More than a meat- or synthetic nitrogen fertiliser-substitute: a review of legume phytochemicals as drivers of 'One Health' via their influence on the functional diversity of soil- and gut-microbes.

Legumes are essential to healthy agroecosystems, with a rich phytochemical content that impacts overall human and animal well-being and environmental sustainability. While these phytochemicals can have both positive and negative effects, legumes have traditionally been bred to produce genotypes with lower levels of certain plant phytochemicals, specifically those commonly termed as 'antifeedants' including phenolic compounds, saponins, alkaloids, tannins, and raffinose family oligosaccharides (RFOs). However, when incorporated into a balanced diet, such legume phytochemicals can offer health benefits for both humans and animals. They can positively influence the human gut microbiome by promoting the growth of beneficial bacteria, contributing to gut health, and demonstrating anti-inflammatory and antioxidant properties. Beyond their nutritional value, legume phytochemicals also play a vital role in soil health. The phytochemical containing residues from their shoots and roots usually remain in-field to positively affect soil nutrient status and microbiome diversity, so enhancing soil functions and benefiting performance and yield of following crops. This review explores the role of legume phytochemicals from a 'one health' perspective, examining their on soil- and gut-microbial ecology, bridging the gap between human nutrition and agroecological science.

SARS-CoV-2 membrane protein-specific antibodies from critically ill SARS-CoV-2-infected individuals interact with Fc receptor-expressing cells but do not neutralize the virus.

The membrane (M) glycoprotein of SARS-CoV-2 is one of the key viral proteins regulating virion assembly and morphogenesis. Immunologically, the M protein is a major source of peptide antigens driving T cell responses, and most individuals who have been infected with SARS-CoV-2 make antibodies to the N-terminal, surface-exposed peptide of the M protein. We now report that although the M protein is abundant in the viral particle, antibodies to the surface-exposed N-terminal epitope of M do not appear to neutralize the virus. M protein-specific antibodies do, however, activate antibody-dependent cell-mediated cytotoxicity and cytokine secretion by primary human natural killer cells. Interestingly, while patients with severe or mild disease make comparable levels of M antigen-binding antibodies, M-specific antibodies from the serum of critically ill patients are significantly more potent activators of antibody-dependent cell-mediated cytotoxicity than antibodies found in individuals with mild or asymptomatic infection.

Usefulness of 18F-FDG PET-CT in the Management of Febrile Neutropenia: A Retrospective Cohort from a Tertiary University Hospital and a Systematic Review.

Febrile neutropenia (FN) is a complication of hematologic malignancy therapy. An early diagnosis would allow optimization of antimicrobials. The 18F-FDG-PET-CT may be useful; however, its role is not well established. We analyzed retrospectively patients with hematological malignancies who underwent 18F-FDG-PET-CT as part of FN management in our university hospital and compared with conventional imaging. In addition, we performed a systematic review of the literature assessing the usefulness of 18F-FDG-PET-CT in FN. A total of 24 cases of FN underwent 18F-FDG-PET-CT. In addition, 92% had conventional CT. In 5/24 episodes (21%), the fever was of infectious etiology: two were bacterial, two were fungal, and one was parasitic. When compared with conventional imaging, 18F-FDG-PET-CT had an added value in 20 cases (83%): it diagnosed a new site of infection in 4 patients (17%), excluded infection in 16 (67%), and helped modify antimicrobials in 16 (67%). Antimicrobials could be discontinued in 10 (41.6%). We identified seven publications of low quality and one randomized trial. Our results support those of the literature. The available data suggest that 18F-FDG-PET-CT is useful in the management of FN, especially to diagnose fungal infections and rationalize antimicrobials. This review points out the low level of evidence and indicates the gaps in knowledge.

Evaluation of particulate organic carbon from MODIS-Aqua in a marine-coastal water body.

