Incidência de complicações durante os anos iniciais de formação de um serviço de fissuras labiopalatinas / Incidence of complications during the initial years of formation of a cleft lip and palate service

Introdução: A fissura labiopalatina é a malformação congênita craniofacial mais comum. Dificuldades na alimentação, fala e audição são comuns nestes pacientes, necessitando de tratamento multidisciplinar, o que dificulta a criação e manutenção de serviços especializados. A diversidade de classificações e o grande número de técnicas cirúrgicas utilizadas nas cirurgias primárias (queiloplastia e palatoplastia) dificultam a comparação de dados epidemiológicos e de complicações entre os serviços, existindo carência de estudos avaliando centros especializados em fissuras labiopalatinas recém-criados. Método: Foi realizado estudo do tipo coorte prospectiva com pacientes com diagnóstico de fissura labiopalatina submetidos a procedimentos cirúrgicos primários, no Hospital de Clínicas da Universidade Federal de Uberlândia, entre julho de 2017 e fevereiro de 2023. Foram incluídos pacientes menores de 18 anos com acompanhamento pós-operatório de pelo menos 3 meses. Resultados: Participaram do estudo 79 pacientes, que foram submetidos a 115 cirurgias primárias (54 queiloplastias e 61 palatoplastias). Foram relatadas 11 complicações neste período: 2 deiscências em queiloplastia (3,70%), 1 cicatriz hipertrófica em queiloplastia (1,85%), 6 fístulas em palatoplastia (9,83%) e 2 deiscências em palatoplastia (3,28%). A incidência de complicações foi de 9,56% quando analisado o total de cirurgias, sendo 5,55% nos pacientes submetidos a queiloplastia e 13,11% nos pacientes submetidos a palatoplastia. Conclusão: A incidência de complicações durante os anos iniciais de estruturação do serviço foi semelhante a outros estudos da literatura.

Introduction: Cleft lip and palate is the most common congenital craniofacial malformation. Difficulties in eating, speaking, and hearing are common in these patients, requiring multidisciplinary treatment, which makes it difficult to create and maintain specialized services. The diversity of classifications and the large number of surgical techniques used in primary surgeries (cheiloplasty and palatoplasty) make it difficult to compare epidemiological data and complications between services, and there is a lack of studies evaluating newly created specialized centers for cleft lip and palate. Method: A prospective cohort study was carried out with patients diagnosed with cleft lip and palate who underwent primary surgical procedures at the Hospital de Clínicas of the Universidade Federal de Uberlândia, between July 2017 and February 2023. Patients under 18 years of age with follow-up were included. post-operative period of at least 3 months. Results: 79 patients participated in the study, who underwent 115 primary surgeries (54 cheiloplasties and 61 palatoplasties). 11 complications were reported in this period: 2 dehiscences in cheiloplasty (3.70%), 1 hypertrophic scar in cheiloplasty (1.85%), 6 fistulas in palatoplasty (9.83%) and 2 dehiscences in palatoplasty (3.28%). The incidence of complications was 9.56% when analyzing the total number of surgeries, being 5.55% in patients undergoing cheiloplasty and 13.11% in patients undergoing palatoplasty. Conclusion: The incidence of complications during the initial years of structuring the service was similar to other studies in the literature.

FIRST REPORT OF CHEMICAL IMMOBILIZATION AND PHYSIOLOGICAL PARAMETERS FOR FREE-RANGING MANED SLOTH (BRADYPUS TORQUATUS), USING A COMBINATION OF KETAMINE AND MEDETOMIDINE.

The maned sloth (Bradypus torquatus) is an endemic and endangered species of two Brazilian states, with much unknown biological information needed to direct conservation actions. Other sloth species have been studied regarding anesthesia; however, there is a lack of anesthesia research for the maned sloth. Anesthetic data were collected from 12 free-range maned sloths that were immobilized for a field examination. Individuals were anesthetized using a combination of ketamine (4.0 mg/kg) and medetomidine (0.03 mg/kg), and antagonized with atipamezole (0.1 mg/kg). Time to induction and recovery were recorded and compared with sex and age classes. After the induction and until antagonist administration, physiological parameters (rectal temperature, heart rate, respiratory rate, and oxygen saturation) were recorded every 10 min during anesthesia and were statistically evaluated over time. Induction was fast (3.21 ± 0.76), but recovery was longer (113.3 ± 18) when compared to other studies. Induction and recovery times were not different across sex or age classes. Rectal temperature, heart rate, and oxygen saturation remained stable throughout the procedure. Respiratory rate significantly decreased over time, from 18.25 ± 7.03 to 13.17 ± 3.66 movements per minute. Our results indicate that the described combination of ketamine and medetomidine is a safe and effective choice for anesthesia of maned sloths.

