Neurofeedback training of executive function in autism spectrum disorder: distinct effects on brain activity levels and compensatory connectivity changes.

BACKGROUND: Deficits in executive function (EF) are consistently reported in autism spectrum disorders (ASD). Tailored cognitive training tools, such as neurofeedback, focused on executive function enhancement might have a significant impact on the daily life functioning of individuals with ASD. We report the first real-time fMRI neurofeedback (rt-fMRI NF) study targeting the left dorsolateral prefrontal cortex (DLPFC) in ASD. METHODS: Thirteen individuals with autism without intellectual disability and seventeen neurotypical individuals completed a rt-fMRI working memory NF paradigm, consisting of subvocal backward recitation of self-generated numeric sequences. We performed a region-of-interest analysis of the DLPFC, whole-brain comparisons between groups and, DLPFC-based functional connectivity. RESULTS: The ASD and control groups were able to modulate DLPFC activity in 84% and 98% of the runs. Activity in the target region was persistently lower in the ASD group, particularly in runs without neurofeedback. Moreover, the ASD group showed lower activity in premotor/motor areas during pre-neurofeedback run than controls, but not in transfer runs, where it was seemingly balanced by higher connectivity between the DLPFC and the motor cortex. Group comparison in the transfer run also showed significant differences in DLPFC-based connectivity between groups, including higher connectivity with areas integrated into the multidemand network (MDN) and the visual cortex. CONCLUSIONS: Neurofeedback seems to induce a higher between-group similarity of the whole-brain activity levels (including the target ROI) which might be promoted by changes in connectivity between the DLPFC and both high and low-level areas, including motor, visual and MDN regions.

Characterization of variables related to high stability of raw cow milk.

This research paper analyzes the stability of raw cow milk in the alcohol test and seeks to understand to know the factors that influence milk stability and the occurrence of unstable non-acid milk. Milk samples were collected from the cooling tanks of rural farmers in the state of Paraná twice in summer and twice in winter. The farms were classified according to the production system: pasture with supplementation and feedlot. The following variables were analyzed: stability in the alcohol test, titratable acidity, ionized calcium concentration (iCa), chemical composition of milk, somatic cell count and standard plate count. The results showed that milk stability was greater in winter vs. summer, when the milk contained higher iCa, and in the feedlot vs. pasture system. The Pearson Correlation between variables (ethanol stability, milk composition, iCa, cooling tank temperature, milk volume, number of milking, number of cows milked, fat/protein ratio, distance and travel time) were analyzed. Stability was negatively correlated with iCa concentration and positively with lactose content. Logistic regression of the risk of unstable non-acid milk at 72% alcohol (UNAM72) showed that only iCa and lactose were determinants, while evaluation of the same risk at 78% alcohol revealed iCa, titratable acidity, lactose and milk urea nitrogen as risk factors. Under the dairy farming conditions of Paraná state, the frequency of UNAM72 was low (12.16%) and was higher in summer and in pasture systems with supplementation. In conclusion, in dairy herds bred with high technological level, with adequate nutritional and health management, the frequency of UNAM is low and is related to nutritional management abnd, perhaps, heat stress, factors that alter iCa and lactose levels.

Carbon allocation of Spirodela polyrhiza under boron toxicity.

Pectic polysaccharides containing apiose, xylose, and uronic acids are excellent candidates for boron fixation. Duckweeds are the fastest-growing angiosperms that can absorb diverse metals and contaminants from water and have high pectin content in their cell walls. Therefore, these plants can be considered excellent boron (B) accumulators. This work aimed to investigate the relationship between B assimilation capacity with apiose content in the cell wall of Spirodela polyrhiza subjected to different boric acid concentrations. Plants were grown for 7 and 10 days in ½ Schenck-Hildebrandt media supplemented with 0 to 56 mg B.L-1, the non-structural and structural carbohydrates, and related genes were evaluated. The results showed that B altered the morphology and carbohydrate composition of this species during plant development. The optimum B concentration (1.8 mg B.L-1) led to the highest relative growth and biomass accumulation, reduced starch, and high pectin and apiose contents, together with increased expression of UDP-apiose/UDP-xylose synthase (AXS) and 1,4-α-galacturonosyltransferase (GAUT). The toxic state (28 and 56 mg B.L-1) increased the hexose contents in the cell wall with a concomitant reduction of pectins, apiose, and growth. The pectin content of S. polyrhiza was strongly associated with its growth capacity and regulation of B content within the cells, which have AXS as an important regulator. These findings suggest that duckweeds are suitable for B remediation, and their biomass can be used for bioenergy production.

