User-Centered Design and Evaluation of Clinical Decision Support to Improve Early Peanut Introduction: Formative Study.

BACKGROUND: Peanut allergy has recently become more prevalent. Peanut introduction recommendations have evolved from suggesting peanut avoidance until the age of 3 years to more recent guidelines encouraging early peanut introduction after the Learning Early about Peanut Allergy (LEAP) study in 2015. Guideline adherence is poor, leading to missed care opportunities. OBJECTIVE: In this study, we aimed to develop a user-centered clinical decision support (CDS) tool to improve implementation of the most recent early peanut introduction guidelines in the primary care clinic setting. METHODS: We edited the note template of the well-child check (WCC) visits at ages 4 and 6 months with CDS prompts and point-of-care education. Formative and summative usability testing were completed with pediatric residents in a simulated electronic health record (EHR). We estimated task completion rates and perceived usefulness of the CDS in summative testing, comparing a test EHR with and without the CDS. RESULTS: Formative usability testing with the residents provided qualitative data that led to improvements in the build for both the 4-month and 6-month WCC note templates. During summative usability testing, the CDS tool significantly improved discussion of early peanut introduction at the 4-month WCC visit compared to scenarios without the CDS tool (9/15, 60% with CDS and 0/15, 0% without CDS). All providers except one at the 4-month WCC scenario gave at least an adequate score for the ease of use of the CDS tool for the history of present illness and assessment and plan sections. During the summative usability testing with the 6-month WCC new build note template, providers more commonly provided comprehensive care once obtaining a patient history concerning for an immunoglobulin E-mediated peanut reaction by placing a referral to allergy/immunology (P=.48), prescribing an epinephrine auto-injector (P=.07), instructing on how to avoid peanut products (P<.001), and providing an emergency treatment plan (P=.003) with CDS guidance. All providers gave at least an adequate score for ease of use of the CDS tool in the after-visit summary. CONCLUSIONS: User-centered CDS improved application of early peanut introduction recommendations and comprehensive care for patients who have symptoms concerning for peanut allergy in a simulation.

Length-weight relationships of 24 stream-dwelling fish species from the Atlantic Forest in Rio de Janeiro, Brazil / Relação peso-comprimento de 24 espécies de peixes de riachos da Mata Atlântica do Rio de Janeiro, Brasil

Abstract The length-weight relationship parameter is important for obtaining fish weight and biomass data with relevant implications about species role on ecosystem functioning. Here we report the length-weight relationship (LWR) for 24 fish species from three streams located in the Atlantic Forest in the Rio de Janeiro State, Brazil. Fish were collected with electrofishing and standard length (cm) and wet weight (g) were measured to obtain the a and b parameters of the Log (W) = Log (a) + b Log (SL) equation. Length-weight relationships for seven out of 24 species (Hypostomus punctatus, Deuterodon taeniatus, Deuterodon hastatus, Deutorodon janeiroensis, Characidium vidali, Characidium interruptum and Rineloricaria zawadiskii) are reported for the first time. The length-weight relationships reported here contribute to the database that can support fish diversity conservation, fisheries management plans and studies on fish biology.

Resumo A relação peso-comprimento é um parâmetro importante para se obter o peso do peixe e sua biomassa, fornecendo dados importantes a serem incorporados em estudos sobre o papel das espécies em processos ecossistêmicos. Aqui, reportamos as relações peso-comprimento de 24 espécies de peixes de três rios localizados na Mata Atlântica do estado do Rio de Janeiro, Brasil. Os peixes foram coletados com a pesca elétrica e seu comprimento padrão (cm) e peso (g) foram medidos para obter os parâmetros a e b da equação Log(P) = Log (a) + b Log (CP). As relações peso-comprimento de sete entre as 24 espécies (Hypostomus punctatus, Deuterodon taeniatus, Deuterodon hastatus, Deutorodon janeiroensis, Characidium vidali, Characidium interruptum e Rineloricaria zawadiskii) são reportados pela primeira vez. As relações peso-comprimento informadas contribuem para a base de dados que auxilia na conservação da diversidade de peixes, na preparação de planos de manejo de pesca e estudos da biologia de peixes.

Body size has primacy over stoichiometric variables in nutrient excretion by a tropical stream fish community.

