Comparison of preoperative fluid therapy protocols associated with inhalational or total intravenous anesthesia for anesthetic procedures in dogs with sepsis.

This randomized clinical trial aimed to evaluate different fluid therapy protocols associated with inhalational or total intravenous anesthesia in the cardiorespiratory stability of bitches with sepsis subjected to a surgical procedure to control the infectious focus. Thirty-two bitches diagnosed with pyometra and sepsis and treated at the University Veterinary Hospital between 2018 and 2019 were recruited. After admission, diagnosis, clinical, and laboratory evaluation, patients were randomly distributed into the following groups: propofol 5 (P[5]: preoperative restrictive fluid therapy-5mL/kg/h and intravenous general anesthesia); propofol 10 (P[10]: preoperative liberal fluid therapy-10mL/kg/h and intravenous general anesthesia); and isoflurane 5 (I[5]: preoperative restrictive fluid therapy-5mL/kg/h and inhalational general anesthesia). Lactate on admission (LAC1) and release (LAC2), heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), rectal temperature (RT), oxygen saturation (SpO2), and carbon dioxide extraction rate (EtCO2) were analyzed at PRE, T10, T20, T30, T40, T50, TEXT, and TDIS. Clearance of 20% of lactate occurred in 18 dogs, with the P[10] group displaying the best performance. There was no statistical difference in vasopressor requirements among the groups. Liberal fluid therapy showed greater cardiovascular stability than restrictive therapy in the perioperative period. Regarding general anesthesia, isoflurane showed greater cardiorespiratory stability than propofol during anesthetic maintenance. In conclusion, although the three proposed protocols are safe and there is no difference in their superiority, some observed changes may be relevant and considered when it is possible to individualize the therapy for the patient.

Este ensaio clínico randomizado teve a proposição de avaliar diferentes protocolos de fluidoterapia associados a anestesia inalatória ou total intravenosa, na estabilidade hemodinâmica de cadelas com sepse, submetidas a procedimento cirúrgico, para controle do foco infeccioso. Foram incluídas trinta e duas cadelas, com diagnóstico de piometra e sepse, atendidas em hospital veterinário universitário, no período de 2018 a 2019. Após admissão, diagnóstico, avaliação clínica e laboratoriais, os pacientes foram distribuídos de maneira aleatória nos grupos Propofol 5 (P[5]: fluidoterapia restritiva pré-operatória - 5mL/kg/h e anestesia geral intravenosa), Propofol 10 (P[10]: fluidoterapia liberal pré-operatória - 10mL/kg/h e anestesia geral intravenosa) e Isoflurano 5 (I[5]: fluidoterapia restritiva pré-operatória - 5mL/kg/h e anestesia geral inalatória). Foram analisados lactato na admissão (LAC1) e liberação (LAC2), frequências cardíacas (HR) e respiratória (RR), pressão arterial sistólica (SBP), temperatura retal (RT), saturação de oxigênio (SpO2) e taxa de extração de dióxido de carbono (EtCO2) nos seguintes momentos: PRE, T10, T20, T30, T40, T50, TEXT e TDIS. A depuração de 20% do lactato ocorreu em 18 cães, tendo o grupo P[10] o melhor desempenho. Não houve diferença estatística no requerimento de vasopressores entre os grupos. A fluidoterapia liberal apresentou maior estabilidade cardiovascular quando comparado com a restritiva no período perioperatório. Com relação a anestesia geral, o isoflurano apresentou maior estabilidade cardiorrespiratória que o propofol na manutenção anestésica. Nós concluímos que apesar de os três protocolos propostos serem seguros e sem diferença em superioridade entre eles, algumas alterações observadas podem ser relevantes e ponderadas quando for possível a individualização da terapêutica no paciente.

Development of collagen/nanohydroxyapatite scaffolds containing plant extract intended for bone regeneration.

In this study scaffolds of nanohydroxyapatite (nHA) and anionic collagen (C) combined with plant extracts intended for bone tissue repair were developed. Grape seed (P), pomegranate peel (R) and jabuticaba peel (J) extracts were used as collagen crosslinker agents in order to improve the materials properties. All crude extracts were effective against Staphylococcus aureus, but only for CR scaffold inhibition zone was noticed. The extracts acted as crosslinking agents, increasing enzymatic resistance and thermal stability of collagen. The extracts showed cytotoxicity at the concentrations tested, while nHA increased cell viability. The scaffolds presented porosity and pore size appropriate for bone growth. CR, CnHAP, CnHAR and CnHAJ increased the cell viability after 24 h. The combination of collagen, nHA and plant extracts offers a promising strategy to design novel biomaterials for bone tissue regeneration.

