Características sociodemográficas, laborais, de saúde relacionadas a pacientes submetidos à telenfermagem em estomaterapia / Sociodemographic, employment and health characteristics related to patients submitted to telemonitoring in a stomatherapy clinic / Características sociodemográficas, laborales y de salud relacionadas con los pacientes sometidos a teleenfermería en una clínica de estomaterapia

Objetivo: identificar as características sociodemográficas, laborais de saúde de pessoas submetidas à telenfermagem em uma clínica de estomaterapia. Método: pesquisa quantitativa, descritiva, transversal e de caráter documental, realizada em uma instituição pública de saúde no município do Rio de Janeiro. Resultados: usuários com idade entre 50 e 60 anos (34,79%); pardos (61,96%); homens (55,44%); moradores do município do Rio de Janeiro (69,56%); trabalham sob regime celetista (32,39%); se ausentaram do trabalho ao menos uma vez nos últimos 12 meses (40,85%); não trabalham à noite (81,63%); 18,37% possuem trabalho noturno, 55,85% não descansam ou dormem, e justificam o não descanso noturno pelas altas demandas laborais. Possuem doença crônica (79,75%); são hipertensos (60,31%); não apresentam doença como consequência do trabalho (53,96%). Conclusão: evidenciou-se a necessidade de um maior aprofundamento de práticas de atenção à saúde considerando o impacto das características individuais no processo saúde doença

Objective: to identify the sociodemographic and occupational health characteristics of people undergoing telenursing in a stomatherapy clinic. Method: quantitative, descriptive, cross-sectional and documentary research, carried out in a public health institution in the city of Rio de Janeiro. Results: users aged between 50 and 60 years (34.79%); browns (61.96%); men (55.44%); residents of the city of Rio de Janeiro (69.56%); work under a CLT regime (32.39%); were absent from work at least once in the last 12 months (40.85%); do not work at night (81.63%); 18.37% work at night, 55.85% do not rest or sleep, and they justify the lack of night rest due to the high work demands. They have a chronic disease (79.75%); are hypertensive (60.31%); do not have disease as a result of work (53.96%). Conclusion: the need for a deeper understanding of health care practices was evidenced, considering the impact of individual characteristics on the health-disease process

Objetivo: identificar las características sociodemográficas y de salud ocupacional de personas en teleenfermería en una clínica de estomaterapia. Método: investigación cuantitativa, descriptiva, transversal y documental, realizada en una institución de salud pública de la ciudad de Río de Janeiro. Resultados: usuarios con edad entre 50 y 60 años (34,79%); marrones (61,96%); hombres (55,44%); residentes de la ciudad de Río de Janeiro (69,56%); trabajar en régimen CLT (32,39%); se ausentó del trabajo al menos una vez en los últimos 12 meses (40,85%); no trabaja de noche (81,63%); El 18,37% trabaja de noche, el 55,85% no descansa ni duerme, y justifican la falta de descanso nocturno por las altas exigencias laborales. Tienen una enfermedad crónica (79,75%); son hipertensos (60,31%); no tienen enfermedad como consecuencia del trabajo (53,96%). Conclusión: se evidenció la necesidad de una mayor profundidad de las prácticas de atención a la salud, considerando el impacto de las características individuales en el proceso salud-enfermedad

