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ResumoO objetivo do presente trabalho é criar um modelo de treinamento em artroscopia de ombro de baixo custo abaixo de 100 dólares, tornando-o acessível à capacitação prática de estudantes de medicina e residentes. O modelo foi criado utilizando um cano de PVC de 150 mm de diâmetro em 90 graus e um modelo de ombro sintético. O posicionamento das peças foi disposto de forma a simular a posição de decúbito lateral com membro superior em tração, frequente nas artroscopias. Para auxiliar no treinamento, foram demarcados pontos coloridos na glenóide e foi confeccionado um modelo de parte do manguito rotador na porção superior da escápula. Foi possível confeccionar um modelo para treinamento de artroscopia do ombro com um valor abaixo de 100 dólares, de fácil manufatura, que pode ser um auxiliar no treinamento de cirurgiões.

Alzheimer’s disease (AD) diagnosis is based on psychological and imaging tests but can also include monitoring cerebrospinal fluid (CSF) biomarkers. However, CSF based-neurochemical approaches are expensive and invasive, limiting their use to well-equipped settings. In contrast, blood-based biomarkers are minimally invasive, cost-effective, and a widely accessible alternative. Blood-derived exosomes have recently emerged as a reliable AD biomarker source, carrying disease-specific cargo. Fourier-transformed infrared (FTIR) spectroscopy meets the criteria for an ideal diagnostic methodology since it is rapid, easy to implement, and has high reproducibility. This metabolome-based technique is useful for diagnosing a broad range of diseases, although to our knowledge, no reports for FTIR spectroscopy applied to exosomes in AD exist. In this ground-breaking pilot study, FTIR spectra of serum and serum-derived exosomes from two independent cohorts were acquired and analyzed using multivariate analysis. The regional UA-cohort includes 9 individuals, clinically diagnosed with AD, mean age of 78.7 years old; and the UMG-cohort comprises 12 individuals, clinically diagnosed with AD (based on molecular and/or imaging data), mean age of 73.2 years old. Unsupervised principal component analysis of FTIR spectra of serum-derived exosomes revealed higher discriminatory value for AD cases when compared to serum as a whole. Consistently, the partial least-squares analysis revealed that serum-derived exosomes present higher correlations than serum. In addition, the second derivative peak area calculation also revealed significant differences among Controls and AD cases. The results obtained suggest that this methodology can discriminate cases from Controls and thus be potential useful to assist in AD clinical diagnosis.

Background: Injuries to the articular cartilage of the knee often fail to heal properly, due to the hypocellular and avascular nature of this tissue. Subsequent disability can limit participation in sports and decrease quality of life. Subchondral bone perforations are used for the treatment of small defects. Larger lesions filling out the central portion becomes difficult, and scaffolds can be used as adjuvants, providing a matrix onto which the defect can be filled in completely and also autogenous cartilage grafts can be combined, acting as an inducer and improving healing quality, all in a single procedure.Methods: Evaluate the clinical and quality of life outcomes of patients with articular cartilage lesions of the knee undergoing repair via a microfracture technique combined with a synthetic scaffold and autogenous cartilage graft, with transosseous sutures and fibrin glue fixation, at 12 months of follow-up. Secondarily, assess whether combined procedures, previous surgical intervention, traumatic aetiology, lesion location, and age affect outcomes. Observational study of adult patients (age 18–66 years) with symptoms consistent with chondral or osteochondral lesions, isolated or multiple, ICRS grade III/IV, 2–12 cm2 in size. Patients with corrected angular deviations or instabilities were included. Those with BMI > 40 kg/m2, prior total or subtotal (> 30%) meniscectomy, second-look procedures, and follow-up < 6 months were excluded. Pain (VAS), physical activity (IKDC), osteoarthritis (WOMAC), and general quality of life (SF-36) were assessed.Results: 64 procedures were included, comprising 60 patients. There was significant improvement (P < 0.05) in VAS (5.92 to 2.37), IKDC score (33.44 to 56.33), and modified WOMAC score (53.26 to 75.93) after surgery. The SF-36 showed significant improvements in the physical and mental domains (30.49 to 40.23 and 46.43 to 49.84 respectively; both P < 0.05).Conclusions: Combination of microfractures, autogenous crushed cartilage graft, synthetic scaffold, and transosseous sutures with fibrin glue provides secure fixation for treatment of articular cartilage lesions of the knee. At 12-month follow-up, function had improved by 20 points on the IKDC and WOMAC, and quality of life by 10 points on the SF-36. Age > 45 years had a negative impact on outcomes.

