Hepatic noradrenergic innervation acts via CREB/CRTC2 to activate gluconeogenesis during cold.

BACKGROUND AND AIM: Although it is well established that hormones like glucagon stimulates gluconeogenesis via the PKA-mediated phosphorylation of CREB and dephosphorylation of the cAMP-regulated CREB coactivators CRTC2, the role of neural signals in the regulation of gluconeogenesis remains uncertain. METHODS AND RESULTS: Here, we characterize the noradrenergic bundle architecture in mouse liver; we show that the sympathoexcitation induced by acute cold exposure promotes hyperglycemia and upregulation of gluconeogenesis via triggering of the CREB/CRTC2 pathway. Following its induction by dephosphorylation, CRTC2 translocates to the nucleus and drives the transcription of key gluconeogenic genes. Rodents submitted to different models of sympathectomy or knockout of CRTC2 do not activate gluconeogenesis in response to cold. Norepinephrine directly acts in hepatocytes mainly through a Ca2+-dependent pathway that stimulates CREB/CRTC2, leading to activation of the gluconeogenic program. CONCLUSION: Our data demonstrate the importance of the CREB/CRTC2 pathway in mediating effects of hepatic sympathetic inputs on glucose homeostasis, providing new insights into the role of norepinephrine in health and disease.

Efficacy of the Vaccine Candidate Based on the P0 Peptide against Dermacentor nitens and Ixodes ricinus Ticks.

The control of ticks through vaccination offers a sustainable alternative to the use of chemicals that cause contamination and the selection of resistant tick strains. However, only a limited number of anti-tick vaccines have reached commercial realization. In this sense, an antigen effective against different tick species is a desirable target for developing such vaccines. A peptide derived from the tick P0 protein (pP0) conjugated to a carrier protein has been demonstrated to be effective against the Rhipicephalus microplus, Rhipicephalus sanguineus, and Amblyomma mixtum tick species. The aim of this work was to assess the efficacy of this peptide when conjugated to the Bm86 protein against Dermacentor nitens and Ixodes ricinus ticks. An RNAi experiment using P0 dsRNA from I. ricinus showed a dramatic reduction in the feeding of injected female ticks on guinea pigs. In the follow-up vaccination experiments, rabbits were immunized with the pP0-Bm86 conjugate and challenged simultaneously with larvae, nymphs, and the adults of I. ricinus ticks. In the same way, horses were immunized with the pP0-Bm86 conjugate and challenged with D. nitens larva. The pP0-Bm86 conjugate showed efficacies of 63% and 55% against I. ricinus and D. nitens ticks, respectively. These results, combined with previous reports of efficacy for this conjugate, show the promising potential for its development as a broad-spectrum anti-tick vaccine.

Applicability of machine learning techniques in food intake assessment: A systematic review.

The evaluation of food intake is important in scientific research and clinical practice to understand the relationship between diet and health conditions of an individual or a population. Large volumes of data are generated daily in the health sector. In this sense, Artificial Intelligence (AI) tools have been increasingly used, for example, the application of Machine Learning (ML) algorithms to extract useful information, find patterns, and predict diseases. This systematic review aimed to identify studies that used ML algorithms to assess food intake in different populations. A literature search was conducted using five electronic databases, and 36 studies met all criteria and were included. According to the results, there has been a growing interest in the use of ML algorithms in the area of nutrition in recent years. Also, supervised learning algorithms were the most used, and the most widely used method of nutritional assessment was the food frequency questionnaire. We observed a trend in using the data analysis programs, such as R and WEKA. The use of ML in nutrition is recent and challenging. Therefore, it is encouraged that more studies are carried out relating these themes for the development of food reeducation programs and public policies.

Differential Expression of Immune Genes in the Rhipicephalus microplus Gut in Response to Theileria equi Infection.

Rhipicephalus microplus is the only tick species known to serve as a biological vector of Theileria equi for horses and other equids in Brazil. The protozoan T. equi is one of the causal agents of equine piroplasmosis, a major threat in horse breeding systems. Vector competence is closely linked to the pathogens' ability to evade tick defense mechanisms. However, knowledge of tick immune response against infections by hemoparasites of the Theileria genus is scarce. In the present study, the expression of genes involved in immune signaling pathways of R. microplus adults' guts when challenged with a high or low parasitic load of T. equi was evaluated. This research demonstrates divergences in the immune gene expression pattern linked to T. equi infection in R. microplus since the Toll, IMD, and JNK signaling pathways were transcriptionally repressed in the guts of adult ticks infected with T. equi. Moreover, the results showed that different infectious doses of T. equi induce differential gene expression of key components of immune signaling cascades in R. microplus gut, suggesting a link between the intensity of infection and the activation of tick immunity response. The present study adds knowledge to elucidate the gut immune signaling response of R. microplus to T. equi infection. In addition, the generated data can serve as a basis for further investigations to develop strategies for controlling and preventing equine piroplasmosis.