Poor Trunk Flexibility is Associated with Cardiovascular Risk Factors

Abstract Background: Poor flexibility is a predictor of reduced physical activity. The association between trunk flexibility and cardiovascular risk factors (CVRFs) is not well understood. Objective: To identify the prevalence of CVRFs and their association with trunk flexibility in individuals participating in a community-based health education program. Methods: Volunteers (51 men, 48 women) aged 20-85 years old, participants in a community-based health education program in the city of Santo Antônio de Goiás, Brazil, were selected for this study. Anthropometric measures including body mass, height, body mass index (BMI), waist circumference (WC) and waist/height ratio (WHtR) were evaluated. Physical activity level was evaluated based on leisure activity participation, and trunk flexibility was evaluated by the sit and reach test. Data distribution was assessed using the Shapiro-Wilk test; Pearson's chi-square or Fisher's exact and Student t tests were performed for comparisons. To analyze the association between trunk flexibility and concomitant CVRFs, Spearman's correlation test and linear regression were employed. Statistical significance was defined as p < 0.05. Results: 7.2% of the volunteers had no CVRF, 10.3% had only one CVRF and 82.5% had two or more CVRFs, with no differences between sexes. Increased abdominal adiposity, as assessed by WHtR (p = 0.0097), and systemic arterial hypertension (p = 0.0003) were the most prevalent CVRFs, with differences between age groups. A strong negative correlation was found between mean trunk flexibility and the number of concomitant CVRFs (r = -0.96, p < 0.0028). Conclusion: The strong negative correlation between trunk flexibility and concomitant CVRF indicates an increased risk for cardiovascular events. Therefore, trunk flexibility measurement may be an additional tool for health promotion and prevention of cardiovascular and associated diseases in community health programs.

Simultaneous determination of lead and antimony in gunshot residue using a 3D-printed platform working as sampler and sensor.

3D-printing is an emerging technique that enables the fast prototyping of multiple-use devices. Herein we report the fabrication of a 3D-printed graphene/polylactic acid (G-PLA) conductive electrode that works as a sampler and a voltammetric sensor of metals in gunshot residue (GSR) using a commercially-available G/-PLA filament. The 3D-printed surface was used as swab to collect GSR and next submitted to a square-wave voltammetric scan for the simultaneous detection of Pb2+ and Sb3+. The proposed sensor presented excellent analytical performance, with limit of detection values of 0.5 and 1.8 µg L-1 to Pb2+ and Sb3+, respectively, and linear ranges between 50 and 1500 µg L-1. Sampling was performed through the direct contact of G-PLA electrode in hands and clothes of shooters, followed by immersion in the electrochemical cell in the presence of supporting electrolyte for the SWASV scan. The proposed method showed a great performance in the recovery, identification and semi-quantification of Pb2+ and Sb3+ in the evaluated samples without the need for sample preparation. Moreover, the device can be reused as sampler and sensor (until three times without loss of electrochemical performance) and the fabrication is reproducible (RSD = 7%, for three different devices). Hence, this 3D-printed material is an excellent candidate for the analysis of GSR, an indispensable analysis in the forensic field.

Production of 3D-printed disposable electrochemical sensors for glucose detection using a conductive filament modified with nickel microparticles.

Three-dimensional printing techniques have been widely used in the fabrication of new materials applied to energy, sensing and electronics due to unique advantages, such as fast prototyping, reduced waste generation, and multiple fabrication designs. In this paper, the production of a conductive 3D-printing filament composed of Ni(OH)2 microparticles and graphene within a polylactic acid matrix (Ni-G-PLA) is reported. The nanocomposite was characterized by thermogravimetric, energy-dispersive X-ray spectroscopic, scanning electronic microscopic, Raman spectroscopic and electrochemical techniques. Characteristics such as printability (using fused deposition modelling), electrical conductivity and mechanical stability of the polymer nanocomposite were evaluated before and after 3D printing. The novel 3D-printed disposable electrode was applied for selective detection of glucose (enzyme-less sensor) with a detection limit of 2.4 µmol L-1, free from the interference of ascorbic acid, urea and uric acid, compounds typically found in biological samples. The sensor was assembled in a portable electrochemical system that enables fast (160 injection h-1), precise (RSD < 5%) and selective determination of glucose without the need of enzymes (electrocatalytic properties of the Ni-G-PLA nanocomposite). The obtained results showed that Ni-G-PLA is a promising material for the production of disposable sensors for selective detection of glucose using a simple and low-cost 3D-printer.

3D-printing pen versus desktop 3D-printers: Fabrication of carbon black/polylactic acid electrodes for single-drop detection of 2,4,6-trinitrotoluene.

