Opioids and constipation therapy in the last week of life: Their impact on patients, caregivers, and the location of death.

The use of opioids to control pain at the end of life may cause constipation, a symptom that can negatively influence the well-being of patients and caregivers. The main aim of this study was to evaluate the impact of constipation on symptomatic control and patients' overall quality of life at this stage. A particular focus was placed on opioids. We also intended to investigate whether constipation and caregiver fatigue is related to the place of death (hospital vs home). The approach of 121 patients followed in 2021 in their last week of life by a home team specialized in palliative care was analyzed in an observational, retrospective, non-interventional study. The patients were followed up for an average of 39.7 days. A total of 82.6% wished to die at home, which occurred in 74% of the cases. The constipation prevention protocol reduced constipation by 55.1%. It seems that morphine is more related with constipation and tapentadol seems to reduce constipation induced by opioids. Patients tended to die in hospitals when their caregivers were exhausted; however, it was not possible to determine a cutoff point using the Zarit scale, which was used to assess caregiver burden. Constipation in the last week of life does not seem to influence the well-being of patients or their caregivers significantly and the individualization of intensive treatment of constipation is needed. Different opioids have different probabilities of causing adverse effects such as constipation. Future special support mechanisms can be created and activated for the most tired caregivers to avoid exhaustion and promote death at home, if that is the patient's will.

Coping with Abiotic Stress in Plants-An Endomembrane Trafficking Perspective.

Plant cells face many changes through their life cycle and develop several mechanisms to cope with adversity. Stress caused by environmental factors is turning out to be more and more relevant as the human population grows and plant cultures start to fail. As eukaryotes, plant cells must coordinate several processes occurring between compartments and combine different pathways for protein transport to several cellular locations. Conventionally, these pathways begin at the ER, or endoplasmic reticulum, move through the Golgi and deliver cargo to the vacuole or to the plasma membrane. However, when under stress, protein trafficking in plants is compromised, usually leading to changes in the endomembrane system that may include protein transport through unconventional routes and alteration of morphology, activity and content of key organelles, as the ER and the vacuole. Such events provide the tools for cells to adapt and overcome the challenges brought on by stress. With this review, we gathered fragmented information on the subject, highlighting how such changes are processed within the endomembrane system and how it responds to an ever-changing environment. Even though the available data on this subject are still sparse, novel information is starting to untangle the complexity and dynamics of protein transport routes and their role in maintaining cell homeostasis under harsh conditions.

[Visual behavior and socioeconomic and demographic profile of the premature newborns from Federal University of Pernambuco Maternity (UFPE)]. / Comportamento visual e perfil socioeconômico e demográfico de recém-nascidos prematuros da Maternidade do Hospital das Clínicas de Pernambuco-UFPE.

OBJECTIVE: To characterize the behavior of premature newborns in the first year of chronological age. METHODS: This is a cross-sectional descriptive study, bound to a longitudinal study titled: "Comparison of visual behavior on the first quarter of year of life of premature nursling born at two maternities of Recife/PE." The sample was composed by 52 premature newborns selected from June, 2007 to June, 2008 from the Maternity of the Federal University of Pernambuco (UFPE). Biological, socioeconomic and demographic data was collected through medical records and interviews with progeny. Newborns were evaluated by the Assessment Guide of Visual Ability in Infants. RESULTS: Most of the newborns were male at a gestational period between 33 weeks and 36 weeks and 6 days, showed a good visual behavior development for the age researched, and most of the families showed good socioeconomical and demographic profile. Besides, it was possible to detect ocular signs in 19% of sample, that were referred to an Ophthalmology Service. CONCLUSION: This study results point out the method like an important key in the early detection and visual screening for premature nursling since the first month of life and it led us to believe that clinical view for occupational therapy intervention must be focused not only on biological risks but also at the influence environment in newborn performance.