Linear CT-scan measurements of cerebral ventricles in senile Poodle dogs.

Breed traits seem to influence the dimensions of the cerebral ventricles in dogs. The ratios between the ventricles and the brain are crucial diagnostic criteria for suspected canine cognitive dysfunction (CCD). This study aimed to establish linear computed tomography (CT)-scan measurements of the cerebral ventricles in 55 Poodle dogs aged >7 years. To this end, cross-sectional CT images were evaluated. The measurements in the whole sample were: height of the right ventricle, 6.0 ± 1.6 mm; height of the left ventricle, 5.8 ± 1.6 mm; width of the right ventricle, 6.9 ± 1.4 mm; width of the left ventricle, 7.0 ± 1.3 mm; height of the third ventricle, 3.4 ± 0.8 mm; height of the right cerebral hemisphere, 39.5 ± 2.0 mm; and height of the left cerebral hemisphere, 40.2 ± 2.6 mm. The average ventricular measurements were higher in dogs older than 11 years (p < 0.05). However, the average ratio of the ventricle height to the height of the brain did not reveal differences between age groups, sex, or antimeres. In addition, none of the images showed fused lateral ventricles. Thus, these data can assist in interpreting ventricle size in senile Poodle dogs (aged >7 years).

Características raciais parecem influenciar as dimensões dos ventrículos cerebrais em cães. As proporções entre os ventrículos e o cérebro são cruciais para os casos suspeitos de disfunção cognitiva canina (DCC). Este estudo objetivou estabelecer medidas lineares dos ventrículos cerebrais de 55 cães da raça Poodle com idade acima de sete anos. Para tal, foram avaliadas imagens de cortes transversais obtidas por tomografia computadorizada. As medidas na amostragem total foram: altura do ventrículo direito 6,0 ± 1,6 mm, altura do ventrículo esquerdo 5,8 ± 1,6 mm, largura do ventrículo direito 6,9 ± 1,4 mm, largura do ventrículo esquerdo 7.0 ± 1,3 mm, altura do terceiro ventrículo 3,4 ± 0,8 mm, altura do hemisfério cerebral direito 39,5 ± 2,0 mm e altura do hemisfério cerebral esquerdo 40,2 ± 2,6 mm. As médias das medidas ventriculares foram maiores em cães acima de 11 anos de idade (p < 0,05). Contudo, a relação entre altura ventricular e altura cerebral não revelou diferenças entre grupos etários, sexo ou antímeros. Além disso, nenhuma imagem revelou ventrículos fusionados. Assim, os dados do presente estudo podem auxiliar na interpretação das dimensões ventriculares em cães da raça Poodle acima dos sete anos de idade.

Low Occurrence of Salmonella spp. in Wild Animals in Bahia, Brazil-Population Assessment and Characterization in the Caatinga and Atlantic Forest Biomes.

Salmonella spp. are known to persist in the environment. Wild animals are believed to act as important reservoirs, with antimicrobial resistance frequently occurring in the environment. However, little is known about the role of the wildlife in Bahia as a reservoir for Salmonella in Brazil. This study aimed to isolate and characterize Salmonella spp. from wildlife in the Atlantic Forest and Caatinga biomes considering indicators such as the animal species, degree of anthropization, sampling area, and feeding habits. Convenience wildlife sampling and characterization were conducted, followed by microbiological and molecular identification of Salmonella isolates, serotyping, and antimicrobial susceptibility testing. A total of 674 fecal samples were collected from 12 municipalities during 2015-2021, and 4 were positive for the following Salmonella species: Salmonella enterica subspecies enterica serovar Agona (n = 1), Salmonella enterica subsp. enterica serogroup O:16 (n = 2), and Salmonella enterica subsp. enterica serovar Muenchen (n = 1). Antimicrobial susceptibility analysis revealed that one isolate was resistant to six antibiotics, including extended-spectrum penicillins and beta-lactamase inhibitors. These results indicated a low frequency of Salmonella spp. in the sampled forest fragments. The presence of Salmonella in wild animals increases the risk to public health and biodiversity and indicates that they can act as sentinels of environmental contamination or indicators of preservation.