The fabrication of carbon black/polylactic acid (PLA) electrodes using a 3D printing pen is presented and compared with electrodes obtained by a desktop fused deposition modelling (FDM) 3D printer. The 3D pen was used for the fast production of electrodes in two designs using customized 3D printed parts to act as template and guide the reproducible application of the 3D pen: (i) a single working electrode at the bottom of a 3D-printed cylindrical body and (ii) a three-electrode system on a 3D-printed planar substrate. Both devices were electrochemically characterized using the redox probe [Fe(CN)6]3-/4- via cyclic voltammetry, which presented similar performance to an FDM 3D-printed electrode or a commercial screen-printed carbon electrode (SPE) regarding peak-to-peak separation (ΔEp) and current density. The surface treatment of the carbon black/PLA electrodes fabricated by both 3D pen and FDM 3D-printing procedures provided substantial improvement of the electrochemical activity by removing excess of PLA, which was confirmed by scanning electron microscopic images for electrodes fabricated by both procedures. Structural defects were not inserted after the electrochemical treatment as shown by Raman spectra (iD/iG), which indicates that the use of 3D pen can replace desktop 3D printers for electrode fabrication. Inter-electrode precision for the best device fabricated using the 3D pen (three-electrode system) was 4% (n = 5) considering current density and anodic peak potential for the redox probe. This device was applied for the detection of 2,4,6-trinitrotoluene (TNT) via square-wave voltammetry of a single-drop of 100 µL placed upon the thee-electrode system, resulting in three reduction peaks commonly verified for TNT on carbon electrodes. Limit of detection of 1.5 µmol L-1, linear range from 5 to 500 µmol L-1 and RSD lower than 4% for 10 repetitive measurements of 100 µmol L-1 TNT were obtained. The proposed devices can be reused after polishing on sandpaper generating new electrode surfaces, which is an extra advantage over chemically-modified electrochemical sensors applied for TNT detection.

Electrochemical synthesis of Prussian blue from iron impurities in 3D-printed graphene electrodes: Amperometric sensing platform for hydrogen peroxide.

This communication shows the electrochemical synthesis of Prussian blue (PB) films on additive manufactured (3D-printed) electrodes from iron impurities found at the graphene-polylactic acid (G/PLA) substrate and its application as a highly selective sensor for H2O2. The 3D-printed G/PLA electrode was immersed in dimethylformamide for 30 min to exposure the iron impurities within the PLA matrix. Next, cyclic voltammograms (200 cycles) in the presence of potassium ferricyanide in 0.1 mol L-1 KCl + 0.01 mol L-1 HCl were performed to grow the PB films. The sensing properties of this novel PB/G/PLA platform were evaluated for the amperometric detection of H2O2 using batch-injection analysis, with a limit of detection of 0.56 µmol L-1 under the application of 0.0 V (vs Ag/AgCl/KClsat.). The applicability of the sensor was demonstrated for the analysis of milk samples (10-fold diluted in the supporting electrolyte), resulting in proper recovery values (94-101%).

A Multi-Pump Magnetohydrodynamics Lab-On-A-Chip Device for Automated Flow Control and Analyte Delivery.

This article shows the development of a computer-controlled lab-on-a-chip device with three magnetohydrodynamic (MHD) pumps and a pneumatic valve. The chip was made of a stack of layers of polymethylmethacrylate (PMMA), cut using a laser engraver and thermally bonded. The MHD pumps were built using permanent magnets (neodymium) and platinum electrodes, all of them controlled by an Arduino board and a set of relays. The implemented pumps were able to drive solutions in the open channels with a flow rate that increased proportionally with the channel width and applied voltage. To address the characteristic low pressures generated by this kind of pump, all channels were interconnected. Because the electrodes were immersed in the electrolyte, causing electrolysis and pH variations, the composition and ionic strength of the electrolyte solution were controlled. Additionally, side structures for releasing bubbles were integrated. With this multi-pump and valve solution, the device was used to demonstrate the possibility of performing an injection sequence in a system that resembles a traditional flow injection analysis system. Ultimately, the results demonstrate the possibility of performing injection sequences using an array of MHD pumps that can perform fluid handling in the 0-5 µL s-1 range.

Additive-manufactured (3D-printed) electrochemical sensors: A critical review.