INTRODUCTION: Interventions in different joints may be necessary to correct crouch gait and others musculoskeletal changes that occur as time passes for Cerebral Palsy (CP) children. Multilevel surgery reduces the number of hospitalizations, contributes to the prevention of secondary disabilities, and improves ambulation ability of children with diplegia. OBJECTIVE: Document the changes in mobility outcomes of a bilateral CP child, type diplegia, child after lower limbs multilevel surgery in the Brazilian context MATERIAL AND METHODS: The participant was an eight-year-old girl, Gross Motor Function Classification System level III. The mother signed the informed consent form. The Gross Motor Function Measure–66 (GMFM-66) was performed one day before surgery and one, three, six and twelve months after surgery. To complete the child’s evolution records, additional information was obtained through the electronic system of the hospital. RESULTS: The GMFM-66 total score was: 49.6 pre-operative (CI95%: 47.3-51.9); 42.8 after one month (CI95%: 40.7-45.0); 49.9 after three months (CI95%: 47.6-52.1); 52.6 after six months (CI95%: 50.2-55.0) and 56.9 after one year (CI95%: 54.6-59.2), increasing after 6 months of surgery (*p

Online social network platforms have been, since their rise to prominence, considered as relevant gateways to study individual behaviors. One of those realms is politics, from massive movements and demonstrations to institutionalized events like general elections or referendums in democratic countries. In this paper, we are interested in the behavior of professional politicians in the United Kingdom European Union membership referendum of June 2016, colloquially known as the “Brexit referendum”. We ask how, during the final weeks of the campaign, four key political actors (Jeremy Corbyn, David Cameron, Boris Johnson, and Nigel Farage) used Twitter through their official accounts regarding this popular consultation and how that action was received by their followers. To be more precise, we ask if they predominantly appealed to emotions or to rational arguments (Usage Axis), and what was, in each case, the impact of the tweets (Impact Axis). We conclude that, regardless of the way each actor used Twitter during the campaign, the appeal to emotions and the debasement of the opposing views tended to have more relevance, which may be a distressing hypothesis for democracy.

Context: The lack of thorough knowledge regarding morphological and anatomical variations of the root canal system can result in failure to identify all root canals and lead to inadequate instrumentation and consequent failure of the endodontic treatment. Aims: The aim of the study was to evaluate the anatomy of single-rooted mandibular canines using micro-computed tomography (micro-CT). Subjects and Methods: Eighty mandibular canines were scanned by micro-CT to determine anatomic parameters: Vertucci's classification, number of lateral canals, roundness, and minor and major diameters. The shape of root canal orifices, volume, surface area, and convexity structure model index (SMI) were also evaluated. Analysis Used: The CTAn and CTvol software were used to three-dimensional and morphometric analysis. Results: All canals were classified as Vertucci Type I. Lateral canals were verified in 42.4% of the roots, in apical third. The canal diameters were decreased near the apex. The cross sections at the cementoenamel junction and 1 mm from the apex were oval in 38.3% and 79.4% of the canals, respectively. The mean canal volumes and surface areas were 11.48 ± 4.41 mm3 ≥ and 67.29 ± 19.18 mm2, respectively. The SMI values indicated that mandibular canine was approximately rod like. Conclusions: The morphology of the root canal of single-rooted canines varied widely at different root levels.

