Environmental impact assessment of the electrokinetic adsorption barriers to remove different herbicides from agricultural soils.

In this study, the sustainability of the electrokinetic remediation soil flushing (EKSFs) process integrated without and with adsorption barriers (EKABs) have been evaluated for the treatment of four soils contaminated with Atrazine, Oxyfluorfen, Chlorosulfuron and 2,4-D. To this purpose, the environmental effects of both procedures (EKSFs and EKABs) have been determined through a life cycle assessment (LCA). SimaPro 9.3.0.3 was used as software tool and Ecoinvent 3.3 as data base to carry out the inventory of the equipment of each remediation setup based on experimental measurements. The environmental burden was quantified using the AWARE, USEtox, IPPC, and ReCiPe methods into 3 Endpoint impact categories (and damage to human health, ecosystem and resources) and 7 Midpoints impact categories (water footprint, global warming potential, ozone depletion, human toxicity (cancer and human non-cancer), freshwater ecotoxicity and terrestrial ecotoxicity). In general terms, the energy applied to treatment (using the Spanish energy mix) was the parameter with the greatest influence on the carbon footprint, ozone layer depletion and water footprint accounting for around 70 % of the overall impact contribution. On the other hand, from the point of view of human toxicity and freshwater ecotoxicity of soil treatments with 32 mg kg-1 of the different pesticides, the EKSF treatment is recommended for soils with Chlorosulfuron. In this case, the carbon footprint and water footprint reached values around 0.36 kg of CO2 and 114 L of water per kg of dry soil, respectively. Finally, a sensitivity analysis was performed assuming different scenarios.

Cerebral and Peripheral Immune Cell Changes following Rodent Juvenile Traumatic Brain Injury.

Traumatic brain injury (TBI) is one of the leading causes of death and disability. TBI is associated with neuroinflammation, but temporal changes in immune and inflammatory signaling following TBI have not been fully elucidated. Furthermore, there have been no previous studies on changes in immune cell populations following TBI via the Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA). The current study aimed to determine the time course changes to inflammatory marker mRNA expression in the acute period following TBI in juvenile rats and to determine acute changes to brain and circulating immune cell populations. For this study, post-natal day (PND)-30 male Long Evans rats sustained a TBI or Sham TBI and were euthanized at 0, 3, 6, 12, 24, or 96 h post-injury. Prefrontal cortex and hippocampus samples were used to determine mRNA expression changes of inflammatory factors. The mRNA expression of the pro-inflammatory cytokine TNF-α was significantly elevated at 6 h post-injury in both regions evaluated. To evaluate immune cell populations, male Long Evans rats were euthanized at 48 h post-injury, and brain and blood samples were used for cell sorting by marker-specific antibodies. In the peripheral blood, there was an elevation in CD3+ total T cells, CD45R+ total B cells, and CD3+CD4+ helper T cells in the TBI subjects. However, there were no changes to natural killer cells or CD3+CD8+ cytotoxic T cell populations. In the brain, there was a reduction in CD11b/c+ monocytes/macrophages, but no changes in other immune cell populations. At 48 h post-injury, the TBI subjects also demonstrated expansion of the thymic medulla. These changes in the cerebral and blood immune cell populations and thymic medulla expansion may implicate the subacute recovery timeframe as a vulnerable window for the immune system in the pediatric population.

Evaluation of the technique of localization of the epidural space with the aid of a peripheral nerve stimulator and epidurographic, comparing two techniques for determining the infused volume, in rabbits (Oryctolagus Cuniculus).

Veterinary care for rabbits has been growing, and, consequently, the anesthetic and analgesic management of this species must be improved. The aim of the present study was to evaluate the technique of localization of the epidural space with the aid of a peripheral nerve stimulator and epidurographic, comparing two techniques for determining the infused volume in rabbits (Oryctolagus Cuniculus). In a prospective, randomized blinded study, six healthy New Zealand rabbits, adults, and weighing from 2.2 kg to 3.8 kg received two treatments, at 1 week intervals: 0.33 mL/kg (treatment I) or 0.05 mL per centimeter of the spine (treatment II) of ioexol epidurally. In both treatments, a peripheral nerve stimulator (2 Hz, 0.25 mA and 0.1 milliseconds) was used to determine the location of the epidural space. Latero-lateral and ventro-dorsal radiographs were taken after five (T5) and twenty-five minutes (T25) of iohexol administration. The epidural space was correctly accessed in 92% of attempts. Treatment I received a smaller volume of contrast than treatment II, 1.0 ± 0.2 mL versus 2.1 ± 0.1 mL (mean ± standard deviation), respectively (p = 0.007). At T5, the cranial progression of the contrast varied between L4 and L5 in treatment I, and L5 and T10 in treatment II. At T25, no contrast was observed in any rabbit. In conclusion, peripheral nerve stimulator aided in accessing the lumbosacral epidural space, and the administration of 0.05 mL per centimeter of the spine resulted in greater cranial progression of contrast.

Temporal shifts to the gut microbiome associated with cognitive dysfunction following high-fat diet consumption in a juvenile model of traumatic brain injury.