Pneumocephalus Following an Accidental Dural Puncture, Treated Using Hyperbaric Oxygen Therapy. A Case Report.

INTRODUCTION: Neuraxial techniques, including epidural anaesthesia, are often used for perioperative pain control and are generally safe. However, both transient, mild and even severe, life-threatening neurologic complications can occur. CASE PRESENTATION: A seventy-eight-year-old man was admitted to the hospital for a radical nephrectomy plus transurethral resection due to kidney and bladder cancer. During the epidural exploration, an accidental dural puncture was noted. This was followed by the patient complaining of an intense headache. The epidural catheter was placed in a different location, and surgery was performed uneventfully. The patient presented with confusion, agitation, vertical nystagmus, vision loss, and paraparesis about two hours later. The epidural levobupivacaine and morphine infusion were stopped, followed by motor block resolution. A computerized head-tomography scan showed extra-axial multiple air spots involving the frontal and temporal lobes. Emergent hyperbaric oxygen therapy was commenced. After a single session, there was complete resolution of all symptoms and a marked reduction in the number and volume of the extra-axial air visible on the CT scan. CONCLUSIONS: Although rare, pneumocephalus is a well-recognized complication of a dural puncture. Its rapid recognition in a patient with new-onset neurological symptoms and early treatment with hyperbaric oxygen therapy allows rapid clinical and imaging resolution and an improved prognosis.

Protein Intake, Adherence to Vitamin-Mineral Supplementation, and Dumping Syndrome in Patients Undergoing One Anastomosis Gastric Bypass.

INTRODUCTION: One anastomosis gastric bypass (OAGB) is an effective bariatric procedure. However, nutritional deficiencies or dumping syndrome (DS) may occur. The aim of this study was to assess adherence to nutritional recommendations and development of DS in a 3-year OAGB patient follow-up. METHODS: For 150 OAGB patients, in our center, data were collected through the electronic platform and by an individual telephone interview. The inclusion criterion is OAGB as a primary bariatric procedure, no revisional surgery, or no pregnancy. The adequacy of daily protein intake cutoff was defined as 60 g. Adherence to micronutrient supplementation protocol was considered if a minimum of 5 takes/week were reported. To evaluate the occurrence of DS, the Sigstad score questionnaire was used. For statistical analysis, a significance level less than 5% (p < 0.05) was considered. RESULTS: A total of 150 patients (80% females), BMI 44.3 ± 21.3 kg/m2, were subjected to the OAGB procedure. Of those, 128 fulfilled the study inclusion criteria. After 3 years, the mean %EBMIL was 78.4 ± 14.4. During the 3-year follow-up, the average protein intake was 60 g/day, and 48% reported an adequate daily protein intake. Adherence to the micronutrient supplementation protocol was reported by 70%. According to the Sigstad score questionnaire, DS was present in 24% of patients. CONCLUSION: A significant part of OAGB patients does not comply with the nutrition prescription assessed, emphasizing the need to improve team/patient communication strategies. Long-term studies are needed to characterize and assess the health impact of protein, vitamin, and mineral malnutrition in patients undergoing OAGB.

Effects of muscular strength training and growth hormone (GH) supplementation on femoral bone tissue: analysis by Raman spectroscopy, dual-energy X-ray absorptiometry, and mechanical resistance.

The aim of the present study was to verify the effects of muscular strength training and growth hormone (GH) supplementation on femoral bone tissue by Raman spectroscopy (Raman), dual-energy X-ray absorptiometry (DXA), and mechanical resistance (F-max) analysis. A total of 40 male Wistar animals, 60 days old, were used. The animals were distributed into four groups: control (C), control with GH (GHC), muscular strength training (T), and muscular strength training with GH (GHT). Blood samples were collected for the quantification of creatine kinase (CK-MB) and the femurs were removed for analysis by Raman, DXA, and F-max. A more pronounced increase in the bone mineral components was verified in the T group, for all the variables obtained by the Raman (calcium, phosphate, amide, and collagen). In addition, for animals submitted to GH supplementation, there was a reduction in the variable bone mineral density (BMD) obtained by the DXA (p < 0.05). Finally, the animals that received GH supplementation presented a higher F-max, but without statistical significance (p > 0.05). It was concluded that animals that received GH supplementation demonstrated a decrease in BMD. In addition, T alone was able to promote increased calcium, phosphate, amide, and collagen compounds in bone tissue.

Towards Therapeutic Alternatives for Mercury Neurotoxicity in the Amazon: Unraveling the Pre-Clinical Effects of the Superfruit Açaí (Euterpe oleracea, Mart.) as Juice for Human Consumption.

