Aranhas de interesse médico no Brasil / Spiders of medical interest in Brazil

O documento apresenta informações sobre aranhas de importância médica no Brasil. Descreve a estrutura externa das aranhas e destaca três gêneros de importância em saúde pública: aranha-marrom (Loxosceles), aranha-armadeira ou macaca (Phoneutria) e viúva-negra (Latrodectus). Traz imagens dessas espécies e lista sinais, sintomas e tratamento para acidentes com elas. Apresenta dados de série histórica de acidentes por aranhas no Brasil e Tocantins entre 2000-2022. Por fim, traz recomendações sobre prevenção e primeiro atendimento para acidentes com aranhas.

The document provides information on medically significant spiders in Brazil. It describes the external structure of spiders and highlights three genera of public health importance: brown recluse spider (Loxosceles), wandering spider or macaque spider (Phoneutria), and black widow spider (Latrodectus). It includes images of these species and lists signs, symptoms, and treatment for accidents involving them. It presents historical data on spider-related accidents in Brazil and Tocantins between 2000-2022. Finally, it provides recommendations for prevention and initial first aid for spider bites.

El documento proporciona información sobre arañas de importancia médica en Brasil. Describe la estructura externa de las arañas y destaca tres géneros de importancia para la salud pública: la araña de rincón (Loxosceles), la araña errante o araña mono (Phoneutria) y la viuda negra (Latrodectus). Incluye imágenes de estas especies y enumera los signos, síntomas y tratamiento para accidentes con ellas. Presenta datos históricos sobre accidentes relacionados con arañas en Brasil y Tocantins entre 2000 y 2022. Por último, proporciona recomendaciones para la prevención y la atención de primeros auxilios en caso de picaduras de araña.

Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino / Social representations of motherhood for women deprived of liberty in the female prison system

Resumo Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos "separação" (f=27; OME: 2,9), "tristeza" (f=18; OME: 2,3), "horrível" (f=16; OME: 2,1) e "dor" (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos "separação" (f=18; OME: 3), "tristeza" (f=13; OME: 2,5), "medo" (f=11; OME: 2,2) e "horrível" (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Abstract This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms "separation" (f=27; OME: 2.9), "sadness" (f=18; OME: 2.3), "horrible" (f=16; OME: 2.1) and "pain" (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms "separation" (f=18; OME: 3), "sadness" (f=13; OME: 2.5), "fear" (f=11; OME: 2.2) and "horrible" (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Social representations of motherhood for women deprived of liberty in the female prison system. / Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino.

This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms "separation" (f=27; OME: 2.9), "sadness" (f=18; OME: 2.3), "horrible" (f=16; OME: 2.1) and "pain" (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms "separation" (f=18; OME: 3), "sadness" (f=13; OME: 2.5), "fear" (f=11; OME: 2.2) and "horrible" (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos "separação" (f=27; OME: 2,9), "tristeza" (f=18; OME: 2,3), "horrível" (f=16; OME: 2,1) e "dor" (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos "separação" (f=18; OME: 3), "tristeza" (f=13; OME: 2,5), "medo" (f=11; OME: 2,2) e "horrível" (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Global Expansion of SARS-CoV-2 Variants of Concern: Dispersal Patterns and Influence of Air Travel

In many regions of the world, the Alpha, Beta and Gamma SARS-CoV-2 Variants of Concern (VOCs) co-circulated during 2020-21 and fueled waves of infections. During 2021, these variants were almost completely displaced by the Delta variant, causing a third wave of infections worldwide. This phenomenon of global viral lineage displacement was observed again in late 2021, when the Omicron variant disseminated globally. In this study, we use phylogenetic and phylogeographic methods to reconstruct the dispersal patterns of SARS-CoV-2 VOCs worldwide. We find that the source-sink dynamics of SARS-CoV-2 varied substantially by VOC, and identify countries that acted as global hubs of variant dissemination, while other countries became regional contributors to the export of specific variants. We demonstrate a declining role of presumed origin countries of VOCs to their global dispersal: we estimate that India contributed <15% of all global exports of Delta to other countries and South Africa <1-2% of all global Omicron exports globally. We further estimate that >80 countries had received introductions of Omicron BA.1 100 days after its inferred date of emergence, compared to just over 25 countries for the Alpha variant. This increased speed of global dissemination was associated with a rebound in air travel volume prior to Omicron emergence in addition to the higher transmissibility of Omicron relative to Alpha. Our study highlights the importance of global and regional hubs in VOC dispersal, and the speed at which highly transmissible variants disseminate through these hubs, even before their detection and characterization through genomic surveillance. HighlightsO_LIGlobal phylogenetic analysis reveals relationship between air travel and speed of dispersal of SARS-CoV-2 variants of concern (VOCs) C_LIO_LIOmicron VOC spread to 5x more countries within 100 days of its emergence compared to all other VOCs C_LIO_LIOnward transmission and dissemination of VOCs Delta and Omicron was primarily from secondary hubs rather than initial country of detection during a time of increased global air travel C_LIO_LIAnalysis highlights highly connected countries identified as major global and regional exporters of VOCs C_LI

