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This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms "pregnant women" AND "delivery" AND "autonomy" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman's autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician's recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman's choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.
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Cesárea , Parto Obstétrico , Parto , Autonomia Pessoal , Gestantes , Humanos , Feminino , Gravidez , Gestantes/psicologia , Parto Obstétrico/métodos , Comportamento de EscolhaRESUMO
As with Amazonian primates, mixed associations between species in the Atlantic Forest are also influenced by ecological factors. However, Atlantic Forest primates may face additional challenges, such as isolation pressures and fragmentation of forest habitats, which may increase the frequency of these arrangements. The main of this work is to report a sympatry with possible interaction between individuals of two species of primates of the Pitheciidae and Callitrichidae families: Callicebus nigrifrons (Spix 1823) and Callithrix aurita (É. Geoffroy Saint-Hilaire 1812) in an urban park in the south of the state of Minas Gerais. Individuals were observed interacting during foraging and displacement. The association of individuals of the two species can be explained by the low quality of the forest fragment, as it can increases the chances of obtaining food resources and configures a dilution strategy against predator attacks.
Assim como ocorre com os primatas amazônicos, as associações mistas entre espécies na Mata Atlântica também são influenciadas por fatores ecológicos. No entanto, os primatas da Mata Atlântica podem enfrentar desafios adicionais, como pressões de isolamento e fragmentação de habitats florestais, que podem aumentar a frequência desses arranjos. O objetivo deste trabalho é apresentar um relato de simpatia com possível interação entre indivíduos de duas espécies de primatas das famílias Pitheciidae e Callitrichidae: Callicebus nigrifrons (Spix 1823) e Callithrix Resumo aurita (É. Geoffroy Saint-Hilaire 1812) em um parque urbano no sul do estado de Minas Gerais. Foram observados indivíduos interagindo durante o forrageio e deslocamento. A associação de indivíduos das duas espécies pode ser explicada devido à baixa qualidade do fragmento florestal, pois pode aumentar as chances de obter recursos alimentares e configura uma estratégia de diluição de contra-ataques de predadores.
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AnimaisRESUMO
Chronic stress is a major risk factor for neuropsychiatric conditions such as depression. Adult hippocampal neurogenesis (AHN) has emerged as a promising target to counteract stress-related disorders given the ability of newborn neurons to facilitate endogenous plasticity. Recent data sheds light on the interaction between cannabinoids and neurotrophic factors underlying the regulation of AHN, with important effects on cognitive plasticity and emotional flexibility. Since physical exercise (PE) is known to enhance neurotrophic factor levels, we hypothesised that PE could engage with cannabinoids to influence AHN and that this would result in beneficial effects under stressful conditions. We therefore investigated the actions of modulating cannabinoid type 2 receptors (CB2R), which are devoid of psychotropic effects, in combination with PE in chronically stressed animals. We found that CB2R inhibition, but not CB2R activation, in combination with PE significantly ameliorated stress-evoked emotional changes and cognitive deficits. Importantly, this combined strategy critically shaped stress-induced changes in AHN dynamics, leading to a significant increase in the rates of cell proliferation and differentiation of newborn neurons, overall reduction in neuroinflammation, and increased hippocampal levels of BDNF. Together, these results show that CB2Rs are crucial regulators of the beneficial effects of PE in countering the effects of chronic stress. Our work emphasises the importance of understanding the mechanisms behind the actions of cannabinoids and PE and provides a framework for future therapeutic strategies to treat stress-related disorders that capitalise on lifestyle interventions complemented with endocannabinoid pharmacomodulation.
