Musician's dystonia in a percussionist - clinical video analysis and botulinum toxin intervention: a case report.

OBJECTIVE: Musician's focal hand dystonia is a painless task-specific focal dystonia, which presents with involuntary movements, abnormal postures, and loss of fine motor dexterity. We report here the case of a 63-year-old male, percussionist, with african ethnicity, with musician's focal hand dystonia who was treated with botulinum toxin, and describe the results at 4-weeks follow up. METHODS: Clinical examination and video analysis revealed abnormal flexion of the 3rd finger, followed by flexion of the 4th and 5th fingers while playing the congas. Based on these findings, a diagnosis of musician's focal hand dystonia was established. Ten units of botulinum toxin were injected into the muscle fibres of the flexor digitorum superficialis corresponding to the 4th finger using electromyography and ultrasound guidance. Four weeks later, the patient reported a subjective 60% improvement in his performance. He emphasized the effect of botulinum toxin on performance speed and tension over the forearm and hand. CONCLUSION: Botulinum toxin is not a definitive treatment for musician's focal hand dystonia, but it may potentiate other definitive rehabilitation techniques. More research is needed to determine the long-term effects of botulinum toxin on function enhancement in musician's focal hand dystonia.

Characterization of Brazilian Buriti oil biomaterial: the influence on the physical, chemical properties and behaviour of Goat Wharton's jelly mesenchymal stem cells.

The Brazilian Buriti oil presents low extraction costs and relevant antioxidant properties. Thus, this work aimed to analyze Buriti oil biomaterial (BB), within its physicochemical properties, biocompatibility and cellular integration, with the purpose to the use as a growth matrix for Goat Wharton's jelly mesenchymal stem cells. Biomaterials were produced from Buriti oil polymer (Mauritia flexuosa), for it's characterization were performed Infrared Region Spectroscopy (FTIR) and Thermogravimetric Analysis (TG and DTG). The biointegration was analyzed by Scanning Electron Microscopy (SEM) and histological techniques. In order to investigate biocompatibility, MTT (3-(4,5-dimetil-2-tiazolil)-2,5-difenil-2H-tetrazólio) test and hemolytic activity tests were performed. The activation capacity of immune system cellswas measured by phagocytic capacity assay and nitric oxide synthesis . The BB presented an amorphous composition, with high thermal stability and high water expansion capacity, a surface with micro and macropores, and good adhesion of Wharton's jelly mesenchymal stem cells (MSCWJ). We verified the absence of cytotoxicity and hemolytic activity, in addition, BB did not stimulate the activation of macrophages. Proving to be a safe material for direct cultivation and also for manufacturing of compounds used for in vivo applications.

Instrumentos para avaliação da sexualidade de mulheres grávidas: revisão integrativa / Instruments for assessing the sexuality of pregnant women: integrative review / Instrumentos para evaluar la sexualidad de mujeres embarazadas: revisión integrativa

Objetivo: Identificar instrumentos utilizados para avaliar aspectos inerentes à sexualidade de mulheres grávidas. Método: Revisão integrativa da literatura realizada de agosto a setembro de 2022. A busca ocorreu nas bases de dados LILACS, MEDLINE, BDENF, IBECS, CINAHL e na biblioteca SciELO. Foram utilizados os descritores Pregnancy; Surveys and Questionnaires; Quiz; Forms; Instruments; Sexuality; Sexual behavior; Sexual Dysfunction, Physiological; Sexual Function; eSexual Dysfunction.Resultados:Foram identificados 5.632 estudos. Após aplicação dos critérios de inclusão e exclusão e leitura dos textos na íntegra, a amostra foi composta por 27 artigos. Foram identificados 14 instrumentos. Predominou a utilização de questionários com destaque para o Female Sexual Function Index(FSFI) por vezes associado a outro instrumento de coleta de dados. As abordagens direcionaram-se prioritariamente à função sexual de mulheres grávidas e ocorreram em serviços de saúde direcionados ao atendimento desse público. Conclusões: Evidenciaram-se instrumentos aplicáveis para investigar aspectos inerentes à sexualidade de mulheres grávidas úteis para aplicação no contexto do cuidado clínico de enfermagem durante a assistência pré-natal, o que pode contribuir para a integralidade da atenção à saúde sexual.

Objective: To identify instruments used to assess aspects inherent to the sexuality of pregnantwomen. Method:Integrative literature review occurred from August to September 2022. LILACS, MEDLINE, BDENF, IBECS, CINAHL databases, and the SciELO library were the chosen databases for the search. The descriptors Pregnancy; Surveys and Questionnaires; Quiz; Forms; Instruments; Sexuality; Sexual behavior; Sexual Dysfunction, Physiological; Sexual Function; and Sexual Dysfunction. Results:5,632 studies were identified. After applying the inclusion and exclusion criteria and reading the texts in full, the sample consisted of 27 articles. We identified 14 instruments in the studies. The use of questionnaires predominated, with emphasis on the Female Sexual Function Index (FSFI) associated with another tool for data collection. The approaches were directed primarily to the sexual function of pregnant women and occurred in health services assisting this public. Conclusions:Applicable instruments investigate aspects inherent to the sexuality of pregnant women, useful for application in the context of clinical nursing care during prenatal care, which can contribute to the comprehensiveness of sexual health care.