Ecological Stoichiometry (ES) and the Metabolic Theory of Ecology (MTE) are the main theories used to explain consumers' nutrient recycling. ES posits that imbalances between an animal's body and its diet stoichiometry determine its nutrient excretion rates, whereas the MTE predicts that excretion reflects metabolic activity arising from body size and temperature. We measured nitrogen, phosphorus and N:P excretion, body N:P stoichiometry, body size, and temperature for 12 fish species from a Brazilian stream. We fitted competing models reflecting different combinations of ES (body N:P, armor classification, diet group) and MTE (body size, temperature) variables. Only body size predicted P excretion rates, while N excretion was predicted by body size and time of day. N:P excretion was not explained by any variable. There was no interspecific difference in size-scaling coefficients neither for N nor for P. Fitted size scaling coefficients were lower than the MTE prediction of 0.75 for N (0.58), and for P (0.56). We conclude that differences in nutrient excretion among species within a shared environment primarily reflect contrasts in metabolic rates arising from body size, rather than disparities between consumer and resource stoichiometry. Our findings support the MTE as the primary framework for predicting nutrient excretion rates.

Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective / Ni ángeles ni héroes: discursos de la enfermería durante la pandemia por coronavirus en la perspectiva foucaultiana / Nem anjos, nem heróis: discursos da enfermagem durante a pandemia por coronavírus na perspectiva foucaultiana

ABSTRACT Objective: to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of "angels and heroes" given by society during the pandemic of COVID-19. Methods: a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault. Results: they were organized into two thematic categories: "Angels and heroes? The (not) heroic reality of nursing during the pandemic" and "The search for recognition of the professional work of nursing: between what is said and what is not said". Final considerations: the nurses' speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.

RESUMEN Objetivo: analizar los procesos de producción de sentidos, con base en los discursos de los profesionales de enfermería, acerca de cómo se sienten en relación a los títulos de "ángeles y héroes" dados por la sociedad durante la pandemia de COVID-19. Métodos: investigación cualitativa, del tipo documental. Los datos fueron recolectados en octubre y noviembre de 2020 y analizados en la perspectiva del Análisis del Discurso propuesta por Michel Foucault. Resultados: fueron organizados en dos categorías temáticas: "Ángeles y héroes? La realidad (nada) heroica de la enfermería durante la pandemia" y "La búsqueda por el reconocimiento del trabajo profesional de la enfermería: entre lo dicho y lo no dicho". Consideraciones finales: los discursos de la enfermería enuncian la búsqueda por condiciones dignas para ejecución del cuidado, salarios justos y reconocimiento del trabajo profesional por la sociedad.

RESUMO Objetivo: analisar os processos de produção de sentidos, com base nos discursos dos profissionais de enfermagem, acerca de como se sentem em relação aos títulos de "anjos e heróis" dados pela sociedade durante a pandemia da COVID-19. Métodos: pesquisa qualitativa, do tipo documental. Os dados foram coletados em outubro e novembro de 2020 e analisados na perspectiva da Análise do Discurso proposta por Michel Foucault. Resultados: foram organizados em duas categorias temáticas: "Anjos e heróis? A realidade (nada) heroica da enfermagem durante a pandemia" e "A busca pelo reconhecimento do trabalho profissional da enfermagem: entre o dito e o não dito". Considerações finais: os discursos da enfermagem enunciam a busca por condições dignas para execução do cuidado, salários justos e reconhecimento do trabalho profissional pela sociedade.

Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective.

OBJECTIVE: to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of "angels and heroes" given by society during the pandemic of COVID-19. METHODS: a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault. RESULTS: they were organized into two thematic categories: "Angels and heroes? The (not) heroic reality of nursing during the pandemic" and "The search for recognition of the professional work of nursing: between what is said and what is not said". FINAL CONSIDERATIONS: the nurses' speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.

Cerebral white matter connectivity, cognition, and age-related macular degeneration.