Ultra-processed food consumption and dietary, lifestyle and social determinants: a path analysis in Brazilian graduates (CUME project).

OBJECTIVE: To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). DESIGN: Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. SETTING: Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. PARTICIPANTS: Baseline participants from the CUME Project (n 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. RESULTS: Being employed (P = 0·024), the time spent on the computer (P = 0·031) and the frequency of fried food intake (P < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration (P = 0·007) and the number of meals per d (P < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration (P = 0·032) and fried food intake (P = 0·005), whereas being a student is mediated by the time on the computer (P = 0·048). CONCLUSION: The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.

Built and social environments and overweight among Brazilian adults from medium-sized city: CUME Project.

A cross-sectional study enrolled participants from the CUME project (n = 289) who lived in Viçosa, Brazil. The neighborhood unit adopted was the buffer (200 meters), considering the participant's residence as central point. We measure the number of public and private facilities inside the buffer as well as violent criminal occurrences. Food establishments were categorized into establishments with predominant sale of natural or minimally processed foods, mixed establishments, and establishments with predominant sale of ultra-processed foods. Those who attended the face-to-face interview filled two scales of perception of the environment. Overall, 33.6% of participants reported overweight. We observed a higher concentration of individuals close to the central region of the city. Access to different establishments, food environments, and criminal occurrences differed between normal-weight and overweight individuals. The groups deferred in the perception of the location of squares, open public spaces, clubs, and soccer fields. The results indicate the association between environmental characteristics and overweight in Brazilian adults.

Relationship between food consumption and improvements in circulating melatonin in humans: an integrative review.

Melatonin is an important hormone in the regulation of circadian rhythms and has great antioxidant power. Recent studies have demonstrated the benefits of its supplementation in the metabolic profile. Food sources have also been studied for complementary therapies. However, information on the bioavailability of food sources of melatonin is still scarce. Thus, the objective of this review is to gather in the literature studies that evaluate the relationship between food consumption and improvements in circulating melatonin in humans. In total, 178 studies were found, of which 11 were included in this review. The results show increases in the excretion of the melatonin metabolite (6­sulfatoxymelatonin) or circulating melatonin for foods such as cherries, grapes, bananas, pineapples, dark green vegetables, Japanese vegetables and beer. Significant increases in melatonin were observed even after ingesting cultivars with low concentrations of this hormone. It was possible to assume that other nutrients that precede their synthesis (serotonin and tryptophan) could also have led to this increase. Although consumption of the foods found is beneficial in increasing circulating melatonin, further confirmatory studies are needed.

Built and social environments and overweight among Brazilian adults from medium-sized city: CUME Project / Ambientes construído e social e excesso de peso em adultos brasileiros de uma cidade de médio porte: Projeto CUME

Abstract A cross-sectional study enrolled participants from the CUME project (n = 289) who lived in Viçosa, Brazil. The neighborhood unit adopted was the buffer (200 meters), considering the participant's residence as central point. We measure the number of public and private facilities inside the buffer as well as violent criminal occurrences. Food establishments were categorized into establishments with predominant sale of natural or minimally processed foods, mixed establishments, and establishments with predominant sale of ultra-processed foods. Those who attended the face-to-face interview filled two scales of perception of the environment. Overall, 33.6% of participants reported overweight. We observed a higher concentration of individuals close to the central region of the city. Access to different establishments, food environments, and criminal occurrences differed between normal-weight and overweight individuals. The groups deferred in the perception of the location of squares, open public spaces, clubs, and soccer fields. The results indicate the association between environmental characteristics and overweight in Brazilian adults.

