Intensive neurorehabilitation and allogeneic stem cells transplantation in canine degenerative myelopathy.

Introduction: Degenerative myelopathy (DM) is a neurodegenerative spinal cord disease with upper motor neurons, with progressive and chronic clinical signs, similar to amyotrophic lateral sclerosis (ALS). DM has a complex etiology mainly associated with SOD1 gene mutation and its toxic role, with no specific treatment. Daily intensive rehabilitation showed survival time near 8 months but most animals are euthanized 6-12 months after clinical signs onset. Methods: This prospective controlled blinded cohort clinical study aims to evaluate the neural regeneration response ability of DM dogs subjected to an intensive neurorehabilitation protocol with mesenchymal stem cells (MSCs) transplantation. In total, 13 non-ambulatory (OFS 6 or 8) dogs with homozygous genotype DM/DM and diagnosed by exclusion were included. All were allocated to the intensive neurorehabilitation with MSCs protocol (INSCP) group (n = 8) or to the ambulatory rehabilitation protocol (ARP) group (n = 5), which differ in regard to training intensity, modalities frequency, and MSCs transplantation. The INSCP group was hospitalized for 1 month (T0 to T1), followed by MSCs transplantation (T1) and a second month (T2), whereas the ARP group was under ambulatory treatment for the same 2 months. Results: Survival mean time of total population was 375 days, with 438 days for the INSCP group and 274 for the ARP group, with a marked difference on the Kaplan-Meier survival analysis. When comparing the literature's results, there was also a clear difference in the one-sample t-test (p = 0.013) with an increase in time of approximately 70%. OFS classifications between groups at each time point were significantly different (p = 0.008) by the one-way ANOVA and the independent sample t-test. Discussion: This INSCP showed to be safe, feasible, and a possibility for a long progression of DM dogs with quality of life and functional improvement. This study should be continued.

Performance of point-of-care severity scores to predict prognosis in patients admitted through the emergency department with COVID-19.

BACKGROUND: Identifying COVID-19 patients at the highest risk of poor outcomes is critical in emergency department (ED) presentation. Sepsis risk stratification scores can be calculated quickly for COVID-19 patients but have not been evaluated in a large cohort. OBJECTIVE: To determine whether well-known risk scores can predict poor outcomes among hospitalized COVID-19 patients. DESIGNS, SETTINGS, AND PARTICIPANTS: A retrospective cohort study of adults presenting with COVID-19 to 156 Hospital Corporation of America (HCA) Healthcare EDs, March 2, 2020, to February 11, 2021. INTERVENTION: Quick Sequential Organ Failure Assessment (qSOFA), Shock Index, National Early Warning System-2 (NEWS2), and quick COVID-19 Severity Index (qCSI) at presentation. MAIN OUTCOME AND MEASURES: The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and vasopressors receipt. Patients scored positive with qSOFA ≥ 2, Shock Index > 0.7, NEWS2 ≥ 5, and qCSI ≥ 4. Test characteristics and area under the receiver operating characteristics curves (AUROCs) were calculated. RESULTS: We identified 90,376 patients with community-acquired COVID-19 (mean age 64.3 years, 46.8% female). 17.2% of patients died in-hospital, 28.6% went to the ICU, 13.7% received mechanical ventilation, and 13.6% received vasopressors. There were 3.8% qSOFA-positive, 45.1% Shock Index-positive, 49.8% NEWS2-positive, and 37.6% qCSI-positive at ED-triage. NEWS2 exhibited the highest AUROC for in-hospital mortality (0.593, confidence interval [CI]: 0.588-0.597), ICU admission (0.602, CI: 0.599-0.606), mechanical ventilation (0.614, CI: 0.610-0.619), and vasopressor receipt (0.600, CI: 0.595-0.604). CONCLUSIONS: Sepsis severity scores at presentation have low discriminative power to predict outcomes in COVID-19 patients and are not reliable for clinical use. Severity scores should be developed using features that accurately predict poor outcomes among COVID-19 patients to develop more effective risk-based triage.