Objetivo: Identificar instrumentos utilizados para evaluar aspectos inherentes a la sexualidad de las mujeres embarazadas. Método:Revisión integrativa de la literatura realizada de agosto a septiembre de 2022. Las bases de datos LILACS, MEDLINE, BDENF, IBECS, CINAHL y la biblioteca SciELO fueron las bases de datos elegidas para la búsqueda. Los descriptores Embarazo; Encuestas y Cuestionarios; Prueba; formularios; instrumentos; Sexualidad; Comportamiento sexual; Disfunción Sexual Fisiológica; función sexual; y disfunción sexual. Resultados:Se identificaron 5.632 estudios. Después de aplicar los criterios de inclusión y exclusión y leer los textos en su totalidad, la muestra quedó constituida por 27 artículos. Se identificaron 14 instrumentos en los estudios. Predominó el uso de cuestionarios, con énfasis en el Índice de Función Sexual Femenina (FSFI)asociado a otra herramienta de recolección de datos. Los abordajes estaban dirigidos principalmente a la función sexual de las mujeres embarazadas y ocurrieron en los servicios de salud que atendían a ese público. Conclusiones:Los instrumentos aplicablesinvestigan aspectos inherentes a la sexualidad de la gestante, útiles para su aplicación en el contexto de la atención clínica de enfermería durante el prenatal, que pueden contribuir a la integralidad de la atención a la salud sexual.

Improving the identification of high-risk non-metastatic castration-resistant prostate cancer patients in clinical practice.

Non-metastatic castration-resistant prostate cancer (nmCRPC) represents a challenging disease state in prostate cancer care. nmCRPC patients with a high risk of progression to metastatic disease who are identified by a prostate-specific antigen doubling time (PSADT) ≤10 months are eligible for treatment with the novel androgen receptor inhibitors (ARIs), shown to delay disease progression and extend survival. However, nmCRPC is often unexploited in clinical practice due to a lack of standardization in the methodology and in the tools used for its identification. In this article, a group of Urology and Oncology specialists with acknowledged expertise in prostate cancer reviews the state of the art in the management of high-risk nmCRPC patients, identifies gaps and unmet needs, and proposes strategies to optimize the identification of this patient subgroup in the clinical practice and improve their health outcomes.

Clinical profile and quality of life in climacteric women.

BACKGROUND: The Quality of Life in climacteric women is intrinsically related to signs and symptoms influenced by the decrease of estrogen and psychosocial factors linked to the natural aging process. Thus, this study aimed to trace the sociodemographic and clinical profiles of climacteric women working at the State University of Rio Grande do Norte (UERN) and evaluate their Quality of Life. METHODS: It is a descriptive, exploratory, and quantitative study. The population consisted of female workers from UERN, aging between 40 and 65 years. The total sample consisted of 63 women who answered the forms. Data collection was completely online, which allowed the women to have free choice to choose the most appropriate time to answer the questions. RESULTS: The majority of the participants were older than 50 years (53.97%, n = 34), were married or in a stable union (55.56%, n = 35), and lived in Mossoró-RN (82.53%, n = 52). Regarding skin color, white and brown women had the same percentage of 44.44% (n = 28). The pain, general health status, and vitality domains evidence the predominance of poor quality of life in the SF-36 questionnaire. Regarding the level of satisfaction with their current health status, 4.76% (n = 3) stated that they fit the level considered excellent, 44.44% (n = 28) very good, 46, 03% (n = 29) were good, and 4.77% (n = 3) stated unsatisfied with their current health status. The intensity of symptoms related to estrogen deficiency established by the Kupperman menopause index is as Mild 55.56% (n = 35), moderate 41.27% (n = 26), and severe 3.17% (n = 2). CONCLUSIONS: The occurrence of symptoms and perception of these symptoms differs from woman to woman, to a greater or lesser extent. These findings emphasize the need for qualified and individualized care for the needs of these women in health services and the development of applicable solutions for solving problems based on each woman profile.

Pensamento complexo e formação em enfermagem: possibilidades da extensão universitária / Complex thinking and education in nursing: possibilities of university extension / Pensamiento complejo y educación en enfermería: posibilidades de extensión universitaria

Objetivo:Objetivou-se discutir à luz do Pensamento Complexo as possibilidades da extensão universitária na formação do Enfermeiro. Método:Trata-se de estudo teórico reflexivo com base referencial do pensamento complexo proposto por Edgar Morinem articulação com as cinco diretrizes da extensão universitária. Para articular o conceito propostopeloautor a temática em estudo, foram realizadasbuscas eletrônicas não sistemática sobre o tema, realizando-seleitura crítica de suas obras e de outros estudiosos.Resultados:As discussões utilizaram o referencial do pensamento complexo de Edgar Morin e as cinco diretrizes da extensão universitária: Interação Dialógica; Interdisciplinaridade e Interprofissionalidade; Indissociabilidade Ensino-Pesquisa-Extensão; Impactos na Formação dos estudantes e Impacto e Transformação social, no ensino superior em Enfermagem. Evidenciaram-se contribuições e possibilidades das práticas extensionistas para a formação do enfermeiro direcionadas ao desenvolvimento do pensamento complexo, crítico, reflexivo, humano e cidadão. Considerações finais:Conclui-se que (re)pensar as práticas pedagógicas e curriculares da extensão na formação em Enfermagem em articulação com o pensamento complexo é imprescindível para uma práxis emancipatória e transdisciplinar.

