In the Americas, wild yellow fever (WYF) is an infectious disease that is highly lethal for some non-human primate species and non-vaccinated people. Specifically, in the Brazilian Atlantic Forest, Haemagogus leucocelaenus and Haemagogus janthinomys mosquitoes act as the major vectors. Despite transmission risk being related to vector densities, little is known about how landscape structure affects vector abundance and movement. To fill these gaps, we used vector abundance data and a model-selection approach to assess how landscape structure affects vector abundance, aiming to identify connecting elements for virus dispersion in the state of São Paulo, Brazil. Our findings show that Hg. leucocelaenus and Hg. janthinomys abundances, in highly degraded and fragmented landscapes, are mainly affected by increases in forest cover at scales of 2.0 and 2.5 km, respectively. Fragmented landscapes provide ecological corridors for vector dispersion, which, along with high vector abundance, promotes the creation of risk areas for WYF virus spread, especially along the border with Minas Gerais state, the upper edges of the Serra do Mar, in the Serra da Cantareira, and in areas of the metropolitan regions of São Paulo and Campinas.
Mosquito Vectors , Yellow Fever , Brazil , Animals , Yellow Fever/transmission , Mosquito Vectors/virology , Ecosystem , Tropical Climate , Yellow fever virus , Population Density , Culicidae/virology , Culicidae/physiology
Objective: To classify the bibliometric indicators of online scientific research on placentophagy. Methods: A bibliometric study was conducted to quantify the scientific production of authors and institutions with the aim of highlighting the growth and impact of these publications nationally and internationally. The Bradford Law, network maps, and textual statistics were used, with searches conducted in libraries and databases in October 2021. Results: The sample consisted of 64 articles, whose primary authors were associated with 49 institutions, and mostly with degrees in anthropology. The United States of America was the country that published the most papers on the theme, and most studies were reviews with individual production. Through the term analysis, it was found that the predominant themes regarding placentophagy were the following: Alternative therapy for women's health, methodologies used for research in this area, period of placenta ingestion (postpartum period), and its benefits. Conclusion: The bibliometric indicators found are essential for the development of future research.
Bibliometrics , Placenta , Female , Humans , Pregnancy , Biomedical Research
BACKGROUND: Physical activity and sedentary behavior are treatable traits that may impact asthma control in distinct manners, but this impact remains poorly understood. OBJECTIVE: To evaluate the influence of physical activity and sedentary behavior on clinical control in adults with moderate-to-severe asthma. METHODS: This cross-sectional, multicentric study included 426 individuals with moderate-to-severe asthma. Assessments included physical activity and sedentary time (actigraphy), clinical asthma control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), anthropometric data, and lung function. Participants were grouped according to physical activity levels and sedentary behavior. RESULTS: Participants who walked ≥7500 steps/day presented better ACQ scores than those who walked <7500 steps/day (P < .05), independent of sedentary status. The percentage of patients with controlled asthma was higher in the active/sedentary (43.9%) and active/nonsedentary (43.8%) groups than in the inactive/sedentary (25.4%) and inactive/nonsedentary (23.9%) groups (P < .02). The likelihood of having uncontrolled asthma according to the treatable traits of physical inactivity (odds ratio [95% confidence interval]: 2.36 [1.55-3.59]), higher anxiety (2.26 [1.49-3.42]), and depression symptoms (1.95 [1.28-2.95]) was significant (P ≤ .002). Obesity and sedentary time were not associated with asthma control. CONCLUSIONS: Our results show that ≥7500 steps/day is associated with better asthma control independent of sedentary time in adults with moderate-to-severe asthma. Physical inactivity, anxiety, and depression symptoms are associated with higher odds of uncontrolled asthma. These results suggest that interventions should mainly focus on increasing physical activity rather than reducing sedentary time.
