Insights into the Effect of Charges on Hydrogen Bonds.

Previous computational and experimental studies showed that charges located at the surroundings of hydrogen bonds can exert two opposite effects on them: rupture or strengthening of the hydrogen bond. This work aims to generalize the effect of charges in different hydrogen-bonded systems and to propose a coherent explanation of this effect. For these purposes, 19 systems with intra- and intermolecular hydrogen bonds were studied computationally with DFT. The FT-IR spectra of the systems were simulated, and two energy components of the hydrogen bond were studied separately to determine their variation upon the presence of a charge: charge transfer and molecular overlap. It was determined that either the breaking or strengthening of the hydrogen bond can be favored one over the other, for instance, depending on the heteroatom involved in the hydrogen bond. In addition, it is showed that the strengthening of the hydrogen bond by the presence of a charge is directly related to the decrease in charge transfer between the monomers, which is explained by an increase in molecular overlapping, suggesting a more covalent character of the interaction. The understanding of how hydrogen bonds are affected by charges is important, as it is a key towards a strategy to manipulate hydrogen bonds at convenience.

Osteostatin Mitigates Gouty Arthritis through the Inhibition of Caspase-1 Activation and Upregulation of Nrf2 Expression.

Gouty arthritis results from monosodium urate (MSU) crystal deposition in joints, initiating (pro)-interleukin (IL)-1ß maturation, inflammatory mediator release, and neutrophil infiltration, leading to joint swelling and pain. Parathyroid hormone-related protein (107-111) C-terminal peptide (osteostatin) has shown anti-inflammatory properties in osteoblasts and collagen-induced arthritis in mice, but its impact in gouty arthritis models remains unexplored. We investigated the effect of osteostatin on pyroptosis, inflammation, and oxidation in macrophages, as well as its role in the formation of calcium pyrophosphate dihydrate crystals and MSU-induced gouty arthritis in mice models. Osteostatin ameliorated pyroptosis induced by lipopolysaccharide and adenosine 5'-triphosphate (LPS + ATP) in mice peritoneal macrophages by reducing the expression of caspase-1, lactate dehydrogenase release, and IL-1ß and IL-18 secretion. Additionally, IL-6 and tumor necrosis factor-α (TNF-α) were also decreased due to the reduced activation of the NF-κB pathway. Furthermore, osteostatin displayed antioxidant properties in LPS + ATP-stimulated macrophages, resulting in reduced production of mitochondrial and extracellular reactive oxygen species and enhanced Nrf2 translocation to the nuclei. In both models of gouty arthritis, osteostatin administration resulted in reduced pro-inflammatory cytokine production, decreased leukocyte migration, and reduced caspase-1 and NF-κB activation. These results highlight the potential of osteostatin as a therapeutic option for gouty arthritis.

Adenosine A2B receptor agonist improves epidermal barrier integrity in a murine model of epidermal hyperplasia.

Adenosine regulates multiple physiological processes through the activation of four receptor subtypes, of which the A2B adenosine receptor (A2BAR) has the lowest affinity for adenosine. Being the adenosine receptor subtype most prominently expressed in epidermis, we recently described the antiproliferative and anti-inflammatory effect of the selective A2BAR agonist BAY60-6583 (BAY) in human keratinocytes stimulated with 12-O-tetradecanoylphorbol-13-acetate (TPA), so we sought to establish the effect of topical application of BAY in a model of murine epidermal hyperplasia. Topical application of BAY (1 or 10 µg/site) prevented the inflammatory reaction and skin lesions induced by TPA, minimizing hyperproliferation and acanthosis, as well as the expression of specific markers of proliferative keratinocytes. On the other hand, pre-treatment with the selective A2BAR antagonist, PSB-1115 (PSB, 5 or 50 µg/site) reversed these beneficial effects. Additionally, BAY application normalized the expression of epidermal barrier proteins, whose integrity is altered in inflammatory skin diseases, while treatment with the antagonist alone worsened it. Our results, besides confirming the anti-inflammatory and antiproliferative effects of the A2BAR agonist, further demonstrate a role of A2BAR activation to preserve the epidermal barrier. Therefore, the activation of A2BAR may constitute a possible new pharmacological target for the treatment of skin inflammatory diseases such as psoriasis.

Attenuation of water contamination in the Paraopeba River after the collapse of B1 tailings dam: Natural wash-off and dredging contributions.

