Associação entre peso ao nascer, idade gestacional e diagnósticos secundários na permanência hospitalar de recém-nascidos prematuros / Asociación entre peso al nacimiento, edad gestacional y diagnóstico secundario en estancia hospitalaria de recién nacido prematuro / Association between birth weight, gestational age and secondary diagnoses in the hospital stay of premature newborns

RESUMO Objetivo: verificar a associação entre peso ao nascer, idade gestacional e diagnósticos médicos secundários no tempo de permanência hospitalar de recém-nascidos prematuros. Métodos: estudo transversal, com 1.329 prontuários de recém-nascidos no período de julho de 2012 a setembro de 2015, em dois hospitais de Belo Horizonte, que utilizam o sistema Diagnosis Related Groups Brasil. Para determinar um ponto de corte para o peso ao nascer e a idade gestacional no nascimento que melhor determinasse o tempo de internação, foi utilizada a curva Receive Operator Characteristic. Posteriormente, utilizou-se o teste de análise de variância e teste de Duncan para a comparação entre a média de tempo de permanência hospitalar. Resultados: a prematuridade sem problemas maiores (DRG 792) foi a categoria mais prevalente (43,12%). O maior tempo médio de internação foi de 34,9 dias, identificado entre os recém-nascidos prematuros ou com síndrome da angústia respiratória (DRG 790). A combinação de menor peso ao nascer e menor IG ao nascimento apresentou o maior risco de permanência hospitalar, aumentada quando comparados aos demais perfis formados para esse DRG. Conclusão: os achados poderão direcionar a assistência em relação à mobilização de recursos físicos, humanos e de bens de consumo, além da análise crítica de condições que influenciam os desfechos clínicos. A possibilidade da otimização do uso desses recursos hospitalares aliada à melhoria da qualidade dos atendimentos e da segurança dos pacientes está associada à minimização do tempo de permanência hospitalar e da carga de morbidade e mortalidade neonatal.

RESUMEN Objetivo: verificar la asociación entre el peso al nacer, la edad gestacional y los diagnósticos médicos secundarios en la duración de la estancia hospitalaria de los recién nacidos prematuros. Métodos: estudio transversal, con 1.329 registros de recién nacidos de julio de 2012 a septiembre de 2015, en dos hospitales de Belo Horizonte, que utilizan el sistema Diagnosis Related Groups Brasil. Para determinar un punto de corte para el peso al nacer y la edad gestacional al nacer que mejor determina la duración de la estadía, se utilizó la curva Receive Operator Characteristic. Posteriormente, se utilizó la prueba de análisis de varianza y la prueba de Duncan para comparar la duración media de la estancia hospitalaria. Resultados: la prematuridad sin mayores problemas (DRG 792) fue la categoría más prevalente (43,12%). La estancia media más larga fue de 34,9 días, identificada entre los recién nacidos prematuros o aquellos con síndrome de dificultad respiratoria (DRG 790). La combinación de menor peso al nacer y menor IG al nacer presentó el mayor riesgo de estancia hospitalaria, que se incrementó en comparación con los otros perfiles formados para este DRG. Conclusión: los hallazgos pueden orientar la atención en relación con la movilización de recursos físicos, humanos y de bienes de consumo, además del análisis crítico de las condiciones que influyen en los resultados clínicos. La posibilidad de optimizar el uso de estos recursos hospitalarios, aliada a mejorar la calidad de la atención y la seguridad del paciente, está asociada a minimizar la duración de la estancia hospitalaria y la carga de morbilidad y mortalidad neonatal.

