Self-mutilation: a systematic review.

Self-mutilation lesions can represent a clinical diagnosis challenge for healthcare professionals, as patients do not admit to self-mutilation. This leads to failed diagnoses due to the similarity of this condition to other diseases. Searches on the subject were carried out at the PubMed, Periódicos Capes, Scopus, Science Direct and WoS databases, according to the following inclusion criteria: articles in English, Portuguese or Spanish, published from 2018 to June 2023, encompassing case reports, case series and literature reviews. Men are slight more affected by self-mutilation injuries, also presenting the most serious lesions. Self-mutilation injuries are reported globally, mostly in the Asian and American continents. Clinical presentations are varied, but morphology is, in most cases, associated to the form/instrument used for self-mutilation. Greater evidence of diagnosed mental disorders in women and underreporting of these cases in men due to low demands for specialized treatment are noted. A higher prevalence of self-mutilation lesions was verified for men, affecting a wide age range, with the highest number of cases in the USA. The most affected body areas are arms and external genitalia, mostly due to knife use. An association between self-mutilation injuries and mental disorders is clear, with most cases being previously undiagnosed.

Distribution of phoretic mites and lice in Pseudolynchia canariensis living on pigeons and the relationship with seasonality, carrier sex, plumage coloration and age of definitive hosts.

Among the parasites, some groups that have a limited capacity for locomotion, such as mites and lice, the transmission is challenging to win. These ectoparasites disperse through direct contact between hosts or, in some cases, through phoresy. However, these processes are not well-documented in detail because they are difficult to observe and quantify. In the present study, the patterns of distribution of skin mites and phoretic lice on hippoboscid louse fly Pseudolynchia canariensis sampled from Columba livia were evaluated. The analyzed pigeons were juveniles and adults, with three distinct plumage colors: blue checker, spread, or wild type, and were caught over 24 months. A total of 1,381 hippoboscid flies were collected on 377 hosts. The plumage color did not influence the infestation patterns of louse flies on juvenile and adult pigeons, nor did it influence the infestation patterns of skin mites and phoretic lice on the hippoboscid flies. However, the environmental temperature was directly related to higher prevalence, mean infestation intensity, and phoretic species richness on P. canariensis during the hottest seasons. Furthermore, a higher abundance of phoretic mite eggs, including embryonated eggs, was observed in females of P. canariensis in all seasons.

Impacto do volume de contraste utilizado após procedimentos coronários percutâneos em pacientes predispostos a desenvolver nefropatia induzida pelo contraste / Impact of contrast volume used after percutaneous coronary procedures in patients predisposed to developing contrast-induced nephropathy

INTRODUÇÃO: A nefropatia induzida por contraste (NIC) é uma complicação dos procedimentos angiográficos que requerem a administração de meios de contraste. Grandes volumes estão associados à NIC. Não está claro se o tipo de contraste interfere nessa diferença. OBJETIVO: Avaliar se o volume de contraste utilizado nos procedimentos percutâneos tem interação com o tipo de contraste (baixa ou isosmolar) no desenvolvimento de NIC. MÉTODOS: A NIC é definida como uma elevação de creatinina sérica de mais de 25% ou ≥0,5 mg/dl da basal após 48 h. Subanálise de estudo randomizado, centro único, incluindo 2268 pacientes consecutivos submetidos a procedimentos coronários diagnósticos e terapêuticos entre 2016 a 2018. Todos os procedimentos foram realizados com contraste de baixa osmolaridade ou iso-osmolar. A amostra foi dividida em 2 grupos em relação ao volume de 150ml de contraste. Análise estatística: para avaliar o efeito do contrate e do volume no NIC, utilizou-se um modelo de regressão logística com efeito de interação. Este modelo foi avaliado também ajustado para síndrome coronária aguda, disfunção ventricular, creatinina basal, sexo e idade. Os dados foram analisados com uso do software R versão 4.1.2. RESULTADOS: População predominantemente masculina, HAS (85%), DM (52%), DRC (31%). Modelo de regressão logística com efeito de interação entre contraste e volume (p>0,999). Modelos aditivos para NIC apresentado sem diferença entre os grupos (p= 0.974 e p= 0.202) ajustado para sexo, idade, creatinina basal, IC, SCA. CONCLUSÃO: Nesse estudo, mesmos nos casos em que maior quantidade de contraste foi utilizada, o tipo de contraste (iso-osmolar ou de baixa osmolaridade) não foi associado à ocorrência de NIC.

