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Introdução: A COVID-19 espalhou-se pelo mundo em 2020, tornando-se um problema de saúde pública mundial, responsável pela morte de milhares de pessoas em diversos países, especialmente os pais populosos, como o Brasil. Nessa perspectiva, o Sistema Único de Saúde no âmbito de suas diversas atribuições e complexidades, de modo a garantir o acesso integral e universal a saúde, em seus diversos níveis de atenção, reorganizou os cenários de modo a ofertar e atender às demandas necessárias diante do novo cenário. Objetivo: Avaliar a importância das estratégias de prevenção e condutas dos serviços de Atenção Primária a Saúde no enfrentamento da pandemia da COVID-19. Métodos: Trata-se de uma Revisão Sistemática da literatura e as plataformas literárias utilizadas para a busca dos periódicos foram LILACS e Pubmed. Discussão: A APS torna-se fundamental no controle da transmissão do COVID-19, pois detém de estratégias eficientes de contenção da transmissão, proteção e cuidado. Conclusão: A APS tem grande potencial de dar resolutividade aos casos suspeitos, com síndrome gripal e de manejar quadros leves, de modo a auxiliar na manutenção de leitos livres e diminuição dos custos ao sistema de saúde.

Clinicopathological features and chemotherapy can influence the quality of life (QOL), women with ovarian cancer. This study aimed to evaluate the physical and functional well-being, and ovarian cancer-specific effects scores reported from QOL questionnaire among women with ovarian cancer at the time of in their initial diagnosis and access the scores trajectory of women receiving neoadjuvant and adjuvant chemotherapy. This prospective study used cross-sectional analysis at baseline and longitudinal analysis from baseline to 12-month post-chemotherapy. QOL was evaluated at the baseline, at sixth cycle and 12-month post-chemotherapy using FACT-O questionnaire. Clinicopathological features and chemotherapy regime were evaluated and tested for associations with QOL measures. Of the 38 women enrolled in this study, 27 (80.1%) completed the questionnaire for 12 months. The multivariate linear regression results suggest, at the baseline, women with advance stage and presence of post-surgery residual disease showed lower scores in physical and functional well-being, ovarian cancer-specific effects, and FACT-O TOI domains (p

Purpose This study aims to propose a method for measuring lean supply chain management (LSCM) maturity based on the main lean practices and existing waste of a supply chain. Design/methodology/approach A three-stage approach was developed. First, a thorough literature review was performed to raise concepts and previous findings on maturity models (MMs) and LSCM. This review’s outcomes were then validated by experts in the field using the fuzzy Delphi method (FDM). Subsequently, the proposed model was illustrated and assessed based on a multi-case study. Findings All companies attained high outcomes in the elimination of the waste pillar. The pillars of logistics management, continuous improvement and information technology management also stood out in the three organizations’ results. The company with the lowest maturity level operates in a make-to-order production policy, which may harm the lean supply in its supply chain. Practical implications The proposed model can reveal external opportunities and threats and internal strengths and weaknesses in supply chains (SCs). It is also capable of providing a clear roadmap for SC improvement in companies. Originality/value To the best of the authors’ knowledge, no study to date has proposed a MM in the LSCM context using FDM and considering the crucial relationship between lean practices and wastes.

Ventiladores centrífugos são máquinas amplamente utilizadas em diversos setores da indústria. Devido sua importância e ao fato de o uso de energia elétrica ser uma preocupação nos dias atuais, a busca por melhores rendimentos nestas máquinas faz-se necessário. O objetivo é avaliar a influência do tipo da voluta, normal e com reentrância, no rendimento de ventiladores centrífugos por meio de simulação numérica por técnicas de CFD. O estudo comparativo entre estes dois tipos de volutas ainda é escasso. Para cada tipo de voluta, variou-se a vazão mássica de saída, e, assim, montou-se as curvas diferença de pressão e rendimento. Também foram analisadas as distribuições de pressão e velocidades. Os resultados indicaram uma superioridade da voluta normal.

O estudo teve como objetivo avaliar a influência das finanças pessoais do microempreendedor na gestão financeira em microempresas. Para isso, foi realizada uma pesquisa com 96 donos de microempresas localizadas no Rio de Janeiro e que possuem mais de dois anos de funcionamento sob a mesma gestão.Utilizou-se de um questionário com perguntas fechadas a fim de cumprir o objetivo, esses foram analisados por meio da associação entre as duas variáveis qualitativas, competências em finanças pessoais e capacidade de gestão financeira, a partir de uma abordagem quantitativa. O trabalho se torna relevante na medida em que as empresas de menor porte no Brasil representaram 92% do total de empresas privadas. As microempresas com mais de 2 anos constituídos, em particular, apresentam uma taxa de falência de 45% a.a., em que a educação e capacitação são consideradas como fatores limitantes à abertura e manutenção de novos negócios. Foi possível notar que existe relação entre a gestão financeira pessoal e a gestão financeira das microempresas. Muitos não separam contas pessoais das contas das empresas, não possuem capacitação profissional, muitos dos que não fazem planejamento pessoal não tem / utilizam demonstrações financeiras. Foi notado também que os proprietários com dívidas pessoais também apresentam endividamento em seu negócio e os que não possuem investimentos pessoais também acabam não possuindo investimento em suas empresas. Entender como os microempreendedores no Rio de Janeiro lidam com a questão financeira pessoal x profissional pode auxiliar no aprimoramento de programas de desenvolvimento de novos negócios em diversas regiões.

ResumoUma fratura osteocondral desviada da tíbia anterolateral associada a avulsão da cabeça da fíbula em um paciente de 50 anos é relatada. A fratura avulsão do trato iliotibial em geral está associada lesões do ligamento cruzado, do menisco, e das estruturas laterais do joelho, como no caso em questão.