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Canabinoides , Animais , Canabinoides/farmacologia , Receptores de Canabinoides , Exercício Físico , Hipocampo , Neurogênese/fisiologia , Antidepressivos/farmacologiaRESUMO
Previous metagenomic analyses have suggested that lactobacilli present potential for Quorum Sensing (QS) in cocoa fermentation, and in the present research, laboratory scale fermentations were carried out to monitor the expression of luxS, a universal marker of QS. For that, 96 h-fermentations were studied, as follows: F0 (non inoculated control), F1 (inoculated with yeasts, lactic acid bacteria, and acetic acid bacteria), F2 (inoculated with yeasts and acetic acid bacteria), F3 (inoculated with yeasts only). The parameters evaluated were: plate counting, quantification of key enzymes and analysis of volatile organic compounds associated with key sensory descriptors, using headspace gas chromatography-mass spectrometry (GC-MS). Furthermore, QS was estimated by the quantification of the expression of luxS genes by Reverse Transcriptase Real-Time PCR. The results demonstrated that microbial succession occurred in pilot scale fermentations, but no statistical differences for microbial enumeration and α-diversity index were observed among experiments and control. Moreover, it was not possible to make conclusive correlations of enzymatic profile and fermenting microbiota, likely due to the intrinsic activity of plant hydrolases. Regarding to the expression of luxS genes, in Lactiplantibacillus plantarum they were active along the fermentation, but for Limosilactobacillus fermentum, luxS was expressed only at early and middle phases. Correlation analysis of luxS expression and production of volatile metabolites evidenced a possible negative association of Lp. Plantarum with fermentation quality. In conclusion, these data corroborate former shotgun metagenomic analysis by demonstrating the expression of luxS by lactobacilli in pilot scale cocoa fermentation and evidence Lp. Plantarum is the main lactic acid bacteria related to its expression.
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Cacau , Chocolate , Fermentação , Lactobacillus/genética , Lactobacillus/metabolismo , Cacau/microbiologia , Ácido Acético/metabolismo , Expressão GênicaRESUMO
BACKGROUND: Myocardial bridge (MB) is described as an abnormal band of myocardium covering a variable portion of any coronary artery. METHODS: The current study explores the presence of MB throughout the coronary arterial system and provides a morphometric description through instrumented dissection of a sample of 100 human hearts. The study shows a higher prevalence of MB in the Mexican population than in previous reports. RESULTS: In the total sample (n=100), MB was identified in 96% of it. A total of 421 MBs were observed, with a mean of 4.38mm (±0.28) per dissected heart. The most frequently affected vessel is the anterior interventricular artery where a total of 52 MBs were found, of the total sample studied. DISCUSSION: The high prevalence of MB among Mexican patients could be the result of a genetic association for this population or the neoformation of MB after birth due to lifestyle-associated factors. Further studies are required to better understand the high prevalence of MB among Mexican subjects.
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Ponte Miocárdica , Humanos , México/epidemiologia , Masculino , Feminino , Prevalência , Ponte Miocárdica/epidemiologia , Ponte Miocárdica/patologia , Pessoa de Meia-Idade , Adulto , Idoso , Vasos Coronários/anatomia & histologia , Idoso de 80 Anos ou mais , Miocárdio/patologia , Adulto JovemRESUMO
Objetivo: Evaluar la aplicación de la estrategia reducción del tiempo de tratamiento Antimicrobiano (ATM) en Unidades de Cuidados Intensivos (UCI) en un Programa Stewardship de Antimicrobiano (ASP). Método: Este es un estudio descriptivo y transversal, realizado en dos UCI de un hospital universitario de Fortaleza, Brasil, de enero/2017 a enero/2019. Se incluyeron pacientes adultos, acompañados por un farmacéutico y utilizando ATM, en los que se aplicó la estrategia de reducción del tiempo de tratamiento. La evaluación de la estrategia se realizó a través de la diferencia entre el tiempo previsto establecido al inicio del tratamiento y los días efectivos de uso de cada ATM. Resultados: De los 100 pacientes incluidos, 51,0 % eran del sexo masculino y 64,0 % ancianos. El sistema respiratorio fue el más frecuentemente afectado (37,4 %) y las clases de ATM más prevalentes fueron los carbapenémicos (23,0 %) y los glicopéptidos (20,1 %). Hubo una disminución de 831 días innecesarios de terapia antimicrobiana y de un promedio de 13,7 a 8,9 días de tratamiento. Las mayores reducciones en días se observaron para meropenem, con 202 días reducidos. El estudio también permitió identificar asociaciones entre la reducción > 8 días de tratamiento y las variables estancia > 22 días y pacientes en cuidados paliativos exclusivos; y asociaciones entre alta hospitalaria y reducciones de hasta 7 días de terapia. Conclusiones: Los datos obtenidos sugieren que la presencia de un ASP influye en las prácticas de uso de ATM y su tiempo de tratamiento y enfatizan el papel de los profesionales farmacéuticos en estos programas. (AU)