Resumo Realizou-se um estudo transversal com participantes do projeto CUME (n = 289) que moravam em Viçosa, Brasil. A unidade de vizinhança adotada foi o buffer (200 metros), considerando a residência do participante como ponto central. Foi contabilizado o número de instalações públicas e privadas dentro do buffer, bem como as ocorrências criminais. Os estabelecimentos alimentares foram categorizados em estabelecimentos com venda predominante de alimentos naturais ou minimamente processados, estabelecimentos mistos e estabelecimentos com venda predominante de alimentos ultraprocessados. Os participantes que compareceram à entrevista presencial, preencheram duas escalas de percepção do ambiente. No total, 33,6% dos participantes apresentaram excesso de peso. Foi observada uma maior concentração de indivíduos próximos à região central da cidade. O acesso a diferentes estabelecimentos, ambientes alimentares e ocorrências criminais diferiram entre indivíduos com eutrofia e com excesso de peso. Os grupos diferiram na percepção da localização de praças, espaços públicos abertos, clubes e campos de futebol. Os resultados indicam a associação entre as características ambientais e o excesso de peso em adultos brasileiros.

Online Food Frequency Questionnaire From the Cohort of Universities of Minas Gerais (CUME Project, Brazil): Construction, Validity, and Reproducibility.

Background: The Food Frequency Questionnaire (FFQ) is usually used in epidemiological studies to assess food consumption. However, the FFQ must have good accuracy, requiring its validation and reproducibility for the target population. Thus, this study aimed to describe the construction of the online Food Frequency Questionnaire (oFFQ) used at the Cohort of Universities of Minas Gerais (CUME project, Brazil) and evaluate its validity and reproducibility. Methods: The oFFQ was answered two times in 1 year (March/August 2018-March/April 2019; n = 108 participants-reproducibility), and four 24-h dietary recalls (24hRs) were applied in two seasons of the southern hemisphere [two 24hRs in autumn (March/June 2018) and two 24hRs in winter (August/September 2018); n = 146 participants-validity]. To assess the validity and reproducibility, the intraclass correlation coefficients (ICCs) were estimated. Results: The oFFQ had 144 food items separated into eight groups (dairy products; meat and fish; cereals and legumes; fruits; vegetables; fats and oils; drinks; other foods). In assessing the validity, ICCs for energy and macronutrients were considered moderate, ranging from 0.41 (energy) to 0.59 (protein), while the ICCs for micronutrients were considered low to moderate, ranging from 0.25 (fibers) to 0.65 (vitamin B6). Regarding reproducibility assessment, ICCs for energy and all the assessed items were considered moderate to excellent, ranging from 0.60 (vegetables) to 0.91 (vitamin E and retinol). Conclusions: The self-reported oFFQ had satisfactory validity and reproducibility. So, it can be used to analyze the association between food consumption and chronic diseases in the participants of the Cohort of Universities of Minas Gerais (CUME project-Brazil).

Characterization of the Rhipicephalus (Boophilus) microplus Sialotranscriptome Profile in Response to Theileria equi Infection.

This study intends to characterize the sialotranscriptome profile of Rhipicephalus (Boophilus) microplus in response to Theileria equi and identify genes of interest with differential genomic expression, indicating relevant targets in the tick-protozoan interactions. The experimental design consisted of RNA sequencing from uninfected and T. equi-infected R. microplus salivary glands (SGs) to obtain transcriptomic profiles for characterization and comparison. A total of 288,952 transcripts were obtained from both tick profiles, 3456 transcripts (p < 0.05) differentially expressed in response to T. equi infection. The uninfected SGs' registered 231,179 transcripts, of which 155,359 were annotated. The most transcribed sequences were female-specific histamine binding protein and lipocalins. Regarding the T. equi-infected SGs, from the 238,964 assembled transcripts, 163,564 were annotated. The most transcribed sequences were histone demethylase JARID1 and Y-box-binding protein. Five transcripts (cystatin, arginase, nuclear factor κB kinase inhibitor subunit ß (IκB), IκB delta, lysosomal-trafficking regulator, and reeler protein) presented the gene ontology (GO) category "response to protozoan" and were exclusively displayed in the T. equi-infected profile. The transcriptome of T. equi was also analyzed, registering 4728 hits. The study's genetic and molecular information would be of great value for future studies and biotechnological applications envisaging disease control.