Objective:The objective was to discuss, in the light of ComplexThinking, the possibilities of university extension in the training of nurses. Method:This is a reflective theoretical study based on the complex thinking proposed by Edgar Morin in conjunction with the five guidelines of university extension. In order to articulate the concept proposed by the author to the subject under study, non-systematic electronic searches were carried out on the subject, carrying out a critical reading of his works and those of other scholars. Results:The discussions used Edgar Morin's complex thinking framework and the five university extension guidelines: Dialogical Interaction; Interdisciplinarity and Interprofessionality; Inseparability Teaching-Research-Extension; Impacts on Student Training and Impact and Social Transformation in Nursing Higher Education. Contributions and possibilities of extension practices were evidenced for the training of nurses aimed at the development of complex, critical, reflective, human and citizen thinking. Final considerations:It is concluded that (re)thinking the pedagogical and curricular practices of extension in Nursing education in conjunction with complex thinking is essential for an emancipatory and transdisciplinary praxis.

Objetivo:El objetivo fue discutir, a la luz del Pensamiento Complejo, las posibilidades de la extensión universitaria en la formación de enfermeros. Método:Se trata de un estudio teórico reflexivo basado en el pensamiento complejo propuesto por Edgar Morin en conjunto con los cinco lineamientos de la extensión universitaria. Para articular el concepto propuesto por el autor al tema en estudio, se realizaron búsquedas electrónicas no sistemáticas sobre el tema, efectuando una lectura crítica de sus obras y de las de otros estudiosos. Resultados: Las discusiones utilizaron el marco de pensamiento complejo de Edgar Morin y las cinco directrices de la extensión universitaria: Interacción Dialógica; Interdisciplinariedad e Interprofesionalidad; Inseparabilidad Docencia-Investigación-Extensión; Impactos en la Formación de Estudiantes e Impacto y Transformación Social en la Educación Superior de Enfermería. Se evidenciaron aportes y posibilidades de prácticas extensionistas para la formación de enfermeros encaminados al desarrollo del pensamiento complejo, crítico, reflexivo, humano y ciudadano. Consideraciones finales:Se concluye que (re)pensar las prácticas pedagógicas y curriculares de extensión en la formación de Enfermería en conjunto con el pensamiento complejo es fundamental para una praxis emancipatoria y transdisciplinar.

Percepção de estudantes de enfermagem sobre ensino-aprendizagem de períodos clínicos e mecanismos de parto / Nursing students' perception about teaching and learning of clinical periods and birth mechanisms / Percepción de los estudiantes de enfermería sobrela enseñanza y el aprendizaje de los períodos clínicos y mecanismos de nacimiento

Objetivo: Descrever a percepção de acadêmicos de Enfermagem sobre o processo ensino-aprendizagem de períodos clínicos e mecanismos de parto. Método: Pesquisa descritiva com abordagem qualitativa realizada com 12 acadêmicas de enfermagem recrutadas mediante a utilização da técnicasnowbollno período de março a junho de 2020 via Skype® utilizando entrevista semiestruturada. Os dados foram organizados em três categorias e realizou-se a análise categorial temática. Resultados:Evidenciaram três categorias temáticas: Categoria 1-O processo de ensino aprendizagem sobre períodos clínicos e mecanismos de parto na graduação de enfermagem; Categoria 2-Facilidades e dificuldades no processo ensino-aprendizagem sobre períodos clínicos e mecanismos de parto na graduação de enfermagem; Categoria 3: Necessidades para serem discutidas no processo ensino aprendizagem sobre períodos clínicos e mecanismos de parto na graduação de enfermagem.Os achados evidenciaram que os discentes reconheceram suas próprias dificuldades relacionadas ao comprometimento, organização e corresponsabilidade em desenvolver estudos sobre a temática. Apontaram como principal limitação àdesarticulação entre teoria e prática e como potencialidade a utilização de metodologias ativas. Enfatizaram a necessidade de articulação teórico-prática e ampliação de assuntos sobre a temática, mudanças nos recursos e estratégias pedagógicas, com vistas a favorecer a aprendizagem significativa e contribuir para a oferta de cuidados obstétricos. Considerações finais:Conclui-se que o processo de ensino-aprendizagem sobre períodos clínicos e mecanismos de parto revela fragilidades relativas a forma de abordagem didática e dificuldades de assimilação dos conteúdos, dissociação teórico-prática, dificuldades de organização da rotina de estudos pelos discentes.

Objective: To describe the perception of Nursing students about the teaching-learning process of clinical periods and delivery mechanisms. Method:Descriptive research with a qualitative approach carried out with 12 nursing students recruited using the snowboll technique from March to June 2020 via Skype® using a semi-structured interview. Data were organized into three categories and thematic categorical analysis was performed. Results:Three thematic categories were evidenced: Category 1-The teaching-learning process about clinical periods and childbirth mechanisms in nursing graduation; Category 2-Facilities and difficulties in the teaching-learning process about clinical periods and delivery mechanisms in nursing graduation; Category 3: Needs to be discussed in the teaching-learning process about clinical periods and childbirth mechanisms in nursing graduation. The findings showed that the students recognized their own difficulties related to commitment, organization and co-responsibility in developing studies on the subject. They pointed out as the main limitation the disarticulation between theory and practice and as a potentiality the use of active methodologies. They emphasized the need for theoretical-practical articulation and expansion ofsubjects on the subject, changes in resources and pedagogical strategies, with a view to favoring meaningful learning and contributing to the provision of obstetric care. Final considerations:It is concluded that the teaching-learning process on clinicalperiods and delivery mechanisms reveals weaknesses related to the didactic approach and difficulties in assimilating the contents, theoretical-practical dissociation, difficulties in organizing the study routine by the students.

