Anatomy and evaluation of the optic nerve head / Anatomia e avaliação da cabeça do nervo óptico

ABSTRACT Evaluation of the optic disc is important for the correct diagnosis and follow-up of optic neuropathies, especially glaucoma. The characteristics of the optic disc depend on various factors, including demographic and population aspects, and analysis of these characteristics may vary according to the methods used. The size and format of the neural rim along with the nerve fiber layer are important to the clinician's judgment regarding the susceptibility of the subject to develop glaucoma. In this study, we reviewed the literature to summarize the main methods and its characteristics in the evaluation of the optic nerve head.

RESUMO A avaliação do disco óptico é de suma importância para o diagnostico correto e acompanhamento de neuropatias ópticas, especialmente o glaucoma. Características do disco óptico dependem de uma grande variedade de fatores, incluindo aspectos demográficos e populacionais, e também podem variar de acordo com os métodos usados. Tamanho e formato da rima neurorretiniana junto com a camada de fibras nervosas são importantes ao julgamento clinico a respeito da susceptibilidade do paciente desenvolver glaucoma. Nesse estudo, nós revisamos a literatura para resumir os principais métodos e suas características para a avaliação da cabeça do nervo óptico.

Structural and evolutive features of the Plinia phitrantha and P. cauliflora plastid genomes and evolutionary relationships within tribe Myrteae (Myrtaceae).

Plinia phitrantha and P. cauliflora are Myrtaceae species with recognized horticultural and pharmacological potential. Nevertheless, studies on molecular genetics and the evolution of these species are absent in the literature. In this study, we report the complete plastid genome sequence of these species and an analysis of structural and evolutive features of the plastid genome within the tribe Myrteae. The two plastid genomes present the conserved quadripartite structure and are similar to already reported plastid genomes of Myrteae species concerning the size, number, and order of the genes. A total of 69-70 SSR loci, 353 single nucleotide polymorphisms, and 574 indels were identified in P. phitrantha and P. caulifora. Observed evolutive features of the plastid genomes support the development of programs for the conservation and breeding of Plinia. The phylogenomic analysis based on the complete plastid genome sequence of 15 Myrteae species presented a robust phylogenetic signal and evolutive traits of the tribe. Ten hotspots of nucleotide diversity were identified, evidence of purifying selection was observed in 27 genes, and relative conservation of the plastid genomes was confirmed for Myrteae. Altogether, the outcomes of the present study provide support for planning conservation, breeding, and biotechnological programs for Plinia species.

Anatomy and evaluation of the optic nerve head.

Evaluation of the optic disc is important for the correct diagnosis and follow-up of optic neuropathies, especially glaucoma. The characteristics of the optic disc depend on various factors, including demographic and population aspects, and analysis of these characteristics may vary according to the methods used. The size and format of the neural rim along with the nerve fiber layer are important to the clinician's judgment regarding the susceptibility of the subject to develop glaucoma. In this study, we reviewed the literature to summarize the main methods and its characteristics in the evaluation of the optic nerve head.

Patterns of genetic diversity, spatial genetic structure and gene flow in Campomanesia xanthocarpa: insights from SSR markers of different genomic origins.

Campomanesia xanthocarpa (Mart.) O. Berg is a South American fruit tree species with important ecological and medicinal properties, which remnants are currently found mainly in isolated forest fragments. In this study, SSR markers from three different genomic origins (gene-linked, nuclear neutral, and organellar) were used to evaluate the patterns of genetic diversity, fine-scale spatial genetic structure and historical gene flow in fragmented forest formations of C. xanthocarpa from the Atlantic Forest in southern Brazil. Our results show that the forest fragments present moderate to high levels of genetic diversity in comparison to species presenting similar life traits, although a trend opposite to expected was observed concerning gene-linked and neutral SSR markers. The fine-scale spatial genetic structure revealed different patterns in short and large distance classes, with a distinct influence of gene-linked and neutral markers in driving the genetic structure in each distance class. The presence of an isolation-by-adaptation pattern implies the need for maintenance of the current remnants to assure the conservation of the private alleles. Finally, as the genetic diversity is found predominantly within forest fragments, programs of seed collection and/or genetic rescue should prioritize a larger number of individuals within each fragment, to increase the sampled diversity.