As the population ages, there is a growing need to quickly and accurately identify putative dementia cases. Many cognitive tests are available; among those commonly used are the Cognitive Dementia Rating (CDR) and the Mini-Mental Status Examination (MMSE). The aim of this work was to compare the validity and reliability of these cognitive tests in a primary care based cohort (pcb-Cohort). The MMSE and the CDR were applied to 568 volunteers in the pcb-Cohort. Distinct cut-off points for the MMSE were considered, namely MMSE 27, MMSE 24, and MMSE PT (adapted for the Portuguese population). The MMSE 27 identified the greatest number of putative dementia cases, and, as determined by the ROC curve, it was the most sensitive and specific of the MMSE cut-offs considered. Putative predictive or risk factors identified included age, literacy, depression, and diabetes mellitus (DM). DM has previously been indicated as a risk factor for dementia and Alzheimer's disease. Comparatively, the MMSE 27 cut-off has the greatest sensibility (94.9%) and specificity (66.3%) when compared to MMSE PT and MMSE 24. Upon comparing MMSE and CDR scores, the latter identified a further 146 putative dementia cases, thus permitting one to propose that in an ideal situation, both tests should be employed. This increases the likelihood of identifying putative dementia cases for subsequent follow up work, thus these cognitive tests represent important tools in patient care. Further, this is a significant study for Portuguese populations, where few of these studies have been carried out.

Background/Aims: Diagnosing dementia is challenging in many primary care settings, given the limited human resources and the lack of current diagnostic tools. With this in mind, a primary care-based cohort was established in the Aveiro district of Portugal. Methods: A total of 568 participants were evaluated using cognitive tests and APOE genotyping. Results: The findings revealed a dementia prevalence of 12%. A strong correlation between increasing Clinical Dementia Rating (CDR) scores and education was clearly evident. Other highly relevant risk factors were activities of daily living (ADL), instrumental ADL, aging, depression, gender, the APOE ε4 allele, and comorbidities (depression as well as gastrointestinal, osteoarticular, and neurodegenerative diseases). A hitherto unreported, significant correlation between gastrointestinal disease and high CDR score was clearly observable. Conclusions: This study shows the merit of carrying out a dementia screening on younger subjects. Significantly, 71 subjects in the age group of 50-65 years were flagged for follow-up studies; furthermore, these cases with a potentially early onset of dementia were identified in a primary care setting.

OBJECTIVE To validate an affordable and easily reproducible arthroscopic knee surgery simulator made from simple, low-cost materials by demonstrating its ability to distinguish experienced from novice arthroscopists (i.e., construct validity). Additionally, acceptance and usefulness of the simulator in medical training and education were assessed. DESIGN The simulator was used to perform a partial meniscectomy in both menisci. External and intra-articular images obtained during the procedures were used to assess objective visual parameters. The Arthroscopic Surgical Skill Evaluation Tool and a Likert scale addressing individual perceptions about the simulator and its applicability in medical education were also used. SETTING The study was conducted at Hospital de Clinicas da Universidade Federal do Parana, a teaching hospital in southern Brazil. PARTICIPANTS Thirty sixth-year medical students were recruited, as well as 10 orthopedic surgeons who had knee arthroscopy expertise and were members of a sports traumatology and knee arthroscopy group. RESULTS There were statistically significant differences between the groups in all objective parameters. The mean time to perform the procedure was 60% higher among students compared to surgeons. Students needed 72.5% more time on average to perform triangulations and obtained an error rate approximately twice higher in the assessment of the area removed from the menisci. Regarding Arthroscopic Surgical Skill Evaluation Tool scores, statistically significant differences were found between surgeons and students in all 8 domains and in the total score. The simulator was well accepted, as over 90% of participants found it useful for education and training, believed it contributed to teaching and assessing specific surgical steps and procedures, and reported that the task was enjoyable. CONCLUSIONS The arthroscopic knee surgery simulator was largely accepted and had good applicability in objective measurement of surgical skills, distinguishing medical students from orthopedic surgeons and thus demonstrating construct validity.

