Subjective aspects of body image in women with fibromyalgia / Aspectos subjetivos da imagem corporal em mulheres com fibromialgia

INTRODUCTION: Body image refers to the figuration of the body in the mind, has a strong experiential component, and is permeated by subjective aspectsOBJECTIVE: To analyze the subjective aspects of body image in women with fibromyalgiaMETHODS: This was an observational cross-sectional study. Participants were 16 women with a confirmed diagnosis for at least six months. The instrument used was the Human Figure Drawing (HFD), a projective technique for the exclusive use of psychologists, following the procedures established in the specialized literature. The examination of the material was carried out independently by two expert evaluators, who used meaning attribution criteria established in classic publications in psychological evaluationRESULTS: The following indicators in the participants' drawings were highlighted: medium thickness and continuous line, small size, location in the fourth quadrant, presence of reinforcements and representations of joints, figures with static body posture, and simplified facial features. These indicators were interpreted as signs suggestive of passivity, insecurity, inhibition, feeling of inferiority, conflicts regarding difficulties in contact, propensity to take refuge in fantasy, idealization, regression, and attempts at omnipotent control, psychic rigidity, and devitalization. Therefore, the body image of the participants seemed to be determined by mental representations that include the body, but are not restricted to their biological dimensions or the physical limitations resulting from the symptomatic manifestations of fibromyalgiaCONCLUSION: The participants' body image had an inherently negative value since it was subjectively shaped by internalized and unconscious unfavorable concepts about themselves

INTRODUÇÃO: A imagem corporal se refere à figuração do corpo na mente, possui uma forte vertente experiencial e é perpassada por aspectos subjetivosOBJETIVO: Analisar aspectos subjetivos da imagem corporal em mulheres com fibromialgiaMÉTODO: Trata-se de um estudo observacional de corte transversal. Participaram 16 mulheres com diagnóstico confirmado havia, no mínimo, seis meses. O instrumento empregado foi o Desenho da Figura Humana (DFH), técnica projetiva de uso exclusivo de psicólogos, seguindo os procedimentos estabelecidos na literatura especializada. O exame do material foi realizado de maneira independente por dois avaliadores especialistas, que utilizaram critérios de atribuição de significados estabelecidos em publicações clássicas da área de avaliação psicológicaRESULTADOS: Destacou-se a ocorrência dos seguintes indicadores nos desenhos das participantes: traço médio e contínuo, tamanho pequeno, localização no quarto quadrante, presença de reforços e representações de articulações, figuras com postura corporal estática e traços faciais simplificados. Esses indicadores foram interpretados como sinais sugestivos de passividade, insegurança, inibição, sentimento de inferioridade, conflitos relativos a dificuldades de contato, propensão ao refúgio na fantasia, à idealização, à regressão e a tentativas de controle onipotente, rigidez psíquica e desvitalização. Portanto, a imagem corporal das participantes parece ser determinada por representações mentais que incluem o corpo, mas não se restringem às suas dimensões biológicas ou às limitações físicas decorrentes das manifestações sintomáticas da fibromialgiaCONCLUSÃO: A imagem corporal das participantes apresenta uma valência essencialmente negativa, uma vez que é moldada subjetivamente por concepções internalizadas e inconscientes pouco favoráveis sobre si mesmas

Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study.

OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture.

Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study

SUMMARY OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture

RESUMO OBJETIVO: Traçar o perfil de pacientes atendidos em uma Unidade de Terapia Intensiva Neonatal cirúrgica nível III desvinculada de maternidade e analisar fatores de risco para mortalidade nesta população. MÉTODOS: estudo de coorte retrospectivo, avaliando os pacientes internados em um serviço de Unidade de Terapia Intensiva Neonatal cirúrgica nível III de referência no estado no período de junho/2015 a novembro/2017. A análise univariada foi realizada pelo teste de Qui-quadrado e T-student ou Mann-Whitney. Foi realizada a analise multivariada por regressão logística incluindo no modelo as variáveis que apresentaram valor de P <0,2 na analise univariada. Foi realizada curva de Kaplan-Meier e teste Log-Rank com as varáveis que foram estatisticamente associadas ao óbito na análise multivariada. Adotou-se um nível de significância de a=5% e um erro B=80%. RESULTADOS: Neste período, 246 pacientes foram internados neste serviço. Foram a óbito 58 (23,8%) pacientes, com tempo médio de óbito de 18 dias. Metade dos pacientes apresentaram diagnóstico clínico de sepse (50,6%), com hemocultura foi positiva em 25,2% e bactérias gram-positivas (48,4%) foram os principais patógenos isolados. As variáveis que se mantiveram no modelo final após a análise multivariada foram diagnóstico de cardiopatia congênita (OR=4,5; p=0,016), diagnóstico clinico de sepse (OR=8,1; p=0,000), e isolamento de bactéria gram-positiva na hemocultura (OR=3,9; p=0,006). CONCLUSÃO: O serviço de Unidade de Terapia Intensiva cirúrgica nível III não vinculada a maternidade apresenta perfil diferenciado de morbimortalidade, e o óbito esteve associado ao diagnóstico de cardiopatia congênita, ao diagnostico clinico de sepse e ao isolamento de bactérias gram-positivas na hemocultura.