Effect of steroid eyedrops after trabeculectomy in glaucoma patients: a keratograph analysis / Efeito de colirios esteróides pré-operatório em pacientes com glaucoma: análise com keratograph

ABSTRACT Purpose: To investigate the use of preoperative steroid eyedrops in glaucoma patients undergoing trabeculectomy for ocular surface disease. Methods: A total of 31 eyes of 31 glaucoma patients were included. Only glaucoma patients who had been using at least three topical intraocular pressure-lowering medications for longer than 6 months were included. All patients were treated with loteprednol etabonate ophthalmic suspension 0.5% four times per day for 1 week before trabeculectomy. Data from baseline (day of surgery) and the follow-up visit (2 weeks after surgery) were included. All patients underwent a detailed ophthalmologic examination. Ocular surface disease was evaluated using the Ocular Surface Disease Index questionnaire and clinical measures, including tear breakup time, conjunctival hyperemia, and biomicroscopy to detect the presence or absence of keratitis. Ocular Surface Disease Index scores greater than 13 indicated a clinically relevant presence of ocular surface disease. In addition, all patients underwent keratograph analysis. The comparison of ocular surface disease before and after trabeculectomy was assessed using a paired test. Results: The mean age of the glaucoma patients was 69.90 ± 10.77 years. The average visual acuity was 0.40 ± 0.34 logMAR. The overall Ocular Surface Disease Index prevalence rate was 27.20 ± 17.56 units. Clinical assessment revealed no significant difference in bulbar redness, breakup time, or keratitis before and after surgery (p>0.05 for all comparisons). Keratograph analysis showed that the only two parameters that were significantly different before and after trabeculectomy ewere the bulbar redness by keratograph (BR-K) and the average noninvasive tear breakup time. Patients presented more conjunctival hyperemia and shorter noninvasive tear breakup time after trabeculectomy as compared with before surgery (p=0.013 and p=0.041, respectively). Conclusions: The present study not only confirms the high prevalence of clinical findings of ocular surface disease in glaucoma patients but also reveals new objective parameters measured by keratograph analysis. Apart from using loteprednol etabonate ophthalmic suspension 0.5% 1 week before the surgery, our sample presented a worsening of conjunctival hyperemia (bulbar redness by keratograph) and also a shorter noninvasive tear breakup time postoperatively.

RESUMO Objetivo: Investigar a ação de colírios esteróides na doença de superfície ocular em pacientes a serem submetidos a cirurgia de trabeculectomia. Métodos: Foram incluídos 31 olhos de 31 pacientes com glaucoma em uso de pelo menos 3 medicações tópicas anti- hipertensivas há mais de 6 meses. Todos os pacientes foram tratados com colírio de etabonato de loteprednol 0,5% (1 gota a cada 6 horas) durante os 7 dias precedentes à cirurgia de trabeculectomia. Além disso, foram submetidos a exame oftalmológico completo e responderam questionário validado que visa avaliar parâmetros subjetivos correlacionados a doenças da superfície ocular (Ocular Surface Disease Index). Os aspectos clínicos avaliados foram: tempo de ruptura lacrimal, coloração da córnea após colírio de fluoresceína (ceratite) e hiperemia conjuntival. Os pacientes foram, ainda, submetidos à análise da superfície ocular através de novo software tecnológico denominado "Keratographic", tecnologia não invasiva que permite avaliar a doença da superfície ocular. A comparação da doença de superfície ocular antes e após a trabeculectomia foi avaliada estatisticamente através do teste pareado. Resultados: A média de idade dos participantes foi de 69,90 ± 10,77 anos. A AV média foi de 0,40 ± 0,34 logMAR. A taxa de prevalência global da Ocular Surface Disease Index foi de 27,20 ± 17,56 unidades. Em relação à avaliação clínica, não houve diferença significativa em relação hiperemia, ruptura lacrimal e ceratite antes e após a cirurgia (p>0,05 para todas as comparações). Em relação à análise com o "keratograph (menisco lacrimal, hiperemia, tempo de ruptura do filme lacrimal, meibografia para a pálpebra superior e inferior), os dois únicos parâmetros que diferiram significativamente antes e após a trabeculectomia, foram hiperemia e a média do tempo de rupture do filme lacrimal. Após a cirurgia de trabeculectomia, os pacientes apresentaram aumento da hiperemia conjuntival e diminuição do tempo de ruptura do filme lacrimal (p=0,013 e p=0,041, respectivamente). Conclusões: O presente estudo, não somente confirma a elevada prevalência da doença de superfície ocular em pacientes com glaucoma, como também demonstra que a mesma pode ser mensurada objetivamente através de parâmetros mensurados pelo Keratograph. Apesar de ter utilizado etabonato de loteprednol 0,5% uma semana antes da cirurgia, nossa amostra apresentou piora da hiperemia conjuntival e diminuição no tempo de ruptura do filme lacrimal no pós-operatório.