Age-related macular degeneration (AMD) is a common retina disease associated with cognitive impairment in older adults. The mechanism(s) that account for the link between AMD and cognitive decline remain unclear. Here we aim to shed light on this issue by investigating whether relationships between cognition and white matter in the brain differ by AMD status. In a direct group comparison of brain connectometry maps from diffusion weighted images, AMD patients showed significantly weaker quantitative anisotropy (QA) than healthy controls, predominantly in the splenium and left optic radiation. The QA of these tracts, however, did not correlate with the visual acuity measure, indicating that this group effect is not directly driven by visual loss. The AMD and control groups did not differ significantly in cognitive performance.Across all participants, better cognitive performance (e.g. verbal fluency) is associated with stronger connectivity strength in white matter tracts including the splenium and the left inferior fronto-occipital fasciculus/inferior longitudinal fasciculus. However, there were significant interactions between group and cognitive performance (verbal fluency, memory), suggesting that the relation between QA and cognitive performance was weaker in AMD patients than in controls.This may be explained by unmeasured determinants of performance that are more common or impactful in AMD or by a recruitment bias whereby the AMD group had higher cognitive reserve. In general, our findings suggest that neural degeneration in the brain might occur in parallel to AMD in the eyes, although the participants studied here do not (yet) exhibit overt cognitive declines per standard assessments.

Occurrence of organic micropollutants in an urbanized sub-basin and ecological risk assessment.

The João Mendes River - an important contributor to the Piratininga/Itaipu lagoon system in Rio de Janeiro State, Brazil - receives untreated sewage from the population occupying the drainage basin with no proper sanitation infrastructure. The present study assessed the ecological risk resulting from the presence of five organic micropollutants (17α-ethynylestradiol, ibuprofen, trimethoprim, sulfamethoxazole, bisphenol A) based on four monitoring campaigns which included three sampling points and one reference area. Chronic ecotoxicity assays were conducted with the bioindicators R. subcapitata, C. dubia and O. niloticus. Estrogenicity was assessed with genetically modified S. cerevisiae based on YES protocol. The Ecological Risk Assessment was conducted based on the Chemical and the Ecotoxicological Lines of Evidence (LoE). In order to analyse the results from different sampling points, principal component analysis (PCA) was performed using a correlation matrix. Micropollutants below limit of detection or in very low concentrations were detected in the reference area; no significant differences were observed when samples from the reference area were compared to the negative controls for the ecotoxicity assays. A PCA including selected variables revealed the latent relationships among the three sampling points (not verified for the reference area), which confirmed the analytical results. An extreme ecological risk index was estimated for all sampling points in all campaigns. The extreme ecological risk index was mostly associated to the high concentrations of 17α-ethynylestradiol and the antibiotic sulfamethoxazole.

Relationship between neural functional connectivity and memory performance in age-related macular degeneration.

Age-related macular degeneration (AMD) has been linked to memory deficits, with no established neural mechanisms. We collected resting-state brain functional magnetic resonance imaging and standardized verbal recall tests from 42 older adults with AMD and 41 age-matched controls. We used seed-based whole brain analysis to quantify the strength of functional connectivity between hubs of the default mode network and a network of medial temporal regions relevant for memory. Our results indicated neither memory performance nor network connectivity differed by AMD status. However, the AMD participants exhibited stronger relationships than the controls between memory performance and connectivity from the memory network hub (left parahippocampal) to 2 other regions: the left temporal pole and the right superior/middle frontal gyri. Also, the connectivity between the medial prefrontal cortex and posterior cingulate cortex of default mode network correlated more strongly with memory performance in AMD compared to control. We concluded that stronger brain-behavior correlation in AMD may suggest a role for region-specific connectivity in supporting memory in the context of AMD.

Clinical Outcomes After Implantation of 320°-Arc Length Intrastromal Corneal Ring Segments in Keratoconus.

PURPOSE: To evaluate the clinical outcomes after implantation of a new 320°-arc length Ferrara intrastromal corneal ring segment (320-ICRS) in eyes of patients with keratoconus. METHODS: A multicentric nonrandomized study was conducted in which a new 320-ICRS was placed in 138 eyes of 130 patients with keratoconus. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal volume, asphericity, lines of vision gain/loss, and vectorial analysis were assessed preoperatively and at the final follow-up visit after the procedure. RESULTS: The mean follow-up time was 6.2 ± 3.3 (SD) months (range 3-12 months). Mean UDVA improved from 20/250 to 20/60. Mean CDVA improved from 20/100 to 20/40. Mean Q improved from -1.12 ± 0.49 preoperatively to -0.28 ± 0.51 postoperatively (P < 0.001). Mean corneal volume increased from 56.2 ± 4.28 mm preoperatively to 57.6 ± 4.74 postoperatively (P < 0.001). Mean Km reduced from 53.3 ± 5.5 D preoperatively to 47.8 ± 4.6 D postoperatively (P < 0.001). The change in UDVA, CDVA, and topographic astigmatism was statistically significant (P < 0.0001). CONCLUSIONS: The 320-ICRS can efficiently and safely improve visual acuity in keratoconus, modifying the corneal shape to a more physiologic, aspheric shape.