Cost-effective rhamnolipid production by Burkholderia thailandensis E264 using agro-industrial residues.

The agro-industrial by-products corn steep liquor (CSL) and olive mill wastewater (OMW) were evaluated as low-cost substrates for rhamnolipid production by Burkholderia thailandensis E264. In a culture medium containing CSL (7.5% (v/v)) as sole substrate, B. thailandensis E264 produced 175 mg rhamnolipid/L, which is about 1.3 times the amount produced in the standard medium, which contains glycerol, peptone, and meat extract. When the CSL medium was supplemented with OMW (10% (v/v)), rhamnolipid production further increased up to 253 mg/L in flasks and 269 mg/L in a bioreactor. Rhamnolipids produced in CSL + OMW medium reduced the surface tension up to 27.1 mN/m, with a critical micelle concentration of 51 mg/L, better than the values obtained with the standard medium (28.9 mN/m and 58 mg/L, respectively). However, rhamnolipids produced in CSL + OMW medium displayed a weak emulsifying activity when compared to those produced in the other media. Whereas di-rhamnolipid congeners represented between 90 and 95% of rhamnolipids produced by B. thailandensis E264 in CSL and the standard medium, the relative abundance of mono-rhamnolipids increased up to 55% in the culture medium containing OMW. The difference in the rhamnolipid congeners produced in each medium explains their different surface-active properties. To the best of our knowledge, this is the first report of rhamnolipid production by B. thailandensis using a culture medium containing agro-industrial by-products as sole ingredients. Furthermore, rhamnolipids produced in the different media recovered around 60% of crude oil from contaminated sand, demonstrating its potential application in the petroleum industry and bioremediation. KEY POINTS: • B. thailandensis produced RL using agro-industrial by-products as sole substrates • Purified RL displayed excellent surface activity (minimum surface tension 27mN/m) • Crude RL (cell-free supernatant) recovered 60% of crude oil from contaminated sand.

Surgical capacity assessment in the state of Amazonas using the surgical assessment tool. Cross-sectional study.

OBJECTIVE: Brazil is a country with universal health coverage, yet access to surgery among remote rural populations remains understudied. This study assesses surgical care capacity among hospitals providing care for the rural populations in the Amazonas state of Brazil through in-depth facility assessments. METHODS: a stratified randomized cross-sectional evaluation of hospitals that self-report providing surgical care in Amazonas was conducted from July 2016 to March 2017. The Surgical Assessment Tool (SAT) developed by the World Health Organization and the Program in Global Surgery and Social Change at Harvard Medical School was administered at remote hospitals, including a retrospective review of medical records and operative logbooks. RESULTS: 18 hospitals were surveyed. Three hospitals (16.6%) had no operating rooms and 12 (66%) had 1-2 operating rooms. 14 hospitals (77.8%) reported monitoring by pulse oximetry was always present and six hospitals (33%) never have a professional anesthesiologist available. Inhaled general anesthesia was available in 12 hospitals (66.7%), but 77.8% did not have any mechanical ventilation device. An average of 257 procedures per 100,000 were performed. 10 hospitals (55.6%) do not have a specific post-anesthesia care unit. For the regions covered by the 18 hospitals, with a population of 497,492 inhabitants, the average surgeon, anesthetist, obstetric workforce density was 6.4. CONCLUSION: populations living in rural areas in Brazil face significant disparities in access to surgical care, despite the presence of universal health coverage. Development of a state plan for the implementation of surgery is necessary to ensure access to surgical care for rural populations.

Light availability in the cultivation environment and the action of glyphosate on Digitaria insularis: physiological aspects and herbicide root exudation.