Studies have suggested that meal timing plays a role in nutritional health, but this subject has not been sufficiently studied in pregnant women. We analysed the effect that timing of food intake has on eating patterns, diet quality and weight gain in a prospective cohort study with 100 pregnant women. Data were collected once per trimester: 4th–12th, 20th–26th and 30th–37th weeks. Food intake was evaluated using three 24-h dietary recalls, which were used to assess eating patterns and diet quality. Distribution of energy and macronutrient intake throughout the day was considered eating patterns. Diet quality was assessed using the Brazilian Healthy Eating Index-Revised. Weight gain was evaluated during each trimester. Women were classified as early or late timing of the first and last eating episodes if these values were below or above the median of the population, respectively (first eating episode = 08.38 hours; last eating episode = 20.20 hours). Generalised estimating equation models adjusted for confounders were used to determine the effects of timing of the first and last eating episodes (groups) and gestational trimesters (time) (independent variable) on eating patterns, diet quality and weight gain (dependent variables). Early eaters of the first eating episode have a higher percentage of energy and carbohydrate intake in morning and a lower at evening meals. They also have a better diet quality for fruit components when compared with late eaters of the first eating episode. Our results emphasise the importance of considering meal timing in the nutritional antenatal guidelines to promote maternal–fetal health.

A Leptospirose e uma doenca febril aguda causada pela espiroqueta Leptospira interrogans. Sua transmissao ocorre, principalmente, atraves do contato com a agua ou lama de enchentes contaminadas com urina de animais portadores, sobretudo os ratos. Nessa otica, foi realizado um estudo descritivo qualitativo com analise de dados secundarios disponiveis no Departamento de Informatica do SUS (DATASUS), sobre o perfil clinico-epidemiologico leptospirose no estado do Para entre os anos de 2012 a 2017. Os dados pesquisados foram analisados de acordo com as variaveis: faixa etaria, sexo, raca e evolucao clinica. Apos a analise dos dados, foram evidenciados um total de 782 notificacoes de casos da doenca, no periodo analisado. O grupo etario mais afetado foi o de 20 a 39 anos de idade. Em relacao ao sexo, observou-se predominio nos homens. Quanto a variavel cor, os pardos tiveram 73,9% indice de contagio. Do total de pessoas diagnosticadas com a doenca, 11,5% evoluiram para obito. Observou-se alta incidencia da doenca no periodo analisado, com predominância de adultos, homens e pardos. Esse perfil de acometimento pode ser explicado provavelmente pela maior exposicao desses grupos a doenca, bem como pela composicao da populacao do estado, com ampla preponderância de individuos pardos. Nesse sentido, faz-se necessaria a adocao, por parte das autoridades de Saude, de politicas voltadas a prevencao da doenca, por meio de acoes de educacao em saude sobre a enfermidade para a populacao, controle da populacao de roedores e melhorias no saneamento basico da regiao.

Objetivo: Relacionar prevalencia e adesao vacinal contra o HPV, em jovens, no municipio de Jatai-GO. Metodos: estudo transversal em base de dados secundarios nas plataformas Scielo, Pubmed e DATASUS, restritos a lingua portuguesa e ao recorte temporal 2010-2019. Utilizou-se os descritores “HPV”, “histopatologia” e “vacina”. Resultados: pode-se verificar que existe discrepância entre o numero de vacinados na primeira dose e na dose de reforco. Alem disso, ha desniveis quanto a vacinacao por genero, nota-se que o feminino e prevalente. Conclusao: Diante dos resultados, percebe-se que a adesao vacinal no municipio e baixa. Isso se deve a falta de conhecimento sobre os beneficios da vacinacao na prevencao de diversos cânceres relacionados ao HPV ou ainda esta associado aos pequenos efeitos colaterais da vacina em alguns individuos.

Objectives: The pregnancy period, with its peculiarities and specific symptoms that may or may not be physiological, can lead to medication use through prescription or even self-medication. This study aimed to assess self-medication practices among pregnant women, the most used medications, symptoms reported, and factors associated with this practice.Methods: This was a cross-sectional study conducted with pregnant women with an antenatal care (ANC) appointment in a tertiary teaching hospital referral in women’s health. From April 2019 to February 2020, 297 pregnant women were interviewed. Self-medication was considered as the use of any medicine (including medicinal plants (MPs), herbal products, and vitamins) without a medical or dental prescription. The period considered to assess self-medication practice was the last 60 days prior to the study interview.Results: Among the 297 women interviewed, 107 (36.0%) had practiced self-medication in the previous 60 days. Acetaminophen was the most used medication, and headache was the most frequent symptom reported by self-medicated pregnant women. Pregnant women with high-school (73 (68.2%) (OR = 2.52; 95% CI 1.17–5.43; p = 0.018)) or university-level (23 (21.5%) (OR = 2.82; 95% CI 1.15–6.94; p = 0.024)) education had a higher risk of practicing self-medication when compared to women with lower education. Women in the first gestational trimester (35 (32.7%) (OR = 3.61; 95% CI 1.64–7.96; p = 0.002)) and with two or more pregnancies (87 (81.2%) (OR = 1.96; 95% CI 1.07–3.60; p = 0.029)) were more likely to practice self-medication than pregnant women in the second or third gestational trimester and in the first pregnancy, respectively.Conclusion: Self-medication was practiced by a considerable proportion of our sample, with the majority being OTC drugs. The factors associated with self-medication can help to improve prevention strategies regarding self-medication during pregnancy.

BACKGROUND The literature shows no consensus on whether two- or three-segment surgically assisted rapid maxillary expansion is the best operative technique. METHODS The present clinical trial was designed to compare the outcome of two- and three-segment osteotomy surgically assisted rapid maxillary expansion. Thirty-two adult patients with transverse maxillary deficiency greater than or equal to 5 mm were randomly assigned to two- and three-segment groups (n = 16). Dimensional and psychological assessments (Oral Health Impact Profile and Brazilian Orthognathic Quality of Life Questionnaire) were carried out before surgical intervention and at one of the following time points: completion of expansion, removal of expanding device, 6 months after completion of expansion, or 10 months after completion of expansion. Dimensional assessments for asymmetric expansion of the maxilla and for changes in the area and volume of the palatine vault were performed on digital data from tomographic and laser scanning with the aid of an engineering inspection software. RESULTS No statistically significant differences were found in asymmetry or stability outcomes between groups. The psychological benefit provided by the three-segment technique did not spread through the domains of the quality-of-life questionnaires. CONCLUSIONS The current findings suggest that three-segment surgically assisted rapid maxillary expansion outcomes do not exceed those obtained with its two-segment counterpart regarding symmetry of maxillary expansion and stability of area and volume of the palatine vault. Furthermore, psychological nuances evidenced in two- and three-segment groups with the tools used play a limited, short-lasting role, or a specific, more sensitive assessment tool needs to be developed. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.

A mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m2) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

Demand for agricultural products with zero or reduced amounts of agrochemicals leads to increasingly healthy production alternatives. Thus, seedling formation and fruit yield of three cucumber cultivars were evaluated on different organic substrates in a protected environment. Marketer, Caipira and Verde Comprido cultivars were grown on five substrates: 100% cassava stems + 0% cattle manure; 75% cassava stems + 25% cattle manure; 50% cassava stems + 50% cattle manure; 25% cassava stems + 75% cattle manure and 0% cassava stems + 100% cattle manure. A completely randomized design in a 5 x 3 factorial scheme (5 substrates X 3 cultivars) was used, with six replications of four seedlings in the seedling formation phase and five replications of two plants in the fruit production phase. The seedlings were produced in trays with 72 cells, and fruit production was conducted in 13-liter pots. There was a little influence of the substrates on the emergence of cucumber cultivars: the substrates with 75 and 100% of cattle manure provided the best conditions for seedling formation, as well as the highest yield and the largest amount of fruits. On the best substrates, the cultivar Caipira had fruits with higher mass and larger average fruit diameter, but in smaller numbers.

Introducao: Os pacientes internados em Unidade de Terapia Intensiva (UTI) sao comumente submetidos a sedacao, ventilacao mecânica, imobilidade e tempo de internacao prolongados, que podem acarretar em deficits neuromusculares e cognitivos. O Terapeuta Ocupacional (TO) busca minimizar essas condicoes que interferem diretamente desempenho ocupacional desses pacientes. Conhecer o cliente e suas capacidades funcionais a partir de instrumentos de funcionalidade podem auxiliar num melhor planejamento das intervencoes. Objetivo: Descrever o perfil funcional dos pacientes, bem como levantar as perdas funcionais mais recorrentes, e apontar as possiveis atuacoes da TO em pacientes criticos. Metodo: Estudo de coorte longitudinal que incluiu individuos com independencia total previa a internacao na UTI. Foram utilizados dois instrumentos que avaliam funcionalidade - a Perme Escore durante a internacao na UTI, e a MIF na alta da UTI. Resultados: Amostra de 18 pacientes, com idade media de 56 anos, 55,6% do genero feminino. A maior parte dos pacientes permaneceram somente no leito durante todo o periodo de internacao na UTI. Foram identificadas barreiras potenciais a mobilidade, relacionadas tanto ao proprio paciente, quanto em relacao a organizacao e cultura do servico. As intervencoes da TO englobaram aspectos motores, cognitivos, psicologicos, sensoriais e sociais. Apos alta da UTI, mais da metade dos pacientes foram capazes de realizar atividades fora do leito sem auxilio. Conclusao: O uso de avaliacoes coerentes com as caracteristicas do setor e da populacao atendida, contribuem para um tratamento mais estruturado, bem como possibilita identificar aspectos a serem melhorados, proporcionando um bom atendimento ao paciente critico. Abstract Introduction: Intensive Care Unit (ICU) patients are commonly submitted to prolonged sedation, mechanical ventilation, immobility and length of hospital stay, which can lead to neuromuscular and cognitive deficits. The Occupational Therapist (OT) seeks to minimize these conditions that directly interfere with the occupational performance of these patients. Knowing the client and his / her functional capacities from functional measurement tools can help in a better planning of the interventions. Objective: To describe the functional profile of the patients, as well as to obtain the most recurrent functional losses, and to point out the possible actions of OT in critical patients. Method: A longitudinal cohort study that included individuals with total independence prior to ICU admission. Two instruments were used to assess functionality - Perme Score during ICU stay, and FIM at ICU discharge. Results: A sample of 18 patients, with a mean age of 56 years, 55.6% of the female gender. Most of the patients remained only in bed during the entire ICU stay. Potential barriers to mobility were identified, related both to the patient and to the organization of the service. OT interventions included motor, cognitive, psychological, sensory and social aspects. After discharge from the ICU, more than half of the patients were able to perform activities outside the bed without assistance. Conclusion: The use of evaluations consistent with the characteristics of the sector and the population served contributes to a more structured treatment, as well as allows identifying aspects to be improved, providing a good care to critical patients. Keywords: Occupational Therapy, Intensive Care Units, Disabled Persons. Resumen Introduccion: Los pacientes internados en Unidad de Cuidados Intensivos (UCI) son comunmente sometidos a la sedacion, ventilacion mecanica, inmovilidad y tiempo de internacion prolongados, que pueden acarrear en deficit neuromusculares y cognitivos. El Terapeuta Ocupacional (TO) busca minimizar esas condiciones que interfieren directamente el desempeno ocupacional de estos pacientes. Conocer el cliente y sus capacidades funcionales a partir de instrumentos de evaluacion de funcionalidad pueden auxiliar en una mejor planificacion de las intervenciones. Objetivo: Describir el perfil funcional de los pacientes, asi como levantar las perdidas funcionales mas recurrentes, y senalar las posibles actuaciones de la TO en pacientes criticos. Metodo: Estudio de cohorte longitudinal que incluyo individuos con independencia total previa a la internacion en la UCI. Se utilizaron dos instrumentos que evaluan funcionalidad - la Perme Escore durante la internacion en la UCI, y la MIF en la alta de la UCI. Resultados: Muestra de 18 pacientes, con edad media de 56 anos, 55,6% del genero femenino. La mayoria de los pacientes permanecieron solo en el lecho durante todo el periodo de internacion en la UCI. Se identificaron barreras potenciales a la movilidad, relacionadas tanto al propio paciente, como a la organizacion del servicio. Las intervenciones de TO englobaron aspectos motores, cognitivos, psicologicos, sensoriales y sociales. Despues del alta de la UCI, mas de la mitad de los pacientes fueron capaces de realizar actividades fuera del lecho sin ayuda. Conclusion: El uso de evaluaciones coherentes con las caracteristicas del sector y de la poblacion atendida, contribuye a un tratamiento mas estructurado, asi como posibilita identificar aspectos a ser mejorados, proporcionando una buena atencion al paciente critico. Palabras clave: Terapia Ocupacional, Unidades de Cuidados Intensivos, Hospitalizacion.