Impacto do volume de contraste utilizado após procedimentos coronários percutâneos / Impact of contrast volume used after percutaneous coronary procedures

INTRODUÇÃO: A nefropatia induzida por contraste (NIC) é uma complicação dos procedimentos angiográficos que requerem a administração de meios de contraste. Grandes volumes estão associados à NIC. Não está claro se o tipo de contraste interfere nessa diferença. OBJETIVO: Avaliar se o volume de contraste utilizado nos procedimentos percutâneos tem interação com o tipo de contraste (baixa ou isosmolar) no desenvolvimento de NIC. MÉTODOS: A NIC é definida como uma elevação de creatinina sérica de mais de 25% ou ≥0,5 mg/dl da basal após 48 h. Subanálise de estudo randomizado, centro único, incluindo 2268 pacientes consecutivos submetidos a procedimentos coronários diagnósticos e terapêuticos entre 2016 a 2018. Todos os procedimentos foram realizados com contraste de baixa osmolaridade ou iso-osmolar. A amostra foi dividida em 2 grupos em relação ao volume de 150ml de contraste. Análise estatística: para avaliar o efeito do contrate e do volume no NIC, utilizou-se um modelo de regressão logística com efeito de interação. Este modelo foi avaliado também ajustado para síndrome coronária aguda, disfunção ventricular, creatinina basal, sexo e idade. Os dados foram analisados com uso do software R versão 4.1.2. RESULTADOS: População predominantemente masculina, HAS (85%), DM (52%), DRC (31%). Modelo de regressão logística com efeito de interação entre contraste e volume (p>0,999). Modelos aditivos para NIC apresentado.

Development and validation of an LC-ESI-QTOF-MS method to measure cefepime in the plasma and peritoneal fluid of rats using microdialysis: Application in a pilot pharmacokinetic study.

Cefepime (CEF) is a cephalosporin and can be administered in secondary peritonitis together with metronidazole to treat sepsis. This study aimed to develop and validate an LC-ESI-QTOF-MS method for the quantification of cefepime in the plasma and peritoneal microdialysate of healthy Wistar rats. Chromatographic separation was performed using a CLC-ODS C18 column (250 × 4.6 mm), a C18 pre-column (4 mm, 5 µm) and isocratic elution. Gallic acid was used as the internal standard. The mobile phase consisted of (A) ultrapure water (pH adjusted to 3.5) and (B) acetonitrile (80:20, v/v) at 0.8 ml/min. Quantification was performed using a mass spectrometer with electrospray ionization in positive mode to monitor ions with m/z 481.1322 (CEF) and m/z 171.0288 (IS). The method was validated for selectivity, precision, accuracy, linearity, stability, lower limit of quantification, carryover, recovery and matrix effect. Calibration was done in the ranges 1-40 and 1-100 µg/ml for the peritoneal microdialysate and plasma, respectively. Plasma extraction recovery ranged from 93.9 to 99.9%. The technique was validated and successfully applied in a pilot pharmacokinetic study for estimating the free concentration of CEF in the peritoneal microdialysate of rats for the first time.

Four almost unexplored species of Brazilian Connarus (Connaraceae): Chemical composition by ESI-QTof-MS/MS-GNPS and a pharmacologic potential.

INTRODUCTION: Species of Connaraceae are globally used in traditional medicines. However, several of these have not been studied regarding their chemical composition, and some are even at risk of extinction without proper studies. Therefore, the chemical composition and pharmacological potential of Connarus blanchetii Planch., Connarus nodosus Baker, Connarus regnellii G. Schellenb., and Connarus suberosus Planch., which were previously unknown, were analyzed. OBJECTIVE: This work aims to investigate the pharmacological potential of these four Connarus species. The chemical composition of different extracts was determined by high-resolution mass spectrometry (HRMS), with subsequent analysis by the GNPS platform and competitive fragmentation modeling (CFM). MATERIALS AND METHODS: Leaf extracts (C. blanchetii, C. nodosus, C. regnellii, and C. suberosus) and bark extracts (C. regnellii and C. suberosus) were obtained by decoction, infusion, and maceration. LC/HRMS data were submitted to the GNPS platform and evaluated using CFM in order to confirm the structures. RESULTS: The HRMS-GNPS/CFM analysis indicated the presence of 23 compounds that were mainly identified as phenolic derivatives from quercetin and myricetin, of which 21 are unedited in the Connarus genus. Thus, from the analyses performed, we can identify different compounds with pharmacological potential, as well as the most suitable forms of extraction. CONCLUSION: Using HRMS-GNPS/CFM, 21 unpublished compounds were identified in the studied species. Therefore, our combination of data analysis techniques can be used to determine their chemical composition.

Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis.

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=-0.28, p=0.04), Short Physical Performance Battery score (r=-0.28, p=0.03), and forced vital capacity (r=-0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

Can risk of sarcopenia predict poorer quality of life in hemodialysis patients? / Risco de sarcopenia pode predizer pior qualidade de vida entre pacientes em hemodiálise?

Background: Sarcopenia and low quality of life (QOL) are widely found among hemodialysis (HD) patients. We aimed to verify whether risk of sarcopenia can predict QOL level in patients submitted to HD. Methods: The sample was formed by 147 chronic kidney disease patients undergoing HD in October 2020 at a single dialysis center.  Demographic and clinical data were collected. Risk of sarcopenia was classified using the SARC-F questionnaire. QOL was evaluated by the Brazilian version of the SF-36. QOL scores were compared between patients with and without risk of sarcopenia. Multivariate linear regression was performed to test risk of sarcopenia as an independent predictor of QOL scores. Results: There were 62 (42.2%) patients classified as having risk of sarcopenia. In the comparison of QOL scores between patients with and without risk of sarcopenia, scores of seven dimensions were significantly lower among patients with sarcopenia risk, the only exception being role-emotional. Risk of sarcopenia was an independent predictor of six dimensions of QOL, except for role-emotional and mental health. Conclusion: We found risk of sarcopenia to be an independent predictor of QOL among HD patients. Our results point to the possibility of improving patients' QOL by intervening to minimize the risk of sarcopenia.

Introdução: Sarcopenia e baixa qualidade de vida (QV) são amplamente encontradas entre pacientes em hemodiálise (HD). Nosso objetivo foi verificar se o risco de sarcopenia prediz o nível de QV nesta população. Métodos: A amostra foi formada por 147 pacientes em HD em outubro de 2020 em um único centro de diálise. Dados demográficos e clínicos foram coletados. O risco de sarcopenia foi classificado pelo questionário SARC-F. A QV foi avaliada pela versão brasileira do SF-36. Os escores de QV foram comparados entre pacientes com e sem risco de sarcopenia. A regressão linear multivariada foi realizada para testar o risco de sarcopenia como preditor independente dos escores de QV. Resultados: Havia 62 (42,2%) pacientes classificados como tendo risco de sarcopenia. Comparando os escores de QV entre pacientes com e sem risco de sarcopenia, os escores de 7 dimensões foram significativamente menores entre os pacientes com risco de sarcopenia, exceto aspectos emocionais. O risco de sarcopenia foi um preditor independente de 6 dimensões da QV, exceto para aspectos emocionais e saúde mental. Conclusão: O risco de sarcopenia é um preditor independente de QV entre os pacientes em HD. Nossos resultados apontam para a possibilidade de melhorar a QV dos pacientes intervindo para minimizar o risco de sarcopenia.

Proporção de exodontia no estado de São Paulo e sua relação com a cobertura da Equipe de Saúde Bucal / Proportion of dental extraction in the state of São Paulo and its relation with the coverage of the Oral Health Team

