Acute Toxicity Evaluation of Phosphatidylcholine Nanoliposomes Containing Nisin in Caenorhabditis elegans.

Liposomes are among the most studied nanostructures. They are effective carriers of active substances both in the clinical field, such as delivering genes and drugs, and in the food industry, such as promoting the controlled release of bioactive substances, including food preservatives. However, toxicological screenings must be performed to ensure the safety of nanoformulations. In this study, the nematode Caenorhabditis elegans was used as an alternative model to investigate the potential in vivo toxicity of nanoliposomes encapsulating the antimicrobial peptide nisin. The effects of liposomes containing nisin, control liposomes, and free nisin were evaluated through the survival rate, lethal dose (LD50), nematode development rate, and oxidative stress status by performing mutant strain, TBARS, and ROS analyses. Due to its low toxicity, it was not possible to experimentally determine the LD50 of liposomes. The survival rates of control liposomes and nisin-loaded liposomes were 94.3 and 73.6%, respectively. The LD50 of free nisin was calculated as 0.239 mg mL-1. Free nisin at a concentration of 0.2 mg mL-1 significantly affected the development of C. elegans, which was 25% smaller than the control and liposome-treated samples. A significant increase in ROS levels was observed after exposure to the highest concentrations of liposomes and free nisin, coinciding with a significant increase in catalase levels. The treatments induced lipid peroxidation as evaluated by TBARS assay. Liposome encapsulation reduces the deleterious effect on C. elegans and can be considered a nontoxic delivery system for nisin.

S100B protein: general characteristics and pathophysiological implications in the Central Nervous System.

BACKGROUND: Calcium-binding proteins are heterogeneous proteins that act binding this ion in specific domains, performing numerous functions. OBJECTIVE: In the present review, we aim to gather principal information about S100B protein in the Central Nervous System (CNS), highlighting its particularities, mapping, functionalities, and consequences on CNS dysfunction. METHODS: The research was carried out by searching Pubmed, Medline, Science Direct, Lilacs, the Cochrane Library, and Web of Science databases using the following descriptors: S100 protein; Central Nervous System; Nervous Lesions, as well as their corresponding terms in Portuguese and Spanish. The terms were first searched separately, then together. RESULTS: Due to its ability to bind with calcium, S100B is involved in the regulation of several intra- and extracellular physiological processes. As well as being multifunctional, this protein can be considered both a "marker" and "signaling" since it is capable of triggering functions of detection of and protection in situations of injury to the CNS. CONCLUSIONS: In-depth studies are necessary to discover the innumerable actions of this protein which are still unknown. It is expected that these can bring varied benefits by elucidating its therapeutic potential in preclinical and clinical situations.

Accuracy of Algorithms and Visual Inspection for Detection of Trigger Asynchrony in Critical Patients : A Systematic Review.

OBJECTIVE: This study aimed to summarize the accuracy of the different methods for detecting trigger asynchrony at the bedside in mechanically ventilated patients. METHOD: A systematic review was conducted from 1990 to 2020 in PubMed, Lilacs, Scopus, and ScienceDirect databases. The reference list of the identified studies, reviews, and meta-analyses was also manually searched for relevant studies. The reference standards were esophageal pressure catheter and/or electrical activity of the diaphragm. Studies were assessed following the QUADAS-2 recommendations, while the review was prepared according to the PRISMA criteria. RESULTS: One thousand one hundred and eleven studies were selected, and four were eligible for analysis. Esophageal pressure was the predominant reference standard, while visual inspection and algorithms/software comprised index tests. The trigger asynchrony, ineffective expiratory effort, double triggering, and reverse triggering were analyzed. Sensitivity and specificity ranged from 65.2% to 99% and 80% to 100%, respectively. Positive predictive values reached 80.3 to 100%, while the negative predictive values reached 92 to 100%. Accuracy could not be calculated for most studies. CONCLUSION: Algorithms/software validated directly or indirectly using reference standards present high sensitivity and specificity, with a diagnostic power similar to visual inspection of experts.

Randomized, phase 1/2, double-blind pioglitazone repositioning trial combined with antifungals for the treatment of cryptococcal meningitis - PIO study.