Effect of steroid eyedrops after trabeculectomy in glaucoma patients: a keratograph analysis.

PURPOSE: To investigate the use of preoperative steroid eyedrops in glaucoma patients undergoing trabeculectomy for ocular surface disease. METHODS: A total of 31 eyes of 31 glaucoma patients were included. Only glaucoma patients who had been using at least three topical intraocular pressure-lowering medications for longer than 6 months were included. All patients were treated with loteprednol etabonate ophthalmic suspension 0.5% four times per day for 1 week before trabeculectomy. Data from baseline (day of surgery) and the follow-up visit (2 weeks after surgery) were included. All patients underwent a detailed ophthalmologic examination. Ocular surface disease was evaluated using the Ocular Surface Disease Index questionnaire and clinical measures, including tear breakup time, conjunctival hyperemia, and biomicroscopy to detect the presence or absence of keratitis. Ocular Surface Disease Index scores greater than 13 indicated a clinically relevant presence of ocular surface disease. In addition, all patients underwent keratograph analysis. The comparison of ocular surface disease before and after trabeculectomy was assessed using a paired test. RESULTS: The mean age of the glaucoma patients was 69.90 ± 10.77 years. The average visual acuity was 0.40 ± 0.34 logMAR. The overall Ocular Surface Disease Index prevalence rate was 27.20 ± 17.56 units. Clinical assessment revealed no significant difference in bulbar redness, breakup time, or keratitis before and after surgery (p>0.05 for all comparisons). Keratograph analysis showed that the only two parameters that were significantly different before and after trabeculectomy ewere the bulbar redness by keratograph (BR-K) and the average noninvasive tear breakup time. Patients presented more conjunctival hyperemia and shorter noninvasive tear breakup time after trabeculectomy as compared with before surgery (p=0.013 and p=0.041, respectively). CONCLUSIONS: The present study not only confirms the high prevalence of clinical findings of ocular surface disease in glaucoma patients but also reveals new objective parameters measured by keratograph analysis. Apart from using loteprednol etabonate ophthalmic suspension 0.5% 1 week before the surgery, our sample presented a worsening of conjunctival hyperemia (bulbar redness by keratograph) and also a shorter noninvasive tear breakup time postoperatively.

Molecular relationships of Campomanesia xanthocarpa within Myrtaceae based on the complete plastome sequence and on the plastid ycf2 gene.

Plastomes are very informative structures for comparative phylogenetic and evolutionary analyses. We sequenced and analyzed the complete plastome of Campomanesia xanthocarpa and compared its gene order, structure, and evolutionary characteristics within Myrtaceae. Analyzing 48 species of Myrtaceae, we identified six genes representing 'hotspots' of variability within the plastomes (ycf2, atpA, rpoC2, pcbE, ndhH and rps16), and performed phylogenetic analyses based on: (i) the ycf2 gene, (ii) all the six genes identified as 'hotspots' of variability, and (iii) the genes identified as 'hotspots' of variability, except the ycf2 gene. The structure, gene order, and gene content of the C. xanthocarpa plastome are similar to other Myrtaceae species. Phylogenetic analyses revealed the ycf2 gene as a promissing region for barcoding within this family, having also a robust phylogenetic signal. The synonymous and nonsynonymous substitution rates and the Ka/Ks ratio revealed low values for the ycf2 gene among C. xanthocarpa and the other 47 analyzed species of Myrtaceae, with moderate purifying selection acting on this gene. The average nucleotide identity (ANI) analysis of the whole plastomes produced phylogenetic trees supporting the monophyly of three Myrtaceae tribes. The findings of this study provide support for planning conservation, breeding, and biotechnological programs for this species.

Whole Plastome Sequences of Two Drug-Type Cannabis: Insights Into the Use of Plastid in Forensic Analyses.