ABSTRACT Objective: to verify the association between birth weight, gestational age, and secondary medical diagnoses in the length of hospital stay of premature newborns. Methods: cross-sectional study, with 1,329 medical records of newborns from July 2012 to September 2015, in two hospitals in Belo Horizonte, which use the Diagnosis Related Groups Brasil system. To determine a cutoff point for birth weight and gestational age at birth that best determined the length of hospital stay, the Receive Operator Characteristic curve was used. Subsequently, the analysis of variance test and Duncan's test were used to compare the mean length of hospital stay. Results: prematurity without major problems (DRG792) was the most prevalent category (43.12%). The longest mean length of hospital stay was 34.9 days, identified among preterm infants or infants with respiratory distress syndrome (DRG 790). The combination of lower birth weight and lower GA at birth presented the highest risk of hospital stay, increased when compared to the other profiles formed for this DRG. Conclusion: the findings may direct assistance in relation to the mobilization of physical, human and consumer goods resources, in addition to the critical analysis of conditions that influence clinical outcomes. The possibility of optimizing the use of these hospital resources, allied to improving the quality of care and patient safety, is associated with minimizing the length of hospital stay and the burden of neonatal morbidity and mortality.

Covid-19 vaccination priorities defined on machine learning.

OBJECTIVE: Defining priority vaccination groups is a critical factor to reduce mortality rates. METHODS: We sought to identify priority population groups for covid-19 vaccination, based on in-hospital risk of death, by using Extreme Gradient Boosting Machine Learning (ML) algorithm. We performed a retrospective cohort study comprising 49,197 patients (18 years or older), with RT-PCR-confirmed for covid-19, who were hospitalized in any of the 336 Brazilian hospitals considered in this study, from March 19th, 2020, to March 22nd, 2021. Independent variables encompassed age, sex, and chronic health conditions grouped into 179 large categories. Primary outcome was hospital discharge or in-hospital death. Priority population groups for vaccination were formed based on the different levels of in-hospital risk of death due to covid-19, from the ML model developed by taking into consideration the independent variables. All analysis were carried out in Python programming language (version 3.7) and R programming language (version 4.05). RESULTS: Patients' mean age was of 60.5 ± 16.8 years (mean ± SD), mean in-hospital mortality rate was 17.9%, and the mean number of comorbidities per patient was 1.97 ± 1.85 (mean ± SD). The predictive model of in-hospital death presented area under the Receiver Operating Characteristic Curve (AUC - ROC) equal to 0.80. The investigated population was grouped into eleven (11) different risk categories, based on the variables chosen by the ML model developed in this study. CONCLUSIONS: The use of ML for defining population priorities groups for vaccination, based on risk of in-hospital death, can be easily applied by health system managers.

Covid-19 vaccination priorities defined on machine learning

ABSTRACT OBJECTIVE Defining priority vaccination groups is a critical factor to reduce mortality rates. METHODS We sought to identify priority population groups for covid-19 vaccination, based on in-hospital risk of death, by using Extreme Gradient Boosting Machine Learning (ML) algorithm. We performed a retrospective cohort study comprising 49,197 patients (18 years or older), with RT-PCR-confirmed for covid-19, who were hospitalized in any of the 336 Brazilian hospitals considered in this study, from March 19th, 2020, to March 22nd, 2021. Independent variables encompassed age, sex, and chronic health conditions grouped into 179 large categories. Primary outcome was hospital discharge or in-hospital death. Priority population groups for vaccination were formed based on the different levels of in-hospital risk of death due to covid-19, from the ML model developed by taking into consideration the independent variables. All analysis were carried out in Python programming language (version 3.7) and R programming language (version 4.05). RESULTS Patients' mean age was of 60.5 ± 16.8 years (mean ± SD), mean in-hospital mortality rate was 17.9%, and the mean number of comorbidities per patient was 1.97 ± 1.85 (mean ± SD). The predictive model of in-hospital death presented area under the Receiver Operating Characteristic Curve (AUC - ROC) equal to 0.80. The investigated population was grouped into eleven (11) different risk categories, based on the variables chosen by the ML model developed in this study. CONCLUSIONS The use of ML for defining population priorities groups for vaccination, based on risk of in-hospital death, can be easily applied by health system managers

Correlation of maternal concentrations of plasma testosterone with fetal sex in horses / Correlação das concentrações plasmáticas de testosterona materna com o sexo fetal em equinos

