El efecto del año constituyente en los atletas de triatlón máster / The effect of the constituent year on master triathlon athletes

Objetivo: El estudio evaluó si existe efecto de año constituyente relacionado a la participación y al desempeño entre los atletas participantes de competiciones brasileñas Masters de 2011 a 2017. Método: Utilizando datos del sitio web de la Confederación Brasileña de Triatlón, la frecuencia de participación fue analizada y las puntuaciones de clasificación fueron comparadas entre los triatletas en función del año constituyente. Resultados: Los resultados mostraron un efecto año constituyente relacionado con la participación para la muestra total y para el sexo masculino (χ24 = 30,778, p 0,0001), pero no para el femenino (χ24 = 5,932, p = 0,20). Además, los efectos del año constituyente relacionados con la participación existieron durante la cuarta (χ24 = 22,224, p 0,001) y quinta (χ24 = 10,794, p = 0,029) década de vida, pero no para la sexta (χ24 = 5,570, p = 0,234) década. Al comparar los tres puntajes más altos del ranking en función del año constituyente en cualquier grupo de edad de cinco años, no se observó diferencia significativa para el total de la muestra, sexo y década de vida. Conclusiones: El efecto del año constituyente existe solo en triatletas del sexo masculino; sin embargo, ese fenómeno no parece influenciar el desempeño del ranking. (AU)

Reproducibility of the stability-based classification for ankle fractures.

BACKGROUND: Classification of ankle fracture is important when deciding for operative or conservative treatment. This study rates the reproducibility of ankle stability assessment and compares it with the classification by Lauge-Hansen and Arbeitsgemeinschaft für Osteosyntesefragen (AO) in adult patients with primary ankle fractures. METHODS: A total of 496 consecutive ankle fractures were included, and the X-ray images were reviewed 2 times by 2 medical students, 2 residents, and 1 consultant in orthopedic traumatology. The raters were blinded to each other and to their own results. Unweighted Kappa statistics were used to assess reproducibility. RESULTS: Overall mean (95% CI) interrater Kappa results were 0.65 (0.64; 0.68) for Lauge-Hansen, 0.62 (0.60; 0.63) for AO and 0.61 (0.57; 0.62) for the stability assessment. The intrarater results ranged from a mean Kappa of 0.64-0.80 for the medical students, 0.65-0.81 for the residents and 0.82-0.84 for the consultant. CONCLUSION: The stability assessment has substantial to almost-perfect agreement which is comparable to the Lauge-Hansen and AO classifications.

Demonstrating the value and importance of combining DNA barcodes and discriminant morphological characters for polystome taxonomy (Platyhelminthes, Monogenea).

Polystomes are monogenean parasites that infest mainly semi aquatic vertebrates, such as amphibians and chelonians. Owing to the lack of discriminative morphological characters and because polystomes are considered to be strictly host- and site-specific, host identity is often used as an additional character for parasite identification. Recent genetic studies, however, showed that polystomes infecting freshwater turtles in outdoor turtle enclosures and natural environments, were not strictly host-specific. Therefore, we proposed a new procedure for turtle polystome taxonomy based on the combination of Cytochrome c Oxydase I sequences and two discriminant morphological characters, namely the number of genital spines and the testis shape. We tested the validity of this procedure with Polystomoides oris, which was collected from the pharyngeal cavity of the American painted turtle Chrysemys picta and two undescribed species, both collected from the pharyngeal cavity of the American slider Trachemys scripta and two other European turtles, namely the European pond turtle Emys orbicularis and the Mediterranean turtle Mauremys leprosa. A Principal Component Analysis based on both morphological characters allowed the separation of all specimens in three morphological groups, which matched well with the molecular data. As a result, we describe two new polystome species, i.e., Polystomoides soredensis n. sp. and Polystomoides scriptanus n. sp.