La Paz Bay (LPB) in Mexico is one of the largest marine-coastal bodies of water in the Gulf of California (GC) and is ecologically important for the feeding, reproduction, and refuge of marine species. Although particulate organic carbon (POC) is an important reservoir of oceanic carbon and an indicator of productivity in the euphotic zone, studies in this region are scarce. This study evaluates the performance of satellite-derived POC in LPB from January 2003 to December 2020. The metrics obtained for COP ( RMSE = 33.8 mg m - 3 ; P bias = 29.6 % y r P = 0.4 con p < 0.05 ), Chla-a ( RMSE = 0.23 mg m - 3 ; P bias = - 4.3 % y r P = 0.94 con p < 0.05 ), and SST ( RMSE = 2 . 3 ∘ C ; P bias = - 2.2 % y r P = 0.92 con p < 0.05 ) establish that although in some cases there was a slight over/underestimation, the satellite estimates consistently represent the variability and average values measured in situ. On the other hand, the spatio-temporal analysis of the POC allowed us to identify two seasons with their respective transition periods and five subregions in which the POC is characterized by having its maximum variability; two of these coincide with the locations of the eddies reported for the winter and summer seasons in the LPB, while the following three are located: one in the coastal zone and in the two areas in which the LPB interacts with the GC. The associations, variability nodes, and multiple linear regression analysis suggest that POC fluctuations in the LPB respond mainly to biological processes and, to some extent, to the seasonality of SST and wind. Finally, our results justify the use of the MODIS-Aqua satellite POC for studies in marine-coastal water bodies with similar characteristics to the LPB and suggest that this water body can be considered a reservoir for the marine region of northwestern Mexico.

Mesenchymal stromal cell therapy for COVID-19 acute respiratory distress syndrome: a double-blind randomised controlled trial.

Mesenchymal stromal cells (MSC) have immunomodulatory and tissue-regenerative properties and have shown promising results in acute respiratory distress syndrome (ARDS) of multiple causes, including COVID-19. We conducted a randomised (1:1), placebo-controlled, double-blind clinical trial to assess the efficacy and safety of one bone marrow-derived MSC infusion in twenty patients with moderate to severe ARDS caused by COVID-19. The primary endpoint (increase in PaO2/FiO2 ratio from baseline to day 7, MSC 83.3 versus placebo 57.6) was not statistically significant, although a clinical improvement at day 7 in the WHO scale was observed in MSC patients (5, 50% vs 0, 0%, p = 0.033). Median time to discontinuation of supplemental oxygen was also shorter in the experimental arm (14 versus 23 days, p = 0.007), resulting in a shorter hospital stay (17.5 versus 28 days, p = 0.042). No significant differences were observed for other efficacy or safety secondary endpoints. No infusion or treatment-related serious adverse events occurred during the one-year follow-up. This study did not meet the primary endpoint of PaO2/FiO2 increase by day 7, although it suggests that MSC are safe in COVID-19 ARDS and may accelerate patients' clinical recovery and hospital discharge. Larger studies are warranted to elucidate their role in ARDS and other inflammatory lung disorders.Trial Registration: EudraCT Number: 2020-002193-27, registered on July 14th, 2020, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-002193-27/ES . NCT number: NCT04615429, registered on November 4th, 2020, https://clinicaltrials.gov/ct2/show/NCT04615429 .

Prophylaxis and management of graft-versus-host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation.

Graft-versus-host disease (GVHD) is a major factor contributing to mortality and morbidity after allogeneic haematopoietic stem-cell transplantation (HSCT). In the last 3 years, there has been regulatory approval of new drugs and considerable change in clinical approaches to prophylaxis and management of GVHD. To standardise treatment approaches, the European Society for Blood and Marrow Transplantation (EBMT) has updated its clinical practice recommendations. We formed a panel of one methodologist and 22 experts in the field of GVHD management. The selection was made on the basis of their role in GVHD management in Europe and their contributions to the field, such as publications, presentations at conferences, and other research. We applied the GRADE process to ten PICO (patient, intervention, comparator, and outcome) questions: evidence was searched for by the panel and graded for each crucial outcome. In two consensus meetings, we discussed the evidence and voted on the wording and strengths of recommendations. Key updates to the recommendations include: (1) primary use of ruxolitinib in steroid-refractory acute GVHD and steroid-refractory chronic GVHD as the new standard of care, (2) use of rabbit anti-T-cell (thymocyte) globulin or post-transplantation cyclophosphamide as standard GVHD prophylaxis in peripheral blood stem-cell transplantations from unrelated donors, and (3) the addition of belumosudil to the available treatment options for steroid-refractory chronic GVHD. The EBMT proposes to use these recommendations as the basis for routine management of GVHD during allogenic HSCT. The current recommendations favour European practice and do not necessarily represent global preferences.

COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant.

A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64-2.87), with >1 comorbidity (2.44, 1.85-3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19-2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2-0.37) or BA.4/BA.5 (0.13, 0.08-0.19) periods and among patients vaccinated with one or two (0.51, 0.34-0.75) or three or four (0.22, 0.16-0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03-3.25) and Omicron (3.19, 95% CI 1.59-6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.