ABSTRACT: The objectives of this study were to evaluate the correlation of fetal sex and plasma testosterone concentrations between the 5th and 8th months of pregnancy in mares and to verify the applicability of this test to predict fetal sex. Blood samples were collected from 21 mares at 30-day intervals of between 150 and 240 days of pregnancy. Plasma testosterone was determined by radioimmunoassay and the sex of the foals confirmed at birth. The levels of maternal testosterone were higher in mares carrying female fetuses at months 5 and 8 (P < 0.05). Limit values were determined by analyzing the receiver operating characteristic (ROC) estimates: 35.5 pg/mL and 40 pg/mL for the 5th and 8th month, respectively. For the mares with plasma testosterone values equal to or above the threshold, gestation of female foals was predicted, and for those with plasma testosterone below the threshold values pregnancy of male foals was predicted. In the 5th month, the predictive values for male and female fetuses were 70% and 88.9%, respectively; the detection rates were 87.5% and 72.7%, and the total accuracy of the examination was 78.9%. In the 8th month, the predictive values for male and female fetuses were 80% and 90%, respectively; the detection rates were 88.9% and 81.8%, and the total accuracy of the examination was 85%. It was concluded that there was a correlation between fetal sex and plasma testosterone concentrations in pregnant mares. Prediction of fetal sex based on plasma concentrations of maternal testosterone can be performed in months 5 and 8 with 78.9% and 85% accuracy, respectively.

RESUMO: Os objetivos do estudo foram avaliar a correlação do sexo fetal com as concentrações plasmáticas de testosterona entre o 5° e o 8º mês de gestação na égua e verificar a aplicabilidade deste exame para a predição do sexo fetal. Amostras de sangue foram coletadas de 21 éguas, com intervalos de 30 dias, entre 150 e 240 dias de gestação. A testosterona plasmática foi determinada por radioimunoensaio e o sexo dos potros foi confirmado ao nascimento. Os valores de testosterona materna foram superiores nas éguas gestando fetos fêmeas aos cinco e oito meses (P< 0.05). Através da análise da curva ROC (receiver operating characteristic) foram determinados valores limites de 35,5 pg/mL e 40 pg/mL para o 5º e o 8° mês, respectivamente. Éguas com testosterona plasmática igual ou acima dos valores limites foram preditas como gestando fêmeas e éguas com testosterona plasmática abaixo dos valores limites foram preditas como gestando machos. Aos cinco meses, os valores preditivos para fetos machos e fêmeas foram 70% e 88,9%, respectivamente; as taxas de detecção foram 87,5% e 72,7% e a acurácia total do exame foi de 78,9%. Aos oito meses, os valores preditivos para fetos machos e fêmeas foram 80% e 90%, respectivamente; as taxas de detecção foram 88,9% e 81,8% e a acurácia total do exame foi de 85%. Conclui-se que houve correlação entre o sexo fetal e as concentrações de testosterona plasmática em éguas prenhes. A predição do sexo fetal baseada nas concentrações plasmáticas de testosterona materna pode ser realizada aos cinco e oito meses de gestação com 78,9% e 85% de acurácia, respectivamente.

A randomized controlled trial of social skills training for patients with treatment-resistant schizophrenia with predominantly negative symptoms.

We conducted a randomized controlled trial to assess the effectiveness of social skills training (SST) in improving negative symptoms in patients with treatment-resistant schizophrenia with predominantly negative symptoms. Patients were randomized to receive SST (n = 29) or to a control group (n = 33), in a 20-week program with weekly group sessions. Patients were assessed at baseline, post-treatment (20 weeks) and 6-month follow-up with the Positive and Negative Syndrome Scale. There was no significant improvement in the negative symptoms in either group, at any timepoint. Caution is warranted to interpret the results due to small sample size.

Quality and fertility of frozen ovine spermatozoa from epididymides stored at room temperature (18-25 °C) for up to 48 h post mortem.