Objective: To evaluate the application of the Antimicrobial (ATM) treatment time reduction strategy in Intensive Care Units (ICU) in an Antimicrobial Stewardship Program (ASP).Method: This is a descriptive and cross-sectional study, carried out in two ICU of a university hospital in Fortaleza, Brazil, from January/2017 to January/2019. Adult patients were included, accompanied by a pharmacist, and using ATM, in which the treatment time reduction strategy was applied. The evaluation of the strategy was made through the difference between the predicted time established at the beginning of the treatment and the effective days of use of each ATM.Results: Of the 100 patients included, 51.0 % were male and 64.0 % were elderly. The respiratory system was the most frequently affected by the infections (37.4 %) and the most prevalent classes of ATM were carbapenems (23.0 %) and glycopeptides (20.1 %). There was a decrease from 831 unnecessary days of antimicrobial therapy and from an average of 13.7 to 8.9 days of treatment. The greatest reductions in days were observed for meropenem, with 202 days reduced. The study also allowed the identification of associations between the reduction > 8 days of treatment and the variables length of stay > 22 days and patients in exclusive palliative care, and associations between hospi-tal discharge and reductions of up to 7 days of therapy.Conclusions: The data obtained suggest that the presence of an ASP influences the practices of ATM use and its treatment time and emphasize the role of pharmaceutical professionals in these programs. (AU)
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Humanos , Unidades de Terapia Intensiva , Antibacterianos/uso terapêutico , Gestão de Antimicrobianos , Epidemiologia Descritiva , Estudos Transversais , Brasil , Cuidados CríticosRESUMO
BACKGROUND: HTLV-1-associated uveitis (HAU) is an inflammatory reaction of the choroid, retina, optic nerve and vitreous that can lead to vision impairment. The worldwide prevalence of HAU varies widely. OBJECTIVE: To determine the prevalence of HAU in patients from Salvador, Bahia-Brazil, and describe uveitis type and associated symptoms. METHODS: Cross-sectional analytical study to determine the prevalence of uveitis in HTLV-1-infected patients recruited in Bahia, Brazil, a region considered endemic for HTLV-1. Patients were enrolled at a local reference center for HTLV (infected) and at an outpatient ophthalmology clinic (noninfected group). All patients were examined by the same ophthalmologist following a single protocol. Prevalence ratios (PR) were calculated. RESULTS: A total of 168 consecutively examined HTLV-1-infected patients and 410 noninfected patients (randomly selected) were included. Females predominated (82.1%) in the HTLV-1-infected group (versus 64.4% in the uninfected group) (p < 0.001). The mean age of infected and uninfected patients was 53.2 and 62.8 years, respectively (p < 0.001). The prevalence of uveitis in HTLV-1+ and HTLV-1- patients was 7.14% and 0.73%, respectively (PR = 9.76; 95CI%:2.79-34.15; p < 0.01). Bilateral intermediate uveitis, associated with symptoms including visual disturbances and floaters, was most commonly identified in the HTLV-1-infected patients, whereas unilateral anterior uveitis, in association with symptoms such as blurring and ocular pain, was more common in the uninfected group. CONCLUSION: The prevalence of uveitis in patients with HTLV-1 was markedly higher than in uninfected subjects. HAU patients were mostly asymptomatic and exhibited bilateral presentation, with uveitis more frequently localized in the intermediate chamber.
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Vírus Linfotrópico T Tipo 1 Humano , Uveíte , Feminino , Humanos , Pessoa de Meia-Idade , Brasil/epidemiologia , Estudos Transversais , Prevalência , Uveíte/epidemiologia , MasculinoRESUMO
This study aimed to develop and evaluate bread with the use of pulp and flours of pequi, in partial replacement of water and wheat flour, to develop a bakery product with good technological, nutritional and sensorial qualities. The pequi husk and pulp flours were obtained by means of a thermal pre-treatment, oven drying and standardization of the dry material. Whereas, the bread formulation was defined through the baker's formulation. Besides, the dehydration process caused significant changes (p<0.05) in the L* value and chromaticity (C*), mainly of the flours (husk and pequi pulp), such changes are due to non-enzymatic oxidative processes and pigment degradation, especially carotenoids. The effect of the substitution of ingredients (wheat flour and water) by husk and pulp flours and pequi pulp contributed to the increase in lipid, crude fiber, nitrogen-free extract and energy value content. However, the substitution promoted changes in the attributes of color and textural properties, such as increased hardness, chewiness and cohesiveness. Nevertheless, all formulations showed good sensory acceptance and thus, pequi sweet breads can be implemented in school meals for contributing and meeting the nutritional recommendations established by the School Feeding Brazilian Program (PNAE).
