Screening for Mutations in Hereditary Cancer Susceptibility Genes in a Region with High Endogamy in Brazil.

Introduction Cancer is a multifactorial disease dependent on the influence of genetic and environmental factors. About 10% of cancers are associated with germline mutations, which predispose to a higher risk of developing cancer. Currently, the use of panels that identify susceptibility and/or association genes cancer has been increasingly used, both in clinical practice and in scientific research. Objective To investigate genetic mutations in patients with a profile for hereditary cancer in individuals from a region of northeast Brazil, where there is a high frequency of endogenous and consanguineous marriages. Methods A set of 17 genes ( BRCA1 , BRCA2 , APC , TP53 , PTEN , RET , VHL , RB1 , CDKN2 , CDH1 , CHEK2 , MLH1 , MSH2 , MSH6 , MUTYH , XPA , and XPC ) associated with cancer and hereditary syndromes were analyzed. Fifteen patients with a hereditary cancer profile were evaluated. Results The pathogenic variant found was c.1187G > A (p.Gly396Asp), rs36053993 in the MUTYH gene in a male patient diagnosed with melanoma at the age of 43 years and a family history for this tumor. This gene encodes an important enzyme related to DNA repair and has been associated with other types of cancer, this is the first report of an association with melanoma, the biological plausibility of this association is given once the MUTYH protein is expressed in the skin tissue and is responsible for repairing damage caused, for example, by sun exposure. Conclusion The results of this study suggest that this mutation may be important for the hereditary predisposition to melanoma, but a broader investigation of this mutation is needed.

Content validity of the Post-Stroke Guidance and Follow-up Booklet.

OBJECTIVES: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. METHODS: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. RESULTS: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges' suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. CONCLUSIONS: the booklet presented satisfactory content validity sources of evidence.

Comparison of Physical and Chemical Properties of Green and Brown Brazilian Propolis Collected in Minas Gerais, Brazil.

Among the 13 types of propolis classified in Brazil according to their physicochemical properties, green propolis and brown propolis are the most commonly found and used. In this work, a comparison of the physicochemical properties of green and brown propolis produced in Minas Gerais, Brazil was performed according to the methodology established by the Brazilian legislation. And, the content of 9 bioactive compounds in the samples was determined by RP-HPLC. GrProp showed a higher content of pinocembrin, artepillin C and baccharin, and a higher quantity of total flavonoids, in comparison with BrwProp. The mechanical mass content in both types of propolis was above the limit established by legislation. However, the other physicochemical parameters were within the limits. The chemical composition, especially the flavonoid content and the free radical (DPPH) scavenger property confer to both types of propolis a promising pharmacological activity.

Clinical perspective in relation to age in patients treated with thrombectomy for anterior circulation stroke in a stroke center in Colombia.

BACKGROUND AND AIMS: Endovascular treatment for cerebrovascular disease is accepted as a first-line option with level I evidence in patients with an early and late time of window of onset symptoms, and an additional option in patients who do not respond or with contraindications to systemic thrombolysis; nevertheless the efficacy and outcomes of some groups were not clear, one of them are patients aged 80 years and older, because they were excluded of the trials, so the evidence is controversial with significant heterogeneity, for that reason in our study, we decided to analyze the age in the patients treated in our stroke center, as a predictor of prognosis, and to provide a baseline for the establishment of personalized treatment plans. METHODS: Observational, retrospective study of patients that received endovascular treatment for cerebrovascular disease in a Colombian stroke center between 2016 and 2020, continuous and categorical variables were compared using the Student's t test and Chi-Square. To determine cut-off points in the variable against death and Rankin score variable on 90th day. RESULTS: In total, 108 patients were recruited, 35 of them were of 80 or more years, and the mean age was 72.7 years, we found age as a significant variable to predict the risk in the population over 80 years of age [RR 3.37 CI (95% 1.14-103) p = 0.029]. CONCLUSIONS: Age younger than 80 is a significant predictor for results and long-term outcomes in patients suffering from stroke, and in patients older than 80 years old a Thrombolysis in Cerebral Infarction score 2b-3 is a predictor of good outcomes. Further studies are needed to evaluate the relationship between intrahospital complications and long-term outcomes.

Content validity of the Post-Stroke Guidance and Follow-up Booklet / Validación de contenido del Cuaderno de Orientación y Seguimiento Post-Accidente Cerebrovascular / Validação de conteúdo da Caderneta de Orientação e Acompanhamento Pós-Acidente Vascular Cerebral

ABSTRACT Objectives: to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet. Methods: a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered. Results: of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges' suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97. Conclusions: the booklet presented satisfactory content validity sources of evidence.