Resumo Introdução O conhecimento dos fatores relacionados à perda dentária contribui para o planejamento das ações preventivas realizadas pelas Equipes de Saúde Bucal (ESBs). Objetivo Avaliar o indicador de proporção de exodontia nos municípios do estado de São Paulo e a sua relação com os indicadores socioeconômicos e cobertura das ESBs. Método Estudo ecológico com dados secundários dos 645 municípios do estado de São Paulo do ano de 2012. A variável dependente foi o percentual de exodontia mensurado pelo indicador de proporção de exodontia em relação aos procedimentos individuais realizados pelas ESBs, disponibilizado pelo Sistema de Informação da Atenção Básica. Foram considerados como variáveis independentes a cobertura populacional estimada pelas ESBs, o Produto Interno Bruto (PIB) dos municípios per capita, o Índice de Desenvolvimento Humano (IDH) e o Índice Paulista de Responsabilidade Social (IPRS). Foram aplicados modelos lineares generalizados, avaliados pelo p-valor do teste de Wald, AICC e grau de liberdade. Resultados Apresentaram maior proporção de extrações dentárias as cidades do estado de São Paulo com menor cobertura de ESBs (p < 0,0001), com menor valor de IDH (p < 0,0001) e com maior valor de IPRS (p = 0,0018). Conclusão A baixa cobertura de ESBs e as desigualdades socioeconômicas contribuem para aumentar as extrações dentárias no estado de São Paulo.

Abstract Background Knowledge about factors associated with tooth loss contributes to the planning of preventive actions carried out by Oral Health Teams (OHT). Objective To evaluate the proportion of dental extraction indicator in the cities of the state of São Paulo, Brazil, and its relationship with socioeconomic indicators and coverage of the OHT. Method Ecological study using secondary data from 654 municipalities in the state of São Paulo conducted in 2012. The dependent variable was the percentage of dental extraction measured by the proportion of this indicator in relation to individual procedures performed by the OHT provided by the Primary Health Care (PHC) Information System. The population coverage by the OHT, the per capita Gross Domestic Product (GDP), the Human Development Index (HDI), and the São Paulo Social Responsibility Index (IPRS) of the municipalities were evaluated as independent variables. Generalized linear models, formulated by the Wald test p-value, Corrected Akaike Information Criterion (AICc), and degree of freedom, were applied. Results Higher proportions of dental extraction were found in the municipalities with lower coverage by OHT (p<0.0001), lower HDI value (p<0.0001), and higher IPRS value (p=0. 0018). Conclusion Low coverage by OHT and socioeconomic inequalities contribute to increased proportion of dental extractions in the state of São Paulo.

Shockwave Therapy Plus Eccentric Exercises Versus Isolated Eccentric Exercises for Achilles Insertional Tendinopathy: A Double-Blinded Randomized Clinical Trial.

BACKGROUND: There remains a lack of consensus regarding the treatment of Achilles insertional tendinopathy. The condition is typically treated with eccentric exercises despite the absence of satisfactory and sustained results. Shockwave therapy was presented as an alternative, but there is a paucity of literature, with good outcomes, supporting its use. The purpose of the present single-center, double-blinded, placebo-controlled, randomized trial was to determine if the use of shockwave therapy in combination with eccentric exercises improves pain and function in patients with Achilles insertional tendinopathy. METHODS: A total of 119 patients with Achilles insertional tendinopathy were evaluated and enrolled in the study from February 2017 to February 2019. Patients were allocated to 1 of 2 treatment groups, eccentric exercises with extracorporeal shockwave therapy (SWT group) and eccentric exercises with sham shockwave therapy (control group). Three sessions of radial shockwaves (or sham treatment) were performed every 2 weeks and eccentric exercises were undertaken for 3 months. The primary outcome was the Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) at 24 weeks. Secondary outcomes included the visual analogue scale, algometry, the Foot and Ankle Outcome Score, and the 12-Item Short Form Health Survey. RESULTS: Both groups showed significant improvement during the study period; however, there were no between-group differences in any of the outcomes (all p >0.05). At the 24-week evaluation, the SWT group exhibited a mean VISA-A of 63.2 (95% confidence interval, 8.0) compared with 62.3 (95% confidence interval, 6.9) in the control group (p = 0.876). There was a higher rate of failure (38.3%) but a lower rate of recurrence (17.0%) in the SWT group compared with the control group (11.5% and 34.6%, respectively; p = 0.002 and p = 0.047). There were no complications reported for either group. CONCLUSIONS: Extracorporeal shockwave therapy does not potentiate the effects of eccentric strengthening in the management of Achilles insertional tendinopathy. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Parametric evaluation of impedance curve in radiofrequency ablation: A quantitative description of the asymmetry and dynamic variation of impedance in bovine ex vivo model.