Objetivo: Describir la percepción de los estudiantes de Enfermería sobre el proceso de enseñanza-aprendizaje de los períodos clínicos y los mecanismos de entrega. Método:Investigación descriptiva con enfoque cualitativo realizada con 12 estudiantes de enfermería reclutados mediante la técnica de bola de nieve de marzo a junio de 2020 a través de Skype® mediante entrevista semiestructurada. Los datos se organizaron en tres categorías y se realizó un análisis categórico temático. Resultados:Se evidenciaron tres categorías temáticas: Categoría 1-El proceso de enseñanza-aprendizaje sobre los períodos clínicos y los mecanismos del parto en la graduación de enfermería; Categoría 2-Facilidades y dificultades en el proceso de enseñanza-aprendizaje sobre períodos clínicos y mecanismos de entrega en la graduación de enfermería; Categoría 3: Necesita ser discutido en el proceso de enseñanza-aprendizaje sobre los períodosclínicos y los mecanismos del parto en la graduación de enfermería. Los hallazgos mostraron que los estudiantes reconocieron sus propias dificultades relacionadas con el compromiso, la organización y la corresponsabilidad en el desarrollo de estudios sobre el tema. Señalaron como principal limitación la desarticulación entre teoría y práctica y como potencialidad el uso de metodologías activas. Enfatizaron la necesidad de articulación teórico-práctica y ampliación de asignaturas sobre el tema, cambios en los recursos y estrategias pedagógicas, con miras a favorecer el aprendizaje significativo y contribuir a la prestación de la atención obstétrica. Consideraciones finales:Se concluye que el proceso de enseñanza-aprendizaje sobre períodos clínicos y mecanismos de impartición revela debilidades relacionadas con el enfoque didáctico y dificultades en la asimilación de los contenidos, disociación teórico-práctica, dificultades en la organización de la rutina de estudio por parte de los estudiantes.

Factors associated with sexual practices and positions performed by pregnant women: a cross-sectional study / Factores relacionados a las prácticas y posiciones sexuales realizadas por mujeres embarazadas: estudio transversal / Fatores associados às práticas e posições sexuais realizadas por mulheres grávidas: estudo transversal

ABSTRACT Objectives: to identify factors associated with the sexual practices and positions performed by pregnant women. Methods: a cross-sectional, quantitative study conducted with 354 pregnant women, in the interior of Ceará, Brazil, in 2016. For data collection, a form and a Pregnancy Sexuality Questionnaire were used. Results: there was a reduction in the sexual initiative of the woman, sexual disposition of the couple, sexual practices and most of the sexual positions, while the maintenance of preliminary sexual activities and initiative to perform them was verified. Sexual practices and positions decreased (p<0.0001): preliminary sexual activities, sexual disposition, lubrication, orgasm, pain or discomfort, sexual positions, sexual practices, and sexual satisfaction. Sexual practices and positions increased (p<0.0001) as a function of: education, number of deliveries, sexual life, desire and arousal, and sexual disposition of the pregnant woman, frequency of orgasm and of sexual practices (p<0.0001). Conclusions: sexual practices and positions of pregnant women were affected by domains of sexual function, sexual, reproductive, physical, and psychological aspects.

RESUMEN Objetivos: identificar factores relacionados a prácticas y posiciones sexuales realizadas por mujeres embarazadas. Métodos: estudio transversal, cuantitativo, realizado con 354 mujeres embarazadas, en interior Cearense, Brasil, en 2016. Utilizado formulario y Encuesta de Sexualidad en el Embarazo, para recolecta de datos. Resultados: hubo reducción en la iniciativa sexual de la mujer, disposición sexual del casal, prácticas sexuales y mayoría de las posiciones sexuales, mientras que se constató manutención de actividades sexuales preliminares e iniciativa para realizarlas. Redujeron prácticas y posiciones sexuales (p<0,0001): actividades sexuales preliminares, disposición sexual, lubricación, orgasmo, dolor o incomodidad, posiciones sexuales, prácticas sexuales y satisfacción sexual. Prácticas y posiciones sexuales aumentaron (p<0,0001) en función de: escolaridad, número de partos, vida sexual, deseo y excitación y disposición sexual de la embarazada, frecuencia del orgasmo y prácticas sexuales. Conclusiones: prácticas y posiciones sexuales de embarazadas fueron afectadas por dominios de la función sexual, aspectos sexuales, reproductivos, físicos y psicológicos.

