Structural variation underlies functional diversity at methyl salicylate loci in tomato.

Methyl salicylate is an important inter- and intra-plant signaling molecule, but is deemed undesirable by humans when it accumulates to high levels in ripe fruits. Balancing the tradeoff between consumer satisfaction and overall plant health is challenging as the mechanisms regulating volatile levels have not yet been fully elucidated. In this study, we investigated the accumulation of methyl salicylate in ripe fruits of tomatoes that belong to the red-fruited clade. We determine the genetic diversity and the interaction of four known loci controlling methyl salicylate levels in ripe fruits. In addition to Non-Smoky Glucosyl Transferase 1 (NSGT1), we uncovered extensive genome structural variation (SV) at the Methylesterase (MES) locus. This locus contains four tandemly duplicated Methylesterase genes and genome sequence investigations at the locus identified nine distinct haplotypes. Based on gene expression and results from biparental crosses, functional and non-functional haplotypes for MES were identified. The combination of the non-functional MES haplotype 2 and the non-functional NSGT1 haplotype IV or V in a GWAS panel showed high methyl salicylate levels in ripe fruits, particularly in accessions from Ecuador, demonstrating a strong interaction between these two loci and suggesting an ecological advantage. The genetic variation at the other two known loci, Salicylic Acid Methyl Transferase 1 (SAMT1) and tomato UDP Glycosyl Transferase 5 (SlUGT5), did not explain volatile variation in the red-fruited tomato germplasm, suggesting a minor role in methyl salicylate production in red-fruited tomato. Lastly, we found that most heirloom and modern tomato accessions carried a functional MES and a non-functional NSGT1 haplotype, ensuring acceptable levels of methyl salicylate in fruits. Yet, future selection of the functional NSGT1 allele could potentially improve flavor in the modern germplasm.

Competências do enfermeiro especialista em dermatologia: revisão de escopo / Skills of specialist nurses in dermatology: a scoping review

OBJETIVO: Mapear as competências do enfermeiro especialista em Dermatologia. MÉTODO: Trata-se de uma scoping review, desenvolvida conforme as recomendações do Joanna Briggs Institute (JBI). Para elaboração da questão de pesquisa utilizou-se a estratégia Population, Concept e Context. A busca por publicações, sem limitar idioma e recorte temporal, foi realizada nas fontes: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), National Library of Medicine (MEDLINE) via PubMed, Scopus, Embase e Cochrane Library, além de sites das associações de especialistas e no Google Acadêmico. RESULTADOS: Foram selecionadas 17 publicações, originando as categorias: avaliação integral do paciente dermatológico, prescrição de medicamentos, detecção precoce e prevenção do câncer de pele, tratamento de feridas e estética. CONCLUSÃO: Diante da vasta possibilidade de atuação do enfermeiro nesta área, constata-se a necessidade de ampliação da discussão e de pesquisas sobre o tema.

OBJECTIVE: To map the competencies of specialist nurses in Dermatology. METHOD: A scoping review was conducted according to the recommendations of the Joanna Briggs Institute (JBI). The Population, Concept, and Context framework established the research question. The search for publications was carried out in different sources, including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (MEDLINE) via PubMed, Scopus, Embase, and the Cochrane Library. Additionally, expert association websites and Google Scholar were searched. No language or time restrictions were applied. RESULTS: Seventeen publications were selected, originating the categories: integral evaluation of the dermatological patient, drug prescription, early detection and prevention of skin cancer, wound care, and aesthetics. CONCLUSION: Faced with the vast possibilities for nurses to work in Dermatology, there is a need to expand the discussion and research on the subject.

Prevalência, conhecimento e fatores associados à incontinência urinária em mulheres estudantes de um curso de Fisioterapia / Prevalencia, conocimientos y factores asociados a la incontinencia urinaria en mujeres estudiantes de Fisioterapia / Prevalence, knowledge, and factors associated with urinary incontinence in female students of a physical therapy undergraduate course

RESUMO O objetivo deste estudo foi avaliar a prevalência, o conhecimento e os fatores associados à incontinência urinária (IU) em mulheres estudantes de um curso de fisioterapia, bem como sua qualidade de vida. Foi aplicada uma ficha de avaliação, o International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) e um questionário de conhecimento sobre a musculatura do assoalho pélvico (MAP) e a ocorrência de IU, baseado em estudo tipo conhecimento, atitude e prática (CAP). Das 248 estudantes do curso, 170 (69%) participaram do estudo. Pela ficha de avaliação, 111 (65%) relataram perda urinária. De acordo com o ICIQ-SF, 63 participantes (37%) são incontinentes, sendo que 41 (65%) dessas apresentam IU de esforço, apresentando pequena perda e com frequência de uma vez na semana ou menos, com baixo impacto na sua qualidade de vida. A maioria das participantes que relataram ter dor na relação sexual (59%) e alguns sintomas uroginecológicos e intestinais, como esforço ao urinar (92%), jato interrompido (75%), incômodo na região vaginal (73%), constipação (53%), esforço ao defecar (53%) e esvaziamento intestinal incompleto (70%), apresentou queixa de IU. Todas as que usam protetor (100%) e procuraram atendimento médico (100%) eram incontinentes. O uso de anticoncepcional foi maior em mulheres sem perda urinária (84%). O conhecimento sobre a MAP e a IU foi adquirido gradualmente com o avançar do curso. Esse resultado sugere que as mulheres que não cursam Fisioterapia não têm domínio do assunto, sendo necessário disseminar o conhecimento sobre a IU e a atuação da fisioterapia.