[Reliability and agreement of two smear reading scales for classification and monitoring of multidrug therapy in leprosy patients]. / Confiabilidad y concordancia de dos escalas de lectura de baciloscopias para clasificación y seguimiento del tratamiento con múltiples medicamentos de los pacientes con lepra.

INTRODUCTION: After the clinical diagnosis of leprosy, classification methods are necessary to define a treatment and prognosis of patients consistent with bacterial load. Bacteria are detected in skin smear, and bacterial load typically is established by the internationally used Ridley's logarithmic scale, However, in Colombia an alternative semiquantitative scale is used. OBJECTIVE: The interobserver reproducibility was established for the Ridley and Colombia scales, and the level of correlation-matching was identified between the bacillary indices obtained in order to assess the degree of interchangeability. MATERIALS AND METHODS: Standardization was attained by a reading of the smears by 2 readers with subsequent, blinded evaluation of inter-observer agreement. Each reader quantified the bacterial load of for each sample (n=325) using the Colombian and the Ridley scales. The degree of interobserver agreement was assessed with weighted kappa coefficient. The level of correlation and agreement between the measurements of the bacillary index was established with coefficient of Lin. RESULTS: The interobserver weighted kappa coefficient was 0.83 for the Colombia scale and 0.85 for the Ridley scale. The Lin coefficient was 0.96 for the correlation-matching of bacillary indexes. CONCLUSIONS: Interobserver agreement obtained for both scales was excellent as the correlation-matching bacillary indices determined with both methods. With the cut-off points yielded a good level of agreement, ensuring interchangeability between the scales defining the high or low bacterial load.

Fratura diafisária do fêmur: reprodutibilidade das classificações AO-ASIF e Winquist / Femoral shaft fracture: reproducibility of AO-ASIF and Winquist classifications

OBJETIVO: Avaliar a reprodutibilidade interobservadores das classificações AO/ASIF e de Winquist para as fraturas diafisárias do fêmur no adulto. MÉTODOS: foram selecionadas aleatoriamente 50 radiografias de pacientes adultos portadores de fratura diafisária do fêmur nas incidências em antero-posterior e perfil. As radiografias foram analisadas por 5 observadores, sendo um membro da Sociedade Brasileira de Trauma Ortopédico, um radiologista, um residente do terceiro ano de Ortopedia e Traumatologia, um do segundo e um do primeiro. Para avaliar a concordância interobservadores destas classificações, foi utilizado o índice estatístico Kappa (K). RESULTADOS: Em todas as análises, observou-se um coeficiente de concordância entre observadores estatisticamente significativo (valor p < 0,05) e classificado como bom (valores de 0,61 a 0,80) ou muito bom (valores acima de 0,80), segundo os critérios de Landis e Koch. CONCLUSÃO: As classificações AO e Winquist apresentam alto índice de concordância interobservadores para as fraturas diafisárias do fêmur no adulto.

OBJECTIVE: To evaluate inter-observer reproducibility of AO / ASIF and Winquist-Hansen classifications for shaft fractures of the femur in adults. METHODS: 50 anterior-posterior and profilelateral radiographs were randomly selected, of adult patients awith diaphyseal fracture of the femur. The radiographs were analyzed by 5 observers-a member of the Brazilian Society of Orthopedic Trauma, a radiologist and 3 residents. To assess the concordance between these classifications, we used the statistical index Kappa (K). RESULTS: In all analyses, we observed a statistically significant correlation coefficient between observers (p <0.05) and according to the criteria of Landis and Koch, they were ranked them as good (values of 0.61 to 0.80) or very good (values above 0.80). CONCLUSION: The AO rating and Winquist present a high rate of concordance between observers for shaft fractures of the femur in adults.

[Characteristics of three species of genus Debaryomyces Lodder & Kreger-van Rij].

A taxonomic state of the collection strains of three marketable species of genus Debaryomyses has been specified. Sources of their isolation have been analyzed and a list of econiches where the yeast occur has been supplemented. The properties have been found which are recommended to be used as additional for differentiation of D. hansenii, D. polymorphus, D. pseudopolymorphus species (that was the ability to assimilate nitrites, growth in the medium with 24 % of NaCl, synthesis of riboflavin, availability of jelatinase activity).