Ten sessions of transcranial direct current stimulation for chronic chikungunya arthralgia: study protocol for a randomised clinical trial.

INTRODUCTION: The chikungunya virus infection is still an epidemic in Brazil with an incidence of 59.4 cases per 100 000 in the Northeast region. More than 60% of the patients present relapsing and remitting chronic arthralgia with debilitating pain lasting for years. Transcranial direct current stimulation (tDCS) appears promising as a novel neuromodulation approach for pain-related networks to alleviate pain in several pain syndromes. Our objective is to evaluate the effectiveness of tDCS (C3/Fp2 montage) on pain, muscle strength, functionality and quality of life in chronic arthralgia. METHODS AND ANALYSIS: This protocol is a single-centre, parallel-design, double-blind, randomised, sham-controlled trial. Forty participants will be randomised to either an active or sham tDCS. A total of 10 sessions will be administered over 2 weeks (one per weekday) using a monophasic continuous current with an intensity of 2 mA for 20 min. Participants will be evaluated at baseline, after the 10th session, 2 weeks and 4 weeks after intervention. PRIMARY OUTCOME: pain assessed using numeric rating scale and algometry. SECONDARY OUTCOMES: muscle strength, functionality and quality of life. The effects of stimulation will be calculated using a mixed analysis of variance model. ETHICS AND DISSEMINATION: The study was approved by the ethics committee of the Faculty of Health Sciences of Trairí, Federal University of Rio Grande do Norte (No. 2.413.851) and registered on the Brazilian Registry of Clinical Trials. Study results will be disseminated through presentations at conferences and publications in peer-reviewed journals. TRIAL REGISTRATION NUMBER: RBR-469yd6.

Phenotypes of disease severity in a cohort of hospitalized COVID-19 patients: results from the IMPACC study