RESUMEN El objetivo de este estudio fue evaluar la prevalencia, el conocimiento y los factores asociados a la incontinencia urinaria (IU) en mujeres estudiantes de Fisioterapia, así como su calidad de vida. Se aplicó un formulario de evaluación, el International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) y un cuestionario de conocimiento sobre la musculatura del suelo pélvico (MSP) y la ocurrencia de IU, basado en un estudio de conocimiento, actitud y práctica (CAP). De las 248 estudiantes del curso, 170 (69%) participaron en el estudio. Según el formulario de evaluación, 111 (65%) reportaron pérdida urinaria. Conforme el ICIQ-SF, 63 participantes (37%) son incontinentes, y 41 (65%) de ellas tienen IU de esfuerzo, presentando una pequeña pérdida y con frecuencia de una vez a la semana o menos, con bajo impacto en su calidad de vida. La mayoría de las participantes que informaron sentir dolor en las relaciones sexuales (59%) y algunos síntomas uroginecológicos e intestinales, como esfuerzo al orinar (92%), chorro interrumpido (75%), molestias en la región vaginal (73%), estreñimiento (53%), esfuerzo al defecar (53%) y vaciamiento intestinal incompleto (70%), se quejó de IU. Las participantes que usan protectores (100%) y buscan atención médica (100%) eran incontinentes. El uso de anticonceptivos fue mayor en las mujeres sin pérdida urinaria (84%). El conocimiento sobre la MSP e IU se adquirió de manera gradual a medida que avanzaba el curso. Este resultado apunta que las mujeres que no estudian Fisioterapia no tienen dominio del tema y es necesario difundir conocimientos sobre la IU y la actuación de la fisioterapia.

ABSTRACT This study aimed to evaluate the prevalence, knowledge, factors associated with urinary incontinence (UI), and quality of life in female students enrolled in a physical therapy undergraduate course. Students had to answer a form we developed, the International Questionnaire on Incontinence Consultation - Short Form (ICIQ-SF), and a knowledge questionnaire on pelvic floor musculature (PFM) and the occurrence of UI, based on a previous knowledge, attitude, and practice (KAP) study. Out of 248 students, 170 (69%) participated in our study. According to our evaluation form, 111 women (65%) reported urinary loss at some point in their lives. According to ICIQ-SF criteria, 63 (37%) women were incontinent, 41 (65%) suffered from strain urinary incontinence, showing small urinary losses once per week or less, which slightly impacted their quality of life. Most women who have pain during sexual intercourse (59%) and some urogynecological and intestinal symptom, such as straining (92%), intermittent urination (75%), nausea (73%), constipation (53%), excessive effort (53%), and incomplete outlet (70%) also suffered from UI. All women who used pads (100%) and sought medical care (100%) were incontinent. The use of contraceptive was higher among women without UI (84%). Participants built their knowledge on PFM and UI as the course progressed. These results suggest that women who attend undergraduate courses outside physical therapy have limited knowledge about the subject. We find it necessary to spread knowledge about UI and the importance of physical therapy to prevent and treat UI.

Percepções de pacientes com doença renal crônica sobre tratamento de hemodiálise e assistência de enfermagem / Percepciones de pacientes renal es crónic os sobre el tratamiento de hemodiálisis y los cuidados de enfermería / Perceptions of chronic renal patients about hemodialysis treatment and nursing care

Objetivo: descrever percepções do paciente com doença renal crônica sobre tratamento de hemodiálise e assistência de enfermagem. Método: pesquisa qualitativa realizada com 20 pacientes, com 18 anos ou mais de idade, diagnóstico confirmado de doença renal crônica e tratamento regular de hemodiálise, através de entrevistas semiestruturadas, no período 17 a 20 de maio de 2021. Os dados foram tratados por análise de conteúdo. Resultados: houve déficit de conhecimento dos participantes acerca da doença e do tratamento de hemodiálise e das dificuldades vivenciadas como influenciadoras no enfrentamento da doença. Consideram a assistência de enfermagem de boa qualidade, porém não usufruem de uma boa educação em saúde por parte da equipe. Conclusões: a educação em saúde não foi realizada sistematicamente durante a assistência de enfermagem. Essa carência pode acarretar dificuldades no tratamento de hemodiálise e afetar a percepção do indivíduo sobre seu processo de saúde e doença e qualidade de vida. (AU)

Objective: to describe the perceptions of patients with chronic kidney disease about hemodialysis treatment and nursing care . Method: qualitative research conducted with 20 patients , aged 18 years or older, confirmed diagnosis of chronic kidney disease and regular hemodialysis treatment, through semi - structured interviews , from May 17 to 20, 2021. D ata were processed by analysis of content . Results: there was a lack of knowle dge of the participants about the disease and hemodialysis treatment and the difficulties experienced as influencers in coping with the disease. They consider the nursing care to be of decent quality, but they do not enjoy good health education from the te am. Conclusions: health education was not performed systematically during nursing care. This lack can lead to difficulties in hemodialysis treatment and affect the individual's belief of their health and disease process and quality of life.(AU)