Comportamento visual e perfil socioeconômico e demográfico de recém-nascidos prematuros da Maternidade do Hospital das Clínicas de Pernambuco - UFPE / Visual behavior and socioeconomic and demographic profile of the premature newborns from Federal University of Pernambuco Maternity (UFPE)

OBJETIVO: Caracterizar o comportamento visual e perfil socioeconômico e demográfico de recém-nascidos prematuros no primeiro mês de idade cronológica. MÉTODOS: Estudo descritivo de corte transversal, aninhado a um estudo longitudinal intitulado: "Comparação do comportamento visual no primeiro trimestre de vida de lactentes nascidos pré-termo em duas maternidades da cidade do Recife/PE". A amostra foi composta por 52 recém-nascidos prematuros recrutados de junho de 2007 a junho de 2008, na Maternidade do Hospital das Clínicas da Universidade Federal de Pernambuco. Foram coletados dados biológicos, socioeconômicos e demográficos dos recém-nascidos e famílias, por meio de consulta aos prontuários e entrevista com as genitoras. Para caracterizar o comportamento visual dos recém-nascidos utilizou-se o Método de Avaliação do Comportamento Visual de Lactentes. RESULTADOS: Observou-se que a maioria dos recém-nascidos era do sexo masculino, com idade gestacional entre 33 semanas e 36 semanas e 6 dias, apresentaram comportamento visuomotor adequado para a faixa etária pesquisada e que a maioria das famílias apresentava boas condições socioeconômicas e demográficas. Ainda foi possível detectar em 19 por cento da amostra sinais oculares, os quais foram encaminhados para um Serviço de Oftalmologia. CONCLUSÕES: Os resultados apontam o método como um instrumento importante na triagem visual, possibilitando a detecção oportuna de alterações visuais em lactentes prematuros desde o 1º mês de vida. O olhar clínico da avaliação terapêutica ocupacional de lactentes deve voltar-se para a observação do comportamento considerando não apenas os riscos biológicos, mas também a influência que os fatores ambientais e sociais exercem sobre o desempenho funcional da criança.

OBJECTIVE: To characterize the behavior of premature newborns in the first year of chronological age. METHODS: This is a cross-sectional descriptive study, bound to a longitudinal study titled: "Comparison of visual behavior on the first quarter of year of life of premature nursling born at two maternities of Recife/PE." The sample was composed by 52 premature newborns selected from June, 2007 to June, 2008 from the Maternity of the Federal University of Pernambuco (UFPE). Biological, socioeconomic and demographic data was collected through medical records and interviews with progeny. Newborns were evaluated by the Assessment Guide of Visual Ability in Infants. RESULTS: Most of the newborns were male at a gestational period between 33 weeks and 36 weeks and 6 days, showed a good visual behavior development for the age researched, and most of the families showed good socioeconomical and demographic profile. Besides, it was possible to detect ocular signs in 19 percent of sample, that were referred to an Ophthalmology Service. CONCLUSION: This study results point out the method like an important key in the early detection and visual screening for premature nursling since the first month of life and it led us to believe that clinical view for occupational therapy intervention must be focused not only on biological risks but also at the influence environment in newborn performance.

Metaplasia cartilaginosa renal em espada Trichiurus lepturus L.(Teleostei: Trichiuridae)

O presente trabalho registra a presença de metaplasia cartilaginosa em rim de peixes "espada" (Trichiurus lepturus), capturadosno litoral de Niterói, RJ, O exame histopatológico revelou estruturás nodulares levemente basófilas circundadas por umafina faixa de tecido conjuntivo inflamatório.