a Curso de Graduacao em Medicina, Centro Universitario Christus (Unichristus), Fortaleza, CE, Brasil b CET, Hospital Geral de Fortaleza, Fortaleza, CE, Brasil c Sociedade Brasileira de Anestesiologia (SBA), Rio de Janeiro, RJ, Brasil d Disciplina de Anestesiologia, Faculdade de Medicina, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brasil e CET, Faculdade de Medicina, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brasil f Servico de Anestesiologia, Instituto do Câncer do Estado de Sao Paulo (Icesp), Sao Paulo, SP, Brasil g Servico de Anestesia da Unidade II, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil h CET, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil i Curso Suporte Avancado de Vida em Anestesia (Sava), Sociedade Brasileira de Anestesiologia (SBA), Rio de Janeiro, RJ, Brasil j Sociedade de Anestesiologia do Estado de Sao Paulo (Saesp), Sao Paulo, SP, Brasil k Hospital Sao Carlos, Fortaleza, CE, Brasil l Hospital Haroldo Juacaba, Instituto do Câncer do Ceara, Fortaleza, CE, Brasil m Servico de Oncologia, Hospital Sao Carlos, Fortaleza, CE, Brasil n Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil o CET, Servico de Anestesia e Medicina Perioperatoria, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brasil

The environmental scenario requires the participation of the society in the integration of individual responsibilities to the political action. The recycling pro-environmental behavior contributes to the proper disposal of solid waste, a major challenge in urban public management. The article aims to analyze the scientific production of the pro-environmental behaviors and recycling in order to weave notes that promote behavioral changes provided for in public policies. The PsycINFO, Scielo and EBSCOhost databases were consulted using the keywords: environmental attitudes, pro-environmental behavior and recycling. We selected 51 articles, among which predominated the investigation into motivation to recycle behavior, influence of social network and social norms. Environmental attitudes and behavior to recycle have shown to be related to social norms, motivation, identity, altruism and awareness; these should be considered when planning public policies and environmental awareness actions.

Reiki is a therapy performed by placing hands on specific points in the body and using energy transfer to provide a natural well-being. The Nursing also presents within its specific interventions, an essential part based on the touch to the person to whom it cares, being therefore important to have correct knowledge on these techniques. Thus the study intends to evaluate the knowledge that the nurses have about Reiki and to identify determining factors in this knowledge. It is a cross-sectional, descriptive and correlational study, carried out in a non-probabilistic sample by convenience, consisting of 49 nurses with a mean age of 38.96 years, working in health institutions in the central region of Portugal to whom was applied a questionnaire to evaluate knowledge about Reiki, which was developed for this purpose by the researchers. We found that 59.1% of the Nurses had reasonable knowledge, 38.6% had high knowledge and only 2.3% had low knowledge. Knowledge was higher in nurses who had already received Reiki treatment (p = 0.032) who had differentiated care (p = 0.019) who were holders of the master degree (0.040) and had a higher professional category (p = 0.016). We conclude that the knowledge of nurses about Reiki is moderately positive and these are clearly superior in the group that performs functions in differentiated care when compared to those of primary care. On the other hand we found several factors that correlate with this knowledge and on which it is important to intervene in order to improve knowledge info:eu-repo/semantics/publishedVersion

This article is a contribution to the formalisation of the process of song composition, focusing on a case study: Portuguese fado (a performance practice). Based on previous musicological studies, we describe a theoretical model which is parametrised using empirical data retrieved from a representative symbolic corpus. Starting from the model, we present the formalisation of a symbolic artificial intelligence implemented as a generative system. This system is able to automatically generate instrumental music based on the musics and vocal sounds typically associated with fado’s practice. The output of the system is evaluated resorting both to a supervised classification system and to a quasi-Turing test. We conclude that the output of our system approaches the one from the corpus and has relevant pleasantness to human listeners.