RESUMO Objetivos: identificar fatores associados às práticas e posições sexuais realizadas por mulheres grávidas. Métodos: estudo transversal, quantitativo, realizado com 354 mulheres grávidas, no interior do Ceará, Brasil, em 2016. Para coleta de dados, utilizou-se formulário e Questionário de Sexualidade na Gestação. Resultados: houve redução na iniciativa sexual da mulher, disposição sexual do casal, práticas sexuais e da maioria das posições sexuais, ao passo que se constatou manutenção das atividades sexuais preliminares e da iniciativa para realizá-las. Reduziram-se práticas e posições sexuais (p<0,0001): atividades sexuais preliminares, disposição sexual, lubrificação, orgasmo, dor ou desconforto, posições sexuais, práticas sexuais e satisfação sexual. Práticas e posições sexuais aumentaram (p<0,0001) em função de: escolaridade, número de partos, vida sexual, desejo e excitação e disposição sexual da gestante, frequência do orgasmo e de práticas sexuais. Conclusões: práticas e posições sexuais de mulheres grávidas foram afetadas por domínios da função sexual, aspectos sexuais, reprodutivos, físicos e psicológicos.

Compreensão da dor do recém-nascido pré-termo pela equipe de saúde / Understanding of pain in pre-term newborn by the multiprofessional team / Comprensión que tiene el equipo multiprofesional del dolor del recién nacido prematuro

Objetivo: verificar a compreensão sobre o conhecimento da dor do recém-nascido pré-termo pela equipe de saúde na unidade neonatal. Método: pesquisa exploratório-descritiva de abordagem qualitativa, aprovada pelo Comitê de Ética em Pesquisa da instituição, realizada entre maio a novembro de 2019, com 15 membros da equipe de saúde da unidade de tratamento intensivo neonatal de um hospital da rede federal de ensino. Os dados foram coletados por meio de entrevista semiestruturada e submetidos à Análise de Conteúdo. Resultados: emergiram quatro categorias: compreensão da dor no pré-termo; compreensão das situações produtoras de dor; compreensão do conhecimento adquirido sobre os métodos de manejo, avaliação e tratamento da dor; e compreensão do trabalho multiprofissional e a dor no pré-termo. Conclusão: a equipe de saúde compreende e reconhece a dor do pré-termo, os métodos de manejo e avaliação utilizados, de forma não sistematizada, apontam seus potenciais benefícios, destacando a importância de capacitação da equipe e elaboração de protocolos para a prática clínica segura. Implicações para a prática: este estudo poderá contribuir no planejamento na organização sistematizada de estratégias quanto ao conhecimento teórico e prático da equipe de saúde como estratégia necessária para implementação de medidas controle da dor, com vista a proporcionar cuidado de excelência. (AU).

Objective: to verify the understanding of the preterm newborn's knowledge of pain by the health team in the neonatal unit. Method: exploratory-descriptive research with a qualitative approach, approved by the Research Ethics Committee of the institution, carried out between May and November 2019, with 15 members of the health team of the neonatal intensive care unit of a hospital in the federal education network. Data were collected through semistructured interviews, submitted to Content Analysis. Results: four categories emerged: understanding preterm pain; understanding of pain-producing situations; understanding of acquired knowledge about pain management, assessment and treatment methods; and understanding of multidisciplinary work and preterm pain. Conclusion: the health team understands and recognizes preterm pain, the management and evaluation methods used, in a non-systematized way, point out its potential benefits, highlighting the importance of team training and elaboration of protocols for safe clinical practice. Implications for practice: this study may contribute to planning in the systematic organization of strategies regarding the theoretical and practical knowledge of the health team as a necessary strategy for the implementation of pain control measures, with a view to providing excellent care. (AU).

Objetivo: comprobar la comprensión que tiene el equipo de salud de la unidad neonatal del dolor del recién nacido prematuro. Método: investigación exploratoria-descriptiva con enfoque cualitativo, aprobada por el Comité de Ética en Investigación de la institución, realizada entre mayo y noviembre de 2019, con 15 integrantes del equipo de salud de la unidad de cuidados intensivos neonatales de un hospital de la red federal de educación. Los datos fueron recolectados por medio de entrevistas semiestructuradas y sometidos a Análisis de Contenido. Resultados: surgieron cuatro categorías: comprensión del dolor del prematuro; comprensión de las situaciones que producen dolor; comprensión de los conocimientos adquiridos sobre el manejo del dolor, métodos de evaluación y tratamiento del dolor; y comprensión del trabajo multidisciplinario y del dolor del prematuro. Conclusión: el equipo de salud comprende y reconoce el dolor del prematuro, los métodos de manejo y evaluación utilizados, de forma no sistematizada, señalan sus potenciales beneficios, destacan la importancia de la capacitación del equipo y de la elaboración de protocolos para la práctica clínica segura. Implicancias para la práctica: este estudio puede contribuir a planificar la organización sistemática de estrategias sobre el conocimiento teórico y práctico del equipo de salud como estrategia necesaria para la implementación de medidas de control del dolor, con el objetivo de brindar una atención de excelencia. (AU).

Factors associated with sexual practices and positions performed by pregnant women: a cross-sectional study.