Radiofrequency ablation (RFA) is a treatment for liver tumors with advantages over the traditional treatment of surgical resection. This procedure has the shortest recovery time in early stage tumors. The objective of this study is to parameterize the impedance curve of the RFA procedure in an ex vivo model by defining seven parameters (t1/2, tminimum, tend, Zinitial, Z1/2, Zminimum and Zend). Based on these parameters, three performance indices are defined: one to identify the magnitude of impedance curve asymmetry (δ), one Drop ratio (DR) describing the percentage of impedance decrease until the minimum impedance point is reached, and Ascent Ratio (AR) describing the magnitude of increase in impedance from the minimum impedance point to its maximum point. Fifty ablations were performed in a bovine ex vivo model to measure and evaluate the proposed parameters and performance index. The results show that the groups had an average δ of 29.02%, DR of 22.41%, and AR of 545.33% for RFA without the use of saline or deionized solutions. The saline solution and deionized water-cooled groups indicated the correlation of performance indices δ, DR, and AR with the obtained final ablation volume. Therefore, by controlling these parameters and indices, lower recurrence is achieved.

Cytotoxic Effects of Diclofenac and Ibuprofen Zinc (II)-Nicotinamide Ternary Complexes in Breast Cancer Cell Lines

Abstract Breast cancer is one of the leading types of cancer worldwide, and the search for new treatment options are crucial. Nonsteroidal anti-inflammatory drugs (NSAIDs) -specially ibuprofen and diclofenac-, have shown antitumoral effect against several types of cancer. The synthesis of organometallic compounds has shown significant improvements in pharmacological properties and efficacy of organic molecules. Two zinc II ternary complexes containing the NSAIDs diclofenac and ibuprofen and nicotinamide neutral linker (Nic) were obtained by the two-step solvent metalligand complexation method. The compounds Zn2(Diclof)4(Nic)2 (complex 1) and Zn2(Ibup)4(Nic)2 (complex 2) were tested in breast cancer cell lines (4T1, MCF-7 and MDA-MB-231) to evaluate their cytotoxicity, comparing to ibuprofen and diclofenac as controls. We found that both complex 1 and 2 exerted more than 60% reduction in 4T1 viability at 250µM, and complex 2 decreased cell viability at 250 µM and 137.5 µM in MCF-7 (34.35% and 26.42% reduction, respectively) and in MDA-MB-231 (57.2% and 22.88% reduction, respectively), all compared to controls. Complex 1 was selective only in MCF-7, and complex 2 was selective in both MCF-7 and MDA-MB-231. In summary, our data showed that the cytotoxic effect of complex 1 and 2 is increased comparing to their original NSAID in different breast cancer cell lines, highlighting their potential anti-tumoral activity.

Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=−0.28, p=0.04), Short Physical Performance Battery score (r=−0.28, p=0.03), and forced vital capacity (r=−0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

Serum anti-Toxoplasma gondii antibodies in Passer domesticus (Linnaeus, 1758) (Passeriformes: Passeridae), in the municipality of Pelotas, RS, Brazil / Anticorpos séricos anti-Toxoplasma gondii em pardais, Passer domesticus (Linnaeus, 1758) (Passeriformes: Passeridae), do município de Pelotas, RS, Brasil

The objective of this study was to detect the presence of anti-Toxoplasma gondii antibodies in serum samples from 100 house sparrows (Passer domesticus Linnaeus, 1758) that were caught in the municipality of Pelotas, Rio Grande do Sul, Brazil. The modified agglutination test (MAT) was used to investigate anti-T. gondii antibodies and samples with a cut-off dilution > 5 were considered positive. Among the 100 serum samples analyzed, 80 (80%) were reactive. These results demonstrate that P. domesticus may play an important role in the epidemiological chain of T. gondii, since it is widely distributed throughout Brazil, and may act as a source of infection to domestic and wild felids.(AU)

O objetivo deste estudo foi detectar a presença de anticorpos anti-Toxoplasma gondii em amostras de soro de 100 pardais (Passer domesticus Linnaeus, 1758) capturados na área urbana do município de Pelotas, Rio Grande do Sul, Brasil. Para a pesquisa de anticorpos anti-T. gondii foi utilizado o teste de aglutinação modificado (MAT) e foram consideradas positivas as amostras que apresentaram título > 5. Das 100 amostras de soro analisadas, 80 (80%) foram reagentes. Esses resultados demonstram que P. domesticus, por ser amplamente distribuído em todo país, pode desempenhar um papel importante na cadeia epidemiológica de T. gondii, podendo atuar como fonte de infecção para felinos domésticos e silvestres.(AU)

Synthesis, chemical characterization and DNA interaction study of new diclofenac and ibuprofen zinc (II)-nicotinamide ternary complexes as cyclooxygenase inhibitor prototypes.