BACKGROUND: Cryptococcosis affects more than 220,000 patients/year, with high mortality even when the standard treatment [amphotericin B (AMB), 5-flucytosin (5-FC) and fluconazole] is used. AMB presents high toxicity and 5-FC is not currently available in Brazil. In a pre-clinical study, pioglitazone (PIO - an antidiabetic drug) decreased AMB toxicity and lead to an increased mice survival, reduced morbidity and fungal burden in brain and lungs. The aim of this trial is to evaluate the efficacy and safety of PIO combined with standard antifungal treatment for human cryptococcosis. METHODS: A phase 1/2, randomized, double blind, placebo-controlled trial will be performed with patients from Belo Horizonte, Brazil. They will be divided into three groups (placebo, PIO 15 mg/day or PIO 45 mg/day) and will receive an additional pill during the induction phase of cryptococcosis' treatment. Our hypothesis is that treated patients will have increased survival, so the primary outcome will be the mortality rate. Patients will be monitored for survival, side effects, fungal burden and inflammatory mediators in blood and cerebrospinal fluid. The follow up will occur for up 60 days. CONCLUSIONS: We expect that PIO will be an adequate adjuvant to the standard cryptococcosis' treatment. TRIAL REGISTRATION: ICTRP/WHO (and International Clinical Trial Registry Plataform (ICTRP/WHO) (http://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-9fv3f4), RBR-9fv3f4 (http://www.ensaiosclinicos.gov.br/rg/RBR-9fv3f4). UTN Number: U1111-1226-1535. Ethical approvement number: CAAE 17377019.0.0000.5149.

Applicability of statistical analysis for performance and reliability evaluation of large-scale water treatment plants with direct filtration systems.

Water treatment plants (WTPs) are extremely important in basic sanitation services because of their association with human health by producing safe drinking water. Thus, their proper operation is of utmost relevance and has led to the development of distinct performance evaluation methodologies. Direct filtration is a leading technology applied in WTPs. However, although it costs less than conventional treatment, it might also be less flexible and robust. To evaluate performance with data from real-scale WTPs with direct filtration systems, the use of a statistical analysis methodology for turbidity, apparent color, and pH data from raw and effluent water is proposed. Reliability analysis, a probabilistic-based methodology, was applied for turbidity alongside evaluating the compliance of the treated water with different potability standards. The parameters pH (between 6.0 and 8.0) and apparent color (< 15 HU) showed almost complete compliance (> 99%). Reliability analysis could not be applied for apparent color and pH, while apparent color did not adhere to the lognormal distribution frequency. The turbidity results show high variability in the coefficients of variation and reliability among various plants and a general difficulty in complying with stricter standards, such as the 0.1 and 0.3 NTU defined by the United States Environmental Protection Agency. All WTP studies show a 95% compliance with the World Health Organization standard of 5.0 NTU. A higher value for the coefficient of reliability and a lower value for the variation coefficient could indicate a more stable process, regardless of the treated water quality, highlighting the relevance of applying combined methods for performance evaluation, such as compliance with established standards.

Adequacy analysis of drinking water treatment technologies in regard to the parameter turbidity, considering the quality of natural waters treated by large-scale WTPs in Brazil.

This paper seeks to present a performance evaluation of large-scale water treatment plants and verify the adjustment of the treatment to the parameter turbidity of natural waters. Nonparametric and multivariate statistical tools were used to analyze raw water and treated water turbidity of a large on-line monitoring databank for the period from 2013 to 2015, from six large-scale treatment plants utilizing different technologies. Cluster analysis was able to differentiate adequately groups of treatment plants with similar raw and treated water quality. Considering the effluent turbidity as a marker parameter, the results indicated that selection of the technology to be applied must be well studied to always seek the best solution, and that other factors than only the raw water characteristics should be evaluated. It was also demonstrated that utilization of the same treatment technology does not always result in the same effluent quality, since there are many factors related to operation, maintenance, raw water variability, climatic interferences, and others.

Antibacterial and Antibiofilm Activities of Psychorubrin, a Pyranonaphthoquinone Isolated From Mitracarpus frigidus (Rubiaceae).

Psychorubrin, a natural pyranonaphthoquinone found in different plants, has become an interesting compound in the search for new antimicrobial therapeutic agents. Here, we investigated the potential antagonistic activity of psychorubrin against planktonic and biofilm bacteria. First, psychorubrin was tested against several Gram-positive and Gram-negative bacteria strains by a broth microdilution susceptibility method. Second, bacterial killing assay, bacterial abundance, and membrane viability were evaluated. The nucleotide leakage assay was used to verify membrane destabilization while antibiofilm activities were analyzed by the effect on established biofilm, static biofilm formation, isolation of biofilm matrix assay and scanning electron microscopy. In parallel, the combinatorial effect of psychorubrin and chloramphenicol was evaluated by the checkerboard method. Psychorubrin was active against Gram-positive bacteria, showing rapid time-dependent kinetics of bacterial killing, amplified nucleotide leakage, and greater activity against the methicillin-resistant species (MRSA) Staphylococcus aureus 33591 and 33592 and Staphylococcus pyogenes 10096. Psychorubrin also interfered with the composition of the biofilm matrix by reducing the total content of carbohydrates and proteins. A synergic effect between psychorubrin and chloramphenicol was observed for S. aureus 33592 and S. pyogenes 10096 while an additive effect was detected for S. aureus 33591. Our findings demonstrate, for the first time, an antagonistic activity of psychorubrin against bacteria not only in their planktonic forms but also in biofilms, and identify bacterial membranes as primary targets for this compound. Based on these observations, psychorubrin has a good potential for the design of novel antimicrobial agents.