Elaboração de um histórico de enfermagem baseado na taxonomia II da North American Nursing Diagnosis Association / Elaboration of an assesssment tool based ontaxonomy II of the north american nursing diagnoses association / Elaboración de un histórico de enfermeira basado em la taxonomia II de la North American Nursing diagnosis association

Buscando melhorar a qualidade da assistência de enfermagem, este estudo teve como objetivo elaborar um histórico de enfermagem baseado na taxonomia II da North American Nursing Diagnoses Association e realizado no Instituto Lauro de Souza Lima. Participaram 11 enfermeiras que concordaram em participar dando seu consentimento livre e esclarecido por escrito. Foram realizadas quatro sessões de entrevista em grupo focal de, aproximadamente, duas horas cada uma. As reuniões foram gravadas e transcritas. O instrumento elaborado pelas autoras foi julgado; e as sugestões, discutidas até que se chegasse a um consenso do grupo. O trabalho conclui que a iniciativa de se validar o histórico de enfermagem antes de sua utilização prática facilitará sua execução.

Aiming to improve the nursing assistance quality pattern, the objective of this study was to elaborate an assessment tool based on taxonomy II of the North American Nursing Diagnoses Association. This study took place at the Instituto Lauro de Souza Lima. The study sample was constituted by 11 nurses who agreed to participate giving their written confirmed consent. Four focus group interview sessions were realized, and each session lasted about two hours. Meetings were recorded and transcribed. The assessment tool, elaborated by the authors, was analyzed, and the suggestions were discussed until a consensus was obtained. The results were concerning the layot and they suggested a better format. About the content, some items were added and others were excluded. The idea of validating an assessment tool before its practical utilization will facilitate its application.

Buscando mejorar la calidad de la assistência de la enfermeira basado em la Taxonomía II de la North American Nursing Diagnoses Association; realizado em el Insituto Lauro de Souza Lima. Constituyeron la muestra del estudio once enfermeiras que estuvieron de acuerdo em participar dando su consentimento libre y esclarecido por escrito; fueron realizadas cuatro sesiones de entrevistas em gruo focal de aproximadamente dos horas cada uma. Las reuniones fueron grabadas y transcritas. El instrumento elaborado por las autoras fue juzgado y las sugerencias discutidas hasta que se ilegara a um consenso entre el grupo. Los resultados fueron en relación al layout que debería ser más atractivo y cuanto al contenido aãdimos y retiramos items de acuerdo a las sugerencias consensuales del grupo. Este concluye que la iniciativa de validarse el Histórico de Enfermería antes da su utilización prácitca facilitará su ejecución.

Methods for the classification of leprosy for treatment purposes.

The World Health Organization advocates 2 leprosy treatment regimens on the basis of disease classification (as multibacillary or paucibacillary) by skin lesion count. This method, which, in the Philippines, results in a high prevalence (78%) of patients with multibacillary leprosy, was directly compared with classification using standard histopathological and microbiological criteria in 264 currently untreated patients with leprosy. Of those whose leprosy was classified as paucibacillary, 38%-51% of patients had multibacillary leprosy according to classic criteria and were thus at risk of undertreatment according to World Health Organization recommendations.

Falcaustra donanaensis sp. nov. (Nematoda: Kathlaniidae) a parasite of Mauremys leprosa (Testudines, Bataguridae) in Spain.