In the search for new drugs, strategies such as bioisosterism have been evidenced, in which the modification of molecules is already known to be active. Thus, metal complexes of known drugs have been highlighted, with examples of significant improvements in therapeutic efficacy. In this way, this work aimed at the synthesis of new zinc complexes with nonsteroidal anti-inflammatory drugs (NSAIDs), as well as the chemical characterization and the previous toxicity by cytotoxicity with Artemia salina, and evaluating the ability of these compounds to interact with DNA. As result, two new zinc II ternary complexes containing the NSAIDs diclofenac (Diclof) and ibuprofen (Ibup) and nicotinamide neutral linker (Nic) were obtained by the two-step solvent metal-ligand complexation method. Molecular structures were determined by NMR, FTIR, HR-MS, UV-Vis and X-ray diffraction, which demonstrated that both complexes are binuclear systems of general formula [Zn2(R-COO-)4(Nic)2]. Plasmidial DNA breakdown capacities were evaluated by producing single and double breaks (DNA FII and FIII) from plasmid incubation with complex solutions in the concentration range 0 to 400 µmol·L-1 in experiments with the presence and absence of light. Both experiments did not show significant differences (P ≤ 0.05) in induced DNA cleavage activity between the maximum study concentrations (400 µmol·L-1) and the negative controls for both complexes. The types of complex 1 and 2 interactions with the secondary DNA structure were determined by titrating a CT-DNA solution with complex solutions and monitored by circular dichroism spectrometry. The results showed that both complexes interact with the grooves of the secondary structure of CT-DNA by electrostatic attraction, but without evidence of alteration in the primary structure. Acute toxicity tests against Artemia salina showed that both complexes did not produce lethality >10% of the population up to a maximum concentration of 1200 µg·mL-1 within an exposure interval of 24 h. Thus, two new compounds were synthesized, characterized and had their previous toxicities determined. These compounds are promising new drugs, with the next step being evaluations of their activity.

Assistência ao paciente renal antes do início da hemodiálise: estudo retrospectivo / Renal patient care before hemodialysis beginning: a retrospective study

INTRODUCTION: the monitoring of renal patients before the start of hemodialysis is an important element for the implementation of preventive measures that delay or interrupt the progression to more advanced stages of the disease. OBJECTIVE:to evaluate primary and tertiary care for people with Chronic Kidney Disease before hemodialysis. METHODS:retrospective, documentary, quantitative study with 35 renal patients who started hemodialysis in Sobral-Ceará, Brazil. Data were collected between January and March 2015. An instrument was used to outline the socioeconomic profile, laboratory data, etiology of chronic kidney disease, type of vascular access, and degree of comorbidity. In the Family Health Strategy, we sought to collect data on the number and dates of consultations, creatinine levels, qualitative urine tests, and referral to nephrologist. Data were analyzed using descriptive statistics. RESULTS:of the 35 patients, 19 (54.3%) were women and 16 (45.7%) men, with a mean age of 58.8 ± 17.7 years. Of the total, 22 (62.8%) were consulted in the Family Health Strategy before the start of hemodialysis. Of these, only 6 (22.3%) had their renal function assessed and 4 (18.1%) consulted a nephrologist. The time elapsed between the first consultation at the FHS and the start of hemodialysis was 2.5 days (median) and between the first consultation with a nephrologist and the start of hemodialysis, 273.5 days (median). The interval of 2.5 days indicated the start of urgent renal replacement therapy. CONCLUSION:chronic kidney disease is not screened in the majority of patients monitored by the FHS and few are seen by a nephrologist before starting hemodialysis.