This study investigates the effect of time of storage of epididymides at room temperature and the addition of 20% of seminal plasma to the cryopreservation extender, on post thaw quality and fertility of ovine spermatozoa collected from the cauda epididymis. Spermatic kinetics, integrity and the stability of plasma membrane, damage to the acrosome and fertility following laparoscopic artificial insemination were evaluated in samples collected in an artificial vagina (AV) and from epididymides stored at room temperature for zero (G0), six (G6), twelve (G12), twenty-four (G24) and forty-eight (G48) hours post mortem. There were no significant differences in spermatic parameters between the methods of sample collection, except for progressive motility and velocity according to the straight path(VSL). G48 samples had significant lower total motility(TM), progressive motility(PM), kinetic parameters, viability and acrosomal integrity. Pregnancy rate after insemination was similar for samples collected using AV, and the G0, G6, G12 and G24 samples. In conclusion, ovine epididymides can be exposed to room temperature, for up to 24 h post mortem, with no effect on viability and fertility of cryopreserved seminal samples. The addition of seminal plasma to the cryopreservation extender had no effect on spermatozoa quality nor fertility.

In vitro and in vivo fertilization potential of cryopreserved spermatozoa from bull epididymides stored for up to 30 hours at ambient temperature (18 °C-20 °C).

The aims of this study were to compare the viability and in vivo and in vitro fertilization potential post-thaw sperm collected at different times postorchiectomy from bull epididymides (EP) at 18 °C to 20 °C, with those of semen collected by electroejaculation (EJ) from the same bulls. Semen samples were collected by EJ from 10 Zebu bulls and cryopreserved. A week later 20 epididymides from these bulls were obtained by orchiectomy and randomly divided into five groups (G) to be maintained at ambient temperature for 6, 12, 18, 24, and 30 hours before sperm recovery by retrograde flow. The sperm were cryopreserved, and post-thaw parameters were determined by both computer-assisted sperm analysis and morphologic analysis. In vitro fertilization of oocytes was performed to assess the cleavage rate, blastocyst rate, total number of cells, and hatching rate of embryos. The G30 sperm samples were also used for fixed time artificial insemination (FTAI) of Zebu heifers (n = 10). The results of post-thaw sperm viability showed that total and progressive motility and plasma membrane integrity were lower in sperm in which cryopreservation was delayed for 30 hours, showing a negative correlation of these parameters with delay before cryopreservation. In all groups, it was possible to obtain viable embryos, and embryos from G6 samples had more cells than the other groups. The greatest embryo production rates were observed in G6, G12 and G18 (27.2 to 32.2%) and it was significantly lower in G24 and G30 samples. For EJ, many individual variations were observed in embryo production potential between bulls. G30 samples, with only 5.2% of post-thaw progressive motility, were able to fertilize and produced a pregnancy. To the authors' knowledge, this is the first time in vitro embryos up to 8 days of development and a pregnancy after FTAI have been produced with sperm from bull epididymides that had been stored at 18 °C to 20 °C for up to 30 hours.

Melanocitoma dérmico fibroso em bovino: relato de caso / Fibrous skin melanocitome in cattle: a case report / Melanocitoma dérmico fibroso en bovino: relato de caso

Melanomas e melanocitomas são neoplasias de melanoblastos e melanócitos. Neoplasias melanocíticas raramente são observadas em bovinos sendo frequentemente confundidas com outros aumentos de volume ou neoplasias, apresentando comportamento predominantemente benigno. É relatado um caso de melanocitoma em uma novilha da raça Jersey de oito meses de idade, descrevendo-se seu aspecto macro e microscópico. A neoplasia foi integralmente retirada por meio cirúrgico sem complicações ou recidivas até o momento. Ressalta-se a importância para este distúrbio, principalmente para o seu diagnóstico diferencial e a resolução relativamente descomplicada para o médico veterinário.(AU)

Melanoma and meloanocitome are melanoblast and melanocyte tumors. Melanocytic neoplasms are rarely observed in cattle and can be confused with other volume increases or neoplasms. Bovine melanoma is predominantly benign. One case of melanocitome in an 8-month old Jersey heifer is reported, describing their macro- and microscopic appearance. The tumor was completely removed by surgical means without complications. The importance of this disorder must be emphasized, especially for the differential diagnosis and the relatively uncomplicated resolution to the veterinarian.(AU)