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Frutas , Malpighiales , Frutas/química , Farinha/análise , Pão/análise , TriticumRESUMO
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Gastroenterologia , Lactente , Criança , Feminino , Humanos , Cocos , Consenso , América Latina , Fenômenos Fisiológicos da Nutrição do LactenteRESUMO
Stereopsis is the three-dimensional perception capability, which is possible when binocular vision is present. Development of binocular vision system ends around 7-year-old, and after this time brain connections are already set, therefore, it will be difficult to recover stereopsis. Early diagnosis of Stereoscopic Visual Alterations (SVA) in the childhood is paramount to receive an appropriate treatment as soon as possible. Currently, to detect SVA, ophthalmologists commonly carry out tests based on cards. All these tests are based on the random-dot-stereogram principle, with different seconds of arc images, which allows doctors to graduate stereopsis. Some limits of this tests have been identified, such as monocular clues (e.g., the contours of the objects), or the non-standardized range levels depending on the test. This paper presents a novel concept of measuring stereopsis based on computer vision techniques. The system detects SVA in patients and calculates the degree of the perceived depth. As early diagnosis of SVA may suppose a therapeutic possibility, this platform is aimed at children by using stereoscopic models with varied and attractive designs. To validate the proposal, an early-stage prototype has been implemented and an objective evaluation of the measurement accuracy and reliability has been carried out with satisfactory results.
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Percepção de Profundidade , Visão Binocular , Criança , Humanos , Reprodutibilidade dos Testes , Encéfalo , Diagnóstico PrecoceRESUMO
OBJECTIVE: Handgrip strength (HGS) is an indicator of general muscular strength and in cancer patients acts as a relevant marker associated with mortality and health. This study aimed to evaluate the association between peripheral muscle function and health-related quality of life (HRQoL) in breast cancer (BC) survivors. METHODS: Systematic review registered on PROSPERO under number: CRD 42021225206. The searches were carried out on MEDLINE via Pubmed, PEDro, Cochrane Library, Embase, CINAHL via EBSCO and Science Direct databases. Observational studies evaluating the association between handgrip strength (HGS) and HRQoL in adult female BC survivors were included. No linguistic or time restrictions were applied. Two reviewers reviewed full texts for inclusion and performed data extraction and risk of bias using the Newcastle and Ottawa scale (NOS). RESULTS: Five articles were included and involved 587 patients, mean age of 47 to 59 years. The percentage of decreased HGS ranged from 38.3% to 60.3%. HGS was associated with different quality of life measures. From meta-analysis including 220 patients, the correlation coefficient between HGS and HRQoL was 0.26 (95% CI: 0.07-0.35). CONCLUSIONS: Breast cancer survivors face decline of HGS. In this population HGS was correlated with HRQoL. However, more evidence are necessary.
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Neoplasias da Mama , Sobreviventes de Câncer , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Qualidade de Vida , Força da Mão/fisiologia , Neoplasias da Mama/epidemiologia , SobreviventesRESUMO
ABSTRACT Zephyranthes citrina is an ornamental American bulbous plant used as an ornamental garden crop for the aesthetic qualities of its yellow perigonium. The objective of this work was to characterize the species by classical chromosome staining and fluorochrome banding. A sporophytic chromosome number of 2n=8x=48 chromosomes was observed, being the karyotypic formula 20 m + 26 sm + 2 st. Satellites were detected in the short arm of metacentric chromosomes 8, 9, 11 and 12, which colocalized with constitutive heterochromatin CMA+/DAPI-/0 bands. The karyotype comprised chromosome pairs with terminal constitutive heterochromatin bands that included satellites and heteromorphic clusters indicating that it is an allooctoploid. These results will be used as a tool for monitoring genetic improvement, in interspecific crosses and its progenies and in biotechnological procedures by in vitro culture.
