Leishmanicidal activity of the venoms of the Scorpions Brotheas amazonicus and Tityus metuendus.

Leishmaniasis is a vector-transmitted zoonosis caused by different species of the genus Leishmania, with a wide clinical spectrum. It is a public health problem aggravated by a series of limitations regarding treatment. In the search for new therapeutic alternatives, scorpion venoms are a source of multifunctional molecules that act against the natural resistance of pathogens. This work evaluated the antileishmanial potential of Brotheas amazonicus and Tityus metuendus venoms against the promastigote forms of Leishmania amazonensis e Leishmania guyanensis. The venoms of B. amazonicus and T. metuendus were evaluated for their constituents using Fourier Transform Infrared (FTIR). Growth inhibition and death of promastigotes were evaluated in the presence of diferente crude venom concentrations (100 µg/mL, 50 µg/mL, 10 µg/mL, 1 µg/mL) after one hour of incubation at 25 °C. The FTIR spectra of both venoms exhibited bands in approximate regions, revealing that both exhibit similar functional groups. Crude venom from both scorpion species showed similar or superior leishmanicidal effects to the standart drug N-methylglucamine antimoniate. At the highest concentration of 100 µg/mL, cultures of L. guyanensis treated with the venom of B. amazonicus showed the highest mortality percentages, above 28%, while T. metuendus venom showed the highest activity against L. amazonensis, with mortality above 7%. This preliminar study demonstrates that B. amazonicus and T. metuendus venoms can be important tools in the search for new drugs Against leishmaniasis. Next step involves evaluating the activity against the amastigote forms and purifying the venom proteins in order to identify the best anti-leishmania candidates.

Biomass and enzymatic activities of marine bacteria in the presence of multiple metals.

Marine environments are a repository for metals, and humans have enhanced this phenomenon over the years. Heavy metals are notoriously toxic due to their ability to biomagnify in the food chain and interact with cellular components. Nevertheless, some bacteria have physiological mechanisms that enable them to survive in impacted environments. This characteristic makes them important as biotechnological tools for environmental remediation. Thus, we isolated a bacterial consortium in Guanabara Bay (Brazil), a place with a long metal pollution history. To test the growth efficiency of this consortium in Cu-Zn-Pb-Ni-Cd medium, we measured the activity of key enzymes of microbial activity (esterases and dehydrogenase) under acidic (4.0) and neutral pH conditions, as well as the number of living cells, biopolymer production, and changes in microbial composition during metal exposure. Additionally, we calculated the predicted physiology based on microbial taxonomy. During the assay, a slight modification in bacterial composition was observed, with low abundance changes and little production of carbohydrates. Oceanobacillus chironomi, Halolactibacillus miurensis, and Alkaliphilus oremlandii were predominant in pH 7, despite O. chironomi and Tissierella creatinophila in pH 4, and T. creatinophila in Cu-Zn-Pb-Ni-Cd treatment. The metabolism represented by esterases and dehydrogenase enzymes suggested bacterial investment in esterases to capture nutrients and meet the energy demand in an environment with metal stress. Their metabolism potentially shifted to chemoheterotrophy and recycling nitrogenous compounds. Moreover, concomitantly, bacteria produced more lipids and proteins, suggesting extracellular polymeric substance production and growth in a metal-stressed environment. The isolated consortium showed promise for bioremediation of multimetal contamination and could be a valuable tool in future bioremediation programs.

Assessing the quality of reporting on quality improvement initiatives in plastic surgery: A systematic review.