A urolitíase é uma enfermidade de ampla incidência em cães. Este termo caracteriza a presença de urólitos, que consistem na união de cristais que se formam no trato urinário. A deposição destes cristais é decorrente de vários fatores, sejam estes adquiridos ou congênitos cursando em debilidade do animal quando ocorre obstrução podendo levar a morte quando um processo de intervenção não ocorre. A reincidência da patologia é alta para os animais onde se realizou intervenção cirúrgica sendo sua causa ainda não determinada. Sendo assim, o objetivo com a execução deste trabalho foi relatar um caso de reincidência de urolitíase em um cão da raça Pug atendido em clínica veterinária da região de Dourados – MS. O cão foi encaminhado para atendimento devido a alterações comportamentais observadas pelo proprietário e em anamnese realizada por veterinário foi constatado possível quadro de urolitíase já que este apresentava distensão e desconforto abdominal, hematúria e polaquiúria, procedendo-se então exames confirmatórios de raio-X e ultrassom para verificação da localização e número de cálculos. Realizou-se procedimento de cistotomia e acompanhamento clínico do animal, porém o mesmo apresentou três outras recidivas. Por meio do acompanhamento do animal e análise dos urólitos diagnosticou-se que a patologia estava associada à alimentação procedendo-se recomendações quanto a dieta e, ainda, em virtude de suas recidivas determinou-se que esta patologia também estava associada ao estresse sofrido pelo animal já que havia durante todas as ocorrências agentes estranhos no ambiente e após sua retirada houve melhora.

Made available in DSpace on 2020-12-12T02:24:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background: The initiation and progression of periodontitis might involve a local renin-angiotensin system in periodontal tissue. This study hypothesized that Losartan treatment could promote protection to rats submitted to experimental periodontitis (EP) by attenuating alveolar bone loss due to reduction in inflammatory cytokines, better reactive oxidant species regulation and maintenance of the balance between bone formation and resorption factors. Methods: One hundred and thirty rats were submitted to EP with a silk suture thread (4.0) placed around the lower right first molar for 1, 3, 7, and 14 consecutive days. The study comprised four groups: G1—control without EP; G2—animals with EP treated with water; G3—Losartan-treated animals (treatment started at the same day of EP induction), and G4—animals previously treated with Losartan for 30 days followed by induction of EP and continuity of treatment. Results: G2 rats had greater bone loss volume, increased number, and thickness and decreased separation of trabeculae. On the other hand, G4 animals showed significant improvements in these parameters. Histological analysis revealed that EP favors inflammatory cell infiltration and junctional epithelium, cementum with alveolar bone crest destruction, but animals pretreated with Losartan (G4) did not show these features. Although the G3 animals did not demonstrate the improvements detected in G4, mRNA expression results were similar. In mandibular tissue, EP promoted mRNA increases for ACE, AT1 receptor, and inflammatory mediators as well as decreases for antioxidant enzymes. However, Losartan treatments attenuated these responses in addition to promoting an increase in bone formation markers and transcription factors. Conclusion: AT1 receptor modulates EP progression. Department of Biological Sciences Bauru School of Dentistry University of São Paulo Department of Basic Sciences School of Dentistry São Paulo State University-UNESP Department of Biomedical Engineering Medical College of Wisconsin Department of Basic Sciences School of Dentistry São Paulo State University-UNESP FAPESP: 2015/03965-2

Define-se neonatologia como a ciência responsável pelo estudo dos cuidados aos neonatos, aos seus aspectos fisiológicos e às suas afecções neonatais propriamente ditas. O sistema de escore Apgar é um método fácil e confiável para avaliar a vitalidade de neonatos animais. No presente trabalho objetivou-se avaliar a vitalidade de neonatos caninos nascidos de parto eutócico e cesariana. Foram coletados dados de 31 neonatos de cães de diferentes portes e raças. Desse número amostral, 21 nasceram de parto eutócico e 10 através de cesariana. Coletaram-se os dados cerca de 10 minutos após o nascimento, aferindo-se: frequências cardíacas, respiratórias e inspecionados a coloração da mucosa gengival, tônus muscular e irritabilidade reflexa, atribuindo-lhes notas de 0 a 2. A somatória das notas específica de cada variável conferiu aos neonatos o escore Apgar total de 0 a 10. Os resultados foram submetidos à análise de variância ao nível de 5% de probabilidade e realizou-se o teste de normalidade e homogeneidade. As variáveis foram comparadas pelo teste t- Student, ao nível de 5% de probabilidade. As frequências cardíaca, respiratória e escore Apgar foram influenciados pelos tipos de parto. As maiores médias de frequências cardíacas, respiratórias e escore Apgar de 184,05 ± 6,95 bpm e 47,23 ± 2,18 mpm e 8,95 ± 0,22, respectivamente, foram encontrados em animais nascidos de parto eutócico. O escore Apgar demonstrou-se um método eficiente na avaliação neonatal de cães, bem como colaborou para identificação de alterações inespecíficas do período neonatal imediato.

BACKGROUND Clown intervention has been shown to enhance emotional and behavioral processes, but few studies have comprehensively examined the effectiveness of this practice using biomarkers. OBJECTIVE The aim of this study was to evaluate the effect of a clown intervention on the levels of psychological stress and cancer-related fatigue in pediatric patients with cancer undergoing chemotherapy. METHODS Sixteen patients who met all criteria from a pediatric oncology inpatient unit in a Brazilian comprehensive cancer care hospital participated in this quasi-experimental study. Eight saliva samples were collected, comprising 4 at baseline and 4 after clown intervention (+1, +4, +9, and +13 hours after awakening). Salivary cortisol and α-amylase levels were determined using high-sensitivity enzyme-linked immunosorbent assay kits. Stress and fatigue were measured by the Child Stress Scale-ESI and the PedsQL Multidimensional Fatigue Scale, respectively. Relationships among stress, fatigue, and biomarker levels were investigated using nonparametric statistics. RESULTS In comparison with baseline measurements, the total psychological stress and fatigue levels improved after the clown intervention at the collection time point +4 hours (P = .003 and P = .04, respectively). Salivary cortisol showed a significant decrease after clown intervention at the collection time points +1, +9, and +13 hours (P < .05); however, α-amylase levels remained unchanged. CONCLUSION These findings provide preliminary evidence that clown intervention merits further study as a way to reduce stress and fatigue in pediatric cancer inpatients, and that self-report and biomarker measures are feasible to collect in this patient group. IMPLICATIONS FOR PRACTICE Clown intervention as a nonpharmacological intervention may improve stress and fatigue levels in pediatric inpatients with cancer undergoing chemotherapy.