Evaluation of violations in water quality standards in the monitoring network of São Francisco River basin, the third largest in Brazil.

The São Francisco River is the largest river located entirely within Brazil, and water scarcity problems have been a major concern of Brazilian society and government. Water quality issues are also a concern and have worsened with the recent intensification of urbanization and industrialization. In this study, violations to water quality standards established by local legislation were calculated as a percentage for 26 selected parameters over a monitoring period of 14 years. The violation percentages were analyzed spatially using the Kruskal-Wallis test, followed by multiple comparison analysis. Temporal analysis was performed using the Mann-Kendall test and Spearman correlation. Some parameters could be identified as cause for concern due to high violation levels, such as the fecal coliform indicator (FCI) and phosphorus-both related to domestic and effluent disposal without treatment or with insufficient treatment-and color, turbidity, manganese, and total suspended solids-which can be affected by erosive processes of natural and anthropogenic causes. The study found that these violations are concentrated in the most urbanized and industrialized areas of the basin. Some metallic parameters, such as iron and arsenic violations, may be related to mining activities in the rich soil of the Iron Quadrangle area located within the Minas Gerais State. Trend analysis results indicated that most monitoring stations did not have significant modification (elevation or reduction) trends over time, which, together with the high violation percentages, might indicate the maintenance of a scenario of constant pressure upon water resources, in particular in those more urbanized areas.

Evaluation of the functionality of bread loaves prepared with quinoa flakes through biological tests

ABSTRACT The aim of this study was to evaluate quinoa flakes and bread prepared with the pseudocereal with regard to nutritional aspects by determining chemical composition, content of tocopherols and fatty acid composition as well as to possible beneficial effects in Wistar rats given commercial feed supplemented or not with quinoa flakes and cholesterol. The following parameters were determined: weight gain, food intake, liver weight, fat in liver and lipid profile in blood and liver. The results showed that processing affected the nutritional characteristics of bread because there was a significant increase in dietary fiber content but reduction in soluble fiber. Increased fiber did not influence food intake or weight gain. Regarding fat in liver of rats, the group that consumed bread without quinoa but with cholesterol showed higher lipid content. The addition of quinoa increased significantly the level of all types of tocopherols, especially in the group of animals that consumed 20% quinoa bread, improving the lipid profile both in blood and liver, largely due to a reduction in oxidized LDL.

RESUMO O objetivo deste estudo foi avaliar os flocos de quinoa e os pães elaborados com o pseudocereal, tanto em relação a aspectos nutricionais por meio da análise da composição centesimal, do teor de tocoferóis, composição em ácidos graxos, quanto aos possíveis efeitos benéficos, através de experimento com ratos Wistar, consumindo ração comercial, suplementados ou não com flocos de quinoa e colesterol. Foram determinados: ganho de peso, consumo de alimento, peso e gordura do fígado e perfil lipídico do sangue e do fígado. Pelos resultados, verificou-se que o processamento afetou as características nutricionais dos pães, pois houve aumento significativo no teor de fibras totais, porém redução nas fibras solúveis. O aumento de fibras não influenciou no consumo alimentar nem no ganho de peso. Em relação à gordura do fígado dos ratos, o grupo que consumiu pão sem quinoa com colesterol apresentou maior teor de lipídios. A adição de quinoa incrementou significativamente o teor de alguns tipos de tocoferóis, principalmente no grupo de animais que consumiu o pão com 20% de quinoa, melhorando o perfil lipídico, tanto do sangue quanto do fígado, principalmente devido à redução do LDLoxidado.