This study presents a life cycle cost prediction and cost minimisation methodology for a set of highway concrete bridges, during a medium or a long period of time, in order to facilitate the decision process of the structure management. This methodology takes into consideration bridge intervention costs in addition with some Markov matrices degradation model. It applies a genetic algorithm in order to identify the optimised intervention plan, considering the available budget and the desired minimum performance level. Some Portuguese direct and indirect cost parameters, associated with different types of interventions during bridges lifetime, are presented. Finally, a probabilistic sensitivity analysis is carried out using Monte Carlo simulations. 5A1D-90C1-54FE | Joana Maria Martins Rosa Maia de Oliveira Almeida info:eu-repo/semantics/publishedVersion

The trope of space exploration that attracted so many writers during the "golden age" of the genre remains an SF hallmark. We may, however, question its contemporary centrality after the waning of the intellectual climate that De Witt Douglas Kilgore labeled as "astrofuturism." Perhaps, just like David Hartwell argues in Age of Wonders, "When it comes true," meaning the Moon landing and other achievements from the American space program, "it's no fun anymore." This paper looks at the peculiar way Philip K. Dick embraced space exploration, anticipating its exhaustion and substituting in its place a more inner (perhaps "virtual") approach.

Introdução: Um plano de transição para a vida adulta, elaborado e delineado para o indivíduo deve, necessariamente, dotar o jovem com Necessidades Educativas Especiais (NEE) de competências fundamentais para o exercício da sua vida quotidiana, no sentido de perspetivar a sua plena inclusão . Objetivo: Analisar aperceção dos professores, de um Agrupamento de Escolas, relativamente ao desenvolvimento do processo de transição para a vida adulta (TVA) de alunos com NEE. Metodologia: É uma investigação de natureza quantitativa, transversal e descritiva. O instrumento de recolha de dados utilizado, agrega três secções: A secção A visa proceder a uma caracterização dos participantes; a secção B objetiva o conhecimento e a opinião dos professores, centrados nas suas práticas, relativamente ao processo de TVA; e a secção C procura identificar a perceção dos professores e as opções de mudança, no que concerne ao desenvolvimento do processo de transição dos alunos com NEE. A amostra é constituída por 48 professores. Resultados: A amostra é constituída principalmente por indivíduos do sexo feminino, a média de idades é de 41,52 anos, todos com licenciatura, existindo 25% com formação especializada no âmbito da educação especial. A TVA é percecionada como um processo contínuo ao longo do percurso escolar do aluno, principalmente destinada aos que têm Currículo Específico Individual (CEI), procurando assegurar, o desenvolvimento de competências pessoais, sociais e laborais. O Programa Educativo Individual (PEI) e o Plano Individual de Transição (PIT) são considerados os principais documentos norteadores. São destacadas como dificuldades de maior relevância, a oferta de emprego, a falta de empresas para receberem os alunos, parcos recursos humanos e parcerias insuficientes. Conclusão: As perceções apresentadas revelam um número significativo de barreiras no Agrupamento, ao desenvolvimento e à operacionalização dos processos de transição, colocam em causa o adequado desenvolvimento de saberes e experiências válidos que permitam, quando saem da escola, corresponder às exigências que lhes são colocadas pela sociedade., Gestão e Desenvolvimento, n. 24 (2016)