Socket regeneration after immediate loading implants with tissue and bone graft: 1-year clinical follow-up

Evaluation of ridge alteration after 1 year follow up after immediate loading implant placement. Methods: Ten patients were included in the study, in whom the ridge volume, height, and thickness were evaluated from region of interest (ROI) of tomographic images of the operated areas (test group) and compared to the opposite tooth (control group). Results: After one year, there was no implant loss and all patients were satisfied with the treatment. In the test group there was a statistically significant increase in ridge height (2.89±1.05 mm) when compared to the control group. No significant difference in relation to ridge volume and thickness was observed. In the intragroup evaluation, a significant gain in ridge height (2.65±3.08 mm) was observed when compared to baseline. Conclusion: The placement of an immediate implant, temporary crown, and tissue regeneration in sockets with buccal defects promotes the regeneration of the buccal wall while preventing the reduction of bone volume and thickness

Mobile Application Model for Supporting in Wound Treatment.

OBJECTIVE: This article presents a mobile application model for the treatment tracking of in-hospital wounds. METHODS: A survey of the literature on mobile apps for wound monitoring was carried out. Health professionals were interviewed and wound forms were analyzed to synthesize the application's fields and features. We designed the application model using a prototyping tool. RESULTS: The prototype features interfaces for patient evaluation, different functionalities according to the role of the health professional, a dashboard for monitoring the open admissions, selection of wound locations using a body model, treatment prescribing, tracking the wounds using photos, and generating wound reports. CONCLUSION: The adoption of this application could optimize wounds' treatment, increase patient safety, reduce material expenditures and time for professionals with rework in the dressing procedure.

Sloth's giant tick (Amblyomma varium) parasitizing free-ranging maned sloth (Bradypus torquatus) in the Atlantic Forest biome, Brazil.

Amblyomma varium is a neotropical tick popularly known as the sloth's giant tick, during the adult stage is found almost exclusively on mammals of the Bradypodidae and Megalonychidae families of the superorder Xenarthra. The maned sloth (Bradypus torquatus) is the only sloth species in danger of extinction in Brazil. This species is arboreal and descends to the ground only to perform defecation behavior. This behavior can be the determining factor for infestation and infection by different parasitic agents, including A. varium. This study reported the occurrence of A. varium found parasitizing free-living maned sloths (B. torquatus) in the Atlantic Forest biome of Northeast and Southeast Brazil. A total of 36 individuals were evaluated and more than 50% of the individuals were parasitized by ticks of the species A. varium. This study confirmed the importance of B. torquatus as a host for adults and nymphs of A. varium and reported the variation in length of the spurs on coxa IV of A. varium males.

O Amblyomma varium é um carrapato neotropical popularmente conhecido como carrapato gigante da preguiça, durante a fase adulta é encontrado quase que exclusivamente em mamíferos das famílias Bradypodidae e Megalonychidae da superordem Xenarthra. A preguiça-de-coleira (Bradypus torquatus) é a única espécie de preguiça ameaçada de extinção no Brasil. Esta espécie é arbórea e desce ao solo apenas para realizar comportamentos de defecação. Esse comportamento pode ser o fator determinante para infestação e infecção por diferentes agentes parasitários, incluindo A. varium. Este estudo relatou a ocorrência de A. varium encontrado parasitando preguiças-de-coleira (B. torquatus) de vida livre no bioma Mata Atlântica do Nordeste e Sudeste do Brasil. Foram avaliados 36 indivíduos e mais de 50% dos indivíduos estavam parasitados por carrapatos da espécie A. varium. Este estudo confirmou a importância de B. torquatus como hospedeiro para adultos e ninfas de A. varium e relatou a variação no comprimento dos espinhos da coxa IV de machos de A. varium.

Scenario validation for clinical simulation: prenatal nursing consultation for adolescents / Validación de escenario para simulado clínico: consulta de enfermería en el prenatal para adolescente / Validação de cenário para simulação clínica: consulta de enfermagem no pré-natal para adolescente

ABSTRACT Objectives: to validate a scenario for clinical simulation: prenatal nursing consultation for adolescents. Methods: methodological study developed from January to December 2019, in five stages (overview, scenario, scenario design, progression, debriefing and assessment). The validation involved four volunteer students, a teacher as a facilitator and four judges. The judges filled out a Likert scale with four responses. Data was analyzed using Microsoft Excel® software, version 2016. Absolute and relative frequencies and the content validity index were calculated, considering a minimum acceptable value of 1.0. Results: the preparation of the scenario was based on the proposed learning objectives. The scenario was validated with a global content validity index equal to 1.0. Final Considerations: the study achieved the proposed objective. This scenario can contribute to preparing nurses to work in the care of pregnant teenagers, a representative public in Brazil that requires specific care.