OBJECTIVES: to identify factors associated with the sexual practices and positions performed by pregnant women. METHODS: a cross-sectional, quantitative study conducted with 354 pregnant women, in the interior of Ceará, Brazil, in 2016. For data collection, a form and a Pregnancy Sexuality Questionnaire were used. RESULTS: there was a reduction in the sexual initiative of the woman, sexual disposition of the couple, sexual practices and most of the sexual positions, while the maintenance of preliminary sexual activities and initiative to perform them was verified. Sexual practices and positions decreased (p<0.0001): preliminary sexual activities, sexual disposition, lubrication, orgasm, pain or discomfort, sexual positions, sexual practices, and sexual satisfaction. Sexual practices and positions increased (p<0.0001) as a function of: education, number of deliveries, sexual life, desire and arousal, and sexual disposition of the pregnant woman, frequency of orgasm and of sexual practices (p<0.0001). CONCLUSIONS: sexual practices and positions of pregnant women were affected by domains of sexual function, sexual, reproductive, physical, and psychological aspects.

Epidemiology of gestational syphilis in a Brazilian state: analysis in the light of the social-ecological theory.

OBJECTIVE: To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. METHOD: This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. RESULTS: A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). CONCLUSION: Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.

Development of castor polyurethane scaffold (Ricinus communisL.) and its effect with stem cells for bone repair in an osteoporosis model.

The development of 'smart' scaffolds has achieved notoriety among current prospects for bone repair, especially for chronic osteopathy, such as osteoporosis. Millions of individuals in the world suffer from poor bone healing due to osteoporosis. The objective of this work was to produce and characterize castor polyurethane (PU) scaffolds (Ricinus communisL.)andevaluate itsin vitrobiocompatibility with stem cells and osteoinductive effectin vivoon bone failures in a leporid model of osteoporosis. The material was characterized using Fourier-transform infrared spectroscopy, thermogravimetric analysis, SEM, and porosity analysis. Then, the biocompatibility was assessed by adhesion using SEM and cytotoxicity in a 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium assay. The osteoinductive effectin vivowas determined in bone defects in rabbit tibias (Oryctolagus cuniculus) submitted to castor PU scaffold, castor PU scaffold associated with stem cells, and negative control, after four and eight weeks, evaluated by computed microtomography and histopathology. The scaffolds were porous, with an average pore size of 209.5 ± 98.2 µm, absence of cytotoxicity, and positive cell adhesivenessin vitro.All the animals presented osteoporosis, characterized by multifocal osteoblastic inactivity and areas of mild fibrosis. There were no statistical differences between these treatments in the fourth week of treatment. In the eighth week, the treatment with castor PU scaffold alone induced more significant bone formation when compared to the other groups, followed by treatment with an association between castor PU scaffold and stem cells. The castor PU scaffold was harmless to cell culture, favoring cell adhesiveness and proliferation, in addition to inducing bone neoformation in osteoporotic rabbits.

Co-Inoculation with Staphylococcus equorum and Lactobacillus sakei Reduces Vasoactive Biogenic Amines in Traditional Dry-Cured Sausages.

Dry-cured sausages are traditional in Mediterranean countries, and Paio do Alentejo (PA) is one of the most popular in South Portugal. The aim of the present work was to evaluate the effect of combined starters on the safety and quality of PA preserving its sensory quality. Physicochemical parameters, namely pH and water activity (aW), microbiological parameters, biogenic amines, color, texture, and sensory attributes were assessed. Three starter cultures were used, namely Staphylococcus equorum S2M7 and Lactobacillus sakei CV3C2, both separate and combined with the 2RB4 yeast strain at a concentration of 106 cfu/g. Dextrose 0.25% was added to the meat batter. Starters had a significant effect on the reduction of aW values (0.845 to 0.823). The treatment with L. sakei as well as the co-inoculation of L. sakei with S. equorum effectively reduced the L. monocytogenes counts to undetectable levels. Sausages co-inoculated with S. equorum S2M7/L. sakei CV3C2 showed a significant reduction in the content of vasoactive amines, namely tryptamine (26.21 to 15.70) and ß-phenylethylamine (4.80 to 3.69). Regarding texture, control PA showed higher hardness values, and the starters promoted the cohesiveness of the batter while reducing chewiness. The studied starters did not compromise the sensory characteristics of PA.

Polyurethane derived from castor oil monoacylglyceride (Ricinus communis) for bone defects reconstruction: characterization and in vivo testing.

Biomaterials used in tissue regeneration processes represent a promising option for the versatility of its physical and chemical characteristics, allowing for assisting or speeding up the repair process stages. This research has characterized a polyurethane produced from castor oil monoacylglyceride (Ricinus communis L) and tested its effect on reconstructing bone defects in rat calvaria, comparing it with commercial castor oil polyurethane. The characterizations of the synthesized polyurethane have been performed by spectroscopy in the infrared region with Fourier transform (FTIR); thermogravimetric analysis (TG/DTG); X-ray diffraction (XRD) and Scanning Electron Microscopy (SEM). For the in vivo test, 24 animals have been used, divided into 3 groups: untreated group (UG); control group treated with Poliquil® castor polyurethane (PCP) and another group treated with castor polyurethane from the Federal University of Piauí - UFPI (CPU). Sixteen weeks after surgery, samples of the defects were collected for histological and histomorphometric analysis. FTIR analysis has shown the formation of monoacylglyceride and polyurethane. TG and DTG have indicated thermal stability of around 125 °C. XRD has determined the semi-crystallinity of the material. The polyurethane SEM has shown a smooth morphology with areas of recesses. Histological and histomorphometric analyzes have indicated that neither CPU nor PCP induced a significant inflammatory process, and CPU has shown, statistically, better performance in bone formation. The data obtained shows that CPU can be used in the future for bone reconstruction in the medical field.