Methylmercury (MeHg) exposure is a serious problem of public health, especially in the Amazon. Exposure in riverine populations is responsible for neurobehavioral abnormalities. It was hypothesized that consumption of Amazonian fruits could protect by reducing mercury accumulation. This work analyzed the effects of commercial samples of Euterpe oleracea (EO) for human consumption (10 µL/g) against MeHg i.p. exposure (2.5 mg/Kg), using neurobehavioral (open field, rotarod and pole tests), biochemical (lipid peroxidation and nitrite levels), aging-related (telomerase reverse transcriptase (TERT) mRNA expression) and toxicokinetic (MeHg content) parameters in mice. Both the pole and rotarod tests were the most sensitive tests accompanied by increased lipid peroxidation and nitrite levels in brains. MeHg reduced TERT mRNA about 50% demonstrating a strong pro-aging effect. The EO intake, similar to that of human populations, prevented all alterations, without changing the mercury content, but avoiding neurotoxicity and premature aging of the Central Nervous System (CNS). Contrary to the hypothesis found in the literature on the possible chelating properties of Amazonian fruits consumption, the effect of EO would be essentially pharmacodynamics, and possible mechanisms are discussed. Our data already support the regular consumption of EO as an excellent option for exposed Amazonian populations to have additional protection against MeHg intoxication.

Self-Modulation of Premotor Cortex Interhemispheric Connectivity in a Real-Time Functional Magnetic Resonance Imaging Neurofeedback Study Using an Adaptive Approach.

Recent studies have reported on the feasibility of real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) training. Although modulation of blood oxygenation level-dependent signal of single brain regions in rt-fMRI NF is a well established technique, the same does not hold true for modulation of connectivity. Self-modulation of interregional connectivity is a potential alternative in clinical neuroscience applications, since long-range functional dysconnectivity is being increasingly recognized as a mechanism underlying neuropsychiatric disorders. In this study, a framework was designed to train participants to self-regulate, in real time, interhemispheric functional connectivity between bilateral premotor cortices. To this end, participants use a novel adaptive motor imagery task, with gradual frequency variation preventing activity plateaus and subsequent decreases in correlation of activity (three NF runs). Participants were able to upregulate and maintain interhemispheric connectivity using such adaptive approach, as measured by correlation analysis. Modulation was achieved by simultaneous volitional control of activity in premotor areas. Activation patterns in the downregulation condition led to significantly lower correlation values than those observed in the upregulation condition, in the first two NF runs. Comparison between runs with and without feedback showed enhanced activation in key reward, executive function, and cognitive control regions, suggesting NF promotes reward and the development of goal-directed behavior. This proof-of-principle study suggests that functional connectivity feedback can be used for volitional self-modulation of neuronal connectivity. Functional connectivity-based NF could serve as a possible therapeutic tool in diseases related to the impairment of interhemispheric connectivity, particularly in the context to motor training after stroke.

Electrostimulation of the posterior tibial nerve in individuals with overactive bladder: a literature review.

[Purpose] This study aims to gather scientific evidence to identify whether clinical trials on Electrostimulation of the Posterior Tibial Nerve (ESPTN) in individuals with overactive bladder present an adequate methodological standard according to the PEDro (Physiotherapy Evidence Database) criteria. [Methods] Integral literature review, including randomized controlled clinical trials found in PEDro. [Results] We found 16 articles, of which only one did not meet the inclusion criteria. This article has shown that ESPTN is a conservative tool of physiotherapy that is less invasive than other therapies, is well tolerated by patients and has been shown to be effective in the treatment of overactive bladder. However, few standardized clinical studies have been conducted, and only 26.6% of the articles included in this review obtained a score of more than five items on the PEDro scale. [Conclusion] This article has shown that ESPTN is a conservative tool of physiotherapy that is less invasive than other therapies, is well tolerated by patients and has been shown to be effective in the treatment of overactive bladder. Thus, there is a need for more clinical articles that follow the quality criteria for randomized clinical trials, allowing more reliable scientific results.

Counter-current chromatography with off-line detection by ultra high performance liquid chromatography/high resolution mass spectrometry in the study of the phenolic profile of Lippia origanoides.