DNA is one of the fastest growing tools in forensic sciences, increasing reliability in forensic reports and judgments. The use of DNA has increased in different areas of the forensic sciences, such as investigation of plant species, where plastid DNA has been used to elucidate and generate evidence in cases of traceability of genetically modified and controlled plants. Even with several advances and the practice of using DNA in forensic investigations, there are just few studies related to the identification of genetic tools for the characterization of drug and nondrug-types of Cannabis. Herein, the whole plastomes of two drug-type Cannabis are presented and have their structures compared with other Cannabis plastomes deposited in the GenBank, focusing in the forensic use of plastome sequences. The plastomes of Cannabis sativa "Brazuka" and of the hybrid Cannabis AK Royal Automatic presented general structure that does not differs from the reported for other C. sativa cultivars. A phylogenomic analyses grouped C. sativa "Brazuka" with the nondrug C. sativa cultivars, while the hybrid Cannabis AK Royal Automatic placed isolated, basal to this group. This suggests that the analysis of plastomes is useful toward genetic identification of hybrids in relation to C. sativa.

Repetitive genomic elements in Campomanesia xanthocarpa: prospection, characterization and cross amplification of molecular markers.

Repetitive genomic elements were prospected in Campomanesia xanthocarpa, aiming to characterize these elements in a non-model plant species and to develop species-specific microsatellite markers. Approximately 4.12% of the partial genome of C. xanthocarpa is composed of repetitive elements, being retrotransposons the most widely represented. A total of nine polymorphic microsatellite markers were obtained: four nuclear-neutral, two nuclear EST, two plastidial and one mitochondrial. Levels of population genetic diversity of four natural populations of C. xanthocarpa were characterized using these markers. In addition, the cross-species amplification of the microsatellite markers was tested in seven species of tribe Myrteae (Myrtaceae). The characterized microsatellite markers revealed low to moderate levels of genetic diversity (expected heterozygosity range: 0.33-0.57; observed heterozygosity: 0.26-0.74 and number of alleles: 2.25-4.25). Cross-species amplification was successful for all loci, except Cxant76. These nine markers will contribute for studies on genetic diversity, gene flow, plant selection and breeding of this species, towards the conservation of natural populations, as well as its commercial use.

Factors associated with vision-related quality of life in Brazilian patients with glaucoma / Fatores associados à qualidade de vida relacionada à visão em pacientes brasileiros com glaucoma

ABSTRACT Purpose: To evaluate the impact of visual acuity, visual field damage, and other factors on the quality of life in Brazilian patients with glaucoma. Methods: This cross-sectional prospective study involved 49 patients with glaucoma enrolled based on the presence of reproducible standard automated perimetry defects in at least one eye at the time of evaluation. A detailed ophthalmologic examination was performed on each patient. All patients had reproducible standard automated perimetry and completed an NEI VFQ-25 questionnaire. The associations of the quality of life scores to the best-corrected visual acuity and the visual field loss of the better and worse eyes were investigated. Results: The mean quality of life score of the patients was 58.8 ± 18.7 units. The highest and lowest mean values (85.0 ± 24.2 and 37.5 ± 36.5 units) were observed in the "Social Functioning Subscale" and "Driving Subscale," respectively. Patients with advanced glaucoma (mean deviation <-12 dB) in the worse eye had significantly lower quality of life scores (p=0.007). There was a significant correlation between the quality of life scores and the visual acuity of the better and worse eyes (r2=13%, p=0.010 and r2=32%, p<0.001, respectively). There was also a significant correlation between the quality of life scores and standard automated perimetry mean deviation of the better and worse eyes (r2=13%, p=0.023 and r2=47%, p<0.001, respectively). In a multivariate model containing so­cioeconomic and comorbidity indices, quality of life remained significantly related to the standard automated perimetry mean deviation of the better and worse eyes (r2=23%, p=0.29 and r2=49%, p<0.001, respectively) as well as to the visual acuity of the better and worse eyes (r2=18%, p=0.017 and r2=40%, p<0.001, respectively). Conclusion: The standard automated perimetry mean deviation and the visual acuity of the better and worse eyes were associated with lower quality of life in Brazilian patients with glaucoma. Quality of life was mostly highly associated with the standard automated perimetry mean deviation of the worse eye.