Exercise and Cyclic Light Preconditioning Protect Against Light-Induced Retinal Degeneration and Evoke Similar Gene Expression Patterns.

To compare patterns of gene expression following preconditioning cyclic light rearing versus preconditioning aerobic exercise. BALB/C mice were preconditioned either by rearing in 800 lx 12:12 h cyclic light for 8 days or by running on treadmills for 9 days, exposed to toxic levels of light to cause light-induced retinal degeneration (LIRD), then sacrificed and retinal tissue harvested. Subsets of mice were maintained for an additional 2 weeks and for assessment of retinal function by electroretinogram (ERG). Both preconditioning protocols partially but significantly preserved retinal function and morphology and induced similar leukemia inhibitory factor (LIF) gene expression pattern. The data demonstrate that exercise preconditioning and cyclic light preconditioning protect photoreceptors against LIRD and evoke a similar pattern of retinal LIF gene expression. It may be that similar stress response pathways mediate the protection provided by the two preconditioning modalities.

Canine heartworm disease in Porto Velho: first record, distribution map and occurrence of positive mosquitoes / Dirofilariose canina em Porto Velho: primeiro registro, mapa de distribuicao e ocorrencia de mosquitos positivos

The aim of this study was to make the first report on canine heartworm disease in the state of Rondônia and confirm its transmission in this state. Blood samples were randomly collected from 727 dogs in the city of Porto Velho. The samples were analyzed to search for microfilariae and circulating antigens, using three different techniques: optical microscopy on thick blood smears stained with Giemsa; immunochromatography; and PCR. Mosquitoes were collected inside and outside the homes of all the cases of positive dogs and were tested using PCR to search for DNA of Dirofilaria immitis. Ninety-three blood samples out of 727 (12.8%) were positive according to the immunoassay technique and none according to the thick smear method. Among the 93 positive dogs, 89 (95.7%) were born in Porto Velho. No difference in the frequency of infection was observed between dogs raised indoors and in the yard. PCR on the mosquitoes resulted in only one positive pool. This result shows that the transmission of canine heartworm disease is occurring in the city of Porto Velho and that there is moderate prevalence among the dogs. The techniques of immunochromatography and PCR were more effective for detecting canine heartworm than thick blood smears. The confirmation of canine heartworm disease transmission in Porto Velho places this disease in the ranking for differential diagnosis of pulmonary nodules in humans in Rondônia.

O objetivo deste estudo foi de registrar pela primeira vez a dirofilariose canina no estado de Rondônia e confirmar sua transmissão neste estado. Amostras de sangue de 727 cães foram colhidas aleatoriamente na cidade de Porto Velho. As amostras foram analisadas em busca de microfilárias e antígenos circulantes usando três técnicas diferentes: microscopia ótica de gota espessa corada com Giemsa e imunocromatografia de fluxo lateral e PCR. Mosquitos foram colhidos no domicilio e peridomicílio de todos os casos de cães positivos, estes mosquitos foram testados pela PCR na detecção de DNA de Dirofilaria immitis. Noventa e três das 727 amostras de sangue foram positivas na técnica de imunoensaio (12,8%). Nenhuma amostra foi positiva na gota espessa. Entre os 93 cães positivos, 89 (95,7%) foram nascidos em Porto Velho. Nenhuma diferença na frequencia de infecção foi observada entre cães criados dentro da casa ou no quintal. O PCR dos mosquitos resultou em apenas um pool positivo. Este resultado mostra que a transmissão de dirofilariose canina está ocorrendo na cidade de Porto Velho e a frequência que ocorre nos cães é considerada moderada. As técnicas de imunocromatografia e PCR são mais eficazes na detecção de dirofilariose comparadas a gota espessa. A confirmação de transmissão de dirofilariose canina em Porto Velho, coloca esta doença no ranking de diagnóstico diferencial de nódulos pulmonares em seres humanos em Rondônia.

High-fat diet-induced alterations in the feeding suppression of low-dose nisoxetine, a selective norepinephrine reuptake inhibitor.