Following the B1 dam collapse at Córrego do Feijão Mine, actions were taken to address environmental damage and enhance the quality of water in the Paraopeba River. Natural processes in the river involve gradual reduction of contamination through dispersion and downstream transportation of tailings-a slow, nature-driven process. Dredging, a human intervention, aimed to expedite recovery. Hence, this study aimed to explore dredging's role in reducing contamination in the impacted Paraopeba River zone. Analysis revealed a direct link between dredging and post-collapse turbidity, though recent trends suggest a lessening impact on pre-collapse conditions. Distinct seasonal variations were observed in iron and manganese concentrations, peaking during wet seasons and displaying notable upstream-downstream disparities. An analysis of ratios (downstream/upstream) was conducted to understand and even predict the return to pre-collapse conditions. Wet season averages for iron and manganese decreased by around 90 % over time, with standard deviations reducing by about 48 % and 58 %, respectively. In the dry season, the averages decreased by over 100 %, indicating water quality improvements surpassing pre-collapse levels. Standard deviations also decreased significantly, by approximately 67 % and 79 %, respectively. Employing an exponential decay model revealed that the contribution of dredging in the dry period is negligible, but in the wet period the contribution can be estimated at 28.6 % in the case of iron and 25 % in the case of manganese. While the models performed well based on extensive data, some limitations occur in estimating dredging contribution rates. The model's sensitivity might overlook influential factors, underscoring the importance of considering sediment nature and dredged area extent in understanding water quality dynamics. Despite these potential limitations, this investigation provides crucial insights into the intricate relationship between dredging and water quality in the Paraopeba River. These findings pave the way for future studies aimed at deeper exploration and more accurate assessments of this association.

A fantasia e "a condição humana": a psicanálise em contato com a obra de René Magritte / Fantasy and "the human condition": psychoanalysis in contact with the work of René Magritte / Le fantame et "la condition humaine": la psychanalyse au contact de l'oeuvre de René Magritte / La fantasia y "la condición humana': el psicoanálisis en contacto con la obra de René Magritte

O artigo se propõe a incitar reflexões sobre a função da fantasia na psicanálise a partir do contato de Lacan com a obra do artista René Magritte, e especificamente, com o quadro La condition humaine (1933). Analisam-se algumas vertentes do funcionamento fantasístico como realidade do sujeito e, acima de tudo, como "condição humana" ligada a uma evitação do contato com "a janela para o real", em relação à falta de objeto último para a satisfação pulsional, à inconsistência do Outro e ao desamparo fundamental. Para tanto, examinam-se os dilemas da relação subjetiva com o objeto a e com das Ding, investigando o funcionamento ambíguo da fantasia e o seu possível entendimento como obra de arte para uso interno do sujeito. Propõe-se, finalmente, uma ressonância entre a compreensão da arte na obra de Magritte e a direção do tratamento conforme proposta por Lacan.

Resumos The article aims to incite reflections on the function of fantasy in psychoanalysis based on Lacan's contact with the work of the artist René Magritte, and specifically with the painting "La condition humaine" (1933). It analyzes some aspects of the functioning of fantasy as the subject's reality and, above all, as the "human condition" related to an avoidance of contact with "the window to the real," in relation to the lack of ultimate object for drive satisfaction, to the inconsistency of the Other and to fundamental helplessness. To this end, the dilemmas of the subjective relation with the object a and with das Ding are examined, investigating the ambiguous functioning of fantasy and its possible understanding as a work of art for the subject's internal use. Finally, a resonance is proposed between the understanding of art in Magritte's work and the direction of treatment as proposed by Lacan.

L'article réfléchit sur la fonction du fantasme dans la psychanalyse à partir du contact de Lacan avec l'œuvre de l'artiste René Magritte, et plus particulièrement avec le tableau « La condition humaine ¼ (1933). Il analyse certains aspects du fonctionnement fantasmatique comme réalité du sujet et, surtout, comme « condition humaine ¼ liée à l'évitement du contact avec « la fenêtre du réel ¼, en relation avec le manque d'objet ultime pour la satisfaction des pulsions, avec l'inconsistance de l'Autre et avec l'impuissance fondamentale. À cette fin, on examine les dilemmes de la relation subjective avec l'objet a et das Ding, en étudiant le fonctionnement ambigu du fantasme et sa compréhension possible en tant qu'œuvre d'art destinée à l'usage interne du sujet. Enfin, on propose une résonance entre la compréhension de l'art dans l'œuvre de Magritte et l'orientation de la cure telle que proposée par Lacan.

Este artículo pretende incitar a la reflexion sobre la función de la fantasía en el psicoanálisis desde el contacto de Lacan con la obra del artista René Magritte, más específicamente el cuadro "La condition humaine" (1933). Analiza algunos aspectos del funcionamiento de la fantasía como realidad del sujeto, sobre todo, como "condición humana" ligada a una evitación del contacto con "la ventana a lo real", con relación a la falta de objeto último para la satisfacción pulsional, con la inconsistencia del Otro y con el desamparo fundamental. Para ello, se examinan los dilemas de la relación subjetiva con el objeto a y das Ding, investigando el funcionamiento ambiguo de la fantasía y su posible comprensión como obra de arte para uso interno del sujeto. Por último, se propone una resonancia entre la comprensión del arte en la obra de Magritte y la dirección del tratamiento que propone Lacan.