RESUMEN Objetivos: validar un escenario para simulado clínico, en enseñanza de enfermería, sobre primera consulta de prenatal a gestante adolescente. Métodos: estudio metodológico desarrollado de enero a diciembre de 2019, en cinco etapas (overview, scenario, scenario design progression, debriefing y assessment). La validación involucró cuatro alumnos voluntarios, una docente como facilitadora y cuatro jueces. Los jueces rellenaron una escala Likert con cuatro respuestas. Datos fueran analizados en el software Microsoft Excel®, versión 2016. Calculadas las frecuencias absolutas y relativas y el índice de validez de contenido, considerando valor mínimo aceptable de 1,0. Resultados: la elaboración del escenario partió de los objetivos de aprendizaje propuestos. El escenario fue validado con índice de validez de contenido global igual a 1,0. Consideraciones Finales: el estudio alcanzó el objetivo propuesto. Este escenario puede contribuir para preparar enfermeros para actuación en la atención a gestantes adolescentes, un público representativo en Brasil y que requiere cuidados específicos.

RESUMO Objetivos: validar um cenário para simulação clínica, no ensino de enfermagem, sobre primeira consulta de pré-natal à gestante adolescente. Métodos: estudo metodológico desenvolvido de janeiro a dezembro de 2019, em cinco etapas (overview, scenario, scenario design progression, debriefing e assessment). A validação envolveu quatro alunos voluntários, uma docente como facilitadora e quatro juízes. Os juízes preencheram uma escala Likert com quatro respostas. Os dados foram analisados no software Microsoft Excel®, versão 2016. Calcularam-se as frequências absolutas e relativas e o índice de validade de conteúdo, considerando valor mínimo aceitável de 1,0. Resultados: a elaboração do cenário partiu dos objetivos de aprendizagem propostos. O cenário foi validado com índice de validade de conteúdo global igual a 1,0. Considerações Finais: o estudo alcançou o objetivo proposto. Este cenário pode contribuir para preparar enfermeiros para atuação na atenção às gestantes adolescentes, um público representativo no Brasil e que requer cuidados específicos.

Scenario validation for clinical simulation: prenatal nursing consultation for adolescents.

OBJECTIVES: to validate a scenario for clinical simulation: prenatal nursing consultation for adolescents. METHODS: methodological study developed from January to December 2019, in five stages (overview, scenario, scenario design, progression, debriefing and assessment). The validation involved four volunteer students, a teacher as a facilitator and four judges. The judges filled out a Likert scale with four responses. Data was analyzed using Microsoft Excel® software, version 2016. Absolute and relative frequencies and the content validity index were calculated, considering a minimum acceptable value of 1.0. RESULTS: the preparation of the scenario was based on the proposed learning objectives. The scenario was validated with a global content validity index equal to 1.0. FINAL CONSIDERATIONS: the study achieved the proposed objective. This scenario can contribute to preparing nurses to work in the care of pregnant teenagers, a representative public in Brazil that requires specific care.

Amazon tree dominance across forest strata.

The forests of Amazonia are among the most biodiverse plant communities on Earth. Given the immediate threats posed by climate and land-use change, an improved understanding of how this extraordinary biodiversity is spatially organized is urgently required to develop effective conservation strategies. Most Amazonian tree species are extremely rare but a few are common across the region. Indeed, just 227 'hyperdominant' species account for >50% of all individuals >10 cm diameter at 1.3 m in height. Yet, the degree to which the phenomenon of hyperdominance is sensitive to tree size, the extent to which the composition of dominant species changes with size class and how evolutionary history constrains tree hyperdominance, all remain unknown. Here, we use a large floristic dataset to show that, while hyperdominance is a universal phenomenon across forest strata, different species dominate the forest understory, midstory and canopy. We further find that, although species belonging to a range of phylogenetically dispersed lineages have become hyperdominant in small size classes, hyperdominants in large size classes are restricted to a few lineages. Our results demonstrate that it is essential to consider all forest strata to understand regional patterns of dominance and composition in Amazonia. More generally, through the lens of 654 hyperdominant species, we outline a tractable pathway for understanding the functioning of half of Amazonian forests across vertical strata and geographical locations.

Evolutionary history or function? Which preponderates in the expression of the muscle mass of the thoracic limb in wild carnivorans?