Objetivo: describir percepciones de pacientes con enfermedad renal crónica sobre tratamiento de hemodiálisis y cuidados de enfermería . Método: inv estigación cualitativa realizada con 20 pacientes, con edad igual o superior a 18 años, diagnóstico confirmado de enfermedad renal crónica y tratamiento regular de hemodiálisis, a través de entrevista semiestructurada, del 17 al 20 de mayo de 2021. El anál isis fue de contenido . Resultados: h ubo desconocimiento de los participantes sobre la enfermedad y el tratamiento de hemodiálisis y las dificultades experimentadas como influenciadores en el enfrentamiento de la enfermedad. Consideran que los cuidados de e nfermería son de calidad aceptable, pero no disfrutan de una buena educación en salud por parte del equipo . Conclusiones: no se realizó educación en salud sistemáticamente durante la atención de enfermería. Esa carencia puede generar dificultades en el tra tamiento de hemodiálisis y afectar la percepción del individuo sobre su proceso de salud y enfermedad y calidad de vida.(AU)

Relationship between Obesity and Coronary Artery Disease Defined by Coronary Computed Tomography Angiography

Abstract Background: Although associated with traditional cardiovascular risk factors, it is unclear whether obesity alone is associated with coronary artery disease (CAD). Objective: To investigate the role of obesity as a risk factor for CAD, defined by coronary computed tomography angiography (CCTA). Methods: This study retrospectively included 1,814 patients referred for CCTA in a hospital in São Paulo, from August 2010 to July 2012. CAD was identified by coronary calcium score and presence of coronary stenosis > 50%. Images were analyzed by two specialists, and the coronary findings were compared between obese and non-obese groups. A multivariate analysis model was used to assess obesity as an independent variable for the occurrence of obstructive CAD. Results: Among the study population, mean age was 58.5 +/- 11.5 years, 22.8% were obese (BMI = 30 kg/m2) and 66.3% were male. The prevalence of obstructive CAD was 18.4% in both groups. Obese patients had higher median calcium score compared to non-obese subjects (14.7 vs. 1.4, respectively, p = 0.019). In the multivariate analysis, obesity was not an independent factor for obstructive CAD (coefficient = -0.035, p = 0.102). Conclusion: Although no differences were observed in the prevalence of obstructive CAD between obese and non-obese individuals, coronary calcium scores were significantly in lower the latter group.

Challenges in the Regulation of High-Cost Treatments: An Overview From Brazil.

Regulation of drug prices that ensures adequate access to effective treatments and promotes innovation is a global challenge. In the United States, the government does not regulate drug prices when they come onto market. On the other hand, in countries such as France and Brazil, government agencies are responsible for setting up price limits by leveraging the interests of the companies and the countries' population. In Brazil, safety and efficacy of drugs are regulated by the Brazilian Health Regulatory Agency, and drug prices are regulated by the Pharmaceutical Market Regulation Chamber with a participation of Brazilian Health Regulatory Agency. Here, we introduce the current challenges faced by the Brazilian government in the drug price regulation and present proposed initiatives aiming to streamline access to innovative treatments for its citizens.

Comparação das medidas extraorais com as medidas intraorais na confecção da prótese total / Comparison of the extra-oral measurements with the intra-oral measurements in the manufacture of the total prosthesis

Introdução: o edentulismo é um problema bastante comum, e o conhecimento adequado da anatomia e da fisiologia da cavidade oral é essencial na recuperação e no equilíbrio neuromuscular do sistema estomatognático. O uso das linhas de referência juntamente com o plano oclusal orientam o posicionamento dos dentes artificias, que são utilizados para construção das próteses totais. Objetivo: comparar as medidas extraorais com as intraorais da largura dos dentes anteriores com as medidas das linhas de referências preconizadas na literatura para confecção de uma prótese total. Métodos: estudo do tipo observacional transversal, com amostra não probabilística, com 50 indivíduos de ambos os gêneros, no quais se realizou uma análise dentária e facial com auxílio de fotografias e um paquímetro digital. Resultados: foi observado que, na maioria dos indivíduos, não houve coincidência entre a largura dos dentes e as linhas de referência analisadas, que as mulheres apresentaram menor coincidência entre os dentes e a largura da asa do nariz, quando comparadas com os homens (8,3% e 91,7%, respectivamente), com p = 0,001. Conclusão: as linhas de referência não foram coincidentes com o tamanho dos dentes na maioria dos casos avaliados. (AU)

Introduction: edentulism is a fairly common problem, and adequate knowledge of the anatomy and physiology of the oral cavity is essential in the recovery and neuromuscular balance of the stomatognathic system. The use of reference lines together with the occlusal plane guide the positioning of the artificial teeth, which are used to construct the total dentures. Objective: to compare the extra-oral and intra-oral measurements of the width of the anterior teeth with the measurements of the reference lines recommended in the literature for making a total prosthesis. Methods: cross-sectional observational study with a non-probabilistic sample, with 50 individuals of both sexes, where a dental and facial analysis was carried out using photographs and a digital caliper. Results: it was observed that most of the individuals analyzed did not coincide between the width of the teeth and the reference lines, and that the analyzed women showed less coincidence between teeth and the width of the nose wing when compared with men (8.3% and 91.7%, respectively), with p = 0.001. Conclusion: the reference lines did not coincide with tooth size in most cases analysed. (AU)

Práticas de enfermagem ao paciente com dor crônica: revisão integrativa / Prácticas de enfermería para pacientes con dolor crónico: revisión integrativa / Nursing practices in patients with chronic pain: an integrative review

Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através intervenções qualificadas e resolutivas, visando adaptação e ou melhora da sua condição de saúde. Conclusão Os estudos indicam benefícios gerados pelas práticas sistematizadas implementadas por enfermeiros, por meio de instrumentos e ferramentas para detecção, intervenção e avaliação, além de apoio clínico.