RESUMEN Objetivos: proporcionar fuentes de evidencia de validación de contenido para el Manual de Orientación y Seguimiento Post-Accidentes Cerebrovascular. Métodos: abordaje cuantitativo-cualitativo, utilizando dos rondas del método Delphi y análisis de contenido. El Instrumento de Validación de Contenido de Educación en Salud fue enviado a 53 jueces independientes. Se consideró un Índice de Validez de Contenido superior a 0,90. Resultados: de los 14 enfermeros que participaron, el 64,3% tiene experiencia en el cuidado del ictus, el 35,7% en la atención primaria y el 64,3% en la producción de material educativo. En el análisis de contenido, las sugerencias de los jueces fueron estratificadas en cuatro categorías: conformación, objetividad, precisión y percepción del material. Se realizaron cambios ortográficos a las imágenes, adición de escala de funcionalidad, adecuación de términos técnicos y lenguaje. El Índice de Validez de Contenido en la segunda ronda mostró una concordancia de 0,97. Conclusiones: la cartilla presentó fuentes de evidencia de validez de contenido satisfactorias.

RESUMO Objetivos: prover fontes de evidências de validação de conteúdo para a Caderneta de Orientação e Acompanhamento Pós-Acidente Vascular Cerebral. Métodos: abordagem quanti-qualitativa, utilizando duas rodadas do método Delphi e análise de conteúdo. O Instrumento de Validação de Conteúdo Educativo em Saúde foi enviado para 53 juízes independentes. Considerou-se um Índice de Validade de Conteúdo acima de 0,90. Resultados: dos 14 enfermeiros que participaram, 64,3% têm experiência com atendimento a Acidente Vascular Cerebral, 35,7% com atenção primária e 64,3% com produção de material educativo. Na análise de conteúdo, as sugestões dos juízes foram estratificadas em quatro categorias: conformação, objetividade, precisão e percepção do material. Foram realizadas alterações ortográficas nas imagens, adição de escala de funcionalidade, adequação de termos técnicos e linguagem. O Índice de Validade de Conteúdo na segunda rodada demonstrou concordância de 0,97. Conclusões: a caderneta apresentou fontes de evidências de validade de conteúdo satisfatórias.

Negative impacts of the administration of hydroxycloroquine and anticoagulant in patients with SARS-COV-2 infection: a randomized clinical trial / Impactos negativos da administração de hidroxicloroquina e anticoagulante em pacientes com infecção por SARS-COV-2: um ensaio clínico randomizado

Purpose: To evaluate antimalarial with or without anticoagulant treatment, in patients with recent SARS-COV-2 infection. Methods: Clinical study carried out at Samuel Libânio Clinic Hospital, University of Vale do Sapucaí, Pouso Alegre-MG. Approved by the Ethics Committee (4.034.077) and registered in the Clinical Trials (NCT04788355). Suspected patients for COVID-19 were included in the emergency room. The groups were: C (control) with 6 patients, A (anticoagulant apixaban) with 9 patients, H (hydroxychloroquine) with 5 patients and HA (hydroxychloroquine and anticoagulant apixaban) with 8 patients. Results: there were no significant differences between groups. The HA group, in which there was an intervention with two drugs, presented a greater number of days with symptoms (p = 0.037) and worse results, when compared to the control: most relevant symptoms, were: cough (p = 0.001), and anosmia / ageusia (p = 0.011) headache (p = 0.001). Conclusion: The present study began when there were doubts about the use of drugs such as Hydroxychloroquine (HCQ) and apixaban (APX). The reduced "n" was defined through bureaucratic and polemic issues independent of the authors' actions. No clinical benefit was associated with HCQ and APX. There was an increase in the number of symptomatic days when HCQ and APX were administered. Despite the limitations, there was no therapeutic indication of the evaluated drugs. [au]