Lippia origanoides (Verbenaceae) is an important Brazilian medicinal plant, also used for culinary purposes. Most chemical studies with this plant have been focused on its volatile composition. In this work, we combined High-Speed Counter-current Chromatography (HSCCC) and High Performance Liquid Chromatography coupled to Ultra Violet detection and High Resolution Mass Spectrometry (HPLC-UV-HRMSn) methodologies to access the non-volatile chemical composition of L. origanoides. The crude ethanol extract of L. origanoides (LOEF) was first analyzed by HPLC-UV-HRMSn and allowed the identification of 7 major compounds. Among them, eriodictyol, naringenin and pinocembrin, were determined and are phytochemical markers of this plant. However, owing to the complexity of this plant matrix, LOEF was fractionated by HSCCC (hexane-ethanol-water, 4:3:1) as a tool for preparative pre-purification, affording a flavonoid-rich fraction. A column screening with the chromatographic stationary phases ZIC-HILIC, monolithic and particulate RP18 was performed. The best column separation was achieved with a Purospher STAR RP18e, which was used for HPLC-DAD-HRMSn studies. By this approach 12 compounds were further identified in addition to the major ones identified in the raw extract. Two of them, 6,8-di-C-hexosyl-luteolin and 6,8-di-C-glucosyl-apigenin, are being reported for the first time in the family Verbenaceae. This work shows the integration of HSCCC as a preparative tool for the fractionation and purification of natural products from a complex plant extract with other analytical techniques, with the purpose of showing each technique's potential.

Analysis of photobiomodulation associated or not with platelet-rich plasma on repair of muscle tissue by Raman spectroscopy.

Treatment of muscle injuries usually results in the interruption of sports practice; thus, studies aimed at accelerating the return to activity, with proper tissue repair, are important. Therefore, this study aimed to evaluate the effects of photobiomodulation (PBM), associated or not with platelet-rich plasma (PRP), on the treatment of muscle injury. Thirty-five animals were used and divided into five groups (n = 7): control (C), control lesion (CL), lesion treated with low-level laser therapy (LLLT) (LLt), lesion treated with PRP (LP), and lesion treated with both techniques, LLLT and PRP (LLtP). Muscle injury was induced by stretching the gastrocnemius muscle, and the animals in the LLtP and LP groups received the application of PRP immediately following the injury. The LLLT was applied daily for 7 days. The animals were euthanized 7 days after the injury. Analysis of the NADH/NAD ratio and collagen was performed by Raman spectroscopy; in addition to which, histological analysis of the gastrocnemius muscle was performed. The LLtP group demonstrated a reduction in the area of injury, regenerating cells and a healthy appearance of muscle fibers. The Raman analyses showed a reduction in the NADH/NAD ratio in the CL group, demonstrating oxidative stress, and the collagen presented a reduction in the CL and LLt groups, when compared with the C group. It is concluded that either PBM or PRP, and the association of both, was able to reduce the oxidative stress promoted by injury and modulate collagen production at the site of the injury. Furthermore, although both treatments individually were effective for repairing the damage caused by muscle injury, the association of both demonstrated a better histological aspect.

Evaluation of inorganic elements in cat's claw teas using ICP OES and GF AAS.

The determination of Ba, Ca, Cu, Fe, Mg, Mn, P, Pb, and Zn by inductively coupled plasma optical emission spectrometry (ICP OES), and Se by graphite furnace atomic absorption spectrometry (GF AAS), has been carried out in dry matter and teas from 11 samples of the cat's claw plant. The accuracy and precision values were verified against GBW 07604 (Poplar leaves) certified reference material and by the recovery test. Results showed a high content of Ca in the medicinal plant studied, followed by Mg and P. The values obtained showed that the elements studied have different concentrations depending on the method of tea preparation. The highest levels were observed in Ca and Mg, and the lowest for Se and Pb, by both infusion and decoction. Teas prepared from this plant were found to be at safe levels for human consumption, and may be suitable as sources of these elements in the human diet.

Ethnobotanical study of medicinal plants by population of Valley of Juruena Region, Legal Amazon, Mato Grosso, Brazil.