Resumen Objetivo Conocer en la literatura la producción científica sobre prácticas de enfermería para pacientes con dolor crónico realizada en las clínicas de dolor. Métodos Revisión integrativa de literatura, utilizando el portal SCIELO, y las bases CINAHL y PubMed Central, con recorte temporal de 2008 a 2018 y período de recolección de datos de junio a julio de 2018. Como descriptores de salud (DeCs): Pacientes, Dolor Crónico, Atención de Enfermería, Clínicas de Dolor; y, en Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Se evidenció que la producción analizada se refiere principalmente a prácticas de enfermería no farmacológica a pacientes con dolor crónico, con publicaciones reducidas en Brasil, que tienden a concentrarse en los últimos cinco años. Los pacientes con este tipo de problemas experimentan condiciones multifactoriales que influyen directamente en su estado de salud y necesitan un seguimiento completo por equipo interprofesional, incluyendo la red de atención, mediante intervenciones calificadas y resolutivas, con el objetivo de adaptar y/o mejorar su estado de salud. Conclusión Los estudios indican beneficios generados por las prácticas sistematizadas implementadas por enfermeros, a través de instrumentos y herramientas de detección, intervención y evaluación, además del apoyo clínico. El propósito es mejorar la calidad de vida, la adhesión al tratamiento, manejo del autocuidado y minimización del sufrimiento en pacientes con dolor crónico.

Abstract Objective To know the benefits of nursing practices to patients with pain followed-up in the pain clinic. Methods Integrative literature review, using the electronic portal SCIELO, CINAHL and PubMed Central databases, with time cut from 2008 to 2018 and data collection period between June and July 2018. The Health Science Descriptors (DeCs) and Medical Subject Heading (MeSH) were: Patients, Chronic pain, Nurse Care, Pain clinic. Results It was evidenced that the production analyzed is mostly on non-pharmacological nursing practices for patients with chronic pain, with reduced publications in Brazil and tended to focus on the last five years. The patient with this type of injury experiences multifactorial conditions that directly influence the health condition, and requires integral follow-up by interprofessional team, including the care network, through qualified and resolutive interventions, aiming at adaptation and/or improvement of their health condition. Conclusion The studies indicate benefits generated by systematized practices implemented by nurses, through instruments and tools for detection, intervention and evaluation, as well as clinical support.

Análise de relatos de caso de reabilitação implantossuportada em pacientes irradiados / Analysis of case reports for implant-supported rehabilitation in irradiated patients

Objetivo: fazer uma avaliação crítica dos relatos de casos de pacientes oncológicos e irradiados que receberam implantes. Material e métodos: uma revisão da literatura foi realizada, sendo selecionados 11 artigos disponíveis on-line nos sites Bireme e PubMed, nos idiomas inglês, espanhol e português, por um único pesquisador, por meio dos títulos e resumos. Resultados: as causas dos insucessos foram apontadas em cada descrição. Conclusão: não há consenso na literatura sobre a indicação de próteses implantossuportadas e qual seria o melhor período para a instalação do implante pós-radioterapia de cabeça e pescoço. (AU)

Objectives: to make a critical evaluation of the case reports regarding oncological and irradiated patients who received dental implants. Material and methods: a review of the literature was carried out by selecting 11 articles available online at the Bireme and PubMed sites, in English, Spanish and Portuguese languages, by a single researcher through their titles and abstracts. Results: the causes of the failures were described in each report. Conclusion: There is no consensus in the literature on the indication of implants and what the best period for the installation of the implant after radiotherapy of the head and neck. (AU)

Association between Insulin Resistance and Cardiovascular Risk Factors in Polycystic Ovary Syndrome Patients.

OBJECTIVE: To analyze the association between the indirect methods of evaluating insulin resistance (IR) and blood pressure, anthropometric and biochemical parameters in a population of polycystic ovary syndrome (PCOS) patients. METHODS: Cross-sectional study performed at the Hospital Universitário de Brasília (HUB, in the Portuguese acronym) involving PCOS patients diagnosed from January 2011 to January 2013. Four indirect methods, namely, fasting blood insulin level, fasting glucose/insulin ratio (G/I), homeostatic model-assessment-insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI), were used to obtain the IR diagnosis. The data were analyzed using the test of proportions, the Chi-square test, and Fisher exact test, when indicated. RESULTS: Out of the 83 patients assessed, aged 28.79 ± 5.85, IR was found in 51.81-66.2% of them using the G/I ratio and the QUICKI, respectively. The test of proportions did not show a significant difference between the methods analyzed. The proportion of IR diagnoses was statistically higher in obese women than in women with normal body mass index (BMI). We observed a statistically significant association between all the methods for diagnosing IR and BMI, waist circumference (WC) and lipid accumulation product (LAP). With regards to arterial hypertension (AH), we observed a significant association according to three methods, with the exception of the ratio G/I. CONCLUSION: Insulin resistance prevalence varied according to the diagnostic method employed, with no statistical difference between them. The proportion of IR diagnoses was statistically higher in obese women than in women with normal BMI. We observed a significant association between IR and WC, BMI, LAP, as well as dyslipidemia and AH in a high proportion of patients.