Prediction of patient admission and readmission in adults from a Colombian cohort with bipolar disorder using artificial intelligence.

Introduction: Bipolar disorder (BD) is a chronically progressive mental condition, associated with a reduced quality of life and greater disability. Patient admissions are preventable events with a considerable impact on global functioning and social adjustment. While machine learning (ML) approaches have proven prediction ability in other diseases, little is known about their utility to predict patient admissions in this pathology. Aim: To develop prediction models for hospital admission/readmission within 5 years of diagnosis in patients with BD using ML techniques. Methods: The study utilized data from patients diagnosed with BD in a major healthcare organization in Colombia. Candidate predictors were selected from Electronic Health Records (EHRs) and included sociodemographic and clinical variables. ML algorithms, including Decision Trees, Random Forests, Logistic Regressions, and Support Vector Machines, were used to predict patient admission or readmission. Survival models, including a penalized Cox Model and Random Survival Forest, were used to predict time to admission and first readmission. Model performance was evaluated using accuracy, precision, recall, F1 score, area under the receiver operating characteristic curve (AUC) and concordance index. Results: The admission dataset included 2,726 BD patients, with 354 admissions, while the readmission dataset included 352 patients, with almost half being readmitted. The best-performing model for predicting admission was the Random Forest, with an accuracy score of 0.951 and an AUC of 0.98. The variables with the greatest predictive power in the Recursive Feature Elimination (RFE) importance analysis were the number of psychiatric emergency visits, the number of outpatient follow-up appointments and age. Survival models showed similar results, with the Random Survival Forest performing best, achieving an AUC of 0.95. However, the prediction models for patient readmission had poorer performance, with the Random Forest model being again the best performer but with an AUC below 0.70. Conclusion: ML models, particularly the Random Forest model, outperformed traditional statistical techniques for admission prediction. However, readmission prediction models had poorer performance. This study demonstrates the potential of ML techniques in improving prediction accuracy for BD patient admissions.

Determinación de los factores asociados con el reingreso temprano de pacientes con enfermedad mental en dos ciudades de Colombia durante 2018 / Determination of Factors Associated with Early Readmission of Patients with Mental Illness in Two Cities in Colombia During 2018

RESUMEN Introducción: La rehospitalización temprana en unidades de salud mental (USM) es la necesidad de hospitalización de un paciente en los primeros 30 días tras el alta, principalmente por descompensación recurrente de su enfermedad mental. Este fenómeno se relaciona con un peor pronóstico y tiene impacto en el entorno familiar, social y laboral. El ausentismo laboral y las estancias hospitalarias adicionales son gastos para el sistema de salud y de empleo que han hecho de la rehospitalización un fenómeno de especial interés. El presente estudio se llevó a cabo con el objetivo de explorar los factores asociados con el reingreso de los pacientes con enfermedad psiquiátrica atendidos en 2 USM en 2018, así como aquellos modificables que actúen como protección contra esta condición. Métodos: Estudio observacional descriptivo con componente analítico de tipo casos y controles en 2 USM de distintas ciudades de Colombia. Se obtuvo información por medio de una ficha de recolección de datos tomados de los registros de historias clínicas de los pacientes que ingresaron entre el 1 de enero y el 31 de diciembre de 2018. La recolección de datos se hizo del 20 de febrero al 27 de mayo de 2019. Compusieron la muestra todos los pacientes que cumplían los criterios de reingreso temprano en ambas instituciones. El grupo de estudio estuvo conformado por 113 pacientes: 28 casos y 85 controles, emparejados por las variables edad, sexo, lugar de hospitalización y diagnóstico. Resultados: En las 2 USM hospitalarias, los diagnósticos encontrados fueron: depresión (15,5%), trastorno afectivo bipolar (33,1%) y esquizofrenia (37,3%); en Bogotá la más prevalente fue la depresión (31,1%) y en Tunja, la esquizofrenia (44,8%). Para ambas instituciones, el factor que más se asocia con el reingreso es el consumo de alcohol, pero otras variables de tratamiento, núcleo familiar e intervención individual también se asociaron con mayor probabilidad de reingreso temprano. Conclusiones: Se pudo demostrar que el uso de antipsicóticos atípicos y/o de depósito, las hospitalizaciones de más de 15 días y la prescripción de menos de 3 medicamentos al alta disminuyen el número de reingresos tempranos en las USM.

