A pessoa portadora de esclerose múltipla, o familiar cuidador e processo familiar / Multiple sclerosis carrier, family career and family process

Objectives: To characterize the person with Multiple Sclerosis and the family member caregiver; to evaluate the needs of families with a member with Multiple Sclerosis within the family process. Methods: The study is quantitative, descriptive, exploratory and cross-sectional, with a sample of 25 families. In the evaluation of the family process was followed the operative matrix of the Dynamic Model of Family Assessment and Intervention. Data collection was organized through semi-structured interviews. Results: The person with Multiple Sclerosis is mostly female (76%), with the most referenced limitations being extreme fatigue (80%), spasticity and weakness (44%). The person identified as a caregiver is mostly female (56%), spouse / partner (48%). Within the family process, families are mostly functional. Conclusion: Having knowledge of the characteristics and needs of each family will allow the family nurse a more targeted and specific intervention

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Estratégias de coping na família da pessoa portadora de esclerose múltipla / Coping strategies in the family of the multiple sclerosis holder

Caring for someone is a naturally demanding task, especially when the person is physically and mentally impaired, such as a person with Multiple Sclerosis. Thus, this study aims to identify coping strategies of people identified as caregivers by the person with Multiple Sclerosis, thus understanding the way families view and adapt to this very specific chronic disease. This study is of quantitative, descriptive and cross-sectional nature, with a sample of 25 Portuguese families. The F-COPES questionnaire was applied to assess the coping strategies, using the operational matrix of the Dynamic Model of Family Evaluation and Intervention, organized through a semi-structured interview. The study highlights that the person with Multiple Sclerosis is the one mostly expressing feelings (56%) and shows more initiative to solve them (52%). However, this study also shows that about 80% of families reach out to external resources. According to the strategies coping assessment using the F-COPES, 44% of the families involved in this study, agree with Social Support. However, the most adopted strategies are the reframing and passive evaluation (64%), and the least adopted is the search for spiritual support (20%). The knowledge of the adopted coping strategies by the families will enable the family nurse a more tailored intervention to the family needs

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Alternative methods for estimating maximum lactate steady state velocity in physically active young adults / Métodos alternativos para estimar a velocidade da máxima fase estável de lactato em adultos jovens fisicamente ativos

The aim of this study was to compare the velocities found in the protocols used to measure the indirect individual anaerobic threshold (IATind), glucose threshold (GT) and critical velocity (CV) with the gold standard, the maximum lactate steady state (MLSS) protocol. Fourteen physically active young adults (23±3.1 years; 72±10.97 kg; 176±7 cm; 21±5.36% body fat) performed a 3000-m track running test to determine IATind using the prediction equation and an incremental test on a treadmill to determine GT. The CV was identified by linear regression of the distance-time relationship based on 3000-m and 500-m running performance. The MLSS was identified using two to five tests on different days to identify the intensity at which there was no increase in blood lactate concentration greater than 1 mmol/L between the 10th and 30th minute. A significant difference was observed between mean CV and MLSS (P≤0.05) and there was a high correlation between MLSS and IATind (R2=0.82; P≤0.01) and between MLSS and GT (R2=0.72; P≤0.01). The Bland-Altman method showed agreement between MLSS and IATind [mean difference -0.24 (confidence interval -1.72 to 1.24) km/h] and between MLSS and GT [0.21 (-1.26 to 1.29) km/h]. We conclude that the IATind and GT can predict MLSS velocity with good accuracy, thus making the identification of MLSS practical and efficient to prescribe adequate intensities of aerobic exercise.

O objetivo do presente estudo foi comparar as velocidades encontradas nos protocolos de Limiar Anaeróbio Individual Indireto (LAIind), Limiar Glicêmico (LG) e Velocidade Crítica (VC) com o padrão ouro, o protocolo de identificação da máxima fase estável do lactato (MFEL). Participaram 14 adultos jovens fisicamente ativos (23±3,1 anos; 72±10,97 kg; 1,76±0,07 m; 21±5,36 % gordura corporal) que realizaram um teste de 3000m em pista para determinar o LAIind através de equação de predição; teste incremental em esteira ergométrica para determinação do LG; a VC foi identificada por regressão linear através da relação distância-tempo com base no desempenho em corridas nas distâncias de 3.000m e 500m; a MFEL foi identificada utilizando de dois a cinco testes em dias distintos até encontrar a intensidade onde não houve aumento da concentração de lactato sanguíneo maior que 1 mmol.L-1 entre os minutos 10 e 30. Houve diferença estatística entre os valores médios da VC e a MFEL (P≤0,05), elevada correlação entre MFEL e LAIind (R2=0,82; P≤0.01) e MFEL e LG (R2=0,72; P≤0.01). Através do método Bland-Altman foram encontradas as concordâncias entre MFEL e LAIind [diferença média -0,24 (intervalo de confiança -1,72 a 1,24) km/h] e MFEL e LG [0,21 (-1,26 a 1,29) km/h]. Concluímos que o LAIind e o LG são testes que podem predizer com boa precisão a velocidade da MFEL, tornando sua identificação prática e eficiente para prescrição de intensidades adequadas para o treinamento aeróbio.