PURPOSE: To evaluate the magnetic resonance imaging (MRI) features that may help distinguish leiomyosarcomas from atypical leiomyomas (those presenting hyperintensity on T2-W images equal or superior to 50% compared to the myometrium). MATERIALS AND METHODS: The authors conducted a retrospective single-centre study that included a total of 57 women diagnosed with smooth muscle tumour of the uterus, who were evaluated with pelvic MRI, between January 2009 and March 2020. All cases had a histologically proven diagnosis (31 Atypical Leiomyomas-ALM; 26 Leiomyosarcomas-LMS). The MRI features evaluated in this study included: age at presentation, dimension, contours, intra-tumoral haemorrhagic areas, T2-WI heterogeneity, T2-WI dark areas, flow voids, cyst areas, necrosis, restriction on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) values, signal intensity and heterogeneity after contrast administration in T1-WI, presence and location of unenhanced areas. The association between the MRI characteristics and the histological subtype was evaluated using Chi-Square and ANOVA tests. RESULTS: The MRI parameters that showed a statistically significance correlation with malignant histology and thus most strongly associated with LMS were found to be: irregular contours (p < 0.001), intra-tumoral haemorrhagic areas (p = 0.028), T2-WI dark areas (p = 0.016), high signal intensity after contrast administration (p = 0.005), necrosis (p = 0.001), central location for unenhanced areas (p = 0.026), and ADC value lower than 0.88 × 10-3 mm2/s (p = 0.002). CONCLUSION: With our work, we demonstrate the presence of seven MRI features that are statistically significant in differentiating between LMS and ALM.
Leiomyoma , Leiomyosarcoma , Smooth Muscle Tumor , Uterine Neoplasms , Female , Humans , Leiomyosarcoma/diagnostic imaging , Leiomyosarcoma/pathology , Smooth Muscle Tumor/diagnostic imaging , Smooth Muscle Tumor/pathology , Uterine Neoplasms/pathology , Retrospective Studies , Portugal , Magnetic Resonance Imaging/methods , Leiomyoma/pathology , Diffusion Magnetic Resonance Imaging , Myometrium/pathology , Diagnosis, Differential , Necrosis
BACKGROUND: Changes in food environments have the potential to affect consumption, nutritional status, and health, and understanding these changes is of utmost importance. This study, therefore, aimed to examine the fluctuation of food stores that sell fruits and vegetables over five years in the health promotion service area of Primary Health Care (PHC) in Belo Horizonte, Minas Gerais, Brazil. METHODS: This was an ecological study that used data from a food environment audit conducted in the realm of Brazilian PHC. Buffers of 1 mile (equivalent to 1600 m) were created around health promotion services to define food environments. All food stores and open-air food markets that sold fruits and vegetables (FV) within this buffer area were considered eligible. The data collection was performed during two periods: the baseline, in 2013, and after five years, in 2018. This study compares the fluctuation by the type of stores and according to the health vulnerability index (HVI). RESULTS: After 5 years, 35.2% of the stores were stable; 154 stores were closed, and 155 were opened. The stability was greater in low-vulnerability areas, and the fluctuation differed by type of store only for areas with high vulnerability. The number of supermarket decreased in high HVI territories; and local stores, showed greater stability when compared to specialized FV markets. CONCLUSIONS: The differences in store fluctuations according to the vulnerability of areas demonstrate the importance of food supply policies considering the local characteristics to reduce inequities of access to healthy foods.
Commerce , Residence Characteristics , Humans , Brazil , Fruit , Vegetables , Food Supply
Objetivo:Analisar as evidências disponíveis na literatura acerca da utilização da fotobiomodulação no tratamento de intercorrências mamárias pós-parto. Método: Revisão integrativa dos manuscritos nas bases de dados National Library of Medicine National Institutes of Health (PubMed), Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE e Scopus. Foram incluídos artigos originais redigidos em português e inglês, analisados de acordo com o nível de evidência e qualidade metodológica. Resultados: A amostra constituiu-se de cinco artigos. Com base na análise dos resultados, foram elaboradas três categorias temáticas: tipos de fotobiomodulador utilizados nas intercorrências mamárias, efeitos do fotobiomodulador na cicatrização das intercorrências mamárias e efeitos do fotobiomodulador na redução da dor mamilar. Tanto o fotobiomodulador de light-emitting diode (LED) quanto o de laser foram eficazes no tratamento dos traumas mamilares, pois a aplicação proporcionou aceleração do processo cicatricial. A terapia com laser de baixa intensidade foi considerada eficaz para tratar lesões mamilares em lactantes com dor, oferecendo alívio e prolongando o aleitamento materno exclusivo. O protocolo de laser de uma única aplicação não foi eficaz na redução da dor em mulheres com mamilos danificados. Conclusão: Este estudo buscou mitigar as lacunas existentes entre assistência e pesquisa em enfermagem, uma vez que contribui para o cuidado pautado na prática baseada em evidências.