BACKGROUND: There has been a recent increase in the number and complexity of quality improvement studies in plastic surgery. To assist with the development of thorough quality improvement reporting practices, with the goal of improving the transferability of these initiatives, we conducted a systematic review of studies describing the implementation of quality improvement initiatives in plastic surgery. We used the SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence) guideline to appraise the quality of reporting of these initiatives. METHODS: English-language articles published in Embase, MEDLINE, CINAHL, and the Cochrane databases were searched. Quantitative studies evaluating the implementation of quality improvement initiatives in plastic surgery were included. The primary endpoint of interest in this review was the distribution of studies per SQUIRE 2.0 criteria scores in proportions. Abstract screening, full-text screening, and data extraction were completed independently and in duplicate by the review team. RESULTS: We screened 7046 studies, of which 103 full texts were assessed, and 50 met inclusion criteria. In our assessment, only 7 studies (14%) met all 18 SQUIRE 2.0 criteria. SQUIRE 2.0 criteria that were met most frequently were abstract, problem description, rationale, and specific aims. The lowest SQUIRE 2.0 scores appeared in funding, conclusion, and interpretation criteria. CONCLUSIONS: Improvements in QI reporting in plastic surgery, especially in the realm of funding, costs, strategic trade-offs, project sustainability, and potential for spread to other contexts, will further advance the transferability of QI initiatives, which could lead to significant strides in improving patient care.

Decoupling the role of chemistry and microstructure in hMSCs response to an osteoinductive calcium phosphate ceramic.

Calcium phosphates (CaP) are widely used synthetic bone graft substitutes, having bioactivity that is regulated by a set of intertwined physico-chemical and structural properties. While some CaPs have shown to be as effective in regenerating large bone defects as autologous bone, there is still the need to understand the role of individual material properties in CaP performance. Here, we aimed to decouple the effects of chemical composition and surface-microstructure of a beta-tricalcium phosphate (TCP) ceramic, with proven osteoinductive potential, on human mesenchymal stromal cells (hMSCs) differentiation. To this end, we replicated the surface structure of the TCP ceramic into polylactic acid without inorganic additives, or containing the chemical constituents of the ceramic, i.e., a calcium salt, a phosphate salt, or TCP powder. The microstructure of the different materials was characterized by confocal laser profilometry. hMSCs were cultured on the materials, and the expression of a set of osteogenic genes was determined. The cell culture medium was collected and the levels of calcium and phosphate ions were quantified by inductively-coupled plasma mass spectrometry. The results revealed that none of the tested combinations of properties in polymer/composite replicas was as potent in supporting the osteogenic differentiation of hMSCs as the original ceramic. Nevertheless, we observed some effects of the surface structure in the absence of inorganics, as well as combined effects of surface structure and the added salts, in particular calcium, on osteogenic differentiation. The approach presented here can be used to study the role of independent properties in other CaP-based biomaterials.

Rosmarinic and chlorogenic acid, isolated from ferns, suppress stem cell damage induced by hydrogen peroxide.

OBJECTIVES: Evaluating the effects of rosmarinic (RA) and cryptochlorogenic (CGA) acids isolated from Blechnum binervatum extract on stem cell viability, toxicity and the protective effect on oxidative cell damage. METHODS: MTT and LDH methods were employed, using stem cells from teeth. RA and CGA were evaluated at 100, 250 and 500 µM. The negative effect of hydrogen peroxide (H2O2) (200-2200 µM) and the capacity of RA and CGA (10-100 µM) as protective agents were also evaluated. DAPI followed by fluorescent microscopy was employed to photograph the treated and untreated cells. KEY FINDINGS: At all tested concentrations, RA and CGA demonstrated the ability to maintain cell viability, and with no cytotoxic effects on the treated stem cells. RA also induced an increase of the cell viability and a reduction in cytotoxicity. H2O2 (1400 µM) induced >50% of cytotoxicity, and both compounds were capable of suppressing H2O2 damage, even at the lowest concentration. At 100 µM, in H2O2 presence, total cell viability was observed through microscope imaging. CONCLUSIONS: These findings contribute to the continued research into natural substances with the potential for protecting cells against oxidative injury, with the consideration that RA and CGA are useful in the regeneration of damaged stem cells.

Mefenoxam and pyraclostrobin: toxicity and in vitro inhibitory activity against Pythium insidiosum.