BackgroundBetter understanding of the association between characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19) and outcome is needed to further improve upon patient management. MethodsImmunophenotyping Assessment in a COVID-19 Cohort (IMPACC) is a prospective, observational study of 1,164 patients from 20 hospitals across the United States. Disease severity was assessed using a 7-point ordinal scale based on degree of respiratory illness. Patients were prospectively surveyed for 1 year after discharge for post-acute sequalae of COVID-19 (PASC) through quarterly surveys. Demographics, comorbidities, radiographic findings, clinical laboratory values, SARS-CoV-2 PCR and serology were captured over a 28-day period. Multivariable logistic regression was performed. FindingsThe median age was 59 years (interquartile range [IQR] 20); 711 (61%) were men; overall mortality was 14%, and 228 (20%) required invasive mechanical ventilation. Unsupervised clustering of ordinal score over time revealed distinct disease course trajectories. Risk factors associated with prolonged hospitalization or death by day 28 included age [≥] 65 years (odds ratio [OR], 2.01; 95% CI 1.28-3.17), Hispanic ethnicity (OR, 1.71; 95% CI 1.13-2.57), elevated baseline creatinine (OR 2.80; 95% CI 1.63-4.80) or troponin (OR 1.89; 95% 1.03-3.47), baseline lymphopenia (OR 2.19; 95% CI 1.61-2.97), presence of infiltrate by chest imaging (OR 3.16; 95% CI 1.96-5.10), and high SARS-CoV2 viral load (OR 1.53; 95% CI 1.17-2.00). Fatal cases had the lowest ratio of SARS-CoV-2 antibody to viral load levels compared to other trajectories over time (p=0.001). 589 survivors (51%) completed at least one survey at follow-up with 305 (52%) having at least one symptom consistent with PASC, most commonly dyspnea (56% among symptomatic patients). Female sex was the only associated risk factor for PASC. InterpretationIntegration of PCR cycle threshold, and antibody values with demographics, comorbidities, and laboratory/radiographic findings identified risk factors for 28-day outcome severity, though only female sex was associated with PASC. Longitudinal clinical phenotyping offers important insights, and provides a framework for immunophenotyping for acute and long COVID-19. FundingNIH RESEARCH IN CONTEXTO_ST_ABSEvidence before this studyC_ST_ABSWe did a systematic search of the PubMed database from January 1st, 2020 until April 24th, 2022 using the search terms: "hospitalized" AND "SARS-CoV-2" OR "COVID-19" AND "Pro-spective" AND "Antibody" OR "PCR" OR "long term follow up" and applying the following filters: "Multicenter Study" AND "Observational Study". No language restrictions were applied. While clinical, laboratory, and radiographic features associated with severe COVID-19 in hospitalized adults have been described, description of the kinetics of SARS-CoV-2 specific assays available to clinicians (e.g. PCR and binding antibody) and their integration with other variables is scarce for both short and long term follow up. The current literature is comprised of several studies with small sample size, cross-sectional design with laboratory data typically only recorded at a single point in time (e.g., on admission), limited clinical characteristics, variable duration of follow up, single-center setting, retrospective analyses, kinetics of either PCR or antibody testing but not both, and outcomes such as death or, mechanical ventilation that do not allow delineation of variations in clinical course. Added value of this studyIn our large longitudinal multicenter cohort, the description of outcome severity, was not limited to survival versus death, but encompassed a clinical trajectory approach leveraging longitudinal data based on time in hospital, disease severity by ordinal scale based on degree of respiratory illness, and presence or absence of limitations at discharge. Fatal COVID-19 cases had the lowest ratio of antibody to viral load levels over time as compared to non-fatal cases. Integration of PCR cycle threshold and antibody values with demographics, baseline comorbidities, and laboratory/radiographic findings identified additional risk factors for outcome severity over the first 28 days. However, female sex was the only variable associated with persistence of symptoms over time. Persistence of symptoms was not associated with clinical trajectory over the first 28 days, nor with antibody/viral loads from the acute phase. Implications of all the available evidenceThe described calculated ratio (binding IgG/PCR Ct value) is unique compared to other studies, reflecting host pathogen interactions and representing an accessible approach for patient risk stratification. Integration of SARS-CoV-2 viral load and binding antibody kinetics with other laboratory as well as clinical characteristics in hospitalized COVID-19 patients can identify patients likely to have the most severe short-term outcomes, but is not predictive of symptom persistence at one year post-discharge.

Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis.

Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD. Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms. Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included. Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III - motor aspects (MD = -0.98%, 95% CI = -10.03 to 8.07, p = 0.83, I 2 = 0%), UPDRS IV - dyskinesias (MD = -0.89%, CI 95% = -3.82 to 2.03, p = 0.55, I 2 = 0%) and motor fluctuations (MD = -0.67%, CI 95% = -2.45 to 1.11, p = 0.46, I 2 = 0%), timed up and go - gait (MD = 0.14%, CI 95% = -0.72 to 0.99, p = 0.75, I 2 = 0%), Berg Balance Scale - balance (MD = 0.73%, CI 95% = -1.01 to 2.47, p = 0.41, I 2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III - motor aspects (MD = 2.05%, CI 95% = -1.96 to 6.06, p = 0.32, I 2 = 0%) and gait (SMD = -0.05%, 95% CI = -0.28 to 0.17, p = 0.64, I 2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = -1.7, SE = 1.51, z-score = -1.18, p = 0.2, IC = -4.75 to 1.17) and cumulative time (estimate = -0.07, SE = 0.07, z-score = -0.99, p = 0.31, IC = -0.21 to 0.07) had no significant association. Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.

Does current evidence support the use of kinesiology taping in people with knee osteoarthritis?