Additive manufacturing or three-dimensional (3D)-printing is an emerging technology that has been applied in the development of novel materials and devices for a wide range of applications, including Electrochemistry and Analytical Chemistry areas. This review article focuses on the contributions of 3D-printing technology to the development of electrochemical sensors and complete electrochemical sensing devices. Due to the recent contributions of 3D-printing within this scenario, the aim of this review is to present a guide for new users of 3D-printing technology considering the required features for improved electrochemical sensing using 3D-printed sensors. At the same time, this is a comprehensive review that includes most 3D-printed electrochemical sensors and devices already reported using selective laser melting (SLM) and fused deposition modeling (FDM) 3D-printers. The latter is the most affordable 3D-printing technique and for this reason has been more often applied for the fabrication of electrochemical sensors, also due to commercially-available conductive and non-conductive filaments. Special attention is given to critically discuss the need for the surface treatment of FDM 3D-printed platforms to improve their electrochemical performance. The insertion of biochemical and chemical catalysts on the 3D-printed surfaces are highlighted as well as novel strategies to fabricate filaments containing chemical modifiers within the polymeric matrix. Some examples of complete electrochemical sensing systems obtained by 3D-printing have successfully demonstrated the enormous potential to develop portable devices for on-site applications. The freedom of design enabled by 3D-printing opens many possibilities of forthcoming investigations in the area of analytical electrochemistry.

Mechanical Study of the Properties of Sutures used in Orthopedics Surgeries.

Objective To evaluate the mechanical properties of sutures commonly used in orthopedic surgeries, characterizing their behavior through tensile tests and determining which one has greater mechanical strength. Method Tensile tests of different sutures were performed in a mechanical testing machine BME 10 kN, using a 50 kgf maximum capacity loading cell. Seven samples from each suture material were tested. Both ends of the sample material were fixed in the proper metal claw, maintaining an initial length of 5 cm. Tests were performed at a speed of 20 mm/minute and at room temperature, recording data for maximum displacement and maximum force at the rupture point. Results FiberWire® #2 (Artrhex, Naples, FL, USA) presented the highest mean strength of rupture (240.17 N), followed by HiFi® #2 (Conmed, Utica, NY, USA) (213.39N) and Ethibond® #5 (Ethicon Inc., Somerville, NJ, USA) (207.38 N). Ethibond® #2 (Ethicon Inc., Somerville, NJ, USA) had the lowest mean strength of rupture (97.8 N). Conclusion Non-absorbable braided polyblend sutures, more recently introduced, are superior to conventional, braided polyester sutures, and FiberWire® #2 is the most resistant suture evaluated in the present study.

Graphite sheet as a novel material for the collection and electrochemical sensing of explosive residues.

This work presents the use of a graphite sheet (graphite papers) as a new platform for the collection and sensing of explosive residues. This material offers a lightweight, highly conductive, flexible platform that can be cut in several ways, enabling for the collection of explosive residues at the place of interest, without any further sample preparation steps. As a proof-of-concept, the device was utilised for the collection and electrochemical sensing of 2,4,6-trinitrotoluene (TNT) residues. The GS has a remarkable performance for the sensing of TNT within the supporting electrolyte (0.1 mol dm-3 HCl) resulting in a linear range between 1 and 1300 µmol dm-3 and detection limit of 0.06 µmol dm-3 using square-wave voltammetry (SWV). Five surfaces (granite, gloved and bare hands, metal and cash banknotes) were contaminated with traces of TNT and the collection was performed using the graphite sheet (1 cm2 square pieces were swiped over the different surfaces). The results obtained using SWV enabled the identification of TNT residues, at quantities of 0.01-0.23 ng (quantification by the measured coulometric charge of the SWV scan), demonstrating that this novel material can be used as a promising device at crime scene investigations.