Carbohydrate (CHO) mouth rinsing seems to improve performance in exercises lasting 30–60 min. However, its effects on intermittent exercise are unclear. It is also unknown whether serial CHO mouth rinses can promote additional ergogenic effects when compared with a single mouth rinse. The aim of this study was to evaluate the effect of single and serial CHO mouth rinses on Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) performance in soccer players. In a randomized, crossover, double-blind, placebo-controlled design, 12 male (18.9 ± 0.5 years) soccer players performed eight serial mouth rinses under three different conditions: placebo solution only (noncaloric juice), seven placebo mouth rinses plus a single CHO mouth rinse (8% maltodextrin), or eight CHO mouth rinses (8-CHO). Following the final mouth rinse, individuals performed the Yo-Yo IR1 test to evaluate the maximal aerobic endurance performance measured via total distance covered. There were no differences in Yo-Yo IR1 performance between sessions (p = .32; single CHO mouth rinse (8% maltodextrin): 1,198 ± 289 m, eight CHO mouth rinses: 1,256 ± 253 m, placebo: 1,086 ± 284 m). In conclusion, single and serial CHO mouth rinsing did not improve performance during the Yo-Yo IR1 for soccer players. These data suggest that CHO mouth rinsing is not an effective ergogenic strategy for intermittent exercise performance irrespective of the number of rinses.

The aim of the present study was to verify if a protocol for cleaning the oral cavity of infants in the pre-dental period can reduce extrinsic salivary metabolites observed through Nuclear Magnetic Resonance (NMR). A cross-sectional clinical study with a convenience sample was conducted, and infants were recruited at the UFRJ Pediatric Dentistry Clinic. Participants who had used antibiotics and/or antifungals up to 3 months before and whose legal guardians did not consent or sign the Informed Consent Form were excluded. An anamnesis was performed with the guardians and the participants' intraoral clinical examination. Initial collection of unstimulated total saliva was performed using an automatic pipette with sterile plastic tips in the buccal floor region, at least 1 h after the last feeding. Subsequently, the infants' oral mucosa was cleaned with gauze moistened with filtered water, and after 5 min, a new collection was performed, using the same methodology. The obtained samples were immediately transferred on ice to the laboratory, centrifuged (10,000 g), and stored at −80°C. The NMR analyses were performed using a 500-MHz spectrometer Bruker, Germany); evaluations were done via the 1H and 1H-1H TOCSY spectra for metabolite signaling. Eleven pre-dental infants were evaluated, with a mean age of 3.8 months, including six girls (55%). Of these, nine participants (82%) were exclusively breastfed. The higher presence of components such as lactose, glucose, sugars, acetate, alanine, and lactate were observed in the samples before oral mucosa cleaning. Regarding the type of diet, more lactose was observed in the saliva of patients who were exclusively breastfed than those that received mixed feeding. We conclude that the oral mucosa cleaning of infants in the pre-dental period tends to reduce the concentration of extrinsic components from the diet, such as lactose, in the salivary metabolomic profile analyzed by NMR.

In 2017 the School of Medicine of the University of the Republic included advanced cardiopulmonary resuscitation as a mandatory curricular activity during the rotating internship. The decision is justified by morbility and mortality rates of heart disease, in particular cardiopulmonary arrests and sudden death. Resuscitation courses enable the acquisition of technical and non- technical skills to respond to a prevalent condition and to compensate the absence of this specific training in the training of medical doctors.The study aimed to communicate and evaluate the first experience during the 2017-2018 rotating internship.A transversal study was conducted to analyse the number of participants and the percentage of successful candidates. Likewise, a survey was designed to assess self-perception of skills prior to the course and skills acquired during the course, as well as a course satisfaction.Results revealed the high acceptance rate of this first instance of the course and its positive assessment. Similarly, interns evidenced improvement in their self-perception of identified skills. As to a weaknesses found, the questionnaire used had not been validated and not all Interns completed the assessment, both aspects that will be improved in future assessments.To conclude, we managed to inform about the experience, advanced cardiopulmonary resuscitation courses are an advantage in itself, and it has been a significant advance in the professional training of future medical doctors.

A 4-year-old male mixed-breed cat was evaluated with a history of the presence of a reddish mass in the left eye medial corner. Ophthalmic examination revealed prolapse of the third eyelid gland, conjunctival secretion and hyperemia. The animal underwent gland replacement surgery using the modified Morgan technique. After surgery, clinical signs improved on the first day. The cat was observed for 2 years after surgery and there was no recurrence of the condition. The surgical technique was effective in resolving the condition., Um felino de quatro anos de idade, macho e sem raça definida foi atendido com histórico de surgimento de uma massa avermelhada no canto medial do bulbo ocular esquerdo. Ao exame oftalmológico foi observado o prolapso da glândula da terceira pálpebra, hiperemia e secreção em conjuntiva. O animal foi submetido ao procedimento cirúrgico de reposição da glândula pela técnica de Morgan modificada. Após a cirurgia, notou-se melhora dos sinais clínicos. O animal foi acompanhado durante 3 anos após o procedimento e não houve, até o presente momento, a recidiva do prolapso da glândula. Esse é o primeiro caso relatado no Brasil de prolapso da glândula terceira pálpebra em felino. A técnica cirúrgica utilizada foi efetiva na resolução da condição.

Demodicose é uma dermatose parasitária considerada incomum no gato doméstico. Este estudo tem como objetivo relatar o primeiro sucesso terapêutico do sarolaner por via oral no tratamento de Demodex spp. em um gato naturalmente infestado no Brasil. Um gato adulto, positivo para o vírus da leucemia felina e em tratamento com glicocorticóides, apresentava sinais clínicos da pele como prurido intenso, hiperceratose, lignificação, fragilidade da pele e alopecia simétrica. O diagnóstico foi confirmado em arranhões na pele, impressão em tiras de acetato e exame coproparasitológico. Após o diagnóstico, o sarolaner foi administrado por via oral (4mg / kg). A avaliação foi realizada com arranhões na pele 24, 48 horas e 7, 14, 21 e 28 dias após o tratamento. Após 21 dias, nenhum ácaro foi observado e houve uma melhora na fragilidade da pele e na repilação parcial. Com base nos resultados deste estudo, pode-se concluir que o sarolaner foi eficaz no tratamento da sarna demodécica felina., Demodicose é uma dermatose parasitária considerada incomum no gato doméstico. Este estudo tem como objetivo relatar o primeiro sucesso terapêutico do sarolaner, por via oral, no tratamento de Demodex spp. em um gato naturalmente infestado no Brasil. Um gato adulto, positivo para vírus da leucemia felina e no tratamento com glicocorticóides, apresenta sinais clínicos de pele como prurido intenso, hiperqueratose, lignificação, fragilidade da pele e alopecia simétrica. O diagnóstico foi confirmado em raspados cutâneos, imprimindo em fita de acetato e sem exame coproparasitológico. Após o diagnóstico, o sarolaner foi administrado por via oral (4mg / kg). Uma avaliação foi realizada com raspados cutâneos com 24 e 48 horas e com 7, 14, 21 e 28 dias após o tratamento. Após 21 dias, nenhum óleo foi observado e houve uma melhora na fragilidade da pele e com a reabilitação parcial. Com base nos resultados deste estudo, pode-se concluir que o sarolaner foi eficaz no tratamento da sarna demodécica felina.