OBJECTIVE: To analyze the current evidence about the effects of kinesiology taping (KT) with different amounts of tension in people with knee osteoarthritis (OA). DATA SOURCES: MEDLINE (via PUBMED), SciELO, COCHRANE Library, Scopus, PEDro, Web of Science and EMBASE were used as search databases. STUDY SELECTION: Two independent researchers searched these databases from inception until June 2020 using the descriptors "kinesiotaping", "kinesio taping", "kinesiotape", "tape", "taping", "kinesiology taping", "kinesiology tape", "kinesthetic taping" or "elastic therapeutic tape" associated with "knee osteoarthritis". We included clinical trials that compared the application of KT with and without tension in people with knee OA. DATE EXTRACTION AND QUALITY ANALYSIS: Data extraction included sample description, KT tension used in the study groups, duration of KT application, area of KT application, outcome measures and study methodological quality. The quality of the studies was evaluated by means of the Physiotherapy Evidence Database (PEDro) score. DATA SYNTHESIS: Of the 850 studies identified, eight met the inclusion criteria and were ultimately included in this review. Most studies had moderate quality, with a satisfactory PEDro score. Results showed that KT application with tension was not superior to the application without tension for the outcomes of pain, physical function, range of motion and muscle strength. Evidence for edema, balance and quality of life is still limited. CONCLUSION: Current evidence does not support the use of kinesiology taping in people with knee OA.

Conhecimento dos docentes e discentes de enfermagem sobre o suporte básico de vida / Knowledge of professors and students on basic life support / Conocimientos profesores y estudiantes sobre apoyo básico a la vida

Objetivo: identificar o conhecimento dos docentes e discentes de enfermagem de uma universidade pública sobre suporte básico de vida. Método: estudo exploratório-descritivo, com delineamento transversal e abordagem quantitativa realizado por meio de questionário com docentes e discentes do curso técnico em enfermagem e docentes da graduação em enfermagem. Resultados: observou-se maior conhecimento dos participantes referente ao ambiente onde se pode realizar a ressuscitação cardiopulmonar (88,4%), aos sinais clínicos que identificam uma parada cardiorrespiratória (77,5%), à relação compressão-ventilação (71,3%), aos elos da cadeia de sobrevivência (56,6%) e à profundidade das compressões torácicas (55,0%). Em outras questões, porém, ocorreu percentual expressivo de erros, tais como situações especiais para utilização do desfibrilador externo automático (93,8%), sinais da parada respiratória (69,8%), ritmos chocáveis (65,1%) e frequência das compressões torácicas (50,4%). Conclusão: o estudo demonstrou conhecimento importante sobre suporte básico de vida entre os pesquisados. Contudo, houve erros em situações pontuais relativas ao questionário (AU).

Objective: to identify the knowledge of nursing professors and students from a public university on basic life support. Method: exploratory-descriptive study, with cross-sectional design and quantitative approach, conducted by means of a questionnaire with professors and students from the technical nursing course and professors from the undergraduate nursing course. Results: there was a greater knowledge of the participants regarding the environment where cardiopulmonary resuscitation may be performed (88.4%), the clinical signs that identify a cardiorespiratory arrest (77.5%), the compression-ventilation ratio (71.3%), the links in the survival chain (56.6%) and the depth of thoracic compressions (55.0%). On other questions, however, there was a significant percentage of errors, such as: special situations for using the automatic external defibrillator (93.8%), signs of respiratory arrest (69.8%), shockable rhythms (65.1%) and frequency of thoracic compressions (50.4%). Conclusion: the study demonstrated important knowledge on basic life support among those surveyed. Nevertheless, there were errors in specific situations related to the questionnaire (AU).

Objetivo: identificar los conocimientos de profesores y estudiantes de enfermería de una universidad pública sobre soporte vital básico. Método: estudio exploratorio-descriptivo, con diseño transversal y enfoque cuantitativo, realizado a través de un cuestionario con profesores y estudiantes del curso técnico en enfermería y profesores de pregrado en enfermería. Resultados: hubo un mayor conocimiento de los participantes sobre el entorno donde se puede realizar la reanimación cardiopulmonar (88,4%), los signos clínicos que identifican una parada cardiorrespiratoria (77,5%), la relación compresión-ventilación (71,3%), los eslabones de la cadena de supervivencia (56,6%) y la profundidad de las compresiones torácicas (55,0%). En otras cuestiones, sin embargo, hubo un porcentaje significativo de errores, tales como: situaciones especiales de uso del desfibrilador externo automático (93,8%), signos de parada respiratoria (69,8%), ritmos desfibrilables (65,1%) y frecuencia de las compresiones torácicas (50,4%). Conclusión: el estudio demostró importantes conocimientos sobre soporte vital básico entre los encuestados. Sin embargo, hubo errores en situaciones específicas relacionadas con el cuestionario (AU).