RESUMO Objetivo: Avaliar o impacto da acuidade visual, danos no campo visual e outros fatores na qualidade de vida em pacientes brasileiros com glaucoma. Métodos: Este foi um estudo transversal prospectivo incluindo 49 pacientes com glau­coma selecionados com base na presença de defeitos por perimetria automatizada padrão reprodutíveis em pelo menos um olho no momento da avaliação. Um exame oftalmológico detalhado foi realizado em cada paciente. Todos os pacientes possuíam perimetria automatizada padrão reprodutível e preencheram um questionário NEI VFQ-25. As associações dos escores de qualidade de vida à acuidade visual melhor corrigida e à perda de campo visual dos melhores e piores olhos foram investigadas. Resultados: A média dos escores de qualidade de vida dos pacientes foi de 58,8 ± 18,7 unidades. Os maiores e menores valores médios (85,0 ± 24,2 e 37,5 ± 36,5 unidades) foram observados nas subescalas "Social Functioning Subscale" e "Driving Subscale", respectivamente. Pacientes com glaucoma avançado (desvio médio <-12 dB) no pior olho tiveram escores de qualidade de vida significativamente menores (p=0,007). Houve correlação significativa entre escores de qualidade de vida e a acuidade visual dos olhos melhores e piores (r2=13%; p=0,010 e r2=32%; p<0,001; respectivamente). Houve também uma correlação significativa entre os escores de qualidade de vida e desvios médios da perimetria automatizada padrão dos olhos melhores e piores (r2=13%; p=0,023 e r2=47%; p<0,001; respectivamente). Em um modelo multivariado contendo dados socioeconômicos e de comorbidades, a qualidade de vida permaneceu significativamente relacionada ao desvio médio padrão da perimetria automatizada do olho melhor e pior (r2=23%; p=0,29 e r2=49%; p<0,001, respectivamente) bem como para a acuidade visual do olho melhor e pior (r2=18%; p= 0,017 e r2=40%; p<0,001, respectivamente). Conclusão: O desvio padrão da perimetria automatizada padrão e a acuidade visual dos olhos melhor e pior foram associados à menor qualidade de vida em pacientes brasileiros com glaucoma. A qualidade de vida foi em grande parte altamente associada ao desvio padrão da perimetria automatizada padrão do pior olho.

Factors associated with vision-related quality of life in Brazilian patients with glaucoma.

PURPOSE: To evaluate the impact of visual acuity, visual field damage, and other factors on the quality of life in Brazilian patients with glaucoma. METHODS: This cross-sectional prospective study involved 49 patients with glaucoma enrolled based on the presence of reproducible standard automated perimetry defects in at least one eye at the time of evaluation. A detailed ophthalmologic examination was performed on each patient. All patients had reproducible standard automated perimetry and completed an NEI VFQ-25 questionnaire. The associations of the quality of life scores to the best-corrected visual acuity and the visual field loss of the better and worse eyes were investigated. RESULTS: The mean quality of life score of the patients was 58.8 ± 18.7 units. The highest and lowest mean values (85.0 ± 24.2 and 37.5 ± 36.5 units) were observed in the "Social Functioning Subscale" and "Driving Subscale," respectively. Patients with advanced glaucoma (mean deviation <-12 dB) in the worse eye had significantly lower quality of life scores (p=0.007). There was a significant correlation between the quality of life scores and the visual acuity of the better and worse eyes (r2=13%, p=0.010 and r2=32%, p<0.001, respectively). There was also a significant correlation between the quality of life scores and standard automated perimetry mean deviation of the better and worse eyes (r2=13%, p=0.023 and r2=47%, p<0.001, respectively). In a multivariate model containing so-cioeconomic and comorbidity indices, quality of life remained significantly related to the standard automated perimetry mean deviation of the better and worse eyes (r2=23%, p=0.29 and r2=49%, p<0.001, respectively) as well as to the visual acuity of the better and worse eyes (r2=18%, p=0.017 and r2=40%, p<0.001, respectively). CONCLUSION: The standard automated perimetry mean deviation and the visual acuity of the better and worse eyes were associated with lower quality of life in Brazilian patients with glaucoma. Quality of life was mostly highly associated with the standard automated perimetry mean deviation of the worse eye.

Evaluation of Ocular Surface Disease in Patients With Glaucoma: Clinical Parameters, Self-report Assessment, and Keratograph Analysis.