Dependência de jogos eletrônicos em crianças e adolescentes / Video game addiction

Com o incrível avanço tecnológico das últimas décadas, os jogos eletrônicos se tornaram uma das principais atividades de lazer de crianças e adolescentes. Os problemas relacionados ao uso excessivo dos games despertam cada vez mais a atenção de profissionais da saúde, e o número de artigos sobre o tema tem aumentado progressivamente. MÉTODOS: Foi realizada uma revisão não sistemática da literatura utilizandose os bancos de dados PubMed, SciELO e LILACS. RESULTADOS: São descritas as características dos jogos e dos jogadores que parecem estar envolvidos nesse comportamento de dependência, assim como as características clínicas, as bases neurobiológicas, o perfil de comorbidades e as opções de tratamento. A inclusão da categoria Internet Gaming Disorder no DSM-5 demonstra a importância que a comunidade científica tem dado ao assunto e estimula o desenvolvimento de mais pesquisas nessa área. Estudos epidemiológicos, clínicos e de neuroimagem observam que trata-se de um transtorno prevalente principalmente entre os jovens, que acarreta prejuízo significativo na vida dos indivíduos acometidos e que apresenta grandes semelhanças com outros comportamentos de dependência. Discute-se também a influência e os potenciais mecanismos pelos quais os jogos violentos podem estimular a agressividade, principalmente entre os jogadores que já apresentam outros fatores de risco para esse comportamento. CONCLUSÃO: Apesar do crescente corpo de evidências científicas disponíveis na literatura, muitas dúvidas ainda necessitam de esclarecimento e mais pesquisas sobre o tema devem ser estimuladas para que se tenha um maior êxito no reconhecimento e tratamento desse transtorno.(AU)

Along with the amazing technological development seen in the last decades, video games have become one of the main entertainment activities of children and adolescents. The problems due to the overuse of video games have increasingly drawn more attention from health professionals, and the number of publications is growing steadily. METHODS: A non-systematic literature review using the PubMed database, SciELO and LILACS databases was performed. RESULTS: The characteristics of games and players that seem to be involved in addictive behavior, as well as clinical characteristics, neurobiology, comorbidity profile and treatment options are described. The inclusion of Internet Gaming Disorder in DSM-5 demonstrates the importance that the scientific community has given to the subject, and stimulates the development of further research. Epidemiological, clinical and neuroimaging studies show that it is a prevalent disorder particularly among youth, which causes significant impairment in the life of affected individuals, and that presents strong similarities with other addictive behaviors. The influence and potential mechanisms by which violent games can stimulate aggression, especially among players who already have other risk factors for this behavior is also discussed. CONCLUSION: Despite the growing body of scientific evidence available in the literature, many questions still need clarification, and further research on the topic should be encouraged in order to improve the recognition and treatment of this disorder.(AU)

Mapping the lignin distribution in pretreated sugarcane bagasse by confocal and fluorescence lifetime imaging microscopy.