Concentração de mercúrio e análise histopatológica em músculo, rim e cérebro de peixe-espada (Trichiurus lepturus) coletados na praia de Itaipu - Niterói, Rio de Janeiro, Brasil / Mercury level and histopathologic analysis of muscle, kidney and brain of largehead hairtail (Trichiurus lepturus) collected in Itaipu beach - Niterói, Rio de Janeiro, Brazil

O pescado e seus derivados destacam-se como fonte de exposição e contaminação por metais pesados para o homem. A acumulação do metal mercúrio (Hg) ocorre de forma progressiva através da cadeia trófica e da água sendo o peixe-espada um carnívoro localizado no topo da cadeia alimentar ele pode representar o grau de contaminação da região estudada. Os objetivos neste estudo foram determinar os teores de mercúrio (Hg) e realizar análise histopatológica em órgãos da espécie Trichiurus lepturus em peixes comercializados na região da praia de Itaipu, Niterói - RJ. Foram analisados trinta e um animais, nos quais foram encontrados em musculatura e rim valores médios de Hg de 0,051±0,031µ g g-1 e 0,006±0,004µ g g-1, respectivamente. No pool de cérebro de todos os animais obteve-se o valor de 0,019µ g g-1. Os valores individuais mínimos e máximos de Hg na musculatura e no rim demonstraram uma ampla dispersão. Nas análises de correlação entre comprimento total e teores de Hg em musculatura, e peso total e teores de Hg em musculatura, foi verificada uma correlação positiva (r=0,85 e r=0,88 respectivamente) altamente significativa (P<0,0001). Entretanto, na correlação entre peso do rim e os teores de Hg no mesmo órgão, não foi demonstrada uma correlação significativa (r=0,24) ao nível de confiança de 95 por cento (P>0,19). Nos testes de comparação múltipla entre os teores médios encontrados em musculatura, rim e cérebro, foi observada uma diferença altamente significativa entre os valores do músculo e do rim, assim como entre os do músculo e do cérebro (P<0,001 para ambos). Na comparação entre rim e cérebro, também foi verificada uma diferença significativa ao nível de 5 por cento de probabilidade (P<0,05). Na análise histopatológica, foram observadas lesões no rim, caracterizando-se por metaplasias cartilaginosas em alguns exemplares e uma intensa presença de corpos melanomacrofágicos.

Fish is an important source of heavy metal exposition and contamination for human being. Accumulation of mercury (Hg) in men occurs by chronicle exposition, through the food chain, by ingestion of fish contaminated with mercury. Because of biomagnifications the carnivorous fish that is on the top of the food chain shows a higher concentration of mercury in their tissues and can represent the aquatic environmental contamination. This work aims to establish histopathologic analysis and total mercury concentration in different tissues from thirty-one Trichiurus lepturus, a commercial fish from Itaipu Beach, Niterói, RJ. T. lepturus collected showed mean values of total mercury concentration of 0.051±0.031µ g g-1 and 0.006±0.004µ g g-1, respectively in muscle and kidney tissues. It was also conducted an analysis of mercury concentration from a pool of brain tissue from all individuals (0.019µ g g-1). Minimum and maximum mercury values in muscular and kidney tissues showed a wide dispersion. There was a positive correlation between total length and mercury muscular tissue concentration (R=0.85) and between body weight and mercury muscular tissue concentration (R=0.88), both highly significant. No significant correlation (r=0.24) was observed between kidney weight and mercury tissue concentration (P>0.19). In a multiple comparison test among muscle, kidneys and brain mercury tissue concentration, it was observed a highly significant difference between muscle and kidneys (P<0.001), as well as between muscle and brain (P<0.001). Comparison between kidney and brain mercury tissue concentration also showed a significant difference with a probability level of 5 percent (P<0.05). Histopathology demonstrated damage in the kidneys (cartilaginous metaplasia in some individuals and a high presence of melanomacrophage centers).