Central noradrenergic pathways are involved in feeding and cardiovascular control, physiological processes altered by obesity. The present studies determined how high-fat feeding and body weight gain alter the sensitivity to the feeding suppression and neural activation to a selective norepinephrine reuptake inhibitor, nisoxetine. Acute administration of nisoxetine (saline: 0, 3, 10, and 30 mg/kg; i.p.) resulted in a dose-dependent reduction in the 24 h refeeding response in male Sprague Dawley rats maintained on standard chow. In a similar fashion, nisoxetine resulted in reductions in blood pressure and a compensatory increase in heart rate. From these studies, the 3 mg/kg dose was subthreshold. In a separate experiment, however, 10 wk exposure to a high-fat diet (60% fat) resulted in weight gain and significant feeding suppression following administration of nisoxetine (3 mg/kg) compared with animals fed a control diet (10% fat). Nisoxetine (3 mg/kg) also resulted in greater neural activation, as measured by c-Fos immunohistochemistry, in the arcuate nucleus of the hypothalamus in animals exposed to the high-fat diet. Such data indicate acute nisoxetine doses that suppress food intake can impact cardiovascular measures. It also suggests that the feeding suppression to a low-dose nisoxetine is enhanced as a result of high-fat diet and weight gain.

Acute toxicity bioassay with the amphipod, Grandidierella bonnieroides S. after exposure to sediments from an urban estuary (Macaé River Estuary, RJ, Brazil).

Acute toxicity to Grandidierella bonnieroides and physicochemical analysis were used for quality assessment of the sediment of the Macaé River urban estuary, located in the Brazilian coast where rapid socioeconomic growth has been induced by offshore oil and gas exploration at the Campos Basin. Sediment samples were collected during four events in four sampling sites of the estuary and also in a control site. Organism mortality after exposure to the estuarine sediments was, on average, 30 % a value higher than in the control site where it was 10 %. This result together with the physicochemical analysis suggests an initial toxicity condition of the sediments from this aquatic coastal environment.

Canine heartworm disease in Porto Velho: first record, distribution map and occurrence of positive mosquitoes.

The aim of this study was to make the first report on canine heartworm disease in the state of Rondônia and confirm its transmission in this state. Blood samples were randomly collected from 727 dogs in the city of Porto Velho. The samples were analyzed to search for microfilariae and circulating antigens, using three different techniques: optical microscopy on thick blood smears stained with Giemsa; immunochromatography; and PCR. Mosquitoes were collected inside and outside the homes of all the cases of positive dogs and were tested using PCR to search for DNA of Dirofilaria immitis. Ninety-three blood samples out of 727 (12.8%) were positive according to the immunoassay technique and none according to the thick smear method. Among the 93 positive dogs, 89 (95.7%) were born in Porto Velho. No difference in the frequency of infection was observed between dogs raised indoors and in the yard. PCR on the mosquitoes resulted in only one positive pool. This result shows that the transmission of canine heartworm disease is occurring in the city of Porto Velho and that there is moderate prevalence among the dogs. The techniques of immunochromatography and PCR were more effective for detecting canine heartworm than thick blood smears. The confirmation of canine heartworm disease transmission in Porto Velho places this disease in the ranking for differential diagnosis of pulmonary nodules in humans in Rondônia.

Leitura mediada com enfoque sociocognitivo: avaliação de uma pesquisa-intervenção / Mediated reading with a social cognitive approach: assessment of a research intervention / La lectura mediada con enfoque socio cognitivo: evaluación de una investigación-intervención

Este estudo teve como objetivo avaliar a efetividade de um programa dirigido a diversificar a prática docente de contar histórias e a promoção indireta da compreensão infantil dos estados mentais e do processamento de informação social. Participaram 5 docentes e 57 alunos com média de 6 anos de idade de uma escola pública. As docentes foram capacitadas e pré e pós-avaliadas por questionários que investigaram concepções sociocognitivas e o impacto da capacitação sobre a prática de leitura mediada. Aspectos sociocognitivos e a atribuição dos termos mentais infantis foram avaliados mediante a análise da leitura de dois livros. Foi utilizado um diário de campo para documentar as observações semanais. Evidenciou-se aperfeiçoamento docente na seleção de livros e na exploração dos termos mentais nas narrativas e, quanto aos alunos, diferenças significativas quanto à linguagem mentalista e aprimoramento do processamento de informação social. Conclui-se pela viabilidade de se implementar a leitura mediada com enfoque sociocognitivo na escola.