Identificação de bacterias presentes na cloaca das espécies Amazona Aestiva e Amazona Amazonica mantidos em cativeiro no criatório conservacionista do Centro Universitário CESMAC, Alagoas / Identification of cloacal bacteria in Amazona Aestiva and Amazona amazonica kept in captivity in CESMAC University, Alagoas

Os animais selvagens, tanto na natureza quanto no cativeiro, podem ser reservatórios de zoonoses. O estudo da microbiota bacteriana de aves silvestres clinicamente saudáveis é um passo importante para a compreensão da epidemiologia das doenças bacterianas. Objetivou-se traçar o perfil de bactérias cloacais presentes em Psitacídeos das espécies Amazona aestiva e Amazona amazonica, mantidos em cativeiro no Criatório Conservacionista do Centro Universitário Cesmac, Marechal Deodoro, Alagoas. Foram colhidas 20 amostras de mucosa clocais de psitacídeos (10 da espécie Amazona aestiva e 10 da espécie Amazona amazonica) com o auxílio de suabes. As amostras foram semeadas em placas com Ágar Sangue (5%) e Ágar MacConkey, incubadas em estufa bacteriológica em aerobiose a 37°C por 24 horas, e em seguida avaliadas as características morfológicas das colônias. Para a avaliação microscópica as amostras foram coradas em Gram e, em seguida, observadas em microscópio. Todas as côlonias que cresceram, foram submetidas a testes bioquímicos. Na análise microbiológica foram identificadas 07 espécies de bactérias. Nas 10 amostras colhidas de suabes cloacais na espécie Amazona amazonica foram isoladas 07 espécies de bactérias, sendo 2 Klebsiella oxytoca, 1 Shigella sonnei, 5 Enterobacter aerogenes, 2 Enterobacter sakazakiie, 2 Yersinia pseudotuberculosis. Nas 10 amostras colhidas de cloaca na espécie Amazona aestiva, foram identificadas 04 espécies bacterianas distintas, sendo 2 Enterobacter aerogenes, 1 Salmonella typhi, 1 Klebsiella pneumoniae e 1 Shigella sonnei. A espécie bacteriana de maior frequência neste estudo foi Enterobacter aerogenes, encontrada nas duas espécies de psitacídeos estudadas. Como medida de controle, devam ser coletados suabes cloacais periodicamente, assim como aplicar cuidados com higiene, limpeza correta e frequente do recinto ou gaiola, bem como disponibilizar alimentação adequada para cada espécie. Os Psitacídeos em cativeiro têm o trato gastrointestinal colonizado por diferentes tipos de Enterobacteriaceae, sendo que algumas dessas espécies bacterianas possuem fundamental importância para a saúde única. Um risco para estes animais, que são submetidos ao estresse do cativeiro, que em condições adversas estas bactérias podem produzir infecção secundária, quase sempre fatal. Além disso, as duas espécies de psitacídeos estudadas são comumente criadas como pets em residências e podem apresentar bactérias com alto potencial zoonótico.

Identificação de bacterias e fungos veículados por formigas e seu potencial risco à saúde pública / Identification of bacteria and fungi served by ants and its potential risk to public health

As formigas podem atuar como vetores de microrganismos patogênicos, contribuindo para a transmissão de doenças infecciosas. Objetivou-se isolar, identificar fungos e bactérias e traçar o perfil de resistência dos microrganismos veiculadas por formigas de hospitais humanos, veterinários e residências de Viçosa, Alagoas. Obteve-se 600 amostras de formigas, sendo 200 em hospital humano, 200 em hospital veterinário e 200 em residências. Realizou-se um pool de amostras, as quais passaram por um processo de maceração, foram imersas em caldo BHI e incubadas a 37°C. Para isolamento fúngico, o material foi inoculado em placas com Agar Sabouraud, incubadas a 25°C. Os fungos isolados foram corados e identificados. Para detecção de bactérias, as amostras foram semeadas em placas com Agar sangue e incubadas a 37°C. Foram selecionadas 12 espécies de bactérias para avaliação de resistência, frente aos antimicrobianos Gentamicina (10ug), Penicilina (10ug), Eritromicina (15ug), Sulfa+Trimetropim (25ug), Cefalotina (30 ug) e Amoxicilina (10ug). Foi feita a leitura através da medida dos halos. Detectou-se 7 espécies de fungos em hospitais humanos, sendo 4 Aspergillus sp, 1 Fusarium sp, 1 Dermatofito sp e 1 Sporothix sp. Em hospitais veterinários observou-se duas amostras, sendo 1 Penicillium sp e 1 Sporothix sp. E nas residências identificou-se 8 amostras, sendo 3 Aspergillus sp, 3 Dermatofito sp, 1 Fusarium sp e 1 Curvalina sp. Na análise microbiológica das amostras de hospitais humanos foram identificadas 9 gêneros e espécies bacterianas, sendo 5 Enterobacter sp, 3 Pseudomonas spel Salmonella sp. Nas amostras obtidas em hospitais veterinários, identificou-se 5 gêneros e espécies, onde 2 isolados de Pseudomonas sp, 1 de Salmonella sp, 1 Enterobacter coaclae e 1 Providencia sp, já nas amostras oriundas de residências, 7 foram o total de gêneros identificados, no qual foram 2 Proteus sp, Enterobacter sp, 1 Salmonella sp, Pseudomonas sp e Providencia sp. Na avaliação da resistência bacteriana, todas as amostras de Pseudomonas sp (2/2), Salmonella sp (2/2), Enterobacter sp(2/2), Enterobacter aerogenas (2/2) e Proteus vulgaris (2/2) apresentaram resistência a Penicilina, Eritromicina, Sulfa+Trimetropim, Cefalotina e Amoxilina, exceto a Gentamicina, no qual todas as amostras apresentaram sensibilidade. A bactéria Providencia sp (2/2) apresentou resistência a Penicilina, Eritromicina, Amoxicilina e Cefalotina, sendo sensível a Gentamicina e Sulfa+Trimetropim. Enterobacter coaclae demonstrou (1/1) resistência a Penicilina, Eritromicina e Amoxicilina, e sensibilidade a Gentamicina (1/4), Cefalotina (3/4) e Sulfa+Trimetropim (2/4). Os fungos identificados provenientes de hospitais humanos e veterinários evidenciam o risco de transmissão de micoses sistêmicas, subcutâneas, e superficiais para pacientes internados. Observou-se o isolamento de bactérias com elevada virulência, importantes para a saúde única. Verifica-se que Pseudomonas sp, foi isolado em hospitais humanos e veterinários. E apresentou multirresistência em alguns gêneros bacterianos, destacando a resistência de Pseudomonas sp a todos os antibióticos avaliados.

