Obesity and recurrent miscarriage: The interconnections between adipose tissue and the immune system.

Currently, obesity is considered a global public health problem. It is the main risk factor for noncommunicable diseases and reproductive complications, such as recurrent miscarriage (RM). RM affects approximately 1% of couples of reproductive age, and recent studies suggest that its prevalence is increasing. Immunological abnormalities may be responsible for a significant number of cases of unexplained RM. Obesity is recognized as a chronic low-grade inflammatory condition. The accumulation of fat in obese adipose tissue promotes changes in the local and systemic immune response. Adipokines, exosomes, micro-RNAs, lipids, and other factors released or secreted by adipose tissue are responsible for the interconnection between obesity and the immune system. Obesity-induced dysregulation of the innate and acquired immune response is also involved in the immunopathology of pregnancy loss in patients with unexplained RM. Therefore, understanding the communication pathways between maternal adipose tissue and the immune response in women living with obesity and RM is an important objective. Thus, diagnostic tools and new immunomodulatory therapies may be proposed for the management of patients with concurrent obesity and RM.

Fertility preservation: knowledge, awareness, and attitude of university students and professors.

BACKGROUND: Delayed pregnancy is a worldwide trend, especially in Western countries. University students and professors are at high risk of presenting age-related reproductive difficulties due to this new reproductive profile. Thus, through this study, we aimed at exploring the knowledge, awareness, and attitude of university students and professors related to fertility and fertility preservation (FP). METHODS: We adopted a prospective cross-sectional study design and included students and professors from private university located in the Northeast of Brazil. Eligible participants (male and female) were invited through an online message. The participants accessed the online questionnaire through a link. RESULTS: We performed 256 surveys (100 students and 156 professors). The overall mean age of participants was 35.8 ± 13.1 years (from 18 to 67 years). Fertility was considered relevant by all participants, being very important among a greater number of students compared to professors, 61% versus 30.1%, p < 0.001, respectively. The main reasons why participants could have postponed parenthood were reach financial stability (62.1%), career building (51.2%), health issues (37.9%), and not having a partner (33.9%). Students demonstrated a better understanding of FP and highlighted the importance of the age of females at the time of the oocyte cryopreservation. Very few students and professors already discussed reproductive planning with a health professional. CONCLUSIONS: We observed a deficiency in the knowledge of Brazilian university students and professors about female fertility and FP options. Thus, exposing the population to information related to FP should be hyped in the university environment.

The Dietary Inflammatory Index as a predictor of pregnancy outcomes: Systematic review and meta-analysis.

Unhealthy diets have been linked to low-grade chronic inflammation, a condition known to play a role in the pathophysiology of non-communicable diseases as well as pregnancy complications. The Dietary Inflammatory Index (DII) is a tool for evaluating the inflammatory potential of various diets. The goal of this systematic review and meta-analysis is to assess the current state of evidence on the use of DII as a predictor of pregnancy outcomes in pregnant women. This study was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PROSPERO, number CRD42021288966). DII was evaluated as a predictor of obstetric complications in observational studies. The search was conducted in PubMed/Medline, Embase, and Web of Science. Data from eligible studies were extracted independently by two reviewers. The Newcastle-Ottawa Scale was used to assess the methodological quality of the studies. A total of eight studies were eligible for the review. In a meta-analysis of continuous and categorical variables, DII was a predictor of any obstetric complications [mean difference: 0.39, 95 %CI 0.02-0.75, (p = 0.04); and odds ratio: 1.24, 95 %CI 1.11-1.40, (p = 0.0002)]. High DII was associated with pregnancy complications, particularly preeclampsia/hypertensive disorder of pregnancy and preterm birth. The DII is a tool that can assist in the food and therapeutic planning of pregnant women with obstetric risks. Well-designed clinical trials are necessary, especially studies that focus on recurrent pregnancy losses and implantation failures.

Rare earth elements (REEs): geochemical patterns and contamination aspects in Brazilian benchmark soils.

