical Sciences: The Need for Objective Bibliometric Parameters-A Report from Brazil.

In Brazil, the CNPq (National Council for Scientific and Technological Development) provides grants, funds and fellowships to productive scientists to support their investigations. They are ranked and categorized into four hierarchical levels ranging from PQ 1A (the highest) to PQ 1D (the lowest). Few studies, however, report and analyse scientific productivity in different sub-fields of Biomedical Sciences (BS), e.g., Biochemistry, Pharmacology, Biophysics and Physiology. In fact, systematic comparisons of productivity among the PQ 1 categories within the above sub-fields are lacking in the literature. Here, the scientific productivity of 323 investigators receiving PQ 1 fellowships (A to D levels) in these sub-fields of BS was investigated. The Scopus database was used to compile the total number of articles, citations, h-index values and authorship positions (first-, co- or last-listed author) in the most cited papers by researchers granted CNPq fellowships. We found that researchers from Pharmacology had the best performance for all of the parameters analysed, followed by those in Biochemistry. There was great variability in scientific productivity within the PQ 1A level in all of the sub-fields of BS, but not within the other levels (1B, 1C and 1D). Analysis of the most cited papers of PQ 1(A-D) researchers in Pharmacology revealed that the citations of researchers in the 1C and 1D levels were associated with publications with their senior supervisors, whereas those in the 1B level were less connected with their supervisors in comparison to those in 1A. Taken together, these findings suggest that the scientific performance of PQ 1A researchers in BS is not homogenous. In our opinion, parameters such as the most cited papers without the involvement of Ph.D. and/or post-doctoral supervisors should be used to make decisions regarding any given researcher's fellowship award level.

Sentimentos de profissionais da estratégia saúde da família frente à demanda de usuários de álcool e outras drogas / Feelings of professionals of the family health strategy against the demand of alcohol and other drugs users

Introdução: A Organização Mundial de Saúde identificou que o uso abusivo de álcool e outras drogas está entre os principais problemas de saúde no mundo. Estudos demonstram, entretanto, a dificuldade dos profissionais da saúde ao lidar com usuários de tais substâncias. Objetivo: Conhecer os sentimentos dos profissionais da estratégia saúde da família frente à demanda de usuários de álcool e outras drogas no município de Teresina (PI). Materiais e Métodos: Estudo descritivo transversal, cujo universo foram as 250 equipes de Estratégia Saúde da Família. Foram escolhidas duas categorias profissionais de nível superior: médicos e enfermeiros. Calculou-se um número amostral de 203 entrevistas para cada categoria profissional. Resultados: Foram abordados 406 profissionais e obtidas 86 questionários respondidos. A coleta de dados foi por meio de questionário individual estruturado. O grupo foi composto predominantemente por mulheres 71 (82,56%); 51 (59,3%) pós-graduados, sendo 49 (57%) enfermeiros; 51 (59,3%) com 06 ou mais anos no serviço. Os sentimentos tristeza, desconforto, compaixão, insegurança, medo e receio foram os destaques para ambas as categorias profissionais e em todos os períodos de atuação na Estratégia Saúde da Família. Conclusão: Apesar das limitações desse estudo é necessário pensar nos modos de produção do cuidado que levem em conta os sentimentos e angústias dos profissionais de saúde, a fim de se desmistificar as práticas e, sobretudo ajudar os trabalhadores na complexa tarefa de cuidar do outro.

Introduction: The World Health Organization has identified that alcohol and drug abuse is among the major health problems in the world. Studies show, however, the difficulty of health professionals in dealing with users of such substances. Objective: To know the feelings of family health strategy professionals regarding the demand of users of alcohol and other drugs in the municipality of Teresina (PI). Materials and Methods: Descriptive cross-sectional study, whose universe consisted of 250 Family Health Strategy teams. Two higher level professional categories were chosen: doctors and nurses. A sample of 203 interviews was calculated for each professional category. Results: 406 professionals were approached and 86 questionnaires answered. Data collection was through a structured individual questionnaire. The group consisted predominantly of women 71 (82.56%); 51 (59.3%) postgraduates, 49 (57%) nurses; 51 (59.3%) with 06 or more years in the service. The feelings of sadness, discomfort, compassion, insecurity, fear and fear were the highlights for both professional categories and in all periods of activity in the Family Health Strategy. Conclusion: Despite the limitations of this study, it is necessary to think about the modes of care production that take into account the feelings and anxieties of health professionals, in order to demystify practices and, above all, help workers in the complex task of caring for others.