ABSTRACT Introduction: Early rehospitalisation in mental health units (SMHUs) is when a patient needs to be readmitted in the first 30 days after receiving discharge, and is mainly due to recurrent decompensation of their mental illness. This phenomenon is related to a worse prognosis and has an impact on the family, social and work environment. Absenteeism from work and additional hospital time are expenses for the health and employment system which have made rehospitalisation a phenomenon of special interest. The present study was carried out with the objective of exploring the factors associated with the readmission of patients with psychiatric illnesses treated in two MHUs during 2018, as well as those modifiable factors that act as protection for this condition. Methods: Observational, descriptive study with analytical component of cases and controls in two MHUs in different cities of Colombia. Information was obtained by collecting data from the medical records of patients who were admitted between 1 January 2018 and 31 December 2018. The data were collected between 20 February and 27 May 2019. The sample was composed of all the patients who met the criteria for early readmission in both institutions. The study group consisted of 113 patients: (28 cases and 85 controls), matched by the variables: age, sex, place of hospitalisation and diagnosis. Results: In the two hospital MHUs the diagnoses found were: depression (15.5%), bipolar affective disorder (33.1%) and schizophrenia (37.3%). In Bogotá, the most prevalent was depression (31.1%) and, in Tunja, it was schizophrenia (44.8%). For both institutions, the factor most associated with readmission was alcohol consumption, but other variables of treatment, family nucleus, and individual intervention were also associated with a greater probability of early readmission. Conclusions: It was possible to demonstrate that the use of atypical and/or depot antipsychotics, hospitalisations longer than 15 days, and prescriptions of less than three drugs at discharge, reduce the number of early readmissions to MHUs.

Diários de batalha: enfermeiros na linha de frente do enfrentamento ao covid-19 / Diarios de batalla: enfermeras a la vanguardia para hacer frente a covid-19 / Battle diaries: nurses at the forefront of coping with covid-19

Introdução: Com o aparecimento do Covid-19 como desafio para a saúde mundial, milhões de pessoas no mundo todo passaram a enfrentar mudanças no estilo de vida, na rotina diária, nos meios de conviver. Contudo, nem todos conseguem vivenciar o distanciamento social, para profissionais da saúde, em especial o enfermeiro, o novo momento pede reorganização da rotina e do modo de experimentar o cuidado. Objetivo: Relatar a experiência vivida por Enfermeiros na linha de frente do enfrentamento ao Covid-19 em um Hospital de Campanha da rede privada. Métodos: Trata-se de estudo exploratório-descritivo, do tipo relato de experiência, desenvolvido a partir das vivências de enfermeiros atuantes na linha de frente do enfrentamento ao COVID-19 em um Hospital de Campanha da rede privada na Cidade de Fortaleza, CE. Resultados: Diante da experiência vivida, pode-se observar que a pandemia trouxe aos enfermeiros além dos vários desafios, muitas incertezas, riscos e medos, devido ao cenário desconhecido e cheio de dúvidas, como também gerou sofrimentos psíquicos tendo em vista lidar de forma mais constante com a morte de pacientes. Contudo, evidenciou-se que o enfermeiro tem feito toda uma diferença no fortalecimento do elo entre a equipe, bem como nas orientações e ações do cuidado clínico junto aos pacientes e familiares. Conclusões: Diante de tudo, o enfermeiro tem sido profissional de destaque no enfrentamento da pandemia do novo coronavírus, pois se têm mostrado munido de competências e habilidades, desde a promoção, prevenção, recuperação e reabilitação. Contudo, as autoridades precisam pensar em investimentos para melhoria das condições de trabalho dessa classe profissional que já foi tanto desvalorizada.

Introducción: Con el surgimiento de Covid-19 como un desafío para la salud global, millones de personas en todo el mundo comenzaron a enfrentar cambios en el estilo de vida, la rutina diaria y las formas de vida. Sin embargo, no todos pueden experimentar la distancia social, para los profesionales de la salud, especialmente las enfermeras, el nuevo momento requiere una reorganización de la rutina y la forma de experimentar la atención. Objetivo: Informar la experiencia vivida por las enfermeras en la primera línea de confrontación con Covid-19 en un hospital de campaña privado. Métodos: Este es un estudio exploratorio descriptivo, un informe de experiencia, desarrollado a partir de las experiencias de enfermeras que trabajan en la primera línea de afrontamiento con COVID-19 en un hospital privado de campaña en la ciudad de Fortaleza, CE. Resultados: en vista de la experiencia vivida, se puede observar que la pandemia trajo enfermeras, además de los diversos desafíos, muchas incertidumbres, riesgos y temores, debido al escenario desconocido y lleno de dudas, así como también generó sufrimiento psicológico para tratar más constante con la muerte de pacientes. Sin embargo, era evidente que la enfermera ha marcado la diferencia en el fortalecimiento del vínculo entre el equipo, así como en las pautas y acciones de atención clínica con pacientes y familiares. Conclusiones: En vista de todo, la enfermera ha sido un profesional destacado al enfrentar la pandemia del nuevo coronavirus, ya que ha demostrado estar equipada con habilidades y destrezas, desde promoción, prevención, recuperación y rehabilitación. Sin embargo, las autoridades deben pensar en inversiones para mejorar las condiciones de trabajo de esta clase profesional, que ya ha sido tan devaluada.