Integração ensino-serviço no contexto das escolas médicas brasileiras: revisão integrativa / Education-service integration in the context of Brazilian medical schools: an integrative review

Este trabalho teve por objetivo caracterizar a trajetória histórica, incluindo os avanços e os desafios, da integração ensino-serviço no processo de formação médica. Diante deste contexto, por meio de estudos científicos indexados em bases de dados, foi realizada uma revisão crítica da literatura a partir da busca por trabalhos considerados referência até o momento atual. A maioria dos artigos consultados trata de material referencial sobre o tema publicado em periódicos científicos indexados nas bases de dados da Biblioteca Virtual da Saúde. A busca evidenciou que foi a partir da década de 1970 que o país passou por experiências transformadoras nos campos da saúde e educação e, desde então, a integração ensino-serviço aproximou as universidades e as instituições de saúde por meio da reorganização do ensino e da assistência à saúde. Apesar dos avanços significativos, principalmente na última década, ainda há desafios a serem superados na integração destes diferentes mundos, um deles é a criação e a implementação de instrumentos de gestão como o Contrato Organizativo da Ação Pública Ensino Saúde (COAPES), capazes de suportar a complexidade deste processo. (AU)

This paper aimed to characterize the historical trajectory, including the advances and challenges, of the teaching-service integration in the medical training process. In this context, through scientific studies indexed in databases, a critical review of the literature was performed from the search for works of reference until the present moment. Most of the works consulted were reference material on the topic published in scientific journals and indexed in the databases of the Virtual Health Library. The search evidenced that the country underwent transformative experiences in the fields of health and education in the 1970's and, since then, the teaching-service integration has drawn universities and health institutions closer through the reorganization of education and healthcare. Despite the progress achieved mainly in the last decade, there are challenges to overcome in the integration of these different worlds, of one which is the creation and implementation of management tools such as the Organizing Contract for Public Health Education Action (COAPES), capable of withstanding the complexity of this process.(AU)

Guillain-Barré Syndrome in a pediatric patient with COVID-19: A case report and review of literature

@#The novel coronavirus disease 2019 (COVID-19) has created a global health impact to millions of people. There have been studies of COVID-19 patients manifesting with neurologic symptoms. Although the number of adult COVID-19 infections diagnosed with Guillain-Barré Syndrome (GBS) is increasing, the occurrence of cases in pediatric population remains limited or perhaps underreported. We report a rare case of an asymptomatic COVID-19 infection manifesting as acute progressive ascending polyneuropathy and hyporeflexia in a 16-year-old teen. The diagnosis of COVID-19 infection was confirmed by reverse transcription polymerase chain reaction for SARS-CoV-2 of oropharyngeal and nasopharyngeal swab specimens. Magnetic resonance imaging of the spine revealed abnormal enhancement of the cauda equina, including the dorsal and ventral roots. Electromyography and nerve conduction studies were compatible with an acute inflammatory demyelinating polyneuropathy subtype of GBS. Although lumbar puncture was not done, the clinical findings and electrodiagnostic tests were both consistent with GBS. The patient had improvement of both motor and sensory functions after completing the treatment of intravenous immunoglobulins. Neurologic manifestations of systemic illness especially in children during this time of pandemic warrants scrutiny, as these may mask a potentially dangerous and infectious ongoing COVID infection.

Uso de álcool e comportamento de saúde entre profissionais da enfermagem / Uso de alcohol y comportamiento de salud entre profesionales de enfermería / Alcohol use and health behavior among nursing professionals

RESUMO Objetivo: Avaliar o uso problemático de álcool e comportamentos de saúde entre profissionais de enfermagem de um hospital geral. Método: Estudo transversal realizado em um hospital geral. Foi aplicado um questionário com informações sociodemográficas, o teste de triagem do uso álcool e de outras drogas e o questionário de comportamentos de saúde. Resultado: Participaram da pesquisa 416 profissionais. No modelo final da regressão logística, os profissionais do sexo masculino (OR 4,3), solteiros (OR 3,7), que professam outras religiões (OR 3,8), exercem função de técnico de enfermagem (OR 2,3), não consomem baixas doses de bebidas alcoólicas por dia (OR 2,0), fazem uso de tabaco (OR 8,9), evitam o consumo de bebidas com cafeína (OR 1,9) e ambientes barulhentos (OR 2,0) apresentaram chances aumentadas para o consumo de álcool em nível problemático. Conclusão: O uso de álcool e comportamentos de saúde não saudáveis entre profissionais de enfermagem estão fortemente associados. Esses achados têm implicações para a implementação de trabalhos com estratégias de promoção de saúde e prevenção do uso de álcool nas relações de trabalho.