Objetivo: Avaliar antimalárico com ou sem tratamento anticoagulante, em pacientes com infecção recente por SARS-COV-2. Métodos: Estudo clínico realizado no Hospital das Clínicas Samuel Libânio da Universidade do Vale do Sapucaí, Pouso Alegre-MG. Aprovado pelo Comitê de Ética (4.034.077) e registrado nos Ensaios Clínicos (NCT04788355). Pacientes suspeitos de COVID-19 foram incluídos na sala de emergência. Os grupos foram: C (controle) com 6 pacientes, A (anticoagulante apixabana) com 9 pacientes, H (hidroxicloroquina) com 5 pacientes e HA (hidroxicloroquina e anticoagulante apixabana) com 8 pacientes. Resultados: não houve diferenças significativas entre os grupos. O grupo HA, no qual houve intervenção com dois medicamentos, apresentou maior número de dias com sintomas (p = 0,037) e piores resultados, quando comparado ao controle: os sintomas mais relevantes foram: tosse (p = 0,001), e anosmia/ageusia (p = 0,011) cefaléia (p = 0,001). Conclusão: O presente estudo teve início quando havia dúvidas sobre o uso de medicamentos como hidroxicloroquina (HCQ) e apixabana (APX). O "n" reduzido foi definido por meio de questões burocráticas e polêmicas independentes das ações dos autores. Nenhum benefício clínico foi associado com HCQ e APX. Houve um aumento no número de dias sintomáticos quando HCQ e APX foram administrados. Apesar das limitações, não houve indicação terapêutica dos medicamentos avaliados. [au]

Identification of LOC101927355 as a Novel Biomarker for Preeclampsia.

Preeclampsia, a disorder with a heterogeneous physiopathology, can be attributed to maternal, fetal, and/or placental factors. Long non-coding RNAs (lncRNAs) refer to a class of non-coding RNAs, the essential regulators of biological processes; their differential expression has been associated with the pathogenesis of multiple diseases. The study aimed to identify lncRNAs, expressed in the placentas and plasma of patients who presented with preeclampsia, as potential putative biomarkers of the disease. In silico analysis was performed to determine lncRNAs differentially expressed in the placentas of patients with preeclampsia, using a previously published RNA-Seq dataset. Seven placentas and maternal plasma samples collected at delivery from preterm preeclamptic patients (≤37 gestational weeks of gestation), and controls were used to validate the expression of lncRNAs by qRT-PCR. Six lncRNAs were validated and differentially expressed (p < 0.05) in the preeclampsia and control placentas: UCA1 and HCG4 were found upregulated, and LOC101927355, LINC00551, PART1, and NRAD1 downregulated. Two of these lncRNAs, HCG4 and LOC101927355, were also detected in maternal plasma, the latter showing a significant decrease (p = 0.03) in preeclamptic patients compared to the control group. In silico analyses showed the cytoplasmic location of LOC101927355, which suggests a role in post-transcriptional gene regulation. The detection of LOC101927355 in the placenta and plasma opens new possibilities for understanding the pathogenesis of preeclampsia and for its potential use as a biomarker.

Anjos da Guarda: ferramenta para o ensino médico / Anjos Da Guarda (Guardian Angels): Medical Teaching Tool

Resumo A verdadeira medicina combina conhecimento biotecnocientífico ao cuidado. No entanto, as escolas médicas têm dado maior ênfase ao conhecimento científico em detrimento da relação médico-paciente. Objetivos: Este relato tem como objetivo descrever a experiência de imersão vivida por quatro estudantes de medicina do sexto período nos meses de fevereiro e março de 2020. Método: Tal imersão deu-se em um projeto de ensino denominado Anjos da Guarda, o qual é usado como ferramenta de educação médica no Hospital Universitário Gaffrée e Guinle da Universidade Federal do Estado do Rio de Janeiro (HUGG-UNIRIO). Resultados: O Projeto Anjos da Guarda desenvolve o profissionalismo médico, a empatia e os fundamentos da medicina centrados na pessoa do paciente como parte do processo de cuidado, sem menosprezar a importância do conhecimento biotecnocientífico e do raciocínio clínico. Conclusão: A experiência possibilitou ganhos em aprendizado para os estudantes, além de contribuir com o sistema de saúde e de beneficiar os pacientes envolvidos.

Abstract Conventional medicine combines biotechnoscientific knowledge with care. However, medical schools have placed greater emphasis on scientific knowledge to the detriment of the doctor-patient relationship. Objectives: This report aims to describe the immersion experience lived by four sixth-term medical students during the months of February and March 2020. Method: Such immersion took place in a teaching project named Anjos da Guarda, which is used as a medical education tool at the Gaffrée e Guinle University Hospital of the Federal University of the State of Rio de Janeiro (HUGG-UNIRIO). Results: The Anjos da Guarda Project develops medical professionalism, empathy and the fundamentals of medicine centered on the patient as part of the care process, without underestimating the importance of biotechnoscientific knowledge and clinical reasoning. Conclusion: The experience enabled gains in learning for students, in addition to contributing to the health system and benefiting the patients involved.

Improving Health Professions Students' Understanding of Interprofessional Roles Through Participation in a Patient Stabilization Simulation.