Rare earth elements have been increasingly used in modern societies and soils are likely to be the final destination of several REE-containing (by)products. This study reports REE contents for topsoils (0-20 cm) of 175 locations in reference (n = 68) and cultivated (n = 107) areas in Brazil. Benchmark soil samples were selected accomplishing a variety of environmental conditions, aiming to: i) establishing natural background and anthropogenic concentrations for REE in soils; ii) assessing potential contamination of soils - via application of phosphate fertilizers - with REE; and, iii) predicting soil-REE contents using biomes, soil type, parent material, land use, sand content, and biomes-land use interaction as forecaster variables through generalized least squares multiple regression. Our hypotheses were that the variability of soil-REE contents is influenced by parent material, pedogenic processes, land use, and biomes, as well as that cultivated soils may have been potentially contaminated with REE via input of phosphate fertilizers. The semi-total concentrations of REE were assessed by inductively coupled plasma mass spectrometry (ICP-MS) succeeding a microwave-assisted aqua regia digestion. Analytical procedures followed a rigorous QA/QC protocol. Soil physicochemical composition and total oxides were also determined. Natural background and anthropogenic concentrations for REE were established statistically from the dataset by the median plus two median absolute deviations method. Contamination aspects were assessed by REE-normalized patterns, REE fractionation indices, and Ce and Eu anomalies ratios, as well as enrichment factors. The results indicate that differences in the amounts of REE in cultivated soils can be attributed to land use and agricultural sources (e.g., phosphate-fertilizer inputs), while those in reference soils can be attributed to parent materials, biomes, and pedogenic processes. The biomes, land use, and sand content helped to predict concentrations of light REE in Brazilian soils, with parent material being also of special relevance to predict heavy REE contents in particular.

Programa estadual de saúde pública: relato de experiência / State public health program: an experience report

Objetivo: relatar a experiência da implantação e processo de trabalho no programa Força Estadual de Saúde do Maranhão. Método: relato de experiência dos profissionais integrantes da equipe da Força Estadual de Saúde do Maranhão em um dos municípios de menor índice de desenvolvimento humano do estado. Resultados: o programa é formado por equipes de caráter interdisciplinar, pautando o processo de trabalho na assistência à saúde e no apoio institucional à gestão municipal para reverter indicadores de saúde como morbimortalidade infantil e materna, taxas de internação por complicações de doenças crônicas e controle de endemias negligenciadas. O apoio institucional foi fundamentado na metodologia Paideia, método reverso da procura de casos e com implementação da Planificação da Atenção à Saúde. Conclusão: o programa possui papel inovador no fortalecimento da atenção primária em saúde, com modelo de cuidado integral ao indivíduo e promovendo articulação com diversos atores envolvidos na organização e processo de trabalho em saúde.

Objective: to report the experience of the "State of Maranhão Health Force Program", its implementation and work process. Method: it is an experience report of health professionals from the State of Maranhão Health Force allocated in a city with the lowest Human Development Index in the State. Results: the program is forged by teams of interdisciplinary nature, lead by the work process in health care and institutional support to the municipal management to the reversal of health indicators such as infant and maternal morbidity and mortality, hospitalization rates due to complications of chronic disorders and control of endemic neglected diseases. Institutional support was based on the Paideia methodology, the reverse case search method and the implementation of Health Care Planning. Conclusion: the program has an innovative role in the strengthening of primary health care, proposing a model of comprehensive care for the individuals and promoting articulation among several actors involved in the work process and organization.

Projeto de vivências e estágios na saúde pública: perspectiva de acadêmicos de enfermagem / Project experiences and internships in public health: nursing academic perspective

Objetivo: relatar a experiência de acadêmicos de enfermagem em um projeto de vivências e estágios na saúde pública. Metodologia: trata-se de um relato de experiência de acadêmicos de enfermagem no projeto Vivências e Estágios na Realidade do Sistema Único de Saúde, que consistiu na imersão em organizações de trabalho, presentes em quatro municípios do litoral piauiense durante doze dias, e na discussão crítico-reflexivada realidade encontrada com base nos princípios e diretrizes do Sistema Único de Saúde. O processo de ensino aprendizagem fundamentou-se nos pressupostos do quadrilátero da formação em saúde. Resultados: a contribuição do projeto para a formação profissional foi analisada a partir de dois eixos: “dispositivo de educação permanente em saúde”e “rede de atenção em saúde”. Conclusão: os acadêmicos foram instigados a propor mudanças exequíveis na conformação assistencial nos serviços de saúde, tornando-se protagonistas na luta pelo direito à saúde, (des)construindo conceitos e valores, e transformando mentes e corações para um sistema de saúde de qualidade.

Objective: To reportthe experience of nursing students in a project experiences and internships in public health. Methodology: this is an account of nursing students experience in project Experiences and Internships Reality of the Unified Health System, which consisted of immersion in work organizations, presentin four municipalities of Piauícoast for twelve days, and discussion critical and reflective of reality found based on the principles and guidelines of the Unified Health System. The teaching and learning process was based on the assumptions of thequad health training. Results: the project's contribution to vocational training has been analyzed from two axes: "lifelong learning device in health" and "health care network". Conclusion: the students were encouraged to propose feasible changes in care conformation in health services, becoming protagonists in the fight for the right to health, (de)constructing concepts and values, and transforming minds and hearts to a quality health care system.

Action of Ants on Vertebrate Carcasses and Blow Flies (Calliphoridae).