Introduction: With the emergence of Covid-19 as a challenge to global health, millions of people around the world began to face changes in lifestyle, daily routine, ways of living. However, not everyone can experience social distance, for health professionals, especially nurses, the new moment calls for a reorganization of the routine and the way of experiencing care. Objective: To report the experience lived by Nurses in the front line of confrontation with Covid-19 in a private Field Hospital. Methods: This is an exploratory-descriptive study, an experience report, developed from the experiences of nurses working on the front line of coping with COVID-19 in a private campaign hospital in the city of Fortaleza, CE. Results: In view of the lived experience, it can be observed that the pandemic brought nurses, in addition to the various challenges, many uncertainties, risks and fears, due to the unknown and full of doubts scenario, as well as it generated psychological suffering in order to deal more constant with the death of patients. However, it became evident that the nurse has made all the difference in strengthening the link between the team, as well as in the guidelines and actions of clinical care with patients and family members. Conclusions: In the face of everything, the nurse has been a prominent professional in facing the pandemic of the new coronavirus, as they have shown themselves to be equipped with skills and abilities, from promotion, prevention, recovery and rehabilitation. However, the authorities need to think about investments to improve the working conditions of this professional class, which has already been so devalued.

Epidemiological and clinical aspects of Guillain-Barré syndrome and its variants / Aspectos epidemiológicos e clínicos da síndrome de Guillain-Barré e suas variantes

Abstract Background: Guillain-Barré syndrome (GBS), an acute polyradiculoneuropathy that occurs because of an abnormal inflammatory response in the peripheral nervous system, is clinically characterized by acute flaccid paresis and areflexia with or without sensory symptoms. This syndrome can lead to disabling or even life-threatening sequelae. Objective: This study aimed to present the clinical and epidemiological aspects of GBS in patients admitted to a tertiary-level hospital in the Federal District between January 2013 and June 2019. Methods: In this observational, cross-sectional and retrospective study, medical records of patients diagnosed with acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy or acute axonal motor-sensitive neuropathy based on electromyographic findings were included, and clinical data were collected retrospectively. Results: A total of 100 patients (63 males and 37 females; ratio, 1.7:1) aged 2-86 years (mean, 36.4 years) were included. The mean annual incidence rate of GBS was 0.54 cases/100,000 inhabitants, with 52 and 49% of the cases occurring between October and March (rainy season) and between April and September (dry season), respectively. The proportions of patients showing each GBS variant were as follows: demyelinating forms, 57%; axonal forms, 39%; and undetermined, 4%. The mean duration of hospitalization was 8-15 days for most patients (38%). During hospitalization, 14% of the patients required mechanical ventilation and 20% experienced infectious complications. Conclusion: The findings indicate that there was an increase in the incidence of GBS during the rainy season. Moreover, we did not observe the typical bimodal distribution regarding age at onset.