Objective. To teach interprofessional communication and teamwork skills to health professions students through a standardized patient simulation on acute patient stabilization and measure the impact on learners' perceptions of interprofessional collaboration.Methods. Medical and pharmacy students in their final year and post-licensure nurses in their initial six-month probationary period worked together to stabilize a simulated acutely ill standardized patient. Perceptions of IPE were assessed pre- and post-simulation using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Medical student participants' scores were compared to those of a concurrently enrolled cohort of medical students who did not participate in the simulation.Results. Eighty learners participated in the simulation and all completed pre and post SPICE-R2 assessments. Learners' perceptions increased significantly in all domains, including understanding of roles in collaborative practice, interprofessional teamwork and team-based practice, and patient outcomes from collaborative practice. Compared to the control cohort, participants' perceptions of team-based practice and the impact on patient outcomes improved significantly, while a statistically similar improvement in scores for understanding of roles and responsibilities was seen. The SPICE-R2 scores increased similarly among students in each profession. Repeat exposure to the simulation continued to improve perceptions but not as robustly as the initial simulation.Conclusion. This simulation changed learners' perceptions of how interprofessional collaboration affects patient care, which supports the incorporation of standardized patient-based interprofessional education even in the late-stage education of health professionals.

COVID-19 y embarazo: caso clínico de presentación crítica, inflamación placentaria y transmisión vertical fetal demostrada / COVID-19 and pregnancy: clinical case of critical presentation, placental inflammation and demonstrated fetal vertical transmission

ANTECEDENTES: La pandemia global de COVID-19 llega al continente americano en marzo del año 2020 y en menos de dos meses reúne a más de la mitad de los casos a nivel global. OBJETIVO: Caso clínico de una mujer embarazada con una presentación crítica de COVID-19 y embarazo a las 25 semanas de gestación, en el contexto del peak de la pandemia en Chile en el otoño del año 2020. CASO CLÍNICO: El 20 de junio de 2020, una mujer de 34 años, con 25 semanas de embarazo, es trasladada desde Hospital de San Bernardo a Clínica Las Condes en Santiago, Chile, con un cuadro de 10 días de evolución de COVID-19, que evoluciona a una situación crítica con insuficiencia respiratoria severa. Ingresa a unidad de cuidados intensivos para ventilación mecánica. Las imágenes de radiología simple y de tomografía axial computarizada de tórax demuestran una neumopatía bilateral con imágenes características opacidades en vidrio esmerilado, asociado a engrosamiento intersticial, imágenes descritas previamente como características para COVID-19. La paciente permanece en unidad de cuidados intensivos en ventilación mecánica por siete días, con evolución favorable posterior, mejoría del cuadro séptico y alta después de 22 días de hospitalización. El parto ocurre en forma espontánea a las 38 semanas, la madre y el recién nacido evolucionan en buen estado general. El examen histopatológico placentario demuestra compromiso inflamatorio vellositario y los exámenes de anticuerpos en sangre del recién nacido demuestran la presencia de anticuerpos del tipo IgG e IgM. Se trata de uno de los pocos casos demostrados reportados de transmisión transplacentaria vía sanguínea de SARS-CoV-2 de la madre al recién nacido.

BACKGROUND: The global COVID-19 pandemic reaches the American continent in March 2020 and in less than two months it brings together more than half of the cases globally.OBJECTIVE: The clinical case of a 25-week pregnant woman with a critical presentation of COVID-19 and pregnancy at 25 weeks of gestation, is presented in the context of the peak of the pandemic in Chile in the fall of 2020. CLINICAL CASE: On June 20, 2020, a 34-year-old woman, 25 weeks pregnant, is transferred from Hospital de San Bernardo to Clinica Las Condes in Santiago, Chile, with a ten-day evolution of a COVID-19 that evolves to critical with severe respiratory failure. She is admitted to the intensive care unit for mechanical ventilation. Chest computerized axial tomography images demonstrate bilateral pneumopathy with characteristic images of ground-glass opacities, associated with interstitial thickening, images previously described as characteristics for COVID-19. The patient remains in the intensive care unit on mechanical ventilation for seven days, with subsequent favorable evolution, improvement of the septic condition, and discharge after 22 days of hospitalization. Delivery occurs at 38 weeks, the mother and the newborn evolve in good general condition. The placental histopathological examination demonstrates villous inflammatory involvement, and the newborn's blood tests show the presence of IgG and IgM antibodies. It is one of the few reported cases of transplacental transmission of SARS-CoV-2 from the mother to the newborn.