Forensic entomology is a science that uses insect fauna as a tool to assist in criminal investigations and civil proceedings. Although the most researched insects are the Diptera and Coleoptera, ants may be present in all stages of decomposition. The aim of this study was to evaluate the role of ants and their action on blow flies during the decomposition process. Experiments were performed in which four pig carcasses were exposed in the cold and dry season (November/2012 and March/2013) and four in the hot and wet season (May/2013 and August/2013). Flies were the first insects to detect and interact with the carcasses, and six species of the Calliphoridae family were identified. Ants (Hymenoptera: Formicidae) were the second group, with six subfamilies identified. Myrmycinae represented 42% of the species, followed by Formicinae (28%), Ectatominae and Ponerinae (both 10%), and Ecitoninae and Dolichoderinae (both 5%). The ants acted on the carcasses as predators of visiting species, omnivores, and necrophagous, in all cases significantly affecting the decomposition time, slowing it down when the ants preyed on adult and immature insects consuming the carcass, or accelerating it by consuming the carcass and creating holes that could serve as gateways for the action of other organisms. The ants also generated artifacts that could lead to forensic misinterpretation.

Estratégias não medicamentosas utilizadas no controle de doenças cardiovasculares / Non-pharmacological approaches applied inthe controlof cardiovascular diseases

Objetivo: elencar estratégias não medicamentosas efetivas no controle das doenças cardiovasculares evidenciadas na literatura que subsidiem a prática clínica. Método: revisão integrativa com análise dos níveis de evidência e após o levantamento inicial de 2.338 publicações, 19 estudos foram incluídos. Resultados: identificou-se 12 estratégias não farmacológicas, sendo a maioria delas possíveis de serem realizadas por enfermeiros e demais profissionais de saúde, no qual todas as estratégias elencadas apresentam evidências clínicas bem descritas e comprovadas. As intervenções apresentaram ainda resultados efetivos na redução da morbimortalidade e na melhoria da qualidade de vida dos pacientes, com destaque para ações multifatoriais. Conclusão: há estratégias não farmacológicas que quando utilizadas de forma adequada, são clinicamente efetivas, no controle e na redução de danos das doenças cardiovasculares. Tais estratégias devem ser conhecidas por todos os profissionais que prestam assistência as pessoas com doenças cardiovasculares, a fim de oferecer a estes pacientes mais opções de cuidado, com menos efeitos colaterais.

Objective: to list non-pharmacological strategies that are effective in the control of cardiovascular disease with evidenced in the literature that supports clinical practice. Method: integrative review, the analysis of levels of evidence and after the initial survey of 2,338 publications, 19 studies were included. Results: 12 non-pharmacological strategies,were identifcsmost of which areable to be conductedby nurses and byother healthcare professionals, in which all the listed strategies have clinical findings and arewell described and demonstrated. The interventions demonstrated effective results in the reduction of morbidity and mortality, improving the quality of life of patients, especially the multifactorial activities. Conclusion:there are non-pharmacological strategies that when used properly are clinically effective, on the control andin reducing the damage of cardiovascular diseases. These strategies should be recognized by all professionals that provide care topeople with cardiovascular diseases in order to offer to these patients more care options with fewer side effects.

Processo de enfermagem aplicado a paciente submetida à histerectomia: relato de experiência / Nursing process applied to a patient undergoing hysterectomy: experience report

Objetivo: relatar a experiência da execução do processo de enfermagem no pré e pós-operatório de uma paciente submetida à histerectomia total. Metodologia: trata-se de um relato de experiência sobre o cuidado de enfermagem prestado a paciente com diagnóstico de miomatose uterina em hospital público de Floriano-Piauí utilizando a Sistematização da Assistência de Enfermagem (SAE) baseada na Teoria de Wanda Horta. Resultados: o estudo revelou que a paciente possuía algumas dependências no pré-operatório como ansiedade e falta de conhecimento acerca da cirurgia. Ao fornecer informações claras sobre o processo cirúrgico e esclarecer dúvidas percebeu-se maior confiança e menos temor da paciente ante ao procedimento a ser realizado. No pós-operatório foram observadas algumas necessidades psicobiológicas, psicossocial e de autoimagem manifestada. A manutenção do relacionamento terapêutico no pós-operatório fortaleceu o vínculo já estabelecido e aliviou sentimentos negativos reconhecidos no pré-operatório. Conclusão: a implementação da teoria na prática através da utilização da SAE garante atenção adequada e proporciona assistência integral permitindo melhor qualidade dos cuidados prestados e resolubilidade dos problemas.