The gut-brain axis interconnects the central nervous system (CNS) and the commensal bacteria of the gastrointestinal tract. The composition of the diet consumed by the host influences the richness of the microbial populations. Traumatic brain injury (TBI) produces profound neurocognitive damage, but it is unknown how diet influences the microbiome following TBI. The present work investigates the impact of a chow diet versus a 60% fat diet (HFD) on fecal microbiome populations in juvenile rats following TBI. Twenty-day-old male rats were placed on one of two diets for 9 days before sustaining either a Sham or TBI via the Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA). Fecal samples were collected at both 1- and 9-days postinjury. Animals were cognitively assessed in the novel object recognition tests at 8 days postinjury. Fecal microbiota DNA was isolated and sequenced. Twenty days of HFD feeding did not alter body weight, but fat mass was elevated in HFD compared with Chow rats. TBI animals had a greater percentage of entries to the novel object quadrant than Sham counterparts, P < 0.05. The Firmicutes/Bacteroidetes ratio was significantly higher in TBI than in the Sham, P < 0.05. Microbiota of the Firmicutes lineage exhibited perturbations by both injury and diet that were sustained at both time points. Linear regression analyses were performed to associate bacteria with metabolic and neurocognitive endpoints. For example, counts of Lachnospiraceae were negatively associated with percent entries into the novel object quadrant. Taken together, these data suggest that both diet and injury produce robust shifts in microbiota, which may have long-term implications for chronic health.NEW & NOTEWORTHY Traumatic brain injury (TBI) produces memory and learning difficulties. Diet profoundly influences the populations of gut microbiota. Following traumatic brain injury in a pediatric model consuming either a healthy or high-fat diet (HFD), significant shifts in bacterial populations occur, of which, some are associated with diet, whereas others are associated with neurocognitive performance. More work is needed to determine whether these microbes can therapeutically improve learning following trauma to the brain.

Physical activity measured with an accelerometer in dogs following extracapsular stabilisation to treat cranial cruciate ligament rupture.

OBJECTIVES: To quantify the physical activity levels in dogs with cranial cruciate ligament rupture before and after lateral fabellar suture stabilisation surgery. MATERIALS AND METHODS: Seventeen dogs (mean weight, 12.3±5.1 kg) with unilateral cranial cruciate ligament rupture were fitted with an accelerometer for seven consecutive days at four different time points: before surgery (T0), one (T1), three (T3) and six (T6) months after surgery. The total activity and times spent in sedentary activity, light to moderate activity and vigorous activity were recorded by the accelerometer, and preoperative and postoperative data were compared. At all time points, dogs underwent clinical evaluations (lameness score, stifle pain score and thigh circumference) and their owners were asked to respond to questionnaires to subjectively score the physical activity and quality of life of the dogs. RESULTS: At the four time points, the dogs spent between 21.2 and 21.4 hours on sedentary behaviour, 2.3 and 2.5 hours performing light to moderate activity, and 13 to 15 minutes performing vigorous activity. There was no increase in physical activity variables or decrease in sedentary behaviour over time. Lameness scores, pain score and dogs' quality of life improved significantly during the postoperative period. At T6, 17 (100%) of 17 dogs presented no lameness, 16 (94%) of 17 dogs presented no stifle pain, 16 (94%) of 17 owners rated the quality of life as very good and excellent, and 16 (100%) of 16 owners reported a total return to normal activity levels. CLINICAL SIGNIFICANCE: The clinical recovery after extracapsular stabilisation of the stifle joint was not associated with a spontaneous increase in physical activity or a decrease in sedentary behaviour.

DNA methylation of the promoter region at the CREB1 binding site is a mechanism for the epigenetic regulation of brain-specific PKMζ.

Protein kinase M zeta, PKMζ, is a brain enriched kinase with a well characterized role in Long-Term Potentiation (LTP), the activity-dependent strengthening of synapses involved in long-term memory formation. However, little is known about the molecular mechanisms that maintain the tissue specificity of this kinase. Here, we characterized the epigenetic factors, mainly DNA methylation, regulating PKMζ expression in the human brain. The PRKCZ gene has an upstream promoter regulating Protein kinase C ζ (PKCζ), and an internal promoter driving PKMζ expression. A demethylated region, including a canonical CREB binding site, situated at the internal promoter was only observed in human CNS tissues. The induction of site-specific hypermethylation of this region resulted in decreased CREB1 binding and downregulation of PKMζ expression. Noteworthy, CREB binding sites were absent in the upstream promoter of PRKCZ locus, suggesting a specific mechanism for regulating PKMζ expression. These observations were validated using a system of human neuronal differentiation from induced pluripotent stem cells (iPSCs). CREB1 binding at the internal promoter was detected only in differentiated neurons, where PKMζ is expressed. The same epigenetic mechanism in the context of CREB binding site was identified in other genes involved in neuronal differentiation and LTP. Additionally, aberrant DNA hypermethylation at the internal promoter was observed in cases of Alzheimer's disease, correlating with decreased expression of PKMζ in patient brains. Altogether, we present a conserved epigenetic mechanism regulating PKMζ expression and other genes enhanced in the CNS with possible implications in neuronal differentiation and Alzheimer's disease.