Emergência obstétrica e ovariohisterectomia em porquinho da india (Cavia porcellus): relato de caso / Obstetric emergency and ovariohisterectomy in guinea pig (Cavia porcellus): Case report

Os Porquinhos da Índia (Cavia porcellus) pertencem a classe Mammalia, ordem Rodentia, sendo criados com as finalidades de produção de carne, criação para uso como cobaias em pesquisas científicas e como animais de companhia (pet). A ovário- -histerectomia é pouco relatada na espécie, mas é indicada para controle populacional e em enfermidades obstétricas como aborto, hemorragia uterina, piometra e maceração fetal. Foi recebido no Laboratório de Inovação em Cirurgia, Hemoterapia e Terapias Celulares Veterinárias da UFAL (LABINOVET- UFAL) um roedor da espécie Cavia porcellus, fêmea, branca, com 6 meses de idade, de companhia (pet) e massa corporal de 470 gramas com queixa clínica era de sangramento vaginal e apatia há três dias, sendo que foi levada ao medico veterinário e ao exame radiológico apresentou imagem sugestiva de prenhez com dois fetos, sendo aplicado vitamina K. Há 24 horas havia abortado um feto e uma massa dismorfa, continuando com sangramento até o momento do exame clínico, quando apresentou FC 210 bpm, FR 68 mpm, temperatura de 37,1 °C e muita dor à palpação abdominal. A opção terapêutica foi a anestesia dissociativa de urgência e ovário-histerectomia (OVH), não sendo realizado hemograma pré-cirúrgico pela dificuldade de coleta na espécie, estresse animal e possível anemia devido ao sangramento (evitando retirada de mais sangue). Foi realizado indução anestésica com atropina (0,05 mg/kg), Midazolam (2 mg/kg) e Cetamina ( 100 mg/kg) na mesma seringa por via intramuscular. A celiotomia foi retro-umbilical, com ovários-histerectomia realizada por laqueadura simples dos vasos ovarianos, rafia uterina com padrão Parker-Kerr, fechamento de muscular padrão Sultan, Cushing no subcutâneo e isolado simples na pele, todos utilizando fios poliglactina 910 4,0. A cirurgia durou 28 minutos, sem complicações cirúrgicas, porém com as intercorrências anestésicas de bradipnéia (20 mpm) e hipotermia (32,7°C) no pós-cirúrgico imediato, com o animal despertando em 5 horas após a cirurgia, necessitando de cuidados de aquecimento, monitoração fisiológica e fuidoterapia com ringer lactato morno por via subcutânea ( 80 mL /kg em duas aplicações), associando: 10 mg/kg de enrofloxacina, 100 mg/kg de ácido tra- nexâmico, 20 mg/kg de aminofilina e 3 mg/kg de cetoprofeno. No pós-cirúrgico foi utilizado enrofloxacina (10 mg/kg/a cada 12 horas/ 5 dias) e cetoprofeno ( 3 mg/kg/24 h/3 dias) por via oral, além de curativo com clorexidine 1%. A OVH éi exequível em animal da espécie Cavia porcellus utilizando anestesia dissociativa, porém são necessárias monitoração rigorosa e intervenções promotoras de homeostase na recuperação anestésica, devido aos riscos de hipotermia e bradipnéia.