RESUMEN Objetivo: Evaluar el uso problemático de alcohol y comportamientos de salud entre profesionales de enfermería de un hospital general. Método: Estudio transversal llevado a cabo en un hospital general. Se aplicó un cuestionario con informaciones sociodemográficas, la prueba de cribado del uso de alcohol y de otras drogas y el cuestionario de comportamientos de salud. Resultado: Participaron en la investigación 416 profesionales. En el modelo final de la regresión logística, los profesionales del sexo masculino (OR 4,3), solteros (OR 3,7), que profiesan otras religiones (OR 3,8), ejercen función de técnico de enfermería (OR 2,3), no consumen bajas dosis de bebidas alcohólicas por día (OR 2,0), son tabaquistas (OR 8,9), evitan el consumo de bebidas con cafeína (OR 1,9) y ambientes ruidosos (OR 2,0) presentaron probabilidades aumentadas para el consumo de alcohol a nivel problemático. Conclusión: Uso de alcohol y comportamientos de salud no sanos entre profesionales de enfermería están fuertemente asociados. Dichos hallazgos tienen implicaciones para la implantación de trabajos con estrategias de promoción de salud y prevención del uso de alcohol en las relaciones laborales.

ABSTRACT Objective: To evaluate the problematic use of alcohol and health behavior among the nursing staff of a general hospital. Method: Cross-sectional study conducted at a general hospital. A questionnaire with socio-demographic information, the alcohol and substance use screening test, and a questionnaire on health behavior were applied. Results: A total of 416 professionals participated in the study. In the final model of logistical regression, male professionals (OR 4.3), singles (OR 3.7), those that professed to having other religions (OR 3.8), worked as nursing technician (OR 2.3), did not consume low doses of alcoholic beverages per day (OR 2.0), used tobacco (OR 8.9), avoided consuming beverages with caffeine (OR 1.9) and avoided noisy environments (OR 2.0) showed higher chances of consuming alcohol at a problematic level. Conclusion: Among nursing professionals, the use of alcohol and not engaging in health behavior are strongly associated. These findings have implications for the implementation of strategies for the promotion of health and the prevention of alcohol use in work relationships.

ß-lactamase-producing Gram-negative bacteria in an intensive care unit in southern Brazil

ABSTRACT The present study evaluated the antimicrobial susceptibility profile, ß-lactamase production, and genetic diversity of Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. using phenotypic identification, antimicrobial susceptibility testing, and ß-lactamase phenotypic detection. Isolates were obtained from patients in an intensive care unit in a hospital in southern Brazil. Bacterial genomic DNA was extracted, followed by the genotypic detection of carbapenemases and enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). Fifty-six isolates (26 Klebsiella pneumoniae, five Escherichia coli, three Enterobacter aerogenes, nine P. aeruginosa, and 13 Acinetobacter spp.) were evaluated. The phenotypic extended spectrum ß-lactamase (ESBL) test was positive in 53.8% of the K. pneumoniae isolates, 100.0% of the E. coli isolates, and 100.0% of the E. aerogenes isolates. Phenotypic and genotypic testing of K. pneumoniae carbapenemase (KPC) was positive in 50.0% of the K. pneumoniae isolates. Phenotypic and genotypic testing showed that none of the P. aeruginosa or Acinetobacter spp. isolates were positive for metallo- ß-lactamase (MBL). The bla OXA gene was detected only in Acinetobacter spp. The lowest genetic diversity, determined by ERIC-PCR, was observed among the KPC-producing K. pneumoniae isolates and OXA-producing Acinetobacter spp. isolates, indicating the inadequate dissemination control of multidrug-resistant bacteria in this hospital environment.

Planejamento de restauro de qualidade ecologica de duas ribeiras litorais / Restoration plan of the ecological quality of two coastal streams

Este trabalho faz parte de um projeto de restauro de bacias e baseia-se em uma pré-classificação do estado ecológico das mesmas através da metodologia KT, que permite a divisão do sistema fluvial em segmentos fluviais designados Unidades Fisiográficas Homogêneas e a identificação do nível de degradação dos mesmos através da mensuração das pressões humanas locais. A partir dos dados obtidos, podem ser propostas as medidas de recuperação fluvial necessárias para um "bom estado" ecológico de cada unidade. O projeto busca cumprir os objetivos das convenções internacionais de proteção ao meio ambiente e atingir as metas da Diretiva Quadro da Água. Este trabalho desenvolve uma carta sintética expondo o estado de conservação dos segmentos fluviais das bacias da Ribeira do Falcão e da Ribeira da Mata (região das Ribeiras do Oeste, Litoral Centro de Portugal), caracterizando e quantificando o seu nível de degradação, identificando suas respectivas causas e propondo soluções. .