High-Fat Diet Exacerbates Stress Responsivity in Juvenile Traumatic Brain Injury.

Abstract Traumatic brain injury (TBI) is one of the leading causes of death for children in the United States. Juveniles are more likely to sustain TBIs than most other age groups, and TBI has been shown to result in increased anxiety and stress behaviors. In addition, the hypothalamic-pituitary-adrenal (HPA) axis has previously been shown to become dysregulated after a TBI. Further, many children consume diets high in saturated fats and refined sugars, which are also connected to alterations in HPA axis function and behavior disorders. The goal of the current study was to identify a potential relationship between high-fat diet (HFD) consumption and TBI on HPA axis function in juvenile rats. In the present study, male juvenile Long-Evans rats were fed either a combination of an HFD with a high-fructose corn syrup solution or a standard chow diet. On post-natal Day 30, subjects sustained either a sham TBI or a TBI via the Closed-Head Injury Model of Engineered Rotational Acceleration (CHIMERA). Subjects participated in a trial of the open field test (OFT) following injury. In addition, some rats performed in an acute restraint stress test. All subjects were euthanized 7 days post-injury. Brain and blood plasma samples were collected for use in real-time polymerase chain reaction (RT-PCR), immunohistochemistry, and corticosterone or adrenocorticotropic hormone (ACTH) assays. Immediately following TBI, injured juveniles had increased time to righting and walking, with HFD-fed TBI rats having increased time to walking over Chow-fed TBI rats. HFD-fed TBI rats had a reduced number of entries to the center of the OFT, in addition to reduced time spent in the center compared with HFD Sham controls and Chow TBI rats. During the acute restraint stress test, HFD-fed TBI rats had elevated pre-stress ACTH and corticosterone and post-stress ACTH levels. Pre-stress ACTH levels were significantly elevated in HFD TBI compared with Chow TBI. Further, pre-stress ACTH:corticosterone ratios were elevated in HFD TBI compared with Chow TBI. cFos immunoreactivity in the paraventricular nucleus (PVN) of the hypothalamus following the acute restraint stress test was elevated in HFD-fed TBI rats. HFD TBI rats had greater activation of cFos in the PVN compared with Chow TBI. In addition, RT-PCR showed significantly reduced expression of relevant HPA axis genes, NR3C1, NR3C2, and CRHR2, in the hypothalamus of TBI subjects compared with Sham subjects. Further, AVP and CRHR2 in the hypothalamus were significantly reduced in HFD TBI compared with Chow TBI. These results offer evidence that TBI paired with high-fat diet consumption can cause HPA axis dysfunction, resulting in more anxiety-like behaviors.

Biotechnological potential of Hancornia speciosa whole tree: A narrative review from composition to health applicability.

Mangabeira (Hancornia speciosa) is a Brazilian tree and a socioeconomic key due to the commercialization of its food products and tree parts to treat health conditions empirically. This review gathers the main chemical, and microbiological characteristics of the mangabeira tree parts (leaves, fruits, tree bark, latex, and seeds), emphasizing its applicability in food science and focusing on its bioapplicability in health conditions. Leaves, fruits, and tree bark can be used to develop functional foods, and phytochemical products; the tree latex have great potential in the bioengineering material field; and the seeds in sustainable energy production. Leaves and fruits were the main samples bioapplied in health conditions in vitro (oxidative stress and chemopreventive effect) and in vivo (gastrointestinal and cardiovascular health, anti-inflammatory, and antidiabetic effect), whereas tree bark and latex also exhibited health effects and seeds showed low cytotoxicity. All parts of the mangabeira tree can be explored by extractivist families and industries from a sustainable point of view.

Review of anticancer activity of monoterpenoids: Geraniol, nerol, geranial and neral.

In recent years head-to-tail monoterpene geraniol has been widely explored as a potential anticancer agent. Natural analogs like alcohol nerol, aldehydes geranial, and neral have been investigated. We explored the synergism of these terpenes with clinically and non-clinically used compounds as potential candidates for treating different types of cancer. Promising activity for these compounds has also inspired new analog syntheses. The anticancer potential of these compounds is described in this review.