Objective This randomized clinical trial aimed to compare the short-term postsurgical symptoms after insertion of one or two implants for retention of a mandibular overdenture. This study investigated whether the less invasive single-implant approach results in lower postoperative symptoms compared to the conventional two-implant overdenture. Materials and methods Patients received new complete dentures and were randomly assigned to groups receiving one or two single-stage, early-loaded hydrophilic implants, inserted in the midline (n = 23), or the lateral incisor-canine area bilaterally (n = 24). Patient-reported postoperative symptoms were measured in a 0–100 visual analogue scale concerning pain in the surgical area, pain when chewing, bleeding, swelling, and unpleasantness. Data collection occurred 24 h and 7 and 21 days after surgery. Demographic and clinical features (smoking habit, classification of the residual ridges, and mucosal width and thickness at the implant sites), osteotomy for alveolar bone reduction, and surgery time were tested as predictors of symptom levels. Results Overall reported symptoms were mild and self-limited, with high rates of complete remission after the early loading period of 3 weeks. Progressive improvement of symptoms occurred from the 24-h to the 7-day and 21-day follow-ups (p < 0.001), similarly in both groups. None of the clinical predictors was significantly associated with the changes in symptoms. Conclusions Findings suggest that the insertion of one or two implants may result in similar postoperative outcomes. Clinical relevance The severity of short-term postoperative symptoms may not be a critical factor for the decision between overdenture treatment with one or two implants.

To determine the association between cephalometric measurements and polysomnographic parameters in Brazilian patients with midface deficiency. This was a primary, clinical, observational, longitudinal, retrospective, analytical, and single-center study. Forty-eight patients with midface deficiency were divided into two groups as follows: those who underwent surgically assisted rapid palatal expansion (SARME) and those who received maxillary advancement (MA). Pre- and post-operative cephalometric and polysomnography measurements were obtained. Pearson's correlation was used to verify the presence of any significant associations between PSG scores and cephalometric measurements. Associations between BMI (Body Mass Index) and AHI (Apnea Hypopnea Index) as well as arousals were observed. In the SARME group, associations between AHI and SNA, UAS and MP-H, arousals and SNA, and Co-A and MP-H were noted. Associations between AHI and Co-A, PoOr-A and MP-H, arousals and UAS, and between minimum saturation of O2 and SNA, SNB, and Co-A were observed in the MA group. This study demonstrates the alterations in the middle third of the face that were related to sleep disturbance. In addition, it shows the associations between the polysomnographic parameters and the cephalometric representations corresponding to the analyzed deformities and transverse or anteroposterior maxillary deficiencies.

Low-grade inflammation associated with metabolic syndrome (MS) triggers alterations in several organs, but its effects on pulmonary functional and immunological response in older adults are unknown. This cross-sectional study investigated such responses in older adults with and without MS. The study consisted of 77 older adults with MS (68 ± 3 years old) and without MS (67 ± 3 years old). Impulse oscillometry (IOS) was used to evaluate airway and tissue resistance and reactance. Biomarkers of systemic and pulmonary inflammation and fibrosis were studied. Total resistance of respiratory system (R5Hz; p

Otodectes cynotis is a mite with a cosmopolitan distribution that is the primary agent for the development of otitis externa in feline species. The aim of this study was to evaluate the efficacy of the oral administration of sarolaner for the treatment of feline otodectic mange. We used 20 adult cats of both sexes that were naturally infested with O. cynotis. The mite infestation scoring was performed by video-otoscopy before treatment. The cats were randomized according to the infestation score and divided into two groups (treated and control). The treated group underwent oral administration of sarolaner in a single dose of 2–4 mg/kg. The evaluations were performed by video-otoscopy to evaluate the reduction of infestation score 2, 4, 6, 24 and 48 h and 7, 14, 21 and 28 days after medication. At the end of the study, the cats were sedated to enable the recovery of live and dead mites to determine efficacy. No adverse effects or laboratory changes were observed in these cats. Sarolaner showed 100% efficacy 48 h after treatment. Based on the results, a single oral dose of sarolaner was effective in controlling otodectic mange in naturally infested cats.

COVID-19's social distance increased domestic violence (DV). In Brazil, in spite of the existence of services to denounce DV, women who do not communicate through the Brazilian-Portuguese language (Pt-Br) are, in fact, excluded as users. As a previous stage to development of a mobile application to denounce DV by women who are illiterate in Pt-Br, being them Brazilian or immigrant and including Brazilians with disabilities, a study on Brazilian mobile services to denounce DV by women who are Deaf was performed. This paper presents the study's results, requirements and shows that applications are not inclusive. The requirements triggered the need for future Participatory Design activities together with each one and all women involved, in order to guarantee that their other cultural and social specificities are addressed. These activities are part of the feminist interaction design agenda, within which the application design process will be seen.