This working paper is part of a watershed restoration project and is based on a pre-classification of ecological status of same by KT methodology, which allows the division of the river system in river segments designated Physiographic Units Homogeneous and identifies the level of their degradation by measuring the local human pressures. From the data obtained may be proposed river restoration measures needed for a "good status" of each ecological unit. The project seeks to achieve the objectives of international conventions to protect the environment and achieve the goals of the Water Framework Directive. This paper develops a synthetic letter exposing the state of conservation of the segments of the river basins of the Hawk and Ribeira da Mata da Ribeira (Ribeira region of West, Central Coast of Portugal), characterizing and quantifying the level of degradation, identifying their respective causes and proposing solutions.

Anti-Mycobacterium tuberculosis activity and cytotoxicity of Calophyllum brasiliense Cambess (Clusiaceae)

We evaluated the in vitro anti-Mycobacterium tuberculosis activity and the cytotoxicity of dichloromethane extract and pure compounds from the leaves of Calophyllum brasiliense. Purification of the dichloromethane extract yielded the pure compounds (-) mammea A/BB (1), (-) mammea B/BB (2) and amentoflavone (3). The compound structures were elucidated on the basis of spectroscopic and spectrometric data. The contents of bioactive compounds in the extracts were quantified using high performance liquid chromatography coupled to an ultraviolet detector. The anti-M. tuberculosis activity of the extracts and the pure compounds was evaluated using a resazurin microtitre assay plate. The cytotoxicity assay was performed in J774G.8 macrophages using the 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyl tetrazolium bromide colourimetric method. The quantification of the dichloromethane extract showed (1) and (2) at concentrations of 31.86 ± 2.6 and 8.24 ± 1.1 µg/mg of extract, respectively. The dichloromethane and aqueous extracts showed anti-M. tuberculosis H37Rv activity of 62.5 and 125 µg/mL, respectively. Coumarins (1) and (2) showed minimal inhibitory concentration ranges of 31.2 and 62.5 µg/mL against M. tuberculosis H37Rv and clinical isolates. Compound (3) showed no activity against M. tuberculosis H37Rv. The selectivity index ranged from 0.59-1.06. We report the activity of the extracts and coumarins from the leaves of C. brasiliense against M. tuberculosis.

Do debate sobre o Édipo à dissolução do sujeito em Foucault e Lacan / From the Oedipus complex debate to the dissolution of the subject and his senses according to Foucault and Lacan

Este estudo discorre a respeito dos entendimentos sobre o sujeito e sua constituição a partir das obras de Michel Foucault e Jacques Lacan. Desnaturalizado, desessencializado, vazio, negativizado - seria esta a visão sobre o sujeito que Foucault e Lacan, cada qual a sua maneira, nos legam. Pretende-se trabalhar esse argumento na esteira de algumas interlocuções clássicas de Foucault com a psicanálise. Ter-se-á como fio condutor o debate em torno do complexo de Édipo e da possibilidade de sua superação no âmbito da psicanálise vista como método desconstrutivo de sentidos, principalmente a partir da "segunda clínica" lacaniana.(AU)

This study concerns the understandings about the subject and his constitution in the works of Michel Foucault and Jacques Lacan. In spite of several approach differences, the legacies of Foucault and Lacan are similar in the fact that the subject is envisioned as empty, negative and without any essence or nature. This argument is developed through some classical foucaultian afirmations about psychoanalysis. The axis of the article is the Oedipus complex question and the possibility of its surpassing in psychoanalysis when seen as a method for the deconstruction of senses, especially from the advent of Lacan's "second clinic".(AU)

Do debate sobre o Édipo à dissolução do sujeito em Foucault e Lacan / From the Oedipus complex debate to the dissolution of the subject and his senses according to Foucault and Lacan

Este estudo discorre a respeito dos entendimentos sobre o sujeito e sua constituição a partir das obras de Michel Foucault e Jacques Lacan. Desnaturalizado, desessencializado, vazio, negativizado - seria esta a visão sobre o sujeito que Foucault e Lacan, cada qual a sua maneira, nos legam. Pretende-se trabalhar esse argumento na esteira de algumas interlocuções clássicas de Foucault com a psicanálise. Ter-se-á como fio condutor o debate em torno do complexo de Édipo e da possibilidade de sua superação no âmbito da psicanálise vista como método desconstrutivo de sentidos, principalmente a partir da "segunda clínica" lacaniana.