Summary Background and objectives Sevoflurane is presented in three types of vials. The differences in physical-chemical properties of those products are due to different manufacturing processes, although they are essentially identical regarding chemical comparison tests. It has been hypothesized that the Sevoflurane molecule could present chemical instability due to the formation of Lewis acids as a consequence of the materials used in the fabrication of the vials and the water content. The objective of this study was to analyze the clinical efficacy of Sevoflurane conditioned in different vials. Methods Sixty-four adult patients were randomly divided into two groups. Two Datex-Ohmeda vaporizers, one with only Generic Sevoflurane and the other with Sevorane™, were used. The study coordinator was responsible for supplying the vaporizers and he did not participated in none anesthetic procedures. The same anesthetic technique and monitoring (ECG, HR, SpO 2 , P ET CO 2 , BIS, SEF, TOF, % INSP, % EXP, SBP, and DBP) were used in both groups. Results During anesthesia, differences were not observed between both groups. A statistically significant difference was observed in the time between the interruption of Sevoflurane and spontaneous eye opening (13,91 ± 6.39 min in Group II, and 10.34 ± 6.05 min in Group I) and the interruption of Sevoflurane and handgrip on verbal command (15.38 ± 6.47 min in Group II, and 11.88 ± 6.60 in Group I). A statistically significance difference was not observed between the interruption of Sevoflurane and the moment that patients achieved an Aldrete- Kroulik index equal or above 8. Conclusions during anesthesia a significant difference between both groups was not observed. Although awakening was 3,5 minutes faster in Group I (Generic Sevoflurane), anesthesiologists did not observe any difference in the clinical behavior of patients.

A new online archive of encoded fado transcriptions is presented. This dataset is relevant as the first step towards a cultural heritage archive and as source material for the study of songs associated with fado practice using empirical, analytical and systematic methodologies (namely MIR techniques). It is also relevant as a source for artistic purposes, namely the creation of new songs. We detail the constitution of this symbolic music corpus and present how we conceived of and implemented a methodology for testing its internal consistency using a supervised classification system.

Purpose: To investigate the relation between optical properties, population receptive fields (pRFs), visual function, and subjectively perceived quality of vision after cataract surgery. Methods: The study includes 30 patients who had recently undergone bilateral sequential cataract surgery. We used functional magnetic resonance imaging and pRF modelling methods to assess pRF sizes across visual cortical regions (V1-V3). Subjects also performed a complete ophthalmologic and psychophysical examination and answered a quality of vision questionnaire. Results: Subjects with worse optical properties had, as predicted, larger pRF sizes. In addition, analysis in the primary visual cortex revealed significantly larger mean pRF sizes for operated subjects with worse contrast sensitivity (P = 0.038). In contrast, patients who scored high in the subjective "bothersome" dimension induced by dysphotic symptoms had surprisingly lower pRF size fitting interception (P = 0.012) and pRF size fitting slopes (P = 0.020), suggesting a dissociation between objective quality of vision and subjective appraisal. Conclusions: Optical properties of the eye influence pRF size. In particular, visual aberrations have a negative impact on visual cortical processing. A novel dissociation between subjective reports of quality of vision and pRF sizes was further identified. This suggests that patients with better cortical resolution may have a negative subjective response possibly because of improved perception of dysphotic phenomena. pRF properties represent a valuable quantitative measure to objectively evaluate quality of vision but do not necessarily predict subjective complaints.

Maintaining pure cultures using preservation methods is of high importance for biotechnological purposes. However, preservation does not necessarily guarantee the genetic stability of these cultures. Therefore, preservation methods are currently needed to assure viability as well as genetic, physiological, and morphological integrity across storage periods. In this study, preservation of five isolates from the microalgae and cyanobacteria collection of the Plant Biology Department, Federal University of Vicosa, Minas Gerais, Brazil was investigated via monthly analyses of cell viability, biomass recovery, and contaminant concentrations over a period of 120 days. Lyophilization was adequate for both heterocystous cyanobacteria and other strains that were able to differentiate hormogones or to synthesize thick layers of exopolysaccharides. Lyophilization was also able to maintain cultures with low levels of contaminants. Dimethyl sulfoxide was relatively efficient, though some of the strains were susceptible to its cytotoxic effects. Our results demonstrated that cryopreservation with glycerol was the most efficient method. The ability to routinely preserve cyanobacterial strains reduces costs associated with maintaining large culture collections and reduces the risks of losing particular strains or species through contamination and genetic drift. The results obtained in this study are therefore discussed in the context of the efficiency of the methods and the current need to develop suitable methods for maintenance of cyanobacterial collections.