RESUMO Introdução: Síndrome de Guillain-Barré (SGB), uma polirradiculoneuropatia aguda que ocorre devido a uma resposta inflamatória anormal no sistema nervoso periférico, é caracterizada clinicamente por paralisia flácida aguda e arreflexia, com ou sem sintomas sensitivos. Essa síndrome pode deixar sequelas incapacitantes ou até ameaçar a vida. Objetivo: Apresentar os aspectos clínicos e epidemiológicos da SGB em pacientes internados em um hospital terciário do Distrito Federal, no período de janeiro/2013 a junho/2019. Métodos: Estudo observacional, transversal e retrospectivo, no qual pacientes com diagnóstico de polirradiculoneuropatia desmielinizante inflamatória aguda, neuropatia axonal motora aguda ou neuropatia axonal sensitivo motora aguda a partir dos achados eletroneuromiográficos foram selecionados e seus dados clínicos coletados retrospectivamente em seus prontuários. Resultados: Um total de 100 pacientes (63 homens e 37 mulheres; proporção de 1,7:1), com idades entre 2-86 anos (média, 36,4 anos), foram incluídos. A taxa média anual de incidência de SGB foi de 0,54 casos/100.000 habitantes, com 52 e 49% dos casos ocorrendo entre outubro e março (período chuvoso) e entre abril e setembro (período seco), respectivamente. A proporção de pacientes que apresentaram cada variante de SGB foi a seguinte: formas desmielinizantes, 57%; formas axonais, 39%; e indeterminado, 4%. A duração média da hospitalização foi de 8‒15 dias para a maioria dos pacientes (38%). Durante a hospitalização, 14% dos pacientes necessitaram de ventilação mecânica e 20% apresentaram complicações infecciosas. Conclusão: Os resultados indicam aumento na incidência de GBS durante a estação chuvosa. Além disso, não observamos a distribuição bimodal típica em relação à idade de início.

Conselho federal de enfermagem no transcurso da COVID-19: comunicação digital à luz da teoria habermasiana / Federal council of nursing on the COVID-19 tour: digital communication in the light of habermasian theory

Objective: To analyze the articles published by the Federal Nursing Council during the COVID-19 pandemic in the light of the Habermasian communicative action theory. Method: Qualitative documentary study, carried out from May to July 2020, using pandemic news published by the municipality as the primary source. The material was organized through thematic content analysis and discussed based on the theory and related literature. Results: The council produced technical note materials as instruments to guide professionals and approved resolutions and regulations. The performance of the system was focused on the acquisition and distribution of protective equipment through regional offices, lawsuits, the creation of an observatory and an emotional support channel for professionals. Conclusion: Communication with awareness and knowledge to nursing professionals was prioritized, empowering them in work processes in the pandemic context.(AU)

Objetivo: Analizar los artículos publicados por el Consejo Federal de Enfermería durante la pandemia de COVID-19 a la luz de la teoría de la acción comunicativa habermasiana. Método: Estudio documental cualitativo, realizado de mayo a julio de 2020, utilizando como fuente primaria las noticias sobre pandemias publicadas por el municipio. El material fue organizado a través de análisis de contenido temático y discutido con base en la teoría y literatura relacionada con el tema. Resultados: El consejo elaboró materiales de notas técnicas como instrumentos para orientar a los profesionales y aprobó resoluciones y reglamentos. La actuación del sistema se centró en la adquisición y distribución de equipos de protección a través de oficinas regionales, juicios, la creación de un observatorio y un canal de apoyo emocional a los profesionales. Conclusión: Se priorizó la comunicación con conciencia y conocimiento a los profesionales de enfermería, empoderándolos en los procesos de trabajo en el contexto pandémico.(AU)

Objetivo: Analisar as matérias publicadas pelo Conselho Federal de Enfermagem no transcurso da pandemia COVID-19 à luz da teoria da ação comunicativa habermasiana. Método: Estudo documental qualitativo, realizado durante o período de maio a julho de 2020, utilizando-se como fonte primária as notícias relacionadas à pandemia publicadas pela autarquia. O material foi organizado através da análise de conteúdo temática e discutido com base na teoria e literatura relacionada à temática. Resultados: O conselho produziu materiais notas técnicas como instrumentos norteadores aos profissionais e aprovou resoluções e normativas. A atuação do sistema esteve focada na aquisição e distribuição de equipamentos de proteção por intermédio dos regionais, ações judiciais, criação do observatório e de um canal de apoio emocional aos profissionais. Conclusão: Priorizou-se uma comunicação com sensibilização e conhecimento aos profissionais de enfermagem, empoderando-os nos processos de trabalho no contexto pandêmico.(AU)

Rapid detection of Mycobacterium tuberculosis in children using blood and urine specimens