Avaliação do conhecimento acerca do manejo clínico de portadores da doença de Chagas em região endêmica no Brasil / Assessment of knowledge about the clinical management of patients with Chagas disease in an endemic region in Brazil

Objetivo: conhecer o manejo de pacientes com Doença de Chagas (DC) por médicos da Atenção Primária à Saúde (APS) de regiões endêmicas. Método: estudo transversal realizado com 104 médicos da APS de 39 municípios das regiões norte de Minas Gerais e Vale do Jequitinhonha. Foram abordados perfil sociodemográfico, formação acadêmica e prática clínica, por meio de questionário autoaplicado. Resultados: os médicos apresentaram idade média de 33(±9,88) anos, 4(±7,26) anos de atuação na APS, 49% relataram que a graduação não ofereceu formação suficiente em DC. Embora quase 90% tivessem experiência com atendimento de pacientes com DC crônica e 57% com DC aguda, apenas 9% relataram sentir-se totalmente seguros para esses atendimentos e 33% relataram não conhecer o Benzonidazol, único antitripanossômico disponível. Contribuindo para esse quadro, após a graduação, somente 13,3% receberam alguma informação ou treinamento relativo à DC e quase metade recebeu esse treinamento há mais de 4 anos. Há insegurança, desconhecimento e carência de capacitações sobre DC entre profissionais médicos da APS de localidades endêmicas.

Objective: to understand the management of patients with Chagas Disease (CD) by Primary Health Care (PHC) doctors in endemic regions. Methods: cross-sectional study with 104 PHC doctors in 39 municipalities in the northern regions of Minas Gerais and Jequitinhonha Valley. Socio-demographic profile, academic training, and clinical practice were covered through a self-administered questionnaire. Results: the physicians had a mean age of 33 (± 9.88) years, 4 (± 7.26) years experience in the PHC system, and 49% reported that their undergraduate studies did not offer enough training on CD. Although almost 90% had experience with the care of patients with chronic CD and 57% with acute CD, only 9% reported feeling completely secure about these services and 33% reported not knowing about benznidazole, the only antitrypanosomal available. Contributing to this situation, after graduation, only 13.3% received any information or training on CD and almost half received this training more than four years ago. There is insecurity, ignorance, and lack of training on CD among PHC medical professionals in endemic locations.

Fatores relacionados ao não uso de medidas preventivas das infecções sexualmente transmissíveis durante a gestação / Factores relacionados a no adoptar medidas preventivas de enfermedades de transmisión sexual durante el embarazo / Factors associated with the non-use of measures to prevent sexually transmitted diseases during pregnancy

Objetivo conhecer os fatores relacionados ao não uso de medidas preventivas das infecções sexualmente transmissíveis durante o período gravídico. Método estudo descritivo, exploratório, com abordagem qualitativa, realizado com gestantes num hospital universitário do Rio de Janeiro, Brasil. A coleta dos dados foi feita mediante a aplicação de entrevista semiestruturada, no ano de 2017. Resultados as entrevistadas conheciam as principais infecções; não utilizavam nenhum método de prevenção; obtiveram informações sobre as infecções pelas mídias sociais, grupos de planejamento familiar e praticamente nenhuma durante o pré-natal; consideraram a conjugalidade um fator de proteção. Conclusão esta pesquisa desvelou fatores relacionados à não adoção de medidas preventivas das infecções sexualmente transmissíveis por mulheres e seus parceiros durante a gestação.

Objetivo conocer los factores relacionados a la no aplicación de medidas preventivas de enfermedades de transmisión sexual durante el período de gestación. Método estudio descriptivo, exploratorio, con abordaje cualitativo, realizado con embarazadas en un hospital universitario de Rio de Janeiro, Brasil. Datos recolectados mediante aplicación de entrevista semiestructurada, durante 2017. Resultados las entrevistadas conocían las principales enfermedades; no utilizaban ningún método de prevención; obtuvieron información sobre las enfermedades a través de las redes sociales, grupos de planificación familiar, y prácticamente ninguna durante el prenatal; consideraban la vida en pareja como factor de protección. Conclusión esta investigación develó factores relacionados a la no adopción de medidas preventivas de enfermedades de transmisión sexual en mujeres y sus compañeros durante el embarazo.

Objective To know the factors associated with the non-use of measures to prevent sexually transmitted diseases during pregnancy. Method A descriptive and exploratory study with a qualitative approach was carried out with pregnant women in a teaching hospital in the state of Rio de Janeiro, Brazil. Data collection was carried out in 2017 with the use of semi-structured interviews. Results the pregnant women interviewed had knowledge about the main diseases; they did not make use of any prevention methods; they had access to information about diseases through social media, family planning groups, and hardly any during prenatal; and they considered conjugality a protection factor. Conclusion The present study presented factors associated with the non-adoption of sexually transmitted disease prevention measures by pregnant women and their partners during pregnancy.