Mapa de evidências sobre a efetividade clínica das plantas medicinais brasileiras: informe executivo / Evidence Map on the clinical effectiveness of Brazilian medicinal plants: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos das Plantas Medicinais Brasileiras para desfechos em saúde. A partir de uma ampla busca bibliográfica foram incluídos no mapa 214 estudos de revisão sistemática. Todos os estudos foram avaliados, caracterizados e categorizados por um grupo de pesquisadores de Laboratório de Tecnologia de Produtos Naturais (LTPN) da Faculdade de Farmácia da Universidade Federal Fluminense. Principais Achados: ● As revisões avaliaram o efeito de intervenções com 69 tipos de plantas organizadas em 4 categorias: cultivadas, nativas, exóticas e introduzidas no Brasil. ● As intervenções foram associadas a 130 desfechos de saúde organizados em 17 grupos: Bem-Estar, Vitalidade e Qualidade de Vida, Câncer, Condições Patológicas, Dermatopatias, Doenças Cardiovasculares, Doenças Nutricionais e Metabólicas, Doenças Respiratórias, Doenças Reumáticas, Doenças Urogenitais, Dor, Fatores Biológicos, Gastroenteropatias e Hepatopatias, Indicadores Psicológicos e Comportamentais, Indicadores Metabólicos e Fisiológicos, Saúde Mental, Saúde Bucal e Saúde Reprodutiva. ● No total foram 465 associações entre intervenções (as plantas) e desfechos de saúde, com destaque para as plantas cultivadas (251 associações, 54%). ● O grupo dos desfechos "Saúde Mental" foi o que recebeu mais associações (66 associações, 14%), seguido do grupo "Saúde Bucal" (42 associações, 9%). ● Quanto aos desfechos, destaque para: Transtornos de Ansiedade (20 associações), Demência (16 associações), Diabetes Mellitus (17 associações) e Distúrbios Menstruais (15 associações). ● Dentre as plantas, destaque para: Ginkgo biloba (76 associações), Aloe Vera (50), Zingiber officinale (39), Panax ginseng (28) e Curcuma longa (23). Implicações para a prática e pesquisa: ● Considerando o efeito das intervenções para os desfechos, os estudos reportaram efeito positivo ou potencialmente positivo para a maioria (68%) das associações (181 associações com efeito positivo e 137 com efeito potencialmente positivo). ● Destaque para os efeitos positivos ou potencialmente positivos reportados nas intervenções com Ginkgo biloba para os desfechos: Demência, Doença de Alzheimer e Desempenho Cognitivo (8, 7 e 7 associações respectivamente). ● Em 87 associações foi reportado "sem efeito" da intervenção para o desfecho (19,7%). ● Foi reportado efeito inconclusivo para uma pequena parte das associações (9%), que merece mais pesquisas. Nenhum efeito negativo ou potencialmente negativo foi reportado. O efeito não foi informado para 19 associações. ● Note-se que essa lista é dinâmica, podendo mudar com a publicações de novos estudos.

The map provides an overview of the evidence on the effects of Brazilian Medicinal Plants on health outcomes. Based on an extensive literature search, the map includes 214 systematic review studies. All studies were assessed, characterized, and categorized by a group of researchers from the Laboratory of Natural Product Technology (LTPN) at the Faculty of Pharmacy of the Federal Fluminense University. Key Findings: - The reviews evaluated the effects of interventions using 69 types of plants organized into 4 categories: cultivated, native, exotic, and introduced to Brazil. - The interventions were associated with 130 health outcomes organized into 17 groups: Well-being, Vitality and Quality of Life, Cancer, Pathological Conditions, Dermatopathies, Cardiovascular Diseases, Nutritional and Metabolic Diseases, Respiratory Diseases, Rheumatic Diseases, Urogenital Diseases, Pain, Biological Factors, Gastroenteropathies and Hepatopathies, Psychological and Behavioral Indicators, Metabolic and Physiological Indicators, Mental Health, Oral Health, and Reproductive Health. - In total, there were 465 associations between interventions (plants) and health outcomes, with a significant emphasis on cultivated plants (251 associations, 54%). - The "Mental Health" group received the most associations (66 associations, 14%), followed by the "Oral Health" group (42 associations, 9%). - Notable health outcomes included Anxiety Disorders (20 associations), Dementia (16 associations), Diabetes Mellitus (17 associations), and Menstrual Disorders (15 associations). - Among the plants, notable ones included Ginkgo biloba (76 associations), Aloe Vera (50), Zingiber officinale (39), Panax ginseng (28), and Curcuma longa (23). Implications for Practice and Research: - Considering the effects of interventions on health outcomes, the studies reported a positive or potentially positive effect for the majority (68%) of the associations (181 associations with a positive effect and 137 with a potentially positive effect); - Noteworthy are the positive or potentially positive effects reported for interventions with Ginkgo biloba on the outcomes of Dementia, Alzheimer's Disease, and Cognitive Performance (8, 7, and 7 associations, respectively); - In 87 associations, the intervention was reported to have "no effect" on the outcome (19.7%); - An inconclusive effect was reported for a small portion of the associations (9%), indicating a need for further research. No negative or potentially negative effects were reported. The effect was not reported for 19 associations; - It should be noted that this list is dynamic and may change with the publication of new studies.

Immune and Metabolic Biomarkers in a Rodent Model of Spinal Cord Contusion.