Partograma: instrumento de segurança no cuidado multidisciplinar / Partograma: instrumento de monitoreo en la atención multidisciplinar / Partograph: A Monitoring Tool in Multidisciplinary Care

Introdução: O partograma é um traçado de representação gráfica do trabalho de parto que concebe o desencadeamento de sua evolução, permitindo a visualização das alterações no decorrer do partejar. O estudo objetivou descrever o conhecimento sobre partograma por enfermeiros e médicos de uma maternidade escola. Materiais e Métodos: Estudo transversal realizado com enfermeiros e médicos em maternidade escola do nordeste brasileiro. A amostra foi constituída por 8 enfermeiros e 39 médicos. Resultados: Observou-se que a maior parte já fez curso ou treinamento relacionado à ferramenta. Todavia, em 27,6% dos casos ocorrem dúvidas sobre seu manejo. Sobrecarga no plantão; falta de conhecimento no preenchimento e ausência de continuidade foram considerados aspectos dificultadores. Quanto às situações nas quais se deve abrir o instrumento, as mais citadas foram gestantes em trabalho de parto na fase ativa e trabalho de parto normal. Discussão: É indiscutível a importância e necessidade do partograma no decorrer do trabalho de parto. As informações retiradas a partir dele orientam o profissional para os próximos passos a serem seguidos. Conclusão: Acredita-se que o uso do partograma é essencial no processo de parto, e que os conhecimentos referentes à sua utilização são fundamentais na prática. Contudo, mesmo na maternidade, o uso da ferramenta é incipiente.

Introduction: A partograph is the graphic representation of labor from its early stages, which allows observing the changes during the labor process. Objective: To determine partograph-related knowledge among nurses and doctors in a maternity hospital. Materials and Methods: A cross-sectional study was conducted with nurses and doctors from a maternity hospital in northeastern Brazil. The sample consisted of 8 nurses and 39 doctors. Results: Most health professionals have taken courses or training related to the instrument itself. However, there were some doubts about partograph handling in 27.6% of cases. Work overload, lack of knowledge to fill out the instrument and lack of continuity affected this matter. As for the situations in which the instrument should be used, women in active labor and normal labor were listed. Discussion: The importance and necessity of partographs during labor are beyond question. The information obtained through this instrument guides professionals through the next steps of labor and delivery. Conclusion: The use of partograph is considered essential in labor and knowledge related to its handling is critical in practical settings. However, the use of this instrument is just beginning in the maternity ward.

Introducción: El partograma es la representación gráfica del trabajo de parto desde el inicio de su evolución, lo que permite visualizar los cambios durante el proceso de parto. Objetivo: Identificar los conocimientos relacionados con el partograma por parte de los enfermeros y médicos de una clínica de maternidad. Materiales y métodos: Se realizó un estudio transversal con enfermeros y médicos de una clínica de maternidad del noreste de Brasil. La muestra estuvo compuesta por 8 enfermeros y 39 médicos. Resultados: Se observó que la mayoría del personal de salud han tomado cursos o capacitación relacionados con el instrumento en mención. Sin embargo, en el 27.6% de los casos hay dudas sobre el manejo del partograma. La sobrecarga laboral, la falta de conocimiento para diligenciar el instrumento y la falta de continuidad contribuyeron a esta problemática. En cuanto a las situaciones en las que se debe usar el instrumento, se mencionó a las mujeres que se encuentran en trabajo de parto en fase activa y en el trabajo de parto normal. Discusión: La importancia y necesidad del partograma durante el trabajo de parto es indiscutible. La información que se obtiene a través de este instrumento guía al profesional en los siguientes pasos del parto. Conclusión: Se considera que el uso del partograma es esencial en el trabajo de parto y que el conocimiento sobre su manejo es crítico en la práctica. Sin embargo, el uso del instrumento es incipiente en la maternidad.

First case of placental infection with SARS-CoV-2

BackgroundThe effects of Covid-19 in pregnancy remain relatively unknown. We present a case of second trimester pregnancy with symptomatic Covid-19 complicated by severe preeclampsia and placental abruption. MethodsWe analyzed placenta for the presence of SARS-CoV-2 through molecular and immunohistochemical assays and by and electron microscopy, and we measured the maternal antibody response in blood to this infection. ResultsSARS-CoV-2 localized predominantly to syncytiotrophoblast cells at the maternal-fetal interface of the placenta. Histological examination of the placenta revealed a dense macrophage infiltrate, but no evidence for vasculopathy typically associated with preeclampsia. ConclusionThis case demonstrates, for the first time, SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with Covid-19.