Objective:To analyze the evidence available in the literature about the use of photobiomodulation in the treatment of breast complications in the postpartum. Method: Integrative review of manuscripts in National Library of Medicine National Institutes of Health (PubMed), Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and Scopus databases. Original articles written in Portuguese and English were included, analyzed according to the level of evidence and methodological quality. Results: The sample consisted of five articles. Based on the analysis of the results, three thematic categories were created: types of photobiomodulator used in breast complications, effects of photobiomodulators on healing of breast complications, and effects of photobiomodulators on reducing nipple pain. Both light-emitting diode (LED) and laser photobiomodulators were effective in the treatment of nipple trauma, as the application accelerated the healing process. Low-intensity laser therapy was found to be effective in treating nipple injuries in nursing mothers with pain, providing relief and prolonging exclusive breastfeeding. The single application laser protocol was not effective in reducing pain in women with damaged nipples. Conclusion: This study is an effort to mitigate existing gaps between nursing assistance and research, as it contributes to care based on evidence-based practice
Objetivo:Objetivo: analizar la evidencia disponible en la literatura sobre el uso de la fotobiomodulación en el tratamiento de las complicaciones mamarias después del parto. Método: revisión integradora de manuscritos en las bases de datos PubMed, Web of Science, LILACS, CINAHL, EMBASE y Scopus. Se incluyeron artículos originales escritos en portugués e inglés, analizados según nivel de evidencia y calidad metodológica. Resultados: la muestra estuvo compuesta por cinco artículos. Con base en el análisis de los resultados, se crearon tres categorías temáticas: tipos de fotobiomoduladores utilizados en las complicaciones mamarias, efectos de los fotobiomoduladores en la curación de las complicaciones mamarias y efectos de los fotobiomoduladores en la reducción del dolor en los pezones. Tanto el fotobiomodulador LED como el LÁSER resultaron efectivos en el tratamiento del trauma del pezón, ya que su aplicación aceleró el proceso de cicatrización. Se descubrió que la terapia con láser de baja intensidad es eficaz en el tratamiento de lesiones en los pezones en bebés con dolor, proporcionando alivio y prolongando la lactancia materna exclusiva. El protocolo LASER de aplicación única no fue efectivo para reducir el dolor en mujeres con pezones dañados. Conclusión: Este estudio buscó mitigar las brechas existentes entre el cuidado de enfermería y la investigación, ya que contribuye al cuidado basado en la práctica basada en la evidencias.
Breast Feeding , Nursing , Low-Level Light Therapy , Enterostomal Therapy
COVID-19 Related Long-Term Taste Impairment (CRLTTI) is a condition that can be expressed after COVID-19 contagion, lasting for months or even years, affecting the routine and quality of life of individuals. Participants expressing CRLTTI, with a minimum of 2 months, attested by PCR-RT test were assessed for taste and smell, and underwent experimental treatments in 6 distinct groups: Photobiomodulation (PBM) in tongue dorsum and lateral (660 nm, 808 nm, association of 660 and 808 nm), Transmucosal Laser Irradiation of Blood (TLIB)-ventral surface of tongue (660 nm), B complex supplementation, and Sham laser. No intergroup statistical differences were observed at the final evaluation, despite the tendencies of better results with PBM and TLIB observed. PBM, TLIB, and B complex might be treatment options in the management of CRLTTI, despite the lack of total remission of taste and smell perception after 8 sessions (PBM and TLIB) or 30 days of B complex supplementation.