Aim To perform Descemet stripping automated endothelial keratoplasty (DSAEK) using a novel technique to obtain very thin (

OBJETIVOS: relatos da literatura mostram que não há dados conclusivos sobre a associação entre a endometriose e as concentrações de hormônios envolvidos no controle da reprodução. Este estudo foi realizado para determinar as concentrações de FSH, LH, estradiol (E), progesterona (P) e histamina (Hi) no soro, no fluido peritoneal e no fluido folicular de mulheres com e sem endometriose. MÉTODOS: a extensão da doença foi estadiada de acordo com a American Fertility Society classification (1997). Para a coleta de soro e de fluido peritoneal foram selecionadas 28 mulheres com endometriose submetidas à laparoscopia diagnóstica (18 mulheres inférteis com endometriose I-II e dez mulheres inférteis com endometriose III-IV). Para o grupo controle, foram selecionadas 21 mulheres férteis submetidas à laparoscopia para esterilização tubárea. O fluido folicular foi obtido de 39 mulheres inférteis submetidas a fertilização in vitro (21 mulheres com endometriose e 18 mulheres sem endometriose). RESULTADOS: as concentrações de FSH e LH no soro, no fluido peritoneal e no fluido folicular não diferiram significativamente entre os grupos. As concentrações de E e P no fluido peritoneal foram significativamente mais baixas em mulheres inférteis com endometriose (E: 154,2±15,3 para estágios I-II e 89,3±9,8 ng/mL para estágios III-IV; P: 11,2±1,5 para estágios I-II e 7,6±0,8 ng/mL para estágios III-IV) em comparação com mulheres controle (E: 289,1±30,1; P: 32,8±4,1 ng/mL) (Testes de Kruskal-Wallis/Dunn; p

OBJETIVO: avaliar os efeitos de drogas anti-retrovirais isoladas e em associação sobre as taxas de fertilidade em ratas prenhes expostas a estes fármacos, bem como o efeito perinatal nas crias. MÉTODOS: foram utilizadas ratas fêmeas prenhes adultas da raça Wistar, pesando inicialmente entre 200 e 230 g. Foram testadas a azidotimidina (AZT), lamivudina (3TC) e nelfinavir (NFV), cujas dosagens foram padronizadas em 10 vezes a dose normalmente utilizada em gestantes, proporcionalmente ao peso dos animais. No total foram avaliados sete grupos, incluindo o controle. O início da experimentação foi o dia zero da prenhez e as cesarianas foram realizadas com 21 dias de prenhez. Para o cálculo das taxas de fertilidade, avaliaram-se o número de fetos vivos e mortos, sítios de implantação e número de corpos lúteos. Utilizaram-se o teste t de Student e Mann-Whitney para a análise estatística. RESULTADOS: não houve alterações significativas nas taxas de perdas pré-implantação e da eficiência de implantação de ratas tratadas com anti-retrovirais isolados e em associação. No entanto, houve aumento significativo nas taxas de perdas pós-implantação (grupo controle: 7,6%; grupos medicamentos: de 20,2 a 26,7%), redução significativa nas taxas de viabilidade fetal (grupo controle: 92,4%; grupos medicamentos: de 73,3 a 79,8%) e redução significativa no número de fetos por ninhada (grupo controle: 14,7, grupos medicamentos: de 11,1 a 12,7). Observou-se também que houve redução do peso materno e dos fetos nos grupos tratados com 3TC, AZT + 3TC e AZT + 3TC + NFV. CONCLUSÃO: com a utilização de doses elevadas de medicamentos anti-retrovirais na presente casuística, efeitos importantes sobre a fertilidade foram encontrados, o que sinaliza para a necessidade de se pesquisarem outros fármacos anti-retrovirais com menor potencial histotóxico e que possam, com segurança, ser utilizados por gestantes portadoras da infecção pelo vírus da imunodeficiência humana. PURPOSE: to evaluate experimentally the effects of antiretroviral drugs used alone and in association upon the fertility of pregnant Wistar rats and the perinatal effects on the offspring. METHODS: adult female pregnant Wistar rats weighing 200-230 g were used. The antiretroviral drugs zidovudine (AZT), lamivudine (3TC) and nelfinavir (NFV) were used alone and in association at daily doses of ten times the dose normally used in pregnant women, proportionally to the animal's body weight. Seven groups were studied, including the control one. The experiment started on day 0 and the pregnant animals were sacrificed on day 21. The alive and dead fetuses, the total implantation sites and the total numbers of corporea lutea were used to calculate the fertility values. The statistical analysis was performed by Student's t test and by the Mann-Whitney test. RESULTS: there were no significant statistical differences regarding preimplantation loss and implantation efficiency values of the rats treated with isolated and associated antiretroviral drugs. There was a significant increase in the postimplantation loss values (control group: 7.6%; drug groups variation: 20.2-26.7%), a decrease in the fetal viability values (control group: 92.4%, drug groups variation: 73.3-79.8%), and a decreasing number of fetuses per animal (control group: 14.7; drug groups variation: 11.1-12.7). There was a significant weight reduction of the female rats and of the offspring of animals treated with 3TC, AZT + 3TC and AZT + 3TC + NFV. CONCLUSION: with the administration of high antiretroviral doses, important fertility effects could be observed, which showed that less histotoxic antiretroviral drugs must be studied in order to warrant the safety of using these medicines in pregnant HIV-1 - infected women.