Adesão dos idosos às formas de administração do tratamento da tuberculose / Adherence of elderly people to tuberculosis treatment / Adhesión de los ancianos a las formas de administración del tratamiento de la tuberculosis

Objetivo: Conhecer a adesão dos idosos às formas de administração do tratamento da tuberculose. Métodos: Estudo exploratório-descritivo, transversal e quantitativo, desenvolvido no Distrito Sanitário Oeste de Natal, com os idosos que fizeram tratamento entre janeiro de 2010 a dezembro de 2015. Resultados: Observou-se que os idosos utilizam tanto o regime autoadministrado (51,1%) quanto o diretamente observado (48,9%). Em ambos os grupos prevaleceu a faixa etária de 60 a 69 anos (29,8%; 35,1%), a forma pulmonar da doença (41,5%; 44,7%) e o caso novo como tipo de entrada para o tratamento (31,9%; 27,7%). Quanto ao encerramento, destacou-se a conclusão do tratamento (33,0%; 25,5%). Conclusão: A tuberculose ainda é prevalente no Brasil, destacando-se a importância do diagnóstico e tratamento adequados, além da adoção de medidas de controle e capacitação dos profissionais de saúde frente ao cuidado desses pacientes

The study's purpose has been to know the adherence of elderly people to the different forms of management of tuberculosis treatment. Methods: It is a descriptive-exploratory and cross-sectional study with a quantitative approach that was carried out in the Western Sanitary District at Natal city, and counted with elderly patients who underwent treatment from January 2010 to December 2015. Results: It was observed that the elderly people use both the self-administered regimen (51.1%) and directly observed (48.9%). In both groups the participants were within the age group from 60 to 69 years old (29.8%, 35.1%), the pulmonary form of the disease (41.5%, 44.7%) prevailed, and the new case as the type of entry for the treatment (31.9%, 27.7%). Regarding the treatment termination, the accomplishment of the treatment conclusion was highlighted among the studied cases (33.0%, 25.5%). Conclusion: Tuberculosis is still prevalent in Brazil, highlighting the importance of both adequate diagnosis and treatment, as well as the adoption of measures to control and train health professionals with regards to the care of these patients

Objetivo: Conocer la adhesión de los ancianos a las formas de administración del tratamiento de la tuberculosis. Métodos: Estudio exploratoriodescriptivo, transversal y cuantitativo, desarrollado en el Distrito Sanitario Oeste de Natal, con los ancianos que hicieron tratamiento entre enero de 2010 a diciembre de 2015. Resultados: Se observó que los ancianos utilizan tanto el régimen autoadministrado (51, 1%) como el directamente observado (48,9%). En ambos grupos prevaleció el grupo de edad de 60 a 69 años (29,8%, 35,1%), la forma pulmonar de la enfermedad (41,5%, 44,7%) y el caso nuevo como tipo de entrada para El tratamiento (31,9%, 27,7%). En cuanto al cierre, se destacó la conclusión del tratamiento (33,0%, 25,5%). Conclusión: La tuberculosis sigue siendo prevalente en Brasil, destacándose la importancia del diagnóstico y tratamiento adecuados, además de la adopción de medidas de control y capacitación de los profesionales de salud frente al cuidado de esos pacientes

Vivência de pais com o Método Canguru: revisão integrativa / The experience of fathers with the kangaroo mother care method: an integrative review

Objetivo: compreender a vivência de pais com o Método Canguru. Métodos: revisão integrativa da literatura, realizada nas bases de dados: Scientific Electronic Library Online, Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science e Current Nursing and Allied Health Literature. Resultados: obtiveram-se 732 artigos e sete foram selecionados. Identificou-se que pais vivenciam o Método Canguru com realização e prazer. Ademais, apresentaram dificuldades, medo e insegurança que podem estar associados ao funcionamento e a dispositivos de apoio à vida, utilizados para garantir a sobrevida de prematuros no cuidado relacionado ao distanciamento da figura paterna com neonato. Conclusão: a figura paterna, atualmente, apresenta-se mais participativa e consciente acerca do papel no âmbito familiar e nos cuidados inerentes ao filho prematuro. No entanto, pais se sentem despreparados, mas orgulhosos e esperançosos com evolução clínica de bebês, ao vivenciar o Método Canguru. (AU)

Teses e dissertações da enfermagem brasileira sobre saúde da mulher no sistema prisional / Theses and dissertations of Brazilian nursing addressing women's health in the prison system