Mortality for Critical Congenital Heart Diseases and Associated Risk Factors in Newborns. A Cohort Study / Mortalidade para Cardiopatias Congênitas e Fatores de Risco Associados em Recém-Nascidos. Um Estudo de Coorte

Abstract Background: Congenital heart diseases are the most common type of congenital defects, and account for more deaths in the first year of life than any other condition, when infectious etiologies are ruled out. Objectives: To evaluate survival, and to identify risk factors in deaths in newborns with critical and/or complex congenital heart disease in the neonatal period. Methods: A cohort study, nested to a randomized case-control, was performed, considering the Confidence Interval of 95% (95% CI) and significance level of 5%, paired by gender of the newborn and maternal age. Case-finding, interviews, medical record analysis, clinical evaluation of pulse oximetry (heart test) and Doppler echocardiogram were performed, as well as survival analysis, and identification of death-related risk factors. Results: The risk factors found were newborns younger than 37 weeks (Relative Risk - RR: 2.89; 95% CI [1.49-5.56]; p = 0.0015), weight of less than 2,500 grams (RR: 2.33 [; 95% CI 1.26-4.29]; p = 0.0068), occurrence of twinning (RR: 11.96 [95% CI 1.43-99.85]; p = 0.022) and presence of comorbidity (RR: 2.27 [95% CI 1.58-3.26]; p < 0.0001). The incidence rate of mortality from congenital heart disease was 81 cases per 100,000 live births. The lethality attributed to critical congenital heart diseases was 64.7%, with proportional mortality of 12.0%. The survival rate at 28 days of life decreased by almost 70% in newborns with congenital heart disease. The main cause of death was cardiogenic shock. Conclusion: Preterm infants with low birth weight and comorbidities presented a higher risk of mortality related to congenital heart diseases. This cohort was extinguished very quickly, signaling the need for greater investment in assistance technology in populations with this profile.

Resumo Fundamento: As cardiopatias congênitas configuram o tipo mais comum de defeitos congênitos, sendo responsáveis por mais mortes no primeiro ano de vida do que em qualquer outra condição, quando etiologias infecciosas são excluídas. Objetivo: Avaliar a sobrevida e identificar os fatores de risco nos óbitos em recém-nascidos com cardiopatia congênita crítica e/ou complexa no período neonatal. Métodos: Realizou-se um estudo de coorte, aninhado a um caso-controle aleatorizado, considerando Intervalo de Confiança de 95% (IC95%) e nível de significância de 5%, pareado por sexo do recém-nascido e idade materna. Foram feitas buscas ativas de casos, entrevistas, análise de prontuário, avaliação clínica da oximetria de pulso (teste do coraçãozinho) e do ecoDopplercardiograma, bem como análise de sobrevida e identificação dos fatores de risco relacionados ao óbito. Resultados: Os fatores de risco encontrados foram recém-nascidos com menos de 37 semanas (Risco Relativo − RR: 2,89; IC95% 1,49-5,56; p = 0,0015), peso inferior a 2.500 g (RR: 2,33; IC95% 1,26-4,29; p = 0,0068), ocorrência de gemelaridade (RR: 11,96; IC95% 1,43-99,85; p = 0,022) e presença de comorbidade (RR: 2,27; IC95% 1,58-3,26; p < 0,0001). A taxa de incidência de mortalidade por cardiopatias congênitas foi de 81 casos por 100 mil nascidos vivos. A letalidade atribuída às cardiopatias congênitas críticas foi de 64,7%, com mortalidade proporcional de 12,0%. A taxa de sobrevida aos 28 dias de vida diminuiu em quase 70% nos recém-nascidos com cardiopatias congênitas. A principal causa de óbito foi o choque cardiogênico. Conclusão: Recém-nascidos prematuros, com baixo peso e presença de comorbidades apresentaram maior risco de mortalidade relacionada às cardiopatias congênitas. Esta coorte se extinguiu muito rapidamente, sinalizando para a necessidade de maior investimento em tecnologia assistencial em populações com este perfil.