A saúde da pessoa idosa no contexto da pandemia pelo coronavírus: considerações para a enfermagem / La salud de los ancianos en el contexto de la pandemia del coronavirus: consideraciones para enfermería / Elderly health in the context of the coronavirus pandemic: considerations for nursing

Objetivo: Refletir sobre a saúde da pessoa idosa na pandemia pelo COVID - 19, para a elaboração de orientações de enfermagem, dirigidas a Atenção Primária à Saúde e à Assistência Hospitalar Especializada. Método: Análise e discussão à luz da produção científica sobre a COVID 19, pautando-se em indicadores epidemiológicos, clínicos, políticos, sociais e espirituais, considerados estruturantes do cuidado de enfermagem. Resultados: Identificou-se que a prática de enfermagem deve ser direcionada à pessoa idosa em três situações específicas e a seus desdobramentos: o idoso frágil e acamado na comunidade; o idoso autônomo e independente em isolamento social; o idoso em potencial risco de hospitalização. Conclusão: O estudo identificou que idosos acamados, residentes em comunidades, compõem o grupo de alto risco dessa pandemia. Entende-se que os esforços para que a situação seja contida, requer empenho coletivo e conscientização da população e do cuidador do idoso. Sendo então, a articulação, os esforços e apelos realizados pelos profissionais de saúde, parte fundamental, para que ocorra a promoção da saúde e não só auxílio para resolutividade de comorbidades e recuperação dele. Ademais, também é dever do Estado acolher a população vulnerável, considerando os determinantes sociais implicados no processo de adoecimento a fim de minimizar os danos (AU)

Objective: to reflect on elderly health during the COVID-19 pandemic and elaborate nursing guidelines focused on Primary Health Care and Specialized Hospital Care. Method: discussion and analysis of scientific production on COVID-19, based on epidemiological, clinical, political, social and spiritual indicators, which are considered to be the pillars of nursing care. Results: the nursing practice should be directed to the elderly in three specific situations and their consequences: the frail and bedridden elderly in the community; the autonomous and independent elderly in social isolation; the elderly at potential risk of hospitalization. Conclusion: the study shows that bedridden elderly people living in communities are the high-risk group of this pandemic. Efforts to contain the situation require collective commitment, awareness of the population, and attention of the elderly person's caregiver. Therefore, the articulation, efforts and appeals made by health professionals is fundamental for health promotion and not only assistance for the resolution of comorbidities and recovery. Moreover, the Government is responsible for embracing the vulnerable population, considering the social determinants involved in the process of illness in order to minimize the damage (AU)

Objetivo: reflexionar sobre la salud de los ancianos en la pandemia del COVID - 19, para la elaboración de pautas de enfermería dirigidas a la Atención Primaria de Salud y Atención Hospitalaria Especializada. Método: análisis y discusión a la luz de la producción científica sobre COVID 19, basado en indicadores epidemiológicos, clínicos, políticos, sociales y espirituales, considerados base de la estructura de la atención de enfermería. Resultados: se identificó que la práctica de enfermería debía dirigirse a los ancianos en tres situaciones específicas y sus consecuencias: los ancianos frágiles y acostados en la comunidad; los ancianos autónomos e independientes en aislamiento social; ancianos con riesgo potencial de hospitalización. Conclusión: el estudio identificó que los ancianos postrados en cama que viven en comunidades son el grupo de alto riesgo de esta pandemia. Se entiende que los esfuerzos para contener la situación requieren un compromiso y conciencia colectiva de la población y del cuidador de los ancianos. Así, la articulación, los esfuerzos y los llamamientos realizados por los profesionales de la salud, son una parte fundamental para la promoción de la salud y no sólo la asistencia para la resolución de las comorbilidades y la recuperación de las mismas. Además, también es deber del Estado acoger a la población vulnerable, teniendo en cuenta los determinantes sociales involucrados en el proceso de la enfermedad para minimizar el daño (AU)

Species occurrence of ticks in South America, and interactions with biotic and abiotic traits.

The datasets of records of the distribution of ticks and their hosts are invaluable tools to understand the phylogenetic patterns of evolution of ticks and the abiotic traits to which they are associated. Such datasets require an exhaustive collection of bibliographical references. In most cases, it is necessary the confirmation of reliable identification of ticks, together with an update of the scientific names of the vertebrate hosts. These data are not easily available, because many records were published in the so-called "grey literature". Herein, we introduced the Dataset of Ticks in South America, a repository that collates data on 4,764 records of ticks (4,124 geo-referenced) with a special reference to an extra 2,370 records of ticks on cattle, together with a set of abiotic traits, curated from satellite-derived information over the complete target region. The dataset includes details of the phylogenetic relationships of the species of hosts, providing researchers with both biotic and abiotic traits that drive the distribution and evolution of ticks in South America.