Objetivo: caracterizar a produção brasileira de teses e dissertações em enfermagem sobre a saúde de mulheres no sistema prisional. Métodos: estudo bibliométrico, a partir do panorama da produção científica, no âmbito da Pós-Graduação em Enfermagem brasileira, com coleta de dados no Catálogo de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Resultados: 11 documentos fizeram parte da amostra. A maioria destes foi realizada durante mestrado (63,6%), com predominância nas Regiões Nordeste (63,6%), Sudeste (18,1%) e Centro-oeste (18,1%). Quanto às temáticas mais exploradas, as relações de mulheres/mães com os filhos apresentaram maior proporção (54,5%). Predominaram os estudos qualitativos (45,4%), com desenhos descritivos (36,3%). Conclusão: teses e dissertações brasileiras de enfermagem sobre a saúde da mulher no sistema prisional constituíram-se por estudos qualitativos, provenientes das regiões Nordeste, Sudeste e Centro-oeste, as quais apresentaram lacuna na produção do conhecimento de enfermagem. (AU)

Validação de questionário para a avaliação do conhecimento de docentes e discentes de enfermagem sobre o suporte básico de vida / Validation of questionnaire for the evaluation of knowledge of nursing teachers and students on the basic life support

Objetivo: validar o conteúdo de um questionário para a avaliação do conhecimento de docentes e discentesde Enfermagem relacionados ao suporte básico de vida. Método: estudo quantitativo, tipo metodológico,desenvolvendo-se com duas rodadas de validação, sendo a primeira, por 19 pesquisadores selecionados pormeio da Plataforma Lattes e a segunda, por 18 profissionais do Núcleo de Educação Permanente do Serviço deAtendimento Médico de Urgência-SAMU. Após a análise do questionário, foram realizadas modificações,aceitando-se o Índice de Validade de Conteúdo (IVC) >0,75. Resultados: das 11 questões avaliadas naprimeira rodada, cinco obtiveram índice de validade perfeito (IVC=1,00), uma foi excluída e quatro forammodificadas, de acordo com as recomendações dos juízes. Após a segunda rodada, o questionário foiconcluído com dez questões, obtendo um IVC geral de 0,87. Conclusão: o instrumento pode ser consideradoválido em seu conteúdo, com todos os itens considerados adequados, tanto separadamente, como de maneiraglobal.

Stingray venom activates IL-33 producing cardiomyocytes, but not mast cell, to promote acute neutrophil-mediated injury.

One of the hallmarks of acute inflammation is neutrophil infiltration of tissues. We investigated molecular mechanisms implicated in acute neutrophilic inflammation induced by the venom of a freshwater stingray (Potamotrygon cf. henlei) in mice. Ray venom induced early mobilization of neutrophil in the microvasculature of cremaster mice and infiltration of the peritoneal cavity 2 hours after injury, in a dose-response manner. IL-1ß, IL-6, TNF-α, and KC were produced. The neutrophilic infiltration did not occur in mice with ST2 receptor and MyD88 adapters neutralized, or in those with PI3K and p38 MAPK signaling blocked. Drastic reduction of neutrophil infiltration to peritoneal cavities was observed in ST2-/-, TLR2/TLR4-/-, MyD88-/-, TRIF-/- and IL-17A-/- mice, and a partial reduction was observed in IL-18R-/- mice. Mast cell Kit W(sh)/W(sh)-, AHR-, NLRP3-, ICE-, IL-1ß-, P2RX7-, CD39-, IL-17RA-, and TBX21 KO mice retain the ability to induce neutrophilia in peritoneal cavity after ray venom injection. IL-6 and TNF-α alone were insufficient for promote neutrophilia in the absence of ST2 signaling. Finally, abundant production of IL-33 by cardiomyocytes was observed. These results refine our understanding of the importance of the IL-33/ST2 axis and IL-33-producing cardiomyocytes in the early acute neutrophilia induced by freshwater stingray venoms.