STUDY DESIGN: Basic science animal research study. OBJECTIVES: Using T10 spinal contused rats, we sought to identify molecular and circulating, metabolic and immune biomarkers during the subchronic and chronic recovery periods that may inform us concerning neurorehabilitation. METHODS: Gene expression of the cord and ELISA were performed in 28 and 100 days in T10 injured rats and compared to sham-injured rats. Hundred-day injured rats were placed on either a low-fat or high-fat diet following the recovery phase. Linear regression analysis was performed between markers and locomotor score, body weight, body composition, and blood cholesterol and triglycerides. RESULTS: Gene expression in the thoracic cord for complement marker, C1QC, dendritic cell marker, ITGAX, and cholesterol biosynthesis genes, FDFT1, HMCGR, LDLR, and SREBP1, were significantly associated with BBB score, body weight, composition, and other metabolic parameters. Circulating levels of these proteins, however, did not vary by injury or predict the level of locomotor recovery. CONCLUSIONS: Identification of reliable circulating biomarkers that are durable and based on level of spinal injury are complicated by immune and metabolic comorbidities. Continued work is necessary to identify stable markers of disease progression.

Type C botulism in dogs from rural properties located in Goiânia, Brazil

Botulism is a disease usually fatal, caused by the ingestion of neurotoxins produced by Clostridium botulinum. In dogs, intoxication is caused by the ingestion of botulinum toxin type C, and animals often recover spontaneously. The present study describes the occurrence of type C botulism in two dogs domiciled on neighboring rural properties in the municipality of Goiânia, state of Goiás, Brazil, probably associated with ingestion of decomposing bovine carcass. Upon clinical evaluation, the dogs were alert in the lateral decubitus position with ascending flaccid paralysis, absence of eyelid reflexes, and reduced muscle tone. Due to their worsening clinical symptoms, the animals died within 12 h and 3 days after supportive treatment. Botulinum toxin type C was identified, in the serum and feces of both dogs, by seroneutralization in mice with homologous monovalent antitoxin. The results of the high-throughput gene sequencing showed that the abundance of C. botulinum in the fecal microbiota of one of the affected dogs was low (0.53%). In this way, the present study highlights the need of sanitary practices related to the appropriate collection and disposal of bovine carcasses in rural areas since they represent a risk factor for the occurrence of botulism in dogs domiciled on rural properties.

Challenging Airway Management in Patients With Zenker's Diverticulum.

The acquired hypopharyngeal diverticulum (Zenker's) is characterized by a posterior wall outpouching of the pharyngeal mucosa and submucosa through the vulnerable points of the pharyngoesophageal junction. We describe the case of a 67-year-old male who was recently diagnosed with Zenker's diverticulum and had complaints of dysphagia and halitosis. An endoscopic treatment (diverticulotomy) was performed without difficulties. The anesthetic management included rapid sequence induction, avoiding succinylcholine, and intraoperative infusion of dexmedetomidine. The neuromuscular blockade was reversed using sugammadex, decreasing the risk of failed extubation and possible airway re-intervention. The patient was discharged home the following day without complications.

Atuação do enfermeiro no contexto da acreditação hospitalar: uma revisão integrativa / Nurse's performance in the contexto of hospitalar accreditation: na integrative review

Resumo Objetivo: Compreender a atuação do enfermeiro no contexto da Acreditação Hospitalar. Método: Trata-se de uma revisão integrativa da literatura, realizada de janeiro a junho de 2019, nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Bases de Dados Específica da Enfermagem, Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Medical Literature Analysis and Retrieval System Online. Foram selecionados artigos originais, nos idiomas português, inglês e espanhol, que apresentassem relatos ou experiências da atuação do enfermeiro em contextos de Acreditação Hospitalar da Organização Nacional de Acreditação. Os artigos foram analisados por meio da análise de conteúdo. Resultado: Como resultado encontraram-se 10 artigos que respondiam ao objetivo do estudo e emergiram três categorias temáticas referentes ao papel do enfermeiro: Assistencial, Administrativo e Educativo. Na assistência, o enfermeiro exerce atividades de avaliação de resultados e ações, emprego e elaboração de indicadores, aplicação de protocolos, controle de medicamentos, produtos e equipamentos, articulação entre a equipe multiprofissional e incorporação de medidas de segurança. No administrativo, realização de planejamento, estabelecimento de metas, participação em comissões, desenvolvimento de políticas de qualidade e reorganização do trabalho. Como educador, o enfermeiro desenvolve ações de fortalecimento da cultura de segurança e qualidade. Conclusão: Que o enfermeiro possuía competências e habilidades que auxiliavam no processo de Acreditação Hospitalar, importantes para o credenciamento da instituição Hospitalar

Abstract Objective: Understand the role of nurses in the context of Hospital Accreditation. Method: This was an integrative literature review, carried out between January and June 2019, on the basis of Latin American and Caribbean Literature in Health Sciences, Specific Nursing Databases, Cumulative Index to Nursing and Allied Health Literature and Medical Literature Analysis and Retrieval System Online. Original articles were selected, in Portuguese, English and Spanish, that presented reports or experiences of the nurse's performance in contexts of Hospital Accreditation of the National Accreditation Organization. The articles were analyzed through content analysis. Results: As a result, 10 articles were found that responded to the objective of the study and emerged three thematic categories referring to the role of the nurse: Assistance, Administrative and Educational. In care, nurses perform activities to evaluate results and actions, use and develop indicators, apply protocols, control medications, products and equipment, articulation between the multidisciplinary team and incorporation of safety measures. In the administrative area, carrying out planning, setting goals, participating in commissions, developing quality policies and reorganizing work. As an educator, the nurse develops actions to strengthen the culture of safety and quality. Conclusión: That was understood that the nurse had skills and abilities that assisted in the Hospital Accreditation process, which were important for the accreditation of the hospital institution.