Salud adolescente y pandemia en Tucumán / Adolescent health and pandemic in Tucumán

INTRODUCCION La crisis sanitaria por COVID-19 ha impactado en la salud mental y en la seguridad alimentaria de la población, particularmente en los adolescentes. OBJETIVO Analizar la relación entre estado nutricional, presencia de síntomas psicológicos y habilidades sociales en adolescentes escolarizados de la provincia de Tucumán, considerando edad, sexo, NSE y NSA. MÉTODO estudio descriptivo y correlacional, muestreo no probabilístico intencional. Participaron 262 adolescentes (12 a 18 años), de escuelas secundarias públicas de Yerba Buena y Concepción. Se administró a) Escala MESSY de Habilidades Sociales, b) Escalas clínicas de Inventario de Personalidad para Adolescentes (PAI-A), c) Encuesta nutricional, estilo de vida, socioeconómico y ambiental, d) Encuesta sociodemográfica, e) mediciones antropométricas individuales. RESULTADOS 43% presentaba un NSE bajo y 20% menor NSA, relacionándose estas variables (x2=7.66 p=0.00). El 18% registraba obesidad y 14,5% de RCV, con mayor incidencia entre los adolescentes de menor edad (12 a 14 años). Se halló 14.5% de RCV y 36% de RCM. Las mujeres referían más síntomas depresivos, ansiosos y psicosomáticos comparados con sus pares varones. El NSE se relacionó con preocupaciones hipocondriacas y el menor NSA con déficits sociales para hacer amistades como la expresividad emocional y social. Los adolescentes con sobrepeso y obesidad referían más quejas somáticas. DISCUSIÓN Se destaca el papel de la precariedad socioambiental y socioeconómica en la salud adolescente la variabilidad del estado nutricional antropométrico, la presencia de síntomas psicológicos y déficits sociales que permitan una expresión adecuada de sentimientos, derechos y modos de afrontar las situaciones. Se pone en evidencia la necesidad de llevar a cabo intervenciones en salud integral adolescente, considerando sus heterogeneidades históricas, sociales, económicas, geográficas y alimentarias.

Increased Circulating Levels of Tissue-Type Plasminogen Activator Are Associated with the Risk of Spontaneous Abortion During the First Trimester of Pregnancy.

Spontaneous abortion is a common complication in early pregnancy, with an incidence of around 20%. Ultrasound scan and measurement of human chorionic gonadotropin are used to identify patients at risk of spontaneous abortion; however, there is a clinical need to find new biomarkers to prospectively identify patients before the onset of clinical symptoms. Here, we aim to investigate potential biomarkers of spontaneous abortion taken in the first clinical appointment of pregnancy. A case-control study was conducted based on a prospectively collected cohort in which cases and controls were retrospectively stratified based on pregnancy outcome: normal healthy pregnancies (controls = 33) and pregnancies that ended in spontaneous abortion (cases = 10). We evaluated extracellular vesicles isolated by precipitation with ExoQuick™ and protein concentrations of tissue plasminogen activator, leptin, and adiponectin measured by ELISA. The extracellular vesicles showed the typical morphology and membrane proteins: CD63, Alix, and Flotilin-1. The size distributions of the isolated extracellular vesicles were 112 ± 27 and 118 ± 28 nm in diameter for controls and spontaneous abortion, respectively, and the total amount of extracellular vesicles did not show any difference between controls and the spontaneous abortion group. The tissue plasminogen activator showed a significant difference (p = 0.0004) between both groups, although neither adiponectin nor leptin revealed significant changes, indicating that women who had spontaneous abortions have significantly higher levels of tissue plasminogen activator than women who had normal pregnancies.

The Effect of Leadership Interventions on Staff Nurse Job Enjoyment and Leadership Perception.

Nurse managers (NMs) influence retention and job satisfaction, although many facilities lack NM training programs. A program examined staff nurse perceptions after their NMs participated in leadership training. NMs with limited training may find it more challenging to positively affect their nurses' job satisfaction and retention. This program evaluation suggests that nurse executive investment in and support of the NM role yield positive benefits for the NM leader and their staff.

First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study.