OBJETIVO: Analisar a associação entre os métodos indiretos de avaliação de resistência à insulina (RI) e parâmetros pressóricos, antropométricos e bioquímicos em uma população de pacientes com síndrome dos ovários policísticos (SOP). MéTODOS: Estudo transversal realizado no Hospital Universitário de Brasília (HUB), envolvendo pacientes que apresentaram o diagnóstico de SOP no período de janeiro de 2011 a janeiro de 2013. O diagnóstico de RI foi obtido por meio de quatro métodos indiretos: insulinemia de jejum, relação glicemia de jejum/insulinemia de jejum (G/I), avaliação da resistência à insulina através do modelo homeostático (HOMA-IR) e índice quantitativo de sensibilidade à insulina (QUICKI). Os dados foram analisados utilizando o teste de proporções, o teste do Qui-quadrado e o teste exato de Fisher, quando indicado. RESULTADOS: Foram avaliadas 83 pacientes com idade média de 28,79 ± 5,85 anos. A RI foi diagnosticada em 51,81­66,27% dos casos pela relação G/I e QUICKI, respectivamente, e o teste de proporções não evidenciou diferença significativa entre os métodos analisados. A proporção de diagnósticos de RI foi estatisticamente maior em mulheres obesas em comparação à proporção de mulheres com índice de massa corporal (IMC) normal. Foi observada uma associação estatisticamente significativa entre todos os métodos diagnósticos de RI e IMC, circunferência da cintura (CC) e produto de acumulação lipídica (LAP). Quanto à hipertensão arterial (HA), foi observada associação significativa de acordo com três métodos, com exceção da relação G/I. CONCLUSãO: A prevalência de RI variou conforme o método diagnóstico utilizado, mas não houve diferença estatística entre eles. A proporção de diagnósticos de IR foi maior nas mulheres obesas do que naquelas com peso normal. Foi observada associação significativa entre RI e CC, IMC e LAP, assim como com dislipidemia e HA em uma proporção elevada de pacientes.

Um olhar sobre a saúde das mulheres cuidadoras de idosos: desafios e possibilidades / A look at the health of women caregivers of elderly people: challenges and opportunities / Una mirada a la salud de las mujeres cuidadoras de ancianos: desafíos y oportunidades

O objetivo deste estudo é avaliar como as mulheres cuidadoras realizam o seu autocuidado durante o período em que estão dispensando atenção ao idoso dependente. Trata-se de uma pesquisa descritiva, de abordagem qualitativa, desenvolvida com nove mulheres cuidadoras, formais ou informais, de idosos. O estudo permite afirmar a necessidade de serviços e programas sociais destinados às mulheres cuidadoras de idosos, apoiando-as no exercício desta função, visto que as evidências mostram necessidades de atenção e estímulo para o seu autocuidado.

The goal of this study is to evaluate how women caregivers realize their self-care during the period they are offering attention to the dependent elderly. This is a descriptive, qualitative approach, developed with nine women caregivers of elderly people, either formal or informal. The study can sustain the need for social services and programs for women caregivers of elderly people, supporting them in the occupation of caring for the elderly, as the evidence shows that they need attention and encouragement for their self-care.

El objetivo de este estudio es evaluar como las cuidadoras realizan su autocuidado durante el período en que están dedicando atención a las personas mayores dependientes. Se trata de un estudio descriptivo, cualitativo, desarrollado con nueve mujeres cuidadoras formales o informales de personas mayores. El estudio permite afirmar la necesidad de servicios y programas sociales para las mujeres cuidadoras de las personas mayores, apoyándolas en la actividad de cuidar de ancianos, visto que las evidencias muestran que estas necesitan atención y estímulo para el autocuidado.

Conservative treatment and follow-up of vaginal Gartner's duct cysts: a case series.

BACKGROUND: In women, during embryologic development, the paired Müllerian (paramesonephric) ducts fuse distally and develop into the uterus, cervix, and upper vagina. If the Wolffian ducts persist in vestigial form, they can lead to Gartner's cysts, mainly located in the right wall of the vagina. This is one of the few studies of Gartner's cysts with a series of consecutive cases over a long period of time who were exclusively subject to clinical observation. Although Gartner's cysts are found in approximately 0.1 to 0.2% of women, controversy exists regarding the course of action to be taken. CASE PRESENTATION: We describe the cases of four women who were 38-years old, 53-years old, 37-years old, and 49-years old at their first appointment and who were of mixed ethnicity, mixed ethnicity, black, and mixed ethnicity respectively. The follow-up of these patients ranged from 2 to 17 years. In these four cases the location of the cysts was the right wall of the vagina. Transvaginal ultrasound was the test of choice for diagnostic confirmation. In the cases presented in this study, the women were asymptomatic and chose to be observed clinically. CONCLUSIONS: This is the first study reporting long-term clinical observation of these lesions. This study shows that conservative treatment can be a safe option for asymptomatic patients with vaginal Gartner's duct cysts.