OBJECTIVE This randomized clinical trial aimed to compare the outcomes of the mandibular overdenture retained by one (1-IOD) or two (2-IOD) implants. MATERIALS AND METHODS Participants received new complete dentures, were assessed at baseline and randomly assigned to groups. Early loaded single midline implant (1-IOD) or two implants in the canine regions bilaterally (2-IOD). Ball attachments were used for overdenture retention. Post-treatment outcomes (6- and 12-month follow-ups) included patient satisfaction, oral health-related quality of life measures, and chewing function. Data analysis included within- and between-group comparisons, and Generalized Estimating Equations. Both superiority and non-inferiority hypotheses were tested. RESULTS Forty-seven participants were included (1-IOD = 23; 2-IOD = 24). Significant improvements in OHIP-Edent were observed after insertion of new dentures and at the 1-year follow-up compared with baseline. No differences were found between the 1- and 2-IOD groups for the OHIP-Edent and QoLFAST scores. Patient satisfaction with the mandibular denture improved significantly from baseline to the 6-month follow-up and remained unaltered until 1 year, with no differences between groups. The magnitudes of treatment effect sizes were moderate to large for patient-reported outcomes. Progressive improvement in chewing function occurred in both groups. Non-inferiority testing based on a 15% non-inferiority margin showed inconclusive results for patient-reported outcomes, whilst chewing function in the 1-IOD group was concluded to be not inferior to the 2-IOD group. CONCLUSIONS Results support the use of both 1- and 2-IOD. The 1-IOD was also an acceptable alternative to the 2-IOD as a secondary option for the treatment of the edentulous mandible.

Trata-se das contribuicoes da Terapia Ocupacional ao enfrentamento da COVID-19 em pacientes no contexto de Unidade de Terapia Intensiva. Este artigo faz parte do suplemento da Revisbrato, a fim de possibilitar subsidios tecnico-cientificos para terapeutas ocupacionais em situacao de crise pandemica. Foram selecionados procedimentos especificos da terapia ocupacional, a partir das experiencias no servico de terapia ocupacional do Hospital Universitario Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, junto com as contribuicoes da terapia ocupacional na cidade de Sâo Paulo. Abstract These are the contributions of Occupational Therapy to coping with COVID-19 in patients in the context of the Intensive Care Unit. This article is part of the Revisbrato supplement, in order to provide technical-scientific support for occupational therapists in situations of pandemic crisis. Specific occupational therapy procedures were selected, based on experiences in the occupational therapy service at Hospital Universitario Clementino Fraga Filho, Federal University of Rio de Janeiro, together with contributions from occupational therapy in the city of Sao Paulo. Key words : Occupational therapy, ICU, Coronavirus infection. Resumen Estas son las contribuciones de la terapia ocupacional para hacer frente a COVID-19 en pacientes en el contexto de la Unidad de Terapia Intensiva. Este articulo es parte del suplemento Revisbrato, con el fin de proporcionar apoyo tecnico-cientifico para terapeutas ocupacionales en situaciones de crisis pandemica. Se seleccionaron procedimientos especificos de terapia ocupacional, basados en experiencias en el servicio de terapia ocupacional del Hospital Universitario Clementino Fraga Filho de la Universidad Federal de Rio de Janeiro, junto con las contribuciones de la terapia ocupacional en la ciudad de Sao Paulo. Palabras clave : Terapia ocupacional, UCI, infeccion por Coronavirus.

Objective: Respiratory syncytial virus is a pathogen frequently involved in nosocomial outbreaks. Although several studies have reported nosocomial outbreaks in neonatal intensive care units, molecular epidemiology data are scarce. Here, the authors describe two consecutive respiratory syncytial virus outbreaks caused by genotypes ON-1 and NA-2 in a neonatal intensive care unit in São Paulo, Brazil. Methods: A prospective search for respiratory syncytial virus was performed after diagnosing the index case and four other symptomatic newborns in the neonatal intensive care unit. Nasopharyngeal aspirate samples of all patients in the neonatal intensive care unit were tested for 17 respiratory viruses using real-time reverse transcriptase polymerase chain reaction. Genotyping was performed using nucleotide sequencing. Results: From May to August 2013, two different outbreaks were detected in the neonatal intensive care unit. A total of 20 infants were infected with respiratory syncytial virus-A (ten and 14 with ON-1 and NA-2 genotypes, respectively). The mean age of the infants was 10 days, mean birth weight was 1,961 g, and the mean gestational age was 33 weeks. Risk factors (heart disease, lung disease, and prematurity) were present in 80% and 85.7% of infants in the ON-1 and NA-2 groups, respectively. In total, 45.8% of infants were asymptomatic and 20.8% required mechanical ventilation. Coinfections were not detected during the outbreaks. Conclusions: Infants in a neonatal intensive care unit who develop abrupt respiratory symptoms should be tested for respiratory viruses, especially respiratory syncytial virus. Even in the absence of severe symptoms, respiratory syncytial virus detection can prevent nosocomial transmission through infection control measures. A better understanding of respiratory syncytial virus molecular epidemiology is essential for developing new vaccines and antiviral drugs against respiratory syncytial virus. Resumo: Objetivo: O vírus sincicial respiratório é um patógeno frequentemente envolvido em surtos nosocomiais. Embora vários estudos tenham relatado tais surtos em unidades de terapia intensiva neonatal, os dados epidemiológicos moleculares são escassos. Neste artigo, descrevemos dois surtos consecutivos de vírus sincicial respiratório causados pelos genótipos ON-1 e NA-2 em uma unidade de terapia intensiva neonatal em São Paulo, Brasil. Métodos: Uma busca prospectiva por vírus sincicial respiratório foi realizada após o diagnóstico do caso índice e outros quatro recém-nascidos sintomáticos na unidade de terapia intensiva neonatal. Amostras de aspirado nasofaríngeo de todos os pacientes da unidade de terapia intensiva neonatal foram testadas para 17 vírus respiratórios com reação em cadeia da polimerase via transcriptase reversa em tempo real. A genotipagem foi realizada utilizando sequenciamento de nucleotídeos. Resultados: De maio a agosto de 2013, foram detectados dois surtos diferentes na unidade de terapia intensiva neonatal. Vinte e quatro crianças foram infectadas com vírus sincicial respiratório-A (10 e 14 com os genótipos ON-1 e NA-2, respectivamente). A média da idade dos lactentes era de 10 dias, o peso médio ao nascer foi de 1961 g e a idade gestacional média de 33 semanas. Fatores de risco (doença cardíaca, doença pulmonar e prematuridade) estavam presentes em 80% e 85,7% dos bebês nos grupos ON-1 e NA-2, respectivamente. No total, 45,8% dos lactentes eram assintomáticos e 20,8% necessitaram de ventilação mecânica. Não foram detectadas coinfecções durante os surtos. Conclusões: Bebês em unidade de terapia intensiva neonatal que desenvolvem sintomas respiratórios abruptos devem ser testados para vírus respiratórios, especialmente o vírus sincicial respiratório. Mesmo na ausência de sintomas graves, a detecção de vírus sincicial respiratório pode prevenir a transmissão nosocomial através de medidas de controle de infecção. Um melhor entendimento da epidemiologia molecular do vírus sincicial respiratório é essencial para o desenvolvimento de novas vacinas e drogas antivirais contra o vírus sincicial respiratório. Keywords: Respiratory syncytial virus, ON-1, NA-2, Outbreak, Neonatal intensive care unit, Palavras-chave: Vírus sincicial respiratório, ON-1, NA-2, Surto, Unidade de terapia intensiva neonatal