PURPOSE: To assess ocular surface disease (OSD) in glaucoma using clinical parameters, self-report assessment, and keratograph analysis. METHODS: A total of 30 glaucoma patients and 27 subjects with cataracts (control group) were enrolled in the study. Only glaucoma patients who were using at least 1 topical intraocular pressure-lowering medication were included. An ophthalmological examination was performed, including tear break-up time (BUT), assessment of conjunctival hyperemia and keratitis, and completion of the Ocular Surface Disease Index (OSDI) questionnaire. All the patients underwent keratograph analysis including noninvasive BUT, meibography, tear meniscus height, and redness scale. Quality of life was also assessed in all the patients using National Eye Institute Visual Function Questionnaire (NEI VFQ)-25. The comparison of OSD between the 2 groups was assessed. RESULTS: There was a significant difference in OSD: keratitis and conjunctival hyperemia were worse in the glaucoma group (P=0.009 and 0.008, respectively). The glaucoma group had significantly worse scores on the OSDI questionnaire (32.53±20.75 vs. 20.42±18.77; P=0.007). For the keratograph assessment, the glaucoma group had significantly smaller tear meniscus height (0.22±0.08 vs. 0.24±0.04, respectively; P=0.041); worse bulbar redness (2.06±0.67 vs. 1.70±0.45, respectively; P=0.021); higher meibography grades (2.34±1.01 vs. 1.52±0.64, respectively; P=0.001); and worse noninvasive keratograph tear BUT (5.45±4.16 vs. 8.40±5.65, respectively; P=0.023). Patients with glaucoma had a worse quality of life (60.73±18.25 vs. 76.62±8.03, respectively; P=0.039). CONCLUSIONS: Our findings not only confirm the high prevalence of clinical findings of OSD in glaucoma patients but also reveal new objective parameters measured by keratograph analysis.

Reliability and safety of transnasal compared to conventional endoscopy for detecting oesophageal varices in cirrhotic patients.

BACKGROUND & AIMS: Unsedated transnasal endoscopy may be used for detecting oesophageal varices. However, few studies evaluated feasibility and accuracy of this technique. We aimed to evaluate accuracy, interobserver agreement and safety of the transnasal ultrathin compared to conventional endoscopy in patients with cirrhosis. METHODS: This cross-sectional study included consecutive patients referred for screening or surveillance of oesophageal varices. Patients underwent unsedated transnasal and sedated conventional endoscopies at the same day, which were recorded in a digital video file and randomly analysed by two double-blinded endoscopists. High-risk varices were defined by the presence of large calibre or red wale marks. Accuracy, interobserver agreement and safety of transnasal were compared to conventional endoscopy. RESULTS: One hundred and thirty-three cirrhotic patients (48% male, aged of 60 ± 5, 34% Child-Pugh B/C and 71% of cases for variceal screening) were included in the study. The prevalence of oesophageal varices and high-risk oesophageal varices were 59% (n = 79) and 29% (n = 39) respectively. For the presence of oesophageal varices, transnasal GIE yielded sensitivity of 94% [95% Confidence Interval, CI 88-99], specificity of 89% [81-97] as well as positive and negative predictive value of 93% and 91% respectively. A satisfactory interobserver agreement was observed for the presence of oesophageal varices (κ = 0.89) and high-risk varices (κ = 0.65). No serious adverse events were recorded; transnasal GIE was safe and significantly associated with lower rates of hypoxaemia (P < .0001) and hypotension (P < .0001) compared to conventional endoscopy. CONCLUSIONS: Unsedated transnasal endoscopy was safe and had an excellent accuracy and high interobserver agreement for detecting oesophageal varices and for identifying high-risk varices in cirrhotic patients.

Práticas de gestão da mudança: impacto nas atitudes e nos resultados percebidos / Change management practices: impact on attitudes and results perceived with changes / Prácticas de gestión de cambios: impacto sobre las actitudes y resultados percibidos

As práticas de gestão da mudança são intervenções organizacionais que facilitam a promulgação de processos de mudança nas empresas. Este estudo testa a relação entre o uso das práticas de gestão da mudança e seus impactos sobre a atitude e os resultados percebidos com a mudança. A amostra foi composta por 205 participantes de organizações brasileiras (58,5% mulheres e 40,5% homens). Os instrumentos utilizados foram a Escala de Percepção de Mudanças Organizacionais, avaliando os resultados transformacionais e transacionais percebidos; a Escala de Atitude Frente às Mudanças - avaliando ceticismo, temor e aceitação das mudanças; e o Questionário de Avaliação das Práticas de Gestão da Mudança Organizacional, avaliando cinco práticas de mudança organizacional (diagnóstico e alinhamento, liderança, comunicação, compensação e incentivos, e treinamento). Os resultados indicaram que as práticas de gestão da mudança impactam parcialmente as atitudes e os resultados percebidos com a mudança.