Educação permanente em equipe multidisciplinar de um programa gerontológico: concepções, desafios e possibilidades / Permanent education in multidisciplinary team from a geriatric program: concepts, challenges and possibilities

INTRODUÇÃO: O aumento progressivo da população idosa e das enfermidades crônicas torna cada vez mais prioritário a educação permanente dos profissionais de saúde visando o atendimento das necessidades dos idosos. OBJETIVO: Conhecer as concepções da equipe multiprofissional e de gestores sobre Educação Permanente de um Programa de Assistência Integral à Pessoa Idosa. MÉTODOS: Trata-se de um estudo descritivo com abordagem qualitativa. O cenário foi um Programa Gerontológico desenvolvido em um Instituto de Atenção à Saúde de uma Universidade Pública, no município do Rio de Janeiro. Os participantes foram 10 profissionais de saúde incluindo os gestores do referido programa. Foi utilizado como técnica de coleta de dados o grupo focal, cujas reflexões ocorreram a partir de análise de conteúdo na modalidade temática. RESULTADOS: A pesquisa permitiu a construção de duas categorias: 1) Educação Permanente como movimento de atualização profissional e 2) Educação Permanente: aproximando o interesse pessoal, iniciativa institucional e necessidades dos usuários. Pode-se observar que a educação permanente ocorre a partir da identificação de problemas cotidianos e necessidades dos serviços e usuários do sistema de saúde, que se envolve com a responsabilidade de melhorar as condições de saúde da população de idosos atendida. CONCLUSÃO: O estudo contribuiu para uma reflexão que se traduza na organização do processo de trabalho e na busca pelo aprimoramento da prática assistencial qualificada e resolutiva, com vistas à operacionalização futura de processos de Educação Permanente.

INTRODUCTION: The progressive increase of the elderly population and chronic diseases turns the permanent education of health professionals more and more urgent in order to meet the needs of the elderly. OBJECTIVE: To know the conceptions of the multiprofessional team and of managers on Permanent Education of a Program of Integral Assistance to the Elderly. METHODS: This is a descriptive study with a qualitative approach. The scenario was a Geriatric Program offered in a Health Care Institute of a Public University in the city of Rio de Janeiro. The participants were 10 health professionals including the managers of the program. Focal group was used as data collection technique, whose reflections occurred from content analysis in the thematic modality. RESULTS: The research allowed the construction of two categories: 1) Permanent Education as a professional updating movement and 2) Permanent Education: approaching personal interest, institutional initiative and users needs. It can be observed that permanent education occurs from the identification of daily problems and the needs of the services and the users of the health system, being involved with the responsibility of improving the health conditions of the elderly population served. CONCLUSION: The study contributed to a reflection that translates into the organization of the work process and the search for the improvement of the qualified and resolutive assistance practice, with a view to the future operationalization of Permanent Education processes.

Melatonin intake and potential chronobiological effects on human health.

Melatonin is an indolamine with a recognized chronobiotic role. In turn, the supplementation of melatonin through capsules has been shown to be efficient in the modulation of inflammatory markers, oxidative stress, as well as in the control of hypertension and metabolic syndrome. However, the science of nutrition is interested in the study of the food sources of this hormone and its possible therapeutic effects. Thus, this review aimed to identify and present scientific papers that quantified melatonin in foods and evaluated its application in intervention studies. In total, 278 studies were found, of which 17 were included in this review. The results show that meats, fish, eggs, cereals, tubers, oilseeds, mushrooms, fruits, vegetables, alcoholic and non-alcoholic beverages and dairy products had some items analyzed for their melatonin concentrations. The concentrations reported presented considerable amplitude among different foods and even within the same species, possibly due to differences in cultivation and different hormonal dosing techniques. Also, different concentrations of melatonin can be presented for the same food when submitted to processes such as cooking, roasting or fermentation. The intervention studies presented positive results regarding the consumption of foods rich in melatonin and clinical-metabolic indicators. However, in order to guide nutritional behavior, it is necessary to consult a composition table that makes melatonin concentrations available and considers the processes involved in the preparation of the food. With this table, it will be possible to analyze the real effect of habitual consumption of melatonin from food on health.

Educational technology: a facilitating instrument for the elderly care.