RESUMEN Zephyranhtes citrina es una planta bulbosa americana, ornamental, utilizada en jardines por las cualidades estéticas de su perigonio amarillo. El objetivo de este trabajo fue caracterizar citogenéticamente la especie con tinción clásica convencional y bandeo cromosómico. Se observó un número cromosómico esporofítico de 2n=8x=48, siendo la fórmula cariotípica 20 m + 26 sm + 2st. Se detectaron satélites en el brazo corto de los cromosomas metacéntricos 8, 9, 11 y 12, que co-localizaron con bandas de heterocromatina constitutiva CMA+/DAPI-. El cariotipo comprendió pares de cromosomas con bandas de heterocromatina constitutivas terminales que incluyeron satélites y grupos heteromórficos que indican que es un alooctoploide. Estos resultados serán usados como herramientas en el monitoreo del mejoramiento genético, en análisis de cruzamientos interespecíficos y progenies y en procedimientos biotecnológicos de cultivo in vitro.
RESUMO
This study aimed to analyze the average air temperature data estimated by ERA5-Land reanalysis over 10 years (01/01/2011 to 12/31/2020), based on data from 12 automatic weather stations located in different cities in the state of Pernambuco, northeast of Brazil. For more careful evaluation, the average air temperature data were stratified by mesoregions of the state. ERA5-Land reanalysis data were validated using statistical indices that evaluated the accuracy. The average air temperature estimated by ERA5-Land reanalysis agree well with weather stations in almost the entire state of Pernambuco. The highest accuracy of the average air temperature estimated by ERA5-Land occurred in the city of Ibimirim (R2 = 0.98), while the lowest accuracy was measured in the city of Caruaru (R2 = 0.57). Root-mean-square error (RMSE) generated by the ERA5-Land reanalysis was lower than 0.60 °C in most Pernambuco. The highest RMSE of ERA5-Land for average air temperature was calculated using data from the city of Caruaru (1.11 °C), whereas the lowest RMSE was obtained with data from the city of Recife (0.41 °C). According to mean bias errors, (MBE) the ERA5-Land underestimated the average air temperature data compared to automatic weather stations data, especially in Ouricuri, which had the highest underestimation (-0.80 °C). On the other hand, among the municipalities where ERA5-Land overestimated the temperature values, the highest overestimation was identified in Garanhuns (0.35 °C). Therefore, based on the results of this study, ERA5-Land reanalysis successfully estimated the average air temperature for the state of Pernambuco.
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Monitoramento Ambiental , Tempo (Meteorologia) , Brasil , Cidades , TemperaturaRESUMO
Introducción: La elefantiasis verrucosa nostra es una afección dermatológica deformante poco frecuente asociada al linfedema crónico. Se caracteriza por presentar edema de la parte afectada con fibrosis progresiva de aspecto leñoso de la dermis y el tejido subcutáneo, hiperqueratosis de la epidermis y lesiones papilomatosas y verrucosas que dan una apariencia de empedrado a la piel.Presentación del caso:La paciente, además de sufrir elefantisis verrucosa nostra en ambas extremidades, también sufría colonización por larvas de díptero, úlceras por presión en ambos talones y un estado general de salud muy deteriorado. Se realizó un plan de atención de enfermería (PAE), valorando a la paciente según las 14 Necesidades Básicas Humanas de Virginia Henderson, seguida de una fase diagnóstica según la North American Nursing Diagnosis Association (NANDA) realizando una planificación de objetivos basándonos en la Nursing Outcomes Classification (NOC) y llevando a cabo una serie de intervenciones con actividades específicas apoyándonos en la Nursing Interventions Classification (NIC), realizando una evaluación constante de la evolución de la paciente.Para apreciar la evolución del PAE focalizando en un mismo diagnóstico NANDA, Deterioro de la integridad cutánea, a lo largo de todo el proceso hospitalario de la paciente y como el tratamiento de la afección con ácido tricloracético al 20% (TCA 20%) mejoró el estado de la piel.Conclusiones:El tratamiento con ácido tricloroacético al 20% ha resultado efectivo frente a la elefantisis verrucosa nostra, reduciendo la hiperqueratosis hasta obtener una piel aceptablemente sana. El seguimiento del plan de atención a enfermería a lo largo del todo el proceso garantiza los cuidados necesarios para una correcta recuperación del paciente. (AU)