The objective of this study is to verify in vitro susceptibility of Pythium insidiosum against the agricultural fungicides mefenoxam and pyraclostrobin and evaluate the toxicity of both compounds. Twenty-one P. insidiosum isolates were tested against mefenoxam and pyraclostrobin using the broth microdilution method. Minimum inhibitory and oomicidal concentrations for both compounds were established. Additionally, scanning electron microscopy was performed on P. insidiosum hyphae treated with the sublethal concentration of each fungicide. The toxicity of the compounds was evaluated in vivo Caenorhabditis elegans model. The concentration to inhibit 100% of P. insidiosum growth ranged from 0·625 to 10 µg ml-1 for mefenoxam and from 0·019 to 5 µg ml-1 for pyraclostrobin. The SEM analysis revealed changes on the surface of the hyphae treated with the fungicides, suggesting possible damage caused by these compounds. There was no evidence of toxicity in vivo models. Mefenoxam and pyraclostrobin did not show toxicity at the doses evaluated and have inhibitory effects on the pathogenic oomycete P. insidiosum. However, further evaluations of their pharmacokinetics and toxicity in different animal species and possible pharmacological interactions are necessary to infer a possible use in the clinical management of pythiosis.

[Conservation surgery and early rehabilitation in massive necrotizing fasciitis of the lower limbs] / Cirugía de conservación y rehabilitación temprana en fascitis necrotizante masiva de miembros inferiores.

Necrotizing fasciitis is a life-threatening infection. Early diagnosis and treatment are essential. Reconstruction techniques and rehabilitation protocols have been poorly described. The objective of this work is to describe the results of timely treatment for limb preservation and early rehabilitation in a case of massive necrotizing fasciitis of the lower limbs. We present a case of necrotizing fasciitis in the lower limbs, treated surgically with a negative aspiration system, muscle flaps, and skin graft. We describe his rehabilitation protocol and the results at one year of follow-up.

La fascitis necrotizante es una infección potencialmente letal. Es esencial un diagnóstico y tratamiento temprano. Las técnicas de reconstrucción y los protocolos de rehabilitación han sido escasamente descritos. El objetivo de este trabajo es describir los resultados del tratamiento oportuno para la conservación de miembros y la rehabilitación temprana en un caso de fascitis necrotizante masiva de miembros inferiores. Presentamos un caso de fascitis necrotizante en miembros inferiores, tratado quirúrgicamente mediante sistema de aspiración negativa, colgajos musculares e injerto cutáneo. Describimos su protocolo de rehabilitación y los resultados al año de seguimiento.

Activity of biogenic silver nanoparticles against isolates of Prototheca species from bovine mastitis.

Prototheca spp. cause numerous infections in a wide variety of species, including treatment-unresponsive mastitis. Thus, the search for an effective therapy is essential. Silver nanoparticles are compounds with high therapeutic potential. This study aimed to evaluate the susceptibility profile and morphological changes in Prototheca spp. treated with biogenic silver nanoparticles (Bio-AgNP). The algaecide activity was evaluated in microplates by microdilution method, resulting in a MIC50 of 30 µg ml-1 and a MIC90 of 60 µg ml-1 . Scanning electron microscopy demonstrated changes in the surface of Prototheca bovis cells following treatment. The algaecide activity of Bio-AgNP suggests a therapeutic potential as a novel approach for the control of Prototheca spp. in bovine mastitis.

Fragilidade em idosos que vivem na comunidade: prevalência e fatores associados / Frailty in community-dwelling older people: prevalence and associated factors