ETHNOPHARMACOLOGICAL IMPORTANCE: The use of medicinal plants for treatment, cure and prevention of diseases has been described by many people since time immemorial. Because of this use, commercial and scientific interests have emerged, making it necessary to realize ethnobotanical surveys of medicinal plants species, which is important for subsequent chemical and pharmacological bioprospections. AIM OF THE STUDY: This study aimed at surveying, identifying, cataloging and documenting the medicinal plants species used in the Valley of Juruena, Northwestern Mato Grosso, Legal Amazon Brazil for the treatment of various human diseases, as well as assessed the species of interest for bioprospecting potential. MATERIALS AND METHODS: Informants were interviewed using semi-structured form to capture information on socio-demographic and ethnopharmacological data of medicinal plants such as vernacular name, uses, geographic origin, habit, form of preparation and part used. Results were analyzed using descriptive and quantitative means: indices of use-report (Ur) and informant consensus factor (ICF), for the selection of plant species with therapeutic potential. RESULTS: Three hundred and thirty two (332) plants species belonging to 90 families were reported for medicinal purposes and totaling 3973 use-reports were reported by 365 (92.9%) of the people interviewed. Asteraceae (32.2%), Fabaceae (26.7%) and Lamiaceae (24.4%) families were the most represented, with majority being species native (64.45%) to Brazil. Leaves (64.5%) were the part of the plant most used and infusion (45.7%) was the most utilized form. Gastrointestinal disorders followed by respiratory complaints topped the list of use-reports. The native or naturalized plants with the highest use reports in the order of decreasing absolute frequency per each emic-category are Cymbopogon citratus (DC.) Stapfc (104), Mentha pulegium L. (94), Arrabidaea chica (Humb. & Bonpl.) B. Verl. (97), Alternanthera brasiliana (L.) Kuntze (71), Baccharis crispa Spreng (57), Phyllanthus niruri L. (48), Gossypium barbadense L. (44), Solidago microglossa DC. (40) and Bauhinia forficata L. (20). And the most cited exotics are: Chenopodium ambrosioides L. (151), Aloe vera (L.) Burm. f., (89) and Rosmarinus officinalis L. (72). In some cases, high ICF values were found, which reflects high degree of homogeneity of consensus among informants in this region on medicinal plants. CONCLUSION: The population of Valle of Juruena makes use of a wide array of medicinal plants distributed in all use categories with predominance of those use in the treatments of gastrointestinal and respiratory ailments. The therapeutic potential of some of the species of medicinal importance extensively utilized by the population of the region have been scientifically validated, and are therefore promising prototype of new drugs. However, there are some of these species whose ethnomedicinal uses are yet to be scientifically verified and thus constitute an unexplored terrain for future biological/pharmacological studies.

Historic of therapeutic efficacy of albendazol sulphoxide administered in different routes, dosages and treatment schemes, against Taenia saginata cysticercus in cattle experimentally infected.

The present study aimed to notify the history of albendazole sulphoxide (ALB-SO) and albendazole (ALBZ) efficacy against Taenia saginata cysticercus (Cysticercus bovis) parasitizing experimentally infected bovines. A total of 11 efficacy trials were performed between the years of 2002 and 2010. In order to perform these trials, animals were individually inoculated with 2×10(4) eggs of T. saginata in each study's day zero (D0). For every trial, a positive control group (untreated infected animals) and a negative control group (animals that were neither infected nor treated) were used. ALB-SO or ALB were administered in the different dosages, in different days of treatments. In a last study with this formulation, this active principle was administered orally, mixed with the mineral supplement, on the 60th DPI, in a dosage of 30mg/kg. In all trials, on the 100th DPI, all animals were euthanized and submitted to the sequenced slicing of 26 anatomical segments (fragments of approximately five millimeters) for the survey of T. saginata cysticercus. With the obtained results it is possible to verify that in the first trials, conducted in 2002, ALB-SO reached, independently of dosage and treatment scheme, efficacies superior to 98% (arithmetic means). The trials conducted in 2005 (2.5mg/kg on the 30th, 60th, and 90th DPI) obtained values of efficacy all inferior to 60%. In 2008, the trials with 2.5 and 7.7mg/kg demonstrated efficacy values inferior to 40%, for both dosages and treatment schemes (30th/60th/90th DPI and 60th DPI). When this formulation was administered orally on the dosage of 30mg/kg on the 60th DPI, the efficacy against T. saginata cysticercus reached 88.28%. ALB administered orally showed efficacy values of 0.0%, 29.88% and 28.64% in the dosages of 5, 10 and 15mg/kg, respectively, using the treatment schemes described above for each dosage. Based on the results of these trials, conducted in an eight year period (2002-2010) using the sequenced slicing method for evaluating the efficacy of the aforementioned formulations against T. saginata cysticercus, it is possible to observe that, amongst the few molecules used in the chemotherapic treatment against T. saginata larvae, ALB-SO, administered in varied routes, dosages and treatment schemes, the studies conducted in 2008, 2009, and 2010, have a low therapeutic efficacy against C. bovis in Brazil, while ALBZ had insignificant efficacy values against T. saginata larvae parasitizing experimentally infected bovines. However, future studies using molecular biology will be necessary to assess whether the difference on the efficacy of the ALB-SO can be related to strain or another specific factor.