Melanomas y melanocitomas son neoplasias de melanoblastos y melanocitos. Neoplasias melanocíticas son raramente observadas en bovino, a menudo se confunde con otros aumentos de volumen o neoplasias, presentando comportamiento predominantemente benigno. Es relatado un caso de malenocitoma en una novilla de la raza Jersey con ocho meses de edad, describiéndose su aspecto macro y microscópico. La neoplasia fue extirpada completamente por medio quirúrgico sin complicaciones o recidivas hasta el momento. Se resalta la importancia para este disturbio, especialmente para su diagnóstico diferencial y la resolución relativamente poco complicada para el médico veterinario.(AU)

Immunological Parameters Associated With Vitiligo Treatments: A Literature Review Based on Clinical Studies.

Vitiligo, a depigmentary disorder, caused by the loss of melanocytes, affects approximately 1% of the world population, irrespective of skin type, with a serious psychological impact on the patient quality of life. So far, the origin of vitiligo has not been traced and the pathogenesis is complex, involving the interplay of a multitude of variables. Although there is no treatment that ensures the complete cure of the disorder, there are some pharmacological, phototherapy, and surgical therapies available. A series of variables can affect treatment outcome, such as individual characteristics, emotional issues, type of vitiligo, stability of the lesions, and immunological status. The present literature review identified the main immunological parameters associated with treatments for vitiligo. Cytotoxic CD8+ T lymphocytes are the main cell type involved in treatment success, as fewer cells in skin lesions are associated with better results. Other parameters such as cytokines and regulatory T cells may also be involved. Further clinical scientific studies are needed to elucidate the complex mechanisms underlying vitiligo and its treatments, in order to expand the range of therapeutic approaches for each individual case.

Dois diluentes comerciais na criopreservação de espermatozoides do epidídimo de touros / Two commercial extenders for cryopreservation of epididymal bull sperm

A recuperação e a criopreservação de espermatozoides do epidídimo constituem alternativas viáveis para a preservação de material genético de animais valiosos. O objetivo deste estudo foi comparar o desempenho de dois diluentes comerciais Botu-Bov(r) (BB) e Bovimix(r) (BV), sobre a viabilidade pós-descongelação de espermatozoides do epidídimo de touros Tabapuã (Bos taurus indicus) pós-castração. Os espermatozoides foram colhidos da cauda de 20 epidídimos utilizando a técnica de fluxo retrógrado, centrifugados e diluídos com BB ou BV para posterior criopreservação a -196°C. Após a descongelação, as amostras foram avaliadas utilizando a análise computadorizada (CASA) e por análises microscópicas para a determinação da integridade de membranas plasmáticas, acrossomal e morfologia espermática. A avaliação estatística dos dados foi realizada pela análise de variância (ANOVA) com o pós-teste de comparações múltiplas de Tukey-Kramer, com nível de significância (P<0,05). Os resultados do movimento espermático avaliado pelo CASA, não diferiram para o diluente BB e BV. Também não foi observada diferença significativa entre os grupos no percentual de espermatozoides morfologicamente deformados, defeitos de acrossoma e espermatozoides com membrana plasmática íntegra após o descongelamento. Conclui-se que ambos os diluentes (BB e BV) são eficientes e podem ser utilizados na tecnologia do congelamento de espermatozoides colhidos da cauda do epidídimo de touros, não apresentando diferença na viabilidade espermática para os parâmetros estudados.

Recovery and cryopreservation of epididymal sperm is a viable alternative for preservation of genetically valuable animals. The aim of this study was to verify and to compare the effect of two commercial extenders for conventional semen on post-thawing viability of bovine epididymal sperm. For this purpose, the spermatozoa was recovered from the tail of 20 epididymis of Tabapuã bulls (Bos Taurus indicus) using retrograde flow method. After sperm recovery, the cells were centrifuged and divided for dilution with the diluents Botu-Bov(r) (BB) or Bovimix(r) (BV) for cryopreservation at -196°C. After thawing, all samples were evaluated using computer assisted sperm analysis (CASA), and by microscopic analysis for determination of integrity of plasma and acrossomal membrane and morphology. Statistical evaluation was performed by analysis of variance (ANOVA) with post-test for multiple comparisons, the Tukey-Kramer test, with significance level (P<0.05). The results of the sperm movement for diluent BB and BV evaluated with CASA, showed no difference for both (P>0.05). There was also no difference between the percentage of deformed sperm, acrosome defects and the sperm with intact plasma membrane after thawing with BB or BV. We conclude that both extenders (BB and BV) are efficient and can be used for freezing sperm collected from the epididymis of bulls, showing no difference for all the parameters studied.