Pediatric cardiac surgery under the parents sight: a qualitative study.

INTRODUCTION: Congenital heart defects can often be corrected through surgery, providing for parents to expect a normal life, but the hospitalization experience often early, causes more pain, for which surgery is the worst moment. OBJECTIVE: The aim of this study was to analyze the experience of families of children undergoing cardiac surgery and to identify the coping resources used by the families. METHODS: A qualitative approach was the metodology of choice for this study, which took place with six semi-structured interviews and 100 hours of observation. Thematic analysis was used to understand the data. RESULTS: The results were categorized into four themes: feelings and emotions facing the illness of the child; heart disease under the watchful mother, mother and child on the ICU and coping resources. The speech of mothers demonstrated the importance of the heart due to its symbolism that enhances their emotional fragility in the face of illness. Religiosity and a solid social network of support were contributing factors for the maintenance of the adaptive behaviors. The presence of mothers in all stages of the child's treatment contributed to minimizing the suffering generated by hospitalization. CONCLUSION: The experience of families was characterized by ambivalent feelings such as fear of death, guilt and helplessness against the different stages of treatment. The anguish and anxiety prevailed in the face of unknown situations when information were required before therapeutic procedures, hospital routines and the actual life situation of the families.

A cirurgia cardíaca pediátrica sob o olhar dos pais: um estudo qualitativo / Pediatric cardiac surgery under the parents sight: a qualitative study

INTRODUÇÃO: As cardiopatias congênitas podem muitas vezes ser corrigidas por meio de cirurgia, assegurando para os pais a expectativa de uma vida normal, entretanto, a vivência da hospitalização, muitas vezes precoce, ocasiona maior sofrimento, sendo a operação o pior momento. OBJETIVO: O objetivo deste estudo foi analisar a vivência de famílias de crianças submetidas à cirurgia cardíaca, identificando os recursos de enfrentamento utilizados pelos familiares. MÉTODOS: A abordagem qualitativa foi a opção metodológica deste estudo, onde realizou-se seis entrevistas semi-estruturadas e 100 horas de observação participante. Foi utilizada a análise temática para a compreensão dos dados. RESULTADOS: Os resultados foram categorizados em quatro núcleos temáticos: sentimentos e emoções frente ao adoecimento do filho; a doença do coração sob o olhar materno; mãe e filho na dinâmica da unidade de terapia intensiva e recursos de enfrentamento. A fala das mães demonstrou a importância do coração devido a seu simbolismo que, por sua vez, potencializa sua fragilidade emocional diante do adoecimento. A religiosidade e uma consistente rede social de apoio foram fatores contribuintes para a manutenção de comportamentos adaptativos. A presença da mãe em todas as etapas do tratamento da criança contribuiu para a minimização do sofrimento gerado pela internação. CONCLUSÕES: A vivência das famílias foi caracterizada por sentimentos ambivalentes, como medo da morte, culpa e impotência frente às diferentes etapas do tratamento. A angústia e a ansiedade prevaleceram diante de situações desconhecidas, necessidade de informações frente às condutas terapêuticas, rotinas hospitalares e da própria situação de vida das famílias entrevistadas.

INTRODUCTION: Congenital heart defects can often be corrected through surgery, providing for parents to expect a normal life, but the hospitalization experience often early, causes more pain, for which surgery is the worst moment. OBJECTIVE: The aim of this study was to analyze the experience of families of children undergoing cardiac surgery and to identify the coping resources used by the families. METHODS: A qualitative approach was the metodology of choice for this study, which took place with six semi-structured interviews and 100 hours of observation. Thematic analysis was used to understand the data. RESULTS: The results were categorized into four themes: feelings and emotions facing the illness of the child; heart disease under the watchful mother, mother and child on the ICU and coping resources. The speech of mothers demonstrated the importance of the heart due to its symbolism that enhances their emotional fragility in the face of illness. Religiosity and a solid social network of support were contributing factors for the maintenance of the adaptive behaviors. The presence of mothers in all stages of the child's treatment contributed to minimizing the suffering generated by hospitalization. CONCLUSION: The experience of families was characterized by ambivalent feelings such as fear of death, guilt and helplessness against the different stages of treatment. The anguish and anxiety prevailed in the face of unknown situations when information were required before therapeutic procedures, hospital routines and the actual life situation of the families.

Serum levels of brain-derived neurotrophic factor in Sydenham's chorea.