Fundamentos: Idosos que vivem na comunidade são propensos a desenvolver fragilidade, considerada como um estado clinicamente identificável que aumenta a vulnerabilidade a resultados adversos e prediz incapacidade e mortalidade na população idosa. Objetivo: Identificar a prevalência e fatores associados à fragilidade em idosos que vivem em uma comunidade. Método: Trata-se de um inquérito domiciliar transversal e analítico, de abordagem quantitativa realizado com 854 idosos que vivem na comunidade. A fragilidade foi mensurada pela Edmonton Frail Scale (EFS). A associação entre fragilidade e variáveis sociodemográficas e de condições clínicas foi mensurada pela análise múltipla por regressão logística. Resultados: A prevalência de fragilidade encontrada neste estudo foi de 12,3% (IC95%: 10,1 a 14,5). O modelo de regressão logística mostrou que as variáveis estatisticamente associadas à fragilidade foram: queda recorrente, uso de dispositivo para auxílio à marcha, polifarmácia, autopercepção ruim de saúde, dependência nas atividades básicas e instrumentais de vida diária. Conclusão: A prevalência de fragilidade em idosos foi baixa em comparação a outros estudos nacionais que empregaram a EFS. Os resultados indicaram múltiplos fatores associados à fragilidade modificáveis. Assim, a investigação da síndrome da fragilidade bem como dos seus fatores relacionados passíveis de prevenção são ações a serem incluídas na prática clínica. (AU)

Foundations: Elderly people living in the community are prone to developing frailty, considered as a clinically identifiable state that increases vulnerability to adverse events and predicts disability and mortality in the elderly population. Objective: To identify the prevalence and factors associated with frailty in the elderly living in the community. Materials and method: This is a cross-sectional and analytical household survey with a quantitative approach conducted with 854 elderly people living in the community. Frailty was measured by Edmonton Frail Scale (EFS). The association between frailty and sociodemographic and clinical condition variables was measured by multiple analysis using logistic regression. Results: The prevalence of frailty found in this study was 12.3% (95% CI: 10.1 to 14.5). The logistic regression model showed that the variables statistically associated with frailty were: recurrent fall, use of walking aids, polypharmacy, poor self-rated health, dependence on basic and instrumental activities of daily living. Conclusion: The prevalence of frailty in the elderly was low compared to other national studies that employed the SAI. Results indicated potentially modifiable factors associated with frailty. Thus, the investigation of frailty syndrome and its related preventable factors are actions to be included in clinical practice. (AU)

Butyrate-containing structured lipids act on HDAC4, HDAC6, DNA damage and telomerase activity during promotion of experimental hepatocarcinogenesis.

Hepatocellular carcinoma (HCC) presents with a high treatment resistance and poor prognosis. Early diagnosis and preventive approaches such as chemoprevention are essential for the HCC control. Therefore, we evaluated the chemopreventive effects of butyrate-containing structured lipids (STLs) administered during the promotion stage of hepatocarcinogenesis in rats submitted to the 'resistant hepatocyte' (RH) model. Administration of butyrate-containing STLs inhibited the incidence and mean number of visible hepatic nodules per rat and reduced the number and area of glutathione S-transferase placental form-positive (GST-P+) preneoplastic focal lesions in the livers. This was accompanied by the induction of apoptosis and an increased level of hepatic butyric acid. Treatment with butyrate-containing STLs resulted in increased histone H3 lysine 9 (H3K9) acetylation, reduction of total histone deacetylase (HDAC) activity, and lower levels of HDAC4 and HDAC6 proteins. The chemopreventive effect of butyrate-containing STLs was also associated with the increased nuclear compartmentalization of p53 protein and reduced expression of the Bcl-2 protein. In addition, rats treated with butyrate-containing STLs showed decreased DNA damage and telomerase activity in the livers. These results demonstrate that the suppressive activity of butyrate-containing STLs is associated with inhibition of elevated during hepatocarcinogenesis chromatin-modifying proteins HDAC4 and HDAC6, subcellular redistribution of the p53 protein, and decreased DNA damage and telomerase activity.

Understanding Reentrance in Frustrated Magnets: The Case of the Er_{2}Sn_{2}O_{7} Pyrochlore.