Mortality for Critical Congenital Heart Diseases and Associated Risk Factors in Newborns. A Cohort Study.

BACKGROUND: Congenital heart diseases are the most common type of congenital defects, and account for more deaths in the first year of life than any other condition, when infectious etiologies are ruled out. OBJECTIVES: To evaluate survival, and to identify risk factors in deaths in newborns with critical and/or complex congenital heart disease in the neonatal period. METHODS: A cohort study, nested to a randomized case-control, was performed, considering the Confidence Interval of 95% (95% CI) and significance level of 5%, paired by gender of the newborn and maternal age. Case-finding, interviews, medical record analysis, clinical evaluation of pulse oximetry (heart test) and Doppler echocardiogram were performed, as well as survival analysis, and identification of death-related risk factors. RESULTS: The risk factors found were newborns younger than 37 weeks (Relative Risk - RR: 2.89; 95% CI [1.49-5.56]; p = 0.0015), weight of less than 2,500 grams (RR: 2.33 [; 95% CI 1.26-4.29]; p = 0.0068), occurrence of twinning (RR: 11.96 [95% CI 1.43-99.85]; p = 0.022) and presence of comorbidity (RR: 2.27 [95% CI 1.58-3.26]; p < 0.0001). The incidence rate of mortality from congenital heart disease was 81 cases per 100,000 live births. The lethality attributed to critical congenital heart diseases was 64.7%, with proportional mortality of 12.0%. The survival rate at 28 days of life decreased by almost 70% in newborns with congenital heart disease. The main cause of death was cardiogenic shock. CONCLUSION: Preterm infants with low birth weight and comorbidities presented a higher risk of mortality related to congenital heart diseases. This cohort was extinguished very quickly, signaling the need for greater investment in assistance technology in populations with this profile.

In vitro and in silico analysis of the efficiency of tetrahydropyridines as drug efflux inhibitors in Escherichia coli.

The objectives of this study were to evaluate tetrahydropyridine derivatives as efflux inhibitors and to understand the mechanism of action of the compounds by in silico studies. Minimum inhibitory concentration (MIC) determination, fluorometric methods and docking simulations were performed. The compounds NUNL02, NUNL09 and NUNL10 inhibited efflux, and NUNL02 is very likely a substrate of the transporter protein AcrB. Docking studies suggested that the mechanism of action could be by competition with substrate for binding sites and protein residues. We showed for the first time the potential of tetrahydropyridines as efflux inhibitors and highlighted compound NUNL02 as an AcrB-specific inhibitor. Docking studies suggested that competition is the putative mechanism of action of these compounds.

Burnout at Work in Modern Times.

The theme of this research is burnout at work in modern times. The main objective is to analyze aspects of mental health worker. The specific objectives are to evaluate the issue of health and mental illness in the workplace, to understand the field of psychodynamics of work, and to analyze the work and the mental strain. The methodology used is the literature review. We conclude that is not the hostile environment that directly causes burnout and other conditions, but the inability to deal with the powerlessness of the working conditions.

Fundamentos do Colégio Invisível da Para-História / Foundations of the Invisible College of Parahistory / Fundamentos del Colegio Invisible de la Para-Historia

A proposta deste artigo é contribuir para a fundamentação da especialidade ParaHistóriaa partir das atividades pesquisísticas do Colégio Invisível da Para-História.Para tanto, enfoca o estudo da História e a sua compreensão a partir do paradigmaconsciencial. O método adotado foi, a partir do conhecimento da História, contextualizá-lana sua abrangência quanto às vertentes no tempo, autorreflexão da importânciana holobiografia pessoal e descrição sobre a criação e a proposta de trabalho doColégio Invisível da Para-História. O trabalho contribui para a compreensão da importânciado estudo da Para-História no entendimento da Consciência, no contextoe paracontexto em que vive suas relações com as demais consciências, auxiliando-asna compreensão das raízes e relações multimilenares(AU)

This article aims to contribute to the foundations of the Parahistory disciplinethrough the research activities of the Invisible College of Parahistory. Hence, it focuson the study of History and its appreciation under the consciential paradigm. Themethodology employed was the analysis and contextualization of History throughoutthe times, self-analysis of its importance on individual holobiography, and the descriptionof the creation and the scope of work of the Invisible College of Parahistory.This work contributes to the understanding of the importance of the study ofParahistory to fully comprehend the consciousness in the context and paracontext inwhich one lives and interacts with other consciousnesses, aiding the apprehension ofits multi-millenary roots and relationships(AU)