Introduction: Elephantiasis Verrucosa Nostra is a rare deforming dermatologic condition associated with chronic lymphedema. It is characterized by edema of the affected area with progressive woody fibrosis of the dermis and the subcutaneous tissue, hyperkeratosis of the epidermis, and papillomatous and verrucous lesions that give the skin a cobblestone appearance.Case presentation:The patient, in addition to suffering from elephantitisis verrucosa nostra on both limbs, also suffered from dipteran larvae colonisation, pressure ulcers on both heels and aexceptionally deteriorated health condition.A Nursing Care Plan (PAE) was carried out, Assessing the patient according to Virginia Henderson's 14 Basic Human Needs, followed by a diagnostic phase according to the North American Nursing Diagnosis Association (NANDA), carrying out a planning of objectives based on the Nursing Outcomes Classification (NOC) and accomplishing a series of interventions with specific activities based on the Nursing Interventions Classification (NIC), getting a constant evaluation of thepatient's evolution. In order to appreciate the PAE's evolution focusing on the same NANDA diagnosis, Deterioration of Skin Integrity, throughout the entire hospital process and how thedisease's treatment with 20% trichloroacetic acid (TCA 20%) improved the condition of the skin.Conclusions:Treatment with 20% trichloroacetic acid has been effective against elephantiasis verrucosa nostra, reducing hyperkeratosis to an acceptably healthy skin. The monitoring of the nursing care plan throughout the entire process guarantees the necessary care for the correct recovery of the patient. (AU)
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Humanos , Masculino , Elefantíase , Linfedema , MiíaseRESUMO
INTRODUCTION AND AIMS: Endoscopic submucosal dissection (ESD) is a well-established treatment for superficial gastrointestinal tumors and enables en bloc resection. Adequate tissue tension is important for safe and effective dissection. Simplified magnetic anchor-guided ESD (MAG-ESD) with a neodymium magnet has potential benefits, compared with other current traction methods. We evaluated the feasibility of simplified MAG-ESD in an ex vivo porcine model. MATERIALS AND METHODS: An experimental study was conducted, utilizing the standard ESD technique. An external magnet and an internal magnet, both neodymium magnets, were used for the magnetic anchoring. The internal magnet was attached to an arm of a hemoclip with a 2-0 silk suture. After the incision, the clip with the internal magnet was placed at the edge of the lesion. The external magnet was maneuvered around the surface to apply adequate tension. RESULTS: A total of 15 en bloc ESDs (5 with no magnetic anchoring and 10 with magnetic anchoring) were carried out. Traction and dissection were feasible in all cases and the procedures were completed in fewer than 90min. Lesion size ranged from 15 to 50mm (mean 30mm). Two cases in the group with magnetic anchoring presented with punctate perforation (13.3%). CONCLUSIONS: Our study demonstrated the feasibility of simplified MAG-ESD and en bloc resection in an ex vivo porcine model.
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Ressecção Endoscópica de Mucosa , Animais , Dissecação , Humanos , Fenômenos Magnéticos , Imãs , Neodímio , SuínosRESUMO
OBJECTIVE: To evaluate the effects of mechanical versus chemical cleaning protocols for cleaning the root dentin surface before cementation of fiberglass posts for their effect on the bond strength, failure mode, and dentinal penetration of the cementing agent using an etch-and-rinse adhesive system on dentin prepared to receive a fiberglass post. METHODS: Forty roots of bovine teeth were endodontically treated and prepared for fiber post cementation. The specimens were randomized into 4 groups of 10: Control group (CO) - irrigation with 2.5% NaOCl; DW group- irrigation with distilled water; RB group - rotating brush for cleaning root canals, and CUI group - continuous ultrasonic irrigation. The fiberglass posts were cemented, and the specimens were immersed in distilled water for 6 months. A push-out test was performed on the cervical, middle, and apical thirds of the samples. Dentinal penetration of the cementing agent and the fracture pattern were evaluated by laser confocal microscopy. Statistical analysis was performed using analysis of variance (ANOVA) and post hoc Tukey tests (α=0.05). Results: The RB and CUI groups showed significantly higher bond strength values when compared to the Control and DW groups (p<0.05). In addition, in the control and DW groups, the apical third presented lower bond strength values when compared to middle and cervical thirds. CONCLUSION: While DW showed the highest incidence of adhesive type failure, CUI resulted in the highest dentinal penetration of the cementing agent (p<0.05). RB and CUI resulted in the highest bond strength between cementation system and root dentin. In addition, CUI favored greater dentinal penetration of fiberglass post cementing agent.