Mechanical Study of the Properties of Sutures used in Orthopedics Surgeries / Estudo mecânico das propriedades dos fios de sutura usados em cirurgias ortopédicas

Abstract Objective To evaluate the mechanical properties of sutures commonly used in orthopedic surgeries, characterizing their behavior through tensile tests and determining which one has greater mechanical strength. Method Tensile tests of different sutures were performed in a mechanical testing machine BME 10 kN, using a 50 kgf maximum capacity loading cell. Seven samples from each suture material were tested. Both ends of the sample material were fixed in the proper metal claw, maintaining an initial length of 5 cm. Tests were performed at a speed of 20 mm/minute and at room temperature, recording data for maximum displacement and maximum force at the rupture point. Results FiberWire® #2 (Artrhex, Naples, FL, USA) presented the highest mean strength of rupture (240.17 N), followed by HiFi® #2 (Conmed, Utica, NY, USA) (213.39N) and Ethibond® #5 (Ethicon Inc., Somerville, NJ, USA) (207.38 N). Ethibond® #2 (Ethicon Inc., Somerville, NJ, USA) had the lowestmean strength of rupture (97.8 N). Conclusion Non-absorbable braided polyblend sutures, more recently introduced, are superior to conventional, braided polyester sutures, and FiberWire® #2 is the most resistant suture evaluated in the present study.

Resumo Objetivo Avaliar as propriedades mecânicas dos fios de sutura normalmente usados nas cirurgias ortopédicas e caracterizar seu comportamento por meio de ensaios de tração para verificar qual deles apresenta maior resistência mecânica. Método Os ensaios de tração dos diferentes tipos de fios de sutura foram feitos na máquina de ensaios mecânicos BME 10 kN, comcélula de carga de capacidademáxima de 50 kgf. Foram ensaiadas sete amostras de cada tipo de fio de sutura, foram fixadas cada uma das extremidades da amostra na garra metálica própria para o ensaio de fios e manteve-se o comprimento inicial de 5 cm. Os ensaios foram feitos com uma velocidade de 20 mm/minuto e à temperatura ambiente, registraram-se os dados de força máxima e o deslocamento máximo na ruptura dos fios. Resultados A força média de rupturamais elevada foi observada na sutura FiberWire® 2 (Artrhex, Naples, FL, EUA) (240,17 N), seguida pela HiFi® 2 (Conmed, Utica, NY, EUA) (213,39 N) e Ethibond® 5 (Ethicon Inc., Somerville, NJ, EUA) (207,38 N). A menor força média de ruptura foi obtida para o fio Ethibond® 2 (Ethicon Inc., Somerville, NJ, EUA) (97,8 N). Conclusão Os fios de sutura não absorvíveis de polimistura trançada, de surgimento mais recente, são superiores ao fio de sutura convencional de poliéster trançado. O FiberWire® 2 é o mais resistente dos fios avaliados no presente estudo.

3D printing for electroanalysis: From multiuse electrochemical cells to sensors.

This work presents potential applications of low-cost fused deposition modeling 3D-printers to fabricate multiuse 3D-printed electrochemical cells for flow or batch measurements as well as the 3D-printing of electrochemical sensing platforms. Electrochemical cells and sensors were printed with acrylonitrile butadiene styrene (ABS) and conductive graphene-doped polylactic acid (G-PLA) filaments, respectively. The overall printing operation time and estimated cost per cell were 6 h and $ 6.00, respectively, while the sensors were printed within minutes (16 sensor strips of 1 × 2 cm in 10 min at a cost of $ 1.00 each sensor). The cell performance is demonstrated for the amperometric detection of tert-butylhydroquinone, dipyrone, dopamine and diclofenac by flow-injection analysis (FIA) and batch-injection analysis (BIA) using different working electrodes, including the proposed 3D-printed sensor, which presented comparable electroanalytical performance with other carbon-based electrodes (LOD of 0.1 µmol L-1 for dopamine). Raman spectroscopy and scanning electron microscopy of the 3D-printed sensor indicated the presence of graphene nanoribbons within the polymeric matrix. Electrochemical impedance spectroscopy and heterogeneous electron transfer constants (k0) for the redox probe Ru(NH3)6+3 revealed that a glassy-carbon electrode presented faster electron transfer rates than the 3D-printed sensor; however, the latter presented lower LOD values for dopamine and catechol probably due to oxygenated functional groups at the G-PLA surface.

Frailty in the elderly: prevalence and associated factors.