COVID-19 , Low-Level Light Therapy , Humans , COVID-19/radiotherapy , Low-Level Light Therapy/methods , Quality of Life , Taste , Double-Blind Method
OBJECTIVE: To assess longitudinal effects of a nutrition intervention on fruit and vegetable (F&V) intake among Primary Health Care (PHC) service participants in Belo Horizonte, Brazil. METHODS: Demographics and health data on 3414 PHC service participants were collected at baseline in 2013-2014. F&V intake was assessed at baseline, 12, 36, and 48 months until 2017-2018. Services were randomized to control (CG, usual care) or intervention (IG, usual care and a Transtheoretical Model-based intervention to increase F&V intake). We performed difference-in-differences (DiD) analysis to identify intervention effects on F&V intake, and sensitivity analyses of participants observed at all timepoints. RESULTS: Participants were mostly middle-aged, low-income women. Mean baseline intakes were 168.7 g of fruit, 202.0 g of vegetables, and 370.7 g of F&V, with lower fruit in the IG (164.1 g) than the CG (172.3 g). At 12 months, the intervention increased fruit intake in the IG and fruit and F&V intake among individuals with low baseline F&V intake. Fruit intake remained higher at 36 months in the IG. No effect on vegetable intake was identified. According to sensitivity analyses, effects on fruit intake among the complete sample did not remain significant at 36 months, and an effect on fruit intake at 36 months was identified among those with adequate baseline F&V intake. Reductions in F&V intake did not remain significant. CONCLUSIONS: At 12 months, a TTM-based intervention increased fruit intake in the overall sample, and fruit and F&V intake among individuals with low baseline intakes. Repeated interventions may be needed over time. TRIAL REGISTRATION NUMBER: RBR-9h7ckx.
Fruit , Vegetables , Female , Humans , Middle Aged , Brazil , Diet , Feeding Behavior , Follow-Up Studies , Health Promotion , Male
Numerical skills are part of cognitive and formal education development, and low performance in math has been associated with adverse features such as low income and unemployment. The studies of functional magnetic resonance imaging (fMRI) activation in numerical Stroop interference had been accomplished to evidence neural correlates of numerical, automatic, and controlled processes. The aim of this research was to summarize the results of the neural correlates of a number-size congruity task through meta-analysis of fMRI, behavioral evidence, and connectometry. Our study includes 15 fMRI papers (total number of subjects n=155-302, the total number of foci=81-233). Meta-analyses used an activation likelihood estimation (ALE) logarithm. For connectometry, it was used the diffusion tensor image. We found that, for the attentional control numerical Stroop effect, the activated areas were the dorsolateral prefrontal cortex, the anterior cingulate gyrus, and the intraparietal sulcus. Consistent activation over both paradigms was found in five clusters, two in the frontal and three in the parietal lobe. The matrix of connectivity showed connections between insula and inferior parietal right with 587 fibers, cingulate gyrus, and inferior parietal right with 843 fibers. Both paradigms activate parietal areas but differ in the activation of regions correlated to attentional control. The results of these meta-analyses summarized results from fMRI studies that may contribute to current theories. The results of connectometry could be interpreted regarding the fibers connection between the clusters right inferior parietal with insula and cingulate gyrus that suggests the integration of information.
Brain , Gyrus Cinguli , Humans , Brain/diagnostic imaging , Brain/physiology , Stroop Test , Gyrus Cinguli/physiology , Parietal Lobe/physiology , Attention/physiology , Magnetic Resonance Imaging/methods , Brain Mapping/methods
Pulmonary loborraphy can be performed using manual sutures and staples, although other methods, such as tissue adhesives, are also cited in the veterinary literature. Although the surgery is well tolerated in the canine species, failure in pulmonary aerostasis is still a reality since all the methods described so far eventually lead to air leakage after the use of the partial lobectomy technique in the lungs. Within this context, the aim of this research was to compare the effectiveness of different hermetic sealing methods after partial lobectomy of the right caudal lung lobe (RCLL) in dogs. 30 cadavers models were divided in 6 groups: G1-cobbler suture associated with simple continuous; G2-overlapping continuous suture associated with simple continuous suture; G3-Ford interlocking suture; G4-Stapling device; G5-Tissue glue (cyanoacrylate). After performing the sealing techniques, the lungs were submerged in water and inflated with oxygen at positive ventilatory pressures at physiological (up to 14.7 mmHg, which is equivalent to up to 20 cmH2O) and supraphysiological levels (above 14.7 mmHg) to evaluate the performance of the sealing methods. At physiological ventilatory pressure levels, there was no difference between groups. Sealing with surgical glue was superior to interlocking sutures and stapling devices at supraphysiological levels of ventilatory pressure.