Change management practices are organizational interventions that facilitate the enactment of change processes in companies. This study tests the relationship between the use of change management practices and their impacts on attitude and on the results perceived with changes. The sample had 205 participants from Brazilian organizations (58.5% women and 40.5% men). The instruments used were the Organizational Change Perception Scale, assessing perceived transformational and transactional results; the Scale of Attitudes in Relation to Changes, assessing skepticism, fear, and acceptance of changes; and the Assessment of Organizational Change Management Practices Questionnaire, to evaluate five organizational change practices (diagnosis and alignment, leadership, communication, compensation and incentives, and training). As a result, it was found that change management practices partially affect attitudes and perceived results.

Prácticas de gestión cambios son intervenciones organizativas que facilitan la promulgación de los procesos de mudanza en las empresas. Este estudio analiza la relación entre el uso de prácticas de gestión de cambios y su impacto en las actitudes y en los resultados que de ellos se derivan. La muestra incluyó a 205 participantes de organizaciones de Brasil (58,5% mujeres y 40,5% hombres). Los instrumentos utilizados fueron: la Escala de Percepción de Cambios Organizacionales, evaluando los resultados percibidos; la Escala de Actitudes ante las Mudanzas, - evaluando escepticismo, temor y aceptación del cambio - y el Cuestionario de Evaluación de las Prácticas de Gestión de Mudanza Organizacional, para evaluar cinco prácticas de gestión del cambio organizacional (el diagnóstico, el liderazgo, la comunicación, la compensación e incentivos y formación). Los resultados indicaron que las prácticas de gestión de cambios impactan en parte las actitudes y los resultados que se perciben con dichos cambios.

Phylogenomic relationship of feijoa (Acca sellowiana (O.Berg) Burret) with other Myrtaceae based on complete chloroplast genome sequences.

Given their distribution, importance, and richness, Myrtaceae species comprise a model system for studying the evolution of tropical plant diversity. In addition, chloroplast (cp) genome sequencing is an efficient tool for phylogenetic relationship studies. Feijoa [Acca sellowiana (O. Berg) Burret; CN: pineapple-guava] is a Myrtaceae species that occurs naturally in southern Brazil and northern Uruguay. Feijoa is known for its exquisite perfume and flavorful fruits, pharmacological properties, ornamental value and increasing economic relevance. In the present work, we reported the complete cp genome of feijoa. The feijoa cp genome is a circular molecule of 159,370 bp with a quadripartite structure containing two single copy regions, a Large Single Copy region (LSC 88,028 bp) and a Small Single Copy region (SSC 18,598 bp) separated by Inverted Repeat regions (IRs 26,372 bp). The genome structure, gene order, GC content and codon usage are similar to those of typical angiosperm cp genomes. When compared to other cp genome sequences of Myrtaceae, feijoa showed closest relationship with pitanga (Eugenia uniflora L.). Furthermore, a comparison of pitanga synonymous (Ks) and nonsynonymous (Ka) substitution rates revealed extremely low values. Maximum Likelihood and Bayesian Inference analyses produced phylogenomic trees identical in topology. These trees supported monophyly of three Myrtoideae clades.

Prevalence, variability, and outcomes in portal hypertensive colopathy: a study in patients with cirrhosis and paired controls.