Reentrance, the return of a system from an ordered phase to a previously encountered less-ordered one as a controlled parameter is continuously varied, is a recurring theme found in disparate physical systems, yet its microscopic cause is often not investigated thoroughly. Here, through detailed characterization and theoretical modeling, we uncover the microscopic mechanism behind reentrance in the strongly frustrated pyrochlore antiferromagnet Er_{2}Sn_{2}O_{7}. We use single crystal heat capacity measurements to expose that Er_{2}Sn_{2}O_{7} exhibits multiple instances of reentrance in its magnetic field B vs temperature T phase diagram for magnetic fields along three cubic high symmetry directions. Through classical Monte Carlo simulations, mean field theory, and classical linear spin-wave expansions, we argue that the origins of the multiple occurrences of reentrance observed in Er_{2}Sn_{2}O_{7} are linked to soft modes. These soft modes arise from phase competition and enhance thermal fluctuations that entropically stabilize a specific ordered phase, resulting in an increased transition temperature for certain field values and thus the reentrant behavior. Our work represents a detailed examination into the mechanisms responsible for reentrance in a frustrated magnet and may serve as a template for the interpretation of reentrant phenomena in other physical systems.

A Study of Consultant Attitudes to NCHD Less-Than-Full-Time (LTFT) Training.

Aims Less-than-full-time (LTFT) training is increasing in availability and flexibility. Negative perceptions by consultants is a concern. This study aims to ascertain the attitudes of consultants to LTFT training and determine potential barriers to LTFT training. Methods A prospective cohort questionnaire-based study was designed with mixed qualitative and quantitative methodology. It was distributed to consultants in a tertiary paediatric hospital. The main outcome measures were likelihood of negative perceptions of LTFT NCHDs, and perceived advantages and disadvantages of LTFT training. Results 35.4% had worked LTFT, and 40.5% (n=17) of those who hadn't had considered or were currently considering it. Most respondents did not have a negative perception of LTFT NCHDs (84.6%). Work-life balance, reduction of burnout, and being fully committed were perceived advantages of LTFT training to NCHDs. Advantages to the team were energy, staffing, and productivity. Disadvantages to the NCHD were training duration, involvement in clinical activities, and negative perceptions. Disadvantages to the team were continuity, roster planning, and workload distribution. Conclusion Consultant perceptions of LTFT trainees are positive. There are common themes in the perceived impact of LTFT training that must be explored to maximise the success of this training pathway.

Genome-scale phylogenies reveal relationships among Parastagonospora species infecting domesticated and wild grasses.

Several plant pathogenic Parastagonospora species have been identified infecting wheat and other cereals over the past 50 years. As new lineages were discovered, naming conventions grew unwieldy and the relationships with previously recognized species remained unclear. We used genome sequencing to clarify relationships among these species and provided new names for most of these species. Six of the nine described Parastagonospora species were recovered from wheat, with five of these species coming from Iran. Genome sequences revealed that three strains thought to be hybrids between P. nodorum and P. pseudonodorum were not actually hybrids, but rather represented rare gene introgressions between those species. Our data are consistent with the hypothesis that P. nodorum originated as a pathogen of wild grasses in the Fertile Crescent, then emerged as a wheat pathogen via host-tracking during the domestication of wheat in the same region. The discovery of a diverse array of Parastagonospora species infecting wheat in Iran suggests that new wheat pathogens could emerge from this region in the future. Citation: Croll D, Crous PW, Pereira D, et al. 2021. Genome-scale phylogenies reveal relationships among Parastagonospora species infecting domesticated and wild grasses. Persoonia 46: 116-128. https://doi.org/10.3767/persoonia.2021.46.04.

Study on the association between sleep disorders versus oral health related variables.

BACKGROUND: To study the association between sleep quality and oral health related variables, which still have conflicts in the literature. MATERIAL AND METHODS: This was a population-based case-control study between subjects with versus without sleep disorders from the Brazilian Public Health System (SUS), city of Maringá (N=1,643). Subjects answered self-reported questionnaires: a) Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), b) Sleep Assessment Questionnaire (SAQ) and c) North York Dental Health Survey (NYDHS). RESULTS: No significant difference was found for gender, marital status, or income; however, non-Caucasians, people with lower levels of education, and those between 20 to 50 years old had worse scores of sleep disorders in the SAQ. Self-perceived oral health, masticatory capacity to eat foods, and gingival bleeding was significantly worse among subjects with self-reported sleep disorders. Self-reported tooth loss, edentulism and use of removable partial dentures (with clasps) or complete dentures showed no significant difference between groups. Self-reported sleep disorder subjects presented significantly higher prevalence of both self-reported tooth and TMJ pain. CONCLUSIONS: It can be concluded that individuals with self-reported sleep disorders presented worse self-perceived oral health for most studied variables.