Objectives To evaluate the first trimester maternal biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM). Methods The study was a case-control study of healthy women with singleton pregnancies at the first trimester carried out at the Obstetrics and Gynecology Unit, Clinica Davila, Santiago, Chile. After obtaining informed consent, peripheral blood samples of pregnant women under 14 weeks of gestation were collected. At 24-28 weeks of pregnancy, women were classified as GDM (n=16) or controls (n=80) based on the results of a 75-g oral glucose tolerance test (OGTT). In all women, we measured concentrations of fasting blood glucose, insulin, glycated hemoglobin, uric acid, cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), triglycerides, aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), sex hormone-binding globulin (SHBG), adiponectin, tissue plasminogen activator (t-PA), leptin and placental growth factor (PGF). Results The GDM group displayed an increased median concentration of cholesterol (P=0.04), triglycerides (P=0.003), insulin (P=0.003), t-PA (P=0.0088) and homeostatic model assessment (HOMA) (P=0.003) and an increased mean concentration of LDL (P=0.009) when compared to the control group. The receiver operating characteristic (ROC) curve for significant variables achieved an area under the curve (AUC) of 0.870, a sensitivity of 81.4% and a specificity of 80.0%. The OGTT was positive for GDM according to the IADPSG (International Diabetes in Pregnancy Study Group) criteria. Conclusion Women who subsequently developed GDM showed higher levels of blood-borne biomarkers during the first trimester, compared to women who did not develop GDM. These data warrant validation in a larger cohort.

Estado nutricional e comportamento alimentar em trabalhadores em turnos / Nutritional condition and food behavior in shift workers

Objetivo: sistematizar o conhecimento acerca dos efeitos do trabalho em turnos no estado nutricional e comportamento alimentar em trabalhadores em turnos. Método: trata-se de um estudo bibliográfico, tipo revisão Integrativa da literatura, com coleta em dupla nas bases de dados MEDLINE, Web of Science e Science Direct aplicando-se os descritores controlados em saúde: "Shift Work Schedule" and "Nutritional Status" and "Feeding Behavior", para trabalhos publicados entre 2014 e 2019. Resultados: encontraram-se seis artigos e se verificou a associação entre trabalho em turnos, sobrepeso/obesidade e hábitos alimentares inadequados. Conclusão: concluiu-se que o excesso de peso e o comportamento alimentar inadequado são fatores de risco para agravos à saúde, e ações de educação nutricional e higiene do sono durante a escala de trabalho são recomendadas para melhorar a qualidade de vida desses trabalhadores.(AU)

Objective: to systematize the knowledge about the effects of shift work on nutritional status and eating behavior in shift workers. Method: this is a bibliographic study, integrative literature review, with double collection in MEDLINE, Web of Science and Science Direct databases applying the controlled descriptors in health: "Shift Work Schedule" and "Nutritional Status" And "Food Behavior", for papers published between 2014 and 2019. Results: six articles were found and the association between shift work, overweight / obesity and inappropriate eating habits was found. Conclusion: it was concluded that overweight and inadequate eating behavior are risk factors for health problems, and nutrition education and sleep hygiene during the work schedule are recommended to improve the quality of life of these workers.(AU)

Objetivo: sistematizar el conocimiento sobre los efectos del trabajo por turnos sobre el estado nutricional y el comportamiento alimentario en los trabajadores por turnos. Método: este es un estudio bibliográfico, tipo de revisión de literatura integradora, con doble recolección en las bases de datos MEDLINE, Web of Science y Science Direct que aplican los descriptores controlados en salud: "Shift Work Schedule" y "Nutritional Status" y "Feeding Behavior", para artículos publicados entre 2014 y 2019. Resultados: se encontraron seis artículos y se encontró la asociación entre el trabajo por turnos, el sobrepeso / obesidad y los hábitos alimenticios inapropiados. Conclusión: se concluyó que el sobrepeso y el comportamiento alimentario inadecuado son factores de riesgo para problemas de salud, y se recomienda la educación nutricional y las acciones de higiene del sueño durante la escala de trabajo para mejorar la calidad de vida de estos trabajadores.(AU)

Accidentes con material biológico en trabajadores de la salud. Palmira-Valle del Cauca. 2014-2016 / Accidents with biological material in health workers. Palmira-Valle del Cauca. 2014-2016 / Acidentes com material biológico em trabalhadores da saúde, Palmira,Valle del Cauca (2014-2016)