The root exudation decreases the susceptibility of some species to herbicides, which is still little studied in Digitaria insularis, popularly known as sourgrass, one of the main weeds of annual crops in the world. Thus, we sought to identify whether there is an occurrence of root exudation of glyphosate in D. insularis and the influence of this herbicide on physiological and control parameters of this species when cultivated under different light conditions. The experimental design was 2 x 5, with the first factor represented by environments: full sun and artificial shading. The second factor was represented by doses 0, 370, 740, 1110, and 1480 g ha-1 of glyphosate. The plants grown in shading showed more significant injury in the initial phase. The increase in the glyphosate doses reduced the photochemical efficiency of the photosystem II (ФPSII), electron transport rate (ETR), photosynthetic rate, stomatal conductance, transpiration rate, and water use efficiency of D. insularis regardless of the cultivation environment. The light restriction increased the ФPSII in D. insularis at three days after applying the herbicide (DAH); at 6 DAH, the shaded plants showed a more pronounced reduction in ФPSII. D. insularis did not show root exudation of glyphosate, and shading did not influence this process.

Surgical capacity assessment in the state of Amazonas using the surgical assessment tool. Cross-sectional study / Avaliação da capacidade cirúrgica do estado do Amazonas utilizando uma ferramenta de avaliação cirúrgica. Estudo transversal

ABSTRACT Objective: Brazil is a country with universal health coverage, yet access to surgery among remote rural populations remains understudied. This study assesses surgical care capacity among hospitals providing care for the rural populations in the Amazonas state of Brazil through in-depth facility assessments. Methods: a stratified randomized cross-sectional evaluation of hospitals that self-report providing surgical care in Amazonas was conducted from July 2016 to March 2017. The Surgical Assessment Tool (SAT) developed by the World Health Organization and the Program in Global Surgery and Social Change at Harvard Medical School was administered at remote hospitals, including a retrospective review of medical records and operative logbooks. Results: 18 hospitals were surveyed. Three hospitals (16.6%) had no operating rooms and 12 (66%) had 1-2 operating rooms. 14 hospitals (77.8%) reported monitoring by pulse oximetry was always present and six hospitals (33%) never have a professional anesthesiologist available. Inhaled general anesthesia was available in 12 hospitals (66.7%), but 77.8% did not have any mechanical ventilation device. An average of 257 procedures per 100,000 were performed. 10 hospitals (55.6%) do not have a specific post-anesthesia care unit. For the regions covered by the 18 hospitals, with a population of 497,492 inhabitants, the average surgeon, anesthetist, obstetric workforce density was 6.4. Conclusion: populations living in rural areas in Brazil face significant disparities in access to surgical care, despite the presence of universal health coverage. Development of a state plan for the implementation of surgery is necessary to ensure access to surgical care for rural populations.

RESUMO Objetivo: o Brasil é um país com cobertura universal de saúde, mas o acesso à cirurgia entre populações remotas permanece pouco estudado. Este estudo avalia a capacidade cirúrgica em hospitais que servem populações rurais no estado do Amazonas, Brasil, por meio de avaliações aprofundadas das instalações. Métodos: foi realizada avaliação estratificada randomizada transversal de hospitais que relataram prestar assistência cirúrgica de julho de 2016 a março de 2017. A Ferramenta de Avaliação Cirúrgica desenvolvida pela Organização Mundial da Saúde e o Programa de Cirurgia Global e Mudança Social da Harvard Medical School foi administrada em hospitais remotos, incluindo uma revisão retrospectiva de registros médicos e livros cirúrgicos. Resultados: 18 hospitais foram pesquisados. Três hospitais (16,6%) não tinham salas cirúrgicas e 12 (66%) tinham 1-2. 14 hospitais (77,8%) relataram que a oximetria de pulso estava "sempre presente" e seis hospitais (33%) nunca têm um anestesiologista disponível. A anestesia inalatória estava disponível em 12 hospitais (66,7%), 77,8% não possuíam dispositivo de ventilação mecânica. Em média, 257 procedimentos por 100.000 foram realizados. 10 hospitais (55,6%) não possuem unidade de recuperação anestésica. Para as regiões de abrangência dos 18 hospitais, com população de 497.492 habitantes, a densidade média de força de trabalho cirúrgica, anestesista e obstétrica foi de 6,4. Conclusão: as populações que vivem em áreas rurais no Brasil enfrentam disparidades significativas no acesso à assistência cirúrgica, apesar da presença de cobertura universal de saúde. O desenvolvimento de um plano estadual de cirurgia é necessário para garantir acesso à assistência cirúrgica às populações rurais.

Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections.

PURPOSE: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. METHODS: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. RESULTS: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. CONCLUSIONS: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.

Cross-sectional study of surgical quality with a novel evidence-based tool for low-resource settings.

BACKGROUND: Adverse events from surgical care are a major cause of death and disability, particularly in low-and-middle-income countries. Metrics for quality of surgical care developed in high-income settings are resource-intensive and inappropriate in most lower resource settings. The purpose of this study was to apply and assess the feasibility of a new tool to measure surgical quality in resource-constrained settings. METHODS: This is a cross-sectional study of surgical quality using a novel evidence-based tool for quality measurement in low-resource settings. The tool was adapted for use at a tertiary hospital in Amazonas, Brazil resulting in 14 metrics of quality of care. Nine metrics were collected prospectively during a 4-week period, while five were collected retrospectively from the hospital administrative data and operating room logbooks. RESULTS: 183 surgeries were observed, 125 patient questionnaires were administered and patient charts for 1 year were reviewed. All metrics were successfully collected. The study site met the proposed targets for timely process (7 hours from admission to surgery) and effective outcome (3% readmission rate). Other indicators results were equitable structure (1.1 median patient income to catchment population) and equitable outcome (2.5% at risk of catastrophic expenditure), safe outcome (2.6% perioperative mortality rate) and effective structure (fully qualified surgeon present 98% of cases). CONCLUSION: It is feasible to apply a novel surgical quality measurement tool in resource-limited settings. Prospective collection of all metrics integrated within existing hospital structures is recommended. Further applications of the tool will allow the metrics and targets to be refined and weighted to better guide surgical quality improvement measures.

Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections / Perfil microbiológico e de resistência bacteriana no pé diabético infectado

ABSTRACT Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. Results: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. Conclusions: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.

RESUMO Objetivo: identificar o perfil sociodemográfico, microbiológico e de resistência bacteriana em pacientes com pé diabético infectado. Métodos: tratou-se de estudo observacional, transversal que avaliou os perfis sóciodemográfico e microbiológico de pacientes portadores de pé diabético infectado internados em Pronto Socorro de referência. Os dados sociodemográficos foram coletados por meio de entrevista. Foram colhidos, durante os procedimentos cirúrgicos, fragmentos de tecidos das lesões podais infectadas para realização de cultura/antibiograma. Resultados: a amostra foi composta por 105 pacientes. O perfil sociodemográfico mais prevalente foi o de pacientes do sexo masculino, acima dos 50 anos, casados e com baixa escolaridade. Das 105 amostras de fragmentos de tecidos colhidos para realização de cultura e antibiograma, 95 foram positivas, com crescimento de um único germe em cada um dos exames. Houve predomínio de germes da família Enterobacteriaceae (51,5%). Germes Gram-negativos foram isolados em 60,0% das culturas e os espécimes mais isolados individualmente foram os cocos Gram-positivos, Staphylococcus aureus (20,0%) e Enterococcus faecalis (17,9%). Considerando-se os perfis de resistência bacteriana, verificou-se alta taxa de Staphylococcus aureus resistente à meticilina (63,0%) e à ciprofloxacino (55,5%); verificou-se, também, que 43,5% dos germes Gram-negativos eram resistentes à ciprofloxacino. Conclusões: o perfil sociodemográfico majoritário, foi o de homens, com mais de 50 anos e com baixa escolaridade. Concluímos que os germes mais prevalentes nas lesões podais dos pacientes diabéticos foram os Gram-negativos, resistentes ao ciprofloxacino e que o germe mais isolado individualmente foi o Staphylococcus aureus resistente à meticilina.

Fatal cardiac trauma in the city of Manaus, Amazonas state, Brazil. / Trauma cardíaco fatal na cidade de Manaus/AM, Brasil.