Validation of a Spanish version of the psychological inflexibility in pain scale (PIPS) and an evaluation of its relation with acceptance of pain and mindfulness in sample of persons with fibromyalgia.

BACKGROUND: Psychological flexibility has been suggested as a fundamental process in health. The Psychological Inflexibility in Pain Scale (PIPS) is one of the scales employed for assessing psychological inflexibility in pain patients. The aim of this study was to validate the Spanish version of the PIPS and secondly, to compare it to two other psychological constructs, the acceptance of pain and mindfulness scales. METHODS: The PIPS was translated into Spanish by two bilingual linguistic experts, and then, back-translated into English to assess for equivalence. The final Spanish version was administered along with the Pain Visual Analogue Scale, Fibromyalgia Impact Questionnaire, Hospital Anxiety Depression Scale, Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire and the Mindful Attention Awareness Scale, to 250 Spanish patients with fibromyalgia. Face validity, construct validity, reliability (internal consistency and test-retest) and convergent validity were tested. Also a multiple regression analysis was carried out.The usual guidelines have been followed for cross-cultural adaptations. RESULTS: Data were very similar to the ones obtained in the original PIPS version. The construct validity confirmed the original two-components solution which explained 61.6% of the variance. The Spanish PIPS had good test-retest reliability (intraclass correlation coefficient 0.97) and internal consistency reliability (Cronbach's alpha: 0.90). The Spanish PIPS' score correlated significantly with worse global functioning (r = 0.55), anxiety (r = 0.54), depression (r = 0.66), pain catastrophizing (r = 0.62), pain acceptance (r = -0.72) and mindfulness (r = -0.47), as well as correlating modestly with pain intensity (r = 0.12). The multiple regression analyses showed that psychological inflexibility, acceptance and mindfulness are not overlapped. CONCLUSIONS: The Spanish PIPS scale appears to be a valid and reliable instrument for the evaluation of psychological inflexibility among a sample of fibromyalgia patients. These results ensure the use of this scale in research as well as in clinical practice. Psychological inflexibility measures processes different from other related components such as acceptance and mindfulness.

An oil spill surveillance program for Lake Pontchartrain.

This article describes an oil spill surveillance strategy implemented in response to BP's 2010 MC252 oil well blowout in the Gulf of Mexico. A three-pronged strategy consisted of Geographic Information System (GIS) monitoring of the surface slick, hydrodynamic modeling of the potential movement of the slick within the Basin, and weekly field reconnaissance. Our analysis was completed in near real time during the event and the results and predictions helped local responders minimize oiling impacts in Lake Pontchartrain. No prior planning was undertaken before this crisis response, and this article reports our support activities as they happened. For the GIS component, a remote sensing derived surface slick outline layer was obtained to produce near daily maps showing the slick's proximity to Lake Pontchartrain along with weather conditions and deployed response assets. This regular monitoring of the slicks' location was complemented by hydrodynamic numerical modeling that simulated the currents that determined the trajectories of oil particles. These data were ground-truthed through weekly reconnaissance trips that assessed the potential routes of oil penetration into Lake Pontchartrain for the presence of sheen, tarballs, and other oil constituents. Despite the ad hoc design and on-the-fly implementation, these three assessments provided consistent and actionable information.

Análise da atuação dos profissionais de enfermagem no Projeto Montes Claros / Analysis of the performance of nursing professionals in the Montes Claros Projec