OBJECTIVE: To develop educational technology with caregivers of older people based on the needs, difficulties and concerns related to the elderly care expressed by the caregivers themselves. METHOD: Research of qualitative nature, with participant observation, based on concepts used by Paulo Freire. Data collection and analysis used the "World Cafe" methodology and the thematic content analysis, respectively. RESULT: The needs of these caregivers refer to their training and information on aging. The difficulties highlighted are deterrents to quality assistance to older adults, such as: insufficient resources, environmental factor and relationship with the family. The interests are evident in relation to the care and to its more subjective relationship. Final considerations: Educational technologies, printed matter and media, developed along with the caregivers, contribute to orientation and information of caregiver, population and professionals as facilitating instruments, regarding elderly care.

Resistin and visfatin concentrations are related to central obesity and inflammation in Brazilian children

Background:The evidence that cardiovascular disease begins in childhood and adolescence, especially in the presence of excess weight, is associated with dysfunction on adipokine pro-inflammatory secretion. These affect glucose metabolism and lead to other complications related to insulin resistance and cardiovascular disease. This study assessed the association of anthropometric and metabolic parameters related to obesity, cardiovascular risk,and insulin resistance with concentrations of resistin and visfatin, in children. Methods: A cross-sectional study was developed with 178 children of 6­10 years old enrolled in public city schools. Anthropometric data, composition body, clinical, and biochemical were measured according to standard procedures. We used multiple regression models by stepwise method to evaluate the associations of resistin and visfatin with variables of interest.RESULTS: In healthy weight children, resistin was associated with LDL cholesterol, visfatin, atherogenic index, andwaist-to-height ratio, whereas in obese children resistin was associated with visfatin and interaction between conicity index and HOMA-AD. Furthermore, in healthy weight children, visfatin was associated to resistin and triceps skinfold thickness and negatively associated to HOMA-AD, while in obese ones visfatin was associated with waist-to-height ratio, atherogenic index, resistin, and interaction between trunk adiposity index and adiponectin and wasnegatively associated with the HOMA-IR index.CONCLUSIONS:Our study shows an association between anthropometric and biochemical variables related tovisceral fat and inflammation. These results suggest the resistin and visfatin as good pro-inflammatory markers. In addition, both adipokines are strongly related to central obesity, in children. In addition, both adipokines are strongly related to central obesity, in children.

Educational technology: a facilitating instrument for the elderly care / Tecnología educacional: un instrumento dinamizador del cuidado de ancianos / Tecnologia educacional: um instrumento dinamizador do cuidado com idosos

ABSTRACT Objective: To develop educational technology with caregivers of older people based on the needs, difficulties and concerns related to the elderly care expressed by the caregivers themselves. Method: Research of qualitative nature, with participant observation, based on concepts used by Paulo Freire. Data collection and analysis used the "World Cafe" methodology and the thematic content analysis, respectively. Result: The needs of these caregivers refer to their training and information on aging. The difficulties highlighted are deterrents to quality assistance to older adults, such as: insufficient resources, environmental factor and relationship with the family. The interests are evident in relation to the care and to its more subjective relationship. Final considerations: Educational technologies, printed matter and media, developed along with the caregivers, contribute to orientation and information of caregiver, population and professionals as facilitating instruments, regarding elderly care.

RESUMEN Objetivo: Desarrollar tecnología educacional con los cuidadores de ancianos a partir de las necesidades, dificultades e intereses manifestados por dichos cuidadores, relativos al cuidado de personas ancianas. Método: Investigación de carácter cualitativo, con enfoque participante, orientada por los conceptos de Paulo Freire. Para la recolección y el análisis de los datos se utilizaron las técnicas del «World Café¼ y análisis de Contenido del tipo temático, respectivamente. Resultado: Las necesidades de los cuidadores de ancianos se refieren a su capacitación y a información acerca del envejecimiento. Las dificultades señaladas se encuentran en los impeditivos para asistencia de calidad al anciano, tales como: insuficiencia de recursos, factor ambiental y relación familiar. Los intereses son evidentes respecto a la práctica del cuidado y en su relación más subjetiva. Consideraciones finales: Las tecnologías educacionales, impreso y medios, desarrollados con los cuidadores, contribuye en cuanto instrumento dinamizador para orientación e información del cuidador, población y profesionales, frente al cuidado del anciano.