Objective: to know the prevalence and factors associated with frailty in elderly assisted by the Centro Mais Vida de Referência em Assistência à Saúde do Idoso (Mais Vida Health Reference Center for the Elderly) in the North of Minas Gerais, Brazil. Method: cross-sectional study, with sampling by convenience. Data collection occurred in 2015. Demographic and socioeconomic variables, morbidities, use of health services and the score of the Edmonton Frail Scale were analyzed. The adjusted prevalence ratios were obtained by multiple analysis of Poisson regression with robust variance. Results: 360 elderly aged 65 or older were evaluated. Frailty prevalence was 47.2%. The variables associated with frailty were the following: advanced age elderly, who live without a partner, have a caregiver, present depressive symptoms, osteoarticular disease, as well as history of hospitalization and falls in the last twelve months. Conclusion: knowledge of factors associated with frailty allows development of health actions aimed at the elderly.

Objetivo: conhecer a prevalência e fatores associados à fragilidade em idosos assistidos pelo Centro Mais Vida de Referência em Assistência à Saúde do Idoso ao norte de Minas Gerais, Brasil. Método: estudo transversal, com amostragem por conveniência. A coleta de dados ocorreu em 2015. Analisaram-se variáveis demográficas e socioeconômicas, morbidades, utilização de serviços de saúde e o escore da Escala de Fragilidade de Edmonton. As razões de prevalências ajustadas foram obtidas por análise múltipla de regressão de Poisson com variância robusta. Resultados: foram avaliados 360 idosos com idade igual ou superior a 65 anos. A prevalência de fragilidade foi 47,2%. As variáveis associadas à fragilidade foram: idosos longevos, que vivem sem companheiro(a), possuem cuidador, apresentam sintomas depressivos, doença osteoarticular, bem como história de internação e de quedas nos últimos 12 meses. Conclusão: o conhecimento dos fatores associados à fragilidade permite que ações de saúde destinadas a idosos possam ser desenvolvidas.

Frailty in the elderly: prevalence and associated factors / La fragilidad en ancianos: la prevalencia y los factores asociados / Fragilidade em idosos: prevalência e fatores associados

ABSTRACT Objective: to know the prevalence and factors associated with frailty in elderly assisted by the Centro Mais Vida de Referência em Assistência à Saúde do Idoso (Mais Vida Health Reference Center for the Elderly) in the North of Minas Gerais, Brazil. Method: cross-sectional study, with sampling by convenience. Data collection occurred in 2015. Demographic and socioeconomic variables, morbidities, use of health services and the score of the Edmonton Frail Scale were analyzed. The adjusted prevalence ratios were obtained by multiple analysis of Poisson regression with robust variance. Results: 360 elderly aged 65 or older were evaluated. Frailty prevalence was 47.2%. The variables associated with frailty were the following: advanced age elderly, who live without a partner, have a caregiver, present depressive symptoms, osteoarticular disease, as well as history of hospitalization and falls in the last twelve months. Conclusion: knowledge of factors associated with frailty allows development of health actions aimed at the elderly.

RESUMEN Objetivo: identificar la prevalencia y los factores asociados a la fragilidad en ancianos asistidos por el Centro Mais Vida, programa de Asistencia a la Salud del Anciano en el norte de Minas Gerais, Brasil. Método: estudio transversal, con muestreo por conveniencia. Se recolectaron los datos en el 2015. Se evaluaron las variables demográficas y socioeconómicas, comorbilidades, utilización de servicios de salud y el puntaje de la Escala de fragilidad de Edmonton. Se empleó el análisis múltiple de regresión de Poisson con varianza robusta para obtener las tasas de prevalencias ajustadas. Resultados: se evaluaron a 360 ancianos de más de 65 años de edad. Un 47,2% fue la tasa de prevalencia de fragilidad. Las variables asociadas a la fragilidad fueron: ancianos longevos, que viven sin compañero(a), tienen cuidador, presentan síntomas depresivos, enfermedad osteoarticular e historial de hospitalización y de caídas durante los últimos 12 meses. Conclusión: conocer los factores asociados a la fragilidad en ancianos permite desarrollar acciones de salud dirigidas a ellos.