BACKGROUND: Delignification pretreatments of biomass and methods to assess their efficacy are crucial for biomass-to-biofuels research and technology. Here, we applied confocal and fluorescence lifetime imaging microscopy (FLIM) using one- and two-photon excitation to map the lignin distribution within bagasse fibers pretreated with acid and alkali. The evaluated spectra and decay times are correlated with previously calculated lignin fractions. We have also investigated the influence of the pretreatment on the lignin distribution in the cell wall by analyzing the changes in the fluorescence characteristics using two-photon excitation. Eucalyptus fibers were also analyzed for comparison. RESULTS: Fluorescence spectra and variations of the decay time correlate well with the delignification yield and the lignin distribution. The decay dependences are considered two-exponential, one with a rapid (τ1) and the other with a slow (τ2) decay time. The fastest decay is associated to concentrated lignin in the bagasse and has a low sensitivity to the treatment. The fluorescence decay time became longer with the increase of the alkali concentration used in the treatment, which corresponds to lignin emission in a less concentrated environment. In addition, the two-photon fluorescence spectrum is very sensitive to lignin content and accumulation in the cell wall, broadening with the acid pretreatment and narrowing with the alkali one. Heterogeneity of the pretreated cell wall was observed. CONCLUSIONS: Our results reveal lignin domains with different concentration levels. The acid pretreatment caused a disorder in the arrangement of lignin and its accumulation in the external border of the cell wall. The alkali pretreatment efficiently removed lignin from the middle of the bagasse fibers, but was less effective in its removal from their surfaces. Our results evidenced a strong correlation between the decay times of the lignin fluorescence and its distribution within the cell wall. A new variety of lignin fluorescence states were accessed by two-photon excitation, which allowed an even broader, but complementary, optical characterization of lignocellulosic materials. These results suggest that the lignin arrangement in untreated bagasse fiber is based on a well-organized nanoenvironment that favors a very low level of interaction between the molecules.

Púrpura trombocitopênica trombótica associada à gravidez: relato de caso / Thrombotic thrombocytopenic purpura associated with pregnancy: case report

A púrpura trombocitopênica trombótica (PTT) é uma entidade rara em pacientes críticos. Relatamos um caso clínico de paciente gestante admitida em unidade de terapia intensiva obstétrica com quadro de alteração de sensório, atribuído inicialmente à doença hipertensiva da gravidez. Evoluiu com piora do quadro geral caracterizada por anemia e plaquetopenia grave, suscitando a investigação diagnóstica de púrpura trombocitopênica trombótica após o reconhecimento do perfil hematológico. Os autores enfatizam a importância do conhecimento da doença como marcador de prognóstico para pacientes obstétricas, em vista da semelhança com outras patologias comuns ao ciclo gravídico-puerperal e o fato do diagnóstico e tratamento precoce serem determinantes para o desfecho.

Case report of a patient with 37-week gestational age admitted to an obstetric intensive care unit with an altered level of consciousness, related primarily to the pregnancy-induced hypertension. The patient presented a worsening clinical course characterized by, anemia and severe thrombocytopenia, Investigation led to a diagnostic of thrombotic thrombocytopenic purpura after the hematological profile was assessed. The authors emphasize the importance of the disease recognition as a prognostic marker for obstetric patients, in view of the similarity with other common morbidities during pregnancy and the importance of timely diagnosis and early treatment as determinant factors for the outcome.

Thrombotic thrombocytopenic purpura associated with pregnancy: case report. / Púrpura trombocitopênica trombótica associada à gravidez: relato de caso.

Case report of a patient with 37-week gestational age admitted to an obstetric intensive care unit with an altered level of consciousness, related primarily to the pregnancy-induced hypertension. The patient presented a worsening clinical course characterized by, anemia and severe thrombocytopenia, Investigation led to a diagnostic of thrombotic thrombocytopenic purpura after the hematological profile was assessed. The authors emphasize the importance of the disease recognition as a prognostic marker for obstetric patients, in view of the similarity with other common morbidities during pregnancy and the importance of timely diagnosis and early treatment as determinant factors for the outcome.

Synthesis and pharmacological activity of chalcones derived from 2,4,6-trimethoxyacetophenone in RAW 264.7 cells stimulated by LPS: quantitative structure-activity relationships.

Inhibition of nitric oxide (NO) production by altering the expression of induced enzymes involved is potentially an important strategy for obtaining antiinflammatory agents. In the search for hits to obtain lead compounds for new drugs of this class, 14 synthetic chalcones derived from 2,4,6-trimethoxyacetophenone were evaluated in terms of their inhibitory action, in vitro, in relation to NO production in murine macrophages of the line RAW 264.7 induced by bacterial lipopolysaccharides (LPS). All the compounds were obtained by aldolic condensation between the acetophenone and corresponding aldehydes, under basic conditions. The mean IC(50) values, calculated through dose versus inhibitory effect curves, in four independent experiments, varied between 1.34 and 27.60microM, and were compared with the positive control, compound 1400W (IC(50)=3.78microM), a highly selective inhibitor of iNOS (induced nitric oxide synthase). Eight chalcones gave mean IC(50) values less than or equal to those obtained for 1400W, which suggests that these molecules may act as inhibitors of inflammatory process. The QSAR study reveals that electron-withdrawing groups in the B-ring seem to increase the inhibition of nitrite production, mainly when in position 2. A substitution in the ortho position of the A-ring seems to be necessary for the activity.