Falcaustra donanaensis sp. nov. (Nematoda, Kathlaniidae) from the large intestine of Mauremys leprosa (Testudines, Bataguridae) is described. By the absence of pseudosucker, arrangement of the male caudal papillae and the size of the spicules Falcaustra donanaensis sp. nov. resembles only to Falcaustra washingtonensis [Bursey and Aker (2001) J Parasitol 87:1082-1084], a species from Ambistoma tigrinum melanostictum in the Nearctic Region. Papillae pattern in the male of F. washingtonensis is similar to F. donanaensis, but differs by the presence of a median papilla in the American species, length of pharynx, spicule, and gubernacle in males, size of eggs, and number of eggs in female. This is the first species of Falcaustra reported in freshwater turtles in the Iberian Peninsula.

Idenficação dos diagnósticos de enfermagem em uma clínica dermatológica

A Sistematização da Assistência de Enfermagem é um método utilizado para organizar, individualizar e qualificar o cuidado, sendo descrita nos últimosanos nas fases de histórico, diagnóstico, prescrição e evolução. No Brasil a fase introduzida recentemente, foi o diagnóstico de enfermagem, e a maioria das instituições adotam a Classificação da North American Nursing Diagnosis Association (NANDA). Neste estudo descritivo, exploratório, retrospectivo o objetivo foi identificar os Diagnósticos de Enfermagem, bemcomo seus fatores de risco, fatores relacionados e características definidoras, contidos no impresso de padrão mínimo de assistência de enfermagem (PME-b), em uma clínica dermatológica do Instituto Lauro deSouza Lima, Instituição governamental da cidade de Bauru (SP), especializado no atendimento a pacientes com doenças dermatológicas. Os dados foram coletados no período de 01/09/2001 a 31/08/03, em impressopróprio. A amostra foi constituída de 153 prontuários de pacientes do sexo masculino, internados no Setor de Clínica Médica (UIB), e tratados com o método de Sistematização da Assistência de Enfermagem. Os resultados obtidos foram: 100,0% Risco para Infecção; 99,34% Risco para Solidão; 98,69% Isolamento Social; 97,38% Integridade da Pele Prejudicada; 96,73%Risco para Constipação; 96,07% Risco para Integridade da Pele Prejudicada; 92,81% Risco para Trauma; 90,84% Dentição alterada; 84,96% Dor e 83,66% Nutrição alterada menos que as necessidades corporais. Esses resultados confirmam que o impresso de padrão mínimo de assistência de enfermagem utilizado está coerente com a NANDA e com a prática assistencial do Instituto Lauro de Souza Lima

Idenficação dos diagnósticos de enfermagem em uma clínica dermatológica / Identification of nursing diagnosis in a dermatology clinic

A Sistematização da Assistência de Enfermagem é um método utilizado para organizar, individualizar e qualificar o cuidado, sendo descrita nos últimosanos nas fases de histórico, diagnóstico, prescrição e evolução. No Brasil a fase introduzida recentemente, foi o diagnóstico de enfermagem, e a maioria das instituições adotam a Classificação da North American Nursing Diagnosis Association (NANDA). Neste estudo descritivo, exploratório, retrospectivo o objetivo foi identificar os Diagnósticos de Enfermagem, bemcomo seus fatores de risco, fatores relacionados e características definidoras, contidos no impresso de padrão mínimo de assistência de enfermagem (PME-b), em uma clínica dermatológica do Instituto Lauro deSouza Lima, Instituição governamental da cidade de Bauru (SP), especializado no atendimento a pacientes com doenças dermatológicas. Os dados foram coletados no período de 01/09/2001 a 31/08/03, em impressopróprio. A amostra foi constituída de 153 prontuários de pacientes do sexo masculino, internados no Setor de Clínica Médica (UIB), e tratados com o método de Sistematização da Assistência de Enfermagem. Os resultados obtidos foram: 100,0% Risco para Infecção; 99,34% Risco para Solidão; 98,69% Isolamento Social; 97,38% Integridade da Pele Prejudicada; 96,73%Risco para Constipação; 96,07% Risco para Integridade da Pele Prejudicada; 92,81% Risco para Trauma; 90,84% Dentição alterada; 84,96% Dor e 83,66% Nutrição alterada menos que as necessidades corporais. Esses resultados confirmam que o impresso de padrão mínimo de assistência de enfermagem utilizado está coerente com a NANDA e com a prática assistencial do Instituto Lauro de Souza Lima