Sydenham's chorea (SC) is the neurologic manifestation of rheumatic fever. In addition to involuntary movements, SC patients show behavioral changes, such as hyperactivity, obsessions, and compulsions. Brain-derived neurotrophic factor (BDNF) is related to neuronal development and differentiation. Since BDNF serum levels are altered in a series of neuropsychiatric disorders, such as schizophrenia and Huntington's disease, we investigated the serum levels of BDNF in SC patients. Eighteen patients with acute SC, 4 with persistent SC and 27 control subjects were included in this study. BDNF was determined by ELISA. There was no significant difference between BDNF serum levels of control and acute SC groups (P = 0.12). Persistent SC patients presented decreased BDNF levels when compared to both control and acute SC groups (P < 0.001). Our results suggest that the persistence of symptoms in SC may be related to structural changes in the central nervous system as expressed by altered BDNF levels.

Flora fúngica no ambiente da Unidade de Terapia Intensiva Pediátrica e Neonatal em hospital terciário / Environmental fungal flora in Pediatric and Neonatal Intensive Care Units at a tertiary hospital

OBJETIVO: As infecções nosocomiais são responsáveis por morbidade e mortalidade significativas no período neonatal. Considerando-se a preocupação com a qualidade do ar de áreas críticas como Unidades de Terapia Intensiva (UTI), foi realizado um levantamento da flora fúngica das UTI Pediátrica e Neonatal do Hospital das Clínicas Samuel Libânio, Pouso Alegre (MG), com a finalidade de identificar a presença de fungos potencialmente patogênicos e oportunistas. MÉTODOS: Foram realizadas 30 coletas, que incluíram leitos, incubadoras, janelas, aparelhos de ar condicionado, telefone, estetoscópios, portas e maçanetas. Placas de Agar Sabouraud Dextrose com o material das coletas foram incubadas em temperatura ambiente por 15 dias. A identificação foi baseada nas características macroscópicas no exame direto e em microcultivos. RESULTADOS: Fungos potencialmente patogênicos e toxigênicos foram isolados. A análise quantitativa das colônias revelou a presença de 11 gêneros. Verificou-se que mais de 40 por cento das colônias correspondem ao gênero Penicillium spp, seguido por Cladosporium spp e Chrysosporium spp. CONCLUSÕES: Os fungos encontrados podem apresentar grande potencial de patogenicidade, principalmente em imunodeprimidos. É importante adotar medidas de controle ambiental, como assepsia dos equipamentos, controle da presença de visitantes, lavagem das mãos pelos funcionários e troca de filtros de ar condicionado.

OBJECTIVE: Nosocomial infections lead to significant morbidity and mortality in the neonatal period. Considering the concern regarding air quality in critical hospital areas, such as Intensive Care Units (ICU), this study aims to identify the presence of potentially pathological fungi in the Pediatric and Neonatal Intensive Care Unit of the Samuel Libânio Hospital in Pouso Alegre, Minas Gerais, Brazil. METHODS: Thirty samples were collected in the following areas: surface of beds, incubators, windows, air conditioning, telephones, stethoscopes, doors and door knobs. Petri dishes of Sabouraud Dextrose Agar with the collected samples were incubated at air temperature for 15 days. The identification was based on macroscopic and microscopic characteristics and subcultures. RESULTS: Potentially pathological and toxigenic fungi were isolated in the studied areas. The quantitative analysis revealed the presence of 11 genera: 40 percent of the colonies were Penicillium spp., followed by Cladosporium spp. and Chrysosporium spp. CONCLUSIONS: The fungi found may present a great pathogenic potential, mainly in immunocompromised patients. It is important to adopt some measures in order to reduce nosocomial infection in ICU, such as the strict control regarding equipment cleansing, control of visitors, hand washing and periodic cleansing and renewal of air conditioning filters.

Síndrome das pernas inquietas / Restless legs syndrome

A síndrome de pernas inquietas (SPI) é uma condição clínica bastante comum, mas pouco conhecida na classe médica. Subdiagnosticada, interfere na qualidade do sono e de vida de seus portadores. Seu aparecimento tem sido associado ao uso de neurolépticos em portadores de distúrbios do movimento, sugerindo que sua gênese esteja relacionada com o sistema dopaminérgico. Protocolos diagnósticos têm sido propostos para facilitar sua identificação. É de suma importância saber reconhecê-la e tratá-la com o objetivo de minimizar o sofrimento do paciente.