Depression and anxiety before and during the COVID-19 lockdown: a longitudinal cohort study with university students

BackgroundFor young people, just as in the general population, COVID-19 caused many changes in their lives, including an increased risk for mental illness symptoms. We aimed to study the impact of the COVID-19 pandemic in anxiety and depression symptoms in a cohort of university students. MethodsThis study is part of broader longitudinal research on university students mental health with data of the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information. Results341 university students (257 females and 84 males) were included, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived wellbeing loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. The proportion of students with scores equal to or above 15 in the PHQ-9 ranged between 22.6% and 25.5% in 2019 and 37.0% in June 2020. The proportion of GAD-7 scores above cut-off ten ranged between 46.0% and 47.8% in 2019 and 64.5% in 2020. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher. DiscussionCOVID-19 impacted negatively depressive and anxiety symptoms, confirming previous studies and young peoples vulnerability in such uncertain times.

Investigation of schistosomiasis cases and deaths in the city of Recife, Pernambuco, Brazil, 2005-2013. / Investigação sobre os casos e óbitos por esquistossomose na cidade do Recife, Pernambuco, Brasil, 2005-2013.

OBJECTIVE: to describe schistosomiasis cases and deaths among residents of the city of Recife, Pernambuco, Brazil, from 2005 to 2013. METHODS: this was a descriptive epidemiological study using data from the Mortality Information System (SIM) (2005-2013) and the Notifiable Diseases Information System (SINAN) (2007-2013); active tracing of the relatives of the dead was undertaken and probabilistic linkage of the databases (2007-2013) was performed using the Reclink program. RESULTS: 297 schistosomiasis deaths were recorded on the SIM system; through active tracing, 130 relatives were contacted and 20.8% autochthony was identified; 388 cases resident in Recife were registered on the SINAN system; through probabilistic linkage, 23 matching records were identified on SIM and SINAN. CONCLUSION: investigation of deaths showed that some individuals had never traveled outside Recife and progressed to the chronic stage of the disease; 23.8% of the cases registered on SINAN had Recife as the municipality in which infection occurred.

Investigação sobre os casos e óbitos por esquistossomose na cidade do Recife, Pernambuco, Brasil, 2005-2013 / Investigación sobre los casos y los óbitos por esquistosomiasis en la ciudad de Recife, Pernambuco, Brasil, 2005-2013 / Investigation of schistosomiasis cases and deaths in the city of Recife, Pernambuco, Brazil, 2005-2013

Objetivo: descrever os casos e óbitos por esquistossomose em residentes na cidade de Recife, Pernambuco, Brasil, no período 2005-2013. Métodos: estudo epidemiológico descritivo com dados do Sistema de Informações sobre Mortalidade (SIM) (2005-2013) e do Sistema de Informação de Agravos de Notificação (Sinan) (2007-2013); realizou-se a busca ativa dos familiares dos óbitos e o relacionamento probabilístico das bases de dados (2007-2013) pelo aplicativo Reclink. Resultados: no SIM, registraram-se 297 óbitos por esquistossomose no período estudado; pela busca ativa, 130 familiares foram contatados, identificando-se 20,8% de autoctonia; no Sinan, 388 casos foram registrados para residentes no Recife; pelo relacionamento probabilístico, identificaram-se 23 registros pareados entre SIM e Sinan. Conclusão: a investigação dos óbitos demonstrou que alguns indivíduos nunca viajaram para fora do Recife e evoluíram para a fase crônica da doença; 23,8% dos casos notificados no Sinan tiveram como município de infecção o Recife.

Objetivo: describir casos y óbitos por esquistosomiasis en residentes de la ciudad de Recife, Pernambuco, Brasil, en el período de 2005 a 2013. Métodos: estudio epidemiológico descriptivo con datos del Sistema Información sobre Mortalidad (SIM) (2005-2013) y del Sistema de Información de Agravamientos de Notificación (Sinan) (2007-2013); se realizó la búsqueda activa de los familiares de los fallecidos y la relación probabilística de los datos (2007-2013) en el aplicativo Reclink. Resultados: en el SIM, hubo 297 óbitos por esquistosomiasis; en la búsqueda activa, se identificaron 130 familiares y un 20,8% de autoctonía; en Sinan, 388 casos fueron registrados para residentes en Recife; en la relación probabilística, 23 registros pareados fueron identificados en el SIM y el Sinan. Conclusión: la investigación de los óbitos mostró que algunas personas nunca viajaron fuera de Recife y evolucionaron a la fase crónica de la enfermedad; 23,8% de los casos registrados en el Sinan tuvieron a Recife como municipio de la infección.