TEMPORAL DEPENDENCE OF THE RADIATION MONITORING INSTRUMENTS FOR AREA MONITORING USED AT RADIODIAGNOSTIC AND INTERVENTION FACILITIES.

Area monitoring is a fundamental test at radiodiagnostic facilities to maintain an acceptable level of radiation exposure for employees and members of the public. Experimental measurements were taken in an ionising radiation calibration laboratory. Four area monitor instruments were used. Dose and dose rate measurements were measured in integrated and rate operating modes. The results show that precautions are necessary where the area monitor uses exposure times of ≤2 s. When taking measurements in rate mode for times ≤2 s, the area monitors evaluated show a tendency to underestimate dose rate, the inaccuracy was 41 %, and varied between 34 and 45 % for different energies. It is highly recommendable to work in integrated mode, inaccuracy varied from 2 to 35 %. For measurements taken with exposure times of ≥3 s, the average inaccuracy was 15 % and the range was between 2 and 41 %.

Glycosylated hemoglobin is associated with decreased endothelial function, high inflammatory response, and adverse clinical outcome in non-diabetic STEMI patients.

OBJECTIVE: Chronic dysglycemia was recently identified as a predictor for adverse outcomes in patients with ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention. Data for non-diabetic patients who underwent thrombolysis is scarce. In this context, we aimed to study the effect of HbA1c on cardiovascular outcome after STEMI. METHODS: A prospective cohort of 326 non-diabetic STEMI individuals was used for the analyses. We measured plasma glucose, hemoglobin A1c [HbA1c], lipid profile, C-reactive protein (CRP), and nitrate/nitrite (NOx) upon admission and five days after STEMI (D5). Flow-mediated dilation (FMD) was performed 30 days after STEMI. During clinical follow-up, we assessed patients for incident diabetes (progression to HbA1c ≥ 6.5%) and major adverse cardiac events (MACE), defined as a composite of fatal and non-fatal MI, sudden cardiac death, and angina requiring hospitalization. RESULTS: Using ROC-curve analysis, a 5.8% HbA1c best predicted MACE with a sensitivity of 75% and specificity of 53% (AUC 0.673, p = 0.001). Patients were categorized as high HbA1c if ≥ 5.8% and low HbA1c if <5.8%. Compared with patients with low HbA1c, those with high HbA1c presented with 20% higher CRP-D5 (p = 0.009) and 19% higher ΔCRP (p = 0.01), a 32% decrease in ΔNOx (p < 0.001), and 33% lower FMD (p < 0.001). After a median follow-up of 1.9 (1.1-2.8) years, patients with high HbA1c had more incident diabetes (HR 2.3 95% CI 1.01-5.2; p = 0.048) and MACE (HR 3.32 95% CI 1.09-10.03; p = 0.03). CONCLUSION: Non-diabetic STEMI patients with high HbA1c present with decreased endothelial function and increased inflammatory response and long-term risk of MACE.

Contaminação de cassetes radiográficos em hospital privado: uma contribuição da enfermagem / Contamination of radiographic cassettes in private hospital: a nursing contribution

Objetivo - Investigar os cassetes radiográficos como fontes de contaminação cruzada entre pacientes internados e verificar como são realizadas as radiografias nos leitos das Unidades de Terapia Intensiva e apartamentos quanto à prevenção e controle de infecção hospitalar. Métodos - Trata-se de um estudo aplicado, quantitativo e descritivo realizado em um hospital privado do Piauí. Na pesquisa estiveram presentes dois tipos de populações distintas: sete cassetes radiográficos e sete técnicos ou tecnólogos em Radiologia. A realização das culturas e aplicação do checklist foram realizadas de março a abril de 2011. Resultados - Verificou-se que 91,42% das culturas laboratoriais apresentaram a presença de incontáveis unidades formadoras de colônias de microrganismos patogênicos, sendo 62,5% Bacilos Gram negativos. Não é realizada a descontaminação dos cassetes radiográficos antes dos exames nos leitos (100%). Conclusões - A Enfermagem, ao observar elementos que possibilitem a ocorrência de infecção hospitalar, deve cooperar para uma assistência hospitalar de maior qualidade.

Objective - To investigate the radiographic cassettes as sources of cross contamination between patients and see how X-rays are performed in the beds of Intensive Care Units and apartments on the prevention and control of hospital infection. It is an applied study, quantitative and descriptive conducted in a private hospital in Piauí. Methods - In the present study were two types of distinct populations: seven X-ray cassettes and seven technicians or tecnologists in Radiology. The completion of the checklist and application cultures were performed from March to April 2011. Results - It was found that 91.42% of laboratory cultures showed the presence of countless colony-forming units of pathogenic microorganisms, 62,5% Gram negative. Decontamination is not performed before the slides radiographic examinations of the beds (100%). Conclusions - Nursing, the elements that make it possible to observe the occurrence of hospital infection, should cooperate to a higher quality hospital care.