Halitose: limitando a qualidade de vida / Halitosis: limiting the quality of life

O objetivo deste estudo é avaliar as causas, sintomas e consequências da halitose e a influência de medidas preventivas através de uma revisão da literatura. A halitose possui causas multifatoriais, podendo ter origem local, na maioria dos casos provenientes da boca, e sistêmicas. Sabendo-se que o desconhecimento sobre como prevenir a halitose permite a sua ocorrência, limitando a qualidade de vida do indivíduo, é de suma importância que os profissionais sejam melhores preparados e a população orientada quanto aos fatores fisiológicos e patológicos da halitose, para que, assim, possam atuar na prevenção de seus efeitos individuais e sociais

The aim of this literature review is to observe the causes, symptoms and consequences of halitosis and the influence of preventive measures. Halitosis has multifactorial causes, and may have local and systemic origins. It can limit the quality of life of individuals and often occurs due to lack of knowledge of prevention methods. Therefore, it is important that professionals are better prepared and people informed about the physiological and pathological halitosis to prevent its individual and social effects

Causas e sintomas da halitose: estudo do conhecimento entre pacientes do curso de odontologia / Causes and symptoms of halitosis: a study of knowledge among patients of the dentistry course

Introdução: O estudo avalia o conhecimento sobre causas e sintomas da halitose de pacientes da Clínica de Odontologia do Curso de Graduação do Centro Universitário de Araraquara - UNIARA, bem como analisa a eficiência de folheto educativo na mudança de comportamento quanto à prevenção do mau hálito. Métodos: Para isso, um questionário pré-codificado, composto por questões sobre o tema foi aplicado em 2 momentos: antes e após 30 dias da realização do experimento. A amostra foi composta por 30 pacientes, divididos em 2 grupos: GA ? controle (respondeu ao questionário); GB ? respondeu ao questionário e recebeu o folheto para leitura e novamente respondeu ao questionário, passados 30 dias da aplicação do folheto. Os grupos foram comparados por meio da coleta dos dados e análise descritiva da distribuição de frequências. Resultados: Os resultados mostraram que, de maneira geral, o conhecimento sobre halitose se mostrou controverso em alguns aspectos, principalmente, em relação às causas e formas de prevenção; não foi observada melhora no conhecimento sobre halitose para o grupo que recebeu o folheto. Conclusão: Tanto os profissionais quanto a população devem ser mais bem orientados em relação aos fatores fisiológicos e patológicos da halitose para atuarem na prevenção de seus efeitos individuais e sociais

Introduction: This study aims to evaluate the knowledge about the causes and symptoms of halitosis of patients in the clinic of Dentistry of the University Center of Araraquara - UNIARA and analyze the effectiveness of an educational booklet on behavior change in relation to preventing bad breath. Methods: For that, a pre-coded questionnaire, was applied in two phases: before and after 30 days of the study. The sample consisted of 30 patients divided into two groups: GA - control group (only answered the questionnaire); GB - answers questionnaire and received the booklet to read and answer the questionnaire again, after 30 days of booklet application. The groups were compared by means of data collection and descriptive analysis using distributions of frequency. Results: The results showed that, in general, knowledge about halitosis by the studied population was controversial in some respects, especially with regard to the causes and prevention methods; no improvement was observed about halitosis for the group who received the booklet compared with the control group. Conclusion: It may be concluded that professionals and the population must be better focused on the physiological and pathological halitosis, so that they may act to prevent individual and social effects