This study's objective was to evaluate the effectiveness of a program designed to diversify teachers' storytelling practices and indirectly promote children's understanding of mental states and social information processing. Five teachers and 57 students, aged six years old on average, attending a public school, participated in the study. Teachers were trained and pre- and post-tested through questionnaires addressing social-cognitive conceptions and the impact of qualification on their mediated reading practices. The social-cognitive aspects and the attribution of children's mental terms were evaluated during the reading of two books. A field diary was used to document weekly observations. The results revealed teaching improvement in selecting books and in exploring mental terms during narratives. In regard to the students, significant differences were found in the use of mental language and social information processing. The conclusion is that conducting mediated reading with a social-cognitive focus is feasible in schools.

El objetivo fue evaluar la efectividad del programa destinado a la diversificación de prácticas de enseñanza de narración y promoción indirecta de comprensión infantil de estados mentales y procesamiento de información social. Participaron cinco profesores y 57 estudiantes con edad promedia de 6 años en una escuela pública. Profesores fueron evaluados antes y después de la capacitación por cuestionarios que investigaron el impacto de la formación socio-cognitivo en la práctica de lectura mediada. Aspectos sociocognitivos y asignación de términos mentales de los niños fueron evaluados mediante análisis de la lectura de dos libros. Se utilizó un diario de campo para documentar observaciones semanales. Hubo evidencias de mejora de la enseñanza: selección de libros, explotación de relatos y condiciones mentales, para los alumnos, diferencias significativas en lenguaje mental y mejora del procesamiento de información social. Los resultados confirmaron la viabilidad de la aplicación del enfoque socio-cognitivo de lectura mediada en la escuela.

Colecistite alitiásica aguda: revisão de literatura / Acute acalculous cholecystitis: literature review

A colecistite alitiásica aguda (CAA) trata-se de uma inflamação da vesícula biliar sem a evidência de cálculos biliares. É estimado que ocorra em 2-15% de todos os casos de colecistite aguda e geralmente se associa a condições de saúde críticas, como pós-operatório, trauma recente grave e queimaduras. A etiologia da CAA é multifatorial e sua patofisiologia ainda permanece pouco compreendida. Os principais mecanismos de doença propostos incluem lesão por isquemia-reperfusão, resposta inflamatória sistêmica e estase biliar. O diagnóstico, que costuma ser difícil, é baseado em dados clínicos, laboratoriais, radiológicos e peroperatórios. As manifestações costumam ser inespecíficas, tais como dor em quadrante superior direito, febre, náusea, vômitos, icterícia, leucocitose e função hepática alterada. Os achados de imagem na ultrassonografia (US) e tomografia computadorizada (TC) incluem aumento da espessura da parede e do volume da vesícula biliar, barro biliar, fluido pericolecístico e presença de gás intramural. A combinação de pelo menos três desses achados é necessária para o diagnóstico de CAA. A sensibilidade e especificidade dos métodos de imagem são variáveis, entretanto, considera-se que a TC é superior à US. O tratamento de escolha é colecistectomia, com crescente preferência para utilização da via percutânea. O tratamento clínico associado inclui melhora dos parâmetros hemodinâmicos com drogas vasoativas e medicamentos antimicrobianos. A taxa de mortalidade costuma ser alta (10-67%), independentemente do tratamento instituído. Tal fato é atribuído às condições mórbidas pré-existentes que costumam acompanhar o quadro e contribuem para a rápida progressão da doença para gangrena e perfuração. (AU)

Acalculous cholecystitis (AC) is an acute infiamatory disease of the gallbladder without the evidence of biliary stones. It accounts for 2-15% of all cases of acute cholecystitis and is generally associated with critically ill patients, post-operatory, recente trauma and burns. AC etiology is multifactorial and still obscure. The main mechanisms include ischemia/ reperfusion lesions, systemic infiamatory reaction and biliary stasis. The diagnosis may be difficult, being based on clinical, labaratorial, radiographic and peroperatory features. Clinical manifestations, although inespefics, are right hypochondrial pain, fever, nausea, vomit, jaundice, leukocytosis and high liver enzymes. Ultrasound and tomography aspects are thickening of the gallbladder wall with pericholecystic fluid, biliary sludge and emphysematous cholecystitis. The combination of three or more of those aspects is necessary to confirm the diagnosis of AC. The sensibility and specificity of the radiological exams are insconstant, but the tomography is considered superior to ultrasound. The definitive therapy is cholecystectomy. Associated clinical approach include the use of vasoactive drugs and antibiotics. Mortality is high (10-67%), mainly because of the comobidity diseases. (AU)

Histopathological effects of [D-Leu(1)]Microcystin-LR variants on liver, skeletal muscle and intestinal tract of Hypophthalmichthys molitrix (Valenciennes, 1844).