Thoracic limbs are extremely versatile and exhibit informative characteristics about habits of the Carnivora order in the wild. Despite this relevance, comparative studies with quantitative variables on thoracic limb muscles are still scarce in carnivorans. The aims of this study were to measure the mass of the intrinsic muscles of the thoracic limb of neotropical species of the Carnivora order and to establish comparative conjectures. For this purpose, 39 thoracic limbs of 10 neotropical carnivorans species were dissected. The mass of each muscle was measured on a digital scale, muscles were grouped by function, and the mass average percentage that each functional group of muscles occupied in the thoracic limb was calculated. The data of the present study was added to that available in the literature for 22 other carnivoran species. Three groups of species were considered: Canidae, Musteloidea, and Feliformia. Comparatively, the eight canid species included in this analyses concentrate muscle mass proximally in the thoracic limb to prioritize essential cursoriality. The nine musteloids had more muscle mass in the distal muscles due to the demand for versatility and manual strength, and the 14 Feliformia species exhibited an intermediate trend. The analysis of clusters revealed a great overlap of the percentage distribution of muscle mass with the phylogeny previously established for carnivorans. It could be verified that the distribution of muscle masses meets the demand of the locomotor habits of the species up to a certain level, from which phylogeny begins to limit morphological adaptations.

Os membros torácicos são extremamente versáteis e exibem características informativas sobre os hábitos das espécies da ordem Carnivora em vida livre. A despeito desta relevência, estudos comparativos com variéveis quantitativas dos músculos do membro torácico são escassos em carnívoros. Os objetivos deste estudo foram aferir a massa dos músculos intrínsecos do membro torácico de espécies neotropicais da ordem Carnivora e estabelecer conjecturas comparativas. Para este fim, foram dissecados 39 membros torácicos de dez espécies de carnívoros neotropicais. A massa de cada músculo foi mensurada em uma balança digital, os músculos foram agrupados por função e calculou-se a massa percentual média a que cada grupo funcional de músculos correspondia no membro torácico. Os dados do presente estudo foram analisados conjuntamente às informações disponíveis na literatura para outras 22 espécies da ordem Carnivora. Três grupos de espécies foram considerados: Canidae, Musteloidea e Feliformia. Comparativamente, as oito espécies de canídeos incluídas nesta análise demonstraram concentração de massa muscular mais proximalmente no membro torácico em razão dos hábitos essencialmente cursoriais. As nove espécies da superfamília Musteloidea exibiram mais massa nos músculos distais devido à maior demanda por versatilidade e força manual. As 14 espécies da subordem Feliformia apresentaram um padrão intermediário. A análise de clusters revelou nítida sobreposição entre o percentual de distribuição da massa muscular com a filogenia previamente estabelecida para a ordem Carnivora. Verificou-se que a distribuição da massa dos músculos atende à demanda dos hábitos locomotores das espécies até um certo nível, a partir do qual a filogenia começa a limitar as adaptações morfológicas.

Evaluation of Urine SARS-COV-2 RT-PCR as a predictor of Acute Kidney Injury and disease severity in critical COVID-19 patients

The novel coronavirus disease (COVID-19) is an emerging infectious disease caused by SARS-CoV-2, which began as an outbreak in Wuhan, China and spread rapidly throughout the globe. Although the majority of infections are mild, severe and critical COVID-19 patients face deterioration of respiratory function, and may also present extrapulmonary manifestations, mostly affecting the kidney, digestive tract, heart and nervous system. Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material by RT-PCR in urine samples obtained from critical care COVID-19 patients. In 51 patients included, we found higher serum creatinine levels, a longer hospital stay and a more frequent dialysis need in urine-positive patients. These findings could suggest that, in predisposed patients, a direct viral cytopathic effect may contribute to a more severe disease phenotype.

Anatomical variations in cervical vertebrae in two species of neotropical canids: What is the meaning?

Anatomical variation in wild canids is rarely described. Altered shapes, uni- or bilaterally situated, were observed in ventral laminae of C6 and/or in C7 vertebral body of two fox species: Lycalopex gymnocercus and Cerdocyon thous. The specimens were young adults, collected dead on highways in southern Brazil. Deformities were considered anatomical variations because apparently there was no interference in function. The occurrence of such variations in two related species from the same area can suggest an environmental common cause rather than genetic issues. Future studies may deepen the understanding between cause and effect of these vertebral deformities in wild canids.