Objective: to describe schistosomiasis cases and deaths among residents of the city of Recife, Pernambuco, Brazil, from 2005 to 2013. Methods: this was a descriptive epidemiological study using data from the Mortality Information System (SIM) (2005-2013) and the Notifiable Diseases Information System (SINAN) (2007-2013); active tracing of the relatives of the dead was undertaken and probabilistic linkage of the databases (2007-2013) was performed using the Reclink program. Results: 297 schistosomiasis deaths were recorded on the SIM system; through active tracing, 130 relatives were contacted and 20.8% autochthony was identified; 388 cases resident in Recife were registered on the SINAN system; through probabilistic linkage, 23 matching records were identified on SIM and SINAN. Conclusion: investigation of deaths showed that some individuals had never traveled outside Recife and progressed to the chronic stage of the disease; 23.8% of the cases registered on SINAN had Recife as the municipality in which infection occurred.

[Municipal public health spending in the state of Pernambuco, Brazil, from 2000 to 2007]. / Despesa pública municipal com saúde em Pernambuco, Brasil, de 2000 a 2007.

In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R$183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

Despesa pública municipal com saúde em Pernambuco, Brasil, de 2000 a 2007 / Municipal public health spending in the state of Pernambuco, Brazil, from 2000 to 2007

Com o objetivo de identificar o impacto produzido pelas medidas de macropolítica postas em prática na segunda metade dos anos noventa no crescimento do valor da despesa pública com saúde e na possível redução da desigualdade alocativa, foi realizado um estudo descritivo, transversal, de natureza quantitativa, abrangendo os 184 municípios de Pernambuco. Utilizaram-se dados do Sistema de Informações sobre Orçamentos Públicos em Saúde, elegendo-se como indicador a Despesa com saúde sob a responsabilidade do município por habitante. Foi analisada a correlação desta variável com o Índice Desenvolvimento Humana municipal, o porte populacional e o valor do orçamento municipal per capita. Ficou demonstrado que embora o crescimento percentual dos gastos municipais com saúde seja em média de 190,76%, os valores per capita ainda se mostram bastante reduzidos situando-se em torno de R$183,79, bem abaixo das médias nacional e macrorregional. Tanto a despesa per capita com saúde quanto seus percentuais de crescimento distribuem-se de forma bastante irregular entre as regiões de saúde e entre os municípios de uma mesma região. Conclui-se que existe profunda desigualdade entre os municípios na distribuição dos recursos públicos para a saúde, a despeito das medidas de macropolítica adotadas com vistas a sua redução.

In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R$183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

A participação do homem/pai no acompanhamento da assistência pré-natal / The participation of the man/father in the attendance of the prenatal presence / La participación del hombre/padre en el acompañamiento de la asistencia prenatal

Com objetivo de identificar os fatores que influenciam a participação do homem/pai no acompanhamento pré-natal em uma Unidade de Saúde da Família de Recife - PE, foi realizado um estudo transversal do tipo descritivo, exploratório, de abordagem quantitativa. A amostra intencional foi constituída por 13 homens/pais companheiros de gestantes, que realizavam o pré-natal em uma unidade de saúde da família. Este estudo mostra que 53,8% (n =7) dos homens entrevistados não consideraram a gravidez oportuna e referem o trabalho como motivo para não participar da consulta pré-natal, 61,5% (n =8) consideraram como maior contribuição no processo gestacional o apoio emocional e financeiro e 84,6% (n =11) dos pais não participam dos grupos de gestantes na unidade de saúde em estudo. Este estudo evidencia que há baixo envolvimento paterno no período pré-natal com necessidade dos profissionais de saúde atuarem no processo educacional com vistas à aproximação da participação do homem/pai na gestação.