RESUMO Objetivo: conhecer a prevalência e fatores associados à fragilidade em idosos assistidos pelo Centro Mais Vida de Referência em Assistência à Saúde do Idoso ao norte de Minas Gerais, Brasil. Método: estudo transversal, com amostragem por conveniência. A coleta de dados ocorreu em 2015. Analisaram-se variáveis demográficas e socioeconômicas, morbidades, utilização de serviços de saúde e o escore da Escala de Fragilidade de Edmonton. As razões de prevalências ajustadas foram obtidas por análise múltipla de regressão de Poisson com variância robusta. Resultados: foram avaliados 360 idosos com idade igual ou superior a 65 anos. A prevalência de fragilidade foi 47,2%. As variáveis associadas à fragilidade foram: idosos longevos, que vivem sem companheiro(a), possuem cuidador, apresentam sintomas depressivos, doença osteoarticular, bem como história de internação e de quedas nos últimos 12 meses. Conclusão: o conhecimento dos fatores associados à fragilidade permite que ações de saúde destinadas a idosos possam ser desenvolvidas.

Reação adversa a medicamento: uma análise comparativa de protocolos utilizados para o tratamento do câncer colorretal / Adverse drug reaction: a comparative analysis of protocols used for treatment of colorectal cancer

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups (AU)

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups.(AU)

In Vivo Pattern Classification of Ingestive Behavior in Ruminants Using FBG Sensors and Machine Learning.

Pattern classification of ingestive behavior in grazing animals has extreme importance in studies related to animal nutrition, growth and health. In this paper, a system to classify chewing patterns of ruminants in in vivo experiments is developed. The proposal is based on data collected by optical fiber Bragg grating sensors (FBG) that are processed by machine learning techniques. The FBG sensors measure the biomechanical strain during jaw movements, and a decision tree is responsible for the classification of the associated chewing pattern. In this study, patterns associated with food intake of dietary supplement, hay and ryegrass were considered. Additionally, two other important events for ingestive behavior were monitored: rumination and idleness. Experimental results show that the proposed approach for pattern classification is capable of differentiating the five patterns involved in the chewing process with an overall accuracy of 94%.

Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel.

OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC.

Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel / Avaliação da qualidade de vida de pacientes com carcinoma pulmonar de células não pequenas em estágio avançado, tratados com carboplatina associada a paclitaxel

OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC. .

OBJETIVO: O carcinoma pulmonar de células não pequenas (CPCNP) é tipo mais comum de câncer de pulmão. Como a maioria dos pacientes é diagnosticada em estágio avançado, a quimioterapia paliativa é a única opção de tratamento. Este estudo avaliou a qualidade de vida relacionada à saúde (QVRS) de pacientes com CPCNP avançado no decorrer da quimioterapia paliativa com carboplatina e paclitaxel. MÉTODOS: Trata-se de um estudo de casos múltiplos de pacientes ambulatoriais com CPCNP em estágio avançado recebendo quimioterapia em um hospital público no Rio de Janeiro (RJ). Para a avaliação da QVRS, foram usados o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire e seu módulo específico para câncer de pulmão. RESULTADOS: Houve diferenças significativas na pontuação nas escalas de capacidade física e cognitiva durante a quimioterapia, indicando melhora e piora da QVRS, respectivamente. As diferenças na pontuação nos itens dor, perda de apetite, dor no tórax e dor no braço ou ombro indicaram melhora da QVRS. CONCLUSÕES: Observou-se que a quimioterapia melhora alguns aspectos da QVRS de pacientes com CPCNP avançado. .

Ceratoameloblastoma: uma lesão muito rara com recidiva incomum / Keratoameloblastoma: a very rare lesion with an unusual recurrence