Nematóides da família Anisakidae e cestóides da ordem Trypanorhyncha em peixes teleósteos comercializados no estado do Rio de Janeiro / Nematodes of Anisakidae family and cestodes of Trypanorhyncha order in teleosts fishes commercialized in Rio de Janeiro State

O objetivo deste estudo foi realizar a pesquisa de formas larvares de nematóides da família Anisakidae e cestóides da ordemTrypanorhyncha em peixes teleósteos de grande comercialização no estado do Rio de Janeiro. Foram necropsiados 79espécimes que tiveram a sua cavidade geral e musculatura analisadas quanto à presença de parasitos. Do total de exemplaresde peixes, aproximadamente 20 por cento apresentaram pelo menos uma das espécies de parasitos pesquisados. As espécies depeixes mais acometidos por cestóides da ordem Trypanorhyncha foram Lophius gastrophisus (6) e Netuma barba (6), amboscom valores de 66,7 por cento. Os maiores percentuais de exemplares positivos para nematóides da família Anisakidae foram de 60,0 por cento para Genypterus brasiliensis (5); 47,6 por cento para Pagrus pagrus (21), e 42,9 por cento para Pseudopercis numida (7). As espéciesMicropogonias furnieri e Pagrus pagrus apresentaram ambos os parasitismos.

The purpose of this study was to evaluate the presence of nematodes larvaes of Anisakidae family and cestodes larvaes ofTrypanorhyncha order, in teleosts fishes commercialized in Rio de Janeiro state. Were necropsied 79 specimens and analyzedfor the presence of parasites. Of the total of units, about 20 percent had at least one species of parasite. The most infested species bycestodes of the order Trypanorhyncha was Lophius gastrophisus (6) and Netuma barba (6), both of them with values of 66,7 percent.However the high percentiles of positive units for nematodes of the Anisakidae family were 60,0 percent for Genypterus brasiliensis(5); 47.6 percent for Pagrus pagrus (21), and 42.9 percent for Pseudopercis numida (7). The species Micropogonias furnieri and Pagruspagrus had presented both the parasitisms.

Leishmania braziliensis: a novel mechanism in the lipophosphoglycan regulation during metacyclogenesis.

During metacyclogenesis of Leishmania in its sand fly vector, the parasite differentiates from a noninfective, procyclic form to an infective, metacyclic form, a process characterised by morphological changes of the parasite and also biochemical transformations in its major surface lipophosphoglycan (LPG). This lipid-anchored polysaccharide is polymorphic among species with variations in sugars that branch off the conserved Gal(beta1,4)Man(alpha1)-PO4 backbone of repeat units and the oligosaccharide cap. Lipophosphoglycan has been implicated as an adhesion molecule that mediates the interaction with the midgut epithelium of the sand fly in the subgenus Leishmania. This paper describes the LPG structure for the first time in a species from the subgenus Viannia, Leishmania (Viannia) braziliensis. The LPG from the procyclic form of L. braziliensis was found to lack side chain sugar substitutions. In contrast to other species from the subgenus Leishmania, metacyclic forms of L. braziliensis makes less LPG and add 1-2 (beta1-3) glucose residues that branch off the disaccharide-phosphate repeat units of LPG. Thus, this represents a novel mechanism in the regulation of LPG structure during metacyclogenesis.

Controle de qualidade em lactário / Quality control in lactation

Este artigo apresenta o trabalho desenvolvido no lactário de um hospital de grande porte da cidade de Sorocaba-SP, onde foram analisados os perigos e os pontos críticos através do sistema APPCC (Análises de Perigos e Pontos Críticos de Controle), visando minorar ou eliminar falhas no processo de preparação das mamadeiras e estabelecer os parâmetros necessários para um adequado controle de qualidade dos produtos preparados. A análise incluiu os equipamentos, a área física, o ar, a água, os processos e a higiene das lactaristas. O leite oferecido nas mamadeiras foi submetido a análises físico-químicas e microbiológicas.

Metaplasia cartilaginosa renal em espada Trichiurus lepturus L. (Teleostei: Trichiuridae) / Renal metaplastic cartilage in cutlass fish Trichiurus lepturus L. (Teleostei: Trichiuridae)

O presente trabalho registra a presença de metaplasia cartilaginosa em rim de peixes "espada" (Trichiurus lepturus), capturados no litoral de Niterói, RJ. O exame histopatológico revelou estruturas nodulares levemente basófilas circundadas por uma fina faixa de tecido conjuntivo inflamatório