Stingray venom activates IL-33 producing cardiomyocytes, but not mast cell, to promote acute neutrophil-mediated injury

One of the hallmarks of acute inflammation is neutrophil infiltration of tissues. We investigated molecular mechanisms implicated in acute neutrophilic inflammation induced by the venom of a freshwater stingray (Potamotrygon cf. henlei) in mice. Ray venom induced early mobilization of neutrophil in the microvasculature of cremaster mice and infiltration of the peritoneal cavity 2 hours after injury, in a dose-response manner. IL-1 beta, IL-6, TNF-alpha, and KC were produced. The neutrophilic infiltration did not occur in mice with ST2 receptor and MyD88 adapters neutralized, or in those with PI3K and p38 MAPK signaling blocked. Drastic reduction of neutrophil infiltration to peritoneal cavities was observed in ST2(-/-), TLR2/TLR4(-/-), MyD88(-/-), TRIF-/- and IL-17A(-/-) mice, and a partial reduction was observed in IL-18R(-/-) mice. Mast cell Kit W(sh)/W(sh)-, AHR-, NLRP3-, ICE-, IL-1 beta-, P2RX7-, CD39-, IL-17RA-, and TBX21 KO mice retain the ability to induce neutrophilia in peritoneal cavity after ray venom injection. IL- 6 and TNF-alpha alone were insufficient for promote neutrophilia in the absence of ST2 signaling. Finally, abundant production of IL-33 by cardiomyocytes was observed. These results refine our understanding of the importance of the IL-33/ST2 axis and IL-33-producing cardiomyocytes in the early acute neutrophilia induced by freshwater stingray venoms.

Human brain slices for epilepsy research: Pitfalls, solutions and future challenges.

Increasingly, neuroscientists are taking the opportunity to use live human tissue obtained from elective neurosurgical procedures for electrophysiological studies in vitro. Access to this valuable resource permits unique studies into the network dynamics that contribute to the generation of pathological electrical activity in the human epileptic brain. Whilst this approach has provided insights into the mechanistic features of electrophysiological patterns associated with human epilepsy, it is not without technical and methodological challenges. This review outlines the main difficulties associated with working with epileptic human brain slices from the point of collection, through the stages of preparation, storage and recording. Moreover, it outlines the limitations, in terms of the nature of epileptic activity that can be observed in such tissue, in particular, the rarity of spontaneous ictal discharges, we discuss manipulations that can be utilised to induce such activity. In addition to discussing conventional electrophysiological techniques that are routinely employed in epileptic human brain slices, we review how imaging and multielectrode array recordings could provide novel insights into the network dynamics of human epileptogenesis. Acute studies in human brain slices are ultimately limited by the lifetime of the tissue so overcoming this issue provides increased opportunity for information gain. We review the literature with respect to organotypic culture techniques that may hold the key to prolonging the viability of this material. A combination of long-term culture techniques, viral transduction approaches and electrophysiology in human brain slices promotes the possibility of large scale monitoring and manipulation of neuronal activity in epileptic microcircuits.

Studies on pharmacological properties of mucus and sting venom of Potamotrygon cf. henlei.

Stingrays from the Potamotrygon cf. henlei species are widely distributed in high numbers throughout the rivers of central-west Brazil, being the source of numerous envenomations occurring in the dry season, posing a serious public health problem even if not properly reported. The accidents usually involve fishermen and bathers, and to date there is no effective treatment for the injured. Considering these facts and limitations of studies aiming at understanding the effects induced by P. cf. henlei envenoming, this study aimed to describe the principal pharmacological and certain biochemical properties of the mucus and sting venom. We found that mucus and sting venom is toxic to mice having nociceptive, edematogenic and proteolysis activities. Our results also indicate that the inflammatory cellular influx observed could be triggered by the venom and mucus. Furthermore the venom and mucus were partially purified by solid-phase extraction tested for antimicrobial activity in which only the mucus presented activity. It could be inferred from the present study that P. cf. henlei venom possesses a diverse mixture of peptides, enzymes and pharmacologically active components.

Studies on pharmacological properties of mucus and sting venom ofPotamotrygon cf. henlei

Stingrays from the Potamotrygon cf. henlei species are widely distributed in high numbers throughout therivers of central-west Brazil, being the source of numerous envenomations occurring in the dry season, posinga serious public health problem even if not properly reported. The accidents usually involve fishermen andbathers, and to date there is no effective treatment for the injured. Considering these facts and limitations ofstudies aiming at understanding the effects induced by P. cf. henlei envenoming, this study aimed to describethe principal pharmacological and certain biochemical properties of the mucus and sting venom. We foundthat mucus and sting venom is toxic to mice having nociceptive, edematogenic and proteolysis activities. Ourresults also indicate that the inflammatory cellular influx observed could be triggered by the venom andmucus. Furthermore the venom and mucus were partially purified by solid-phase extraction tested forantimicrobial activity in which only the mucus presented activity. It could be inferred from the present studythat P. cf. henlei venom possesses a diverse mixture of peptides, enzymes and pharmacologically activecomponents.