La propuesta de este artículo es contribuir para las fundamentaciones de la especialidadpara-historia partiendo de las actividades de pesquisas del Colegio Invisiblede la Para-Historia. Para tanto, enfoca el estudio de la Historia y su comprensiónpartiendo del paradigma conciencial. El método adoptado fue, a partir del conocimientode Historia, contextualizarla en su alcance cuanto a las vertientes en el tiempo,autorreflexión de la importancia de ella en la Holobiografía personal y descripciónacerca de la creación y la propuesta de trabajo del Colegio Invisible de la ParaHistoria.el trabajo contribuye para la comprensión de la importancia del estudio dela Para-Historia en el entendimiento de la Conciencia, en el contexto e para-contextoen que vive sus relaciones con las demás consciencias, auxiliándolas en la comprensiónde las raíces y relaciones multimilenares(AU)

Impacto das crises de sibilância em crianças de 0 a 3 anos de uma área de baixa renda no sul do Brasil / Impact of wheezing episodes in children 0 to 3 years old from a low-income area in Southern Brazil

Objetivos: Identificar a prevalência de sibilância e fatores associados em crianças com idade inferior a três anos de uma amostra populacional de baixa renda e medir outros marcadores de gravidade associados à sibilância e à asma nos primeiros anos de vida.Métodos: Os pais ou responsáveis das crianças incluídas foram entrevistados no centro de saúde de atenção primária de uma região de baixa renda da cidade de Porto Alegre, Rio Grande do Sul, e responderam a um questionário desenvolvido para estimar a prevalência de sibilância e avaliar os fatores associados, denominado EISL (Estudo Internacional de Sibilância em Lactentes). Foram incluídos pacientes com idade até 36 meses que consultavam para puericultura e/ou vacinação. Pacientes trazidos na emergência não foram incluídos.Resultados: O estudo avaliou um total de 153 crianças com idade média de 12,6±9,5 meses. Destes, 63% tiveram episódios de sibilância relatados, que ocorreram uma ou mais vezes durante os primeiros três anos de vida. A média de idade do primeiro episódio de sibilância foi 4,9±5,3 meses. Utilizaram β2-agonistas, corticoides orais e corticoides inalatórios 58,2%, 32,7% e 19% dos pacientes, respectivamente. Mais de 58% dos pacientes foram à emergência por sibilância e 13% foram hospitalizados pelo menos uma vez nos primeiros anos de vida.Conclusões: Este estudo mostrou que a prevalência de sibilância foi alta entre as crianças pequenas atendidas em um centro de saúde de uma região de baixa renda da cidade de Porto Alegre, sendo que os primeiros sintomas geralmente ocorreram durante os primeiros dois anos de vida. Além disso, alta frequência de uso de medicamentos e internação hospitalar demonstram o impacto da doença pulmonar obstrutiva neste grupo etário...

Aims: To identify the prevalence of wheezing and associated factors in children younger than three years of age in a sample of low income region, and to measure other markers associated with severity and risk of asthma in early life.Methods: Parents or legal guardians of infants were interviewed at the primary health center in a low-income area from Porto Alegre, Rio Grande do Sul state, and answered a questionnaire designed to estimate the prevalence of wheezing and evaluate the associated risk factors, called EISL (International Study of Wheezing in Infants). We included patients up to 36 months of age visiting for routine examination or vaccination. Patients brought to emergency room were not included.Results: The study evaluated a total of 153 children with a mean age of 12.6±9.5 months. Of them, 63% had at least one episode of wheezing reported, which occurred one or more times during the first year of life. The average age of the first episode of wheezing was 4.9±5.3 months. Use of β2-agonists, oral and inhaled corticosteroids was reported by 58.2%, 32.7% and 19%, respectively. More than 59% of the patients visited an emergency unit due to wheezing episodes and 13% were hospitalized at least once in the first years of life because of wheezing.Conclusions: This study has shown that the prevalence of wheezing on young children is high in a low-income area from Porto Alegre, and the symptoms usually occur during the first two years of life. In addition, high frequency of medication usage and hospitalization demonstrates the impact of obstructive lung disease in this age group...

Causas isquêmicas de perda de visão monocular transitória / Ischemical causes of transient monocular vision loss

A amaurose fugaz é um ataque isquêmico transitório da retina que pode aparecer como um preditor de doenças isquêmicas e não isquêmicas. Este trabalho visa revisar a perda de visão monocular transitória relacionada às doenças isquêmicas, cujo diagnóstico e o tratamento precoce são fundamentais para prevenir conseqüências futuras como o AVC e a perda visual permanente.

The amaurosis fugax is a transient ischemic attack of the retina that may appear as a predictor of ischemic and not ischemic disease. This paper aims to review the transient monocular vision loss related to ischemic heart disease, whose diagnosis and early treatment are key to preventing future consequences such as stroke and permanent visual loss.