Resumen Objetivo: Comprender el papel del enfermero en el contexto de la acreditación hospitalaria. Método: Se trata de una revisión integrativa de la literatura, realizada entre enero y junio de 2019, sobre la base de la literatura latinoamericana y caribeña en ciencias de la salud, bases de datos de enfermería específicas, índice acumulativo de literatura de enfermería y salud afín y sistema de análisis y recuperación de literatura médica en línea. Se seleccionaron artículos originales, en portugués, inglés y español, que presentaban informes o experiencias sobre el desempeño del enfermero en contextos de acreditación hospitalaria de la Organización Nacional de Acreditación. Los artículos fueron analizados mediante análisis de contenido. Resultados: Como resultado, se encontraron 10 artículos que respondieron al objetivo del estudio y emergieron tres categorías temáticas relacionadas con el rol del enfermero: Asistencial, Administrativo y Educativo. En el asistencial, el enfermero realiza actividades para evaluar resultados y acciones, usar y desarrollar indicadores, aplicar protocolos, controlar medicamentos, productos y equipos, articulación entre el equipo multidisciplinario e incorporación de medidas de seguridad. En el área administrativa, realiza la planificación, establece metas, participa en comisiones, desarrolla políticas de calidad y reorganiza el trabajo. Como educador, el enfermero desarrolla acciones para fortalecer la cultura de seguridad y calidad. Conclusión: El enfermero tenía habilidades y destrezas que ayudan en el proceso de acreditación del hospital, que son importantes para la acreditación de la institución hospitalaria.

Fatores de risco para infecção de sítio cirúrgico em cirurgias traumato-ortopédicas / Risk factors and surgical site infection in trauma-orthopedic surgeries / Factores de riesgo e infección del sitio quirúrgico en cirugías ortopédicas y traumatológicas

Resumo Introdução A Infecção do Sítio Cirúrgico ocupa a terceira posição entre as infecções adquiridas em serviços de saúde, configurando-se como um importante problema de saúde pública, presente em cerca de 15% daquelas encontradas em pacientes hospitalizados, e um dos tipos de cirurgias de maior probabilidade para esse evento são as traumato-ortopédicas. Objetivo Verificar a associação entre os fatores de risco e a presença de Infecção de Sítio Cirúrgico em cirurgias traumato-ortopédicas. Materiais e métodos Estudo prospectivo descritivo, quantitativo, realizado entre agosto a outubro de 2017 com 84 pacientes. Os dados referentes ao paciente, ao procedimento e os sinais de Infecções de Sítio Cirúrgico, encontrados no terceiro e décimo dia de pós-operatório, foram coletados por meio de um formulário. Resultados Das variáveis estudadas, comportaram-se como fatores de risco de Infecção de Sítio Cirúrgico: tabagismo, diabetes e idade acima de 50 anos. A idade foi o principal fator de risco relacionado ao paciente, presente em 31, 36,9% dos casos. Dor, edema e hiperemia foram os sinais de infecção mais prevalentes. Discussão e conclusões Os fatores de risco relacionados ao paciente possuem maior relevância na associação com infecção do sítio cirúrgico em comparação com os relacionados ao procedimento.

Abstract Introduction Infection of the Surgical Site occupies the third position among infections acquired in health services, representing an important public health problem, present in about 15% of those found in hospitalized patients, and one of the types of most likely for this event are trauma-orthopedic surgies. Objective To verify the association between risk factors and the presence of Surgical Site Infection in traumato-orthopedic surgeries. Materials and methods Prospective descriptive, quantitative study, conducted between August and October 2017 with 84 patients. The data regarding the patient, the procedure and the signs of Surgical Site Infections, found on the third and tenth postoperative days, were collected using a form. Results Of the studied variables, they behaved as risk factors for Surgical Site Infection: smoking, diabetes and age over 50 years. Age was the main risk factor related to the patient, present in 31, 36.9% of cases. Pain, edema and hyperemia were the most prevalent signs of infection. Discussion and conclusions The risk factors related to the patient are more relevant in the association with infection of the surgical site compared to those related to the procedure.

Resumen Introducción La infección del sitio quirúrgico ocupa el tercer lugar entre las infecciones adquiridas en los servicios de salud, lo que representa un problema importante de salud pública, presente en aproximadamente el 15% de las que se encuentran en pacientes hospitalizados, y uno de los tipos de lo más probable para este evento son las cirugías traumatología ortopédica. Objetivo Verificar la asociación entre los factores de riesgo y la presencia de infección del sitio quirúrgico en cirugías traumatológicas. Materiales y métodos Estudio prospectivo descriptivo, cuantitativo, realizado entre agosto y octubre de 2017 con 84 pacientes. Los datos sobre el paciente, el procedimiento y los signos de infecciones del sitio quirúrgico, encontrados en el tercer y décimo día postoperatorio, se obtuvieron mediante un formulario. Resultados De las variables estudiadas, se comportaron como factores de riesgo para la infección del sitio quirúrgico: tabaquismo, diabetes y edad mayor de 50 años. La edad fue el principal factor de riesgo relacionado con el paciente, presente en 31, 36,9% de los casos. El dolor, el edema y la hiperemia fueron los signos más frecuentes de infección. Discusión y conclusiones Los factores de riesgo relacionados con el paciente son más relevantes en la asociación con la infección del sitio quirúrgico en comparación con los relacionados con el procedimiento.