Objetivo: verificar a prevalência de flebite e sua associação com aspectos sociodemográficos e relacionados ao cateter venoso periférico, em adultos internados em um hospital universitário. Método: estudo transversal, com uma amostra de 231 pacientes com acesso venoso periférico. Resultados: a prevalência de flebites foi de 24,7%, com maior concentração no grau 2 com 35,1%. Considerando o grau, encontrou-se estatística significativa (p=0,006) da flebite Grau 1 (92,3%) e 2 (65,0%) com tempo de permanência do cateter até 72 horas e da flebite Grau 3 (63,6%) e Grau 4 (69,2%) com tempo de permanência superior a 72 horas. Considerações finais: a alta prevalência de flebites nos pacientes estudados é preocupante. Discutir estes referenciais com a equipe de enfermagem, instituir indicadores de prevalência de flebites pode ser uma estratégia importante de acompanhamento da assistência de enfermagem/saúde.

1. MD, PhD, Anesthesiologist; Professor at the Medical School of Universidade de Fortaleza (UNIFOR); Responsible for the Centro de Ensino e Treinamento (CET/MEC/SBA) at Hospital Universitario Walter Cantidio, Universidade Federal do Ceara (UFC); President of the Perioperatative Medicine Committee of SBA 2. MD, PhD, Anesthesiologist; Professor at the Anesthesiology Department of Faculdade de Medicina da Universidade Federal de Uberlândia (FMUFU); Responsible for the CET/SBA at FMUFU 3. MD, Anesthesiologist at Instituto Nacional do Câncer (INCA); Co-responsible for the CET/SBA at Hospital Universitario Pedro Ernesto (HUPE), Universidade do Estado do Rio de Janeiro (UERJ); Instructor at the Curso Suporte Avancado de Vida em Anestesia – SAVA/SBA 4. MD, Anesthesiologist; Coordinator of the Anesthesiology Service at Instituto do Câncer de Sao Paulo (ICESP); Member of the SBA Malignant Hyperthermia Committee 5. MD, Anesthesiologist at Hospital Universitario Oswaldo Cruz, Universidade Estadual de Pernambuco (UPE); Co-responsible for the CET/SBA of Hospital da Restauracao, Hospital Getulio Vargas and Hospital Oswaldo Cruz, UPE; President of the Brazilian Society of Anesthesiology, 2011