BACKGROUND: Management of portal hypertensive colopathy (PHC) has been challenged by controversial results in its prevalence and clinical relevance. OBJECTIVE: To describe the PHC prevalence and to evaluate the variability in diagnosis, the relation to severity of liver disease, and the incidence of severe outcomes. DESIGN: Cross-sectional study. SETTING: Endoscopic unit of a tertiary-care academic center in Rio de Janeiro, Brazil. PATIENTS: Patients with cirrhosis with portal hypertension and controls paired for age and sex. INTERVENTIONS: All patients were submitted to standard and image-enhanced colonoscopies, which were recorded in a coded video file and analyzed twice by a blinded endoscopist. MAIN OUTCOME MEASUREMENTS: The prevalence of PHC. RESULTS: A total of 51 patients with cirrhosis (55% male, mean age 59 years) and 51 healthy controls (43% male, mean age 61 years) were included. The top ranking colonoscopic findings were angiodysplasia-like lesions, nonspecific vascular pattern, red spots, and colorectal varices, all significantly more frequent in patients with cirrhosis compared with controls. PHC prevalence was 71% in patients with cirrhosis. For PHC, interobserver and intraobserver agreement (k values [standard error]) were 0.68 (0.09) and 0.63 (0.10), respectively. Intraobserver agreement for colonoscopic findings was satisfactory. PHC was not related to more severe liver disease or liver stiffness. Only 5 patients developed severe outcomes during follow-up. LIMITATIONS: The exclusion of patients with cirrhosis without esophageal varices and the absence of an interobserver agreement analysis by double-blinded endoscopists. CONCLUSION: PHC was highly prevalent in patients with cirrhosis, and its diagnostic agreement was satisfactory. PHC is not associated with relevant severe outcomes in a 12-month follow-up.

[Patient readmission for surgical site infection: integrative review]. / Reingreso por infección de sitio quirúrgico: una revisión integradora.

BACKGROUND: Surgical site infections (SSI) represent an inherent risk after surgical procedures associated both to the surgical procedure and to the patient clinical conditions. AIM: To analyze in an integrative review the studies related to patient readmission due to SSI. MATERIAL AND METHOD: The review was carried out by LILACS, CINHAL, MEDLINE and COCHRANE databases and articles published from 1966 to 2010 were selected. RESULTS: It was analyzed 13 studies classified as transversal (7), cohort (4) and longitudinal (2). Few studies analyzed only the readmissions related to the SSI. Time to define the readmission ranged from 28 to 90 days after surgery and studies related to orthopedic procedures were more frequent. The ISS readmission rates were lower than 5%. The main aetiological agents isolated from ISS were Staphylococcus aureus and coagulase-negative staphylococci. CONCLUSION: Monitoring readmissions due to SSI could contribute to dimension the occurrence of ISS post-discharge, once about half of the SSI post-discharge was diagnosed at the readmission moment.

Reingreso por infección de sitio quirúrgico: una revisión integradora / Patient readmission for surgical site infection: integrative review

Background: Surgical site infections (SSI) represent an inherent risk after surgical procedures associated both to the surgical procedure and to the patient clinical conditions. Aim: To analyze in an integrative review the studies related to patient readmission due to SSI.Material and Method: The review was carried out by LILACS, CINHAL, MEDLINE and COCHRANE databases and articles published from 1966 to 2010 were selected. Results: It was analyzed 13 studies classified as transversal (7), cohort (4) and longitudinal (2). Few studies analyzed only the readmissions related to the SSI. Time to define the readmission ranged from 28 to 90 days after surgery and studies related to orthopedic procedures were more frequent. The ISS readmission rates were lower than 5%. The main aetiological agents isolated from ISS were Staphylococcus aureus and coagulase-negative staphylococci. Conclusion: Monitoring readmissions due to SSI could contribute to dimension the occurrence of ISS post-discharge, once about half of the SSI post-discharge was diagnosed at the readmission moment.

Introducción: Las infecciones de sitio quirúrgico (ISQ) representan un riesgo inherente a la realización de cualquier acto quirúrgico, asociado a factores propios del procedimiento, así como a condiciones del paciente. Objetivo. Analizar, en una revisión integradora, los estudios que abordaran aspectos epidemiológicos relacionados con el reingreso de pacientes por ISQ. Método: Se efectuó una revisión en las bases LILACS, SCOPUS, COCHRANE e MEDLINE con selección de artículos publicados desde 1966 hasta 2010. Resultados: Se analizaron 13 estudios, siendo siete estudios transversales, cuatro de cohortes y dos longitudinales. Escasos estudios se restringieron a analizar exclusivamente los reingresos relacionados a la ISQ. El tiempo para definir el reingreso varió de 28 a 90 días después de la cirugía y hubo un mayor número de estudios relacionados con procedimientos ortopédicos. La tasa de reingreso por ISQ en los estudios fue inferior a 5%. El principal agente aislado en las ISQ fue Staphylococcus aureus y Staphylococcus coagulasa negativas. Conclusión: La vigilancia de los reingresos por ISQ podría contribuir a dimensionar la ocurrencia de ISQ post-alta, ya que aproximadamente la mitad de las ISQ post-alta originaron reingresos a centros hospitalarios.