Anatomia do sistema reprodutor feminino de Alouatta belzebul (Linnaeus, 1766) / [Anatomy of the female reproductive system of the Alouatta belzebul (Linnaeus, 1766)]

O conhecimento da anatomia de qualquer animal silvestre é de fundamental importância para sua preservação e proteção. Neste contexto, o presente estudo objetivou descrever a morfologia do sistema reprodutor feminino de Alouatta belzebul. Foram utilizados seis espécimes de A. belzebul, fêmeas, adultas, e livres de lesões. Observou-se macroscopicamente que os ovários têm características morfológicas em formato ovoides, com superfície lisa, e, na análise histológica na região de córtex, evidenciou-se folículos ovarianos em diferentes estágios de desenvolvimento. As tubas uterinas anatomicamente são finas e curvilíneas, apresentando uma camada mucosa, uma muscular e outra serosa. O útero possui formato simples, com fundo globoso, com um miométrio altamente vascularizado, sendo organizado em feixes de fibras musculares lisas. A estrutura anatômica da vagina apresentou-se como um tubo muscular longo de paredes finas, onde, na região vestibular, o óstio externo da uretra é marcado por uma papila uretral bilobada e, na região de vulva, em sua porção caudal, contatou-se um clitóris bem desenvolvido. No que concerne à análise histológica da vagina, verificou-se, em região de mucosa vaginal, um extrato basal composto por epitélio estratificado pavimentoso não queratinizado atrófico. As descrições morfológicas fornecem, de forma inédita, informações importantes relativas à anatomia macroscópica e microscópica do sistema reprodutor feminino dessa espécie.(AU)

Knowledge of the anatomy of any wild animal is of fundamental importance for its preservation and protection. In this context the present study aimed to describe the morphology of the female reproductive system of A. belzebul. We used 6 specimens of A. belzebul, female, adult and free of lesions. It was macroscopically observed that the ovaries are ovoid with smooth surface and the histological analysis in cortical region showed ovarian follicles in different stages of development. The fallopian tubes are anatomically thin and curvilinear, with one mucous layer, one muscular and one serous layer. The uterus was presented in a simple format with a globular fundus, with a highly vascularized myometrium, being organized in bundles of smooth muscle fibers. The anatomical structure of the vagina presented itself as a long thin-walled muscular tube where in the vestibular region the external orifice of the urethra is marked by a bilobed urethral papilla and in the caudal portion in its caudal portion a well-developed clitoris. Regarding the histological analysis of the vagina, a basal extract composed of atrophic non-keratinized stratified squamous epithelium was found in the vaginal mucosa region. The morphological descriptions provide important information regarding the macroscopic and microscopic anatomy of the female reproductive system of this species in an unprecedented way.(AU)

Revisão integrativa sobre a atenção da psicologia às gestantes surdas / Integrative review on the attention of psychology to deaf pregnant women