Fatores de risco para infecção de sítio cirúrgico em cirurgias traumato-ortopédicas / Risk factors and surgical site infection in trauma-orthopedic surgeries

Introdução: A Infecção do Sítio Cirúrgico ocupa a terceira posição entre as infecções adquiridas em serviços de saúde, configurando-se como um importante problema de saúde pública, presente em cerca de 15% daquelas encontradas em pacientes hospitalizados, e um dos tipos de cirurgias de maior probabilidade para esse evento são as traumato-ortopédicas. Objetivo: Verificar a associação entre os fatores de risco e a presença de Infecção de Sítio Cirúrgico em cirurgias traumato-ortopédicas. Materiais e métodos: Estudo prospectivo descritivo, quantitativo, realizado entre agosto a outubro de 2017 com 84 pacientes. Os dados referentes ao paciente, ao procedimento e os sinais de Infecções de Sítio Cirúrgico, encontrados no terceiro e décimo dia de pós-operatório, foram coletados por meio de um formulário. Resultados: Das variáveis estudadas, comportaram-se como fatores de risco de Infecção de Sítio Cirúrgico: tabagismo, diabetes e idade acima de 50 anos. A idade foi o principal fator de risco relacionado ao paciente, presente em 31, 36,9% dos casos. Dor, edema e hiperemia foram os sinais de infecção mais prevalentes. Discussão e conclusões: Os fatores de risco relacionados ao paciente possuem maior relevância na associação com infecção do sítio cirúrgico em comparação com os relacionados ao procedimento.

Introduction: Infection of the Surgical Site occupies the third position among infections acquired in health services, representing an important public health problem, present in about 15% of those found in hospitalized patients, and one of the types of most likely for this event are trauma-orthopedic surgies. Objective: To verify the association between risk factors and the presence of Surgical Site Infection in traumato-orthopedic surgeries. Materials and methods: Prospective descriptive, quantitative study, conducted between August and October 2017 with 84 patients. The data regarding the patient, the procedure and the signs of Surgical Site Infections, found on the third and tenth postoperative days, were collected using a form. Results: Of the studied variables, they behaved as risk factors for Surgical Site Infection: smoking, diabetes and age over 50 years. Age was the main risk factor related to the patient, present in 31, 36.9% of cases. Pain, edema and hyperemia were the most prevalent signs of infection. Discussion and conclusions: The risk factors related to the patient are more relevant in the association with infection of the surgical site compared to those related to the procedure.

Introducción: La infección del sitio quirúrgico ocupa el tercer lugar entre las infecciones adquiridas en los servicios de salud, lo que representa un problema importante de salud pública, presente en aproximadamente el 15% de las que se encuentran en pacientes hospitalizados, y uno de los tipos de lo más probable para este evento son las cirugías traumatología ortopédica. Objetivo: Verificar la asociación entre los factores de riesgo y la presencia de infección del sitio quirúrgico en cirugías traumatológicas. Materiales y métodos: Estudio prospectivo descriptivo, cuantitativo, realizado entre agosto y octubre de 2017 con 84 pacientes. Los datos sobre el paciente, el procedimiento y los signos de infecciones del sitio quirúrgico, encontrados en el tercer y décimo día postoperatorio, se obtuvieron mediante un formulario. Resultados: De las variables estudiadas, se comportaron como factores de riesgo para la infección del sitio quirúrgico: tabaquismo, diabetes y edad mayor de 50 años. La edad fue el principal factor de riesgo relacionado con el paciente, presente en 31, 36,9% de los casos. El dolor, el edema y la hiperemia fueron los signos más frecuentes de infección. Discusión y conclusiones: Los factores de riesgo relacionados con el paciente son más relevantes en la asociación con la infección del sitio quirúrgico en comparación con los relacionados con el procedimiento.

Effects of Active Vitamin D or FGF23 Antibody on Hyp Mice Dentoalveolar Tissues.