Epidemiology of gestational syphilis in a Brazilian state: analysis in the light of the social-ecological theory / Epidemiología de la sífilis gestacional en un Estado brasileño: análisis a la luz de la teoría social ecológica / Epidemiologia da sífilis gestacional em um estado brasileiro: análise à luz da teoria social ecológica

ABSTRACT Objective: To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. Method: This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. Results: A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). Conclusion: Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.

RESUMEN Objetivo: Analizar, a la luz de la teoría social ecológica, la evolución temporal de la sífilis gestacional y su relación con la implantación de la rede cegonha en Ceará. Método: Estudio retrospectivo, documental, a partir del sistema de información de agravios de notificación acerca de la sífilis gestacional en la perspectiva de la teoría social ecológica. La muestra fue compuesta por todas las notificaciones del estado de Ceará en el período de 2007 a 2017. La colecta de datos fue realizada en octubre de 2019. Resultados: Fueron notificados 229.558 casos de sífilis gestacional en Brasil; de estos, 7.040 fueron provenientes del estado de Ceará (3,1%), con aumento creciente de los casos a lo largo de los años. Con relación a la distribución de los casos de sífilis entre el periodo y después de la implantación de la rede cegonha, hubo asociación con escolaridad (p < 0.0001), clasificación clínica (p < 0,0001) y edad gestacional (p = 0,0005). Consideraciones Finales: A pesar de la efectuación de políticas públicas y mejora del sistema de vigilancia epidemiológica, todavía hay un largo camino para el control de la sífilis en la gestación.

RESUMO Objetivo: Analisar, à luz da teoria social ecológica, a evolução temporal da sífilis gestacional e sua relação com a implantação da rede cegonha no Ceará. Método: Estudo retrospectivo, documental, a partir do sistema de informação de agravos de notificação acerca da sífilis gestacional na perspectiva da teoria social ecológica. A amostra foi composta por todas as notificações do estado do Ceará no período de 2007 a 2017. A coleta de dados foi realizada em outubro de 2019. Resultados: Foram notificados 229.558 casos de sífilis gestacional no Brasil; destes, 7.040 foram oriundos do estado do Ceará (3,1%), com aumento crescente dos casos no decorrer dos anos. Com relação à distribuição dos casos de sífilis entre o período antes e após a implantação da rede cegonha, houve associação com escolaridade (p < 0,0001), classificação clínica (p < 0,0001) e idade gestacional (p = 0,0005). Conclusão: Apesar da efetivação de políticas públicas e aprimoramento do sistema de vigilância epidemiológica, ainda há um longo caminho para controle da sífilis na gestação.

Hospitalização na gravidez de alto risco: representações sociais das gestantes / Hospital admission in high-risk pregnancies: the social representations of pregnant women / Hospitalización en el embarazo de alto riesgo: representaciones sociales de las mujeres embarazadas

Enquadramento: A hospitalização na gravidez de alto risco gera alterações na rotina e na forma de compreender a gravidez, que devem ser consideradas durante o planeamento e execução da assistência. Objetivo: Conhecer as representações sociais de gestantes de alto risco sobre a hospitalização durante o ciclo gravídico. Metodologia: Estudo exploratório, descritivo, norteado pela teoria das representações sociais, realizado em duas maternidades do Ceará com 68 gestantes de alto risco hospitalizadas, entre julho e setembro de 2016, através do teste de associação livre de palavras com análise pelo software Tri-Deux-Mots, versão 5.3. Resultados: A gravidez foi representada pela satisfação de gestar, ancorada na função biológica e social da maternidade, a gravidez de alto risco foi apreendida como situação problemática e de desfecho incerto, envolta em sentimentos negativos. A hospitalização foi interpretada como lugar de dor e solidão, mas também de cuidado e proteção, ampliando possibilidades de evolução favorável. Conclusão: As evocações elucidam conteúdos significativos sobre gravidez com as particularidades do diagnóstico de alto risco e do contexto da hospitalização.

Background: Hospital admission in high-risk pregnancies changes the routine and the way in which pregnancy is experienced. These changes must be taken into account during care planning and delivery. Objective: To identify high-risk pregnant women's social representations of hospital admission during pregnancy. Methodology: An exploratory, descriptive study, guided by the social representations theory, was carried out in two maternity hospitals in Ceará, involving 68 hospitalized high-risk pregnant women, between July and September 2016. The word association test was used and data were analyzed using the Tri-Deux-Mots software, version 5.3. Results: Pregnancy was represented by the satisfaction to gestate a baby, anchored in the biological and social role of motherhood. High-risk pregnancy was perceived as a problematic situation with an uncertain outcome, surrounded by negative feelings. Hospital admission was interpreted as a place of pain and loneliness, but also of care and protection, expanding the possibilities for a favorable evolution. Conclusion: The evoked words reflect important meanings attributed to pregnancy in a context of a high-risk pregnancy that requires hospital admission.