Objective: to describe the experience of implementing the nursing process, in the pre-and postoperatively in a patient who underwent a total hysterectomy. Methodology: this is an experience report on the nursing care provided at a patient with a diagnosis of fibroids uterine in a public hospital of Floriano, Piauí using Care System Nursing (CSN) based on the theory of Wanda Horta. Results: the study that the patient had some dependencies in the preoperative as anxiety and lack of knowledge about the surgery. By providing clear information about the surgical process and of the doubts was realized more confidence and less fear of the patient before the procedure to be performed. In the postoperative some physiological needs were observed psychosocial self-image manifested. The maintenance of the therapeutic relationship postoperative strengthened the bond already established and alleviated negative feelings recognized in pre-operatively. Conclusion: the implementation of the theory in practice through the use of CSN ensures proper care and provides comprehensive care allowing better quality of care and resolution of problems.

Avaliação do desembarque pesqueiro efetuado em Manacapuru, Amazonas, Brasil / Evaluation of the Manacapuru fishing landings, Amazonas State, Brazil

A atividade comercial pesqueira na Amazônia Central é predominantemente direcionada para Manaus, porém o perfil das atividades pesqueiras efetuadas nos demais centros também é fundamental para o planejamento do setor. Neste contexto, o presente trabalho visa caracterizar o perfil da produção pesqueira que abastece a cidade de Manacapuru, um dos principais centros urbanos da Amazônia Central. Os desembarques ocorreram a partir de canoas a remo, canoas motorizadas, barcos de pesca e recreios. A média mensal de pescado desembarcado foi de 175,36 ± 39,50 t em 2001 e de 172,13 ± 18,88 t em 2002, não apresentando diferença significativa entre anos (P>0,05). Dos 35 nomes específicos comuns registrados, observa-se que curimatã (Prochilodus nigricans), jaraquis (Semaprochilodus spp.), cubiu (Anodus spp.), mapará (Hypophthalmus spp.), e tambaqui (Colossoma macropomum) foram os itens mais importantes nos dois anos, e piramutaba (Brachyplatystoma vaillantii) em 2002. Sete sub-regiões foram visitadas pela frota pesqueira, destacando-se Baixo-Solimões e o rio Purus.

The fishing commercial activity in Central Amazonia is mainly addressed for Manaus, even so the characteristics of the fishing activities directed to other important urban centers in the region are also fundamental for the planning of the sector. In this context, the present work seeks to characterize the profile of the fishing production that lands in the city of Manacapuru, one of the main urban centers of Central Amazon. Fish landings were done from non-motorized canoes, motorized canoes, fishing ships and pleasure boats. The monthly average of landed fish was of 175,36 ± 39,50 ton in 2001 and of 172,13 ± 18,88 ton in 2002, not presenting significant difference among years (P>0,05). Of the 35 registered common species names, it is observed that curimatã (Prochilodus nigricans), jaraquis (Semaprochilodus spp.), cubiu (Anodus spp.), mapará (Hypophthalmus spp.), and tambaqui (Colossoma macropomum) were the most important fish landed in 2001 and 2002, and piramutaba (Brachyplatystoma vaillantii) specifically in 2002. out of the seven sub-areas visited by the fishing fleet, Lower Solimões and Purus river stand out.

Cúspide em garra: relato de caso clínico / Talon cusp: case report

A cúspice em garra é uma alteração de desenvolvimento da forma dentária que se caracteriza pela presença de uma cúspide acessória na face lingual ou vestibular de um dente anterior. Sua etiologia é incerta, sendo uma provável alteração na morfodiferenciação do estágio de odontogênese. O presente artigo tem como objetivo relatar um caso clínico de cúspide em garra em uma criança de 10 anos de idade e discutir formas de diagnóstico e tratamento para esta anomalia.

Relação entre os constituintes do solo e seu comportamento espectral / Relationship between the soil constituents and its spectral behavior

A reflectância espectral de solos é a expressão que registra o fluxo de radiação eletromagnética refletida pelo solo em relação ao fluxo radiante. Como os solos apresentam diferentes constituintes, os mesmos podem ser identificados e em certos casos quantificados pela análise de sua resposta espectral. Os principais constituintes dos solos que influenciam seu comportamento espectral são a matéria orgânica, óxidos de ferro, argilominerais, além da distribuição granulométrica e umidade. A utilização da reflectância espectral visando obter informações na identificação e quantificação de características do solo de maneira rápida e não invasiva, tanto em nível laboratorial como em nível orbital, tem ocorrido principalmente em países desenvolvidos. No Brasil, o interesse de pesquisadores pelo estudo do comportamento espectral de solos vem crescendo desde a década de 80 do século passado, sendo esta linha de pesquisa relativamente jovem e necessitada de suporte de pesquisa para melhor entendimento dos efeitos da interação da energia eletromagnética entre os diferentes componentes do solo.