Mutations in the PHEX gene lead to X-linked hypophosphatemia (XLH), a form of inherited rickets featuring elevated fibroblast growth factor 23 (FGF23), reduced 1,25-dihydroxyvitamin D (1,25D), and hypophosphatemia. Hyp mutant mice replicate the XLH phenotype, including dentin, alveolar bone, and cementum defects. We aimed to compare effects of 1,25D versus FGF23-neutralizing antibody (FGF23Ab) monotherapies on Hyp mouse dentoalveolar mineralization. Male Hyp mice, either injected subcutaneously with daily 1,25D or thrice weekly with FGF23 blocking antibody from 2 to 35 d postnatal, were compared to wild-type (WT) controls and untreated Hyp mice. Mandibles were analyzed by high-resolution micro-computed tomography (micro-CT), histology, and immunohistochemistry. Both interventions maintained normocalcemia, increased serum phosphate levels, and improved dentoalveolar mineralization in treated versus untreated Hyp mice. 1,25D increased crown dentin volume and thickness and root dentin/cementum volume, whereas FGF23Ab effects were limited to crown dentin volume. 1,25D increased bone volume fraction, bone mineral density, and tissue mineral density in Hyp mice, whereas FGF23Ab failed to significantly affect these alveolar bone parameters. Neither treatment fully attenuated dentin and bone defects to WT levels, and pulp volumes remained elevated regardless of treatment. Both treatments reduced predentin thickness and improved periodontal ligament organization, while 1,25D promoted a more profound improvement in acellular cementum thickness. Altered cell densities and lacunocanalicular properties of alveolar and mandibular bone osteocytes and cementocytes in Hyp mice were partially corrected by either treatment. Neither treatment normalized the altered distributions of bone sialoprotein and osteopontin in Hyp mouse alveolar bone. Moderate improvements from both 1,25D and FGF23Ab treatment regimens support further studies and collection of oral health data from subjects receiving a newly approved anti-FGF23 therapy. The inability of either treatment to fully correct Hyp mouse dentin and bone prompts further experiments into underlying pathological mechanisms to identify new therapeutic approaches.

Prognostic value of the immunohistochemical expression of vascular endothelial growth factors in malignant salivary gland neoplasms: a systematic review and meta-analysis.

BACKGROUND:  The immunohistochemical expression of vascular endothelial growth factor is a prognostic marker in several cancer types. In salivary gland tumors, the association between vascular endothelial growth factor and prognosis remains unclear. The purpose of this study was to perform a systematic review and meta-analysis to assess whether the immunohistochemical expression of vascular endothelial growth factor in patients with salivary gland neoplasms presents prognostic value. MATERIAL AND METHODS: Immunohistochemical studies assessing the predictive value of vascular endothelial growth factor in salivary gland neoplasms were systematically reviewed using PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases. It was assessed any survival rates. The fixed-effect model with an adjusted hazard ratio (HR) and 95% confidence intervals (95% CI) as effect measures were performed in the meta-analysis. The Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the included studies, and the evidence quality was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) system. RESULTS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms was associated with shortened survival (HR=5.37, 95% CI: 2.67-10.83, P = 0.00001). In addition, the presence of vascular endothelial growth factor was tightly associated with tumor size, lymph node metastasis, clinical stage, perineural invasion, vascular invasion, poor local control of the disease, and recurrence. CONCLUSIONS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms has prognostic value and was associated with decreased survival time. However, more primary well-designed studies are necessary to increase the level of evidence.

Hospital admission flow and nutritional support in a cohort of pediatric patients with COVID-19 / Fluxo de admissão hospitalar e suporte nutricional em uma coorte de pacientes pediátricos com COVID-19

Abstract In view of the current panorama of hospital nutritional care, it is necessary to review nutritional care practices in hospital units, in order to ensure nutritional monitoring and quality of care. Therefore, it is necessary to build flows of nutritional assistance practices at the pediatric hospital level, based on the recommendations of the Federal Council of Nutritionists and the Brazilian Society of Parenteral and Enteral Nutrition, aiming at not generating a deficit in the nutritional monitoring of the patient and in reducing the risk of contamination of the professional. When individual protection equipment is available, nutritional admission will be made in person and during hospitalization, monitoring can be performed using secondary data from electronic medical records and / or telecommunication with the multidisciplinary team. The implementation of nutritional routines in hospitals in times of Covid-19 pandemic generates more assertive conducts for the prevention and treatment of malnutrition and other nutritional implications, also guaranteeing the safety of professionals in assistance in pediatric units..

Resumo Diante do panorama atual da assistência nutricional hospitalar, torna-se necessário a revisão das práticas de assistência nutricional em unidades hospitalares, visando garantir monitoramento nutricional e qualidade assistencial. Portanto, faz-se necessário a construção de fluxos de práticas da assistência nutricional em nível hospitalar pediátrico, baseados nas recomendações do Conselho Federal de Nutricionistas e da Sociedade Brasileira de Nutrição Parenteral e Enteral, visando não gerar déficit no monitoramento nutricional ao paciente e em reduzir o risco de contaminação do profissional. Quando há a disponibilidade de equipamento de proteção individual a admissão nutricional será feita presencialmente e durante o internamento poderá ser realizado monitoramento por meio de dados secundários provenientes do prontuário eletrônico e/ou telecomunicação com a equipe multidisciplinar. A implantação de rotinas nutricionais em âmbito hospitalar em tempos de pandemia da COVID-19 gera condutas mais assertivas para a prevenção e tratamento da desnutrição e de outras implicações nutricionais, garantindo também a segurança do profissional na assistência em unidades pediátricas.