Introducción: Los profesionales sanitarios están expuestos diariamente a diferentes riesgos biológicos generados por su ambiente laboral. Objetivo: Describir el perfi l de los accidentes laborales por riesgo biológico en una institución de salud de segundo nivel de complejidad. Palmira-Valle del Cauca. 2014-2016. Materiales y métodos: Estudio descriptivo, retrospectivo, realizado con 37 reportes. A las variables cuantitativas se les calcularon medidas de tendencia central y dispersión y a las cualitativas proporciones y razones. Para analizar la relación entre variables se usaron los Test del Chi cuadrado, Fisher o Medianas de acuerdo a la distribución de los datos, considerando un valor de p≤0,05 como signifi cante. Resultados: La mayoría de los trabajadores accidentados fueron mujeres jóvenes, principalmente enfermeras auxiliares las cuales fueron lesionadas por elementos punzantes (agujas) durante los turnos matutinos y en los servicios de mayor demanda (urgencias y hospitalización). El 89 % de los trabajadores expuestos al riesgo biológico no utilizaron materiales o equipos de seguridad al momento del accidente. Las causas frecuentes fueron la manipulación de agujas y los movimientos del paciente al realizar procedimientos asistenciales. Las manos fueron el área más afectada. Conclusiones: El elemento vulnerante, el sitio de la lesión, el servicio, la edad del trabajador, el turno y el cargo en la institución prestadora de servicios de salud, determinaron el perfi l de los accidentes de trabajo, que registraron el mayor número de accidentes laborales con exposición a riesgo biológico; las causas más frecuentes se asociaron con la manipulación de elementos punzantes cuando la asistente atiende al paciente.

Introduction: Sanitary professionals are exposed daily to different biological risks generated by their work environment Objective: Describe the profile of work accidents caused by biological risks in a secondary level health care institution. Palmira-Valle del Cauca. 2014-2016. Materials and methods: Descriptive, retrospective study performed with 37 reports. For the quantitative variables, central tendency and dispersion were calculated, and for the qualitative variables, proportions and ratios. To analyze the relation between variables the Pearson's chi-squared test, fisher or the median were used according to the distribution of data, considering a value of p≤0,05 as significant. Results: Most of the workers injured were young women, mainly auxiliary nurses which were injured by sharps (needles) during morning shifts and in services of greater demand (emergencies and hospitalization). 89% of the workers exposed to biological risk did not use safety materials or equipment at the moment of the accident. The frequent causes were needle manipulation and movements of the patient when performing assistant procedures. Hands were the most affected area. Conclusions: The object that caused the accident, the place of the injury, the service, the age of the worker, the shift and the charge in the health care service institution, determined the profile of the work accidents which registered the greatest number of work accidents with exposure to biological risks; the most frequent causes were associated to the manipulation of sharp objects when the assistant or nurse attends the patient.

Introdução: Os professionais sanitários estão expostos diariamente a diferentes riscos biológicos gerados por seu ambiente de trabalho. Objetivo: Descrever o perfil dos acidentes no trabalho por risco biológico numa instituição de saúde de segundo nível de complexidade, na cidade de Palmira, Valle del Cauca, Colômbia (2014-2016). Materiais e Métodos: Estudo descritivo, retrospectivo, realizado com 37 relatórios. Às variáveis quantitativas se lhes calcularam medidas de tendência central e dispersão e às qualitativas proporções e razões. Para analisar a relação entre variáveis se usaram os Teste do Qui-quadrado, Fisher ou Medianas de acordo à distribuição dos dados, considerando um valor de p≤0,05 como significativo. Resultados: A maioria dos trabalhadores acidentados foram mulheres jovens, principalmente auxiliares de enfermagem as quais foram lesionadas por elementos perfurocortantes (agulhas) durante os turnos da manhã e nos serviços de maior demanda (emergências e hospitalização). O 89 % dos trabalhadores expostos ao risco biológico não utilizaram materiais ou equipamentos de segurança ao momento do acidente. As causas frequentes foram a manipulação de agulhas e os movimentos do paciente ao realizar procedimentos de cuidados de saúde. As mãos foram a área mais afeitada. Conclusões: O elemento vulnerável, o local da lesão, o serviço, a idade do trabalhador, o turno e o cargo na instituição fornecedora de serviços de saúde; determinaram o perfil dos acidentes no trabalho que registraram o maior número de acidentes com exposição a risco biológico; as causas mais frequentes se associaram com a manipulação de elementos pontiagudos quando a auxiliar de enfermagem cuidava do paciente

Avaliação dos afastamentos dos servidores públicos estaduais de Santa Catarina no período de 2010 a 2018 / Assessment of absences of state public servants in Santa Catarina from 2010 to 2018