Introdução: o acompanhamento do paciente renal antes do início da hemodiálise é elemento importante para a implementação de medidas preventivas que retardam ou interrompam a progressão para estágios mais avançados da doença.Objetivo:avaliar assistência primária e terciária de pessoas com Doença Renal C rô n i ca antes da hemodiálise. Métodos: estudo retrospectivo, documental, quantitativo, com 35 pacientes renais que iniciaram hemodiálise em Sobral-Ceará, Brasil. Coletaram-se os dados entre janeiro e março de 2015. Utilizou-se instrumento para traçar o perfil socioeconômico, laboratorial, etiologia da Doença Renal Crônica, tipo d e acesso vascular e grau de comorbidade. Na Estratégia Saúde da Família, buscou-se coletar dados sobre quantidade e datas das consultas realizadas, dosagens de creatinina, testes qualitativos da urina e encaminhamentos ao nefrologista. Analisaram-se os dados por meio da estatística descritiva. Resultados: dos 35 pacientes, 19 (54,3%) eram mulheres e 16 (45,7%) homens, com média de idade de 58,8 ± 17,7 anos. Do total, 22 (62,8%) foram consultados na Estratégia Saúde da Família antes do início da hemodiálise. Destes, apenas 6 (22,3%) tiveram a função renal avaliada e 4 (18,1%) se consultaram com nefrologista. O intervalo entre a primeira consulta e início da hemodiálise foi de 2,5 dias (mediana) e 273,5 (mediana) na Estratégia Saúde da Família e com nefrologista, respectivamente. O intervalo de 2,5 dias indicou início de urgência da Terapia Renal Substitutiva. Conclusão: a DRC não é rastreada na maioria dos pacientes atendidos na ESF e poucos são atendidos por nefrologista antes de iniciar hemodiálise.

[Archival documents produced by scientific work: an analysis of laboratory notebooks from the Instituto Oswaldo Cruz]. / Documentos de arquivo produzidos pela atividade científica: uma análise dos cadernos de laboratório do Instituto Oswaldo Cruz.

Analisa o caderno de laboratório, espécie documental produzida a partir dos registros da atividade científica, e seus diferentes tipos, bem como seu uso e seus formatos na pesquisa biomédica. A reflexão se apoia na pesquisa em andamento sobre os documentos dos laboratórios do Instituto Oswaldo Cruz e na relação destes com os conceitos, métodos, técnicas e práticas da arquivologia. A metodologia compreendeu, além de pesquisa bibliográfica, a aplicação de questionário, entrevistas e diagnóstico dos arquivos, nos quais se buscou identificar a gênese documental, as espécies/tipologias presentes e as práticas de manutenção e uso dos registros provenientes de 15 laboratórios. Discute ainda o caderno aberto de laboratório, formato disseminado no âmbito do debate contemporâneo da ciência aberta.

BONE MINERAL DENSITY AND BODY COMPOSITION IN ELDERLY RUNNERS: SIX-YEAR FOLLOW-UP.

OBJECTIVE: To evaluate bone mineral density (BMD) and body composition over a six-year period in elderly long-distance runners. METHODS: We analyzed the medical records of elderly athletes who were long-distance runners, were participants of the IOT-HCFMUSP Orthogeriatric Group, and had their BMD evaluated between 2001 and 2007; of these athletes, 11 were included in the study. Inclusion criteria: athletes should be long-distance runners, should not stop long-distance running during the six-year period, and should have undergone BMD and body composition evaluations. Body composition was evaluated using bone densitometry with dual-energy X-ray absorptiometry with a Lunar-DPX device. RESULTS: Over the six-year period, body composition remained stable, but there was a significant increase only in the fat percentage (p = 0.003). CONCLUSION: Long-distance running may maintain BMD but may lead to an increase in the fat percentage in elderly runners. Level of Evidence II; Prognostic Study - Investigating the Effect of Patient Characteristics on Disease Outcome.

OBJETIVO: Acompanhar a densidade mineral óssea (DMO) e a composição corporal, ao longo de seis anos, em idosos corredores de longa distância. MÉTODOS: analisamos os prontuários médicos de um grupo de atletas idosos, corredores de longa distância, participantes do Grupo de Ortogeriatria do IOT-HC-FMUSP, e reunimos todos os atletas que tiveram a DMO avaliada no ano de 2001 e de 2007, sendo destes, 11 prontuários selecionados. Critérios de inclusão: ser corredor de longa distância; não parar de correr ao longo dos seis anos e ter os dois exames de DMO e composição corporal avaliados. A composição corporal foi avaliada por meio de densitometria óssea, com uma dupla energia de absorção de raios-X (DEXA), em um aparelho LUNAR-DPX. RESULTADOS: Ao longo dos seis anos, a composição corpórea se manteve estável, havendo apenas um aumento significante na gordura expressa em (%) (p=0,003). CONCLUSÃO: A corrida de longa distância parece conservar a DMO de idosos corredores, porém com aumento de gordura. Nível do Evidência II; Estudos prognósticos - Investigação do efeito de características de um paciente sobre o desfecho da doença.