Clavicle in Carnivorans: A Forgotten Bone.

The clavicle is a bone whose development is related to the versatility of the thoracic limbs in mammals. Studies with vestigial structures are scarce and controversial, especially in the order Carnivora. The objective of this study was to verify the presence and to investigate the shape and constitution of the clavicle in neotropical carnivores. In order to do this, 108 cadavers of 19 different species were collected dead on highways and were analyzed. The clavicles were submitted to dissections, longitudinal length measurements, radiographs, histological sections and, in some cases, diaphanization. Sixteen of the 19 species had clavicles in both sides, being significantly larger (P < 0.05) and distinctly more radiopaque in the felids than in the other families. There were no macro or microscopic evidence of clavicle in the specimens of Nasua nasua (n = 6), Conepatus semistriatus (n = 2), and Conepatus chinga (n = 1). The clavicle of the males of Lycalopex gymnocercus, Galictis cuja, and Leopardus geoffroyi was significantly larger (P < 0.05). The predominating contour of the clavicles was a thin stick with cranial convexity. The histological sections demonstrated compact bone consisting of trabecula and lamellae filled by bone marrow and different levels of occupation by chondroid matrix. It can be proposed the clavicles of the order Carnivora, although vestigial and rarely absent, have their presence, constitution and shape more associated with the phylogenetic proximity and evolutionary history of the species than to the variety of movements the thoracic limbs perform in free-living conditions. Anat Rec, 2019. © 2019 American Association for Anatomy Anat Rec, 303:1831-1841, 2020. © 2019 American Association for Anatomy.

Ultrasound-based clinical profiles for predicting the risk of intradialytic hypotension in critically ill patients on intermittent dialysis: a prospective observational study.

BACKGROUND: Intradialytic hypotension, a complication of intermittent hemodialysis, decreases the efficacy of dialysis and increases long-term mortality. This study was aimed to determine whether different predialysis ultrasound cardiopulmonary profiles could predict intradialytic hypotension. METHODS: This prospective observational single-center study was performed in 248 critically ill patients with acute kidney injury undergoing intermittent hemodialysis. Immediately before hemodialysis, vena cava collapsibility was measured by vena cava ultrasound and pulmonary congestion by lung ultrasound. Factors predicting intradialytic hypotension were identified by multiple logistic regression analysis. RESULTS: Intradialytic hypotension was observed in 31.9% (n = 79) of the patients, interruption of dialysis because of intradialytic hypotension occurred in 6.8% (n = 31) of the sessions, and overall 28-day mortality was 20.1% (n = 50). Patients were classified in four ultrasound profiles: (A) 108 with B lines > 14 and vena cava collapsibility > 11.5 mm m-2, (B) 38 with B lines < 14 and vena cava collapsibility ≤ 11.5 mm m-2, (C) 36 with B lines > 14 and vena cava collapsibility Di ≤ 11.5 mm m-2, and (D) 66 with B lines < 14 and vena cava collapsibility > 11.5 mm m-2. There was an increased risk of intradialytic hypotension in patients receiving norepinephrine (odds ratios = 15, p = 0.001) and with profiles B (odds ratios = 12, p = 0.001) and C (odds ratios = 17, p = 0.001). CONCLUSION: In critically ill patients on intermittent hemodialysis, the absence of hypervolemia as assessed by lung and vena cava ultrasound predisposes to intradialytic hypotension and suggests alternative techniques of hemodialysis to provide better hemodynamic stability.

Concentração de iodo urinário em urina de 24 horas de gestantes e sua associação com bócio tireoidiano materno, aborto e peso neonatal: estudo piloto / Urinary iodine concentration in 24-hour urine of pregnant women and its association with goiter in the mother, abortion and neonatal weight: pilot study

