Lipid-core nanocapsules containing simvastatin improve the cognitive impairment induced by obesity and hypercholesterolemia in adult rats.

The development of cognitive impairment may be related to high levels of plasma cholesterol and obesity. Simvastatin (SV) and lovastatin (LV) are drugs that can potentially be used for the treatment of cognitive deficit. This study aimed to develop and characterize lipid-core nanocapsules (LNC) containing SV (SV-LNC) or LV (LV-LNC), evaluating the effects of SV-LNC in an animal model of cognitive deficit. The formulations SV-LNC and LV-LNC presented a particle average size around 200 nm, a low-polydispersity index, and negative zeta potential. Analysis of differential scanning calorimetry, Fourier transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy showed that there is no reaction among LNC components: LV was crystallized in the suspensions, and SV was molecularly dispersed. The encapsulation efficiency of the SV was high (98.9 ± 1.4%), while that of the LV was low (21.5 ± 1.5%).Based on these results, SV-LNC was used in the preclinical studies. Animals fed with a hyperlipidic diet (HD) developed obesity, hypercholesterolemia, and cognitive impairment, which was corroborated by the brain lesions indicated by histological analysis of some of the animals that received the high-fat diet. We observed that free simvastatin (CS3) was able to reduce the enzymatic activity of pyruvate kinase, an important enzyme for brain energy homeostasis, without affecting the memory of the animals that received a standard diet. However, it failed to improve the cognitive damage caused by a diet high in cholesterol and saturated fats. On the other hand, when simvastatin is "camouflaged" in the lipid-core nanocapsules (HNS3), this cognitive impairment improves. Thus, SV-LNC is a promising alternative therapy for the treatment of cognitive impairment.

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months.

OBJECTIVE: to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided. METHODS: the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process. RESULTS: data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI. CONCLUSION: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months / Implantação de registro de trauma como ferramenta para melhorar a qualidade do atendimento a traumatizados: os primeiros 12 meses

ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

RESUMOObjetivo:analisar a implantação de registro de trauma em hospital universitário com atendimento ao SUS, bem como, sua capacidade em identificar pontos para melhorada qualidade no atendimento.Métodos:o grupo de coleta de dados foi composto por alunos dos cursos de medicina e enfermagem, orientados pelos coordenadores do projeto. Utilizamos o software itreg (ECO Sistemas-RJ/SBAIT) como ferramenta de banco de dados. Vários "filtros" de qualidade foram propostos no intuito de selecionar os casos a serem revistos no processo de controle de qualidade.Resultados:entre março e novembro de 2014, foram inseridos no itreg dados de 1344 vítimas de trauma. Cerca de 87% foram vítimas de trauma fechado, 59,6% apresentaram RTS>7,0 e, 67%, ISS<9. Os registros foram completos em 292 casos, que foram selecionados para a revisãono programa de qualidade. Os filtros de auditoria mais frequentemente anotadosforam a laparotomia após quatro horas da admissão e a drenagem dos hematomas subdurais agudos após quatro horas da admissão. Identificamos vários pontos a serem desenvolvidos, como o controle da "supertriagem" de doentes, a necessidade de diminuição do número de exames de imagem negativos, o desenvolvimento de protocolos para passagem de acessos venosos centrais e tratamento de trauma craniencefálico grave.Conclusão:o Registro de Trauma traz uma visão clara dos pontos a serem melhorados no atendimento ao traumatizado, contudo, há características específicas na implantação desta ferramenta.

Preliminary study of coconut water for graft tissues preservation in transplantation.

OBJECTIVE: to verify the effectiveness of coconut water in preserving tissues for transplant. METHODS: Fifty male Wistar rats were randomly distributed in five groups, according to the following preservation solutions for tissue grafts: Group 1: Lactated Ringer; Group 2: Belzer solution; Group 3: mature coconut water; Group 4: green coconut water; Group 5: modified coconut water. In Group 5, the green coconut water has been modified like the Belzer solution. From each animal we harvested the spleen, ovaries and skin of the back segment. These tissues were preserved for six hours in one of the solutions. Then, the grafts were reimplanted. The recovery of the function of the implanted tissues was assessed 90 days after surgery, by splenic scintigraphy and blood exam. The implanted tissues were collected for histopathological examination. RESULTS: The serum levels did not differ among groups, except for the animals in Group 5, which showed higher levels of IgG than Group 1, and differences in relation to FSH between groups 1 and 2 (p <0.001), 4 and 2 (p = 0.03) and 5 and 2 (p = 0.01). The splenic scintigraphy was not different between groups. The ovarian tissue was better preserved in mature coconut water (p <0.007). CONCLUSION: the coconut water-based solutions preserves spleen, ovary, and rat skin for six hours, maintaining their normal function.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles.

INTRODUCTION: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. OBJECTIVE: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. METHOD: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver's license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. RESULTS: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver's license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver's license for at least one year. CONCLUSION: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

Preliminary study of coconut water for graft tissues preservation in transplantation / Estudo preliminar da água de coco para preservação de enxertos teciduais em transplante

OBJECTIVE: To verify the effectiveness of coconut water in preserving tissues for transplant. METHODS: Fifty male Wistar rats were randomly distributed in five groups, according to the following preservation solutions for tissue grafts: Group 1: Lactated Ringer; Group 2: Belzer solution; Group 3: mature coconut water; Group 4: green coconut water; Group 5: modified coconut water. In Group 5, the green coconut water has been modified like the Belzer solution. From each animal we harvasted the spleen, ovaries and skin of the back segment. These tissues were preserved for six hours in one of the solutions. Then, the grafts were reimplanted. The recovery of the function of the implanted tissues was assessed 90 days after surgery, by splenic scintigraphy and blood exame. The implanted tissues were collected for histopathological examination. RESULTS: The serum levels did not differ among groups, except for the animals in Group 5, which showed higher levels of IgG than Group 1, and differences in relation to FSH between groups 1 and 2 (p <0.001), 4 and 2 (p = 0.03) and 5 and 2 (p = 0.01). The splenic scintigraphy was not different between groups. The ovarian tissue was better preserved in mature coconut water (p <0.007). CONCLUSION: the coconut water-based solutions preserves spleen, ovary, and rat skin for six hours, maintaining their normal function.