Expressão do fator de crescimento transformador-beta em mucosa oral submetida à radioterapia: uma revisão crítica da literatura / Expression of transforming growth factor: beta in oral mucosa submitted to radiotherapy. a critical literature review

A radiação ionizante é uma das terapias utilizadas para o tratamento de neoplasias malignas de cabeça e pescoço. Todavia, pode causar complicações agudas, como mucosite, e complicações crônicas, como fibrose tecidual. A radioterapia promove aumento na deposição de colágeno e incrementa a expressão e ativação precoce do fator de crescimento transformador ­ beta, que pode culminar nessa fibrose. O fator de crescimento transformador - beta é uma citocina multifuncional, excretada sob forma latente, com importante função na modulação do sistema fibroblasto-fibrócito, estimulando a síntese e depósito de colágeno, atuando no reparo tecidual, e diminuindo a sua degradação, especialmente em tecido irradiado. A presente revisão de literatura tem como objetivo esclarecer a relação da expressão do fator de crescimento transformador - beta em tecidos submetidos à radiação ionizante utilizada para tratamento antineoplásico, em especial na mucosa oral e reparo tecidual em lesões do tipo mucosite, realizando uma análise crítica dos trabalhos avaliados.

Ionizing radiation is a form of therapy used for the treatment of malignancies of head and neck. However, it can cause acute complications such as mucositis, and chronic complications, such as tissue fibrosis. Radiation promotes increase in collagen deposition and increases the expression and activation of the Transforming Growth Factor - beta, which may result in this fibrosis. The transforming growth factor - beta is a multifunctional cytokine, excreted latent, with an important role in the modulation of the fibroblasts- fibrocytes, stimulating synthesis and deposition of collagen, acting on tissue repair and decreasing its degradation, especially in tissue irradiated. This literature review aims to clarify the relationship between the expression of transforming growth factor - beta in tissues submitted to ionizing radiation used for anticancer treatment, particularly in the oral mucosa and wound repair in lesions with mucositis, performing a critical analyses of the assessed work.

Enterocyte ultrastructural alterations following intestinal obstruction in rats.

PURPOSE: To analyze the small intestinal mucosa ultrastructure, and to characterize the enterocyte lesion severity caused by mechanical intestinal obstruction combined or not with an ischemia of the mesenteric marginal vessels arch. METHODS: It was used 47 Wistar rats divided into 4 groups as follows: Group 1- Control rats (C), Group 2- sham rats (S), Group 3- rats submitted to intestinal obstruction excluding marginal vessel (OEV), Group 4- Intestinal obstruction including marginal vessels (OIV). Rats of groups 3 and 4 were allotted into two subgroups for the removal of small intestinal tissue samples, one at the proximal (P), and the other at the distal (D) segments from the obstruction site. Samples of groups 2, 3, 4 were obtained 24, 48, and 72 hours after post operation care. Small intestinal tissue samples of group 1 were excised following laparotomy. Imaging in Light and Transmission Electronic Microscopy were used for morphological and morphometric studies. The results were analyzed by using the ANOVA and Newman-Keuls tests. RESULTS: No irreversible lesion was observed. In the 24 hours microvilli volume of group 3 turned down at the proximal site henceforth enlarging very slowly within the next 72 hours. At the distal site significant microvilli shrinkage was observed up to 48 hours. Then they recovered their volume after 72 hours. In the 24 hours microvilli volume of group 4 grew twice in comparison with the microvilli of group 1 rats but after 72 hours there was drastic volume shrinkage, shape alterations, and severe flatness, especially in the distal segments of the obstruction site. CONCLUSIONS: Terminal ileum mechanical obstruction with mesenteric marginal arch ischemia led to reversible ultrastructural alterations after 72 hours, and the injury is proportional to the persistence of the obstructive process. Furthermore the mesenteric vessels of the marginal arcade play an important role in the maintenance of mucosal integrity, when such obstructive disorder is present.

Blood carbonyl protein measurement as a specific oxidative stress biomarker after intestinal reperfusion in rats.

PURPOSE: An experimental study was performed to investigate the use of protein carbonyl group as a specific biological marker for oxidative stress in a rat model of intestinal ischaemia-reperfusion. METHODS: Twenty four male Wistar rats were randomly distributed into three groups with eight animals each: Group 1 - Control group; Group 2 - Sham; Group 3 - Intestinal ischaemia by clamping ileal branches of the superior mesenteric artery for one hour, followed by another hour of reperfusion. Blood samples were taken in order to analyze the protein carbonyl level by Slot blotting assay. RESULTS: In group 3 a significant increase of protein carbonyl level was observed if compared to the homogenous levels of groups 1 and 2. CONCLUSION: From the results it may be concluded that the protein carbonylation may be used as a specific marker for measuring oxidative stress in rat intestinal reperfusion model.

Enterocyte ultrastructural alterations following intestinal obstruction in rats / Alterações ultra-estruturais do enterócito após obstrução intestinal em ratos