Introdução: A comida tem um papel proeminente na obtenção do iodo e uma das melhores estratégias é a iodização do sal. No Brasil, a Anvisa reduziu as doses de iodo no sal de cozinha desde 2014. Portanto, é importante avaliar a concentração urinária de iodo (CIU) em nossa população. Com base no exposto, propõe-se avaliar a CIU das gestantes, associando-a à frequência de bócio materno, aborto e peso neonatal. Métodos: Trata-se de um estudo observacional com um corte transversal composto por 37 pacientes atendidos no Serviço de Obstetrícia da Faculdade de Medicina de Barbacena e uma clínica particular em Juiz de Fora. A CIU foi verificada em 24 horas de urina. Resultados: A média de CIU foi de 213,6 µg/l de urina, com dose mínima de 29 µg/l e máxima de 437 µg/l. A glândula tireoide foi avaliada durante o exame clínico prénatal (palpação da glândula) e em 24 pacientes (38,1%) foi considerada normal. A palpação da glândula tireoide foi associada à CIU. Houve maior iodúria em gestantes com glândula não palpável (p = 0,004; T = 14,13). Não houve associação entre a CIU e história de aborto ou peso fetal ao nascimento (p > 0,05). Conclusões: Apesar de ser uma amostra pequena da população, identificamos pacientes expostas ao déficit. No entanto, a CIU não parece estar associada ao peso do recém-nascido ou a abortos, mas à dosagem de TSH e ao tamanho da glândula tireoide. Assim, a palpação da glândula tireoide poderia ser usada como uma medida indireta do CIU. (AU)

Introduction: Food has a prominent role in providing iodine and one of the best strategies is salt iodization. The Brazilian Health Regulatory Agency has reduced iodine content in table salt since 2014. Therefore, there is a need for evaluating urinary iodine concentration in our population, especially after the modified recommendations. Based on the above, we sought to assess urinary iodine concentration in pregnant women, associating it with frequency of maternal goiter, abortion and neonatal weight. Methods: This observational, cross-sectional study included 37 patients seen at the Obstetrics Service of Barbacena Medical School and a private clinic in Juiz de Fora, both in the state of Minas Gerais, Brazil. Iodine concentration was determined in 24- hour urine through chromatography. Results: The mean 24-hour urine iodine was 213.6 µg/l, with minimum and maximum measures of 29 µg/l and 437 µg/l, respectively. The thyroid gland was assessed by prenatal clinical examination (palpation of the gland). In 24 patients (38.1%) it was considered normal. Palpation of the thyroid gland was associated with 24-hour urine iodine concentration, although a higher iodine concentration was identified in pregnant women with non-palpable gland (p = 0.004; T = 14.13). There was no association between 24-hour urine iodine concentration and history of abortion or birth weight (p > 0.05). Conclusions: This study, although based on a small sample of the population, was important to identify that even in areas where iodine is considered sufficient there may be patients exposed to iodine deficit. However, urinary iodine concentration does not appear to be associated with birth weight or abortion frequency but is associated with thyroid-stimulating hormone (TSH) level and thyroid gland size, suggesting that clinical evaluation of the thyroid gland is an important element for predicting urinary iodine concentration. Thus, palpation of the thyroid gland could be used as an indirect measure of urinary iodine concentration. (AU)

A importância do conceito de perejivanie na constituição de agentes transformadores / The importance of the concept perezhivanie in the constitution of transformative agent

Este artigo discute a importância do conceito de perejivanie para repensar o desenvolvimento dos sujeitos como agentes transformadores, que possam desencadear mudanças no âmbito do coletivo. Para tal, entrelaça estudos sobre mobilidade e repertório, com base na Linguística Aplicada, ao conceito vigotskiano de perejivanie, com o intuito de expandir a compreensão de como se processa o desenvolvimento dos sujeitos. Assim, parte da construção de recursos semióticos reiteráveis, tendo em vista as perejivanie vividas e recuperadas como histórias invocadas para a construção de novas formas de ser e agir. Em contextos ensino-aprendizagem, esse conceito parece assumir um papel central.

This article discusses the importance of the concept of perezhivanie in order to rethink the subjects' development as transformative agents, who can trigger transformations in the collective context. To do so, it intersects studies of mobility and repertoire, based on Applied Linguistics, with the Vygotskian concept of perezhivanie aiming to expand the understanding of how the subjects' development is carried out. Thus, it starts with the construction of recurrent semiotic resources, bearing in mind the lived perezhivanii that are recovered as invoked stories for the construction of new ways of being and acting. In teaching-learning contexts, this concept seems to acquire an essential role.

Impact of Temporomandibular Disorders and Sleep Bruxism on Oral Health-Related Quality of Life of Individuals With Complete Cleft Lip and Palate.