A denominação ceratoameloblastoma tem sido utilizada para descrever um grupo histológico heterogêneo de variantes do ameloblastoma, que tem em comum a formação de ceratina pelo epitélio ameloblastomatoso. Até o momento, vinte casos foram previamente reportados na literautra, dos quais cinco exibem um componente papilifero. Nós relatamos um novo caso de um tumor recidivado que se enquadra no espectro do keratoameloblastoma, o qual apresentava uma lesão expansiva, sólida, com calcificações internas, na fossa infratemporal direita, seis anos após uma hemimandibulectomia ipsilateral, de uma mulher branca de 46 anos. Ilhas de células colunares que lembram ameloblastoma ao redor de uma área central com células estreladas, algumas das quais completamente preenchidas por ceratina e outras exibindo células basais colunares a cuboidais com núcleo hipercromático, foram observadas na avaliação histológica do espécime. Nós revisamos o padrão clínico, histopatológico e radiográfico dos casos previamente publicados de ceratoameloblastoma, além do tratamento e acompanhamento realizado. Embora um pequeno número de casos tenha sido reportado, o comportamento biológico agressivo e altas taxas de recorrência sugerem que um manejo mais agressivo deve ser realizado. Ressecção com margens de segurança e análise histopatológica dessas margens são altamente recomendadas. (AU)

The denomination keratoameloblastoma has been used to describe a histologically heterogeneous group of ameloblastoma variants which have in common the formation of keratin by the ameloblastomatous epithelium. Up to now twenty cases of keratoameloblastoma have been previously reported in the literature, of which five exhibited a papilliferous component. Here we report a new case of a relapsed tumor that fits the spectrum of keratoameloblastoma which presented as an expansile, solid lesion with internal calcification in the right infratemporal fossa six years after ipsilateral hemimandibulectomy of a 46- year-old white female. Islands of columnar cells resembling ameloblasts surrounding a central area with starry cells, some of them completely filled with keratin and others also showing columnar to cuboidal basal cells with hypercromatic nuclei were observed in the histological evaluation of the specimen. The clinical, histopathologic and radiographic features of keratoameloblastoma are reviewed so as treatment and follow up. Although only few cases have been reported, the biological aggressive behavior and the high recurrence suggest that a more aggressive approach should be performed. A resection with sufficient safety margins and histopathological analysis of surgical margins are highly recommended. (AU)

Alternativas de produção agrícola em regiões com baixa incidência pluviométrica / Alternatives of agricultural production in regions with low rainfall impact

Economic growth and the need to feed the population can harm the water supply due to the pollution generated and the great need for food production volume. Water scarcity and water pollution pose a public health problem, limiting economic development and degrade the environment, most noticeable consequences in developing countries. In regions where rainfall does not meet the water demand can be used irrigation. On the other side it is known that the availability of fresh water is increasingly scarce, where irrigation systems are the largest consumers of water in Brazil. According to studies, some practices may favor the accumulation of water, allowing the use of the irrigation system, favoring agricultural production in areas classified as unfit for cultivation, especially in arid and semi-arid areas, as in the case of Brazil where water scarcity represents a serious limitation for socioeconomic development, which translates into low incomes and poor standards of nutrition, health and sanitation significant portion of its population. However, only the irrigation project does not guarantee success in the area of production, agronomic need to have knowledge about which species should be managed and how best to conduct adapting according to the actual situation on the property.

O crescimento econômico e a necessidade de alimentação para a população podem prejudicar o abastecimento de água devido à poluição gerada pela indústria e o grande volume necessário para produção de alimentos. A escassez de água e a poluição dos recursos hídricos representam um problema de saúde pública, limitam o desenvolvimento econômico e degradam o meio ambiente, consequências mais notadas nos países em desenvolvimento. Em regiões nas quais as precipitações não atendem a demanda hídrica pode-se utilizar a irrigação. Por outro lado, sabe-se que a disponibilidade de água potável está cada vez mais escassa e os sistemas de irrigação são os maiores consumidores de água no Brasil. Segundo estudos, algumas práticas podem favorecer o acúmulo de água, propiciando a utilização do sistema de irrigação, beneficiando a produção agrícola em áreas classificadas como impróprias para cultivo, especialmente em áreas áridas e semiáridas, como no caso do Nordeste brasileiro, onde a escassez hídrica representa uma séria limitação para o desenvolvimento socioeconômico, o que se traduz em baixos níveis de renda e padrões insatisfatórios de nutrição, saúde e saneamento de parcela representativa da sua população. Porém, somente o projeto de irrigação não garante o sucesso de produção na área, é preciso haver conhecimentos agronômicos sobre quais espécies devem ser manejadas e a melhor forma de condução, adaptando de acordo com a realidade encontrada na propriedade.