A mudança paradigmática no setor saúde, advinda de uma nova proposta do conceito de saúde-doença, proporcionou novos subsídios conceituais que influenciaram a reformulação das práticas de saúde no Brasil e no mundo. O Sistema Único de Saúde (SUS), oficializado em 1988, originou-se desse novo paradigma sanitário e seu processo não-linear de configuração tem em seu cerne um conjunto de ideais contrários à política de saúde vigente na época, denominada Reforma Sanitária (RS). O Projeto Montes Claros (PMC), modelo de extensão de serviços básicos de saúde, desenvolvido na cidade de Montes Claros, Minas Gerais, em meados da década de 70, vinha ao encontro desses ideais da Reforma Sanitária e é considerado inovador, pois ocorreu em período anterior à Conferência de Alma-Ata, que tinha como principal diretriz os cuidados primários em saúde. Para Montes Claros, ocorreu um fluxo intenso de profissionais de saúde e de outras áreas que chegaram a fim de desenvolver suas atividades no projeto. Dessa forma, procurando desvelar quais foram as principais contribuições dos profissionais de enfermagem dentro do PMC, este estudo teve como objetivo analisar a participação dos profissionais de enfermagem no projeto. Para tanto, foi realizado um estudo descritivo-exploratório de cunho qualitativo e que utilizou o método de abordagem da história oral para orientação da coleta de dados. Como instrumento de coleta de dados foi utilizada a entrevista semiestruturada gravada e posteriormente transcrita. O corpus do material reunido foi, então, submetido à análise do discurso. O estudo justifica-se por poder constituir uma fonte de referencial sobre o PMC e por poder contribuir para o enriquecimento das discussões sobre a RS e sobre a atuação dos profissionais de enfermagem no projeto. Do discurso dos entrevistados emergiram três categorias temáticas relativas à atuação dos profissionais de enfermagem no PMC: o enfermeiro e sua atuação na área da saúde pública, o enfermeiro como formador de recursos humanos, e a contribuição do projeto para a criação do SUS. Constatou-se que os enfermeiros executaram funções relativas às atividades de planejamento das ações de saúde do projeto e atuaram na capacitação dos auxiliares de saúde recrutados para operacionalizarem esse novo sistema de saúde em construção. No PMC, surgiu uma nova faceta de atuação da enfermagem, ligada à saúde pública e ao planejamento em saúde, uma vez que, na época, os profissionais dessa categoria tinham o nível hospitalar como o maior campo de atuação. Esse estudo permitiu ampliar a compreensão sobre a atuação da enfermagem dentro do PMC, importante projeto de reorganização dos serviços de saúde, que se caracterizou como uma etapa de destaque na construção do SUS.

The paradigm shift in the health sector, coming from a newly proposed concept of health-disease, provided new conceptual support that influenced the reformulation of health practices in Brazil and worldwide. The Unified Health System (UHS), inaugurated in 1988, originated from this new health paradigm, and its nonlinear process configuration has at its core a set of ideals from Brazilian Health Reform (BHR). The Montes Claros Project (PMC), a basic health services extension model, developed in the city of Montes Claros, Minas Gerais, in the mid ?70s, approached these BHR ideals. There was an intense flow of health professionals toward Montes Claros. Thus, seeking to reveal what the main contributions of nursing professionals were within the PMC, this study aimed to analyze the participation of nursing professionals in the project. To that end, we performed a descriptive exploratory study, qualitative in nature, using the method of the oral history approach. As the data collection instrument, we used the semi-structured recorded interview, later transcribed. The corpus of gathered material was subjected to discourse analysis. The study is warranted as it may constitute a source of reference on the PMC, and may contribute to the enrichment of discussions about BHR and about the performance of nursing professionals on the project. The interview discourse revealed three themes concerning the role of nurses in the PMC: the nurse and his/her work in the area of public health, nurses as human resources trainers, and the project?s contribution to the creation of the UHS. It was found that nurses performed tasks related to the project?s health action planning activities, and worked in the training of health aides. In the PMC, a new facet of nursing activities arose, linked to public health and health planning. This study allowed a broader understanding of nursing activities within the PMC, an important project for the reorganization of health services, which was characterized as a prominent step in the construction of the UHS.

Treatment of candidemia in adult patients without neutropenia--an inconvenient truth.

In 2009 the Infectious Diseases Society of America reviewed the guidelines on the treatment of candidemia in non-neutropenic patients. In this document the preferred treatment was either fluconazole or an echinocandin. Amphotericin-B formulations were considered an alternative. However, careful assessment of published data showed similar efficacy between these drugs.

O Shiatsu como terapêutica alternativa em portadores de distúrbios osteomusculares relacionados ao trabalho / Shiatsu as alternative therapy for work-related musculoskeletal disorders

JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi avaliar se os pacientes diagnosticados como portadores de distúrbios osteomusculares relacionados ao trabalho (DORT), mas especificamente com a síndrome do túnel do carpo, obtém alívio da dor com a aplicação de técnicas da terapia Shiatsu. Além disso, comparar os resultados obtidos através deste recurso terapêutico com os resultados obtidos através da utilização de técnicas de tratamento convencional.MÉTODO: Para o presente estudo foram selecionados 15 indivíduos, sendo que 10 receberam tratamento através de terapia Shiatsu aplicada em cadeira de quick massage por aproximadamente 20 minutos, com duas sessões semanais, em período de 16 semanas e 5 receberam tratamento fisioterapêutico através de cinesioterapia, eletroterapia e mobilização neural neste mesmo período. O questionário de Boston foi a ferramenta utilizada para avaliar a gravidade dos sintomas (EGS) e o grau de funcionalidade (EEF) dos indivíduos antes e após a aplicação das técnicas citadas. RESULTADOS: Quando os índices obtidos nas escalas pré-tratamento pela terapia Shiatsu são comparados com os índices obtidos nas escalas pós-tratamento, constata-se diferença estatisticamente significativa de alívio da dor e melhora da funcionalidade. Contudo, quando os índices obtidos após terapia Shiatsu são comparados aos obtidos após terapia convencional, observa-se que não há diferença estatisticamente significativa. CONCLUSÃO: Ambas as terapias foram eficazes no controle da dor crônica de portadores de DORT.