This study concerns the understandings about the subject and his constitution in the works of Michel Foucault and Jacques Lacan. In spite of several approach differences, the legacies of Foucault and Lacan are similar in the fact that the subject is envisioned as empty, negative and without any essence or nature. This argument is developed through some classical foucaultian afirmations about psychoanalysis. The axis of the article is the Oedipus complex question and the possibility of its surpassing in psychoanalysis when seen as a method for the deconstruction of senses, especially from the advent of Lacan's "second clinic".

Evidências de alterações do processo de cicatrização de queimaduras em indivíduos diabéticos: revisão bibliográfica / Evidence of changes in the healing process of burns in diabetic subjects: literature review

Introdução: Queimaduras são lesões traumáticas que atuam no tecido de revestimento do corpo humano, determinando destruição total ou parcial da pele e seus anexos, podendo atingir camadas mais profundas. A cicatrização de feridas consiste em perfeita e coordenada cascata de eventos celulares, moleculares e bioquímicos, que interagem para que ocorra reconstituição tecidual. O diabetes mellitus é considerado fator de risco para queimaduras. Pacientes diabéticos com queimaduras apresentam maior índice de sepse, infecção e complicações. Feridas em diabéticos apresentam inibição da revascularização e baixa expressão de fatores de crescimento em relação a queimaduras em não-diabéticos, com prejuízo à cicatrização. Objetivo: Evidenciar os estudos clínicos sobre as alterações do processo de cicatrização em pacientes queimados portadores de diabetes mellitus. Método: Revisão bibliográfica sobre ensaios clínicos, realizada nas bases de dados BIREME, Burns, LILACS, MEDLINE, PubMed, e SciELO. Foram selecionados livros e periódicos impressos, no período de 2002 a 2012, utilizando os seguintes descritores: queimaduras, cicatrização, diabetes mellitus e reparo tecidual. Resultados: Estudos afirmam que existe uma diferenciação do processo de reparo em indivíduos diabéticos, sendo descrito como um retardo da cicatrização, evidenciado principalmente na fase inflamatória, na qual ocorre um retardo devido aos fatores associados a diabetes, tais como diminuição de fluxo sanguíneo, sepse e outros, levando a complicações no reparo. Conclusão: O diabetes mellitus altera o processo de cicatrização, exacerbando e prolongando o tempo de reparo da lesão. Fazem-se necessários outros estudos mais específicos para identificar a fase de maior comprometimento, auxiliando no processo de intervenção.

Introduction: Burns are traumatic injuries that operate in the tissuelining the human body, causing total or partial destruction of the skinand its appendages, reaching deeper layers. Wound healing is to perfectand coordinated cascade of cellular, molecular and biochemicalcomponents that interact to reconstitute tissue occurs. Diabetesmellitus is a risk factor for burns. Diabetic patients with burns havehigher rates of sepsis, infection and complications. Wounds in diabeticpatients revascularization and inhibition of low expression of growthfactors compared to nondiabetic patients with burns injury to heal.Objective: To demonstrate the clinical studies on the changes of thehealing process in burn patients with diabetes mellitus. Methods: Aliterature review on clinical trials held in the databases of BIREME,Burns, LILACS, MEDLINE, PubMed, and SciELO. Books and printjournals in the period 2002 to 2012 was selected, using the followingkeywords: burn, wound healing, diabetes mellitus and tissue repair.Results: Studies claim that there is a differentiation in the repairprocess in diabetic subjects has been described as a delayed healing,evidenced particularly in the inflammatory phase where there is a delaydue to factors associated with diabetes such as decreased blood flow,sepsis and other leading to complications in the repair. Conclusion:Diabetes mellitus alters the healing process exacerbating and prolongingthe time to repair the injury. There is a need for other morespecific studies to identify the phase of greater commitment, aidingin the intervention process.

Vigilância de eventos adversos a medicamentos em hospitais: aplicação e desempenho de rastreadores / Surveillance of adverse drug events in hospitals: implementation and performance of triggers

Os eventos adversos a medicamentos (EAMs) são causa importante de comprometimento da qualidade da atenção ao paciente hospitalizado e, por isso, devem ser identificados e caracterizados. Para tanto surgiram listas de rastreadores, entre elas a proposta pelo Institute for Healthcare Improvement. Aqui é apresentado o processo da aplicação dos rastreadores e o seu desempenho em um hospital de ensino. As informações sobre os rastreadores e os EAM foram coletadas por meio de revisão retrospectiva dos prontuários de pacientes com alta hospitalar de janeiro a junho de 2008. Foram identificados 497 rastreadores em 177 prontuários, onde cada prontuário apresentou, em média, 2,33 (DP = 2,7) rastreadores. Os encontrados com mais frequência foram: "antiemético" (72,1/100 prontuários), "interrupção abrupta da medicação" (70,0/100 prontuários) e "sedação excessiva, sonolência, torpor, letargia, queda e hipotensão" (34,6/100 prontuários). Os mais eficientes na captura de EAM (rendimento), isto é, aqueles que uma vez identificados sinalizaram possíveis eventos foram "antagonista de benzodiazepínico", "antidiarréicos" e "rash cutâneo". Os EAM mais encontrados foram relacionados aos rastreadores "interrupção abrupta da medicação" (8,3/100 prontuários), "antiemético" (4,6/100 prontuários) e "rash cutâneo" (2,1/100 prontuários). Essas considerações apontam para a utilidade do emprego da lista de rastreadores e podem contribuir para decidir sobre ajustes na sua aplicação.