This study evaluated the effects of [D-Leu(1)]Microcystin-LR variants, by the exposure of Hypophthalmichthys molitrix to Microcystis aeruginosa NPLJ4. Fish was placed in aquariums and exposed to 10(5) cells mL(-1). For 15 days, 05 individuals were removed every 05 days, and tissue samples of liver, skeletal muscle and intestinal tract were collected for histopathologic analyses. Following exposure, those surviving were placed in clean water for 15 days to evaluate their recovery. A control without toxins was maintained in the same conditions and exhibited normal histology and no tissue damage. In exposed fish, samples were characterized by serious damages that similarly affected the different organs, such as dissociation of cells, necrosis and haemorrhage. Samples showed signs of recovery but severe damages were still observed. The results should be valuable to analyze the potency of microcystin toxicity and to help in the diagnosis of fish deaths.

Evocação de termos mentais por pré-escolares: um estudo com narrativa por imagem / Evocation of mental terms for pre-school: a study with narrative by imagen / Evocación de términos mentales por preescolares: un estúdio con narrativa por imagen

O estudo investigou a evocação de termos mentais em pré-escolares. As crianças foram recrutadas em uma escola particular de uma cidade mineira, as quais realizaram a leitura de um livro contendo narrativa por imagem. Mediante critério de conveniência, selecionaram-se 17 crianças de 5 anos e 17 de 6. Realizou-se a leitura individual do livro; os relatos foram gravados, transcritos e codificados com base na seguinte taxonomia: termos cognitivos, emocionais, de desejo/intenção e perceptivos. Os resultados evidenciaram que as crianças de 5 anos evocaram mais termos mentais (362) do que as de 6 (289). As mais velhas evocaram termos mais sofisticados, sugerindo que estas tendem a expressar uma linguagem mental mais elaborada em relação às crianças de 5 anos. A ênfase nos termos perceptivos evidencia que os dois grupos focalizaram as ações físicas dos personagens, colocando em discussão a estrutura do livro Truks (FURNARI, 1998) e realçando a necessidade de novas pesquisas com outros livros que contenham estruturas diferenciadas.

This study investigated pre-school children's evocation of mental terms. The children were enrolled on a private school of one of Minas Gerais city. Children had to read a narrative by image storybook. Seventeen 5-year-old children and seventeen 6-year-olds were selected by a convenience criterion. Children read the books individually. The reports were recorded, transcribed and encoded using the following taxonomy: cognitive, emotional terms, wish / intention and perceptive. The results showed that the 5-year-old children evoked more mental terms (362) than the 6 year-olds ones (289). The eldest children evoked more sophisticated terms, suggesting that they have a tendency to express mental language more often than the 5-year-olds children. The emphasis in the perceptive terms shows that the two groups focused the physical actions of the characters, questioning the structure of the used books and highlighting the need for new inquiries to be answered using other books that contain differentiated structures.

El estudio investigó la evocación de términos mentales en preescolares de uma escuela pública de una ciudad de Minas Gerais, a partir de la lectura de un libro contiendo narrativa por imagen. Mediante criterio de conveniencia habían sido seleccionados 17 niños de 5 años y 17 de 6 años. Fue realizada la lectura individual del libro; los relatos habían sido grabados, transcritos y codificados a partir de la siguiente taxonómia: términos cognitivos, emocionales, deseo/intención y perceptivos. Los resultados evidenciaron que los pequeños de 5 años evocaron más términos mentales (362) que a los de 6 años (289). Las mayores evocaron términos más sofisticados, sugiriendo que estas tienden expresar uno lenguaje mental más elaborada en relación con los más jovenes de 5 años. El énfasis en los términos perceptivos evidencia que los dos grupos focalizaron las acciones físicas de los personajes, poniendo en discusión la estructura del libro pesquisado y realzando la necesidad de nuevas investigaciones con otros libros que contengan estructuras diferenciadas.