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Colagem Dentária , Técnica para Retentor Intrarradicular , Animais , Bovinos , Cimentação , Cimentos Dentários , Cavidade Pulpar , Dentina , Teste de Materiais , Cimentos de ResinaRESUMO
The present report describes two cases of infection by Molossinema wimsatti in the brain of Pallas's mastiff bats (Molossus molossus). The first bat was captured and killed by a domestic cat in a suburban area of the municipality of Patos, Paraiba, northeastern Brazil. The second bat was found crawling on the ground in the same area before dying. No gross lesions were found at necropsy. Histology of the central nervous system revealed filarioid nematodes in the brain ventricles and cerebellum. There were adults, subadults and eggs, the latter sometimes containing microfilariae. No inflammatory response was observed in bat 1, while bat 2 presented a mild lymphoplasmacytic meningoencephalitis. Three nematodes were recovered and submitted for parasitological examination. The diagnosis of M. wimsatti infection was based on the histomorphological and parasitological characteristics of the agent and its location in the brain ventricular system of insectivorous bats. The infection likely occurs in other insectivorous bats from South American and Caribbean countries but may be overlooked.
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Quirópteros , Animais , Encéfalo/diagnóstico por imagem , Brasil , GatosRESUMO
This study was aimed at describing a case series of brachio-cervical inflammatory myopathy (BCIM) associated with systemic sclerosis (SSc), due to its rarity and limited coverage in published data. Another aim was to provide a literature review. We reported four cases of BCIM-SSc from our tertiary center. In addition, we researched the literature and found six articles featuring 17 patients who fit this phenotype. We pooled all cases and reported their features. Most patients were female and had limited SSc, and the median time of BCIM presentation was three years after SSc diagnosis. Asymmetric muscle involvement, scapular winging, dropped head, axial weakness, camptocormia, dysphagia, and dermatomyositis stigmas were common features. All patients had esophageal involvement. Most had positive antinuclear antibody results, a scleroderma pattern in their capillaroscopy images, elevated serum creatine phosphokinase, myopathic electrophysiology, and muscle involvement in magnetic resonance imaging. Muscle histopathological findings varied widely, but in general all showed the presence of lymphoid infiltrates, muscle atrophy, increased MHC-I expression, MAC deposits, vasculopathy, and muscle fiber necrosis. The response to immunosuppressive therapy was highly irregular. BCIM-SSc is a rare disorder that shares many similar phenotypes among the described cases, but has a highly heterogeneous response to treatment. At present, more data on the physiopathology, clinical features, and treatment is still needed.
Assuntos
Atrofia Muscular Espinal , Doenças Musculares , Miosite , Escleroderma Sistêmico , Curvaturas da Coluna Vertebral , Feminino , Humanos , Miosite/complicações , Escleroderma Sistêmico/complicaçõesRESUMO
The aim was to assess neurological complications in children with an invasive neurological disease by dengue virus (DENV) and the time to resolve symptoms after hospital discharge. A prospective study was conducted at a referral hospital for infectious diseases in Brazil between March 2014 and July 2019. All children hospitalized with neurologic manifestations and DENV RNA detected by real-time reverse transcription-polymerase chain reaction (RT-qPCR) in cerebrospinal fluid (CSF) were followed up until complete resolution of neurological complications. On average, they were followed up for 16 months. Among 56 DENV-positive children, 39% had some neurologic complications after hospital discharge and found that 19.6% were discharged with anticonvulsants due to seizures, 10.7% developed motor complications (e.g. muscle weakness, paresis, ataxia, and walking disability), 5.4% had headaches, and 14.3% had sleep disorders. Among the 56 children, only three had a clinical diagnosis of dengue because the symptoms are nonspecific and 35% showed no change in cerebrospinal fluid (CSF). The average time to resolve complications was 5.9 months (ranging from 1 m to 32 m). These results should alert physicians to the difficulties of a clinical diagnosis of an infection that causes neurological complications after discharge in a significant number of children. RT-qPCR's etiological diagnosis of DENV infection enabled better clinical follow-up for early intervention in children with neurological complications.
Assuntos
Vírus da Dengue , Dengue , Criança , Dengue/complicações , Dengue/diagnóstico , Seguimentos , Humanos , Imunoglobulina M , Estudos ProspectivosRESUMO
We evaluated neurologic complications following noncongenital Zika virus infection in 11 children who presented with central nervous system signs. Zika virus RNA was detected by real-time reverse transcription-polymerase chain reaction in cerebrospinal fluid. Approximately one-quarter of patients required antiepileptic medication in follow-up, and 2 children progressed to learning difficulties or developmental delay.