O absenteísmo no trabalho manifesta-se de várias formas, sendo a Licença para Tratamento de Saúde o benefício mais concedido a servidores públicos estaduais catarinenses lotados na Secretaria da Saúde. O objetivo do estudo foi analisar causas destes afastamentos e a justificativa está na necessidade de maior entendimento destes dados/razões visando buscar nas políticas de prevenção a acidentes/adoecimento no ambiente laboral, maneiras de intervenção. A pesquisa é quantitativa, de caráter ecológico, exploratória em séries temporais. Os dados coletados no banco estadual SIGRH/SEA e tabulados no Programa Statistical Package for the Social Sciences (SPSS), versão 22.0 para Windows indicam que servidores em licença são na maioria mulheres, 40-49 anos, cor branca, casados, com curso profissionalizante. Os capítulos CID 10, V ­ Transtornos Mentais e Comportamentais; XXI - Fatores que influenciam o estado de saúde e o contato com os serviços de saúde e; XIII ­ Doenças do Sistema Osteomuscular e do tecido conjuntivo apresentem mais afastamentos. Enfermagem e serviços gerais representam 51% dos afastamentos da amostra. Comparando o estudo a outros na mesma perspectiva, observa-se forte correlação adoecimento-trabalho e demonstram a necessidade e relevância de estudos/ações relativos à saúde do servidor público catarinense. Resumo outro idioma

The absenteeism in the work manifests itself in several ways, being the License for Health Treatment the most benefit granted to state public servants of Santa Catarina. the purpose of the study was to analyze the causes of these withdrawals and the justification is the need for a better understanding of these data / reasons aiming to seek in the policies of prevention to accidents / sickness in the work environment, ways of intervention. The research is quantitative, of ecological character, exploratory in time series. The data collected in the SIGRH / SEA state bank and tabulated in the Statistical Package for the Social Sciences (SPSS), version 22.0 for Windows indicate that licence servers are mostly women, aged 40-49, white, married, with a vocational course. The chapters CID 10, V Mental and Behavioral Disorders; XXI - Factors that influence health status and contact with health services; XIII - Diseases of the Osteomuscular and Connective Tissue disorders present more absence. Nursing and general services account for 51% of departures from the sample. Comparing the study to others in the same perspective, it is observed strong correlation sickness work and demonstrate the need and relevance of studies / actions regarding the health of the public servant of Santa Catarina.

Placental Exosomes as Early Biomarker of Preeclampsia: Potential Role of Exosomal MicroRNAs Across Gestation.

Context: There is a need to develop strategies for early prediction of patients who will develop preeclampsia (PE) to establish preventive strategies to reduce the prevalence and severity of the disease and their associated complications. Objective: The objective of this study was to investigate whether exosomes and their microRNA cargo present in maternal circulation can be used as early biomarker for PE. Design, Setting, Patients, and Interventions: A retrospective stratified study design was used to quantify total exosomes and placenta-derived exosomes present in maternal plasma of normal (n = 32 per time point) and PE (n = 15 per time point) pregnancies. Exosomes present in maternal circulation were determined by nanoparticle tracking analysis. An Illumina TruSeq® Small RNA Library Prep Kit was used to construct a small RNA library from exosomal RNA obtained from plasma samples. Results: In presymptomatic women, who subsequently developed PE, the concentration of total exosomes and placenta-derived exosomes in maternal plasma was significantly greater than those observed in controls, throughout pregnancy. The area under the receiver operating characteristic curves for total exosome and placenta-derived exosome concentrations were 0.745 ± 0.094 and 0.829 ± 0.077, respectively. In total, over 300 microRNAs were identified in exosomes across gestation, where hsa-miR-486-1-5p and hsa-miR-486-2-5p were identified as the candidate microRNAs. Conclusions: Although the role of exosomes during PE remains to be fully elucidated, we suggest that the concentration and content of exosomes may be of diagnostic utility for women at risk for developing PE.

Percepção de portadores atendidos na Estratégia Saúde da Família sobre diabetes mellitus tipo 2 / Perception of carriers cared for at the Family Health Strategy, about diabetes mellitus type 2

Objetivo: conhecer a percepção do portador de diabetes mellitus tipo 2 atendidos na Estratégia Saúde daFamília. Método: estudo descritivo, realizado com dez diabéticos escolhidos aleatoriamente durante o seuacompanhamento. A coleta de dados ocorreu por meio de um roteiro de entrevista semiestruturado, e osdados foram analisados de forma descritiva pela apresentação de categorias analíticas: Estilo de vida;Atividades Educativas sobre Diabetes Mellitus; Conhecimento sobre Diabetes Mellitus, Complicações doDiabetes Mellitus, Cuidados com o Diabetes Mellitus e Visão sobre a assistência de Enfermagem prestada.Resultados: os portadores de diabetes referiram contentamento na consulta de rotina, por receberem amedicação. Puderam-se observar a deficiência do conhecimento sobre sua doença e a carência de atividadesde educação em saúde nesse público. Conclusão: verificou-se deficiência de atividades educativas, bem comonecessidade da promoção do autocuidado, visando à melhor qualidade de vida a fim de aumentar aautoestima do portador da doença estudada.