Marco contextual: La hospitalización en los embarazos de alto riesgo provoca cambios en la rutina y en la forma de comprender el embarazo, que deben considerarse durante la planificación y la implementación de la atención. Objetivo: Conocer las representaciones sociales de las mujeres embarazadas de alto riesgo sobre la hospitalización durante el ciclo de embarazo. Metodología: Estudio exploratorio y descriptivo, guiado por la teoría de las representaciones sociales, realizado en dos maternidades de Ceará con 68 mujeres embarazadas de alto riesgo hospitalizadas entre julio y septiembre de 2016, mediante la prueba de asociación libre de palabras, analizada con el software Tri-Deux-Mots, versión 5.3. Resultados: El embarazo se representó por la satisfacción del mismo, anclada en la función biológica y social de la maternidad; el embarazo de alto riesgo se percibió como una situación problemática y de resultado incierto, rodeada de sentimientos negativos. La hospitalización se interpretó como un lugar de dolor y soledad, pero también de cuidado y protección, que amplía las posibilidades de evolución favorable. Conclusión: Las evocaciones aclaran contenidos significativos sobre el embarazo, con las particularidades del diagnóstico de alto riesgo y del contexto de la hospitalización.

A Pilot Intervention Study to Improve Sexuality Outcomes in Breast Cancer Survivors.

OBJECTIVE: The main objective of the study is to assess the efficacy of the Permission, Limited information, Specific Suggestion, and sexual therapy (PLISSIT) model directly with breast cancer survivor (BCS) on sexual function and quality of life (QOL) domains. METHODS: A pilot control trial was conducted comparing the PLISSIT model intervention to usual care. The intervention was delivered by two health professionals (nurse and professional sexual therapist) consisted of five sessions on counseling, genitalia anatomy, human sexual response, and sexual function. Data were collected before and 3 months after the intervention using the Female Sexual Function Index and the World Health Organization QOL-BREF questionnaire. RESULTS: The sample consisted of 19 BCS (11 intervention, 8 controls) with a mean age of 54.5 8 years (standard deviation = 7.14) and the majority were married, Black or mixed Brazilian, received chemotherapy, radiation and/or hormonal therapy, and education varied from high school to college. There was significant improvement in physical health (P = 0.031), social relationships (P = 0.046), orgasm (P = 0.055), and pain (P = 0.049) over time and the intervention resulted in improved arousal (P = 0.038). CONCLUSIONS: The results suggest that the PLISSIT model may be an effective intervention for BCS in coping with and managing changes in sexuality and sexual function after treatment. It is important that nurses are aware of sexual intimacy concerns for BCS and integrate assessment into their nursing care.

Autochthonous Starter Cultures Are Able to Reduce Biogenic Amines in a Traditional Portuguese Smoked Fermented Sausage.

Traditional smoked fermented sausages are highly appreciated in Portugal and are mostly manufactured according to traditional procedures. The aim of the present work was to evaluate the effect of autochthonous starter cultures on the safety and quality of a smoked fermented sausage, Painho da Beira Baixa (PBB), preserving its sensory quality. Physicochemical parameters, namely pH and water activity (aW), microbiological parameters, biogenic amines, colour, texture profile and sensory attributes were assessed. Different starters were selected based on our previous work. Staphylococcus equorum S2M7, Staphylococcus xylosus CECT7057, Lactobacillus sakei CV3C2, Lactobacillus sakei CECT7056 and a yeast strain (2RB4) were co-inoculated in meat batters at defined concentrations. Starters had a significant effect on the reduction of pH. Enterobacteria and Listeria monocytogenes were not detected in inoculated end-product sausages. Moreover, sausages inoculated with S. equorum S2M7/L. sakei CV3C2/yeast 2RB4 showed a significant reduction in the total content of biogenic amines. No significant differences between treatments were observed for colour and texture parameters, except for adhesiveness. The studied starters did not compromise the sensory characteristics of PBB. To our knowledge, this is the first comprehensive study on the quality and safety of this type of smoked fermented sausage from the central region of Portugal.

What is the Main Processing Factor Influencing Staphylococcus Species Diversity in Different Manufacturing Units?

The microbiota of traditional dry-cured sausages and industrial environment was assessed to characterize the diversity of coagulase-negative staphylococci (CNS), and establish potential relationships with hygiene level or technological characteristics. Eight processing units from South Portugal were audited according to a checklist of requirements. Environmental and products' samples at different production stages were evaluated regarding hygiene and safety criteria. CNS were recovered, characterized, and their potential use as starters evaluated. Low genetic diversity was observed for Staphylococcus xylosus, whereas Staphylococcus equorum showed diverse genetic profiles. Staphylococcus xylosus predominated in products with a long period of cold smoking, Staphylococcus saprophyticus in products with a long period of hot smoking, Staphylococcus epidermidis in products with a short period of cold smoking, and S. equorum in nonsmoked products. Most S. xylosus were resistant to tetracycline, whereas S. equorum were susceptible. Antibioresistance restricted the selection of starters due to safety recommendations. PRACTICAL APPLICATION: The present manuscript highlighted a few staphylococci strains that could potentially be used as starter cultures in fermented meat products. These selected strains do not show resistance to antimicrobials, exhibit adequate technological features, and are well adapted to the industrial environments of meat processing industries using different processing technologies. Therefore, the selected strains ready to be used in the manufacturing of traditional fermented meat products to ensure safety, standardize product properties, and shorten ripening.