Teoria implícita de organização e padrões de inovação nos processos de gestão / Implicit theory of organization and innovation patterns in the management process

A pesquisa explora o conceito do que é uma organização bem-sucedida segundo a percepção de atores organizacionais inseridos em empresas com diferentes padrões de adoção de novas práticas de gestão do trabalho e da produção. Para tanto, utilizou-se uma metodologia multicasos, totalizando 23 participantes distribuídos em sete empresas. As informações foram coletadas por meio de entrevistas com ítens abertos e estruturados. A teoria implícita dos atores organizacionais não difere significativamente entre os quatro padrões de inovação estudados. Neste sentido, uma postura que combina pró-atividade com reatividade na relação da organização com o ambiente, uma estrutura organizacional com base nas características do modelo mecânico e orgânico e uma relação entre o indivíduo e a organização que combina características do modelo agency e community foram tomados como ideais. Por outro lado, a teoria implícita explorada por livre evocação indicou a existência de características compartilhadas, independente do contexto investigado.(AU)

The research explores the concept of what is a sucessfull organization according to the perception of organizational actors in companies with different adoption patterns of innovative work and production management practices. For this purpose, it adopted a multi-case methodology, with a total of 23 participants distributed among 7 companies. Data was obtained by means of interviews comprising of open and structured items. The organizational actors' implicit theory doesn't differ significantly among the four patterns of innovation studied. In that sense, an attitude combining pro-activity and reactivity in the relationship between organization and environment, an organizational structure based on the characteristics of the mechanical/organic models and a relationship between individual and organization that mixes characteristics of the agency and community models were taken as ideals. On the other hand, the implicit theory explored by free evocation indicated the existence of shared characteristics, independent from the context in which it was inserted.(AU)

Teoria implícita de organização e padrões de inovação nos processos de gestão / Implicit theory of organization and innovation patterns in the management process

A pesquisa explora o conceito do que é uma organização bem-sucedida segundo a percepção de atores organizacionais inseridos em empresas com diferentes padrões de adoção de novas práticas de gestão do trabalho e da produção. Para tanto, utilizou-se uma metodologia multicasos, totalizando 23 participantes distribuídos em sete empresas. As informações foram coletadas por meio de entrevistas com ítens abertos e estruturados. A teoria implícita dos atores organizacionais não difere significativamente entre os quatro padrões de inovação estudados. Neste sentido, uma postura que combina pró-atividade com reatividade na relação da organização com o ambiente, uma estrutura organizacional com base nas características do modelo mecânico e orgânico e uma relação entre o indivíduo e a organização que combina características do modelo agency e community foram tomados como ideais. Por outro lado, a teoria implícita explorada por livre evocação indicou a existência de características compartilhadas, independente do contexto investigado.

The research explores the concept of what is a sucessfull organization according to the perception of organizational actors in companies with different adoption patterns of innovative work and production management practices. For this purpose, it adopted a multi-case methodology, with a total of 23 participants distributed among 7 companies. Data was obtained by means of interviews comprising of open and structured items. The organizational actors' implicit theory doesn't differ significantly among the four patterns of innovation studied. In that sense, an attitude combining pro-activity and reactivity in the relationship between organization and environment, an organizational structure based on the characteristics of the mechanical/organic models and a relationship between individual and organization that mixes characteristics of the agency and community models were taken as ideals. On the other hand, the implicit theory explored by free evocation indicated the existence of shared characteristics, independent from the context in which it was inserted.

Aspectos do padrão mastigatório na dentição decídua e mista em crianças de três a nove anos / Masticatory standard features in decidous and mixed teething among children from three to nine years old

Objetivo: verificar os aspectos do padrão mastigatório na dentição decídua e mista. Métodos: foi feitauma pesquisa em 40 crianças de ambos os gêneros, com faixa etária de três a nove anos. Para aavaliação foi realizada observação da mastigação, com o auxílio de um pão francês amanhecido.Resultados: analisando-se os dados obtidos, verificou-se que existe associação significante entre avelocidade da mastigação; posição dos lábios; movimento da mandíbula com a dentição. Observou-setambém predominância de mastigação bilateral em ambas as dentições. Conclusão: pôde-se concluirque os padrões da mastigação que apresentaram um fator significante entre as dentições mista edecídua foram os movimentos mandibulares, postura dos lábios e velocidade da mastigação. Sendoassim, cabe ao Fonoaudiólogo em sua avaliação levar em consideração esses padrões da mastigação,observando o tipo de alimento empregado, pois sua consistência poderá influenciar no resultado daavaliação.

Purpose: check the aspects of masticatory standard in deciduous and mixed dentition. Methods: aresearch was done in forty children of both genders, with age group from three to nine years old. For theevaluation, an observation of mastication was carried out using a stale roll. Results: analyzing all dataobtained, there is a significant association among mastication speed, lips position, movement of jawwith dentition. The predominance of bilateral mastication was also noted in both “dentitions”. Conclusion:it can be concluded that the standard of mastication that shows a significant factor between mixed anddeciduous dentition, was mandible movements, lips position and mastication speed. Therefore, thespeech therapists, in their evaluation, have considerate these standards of mastication, looking for thekind of food used, because its consistency can influence the evaluation’s result.