The temporomandibular disorders (TMDs) and sleep bruxism (SB) affect the quality of life (QoL) of the individuals in general. However, the literature lacks studies on individuals with cleft lip and palate (CLP). Thus, this study aimed to evaluate the impact of TMD and SB on the oral health-related quality of life (OHRQoL) of individuals with CLP. Thirty-six individuals, both genders, aged between 30 and 50 years, at routine treatment in the Dental Prosthesis Sector of Hospital for Rehabilitation of Craniofacial Anomalies-University of São Paulo were selected and divided into the following groups: G1-unilateral complete CLP (n = 22) and G2-bilateral complete CLP (n = 14). Three questionnaires were applied: Oral Health Impact Profile (OHIP-14), SB self-report and Research Diagnosis Criteria for TMD. Fisher test, Mann-Whitney test, and t test were applied to verify values between TMD, SB, gender, and OHIP-14 (P < 0.05). The mean OHIP-14 score was of 5.80, and females had higher (8.58) OHRQoL than males (3.31). There was association with gender and OHRQoL (t test, P = 0.006), TMD with OHRQoL (Mann-Whitney test, P = 0.036), and TMD and SB (Fisher test, P = 0.006). Temporomandibular disorder was diagnosed in 30% of the individuals. Of these, 16.66% did not present SB, while 13.88% presented it. The association TMD versus SB showed statistically significant differences and 83.33% of the individuals reporting SB also had TMD. Based on this study, the authors can conclude that: TMD impacts OHRQoL in CLP patients, females are more affected in their OHRQoL than males, SB was strongly associated with TMD.

An association between the internalization of body image, depressive symptoms and restrictive eating habits among young males.

The scope of this study was to analyze the relationship between the internalization of body image and depressive symptoms with restrictive eating habits among young males. Three hundred and eighty-three male adolescents, aged between twelve and seventeen, took part in this survey. The "Overall Internalization" and "Athletic Internalization" sub-scales taken from the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) were used to evaluate the internalization of body images. The Major Depression Inventory (MDI) was used to evaluate depressive symptoms. The "Diet" sub-scale from the Eating Attitudes Test (EAT-26) was used to evaluate restrictive eating habits. The logistic regression findings indicated 2.01 times greater chances of youngsters with a high level of overall internalization adopting restrictive eating habits (Wald = 6.16; p = 0.01) when compared with those with low levels. On the other hand, the regression model found no significant association between "Athletic Internalization" (Wald = 1.16; p = 0.23) and depressive symptoms (Wald = 0.81; p = 0.35) with eating restrictions. The findings made it possible to conclude that only overall internalization was related to eating restrictions among young males.

Associação da internalização dos padrões corporais, sintomas depressivos e comportamento alimentar restritivo em jovens do sexo masculino / An association between the internalization of body image, depressive symptoms and restrictive eating habits among young males

O objetivo foi analisar a relação da internalização dos padrões corporais e sintomas depressivos com a restrição alimentar em adolescentes do sexo masculino. Participaram 383 adolescentes do sexo masculino com idade entre 12 e 17 anos. Utilizaram-se as subescalas “Internalização Geral” e “Internalização Atlética” do Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) para avaliar a internalização dos padrões corporais. O Major Depression Inventory (MDI) foi utilizado para analisar os sintomas depressivos. A subescala “Dieta” do Eating Attitudes Test (EAT-26) foi utilizada para avaliar a restrição alimentar. Os achados da regressão logística indicaram 2,01 vezes mais chances para os adolescentes com internalização geral alta adotarem a restrição alimentar (Wald = 6,16; p = 0,01) quando comparados àqueles com baixa. Por outro lado, o modelo de regressão não evidenciou associação significativa da “Internalização atlética” (Wald = 1,16; p = 0,23) e dos sintomas depressivos (Wald = 0,81; p = 0,35) com a restrição alimentar. Os resultados permitiram concluir que somente a internalização geral esteve relacionada à restrição alimentar em jovens do sexo masculino.

The scope of this study was to analyze the relationship between the internalization of body image and depressive symptoms with restrictive eating habits among young males. Three hundred and eighty-three male adolescents, aged between twelve and seventeen, took part in this survey. The “Overall Internalization” and “Athletic Internalization” sub-scales taken from the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) were used to evaluate the internalization of body images. The Major Depression Inventory (MDI) was used to evaluate depressive symptoms. The “Diet” sub-scale from the Eating Attitudes Test (EAT-26) was used to evaluate restrictive eating habits. The logistic regression findings indicated 2.01 times greater chances of youngsters with a high level of overall internalization adopting restrictive eating habits (Wald = 6.16; p = 0.01) when compared with those with low levels. On the other hand, the regression model found no significant association between “Athletic Internalization” (Wald = 1.16; p = 0.23) and depressive symptoms (Wald = 0.81; p = 0.35) with eating restrictions. The findings made it possible to conclude that only overall internalization was related to eating restrictions among young males.