OBJECTIVE: to determine the frequency of fatal cardiac trauma in the city of Manaus, Brazil, between November 2015 and October 2016, and to clarify the mechanisms of trauma and death, previous hospital treatment, as well as the injuries associated with cardiac trauma. METHODS: retrospective, observational, and cross-sectional study, which reviewed the necropsy reports of individuals whose cause of death was cardiac injury. RESULTS: the cardiac trauma rate was of 5.98% (138 cases) out of 2,306 necropsies performed in the study period by Instituto Médico Legal (IML) de Manaus (IML is a Brazilian institute responsible for necropsies and cadaveric reports). Males accounted for 92% of the cases. The median age was 27 years (14-83). Gunshot wounds (GSW) was the trauma mechanism in 62.3% and stab wound (SW) in 29.7%. Exsanguination was responsible for most of the deaths and cardiac tamponade was present in second place. On-site death occurred in 86.2% of the cases. The ventricles were the most common site of cardiac injury. Hemothorax was identified in 90.6% of the individuals. Only 23 patients (16.7%) were taken to the hospital (Emergency Room), but six (26.2%) were submitted only to chest drainage, not to thoracotomy. The lung was unilaterally affected in 57% of the cases and bilaterally in 43%. CONCLUSION: fatal cardiac trauma represented an index of 5.98% in the city of Manaus. Most patients die at the scene of the trauma, usually due to exsanguination caused by gunshot wound. About a quarter of patients who reached the hospital and died were not diagnosed with cardiac trauma in time.

OBJETIVO: determinar o índice de trauma cardíaco fatal na cidade de Manaus e esclarecer os mecanismos de trauma e de morte, o tratamento hospitalar prévio, assim como as lesões associadas ao trauma cardíaco. MÉTODOS: estudo retrospectivo, observacional, transversal, que revisou os laudos de necropsias do Instituto Médico Legal de Manaus entre novembro de 2015 e outubro de 2016, cuja causa mortis foi lesão cardíaca. RESULTADOS: o índice de trauma cardíaco foi de 5,98% (138 casos) dentre 2306 necropsias realizadas no período do estudo. Homens foram afetados em 92%. A mediana de idade foi de 27 anos (14 a 83). A arma de fogo foi o mecanismo de trauma em 62,3% e a arma branca em 29,7%. A exsanguinação foi responsável pela maioria das mortes e o tamponamento cardíaco esteve presente em segundo lugar. Óbito no local ocorreu em 86,2%. Os ventrículos foram as câmaras mais lesionadas. O hemotórax foi descrito em 90,6%. Apenas 23 (16,7%) doentes foram removidos até o pronto socorro, porém seis deles (26,2%) não foram submetidos à toracotomia, apenas à drenagem de tórax. O pulmão foi acometido em 57% unilateralmente e 43% bilateralmente. CONCLUSÃO: o trauma cardíaco fatal representou um índice de 5,98% na cidade de Manaus. A maioria dos doentes morre na cena do trauma, geralmente devido à exsanguinação causada por ferimento de arma de fogo. Cerca de um quarto dos pacientes que chegaram ao pronto socorro e morreram, não foram diagnosticados com trauma cardíaco em tempo hábil.

Trauma cardíaco fatal na cidade de Manaus/AM, Brasil / Fatal cardiac trauma in the city of Manaus, Amazonas state, Brazil

RESUMO Objetivo: determinar o índice de trauma cardíaco fatal na cidade de Manaus e esclarecer os mecanismos de trauma e de morte, o tratamento hospitalar prévio, assim como as lesões associadas ao trauma cardíaco. Métodos: estudo retrospectivo, observacional, transversal, que revisou os laudos de necropsias do Instituto Médico Legal de Manaus entre novembro de 2015 e outubro de 2016, cuja causa mortis foi lesão cardíaca. Resultados: o índice de trauma cardíaco foi de 5,98% (138 casos) dentre 2306 necropsias realizadas no período do estudo. Homens foram afetados em 92%. A mediana de idade foi de 27 anos (14 a 83). A arma de fogo foi o mecanismo de trauma em 62,3% e a arma branca em 29,7%. A exsanguinação foi responsável pela maioria das mortes e o tamponamento cardíaco esteve presente em segundo lugar. Óbito no local ocorreu em 86,2%. Os ventrículos foram as câmaras mais lesionadas. O hemotórax foi descrito em 90,6%. Apenas 23 (16,7%) doentes foram removidos até o pronto socorro, porém seis deles (26,2%) não foram submetidos à toracotomia, apenas à drenagem de tórax. O pulmão foi acometido em 57% unilateralmente e 43% bilateralmente. Conclusão: o trauma cardíaco fatal representou um índice de 5,98% na cidade de Manaus. A maioria dos doentes morre na cena do trauma, geralmente devido à exsanguinação causada por ferimento de arma de fogo. Cerca de um quarto dos pacientes que chegaram ao pronto socorro e morreram, não foram diagnosticados com trauma cardíaco em tempo hábil.