With the objective to identify the factors that influence the participation of the man/father in the prenatal care in a Family Health Care Program Unit in Recife-PE, a transversal, descriptive and exploratory study, of quantitative approach was carried out. The intentional sample was constituted by 13 men/ companions of pregnant women, enrolled on the prenatal program in the Health Care Unit. 53.8% (n=7) didn't consider the pregnancy opportune and state that the work was the main reason for not to participate on prenatal consultation. 61.5% (n=8) considered the emotional and financial support as the greater contribution on pregnancy process. 84.6% (n=11) didn't participate on pregnancy groups in the Health Care Unit studied. There has low paternal involvement in the prenatal period, so health professionals need to act in the educational process in order to foster the participation of the father/man on pregnancy process.

Con el objetivo a identificar los factores que influyen en la participación del hombre/padre en el acompañamiento prenatal en una unidad de Salud de la Familia de Recife-PE, fue realizado un estudio transversal del tipo descriptivo, exploratorio, con enfoque cuantitativo. La muestra intencional fue compuesta por 13 hombres/padres compañeros de las mujeres embarazadas que realizaban el prenatal en una unidad de la salud de la familia. Este estudio muestra que el 53.8% (n=7) de los hombres no considera el embarazo oportuno y mencionan el trabajo como razón de no participar de la consulta prenatal, 61.5% (n=8) consideran como mayor contribución en el proceso del embarazo el apoyo emocional y financiero y 84.6% (n=11) de los padres no participan de los grupos de embarazadas en la unidad de la salud en estudio. Este estudio muestra que hay bajo envolvimiento paterno durante el periodo prenatal con necesidad de intervención de los profesionales de salud en el proceso educativo con vistas al acercamiento de la participación del hombre /padre en el embarazo.

Rheological behavior of anionic collagen injectable gels in the presence of rhamsan for plastic surgery applications.

The present paper describes the rheological properties of anionic collagen gels and anionic collagen:rhamsan composites gels in the concentration of 0.7, 4 and 6%, estimated to be used as injectable biomaterials for plastic reconstruction. Rheological studies of these gels showed that independently of pH, composition and concentration the viscoelastic behavior was dependent on the frequency, with the storage modulus always greater than the loss modulus (G' > G'' and delta < 45 degrees ). Creep experiments showed that anionic collagen:rhamsan composites equilibrated at pH 7.4 were less elastic and more susceptible to deformation in comparison to gels equilibrated at pH 3.5. Flow experiments indicated that the force needed for the extrusion of anionic collagen:rhamsan composites, in comparison to anionic collagen, was significantly smaller and with a smoother flow, suggesting the association with rhamsan may be a good alternative in the replacement of glutaraldehyde to stabilize the microfibril assembly of commercial collagen gel preparations. Finally, on the basis of dynamic viscosity profiles found for different preparations, some of these composites are potential candidates to be utilized in laryngology.

Compósitos de colágeno aniônico: ramsana como géis injetáveis para correções plásticas: preparação, caracterização e propriedades reológicas / Anionic collagen:rhamsan composites as injectable gels for plastics reconstruction: preparation, characterization and rheological properties

Este trabalho descreve a preparação e a caracterização de compósitos de colágeno aniônico:ramsana, com o propósito de desenvolver géis injetáveis para correções plásticas. Os materiais foram caracterizados por eletroforese, espectroscopia no infravermelho, estabilidade térmica, titulação potenciométrica, propriedades reológicas e ensaios de fluidez. Independentemente do processamento, os materiais estudados são formados por colágeno não desnaturado, com um total de grupos carboxílicos de 345,9 ± 9/mol de colágeno, o que representa a pH fisiológico um excedente de 106 ± 17 cargas negativas em relação ao colágeno nativo. O estudo reológico mostrou que: independentemente do pH, géis de colágeno aniônico e seus compósitos com ramsana apresentaram o módulo de armazenamento sempre maior que o módulo de perda (G' > G" e delta <45 graus); géis colégeno aniônico:ramsana equilibrados a pH 7,4, embora menos elásticos que os géis equilibrados a pH 3,5; géis contendo ramsana foram mais susceptíveis à deformação; a força necessária para o escoamento de géis contendo ramsana foi sempre significativamente menor que aquela determinada para o colágeno aniônico e com um perfil mais limpo em relação à presença de picos de contrapressão, sugerindo que a associação colágeno aniônico:ramsana pode substituir com vantagens o glutaraldeído na estabilização das preparações comerciais do gel. Os resultados de biocompatibilidade de géis de CAR injetados na membrana vesical de coelho mostraram que estes compósitos são compatíveis com a sua utilização em correções plásticas.