BACKGROUND AND OBJECTIVES: This study aimed at evaluating whether patients with work-related musculoskeletal disorder (WRMD), more specifically those with carpal tunnel syndrome, have pain relief with Shiatsu therapy techniques. In addition, it aimed at comparing results of such therapeutic resource with results obtained through conventional techniques. METHOD: Participated in this study 15 people of whom 10 were treated with Shiatsu applied in quick massage chair for approximately 20 minutes, with two weekly sessions for 16 weeks, and 5 were treated with physical therapy through kinesiotherapy, electrotherapy and neural mobilization during the same period. Boston questionnaire was used to evaluate severity of symptoms (EGS) and the level of functionality (EEF) before and after the use of such techniques.RESULTS: When indices obtained in pre-treatment scales for Shiatsu therapy are compared to indices obtained in post-treatment there is statistically significant difference in pain relief and improved functionality. However, when indices obtained after Shiatsu therapy are compared to those obtained after conventional therapy, there is no statistically significant difference. CONCLUSION: Carpal tunnel syndrome patients may benefit from alternative therapies, such as Shiatsu, with decreased chronic pain and improved functionality, similarly to conventional physical therapy techniques.

Frequência de distúrbios álgicos da coluna vertebral e tratamento osteopático / Spine pain disorder frequency and osteopathy

Objetivo: Analisar os prontuários onde havia relatos de distúrbio sálgicos da coluna vertebral em um ambulatório de Osteopatia, como intuito de verificar a frequência desse tipo de acometimento e sua resposta ao tratamento osteopático. Métodos: Realizou-se um estudo retrospectivo com análise documental de 182 prontuários com diagnóstico de cervicalgia e lombalgia, com ou sem comprometimento radicular. Considerou-se a intensidade de dor antes e após tratamento osteopático, avaliada através da escala de Borg. Resultados: A média de idade da amostra era de 54,69 ± 13,76 anos, que apresentava distribuição heterogênea pelo teste de Kolmogorov-Smirnov. Encontrou-se predomínio da cervicobraquialgia, seguindo-se lombalgia, lombociatalgia e cervicalgia, sendo mais evidentes no sexo feminino. A presença de dor ocorreu com maior frequência e intensidade nas integrantes da profissão consideradado lar. Seguiram-se os aposentados, auxiliares de enfermagem, professoras, empregadas domésticas, costureiras e as manicures. O tratamento osteopático evidenciou, já após a primeira sessão, significativa redução na intensidade da dor. Conclusão: Conclui-se neste estudo que o sexo feminino, independente da faixa etária é o mais acometido. Apesar de todas as profissões serem predisponentes para o comprometimento álgico da coluna vertebral, em algumas o risco relativo é bem maior, principalmente naquelas mais sedentárias, sendo a osteopatia uma opção terapêutica para resolução da dor em curto prazo de tempo.

Objective: To analyze patients records of an out patient osteopathic clinic in which were reported spine pain, aiming at observing frequency of this kind of disorder and how patients responded to the osteopathic treatment. Methods: A retrospective study was carriedout through analysis of 182 patients records with neck pain and lowback pain with or without radiculopathy. Pain intensity, before andafter osteopathic treatment, was evaluated by Borg Scale. Results: The sample studied showed a heterogeneous distribution according Kolmogorov-Smirnov analysis, mean age 54.69 ± 13.76 years old. Regarding symptoms it was found predominance of cervicobrachialgia, followed by low back pain, lombosciatalgia and cervical pain, mainly in the female gender. The housewifes showed more intensivepain, followed by the retired people, nurses assistants, teachers, domestic servant, dressmakers and nail makers. The osteopathic treatment made evident, just after the first session, a signifi cantreduction of pain intensity in the treated patients. Conclusion: Weconcluded that in this study the female gender is the more aff ected. Although all the professions may present risks of vertebral disorders, some are more at risk, mainly the sedentary people, and the osteopathycould be a short term therapeutic solution.