Bone mineral density and body composition in elderly runners: six-year follow-up / Densidade mineral óssea e composição corporal de idosos corredores: follow-up de seis anos

ABSTRACT Objective: To evaluate bone mineral density (BMD) and body composition over a six-year period in elderly long-distance runners. Methods: We analyzed the medical records of elderly athletes who were long-distance runners, were participants of the IOT-HCFMUSP Orthogeriatric Group, and had their BMD evaluated between 2001 and 2007; of these athletes, 11 were included in the study. Inclusion criteria: athletes should be long-distance runners, should not stop long-distance running during the six-year period, and should have undergone BMD and body composition evaluations. Body composition was evaluated using bone densitometry with dual-energy X-ray absorptiometry with a Lunar-DPX device. Results: Over the six-year period, body composition remained stable, but there was a significant increase only in the fat percentage (p = 0.003). Conclusion: Long-distance running may maintain BMD but may lead to an increase in the fat percentage in elderly runners. Level of Evidence II; Prognostic Study - Investigating the Effect of Patient Characteristics on Disease Outcome.

RESUMO Objetivo: Acompanhar a densidade mineral óssea (DMO) e a composição corporal, ao longo de seis anos, em idosos corredores de longa distância. Métodos: analisamos os prontuários médicos de um grupo de atletas idosos, corredores de longa distância, participantes do Grupo de Ortogeriatria do IOT-HC-FMUSP, e reunimos todos os atletas que tiveram a DMO avaliada no ano de 2001 e de 2007, sendo destes, 11 prontuários selecionados. Critérios de inclusão: ser corredor de longa distância; não parar de correr ao longo dos seis anos e ter os dois exames de DMO e composição corporal avaliados. A composição corporal foi avaliada por meio de densitometria óssea, com uma dupla energia de absorção de raios-X (DEXA), em um aparelho LUNAR-DPX. Resultados: Ao longo dos seis anos, a composição corpórea se manteve estável, havendo apenas um aumento significante na gordura expressa em (%) (p=0,003). Conclusão: A corrida de longa distância parece conservar a DMO de idosos corredores, porém com aumento de gordura. Nível do Evidência II; Estudos prognósticos - Investigação do efeito de características de um paciente sobre o desfecho da doença.

Shockwave Therapy Associated With Eccentric Strengthening for Achilles Insertional Tendinopathy: A Prospective Study.

Background. The usual initial treatment for insertional Achilles tendinopathy is nonsurgical. Yet there is no standard conservative treatment for Achilles insertional tendinopathy. Shockwave therapy (SWT) has become a reliable option for the management of this illness over the past years. The aim of this study is to report the effectiveness of low-energy SWT associated with an eccentric strengthening protocol in 19 consecutive patients. Methods. This is a prospective study with 19 patients aged between 26 and 72 years diagnosed with insertional Achilles tendinopathy. The protocol consisted of SWT associated with eccentric exercises for 12 weeks. All patients were evaluated on the first day and after 24 weeks (final follow-up) with the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire, and by algometry. At the last follow-up, patients were also assessed for adherence to the protocol, complications and final outcome (in their perception as success or fail). Results and Conclusion. Fifteen (79%) patients were fully adherent to the Alfredson protocol, and 13 (68%) patients considered the treatment protocol successful. At the last evaluation, patients demanded higher pressure on calcaneus to trigger pain (algometry 1), reported less pain when the algometer was applied with 3 kg (algometry 2), had less global pain (VAS), and had higher AOFAS and VISA-A scores. This study evidences that eccentric loading associated with SWT can dramatically improve patients' symptoms. We can conclude that eccentric loading associated with SWT is an effective treatment for Achilles insertional tendinopathy. Levels of Evidence: Therapeutic, Level III: Prospective cohort.