OBJETIVO: Verificar a eficácia da água de coco na preservação de tecidos para transplante. MÉTODOS: cinquenta ratas Wistar foram distribuídas aleatoriamente em cinco grupos, de acordo com as seguintes soluções de preservação para enxertos teciduais: Grupo 1- Ringer lactato, Grupo 2- Solução de Belzer, Grupo 3- Água de coco maduro, Grupo 4- Água de coco verde, Grupo 5- Água de coco modificada. No Grupo 5, a água de coco verde foi modificada à semelhança da solução de Belzer. De cada animal, retirou-se o baço, os ovários e um segmento de pele do dorso. Esses tecidos foram preservados durante seis horas em uma das soluções. Em seguida, os enxertos foram reimplantados. A recuperação da função dos tecidos implantados foi avaliada 90 dias após a cirurgia, por meio de cintilografia esplênica, exames de sangue. Os tecidos implantados foram coletados para estudo anatomopatológico. RESULTADOS: as dosagens séricas não apresentaram diferença entre os cinco grupos, exceto pelos animais do Grupo 5, que apresentaram valores mais elevados de IgG do que o Grupo 1,e pelas diferenças em relação ao FSH entre os grupos 1 e 2 (p<0,001), 4 e 2 (p=0,03), 5 e 2 (p=0,01). A cintilografia esplênica não foi diferente entre os grupos. O tecido ovariano foi melhor preservado em água de coco maduro (p<0,007). CONCLUSÃO: as soluções à base de água de coco preservam baço, ovário e pele de rato durante seis horas, mantendo sua função normal.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles / Características dos motociclistas envolvidos em acidentes entre motocicleta e automóvel

Introduction: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. Objective: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. Method: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver’s license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. Results: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver’s license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver’s license for at least one year. Conclusion: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents. .

Introdução: os acidentes de trânsito são uma das principais causas de morte e invalidez, sendo os motociclistas a maior parte de suas vítimas e seus causadores. Objetivo: estudar as características dos motociclistas envolvidos em acidentes entre motocicletas e automóveis. Métodos: foram entrevistados 100 motociclistas feridos em colisões entre motocicleta e automóvel que se encontravam em tratamento hospitalar de urgência no município de Belo Horizonte. O questionário continha sua identificação (idade, sexo, cor da pele, escolaridade, profissão) e perguntas sobre tempo de habilitação para dirigirem automóvel, frequência com que dirigiam automóvel, tempo de habilitação para conduzirem motocicleta, frequência com que dirigiam motocicleta, número de acidentes prévios envolvendo automóvel e número de acidentes prévios sem relação com automóvel. Resultados: dos 100 acidentados consecutivos estudados, 91 eram homens e 9 eram mulheres com idade de 16 a 79 anos (M=29±11). Quanto à finalidade do uso da motocicleta, 83% a empregavam para transporte, 7% para trabalho e 10% para lazer, tendo a maior parte dos acidentados pelo menos o ensino médio completo (47%). Dos motociclistas que possuíam habilitação para automóvel, 68,3% dirigiam o veículo diária ou semanalmente e possuíam a habilitação por período superior a 1 ano; 67% dos acidentados conduziam motocicleta diariamente e tinham pelo menos 1 ano de habilitação para motocicleta. Conclusão: entre os 100 acidentados, predominaram homens com idade superior a 20 anos, ensino médio completo, experiência em conduzir motocicletas e automóveis, indicando que a imprudência ao conduzir a motocicleta tenha sido a principal causa de acidentes de trânsito. .

Cesariana perimortem / Perimortem caesarean

O termo cesariana perimortem refere-se à realização de parto via cesariana em situação de gestante in extremis ou sob ressuscitação cardiopulmonar. O objetivo deste estudo é encontrar na literatura evidências que permitam uma prática mais consistente e otimizada da cesariana perimortem. Foi realizada uma revisão sistemática a partir de um levantamento bibliográfico nas bases de dados eletrônicas Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval System Online (Medline), onde foram selecionados 24 artigos para leitura completa. As questões consideradas foram: principais indicações da cesareana perimortem; implicações da presença do feto intrautero na ressuscitação cardiopulmonar; momento adequado para realização do procedimento e sua interferência na sobrevida materna e fetal. A abordagem de uma gestante com parada cardíaca deve ser multidisciplinar e precoce, com extração do feto idealmente com cinco minutos pós parada cardíaca, o que reduz significativamente as taxas de mortalidade perinatal e materna.(AU)

Perimortem caesarean section refers to caesarean section performed in cases where the pregnant is in extremis or is undergoing cardiopulmonary resuscitation. Our objective was finding evidences in the literature to endorse a more consistent and optimized practice of this procedure. We designed a systematic review based on Scientific Eletronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (Medline) from where we selected 24 articles to complete reading. We considered these issues: main indications of perimortem caesarean; implications of the presence of intrauterine infant on the maternal resuscitation; adequate moment to proceed to the perimortem cesarean and its impacts on maternal and infant?s outcomes. The management of maternal collapse must be multidisciplinary and precocial, with the baby being extracted within five minutes after cardiac arrest, what is fundamental to improve outcomes of both, mother and child.(AU)