The main symptoms of temporomandibular disorders (TMDs) are pain from musculoskeletal and/or joint-in the head and neck region-and complaints of difficulty in mandibular movements. The photobiomodulation therapy (PBMT) has been reported as a promising treatment in the management of these symptoms. The objective of this research was to assess the effect of PBMT immediately after irradiation on TMDs symptoms under a prospective clinical trial, randomized, triple-blinded, placebo-controlled, and with two parallel arms. According to the RDC/TMD, maximum mouth opening (MMO) and pain in the orofacial/cervical muscles and temporomandibular joint (TMJ) were recorded. One hundred forty-five participants (71 placebo and 74 PBMT experimental) were analyzed after irradiation protocols (sham-PBMT or PBMT) at the orofacial/cervical skull musculature and at the TMJ. The results showed a reduction in the total pain score (p = 0.026), a reduction in the number of painful points (p = 0.013), and an increase in the MMO (p = 0.016) in the PBMT protocol group when compared to the placebo protocol (sham-PBMT). The PBMT was shown to be effective in reducing orofacial/cervical skull pain immediately after the irradiation. It is clinically relevant and should be taken into consideration by professionals who are dedicated to treating this pathology because, in addition to bringing comfort to patients who need dental treatment, it also consists of a low-cost and low technical complexity clinical approach.
Ingested-derived DNA (iDNA) from insects represents a powerful tool for assessing vertebrate diversity because insects are easy to sample, have a diverse diet and are widely distributed. Because of these advantages, the use of iDNA for detecting mammals has gained increasing attention. Here we aimed to compare the effectiveness of mosquitoes and flies to detect mammals with a small sampling effort in a semi-controlled area, a zoo that houses native and non-native species. We compared mosquitoes and flies regarding the number of mammal species detected, the amount of mammal sequence reads recovered, and the flight distance range for detecting mammals. We also verified if the combination of two mini-barcodes (12SrRNA and 16SrRNA) would perform better than either mini-barcode alone to inform local mammal biodiversity from iDNA. To capture mosquitoes and flies, we distributed insect traps in eight sampling points during 5 days. We identified 43 Operational Taxonomic Units from 10 orders, from the iDNA of 17 mosquitoes and 46 flies. There was no difference in the number of species recovered per individual insect between mosquitoes and flies, but the number of flies captured was higher, resulting in more mammal species recovered by flies. Eight species were recorded exclusively by mosquitoes and 20 by flies, suggesting that using both samplers would allow a more comprehensive screening of the biodiversity. The maximum distance recorded was 337 m for flies and 289 m for mosquitoes, but the average range distance did not differ between insect groups. Our assay proved to be efficient for mammal detection, considering the high number of species detected with a reduced sampling effort.
The present manuscript is a clinical case report in which antimicrobial photodynamic therapy (aPDT) - using a low-power laser (660 nm) associated with methylene blue photosensitizer (0.01%) - was considered for treating a case of complication after implantation of spiculated polydioxanone (PDO) threads, an aesthetic procedure worldwide performed in facial cosmetic non-surgical procedures. A 72-year-old female patient presented an infection in the face region where the PDO thread was implanted (mandible angle). After divulsion and local drainage, it was decided to associate aPDT using a low-level laser associated with a 0.01% methylene blue photosensitizer. Two sessions of aPDT were performed - on sequential days - and within 48 hours the region was dry and without signs of secretion. The use of aPDT seems to be a promising and effective option in cases of infections after implantation of PDO threads, consisting of a safe technique, of low execution complexity and without adverse effects.
Leontopithecus chrysomelas, the Golden-headed Lion Tamarin (GHLT), is an endangered and endemic Neotropical primate from the Atlantic Forest of Brazil that has suffered a reduction of its habitat and population size in the wild. Ex situ populations have been established as a relevant alternative to safeguard the species and retain its genetic diversity and evolutionary potential. This study evaluated the genetic diversity and structure of the two main Brazilian captive populations of GHLT, which have been under human care at the Primatology Center of Rio de Janeiro (CPRJ) and the Zoological Park Foundation of São Paulo (FPZSP). Our results revealed levels of genetic diversity overall comparable to those observed for other Leontopithecus species and for ex situ and in situ populations of GHLT previously studied. Bayesian and principal coordinate analyses showed a moderate differentiation between CPRJ and FPZSP populations. Both populations presented observed heterozygosity values higher than expected heterozygosity values for most of the microsatellites used in this study, suggesting that the management has been efficient in avoiding an increase in homozygosity. However, simulations point to a significant loss of genetic diversity in the next 100 years, mainly in the FPZSP population. Such data are relevant for further decision-making on the metapopulation management of L. chrysomelas in captive conditions and for integrating in situ and ex situ conservation plans.