Adverse drug events (ADE) are important causes of impairment of the quality of care for inpatients and therefore should be identified and characterized. Thus, lists of triggers were developed, including the proposal by the Institute for Healthcare Improvement. We analyzed the application of these triggers in a university hospital, with the cooperation of pharmacy and medical students, field training, standardized forms and manuals. Here, we present the process of application and performance of these triggers in a teaching hospital. The information on the triggers and ADE were collected through a retrospective chart review of patients discharged from January to June 2008. Four hundred and ninety-seven triggers were identified in 177 charts, and each chart had 2.33 (SD = 2.7) triggers on average. The most frequent triggers were: "antiemetic" (72.1/100 charts), "abrupt cessation of medication" (70.0/100 charts) and "over-sedation, drowsiness, numbness, lethargy, hypotension and fall" (34.6/100 charts). The most effective triggers for capturing ADE were "benzodiazepine antagonist", "antidiarrheal" and "rash", which, when identified in charts, were related to an event. The ADE most commonly found were related to the triggers, "abrupt cessation of medication" (8.3/100 charts), "antiemetic" (4.6/100 charts), "rash" and "anti-allergy" (2.1/100 charts). These results may help to decide which triggers are more useful in each situation.

Enxerto gengival livre versus enxerto de tecido conjuntivo livre – relato de caso clínico / Free gingival graft versus free conective tissue graft – clinical case report

O enxerto gengival livre (EGL) visa aumentar a faixa de mucosa queratinizada, porém tem como desvantagens o aspecto antiestético e a cicatrização por segunda intenção do sítio doador, com pós-operatório doloroso dessa área. O objetivo do presente estudo foi relatar um caso clínico no qual foi utilizada a técnica de enxerto de tecido conjuntivo livre (ETCL), comparada ao EGL, no tratamento de retrações gengivais múltiplas, com o intuito de se obter melhores resultados estéticos. Foi selecionado um paciente que apresentava retrações gengivais múltiplas em dentes contralaterais. Após ser submetido à terapia periodontal básica, foi realizada cirurgia para ganho de tecido queratinizado nos pré- molares inferiores. Aleatoriamente, um lado foi tratado com EGL, enquanto o outro recebeu ETCL. As duas cirurgias foram realizadas simultaneamente. Os seguintes parâmetros clínicos foram avaliados no baseline, 1, 3 e 6 meses após a cirurgia: profundidade de sondagem, altura de coroa clínica, nível de inserção clínico relativo, altura e espessura de tecido queratinizado. Após 6 meses de preservação observou-se resultado satisfatório quanto ao ganho de tecido queratinizado para os dois lados, mas com menor desconforto pós-operatório e melhores características estéticas no lado que recebeu o ETCL. A partir dos resultados observados pode-se concluir que o ETCL pode ser utilizado com previsibilidade para aumento de tecido queratinizado.

The free gingival graft (FGG) is used to increase the keratinized mucosa amount, however it has as disadvantages the anti-aesthetic aspect and the healing by second intention of the donor site, with painful healing of this area. The aim of this case report was to evaluate the use of the free connective tissue graft (FCTG) technique, compared to the FGG, in the treatment of multiple gingival recession, with the aim to achieve better aesthetic results. A patient from the Periodontics clinic of Unoeste, who presented multiple gingival recessions in contralateral teeth, was selected. After being submitted to basic periodontal therapy, surgery for queratinized tissue gains was realized on mandibular pre-molars. Randomly, a side was treated with FGG, while the other received a FCTG. Both surgeries were performed simultaneously. The following parameters were evaluated on the baseline, 1, 3 and 6 months after the surgery: probing depth, clinical crown height, relative clinical attachment level, height and thickness of the keratinized tissues. After 6 months satisfactory results regarding queratinized tissue gain were observed for both sides, but with less discomfort and better aesthetic characteristics for the side that received the FCTG. According to the results observed it can be concluded that the FCTG can be used with predictability for queratinized tissue augmentation

Cultura sobre seguridad del paciente que tienen los trabajadores en consulta externa del Hospital Militar Escuela Dr. Alejandro Dávila Bolaños. diciembre del 2014