PURPOSE: To analyze the small intestinal mucosa ultrastructure, and to characterize the enterocyte lesion severity caused by mechanical intestinal obstruction combined or not with an ischemia of the mesenteric marginal vessels arch. METHODS: It was used 47 Wistar rats divided into 4 groups as follows: Group 1- Control rats (C), Group 2- sham rats (S), Group 3- rats submitted to intestinal obstruction excluding marginal vessel (OEV), Group 4- Intestinal obstruction including marginal vessels (OIV). Rats of groups 3 and 4 were allotted into two subgroups for the removal of small intestinal tissue samples, one at the proximal (P), and the other at the distal (D) segments from the obstruction site. Samples of groups 2, 3, 4 were obtained 24, 48, and 72 hours after post operation care. Small intestinal tissue samples of group 1 were excised following laparotomy. Imaging in Light and Transmission Electronic Microscopy were used for morphological and morphometric studies. The results were analyzed by using the ANOVA and Newman-Keuls tests. RESULTS: No irreversible lesion was observed. In the 24 hours microvilli volume of group 3 turned down at the proximal site henceforth enlarging very slowly within the next 72 hours. At the distal site significant microvilli shrinkage was observed up to 48 hours. Then they recovered their volume after 72 hours. In the 24 hours microvilli volume of group 4 grew twice in comparison with the microvilli of group 1 rats but after 72 hours there was drastic volume shrinkage, shape alterations, and severe flatness, especially in the distal segments of the obstruction site. CONCLUSIONS: Terminal ileum mechanical obstruction with mesenteric marginal arch ischemia led to reversible ultrastructural alterations after 72 hours, and the injury is proportional to the persistence of the obstructive process. Furthermore the mesenteric vessels of the marginal arcade play an important role in the maintenance of mucosal integrity, ...(AU)

OBJETIVO: Analisar as alterações ultra-estruturais da mucosa do intestino delgado e caracterizar a severidade das lesões causadas por uma obstrução intestinal mecânica, associada ou não a isquemia da arcada marginal mesentérica. MÉTODOS: Foram utilizados 47 ratos, da linhagem Wistar, distribuídos em quatro grupos, da seguinte forma: Grupo 1 - Controle (C), Grupo 2- Simulação (S), Grupo 3- Ratos com obstrução intestinal sem inclusão de vaso marginal (OEV), Grupo 4 - Obstrução intestinal com inclusão de vaso marginal (OIV). Os animais dos grupos 3 e 4 foram redistribuídos em dois subgrupos com coleta de amostras do intestino delgado, à montante (P) e à jusante (D) do ponto de obstrução. Nos grupos 2, 3 e 4, as amostras foram colhidas com 24, 48 e 72 horas de pós-operatório. No grupo 1, este material foi retirado após laparotomia. Realizaram-se estudos morfológicos e morfométricos dos microvilos através das Microscopias Óptica e Eletrônica de Transmissão. Os resultados foram analisados mediante os testes estatísticos de ANOVA e Newman-Keuls. RESULTADOS: Não foram observadas lesões irreversíveis. No grupo 3 com 24 horas, o volume dos microvilos diminuiu, à montante, com discreto aumento em 72 horas. Á jusante, houve redução significante até 48 horas, com recuperação em 72 horas. No grupo 4, o volume dos microvilos quase dobrou em relação ao grupo 1, com 24 horas, mas reduziu-se, drasticamente, em especial à jusante, com 72 h de evolução, apresentando deformidade e achatamento severos, achados estes estatisticamente significantes. CONCLUSÕES: A obstrução intestinal mecânica do íleo terminal, associada ou não a isquemia da arcada mesentérica marginal, causa alterações ultra-estruturais reversíveis dos enterócitos, cuja gravidade é diretamente proporcional à duração do processo mórbido obstrutivo, até 72 horas de evolução. Aduz-se que, os vasos mesentéricos da arcada marginal exercem um papel relevante na preservação da mucosa intestinal, na ...(AU)

Blood carbonyl protein measurement as a specific oxidative stress biomarker after intestinal reperfusion in rats / Dosagem da proteína carbonilada sanguínea como biomarcador específico do estresse oxidativo após reperfusão intestinal em ratos

PURPOSE: An experimental study was performed to investigate the use of protein carbonyl group as a specific biological marker for oxidative stress in a rat model of intestinal ischaemia-reperfusion. METHODS: Twenty four male Wistar rats were randomly distributed into three groups with eight animals each: Group 1 - Control group; Group 2 - Sham; Group 3 - Intestinal ischaemia by clamping ileal branches of the superior mesenteric artery for one hour, followed by another hour of reperfusion. Blood samples were taken in order to analyze the protein carbonyl level by Slot blotting assay. RESULTS: In group 3 a significant increase of protein carbonyl level was observed if compared to the homogenous levels of groups 1 and 2. CONCLUSION: From the results it may be concluded that the protein carbonylation may be used as a specific marker for measuring oxidative stress in rat intestinal reperfusion model.(AU)

OBJETIVO: Realizou-se um estudo experimental com a finalidade de investigar o uso da proteína carbonilada como um marcador biológico específico do estresse oxidativo em um modelo de isquemia e reperfusão intestinal, em ratos. MÉTODOS: Vinte e quarto ratos da linhagem Wistar, machos foram distribuídos, aleatoriamente, em três grupos compostos por oito animais cada: Grupo 1 - Controle; Grupo 2 - Simulação e Grupo 3 - Submetido à isquemia, mediante clampeamento de ramos ileais da artéria mesentérica superior por uma hora, seguida de reperfusão, por igual período. Amostras sanguíneas obtidas foram utilizadas para analise dos níveis de proteína carbonilada, através do método Slot blotting. RESULTADOS: No grupo 3 houve uma elevação significante da concentração de proteína carbonilada sérica se comparada aos níveis sanguíneos homogêneos encontrados nos grupos 1 e 2. CONCLUSÃO: Fundamentado nos resultados é possível concluir que, a carbonilação protéica pode ser utilizada como um marcador específico para a mensuração do estresse oxidativo em modelos de reperfusão intestinal, em ratos.(AU)