RESUMO Objetivo: desenvolver tecnologia educacional com cuidadores de idosos a partir de necessidades, dificuldades e interesses manifestados por esses indivíduos quanto ao cuidado com a pessoa idosa. Método: pesquisa de cunho qualitativo, com abordagem participante, orientada por conceitos de Paulo Freire. A coleta e a análise dos dados foram feitas com base nas técnicas do World Café e da análise de conteúdo do tipo temático, respectivamente. Resultado: as necessidades dos cuidadores de idosos se referem a capacitação e informações sobre envelhecimento. As dificuldades apontadas estão nos impeditivos para assistência de qualidade ao idoso, tais como: insuficiência de recursos, fator ambiental e relação com a família. Os interesses são evidentes no tocante à prática do cuidado e em sua relação mais subjetiva. Considerações finais: as tecnologias educacionais, impresso e mídia, desenvolvidas com os cuidadores, contribuem, enquanto instrumentos dinamizadores, para orientação e informação do cuidador, da população e de profissionais sobre o cuidado com o idoso.

Neurofibroma Plexiforme Vesical em portador de Neurofibromatose: relato de caso / Bladder Plexiform Neurofibroma in Neurofibromatosis carrier: a case report / Neurofibroma Plexiforme Vesical en portador de Neurofibromatosis: relato de caso

Introdução: A neurofibromatose do tipo 1 (NF1) é uma doença hereditária de caráter autossômico dominante, com penetrância completa e relacionada a mutações no gene NF1 (17q11.2). Apresenta expressão extremamente variável e predisposição à ocorrência de tumores. Complicações como neurofibromas viscerais estão presentes em apenas 1% dos casos de NF1. Neurofibromas vesicais são extremamente raros. Relato do caso: O presente caso faz referência a um paciente do sexo masculino com 4 anos de idade que apresentava sinais e sintomas de disfunção urinária e intestinal associados a desvio da coluna lombossacra. Ao exame, foram identificadas características típicas de NF1 e os exames complementares permitiram o diagnóstico de um neurofibroma vesical. Posteriormente, foi concluído o diagnóstico de NF1. Conclusão: O diagnóstico de síndromes predisponentes ao câncer e o rastreio de tumores associados a essas condições são essenciais aos portadores dessas doenças.

Introduction: Type 1 neurofibromatosis is an inherited autosomal dominant disease with complete penetrance and is related to mutations in the NF1 gene (17q11.2). It presents extremely variable expression and predisposition to the occurrence of tumors. Complications such as visceral neurofibromas occurs in only 1% of NF1 cases. Vesical neurofibromas are extremely rare. Case report: Here in, we expose a case of a 4 years old boy, who presented signs and symptoms of urinary and intestinal dysfunction associated with lumbosacral spine deviation. His physical exam had neurofibromatosis type 1 features and the complementary exams revealed a vesical neurofibroma. Subsequently, a neurofibromatosis type 1 diagnosis was performed. Conclusion: Diagnose tumor predisposing syndromes and associated complications is essential for these patients.

Introducción: La neurofibromatosis tipo 1 es una enfermedad hereditaria de carácter autosómico dominante, con penetración completa y relacionada con mutaciones en el gen NF1 (17q11.2). Se presenta una expresión extremadamente variable y predisposición a la ocurrencia de tumores. Las complicaciones como los neurofibromas viscerales están presentes en sólo el 1% de los casos de NF1. Los neurofibromas vesicales son extremadamente raros. Relato del caso: Exponemos el caso de un niño de 4 años que presentaba signos y síntomas de disfunción urinaria e intestinal asociados a la desviación de la columna lumbosacra. En el examen se identificaron características típicas de neurofibromatosis y los exámenes complementarios permitieron el diagnóstico de un neurofibroma vesical. Se ha concluido el diagnóstico de neurofibromatosis del tipo 1. Conclusión: Diagnosticar los síndromes predisponentes del tumor y las complicaciones asociadas son esenciais para estos pacientes.