Leontopithecus , Animals , Humans , Leontopithecus/genetics , Bayes Theorem , Brazil/epidemiology , Genetic Variation , Endangered Species
To evaluate the effectiveness of a collective intervention to encourage the consumption of fruits and vegetables on the nutrients intake for the prevention of chronic non-communicable diseases (NCDs), a randomized controlled community trial was conducted with a representative sample from the Health Academy Program. While the individuals in the control group (CG) participated in regular physical exercise, those in the intervention group (IG) also participated in a collective intervention. After 12 months, IG and CG showed a reduction in energy, omega 3 and sodium intake and an increase in the consumption of carbohydrates, fiber, vitamins, and minerals. Individuals from the CG showed an increase in phosphorus consumption and, in the IG, a reduction in the consumption of total, saturated, and polyunsaturated fats as well as an increase in the consumption of monounsaturated fats was seen. In both groups, there was an increase in the prevalence of adequate nutrients. Participation in the nutritional intervention was associated with lower consumption of energy and protein in the diet. The results pointed to the importance of individuals' participation in the program, which, associated with nutritional intervention, promoted an improvement in the nutrient profile of the diet and the prevention and control of NCDs.
Fruit , Vegetables , Humans , Dietary Fats , Diet , Nutrients , Health Promotion , Chronic Disease
INTRODUCTION: The COVID-19 infection triggered in some patients a prolonged reduction in the perception of both gustatory and olfactory senses (ageusia and anosmia). These symptoms could be manifested during the first days after the contagion, acting as predictors of COVID-19 infection, and additionally, they could be the only symptoms manifested at all. Clinical resolution of anosmia and ageusia was expected to occur within a few weeks, yet in some cases, patients began to demonstrate COVID-19-related long-term taste impairment (CRLTTI), a condition that can persist for longer than two months, contradicting initial evidence. Objectives: The authors' aimed to describe the characteristics of the sample of 31 participants with COVID-19-related long-term taste impairment, and their capacity to quantify taste and rate their smell perception. Material and Methods: Participants were submitted to a taste evaluation of four hyper-concentrated tastes perceived by the tongue (0-10), self-reported their smell (0-10), and answered a semi-structured questionnaire. Results: Different tastes seemed to be affected differently by COVID-19, despite the lack of statistical relevance observed in this study. Dysgeusia was only expressed in bitter, sweet, and acidic tastes. The mean age observed was 40.2 (SD 12.06) years, with women representing 71% of the sample. Taste impairment persisted for an average period of 10.8 months (SD 5.7). Self-reported smell impairment was reported by the majority of participants with taste impairment. Non-vaccinated people represented 80.6% of the sample. Conclusions: COVID-19 infection could trigger taste and smell disturbances that lasted as long as 24 months. CRLTTI seems not to affect the four main taste perceptions (hyper-concentrated) equally. Women represented the majority of the sample, with an average age of 40 years (SD 12.06). Previous diseases, medication use, and behavioral aspects seem not to be linked to CRLTTI development.
Objective: to analyze how prenatal care to pregnant women diagnosed with syphilis is provided by nurses working in primary health care, in a health region of the interior of the State of São Paulo. Method: non-experimental, cross-sectional, descriptive correlational research with a quantitative approach. Results: it was possible to observe that 29.6% of nurses reported not performing subsequent prenatal consultations, and also an important association where most nurses who performed the subsequent consultations based their care on municipal protocol (P=0.000). Among the results, 30.4% of nurses did not prescribe benzylpenicillin benzathine for pregnant women who were reagent to syphilis, and 22.7% did not administer it without the presence of a physician in the unit. Another result that deserves attention is the prescription of a single treatment protocol for pregnant women regardless of the stage of syphilis. Conclusion: There are gaps between the protocols for the care of pregnant women diagnosed with syphilis and the care provided by nurses in primary health care. It is expected that the actions evidenced in this study will promote improvements in the practice of nurses and that they will contribute to reaching the goal recommended by the World Health Organization for congenital syphilis in Brazil.