Abstract INTRODUCTION: Laboratory and clinical features of childhood tuberculosis (TB) are non-specific and establishing an accurate diagnosis remains a challenge. This study evaluated a Single tube nested-PCR (STNPCR) to detect genomic DNA of Mycobacterium tuberculosis complex in blood and urine. METHODS: Biological samples were obtained from children (<15 years old) with clinical suspicion of pulmonary and extrapulmonary TB at public hospitals in Recife-Pernambuco, Brazil. Cultures yielded negative results in a majority of childhood TB cases, which are generally paucibacillary. A set of clinical, epidemiological, radiological, and laboratory criteria with evident clinical improvement after anti-TB treatment were frequently used to define childhood TB cases. RESULTS: Ninety children with clinical suspicion were enrolled in this study (44 with TB and 46 without TB). The pulmonary TB group had 20 confirmed cases and 46 negative controls, while the extrapulmonary TB group had 24 confirmed cases. The STNPCR showed sensitivities to pulmonary and extrapulmonary TB of 47.4% and 52.2% (blood) and 38.8% and 20% (urine), respectively. Considering the low performance of STNPCR on separate samples, we decided to perform a combined analysis (parallel sensitivity analysis) of the results from blood and urine samples. The parallel sensitivity increased to 65% in blood and 62.5% in urine. The specificity in both samples ranged from 93.5-97.8%. CONCLUSIONS: Although STNPCR showed moderate sensitivity, the specificity is high; therefore, the test can be used as an auxiliary tool to diagnose TB in children. It is a rapid test that demonstrated better performance than other diagnostic tests in paucibacillary samples as it does in childhood tuberculosis.

Agentes Comunitários de Saúde frente à COVID-19: Vivências junto aos profissionais de enfermagem / Community health agents in front of COVID-19: experiences with nursing professionals

Objetivo: Descrever a experiência vivenciada por enfermeiras em conexão com Agentes comunitários de saúde para enfrentamento local da pandemia COVID-19. Método: Relato de experiência desenvolvido a partir de ações de enfermeiras que atuam na Estratégia Saúde da Família do município de Icó, Estado do Ceará, destacando o importante papel que os Agentes comunitários de saúde desenvolvem junto à população nesse cenário. Resultados: A partir da experiência vivenciada, pode-se observar o importante papel que os Agentes Comunitários de Saúde têm apresentando frente à pandemia da COVD-19, mesmo apresentando medo e insegurança. Evidenciou-se ainda durante esse período que seu papel de educador em saúde é imprescindível nas ações desenvolvidas dentro dos territórios. Além disso, esses profissionais têm sido protagonistas importantes nas atividades realizadas dentro das Estratégias de Saúde da Família, fortalecendo assim o trabalho da equipe bem como o controle e combate da infecção pelo novo Coronavírus. Conclusões: Contar com o trabalho desses profissionais nos territórios tem sido estratégico e representa um diferencial para o cuidado, por auxiliarem no controle da disseminação e no monitoramento de grupos de risco, bem como das pessoas infectadas pela doença. (AU)

Objective: To describe the experience lived by nurses in connection with community health workers to face the pandemic COVID-19 locally. Method: Experience report developed from the actions of nurses working in the Family Health Strategy in the municipality of Icó, State of Ceará, highlighting the important role that community health agents play with the population in this scenario. Results: Based on the experience, it is possible to observe the important role that Community Health Agents have playing in the face of the COVID-19 pandemic, even with fear and insecurity. It was also evident during this period that his role as a health educator is essential in the actions developed within the territories. In addition, these professionals have been important protagonists in the activities carried out within the Family Health Strategies, thus strengthening the team's work as well as controlling and fighting infection by the new Coronavirus. Conclusions: Counting on the work of these professionals in the territories has been strategic and represents a differential for care, as they help in controlling the dissemination and monitoring at-risk groups, as well as people infected by the disease. (AU)

Objetivo: Describir la experiencia vivida por las enfermeras en relación con los trabajadores de salud de la comunidad para enfrentar la pandemia COVID-19. Método: Informe de experiencia desarrollado a partir de las acciones de enfermeras que trabajan en la Estrategia de Salud de la Familia en el municipio de Icó, Estado de Ceará, destacando el importante papel que los trabajadores de salud comunitarios juegan con la población en este escenario. Resultados: En base a la experiencia, es posible observar el importante papel que los agentes de salud comunitarios tienen ante la pandemia da COVID-19, incluso con miedo e inseguridad. También fue evidente durante este período que su papel como educador de salud es esencial en las acciones desarrolladas dentro de los territorios. Además, estos profesionales han sido protagonistas importantes en las actividades llevadas a cabo dentro de las Estrategias de salud familiar, fortaleciendo así el trabajo del equipo y controlando y luchando contra la infección por el nuevo Coronavirus. Conclusiones: contar con el trabajo de estos profesionales en los territorios ha sido estratégico y representa un diferencial para la atención, ya que ayudan a controlar la difusión y el monitoreo de los grupos en riesgo, así como a las personas infectadas por la enfermedad. (AU)