Avaliação de intervenções psicomotoras em idosos com déficit cognitivo leve / Evaluación de intervenciones psicomotoras en ancianos con deterioro cognitivo leve / Evaluation of psychomotor interventions in elderly with mild cognitive deficit

RESUMO O presente estudo teve como objetivo analisar o efeito de atividades psicomotoras sobre equilíbrio em idosos com Déficit Cognitivo Leve. Trata-se de pesquisa quase experimental realizada em duas instituições públicas de saúde, com 43 idosos, residentes em Niterói e Rio de Janeiro/RJ, nos meses de abril a julho/2014. Realizaram-se dez sessões de atividades psicomotoras e avaliações com as escalas antes e após atividades realizadas. Osinstrumentos utilizados foram: Escala de Tinetti e Escala Motora para Terceira Idade (EMTI). Oprojeto foi aprovado pelo Comitê de Ética (Protocolo n° 531.807/2014). Através do Teste Kruskal-Wallis, nível de confiança 95%, significância 0,05, existe diferença significativa entre as avaliações realizadas. Na primeira avaliação,Tinetti apresentou 22 idosos (51,16%), média 17,22 pontos, com alto risco para quedas; 11 idosos (25,58%) com risco moderado. O equilíbrio - EMTI apresentou média 79,81 pontos, equivalente a classificação inferior. E nasegunda avaliação,Tinetti apresentou apenas cinco idosos (11,62%) com alto risco para quedas e 28 idosos (65,11%) com risco moderado para quedas e média 20,67 pontos. Dez idosos não apresentaram risco para quedas. O equilíbrio - EMTI obteve média 92,37 pontos mudando para classificação normal médio. Diante dos resultados,evidenciou-seque as atividades psicomotoras favorecem o equilíbrio dos idosos com Déficit Cognitivo Leve.

RESUMEN El presente estudio tiene el objetivo de analizar el efecto de actividades psicomotoras en el equilibrio en ancianos con Deterioro Cognitivo Leve. Se trata de una investigación casi experimental realizada en dos instituciones públicas de salud, muestra de 43 ancianos, residentes en Niterói y Rio de Janeiro/RJ/Brasil. Tuvo su inicio en abril y terminó en julio/2014. Fueron realizadas diez sesiones de actividades psicomotoras y evaluaciones con las escalas antes y después de actividades realizadas. Instrumentos utilizados: Escala de Tinetti y Escala Motora para Tercera Edad (EMTI). Proyecto aprobado por el Comité de Ética (Protocolo n° 531.807/2014). A través de la Prueba de Kruskal-Wallis, nivel de confianza 95%, significancia 0,05 existe diferencia significativa entre las evaluaciones realizadas. Primera evaluación: Tinetti presentó 22 ancianos (51,16%), promedio de 17,22 puntos, con alto riesgo para caídas; 11 ancianos (25,58%) con riesgo moderado. El equilibrio - EMTI presentó promedio de 79,81 puntos, equivalente a la clasificación inferior. Segunda evaluación: Tinetti presentó solo cinco ancianos (11,62%) con alto riesgo para caídas y 28 ancianos (65,11%) con riesgo moderado para caídas y promedio de 20,67 puntos. Diez ancianos no presentaron riesgo para caídas. El equilibrio - EMTI obtuvo promedio de 92,37 puntos, cambiando para clasificación normal medio. Ante los resultados queda evidenciado que las actividades psicomotoras favorece el equilibrio de los ancianos con Deterioro Cognitivo Leve.

ABSTRACT This study aimed to analyze the effect of psychomotor activities on the balance of elderly patients with Mild Cognitive Deficit. This is a quasi-experimental research carried out in two public health institutions with 43 elderly residents in Niterói and Rio de Janeiro/RJ, in the months of April-July/2014. Ten sessions of psychomotor activities were carried out, as well as assessments with the scales before and after activities. The instruments used were: Tinetti Scale and Equilibrium of the Motor Scale for the Elderly (MSE). The project was approved by the Ethics Committee (Protocol n° 531,807/2014). The Kruskal-Wallis test, with confidence level of 95% and significance of 0.05 showed significant difference between the assessments carried out. In the first evaluation, Tinetti tests presented 22 elderly (51.16%), mean of 17.22 points, at high risk of falls; 11 elderly (25.58%) at moderate risk. The equilibrium - MSE showed a mean of 79.81 points, equivalent to a lower classification. In turn, in the second evaluation, Tinetti presented only five elderly (11.62%) at high risk for falls and 28 elderly (65.11%) at moderate risk for falls and a mean of 20.67 points. Ten elderly showed no risk for falls. The equilibrium - MSE obtained a mean of 92.37 points, shifting to normal medium. Therefore, the results showed that psychomotor activities favor the balance of elderly people with Mild Cognitive Deficit.