ABSTRACT Objective: to determine the frequency of fatal cardiac trauma in the city of Manaus, Brazil, between November 2015 and October 2016, and to clarify the mechanisms of trauma and death, previous hospital treatment, as well as the injuries associated with cardiac trauma. Methods: retrospective, observational, and cross-sectional study, which reviewed the necropsy reports of individuals whose cause of death was cardiac injury. Results: the cardiac trauma rate was of 5.98% (138 cases) out of 2,306 necropsies performed in the study period by Instituto Médico Legal (IML) de Manaus (IML is a Brazilian institute responsible for necropsies and cadaveric reports). Males accounted for 92% of the cases. The median age was 27 years (14-83). Gunshot wounds (GSW) was the trauma mechanism in 62.3% and stab wound (SW) in 29.7%. Exsanguination was responsible for most of the deaths and cardiac tamponade was present in second place. On-site death occurred in 86.2% of the cases. The ventricles were the most common site of cardiac injury. Hemothorax was identified in 90.6% of the individuals. Only 23 patients (16.7%) were taken to the hospital (Emergency Room), but six (26.2%) were submitted only to chest drainage, not to thoracotomy. The lung was unilaterally affected in 57% of the cases and bilaterally in 43%. Conclusion: fatal cardiac trauma represented an index of 5.98% in the city of Manaus. Most patients die at the scene of the trauma, usually due to exsanguination caused by gunshot wound. About a quarter of patients who reached the hospital and died were not diagnosed with cardiac trauma in time.

Correlações entre condições do ambiente, organização do trabalho, sintomas vocais autorreferidos por professores universitários e avaliação fonoaudiológica / Correlation between environment, work organization conditions, voice symptoms self-reported by university professors and speech-language pathology assessment / La correlaciones entre condiciones del ambiente, organización del trabajo, síntomas vocales autorreferidos por profesores universitarios y evaluación fonoaudiológica

Introdução: Os fatores do trabalho podem facilitar os agravos à saúde e voz do professor. Objetivo: Correlacionar condições do ambiente, organização do trabalho, sintomas vocais auto-referidos por professores universitários e avaliação fonoaudiológica. Material e método: 112 docentes responderam ao questionário de Condição de Produção Vocal-Professor adaptado, do qual foram selecionadas as respostas aos itens: identificação, avaliação do ambiente e organização do trabalho e voz. Foi realizada avaliação vocal perceptivo-auditiva e as vozes classificadas em sem ou com alteração. Os dados obtidos nestas duas fontes foram correlacionados. Resultados: Ruído e poeira foram as variáveis que mais obtiveram correlação estatística com os sintomas referidos pelos professores. A violência e o ambiente estressante foram os fatores de risco que mais apresentaram correlações positivas com os sintomas vocais. Os sintomas vocais proprioceptivos mais referidos pelos professores foram garganta seca e esforço ao falar, sendo estes indicativos de falta de hidratação e tensão excessiva durante a fala. A avaliação fonoaudiológica identificou um terço dos professores com distúrbio vocal, sendo a grande maioria de grau leve. Obteve-se correlação positiva com a avaliação fonoaudiologica para rouquidão e voz fraca auto-referidos. Quase a totalidade dos docentes referiu mais de três sintomas vocais. Conclusão: O ambiente de trabalho foi mais bem avaliado que a organização e obteve-se correlação positiva entre fatores do ambiente e organização do trabalho com sintomas vocais auto-referidos. Não foi constatada correlação entre estas condições e a presença de alteração vocal decorrente da avaliação fonoaudiológica.