Alocação do paciente hanseniaco na poliquimioterapia: correlação da classificação baseada no número de lesões com exames baciloscópicos / Allocation of leprosy patients for multidrugtherapy: correlation between the classification according to number of lesions and the skin smears examination

Fundamentos: A integração das artes de controle da hanseníase, as estratégias dos Programas de Saúde da Família e Agentes Comunitários de Saúde, na conformidade do processo de reorganização da atenção básica, fundamentou a atualização das normas da legislação sobre o controle da doença no Brasil. A classificação operacional adotada, para aloação do paciente na polioquimioterapia, foi adaptada da sugerida pela Organização Mundial da Saúde, essencialmente clínica, baseada no número de lesões cutaneas

The mycobacteria: an introduction to nomenclature and pathogenesis.

Tuberculosis, caused by Mycobacterium tuberculosis, and leprosy, caused by M. leprae, are diseases known since antiquity. In developing countries, tuberculosis is still the leading cause of mortality due to an infectious disease. Taxonomically, mycobacteria belong to the genus Mycobacterium, which is the single genus within the family of Mycobacteriaceae, in the order Actinomycetales. Actinomycetales include diverse micro-organisms, but mycobacteria and allied taxa are easily distinguished on the basis of the ability to synthesise mycolic acids. Mycobacterial species are traditionally differentiated on the basis of phenotypic characteristics, and the authors provide an updated list of the biochemical tests currently employed and the culture properties that help to discriminate among various species of mycobacteria. However, as the phenotypic characteristics do not allow precise identification of all species, recent molecular taxonomical approaches for mycobacterial classification and phylogeny are also described. Mycobacteria are also a leading cause of infection in various domesticated animals and wildlife. The authors briefly describe the mycobacteria involved in animal infections, the wildlife reservoirs and strategies to control bovine tuberculosis, and the use of molecular tools for diagnostics and epidemiology of mycobacterial infections in animals. The characteristic of intracellular parasitism is discussed, in addition to the fate of pathogenic mycobacteria that have the ability to grow inside phagosomes and phagolysosomes of infected host macrophages. The mycobacterial cell envelope, which is a complex tripartite structure containing a high proportion of lipids (approximately 30% to 40% of the total weight) could play a crucial role in the adaptation of mycobacteria to intracellular growth and survival, immune modulation and drug resistance.

Use of conventional taxonomy, electrophoretic karyotyping and DNA-DNA hybridization for the classification of fermentative apiculate yeasts.

A taxonomic study was conducted that considered strains of the genera Hanseniaspora/Kloeckera held in the Industrial Yeasts Collection (DBVPG) of the Dipartimento di Biologia Vegetale of the Università di Perugia, Italy. Standard phenotypic as well as molecular criteria were considered in a effort to revisit the classification of these strains, some of which have been in the collection for about 50 years. Results of salient physiological tests showed that some of the DBVPG and type strains could not be identified by current taxonomic keys. Electrophoretic karyotypes were identical for some species, with the type strains of the seven accepted species showing only five distinct chromosomal patterns. DNA-DNA hybridization analyses, using a non-radioactive dot-blot technique, allowed for the distinction of taxa. The taxonomic implications of these results are discussed.

[Is allastrim small pox?]. / Alastrim, variola e?

Between 1910 and 1913, two renowned physicians in the city of Sao Paulo found themselves engaged in a scientific controversy regarding the classification of a disease then assailing the state. Antonio Carini, director of the Instituto Pasteur de Sao Paulo, believed the illness to be small pox, while Emilio Ribas, director of the Servico Sanitario, claimed it was allastrim, or milk pox. The controversy started in the Sociedade de Medicina e Cirurgia but later migrated to other forums and came to incorporate other figures as well. This presentation and discussion of the polemic is meant as a contribution to our understanding of the process by which a scientific consensus is constructed and solidified within the field of the biomedical sciences.