Objetivo: analisar como ocorre a assistência pré-natal às gestantes com diagnóstico de sífilis pelos enfermeiros que atuam na atenção primária à saúde, em uma regional de saúde do interior do Estado de São Paulo. Método: pesquisa de delineamento não experimental, transversal, do tipo correlacional descritiva e de abordagem quantitativa. Resultados: foi possível observar que 29,6% dos enfermeiros referiram não realizar consultas subsequentes de pré-natal, e ainda uma associação importante onde a maioria dos enfermeiros que realizaram as consultas subsequentes baseava sua assistência em protocolo municipal (P=0,000). Destaca-se entre os resultados que 30,4% dos enfermeiros não cumpriram a prescrição de benzilpenicilina benzatina para as gestantes reagentes à sífilis e 22,7% não administraram a mesma sem a presença do médico na unidade. Outro resultado que merece atenção, é a prescrição de protocolo único de tratamento para gestantes independentemente do estágio da sífilis. Conclusão: Há lacunas entre os protocolos para a assistência às gestantes com diagnóstico de sífilis e a assistência prestada pelos enfermeiros da atenção primária à saúde. Espera-se que as ações evidenciadas neste estudo promovam melhorias para a prática dos enfermeiros e que contribua para atingir no Brasil a meta preconizada pela Organização Mundial de Saúde para a sífilis congênita.
Intensive Care Units (ICU) usually provide an excellent environment for the selection of pathogens associated with hospital-acquired infections (HAI), leading to increased mortality and hospitalization costs. Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is a major cause of HAI in dogs worldwide, but the risk factors and dynamics of colonization by MRSP are largely unknown. This study aimed to evaluate the risk factors associated with the acquisition of MRSP in dogs admitted to an ICU, and to report the antimicrobial resistance profiles and genetic relatedness of MRSP isolates. Sterile swabs from the nostril, axilla, and rectum were collected daily during the hospitalization of 54 dogs. Samples were subjected to Mannitol Salt Agar, and colonies were identified by MALDI-ToF, polymerase chain reaction (PCR), and sequencing of the rpoB gene. Antimicrobial susceptibility testing and PCR detection of mecA were performed. Staphylococcus spp. was isolated from 94% of the dogs, and the most frequently isolated species was S. pseudintermedius (88.2%). Carriage of multidrug resistant (MDR) staphylococci was observed in 64.4% of the dogs, and approximately 39% had methicillin-resistant Staphylococcus sp. (MRS), of which 21.6% had MRSP and 1.9% had methicillin-resistant S. aureus (MRSA). The acquisition of MRSP during ICU hospitalization was associated with sex (female), age (>7 years), and dogs that had previously been treated with antimicrobials. Animals colonized by MRSP resistant to ≥9 antimicrobial classes had longer hospital stays than those colonized by other MRS strains. Among the 13 MRSP isolates that were subjected to whole-genome sequencing, ten were classified as ST71. A single nucleotide polymorphism (SNP) analysis revealed three clones, including one that was detected in infected dogs outside the ICU. This study indicates novel risk factors associated with colonization by MRSP. The detection of the same MRSP clone causing HAI outside the ICU reinforces the need for improved infection prevention and control practices at veterinary hospitals in general and at the ICU in particular.
Urethrocystography remains the gold-standard technique for urethral pathology diagnosis. Nowadays, of the various indications for performing urethrocystography, the most common is due to a clinical suspicion of urethral stricture. Due to the high prevalence of strictures and their substantial impact on a patient's quality of life, the examination must allow the location, exclusion of multifocality, and assessment of the extent of the stricture to influence surgical planning. This article intends to demonstrate that the radiologist's role, by performing and interpreting the modality of urethrocystography, influences and is crucial for the urologic therapeutic decision and that the patients who were submitted to reconstruction by urethroplasty had a better success rate. The authors aim to review the radiological anatomy of the male urethra, discuss the modalities of choice for imaging the urethra (retrograde urethrography and voiding cystourethrography), provide an overview of the different indications for performing the study, examine the different etiologies for urethral strictures, understand the relevance of the different appearances of urethral pathology, and identify the surgical options, especially in the treatment of urethral strictures. Simultaneously, the study exposes cases of urethral trauma, fistulas, diverticulum, and congenital abnormalities.
Urethral Stricture , Humans , Male , Urethral Stricture/diagnostic imaging , Urethral Stricture/surgery , Quality of Life , Urethra/diagnostic imaging , Urethra/surgery , Urethra/pathology , Constriction, Pathologic/pathology , Diagnostic Imaging