Este trabajo de investigación forma parte de un proyecto de investigación dirigido a establecer una línea de base sobre el tema de seguridad del paciente enel Hospital Militar Escuela Dr. Alejandro Dávila Bolaños.Esta línea de base incluye la medición de la cultura de seguridad del paciente y de los conocimientos sobre conceptos relacionados con la seguridaddel paciente, prevención de caídas y aspectos básicos del manejo de laHipertensión Arterial. El presente estudio tuvo como objetivo caracterizar la cultura de seguridaddel paciente referida por el personal de consulta externa del Hospital Militar Escuela Dr. Alejando Dávila Bolaños, diciembre de 2014. Es un estudio descriptivo exploratorio, de corte transversal, la muestra estuvo conformada por 79 recursos. El instrumento utilizado fue un cuestionario auto-suministrado y valida dointernacionalmente que permitió describir los aspectos socio-demográficos y las 12 dimensiones de cultura de seguridad del paciente. La mayoría de los trabajadores se encontró en el grupo de edad entre 30 a 39 años, con predominación del sexo femenino, con pocos años de experiencia laboral en su área de trabajo y enhospital militar. Al evaluar los ámbitos contemplados en la encuesta de evaluación observamos que los procedimientos y sistemas son efectivos para la prevenciónde errores de forma equitativa con respecto a la seguridad del paciente. Sedetecta y se da respuesta a los efectos adversos antes de que se afecte al paciente de manera positiva para la cultura de seguridad del paciente. Ela prendizaje organizativo y mejora continua tiene mayor participación activa para mejorar la cultura de seguridad al paciente.

Comparative cytogenetics of Carnegiella marthae and Carnegiella strigata (Characiformes, Gasteropelecidae) and description of a ZZ/ZW sex chromosome system

Comparative cytogenetic analyses of hatchetfishes Carnegiella marthae and Carnegiella strigata (Gasteropelecidae) from the Rio Negro basin were performed using conventional Giemsa staining, silver (Ag) -staining and C-banding. The diploid chromosome numbers of both species equaled 2n = 50 but their karyotypes were distinct. We found evidence for sex chromosomes in C. marthae since karyotype of males presented 20 M + 12 SM + 4 ST + 14 A and ZZ ST chromosomes while the females presented 20 M + 12 SM + 4 ST + 14 A and ZW ST chromosomes of distinct size. Conversely, C. strigata presented 4 M + 4 SM + 2 ST + 40 A chromosomes without sex chromosome heteromorphism. Karyotypes of both species had two NOR-bearing SM chromosomes of distinct size indicating the presence of multiple NOR phenotypes. The sex chromosome pair had specific C-banding pattern allowing identification of both Z and W. This heteromorphic system has previously been described for the gasteropelecids.

Funcionamiento familiar: su relación con el control de las enfermedades crónicas no transmisibles / Family Unfolding: its Relationship with the Control of Non-transmissible Cronic Diseases

Se realizó un estudio descriptivo y transversal sobre el funcionamiento familiar y su relación con el control de enfermedades crónicas no transmisibles en pacientes mayores de 14 años del CMF # 89 perteneciente al policlínico “Romárico Oro” del municipio Puerto Padre en el período comprendido de Septiembre del 2005 a Febrero del 2006. El universo estuvo constituido por 162 y la muestra los 50 individuos portadores de Hipertensión Arterial, Asma Bronquial y Diabetes Mellitus. Para la obtención de la información se utilizó el formulario, Test FF SIL, la historia clínica individual y familiar. Las conclusiones demostraron que existió un predominio de pacientes controlados y de familias moderadamente funcionales, con mayor afectación de las esferas de la comunicación, la adaptabilidad y la permeabilidad, que los diferentes niveles del funcionamiento familiar y la afectación de sus esferas se relacionan con el control de las enfermedades crónicas no transmisibles y que la edad, la escolaridad y el tipo específico de enfermedad constituyeron factores individuales que incidieron modificando el efecto del funcionamiento familiar sobre el control de estas(AU)

A descriptive and traversal investigation about the familiar functioning and its relation with the control of nontransmissible chronic diseases in patients older than 14 years, belonging to the Familiar Medical Clinic No. 89 of the "Romárico Oro" Policlinic from the municipality of Puerto Padre was carried out, for the period between September 2005 and February 2006. The universal set was conformed by 162 patients and the sample consisted of 50 with high blood pressure, bronchial asthma and diabetes. A form, FF SIL tests, familiar and medical history were used in order to obtain the information. The conclusions showed a predominance of controlled patients and moderately functional families, with a major affectation in communication, adaptability and permeability topics; besides, they showed that different levels of familiar functioning and the affectation of its spheres are related to the control of non-transmissible chronic diseases; and that age, education level and the specific disease constituted individual factors that impacted on the effect of familiar functioning over the control of these diseases