Introduction: Work factors may favor hazards to the health and voice of teachers. PURPOSE: to correlate environment and work organization conditions and self-reported voice symptoms of university professors with speech-Language Pathology assessment. Method: 112 teachers answered the adapted Conditions of Voice Production ? Teacher questionnaire, from which answers to the following items were selected: identification, work environment and organization evaluation and voice. A perceptive-auditory voice assessment was conducted and voices were classified with or without disorder. The data obtained in both sources were correlated. Results: Noise and dust were the variables with the most statistical correlation to the symptoms reported by the teachers. Violence and stressful environment were the risk factors with most positive correlations to the vocal symptoms. The perceptive vocal symptoms that were most frequently reported by the teachers were dry throat and strained speech, which are indicative of lack of hydration and excessive tension while speaking. The Speech-Language Pathology assessment identified that one third of the teachers had voice disorders, most of which were mild. There was a positive correlation in between self-reported hoarseness and weak voice with the Speech-Language Pathology assessment. Almost all teachers reported more than three voice symptoms. Conclusion: Work environment was better evaluated than work organization and there was positive correlation between work environment and organization factors and the self-reported vocal symptoms. There was no correlation between these conditions and voice disorder according to Speech-Language Patholog assessment.

Introducción: Factores del trabajo pueden facilitar daños a la salud y a la voz del profesor. Objetivo: Correlacionar condiciones del ambiente, organización del trabajo, síntomas vocales autorreferidos por profesores universitarios y evaluación fonoaudiológica. Materiales y método: 112 docentes respondieron al cuestionario de Condición de Producción Vocal-Profesor adaptado, del cual se seleccionaron las respuestas a los ítems: identificación, evaluación del ambiente y organización del trabajo y voz. Se realizó evaluación vocal perceptivo-auditiva y las voces clasificadas en sin o con alteración. Se correlacionaron los datos obtenidos en estas dos fuentes. Resultados: Ruido y polvo fueron las variables que más obtuvieron correlación estadística con los síntomas referidos por los profesores. La violencia y el ambiente estresante fueron los factores de riesgo que más presentaron correlaciones positivas con los síntomas vocales. Los síntomas vocales propioceptivos más referidos por los profesores fueron garganta seca y esfuerzo al hablar, siendo estos indicativos de falta de hidratación y tensión excesiva durante el habla. La evaluación fonoaudiológica identificó un tercio de los profesores con disturbio vocal, la gran mayoría de grado leve. Se obtuvo correlación positiva con la evaluación fonoaudiológica para ronquera y voz débil autorreferidos. Casi la totalidad de los docentes refirió más de tres síntomas vocales. Conclusión: El ambiente de trabajo fue mejor evaluado que la organización, se obtuvo correlación positiva entre factores del ambiente y organización del trabajo con síntomas vocales autorreferidos. No se constató correlación entre estas condiciones y presencia de alteración vocal derivada de la evaluación fonoaudiológica.

Facultad de Medicina: 180 años después / Facultad de Medicina: 180 years later

Se refiere a la institución con tradición más antigua en la enseñanza médica en Venezuela , la Universidad Central de Venezuela. Esta historia es iniciada por Lorenzo Campins y Ballester, en 1763, con la Cátedra de Prima de Medicina, en lo que se denominaba Real y Pontificia Universidad de Caracas. Los cimientos de esta labor fueron cabalmente enraizados por Simón Bolívar y José María Vargas al crear a la Facultad Médica de Caracas en 1827, ya bajo los márgenes de una Universidad Central de Venezuela naciente y, permitiendo, de este modo, la prosecución del trabajo iniciado por aquella Cátedra de Prima de Medicina. Con el correr de los años cambia de denominación, pasando por el de Facultad de Ciencias Médicas e Historia Natural en 1843, y en 1874 es denominada Facultad de Ciencias Médicas. (AU)