Episódios reacionais da hanseníase / Reactions episodes of leprosy

O maior problema da hanseníase é o desencadeamento de reaçöes imunológicas associadas aos antígenos do Mycobacterium leprae, os quais persistem nos tecidos, mesmo após a morte bacteriana. Se estes estados reacionais näo forem diagnosticados e precocemente tratados, perdas de funçöes nervosas periféricas e consequentes incapacidades físicas permanentes poderäo surgir como sequelas. O objetivo deste trabalho foi a realizaçäo de estudo transversal de 40 pacientes hensenóticos que completaram o tratamento no Centro de Saúde Escola de Capuava, no período de março de 1989 a maio de 1999. Aspectos clínicos e epidemiológicos foram estudados nesta amostra. Concluiu-se que a populaçäo em estudo durante o período é jovem, as formas clínicas mais frequentes foram as multibacilares, indicando que a doença ainda é diagnosticada tardiamente. 57,5 porcento dos pacientes evoluíram com reaçöes hansênicas, sendo o tipo II (eritema nodoso) a forma mais encontrada...

Hanseníase indeterminada: evoluçao clínico-patológica / ?

Foi estudada, em um período de 2 meses a 24 anos, a evoluçao de 51 doentes de hanseníase indeterminada, para formas pauci ou multibacilares da moléstia. O objetivo do estudo foi o de procurar critérios para facilitar a comprovaçao diagnóstica das formas iniciais e o de buscar parâmetros - clínicos, histopatológicos e imunohistoquímicos - que permitissem inferir, desde o início dos sintomas, o sentido evolutivo da doença. Foram examinados os prontuários dos doentes, analisando-se, em relaçao ao quadro inicial da moléstia, o número e características morfológicas das lesoes, a história pregressa, a reaçao de Mitsuda e o tratamento recebido. Nos exames histopatológicos, na coloraçao pela hematoxilina-eosina, foram estudadas as alteraçoes epidérmicas e o infiltrado dermico - sua intensidade, constituiçao e localizaçao

Epiphyseal injuries of the foot and ankle.

A thorough knowledge of functional growth plate anatomy and physiology is essential to proper management of epiphyseal foot and ankle injuries. The ability to classify foot and ankle fractures according to the Salter-Harris anatomic and radiographic classification provides useful prognostic information that may affect treatment. The Dias-Tachdjian mechanistic classification system for pediatric ankle fractures provides useful information about the extent of osseous and soft tissue injury and the best method of closed reduction and correlates well with the Lauge-Hansen system, which is widely used for adult ankle fractures. Most epiphyseal foot fractures involve the metatarsals or phalanges and can usually be managed with closed reduction. Considerable spontaneous correction of deformity can be expected in the younger child (under age 10 years), but one should be aware that sagittal plane and rotational malalignment of the metatarsal heads may cause significant problems. Salter-Harris type I and II fractures of the ankle can usually be managed with closed reduction. Salter-Harris type III and IV ankle fractures with greater than 2 mm of displacement require open reduction and internal fixation. One must also have a high index of suspicion for juvenile Tillaux and triplane transitional fractures that may not be obvious on plain radiographs. Although these fractures usually do not produce significant limb-length discrepancies, they are intra-articular fractures and ankle joint arthritis can result. Finally, younger children (under age 10 years) have a better prognosis for spontaneous correction of nongrowth arrest-induced deformities but a much poorer prognosis with growth arrest injuries than do older children, in whom growth arrest does not usually cause a significant problem. All children with growth plate injuries should be followed at regular intervals for at least 2 years or to skeletal maturity in the case of physeal disturbance. Treatment of epiphyseal fractures of the foot and ankle must be individualized but should always be based upon a thorough knowledge of anatomy, bone growth physiology, classification, potential pitfalls, and prognosis.