A gestação é um período permeado por sentimentos/pensamentos ambivalentes pelos quais a Psicologia demonstra interesse. Os aspectos físicos/biológicos da gestação sempre foram temas centrais nos cuidados pré e pós-natais. Atualmente, programas de cuidados pré-natais psicológicos oferecem espaço acolhedor com o objetivo, por exemplo, de promover a saúde das gestantes e prevenir depressão pós-parto. É possível incluir, também, os companheiros(as) e a família estendida num ambiente de diálogo sobre crenças, expectativas, riscos e anseios presentes nesta fase. Numa breve revisão da bibliografia constata-se que a Psicologia dedica especial atenção aos cuidados das gestantes. O objetivo deste estudo foi verificar, na literatura, se as gestantes surdas têm recebido esta mesma atenção. Realizou-se uma revisão integrativa da literatura, até o dia 31 de março de 2020. Foram consultadas as bases de dados PubMed, SciELO, EBSCO e BVS, sem uso de filtros tampouco limite quanto a data de publicação. Os termos MeSH/descritores utilizados foram pregnant women AND Psychology AND deaf*. Dentre os 52 artigos identificados, apenas nove foram incluídos neste estudo, sendo que oito deles não tinham como foco principal gestantes surdas e sim gestantes com deficiência. Gestantes com deficiência/surdez parecem, assim, excluídas tanto dos dados censitários, quanto dos serviços de saúde e das pesquisas científicas. Nessa amostra, apesar de pequena, depreendeu-se que estas mulheres são vítimas de preconceito e discriminação de diferentes instâncias da sociedade. No entanto, é possível constatar, também, que há um campo importante e necessário para a atuação da Psicologia voltado a essas mulheres, profissionais de saúde e familiares.(AU)

Pregnancy is a period permeated by ambivalent feelings/thoughts for which Psychology shows interest. The physical/biological aspects of pregnancy have always been central themes in pre-and post-natal care. Today, psychological prenatal care programs offer a welcoming space with the aim, for example, of promoting the health of pregnant women and preventing postpartum depression. It is also possible to include partners and extended family in an environment of dialogue about beliefs, expectations, risks and desires present in this phase. In a brief review of the literature, it can be seen that Psychology has devoted special attention to the care of pregnant women. The aim of this study was to verify, in the literature, whether deaf pregnant women have received this same attention. A integrative review of the literature was carried out until March 31, 2020. The PubMed, SciELO, EBSCO and VHL databases were consulted, and no filters were applied, nor a limit as to the date of publication. The MeSH terms/descriptors used were pregnant women AND Psychology AND deaf*. Among the 52 articles identified, only ninve were included in this study, and eight of them did not focus on deaf pregnant women, but disabled pregnant women. Therefore, pregnant women with disabilities/deafness seem to be excluded from census data, health services and scientific research. In this sample, although small, it was possible to infer that these women are victims of prejudice and discrimination from different levels of society. However, it is also possible to verify that there is an important and necessary field for the intervention of Psychology aiming to these women, health professionals and families.(AU)

Teaching Cardiopulmonary Auscultation to Medical Students using a Virtual Patient Simulation Technology.

The teaching process of auscultation is complex in itself, and difficult to operate since it requires a wide spectrum of patients with the most diverse cardiopulmonary pathologies, readily available during teaching and assessment hours, for an ever-growing number of medical students. In this paper we will focus on how virtual patient technologies can promote the evolution of the current teaching methodologies, promoting better learning. The chosen methodology was: a) a review of available medical simulation technologies for auscultation teaching; b) a case study illustrating how a virtual patient simulation technology has been successfully used to teach and certify auscultation skills. Results show the positive impact and high acceptability of virtual patient simulation technologies in the teaching of auscultation to medical students.

Oxígeno hiperbárico para la cistitis inducida por radioterapia: un seguimiento a largo plazo / Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up