Candidiasis invasiva en pacientes pediátricos ingresados / Invasive candidiasis in hospitalized pediatric patients

RESUMEN Introducción: la candidiasis es una infección fúngica causada principalmente por especies de candida no albicans que aparece generalmente en la piel o las membranas mucosas de los pacientes. Objetivos: caracterizar la incidencia de especies de candida con mayor número de aislamientos en los pacientes pediátricos hospitalizados, en el Hospital Mariana Grajales (Servicio de Neonatología) y Hospital José Luis Miranda, en el período 2013 - 2018, en Villa Clara. Métodos: estudio descriptivo y transversal con 50 aislamientos del género candida en hemocultivos de pacientes hospitalizados Hospital Mariana Grajales (Servicio de Neonatología) y Hospital José Luis Miranda (Servicio de Terapia Intensiva), Villa Clara, de enero 2013 - septiembre 2018. Se utilizó la estadística descriptiva e inferencial, mediante el test de Ji cuadrado de Pearson (x2) o el test exacto de Fisher a las variables: año de estudio, tipo de hospital, tipo de servicio y especie de candida aislada. Resultados: los mayores aislamientos de candidiasis invasiva correspondieron al pediátrico, en el servicio de Terapia Intensiva, 2018 (única con significación estadística).En esta misma unidad, el grupo de candida spp obtuvo el mayor índice, seguido de candida tropicalis, sin significaciones estadísticas. En el servicio de Neonatología el mayor número de aislamientos correspondió a candida spp, seguido de candida guillermondii, ambas sin significación estadística. Conclusiones: el servicio de Terapia Intensiva fue el que mayor número de casos de candidiasis invasiva y el año 2018 fue el más representativo. El grupo de candida spp fueron las especies que más se aislaron en ambos hospitales.

ABSTRACT Introduction: candidiasis is a fungal infection caused mainly by non-albicans Candida species that usually appears on the skin or mucous membranes of patients. Objective: to characterize the incidence of Candida species with the highest number of isolates in hospitalized pediatric patients, at Mariana Grajales Hospital (Neonatology Service) and José Luis Miranda Hospital, in the period 2013 - 2018, in Villa Clara. Methods: descriptive and cross-sectional study with 50 Candida genus isolates in blood cultures of patients hospitalized at Mariana Grajales Hospital (Neonatology Service) and José Luis Miranda Hospital (Intensive Care Service), Villa Clara, from January 2013 to September 2018. Descriptive and inferential statistics using Pearson's chi-squared test (χ2) or Fisher's exact test to the variables: year of study, type of hospital, type of service and isolated Candida species. Results: the largest isolates of invasive candidiasis corresponded to the Intensive Therapy service from the pediatric hospital in 2018 (only with statistical significance). In this same hospital, the Candida spp group obtained the highest index, followed by Candida tropicalis, without statistical significance. The largest number of isolates corresponded to Candida spp in the Neonatology service, followed by Candida guillermondii, both without statistical significance. Conclusions: the Intensive Therapy service was the one with the highest number of cases of invasive candidiasis and the year 2018 was the most representative. The group of Candida spp was the most isolated species in both hospitals.

ß-Glucanase Addition in Brewing Malt Produced by Reduced Time of Germination

Abstract The β-Glucans content has straight influence on the quality of malt and beer, mainly during the filtration step. Barley presenting high β-Glucan content demands longer germination time at malting. The application of commercial β-Glucanase is an alternative to accelerate the process and preserve the quality of malt. This work aimed to evaluate the effect of commercial β-Glucanase addition in malt produced within reduced germination time (64 h). Micro-malting was conducted with BRS-Caue and Elis barley cultivars at germination time 64 h and 96 h. The β-Glucanase concentration applied were 0, 25, 50 and 100 mg.kg-1. Barley, malt and wort samples were analyzed to check their physical-chemical features. Beers were produced with BRS-Caue malt and the physical-chemical and sensory attributes were analyzed. The commercial enzyme addition in BRS-Caue and Elis (64 h), at concentration 25 and 50 mg.kg-1, resulted in wort presenting proper β-Glucan content (≤ 178 mg.L-1). The beer produced with malt germinated for 64 h and added with 50 mg.kg-1 of β-glucanase was the one showing the largest number of physical-chemical and sensory parameters similar to the beer made with malt germinated for 96 h (conventional process). Commercial β-glucanase application in malt allowed accelerating the malting process without affecting the quality of the malt for beer production.