INTRODUCCIÓN Y OBJETIVOS: Alrededor del 12% de los pacientes tratados con radioterapia pélvica desarrollan complicaciones en la vejiga. La terapia de oxígeno hiperbárico (TOHB) es una opción para el manejo de la cistitis hemorrágica inducida por radioterapia (CHIR). El objetivo de este estudio fue evaluar la eficacia de la TOHB para tratar la cistitis por radioterapia e identificar factores predictivos para un resultado exitoso. MATERIAL Y MÉTODOS: Revisamos retrospectivamente a 105 pacientes diagnosticados de CHIR que recibieron un tratamiento de TOHB entre 2007 y 2016 en nuestro centro. Los pacientes recibieron oxígeno al 100% en una cámara hiperbárica multiplaza a 2,4 ATA durante 80 min. Todos los pacientes cumplimentaron un cuestionario en el que se documentaba la gravedad de los síntomas previos a la TOHB y tras el período de seguimiento. RESULTADOS: Después de una media de 40 sesiones de TOHB, hubo una tasa de éxito del 92,4% en el control de la hematuria. Durante el período de seguimiento (mediana de 63 meses), el 24,7% de los pacientes presentaron recurrencia de la hematuria. La puntuación media de las variables evaluadas en el cuestionario -disuria, frecuencia urinaria y hematuria- fue significativamente menor después del período de seguimiento (p <0,05). Nuestros datos muestran que cuanto antes se administre la TOHB después del primer episodio de hematuria, se logran mejores tasas de respuesta y se registran menores recurrencias en relación con la hematuria (p <0,05). No se observaron complicaciones graves. CONCLUSIONES: Nuestros resultados apoyan la seguridad y los beneficios a largo plazo de la TOHB para la CHIR y otros síntomas molestos de la vejiga, lo que supondría una mejora en la calidad de vida de nuestros pacientes

INTRODUCTION AND OBJECTIVES: Bladder complications may be seen in up to 12% of patients treated with pelvic irradiation. Hyperbaric oxygen therapy (HBOT) is an option for the management of radiation-induced hemorrhagic cystitis (RIHC). The aim of this study was to evaluate the efficacy of HBOT in radiation cystitis and to identify the predictive factors for a successful outcome. MATERIAL AND METHODS: We retrospectively reviewed 105 patients diagnosed with RIHC which were treated with HBOT between 2007 and 2016 in our institution. Patients received 100% oxygen in a multiplace hyperbaric chamber at 2.4atm for 80minutes. All patients fulfilled a questionnaire documenting symptom severity pre-HBOT and at the end of the follow-up period. RESULTS: After a median of 40 HBOT sessions, there was success rate of 92,4% in the control of hematuria. During our follow-up period (median of 63 months) 24,7% patients presented with recurrence of hematuria. The mean score of the questionnaire-assessed variables: dysuria, urinary frequency and hematuria, was significantly lower after the follow-up period (P<.05). Our data shows that the sooner HBOT is delivered after the first episode of hematuria, better response rates are achieved and lower recurrences concerning hematuria were registered (P<.05). No serious complications were observed. CONCLUSIONS: Our results support the safety and long-term benefits of HBOT on RIHC and other distressful bladder symptoms, which represents an expected improvement of quality of life in our patients

Hyperbaric oxygen for radiation-induced cystitis: A long-term follow-up. / Oxígeno hiperbárico para la cistitis inducida por radioterapia: un seguimiento a largo plazo.

INTRODUCTION AND OBJECTIVES: Bladder complications may be seen in up to 12% of patients treated with pelvic irradiation. Hyperbaric oxygen therapy (HBOT) is an option for the management of radiation-induced hemorrhagic cystitis (RIHC). The aim of this study was to evaluate the efficacy of HBOT in radiation cystitis and to identify the predictive factors for a successful outcome. MATERIAL AND METHODS: We retrospectively reviewed 105 patients diagnosed with RIHC which were treated with HBOT between 2007 and 2016 in our institution. Patients received 100% oxygen in a multiplace hyperbaric chamber at 2.4atm for 80minutes. All patients fulfilled a questionnaire documenting symptom severity pre-HBOT and at the end of the follow-up period. RESULTS: After a median of 40 HBOT sessions, there was success rate of 92,4% in the control of hematuria. During our follow-up period (median of 63 months) 24,7% patients presented with recurrence of hematuria. The mean score of the questionnaire-assessed variables: dysuria, urinary frequency and hematuria, was significantly lower after the follow-up period (P<.05). Our data shows that the sooner HBOT is delivered after the first episode of hematuria, better response rates are achieved and lower recurrences concerning hematuria were registered (P<.05). No serious complications were observed. CONCLUSIONS: Our results support the safety and long-term benefits of HBOT on RIHC and other distressful bladder symptoms, which represents an expected improvement of quality of life in our patients.