Objective: To describe and analyze characteristics of cases of spinal cord Trauma (SCT) among traffic accident victims admitted to a referral hospital. Method: Descriptive, analytical, cross-sectional study with quantitative approach, developed in the city of Campina Grande, in the state of Paraíba, Brazil. The population consists of 1,884 medical records of patients admitted to hospital after damage caused by traffic accidents from January to December 2016. Data were analyzed using descriptive and inferential statistics, adopting a significance level of 5%. Results: Among the victims of traffic accidents, there was a male predominance (85.4%). The most affected age group was 21 to 30 years (29%). Accidents involving motorcyclists were predominant (82.9%) and 43 victims (2.3%) suffered spinal injury. Among these ones, there was a prevalence of males (86%), in the age group between 21 and 30 years (35.7%). In 30 cases (69.8%), the victims had spinal injuries. The cervical level (55.8%) was dominant. In addition, 46.7% of the victims were classified as ASIA and there were 9 cases (30%) of paraplegia and 1 case (3.3%) of tetraplegia. A bivariate analysis revealed a significant association between the variable presence of SCT and type of accident (p

Background The effects of chronotype on dietary intake and weight gain during pregnancy has not been addressed by the literature. The aim of this study was to analyse the effect of chronotype on eating patterns, energy, and macronutrient intake and distribution, as well as weight gain during pregnancy. Methods Prospective cohort study carried out with 100 pregnant women in the first, second, and third gestational trimester. The dietary intake was assessed by three 24-hour dietary recalls in each trimester, totaling 9 recalls. Energy and macronutrient intake and distribution were evaluated at meals throughout the day. Chronotype was derived from mid-sleep time on free days and the obtained scores were categorized into tertiles. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized Estimating Equation models were used to determine the effects of chronotype and gestational trimesters on eating patterns, daily energy, macronutrient distribution, and weight gain. Results Pregnant women with MSF values indicative of eveningness have breakfast later and also have a higher energy and carbohydrate intake at dinner when compared to those ‘morning’ women. Pregnant ‘morning’ women showed a better diet quality in terms of milk and dairy and saturated fat. Also, despite the tendency for all tertiles to gain excess weight during pregnancy, we found that pregnant women with a tendency to eveningness had worse adequacy of gestational weight gain in the third trimester when compared to those pregnant women with a tendency to ‘morning' (2,24 ± 0,25 versus 1,22 ± 0,14, p Conclusions Pregnant women with a tendency to evening consume breakfast later in the day and present a greater consumption of energy and carbohydrates in the evening, as well as a worse standard of gestational weight gain in the third trimester. Our results emphasize the importance of considering chrononutrition variables in the nutritional antenatal guidelines to promote maternal-fetal health.

O presente relato de caso tem como objetivo apresentar um caso de atresia anal tipo III, com megacólon e fistula vaginal em cão sem raça definida. A técnica cirúrgica utilizada e a conduta pós cirúrgica com a realização de enemas diários e hidratação foi eficaz na restauração da motilidade normal do intestino. A atresia é pouco frequente na clínica veterinária, e sua principal complicação é impactação colônica devido ao megacólon. No presente caso o paciente apresentou policitemia o que é mais um caso que confirma a presença de policitemia em presença de megacólon.

This paper describes the implementation of an outreach project that provided care to patients with lip and palate cleft. From 2013 to 2017, four volunteer undergraduate students and three master´s degree students supervised by three professors from an undergraduate course and a post-graduate course provided medical care in the form of outpatient care at a university. Forty-seven patients received care, clinical management and/or individual care on a weekly, fortnight or monthly basis, according to the demand and need of each patient or his/her family. Most of the patients fit into the following profile: male, white with unilateral transforamen incisive cleft. This outreach project improved the teaching quality by increasing the number of hour/classes about the subject as well as the number of scientific production. It was possible to say that the project achieved its goal as observed in the increase of human resources, interdisciplinary attribution, improvement of students’ knowledge in addition to the improvement of the quality in the care offered to these patients.

This study analyzed the type 1 and type 2T helper (Th1/Th2) cytokines (including interleukins), immune cellular, matrix profile, and pathogens in granulomas with unexplained etiology compared to those with infectious and noninfectious etiology. Surgical lung biopsies from 108 patients were retrospectively reviewed. Histochemistry, immunohistochemistry, immunofluorescence, morphometry and polymerase chain reaction were used, respectively, to evaluate total collagen and elastin fibers, collagen I and III, immune cells, cytokines, matrix metalloproteinase-9, myofibroblasts, and multiple usual and unusual pathogens. No relevant polymerase chain reaction expression was found in unexplained granulomas. A significant difference was found between the absolute number of eosinophils, macrophages, and lymphocytes within granulomas compared to uninvolved lung tissue. Granulomas with unexplained etiology (UEG) presented increased number of eosinophils and high expression of interleukins (ILs) IL-4/IL-5 and transforming growth factor-β. In sarcoidosis, CD4/CD8 cell number was significantly higher within and outside granulomas, respectively; the opposite was detected in hypersensitivity pneumonitis. Again, a significant difference was found between the high number of myofibroblasts and matrix metalloproteinase-9 in UEG, hypersensitivity pneumonitis, and sarcoidosis compared to granulomas of tuberculosis. Granulomas of paracoccidioisis exhibited increased type I collagen and elastic fibers. Th1 immune cellular profile was similar among granulomas with unexplained, infectious, and noninfectious etiology. In contrast, modulation of Th2 and matrix remodeling was associated with more fibroelastogenesis and scarring of lung tissue in UEG compared to infectious and noninfectious. We concluded that IL-4/IL-5 and transforming growth factor-β might be used as surrogate markers of early fibrosis, reducing the need for genotyping, and promise therapeutic target in unexplained granulomas.

As variáveis que interferem no cuidado do idoso dizem respeito às normas, atitudes, valores e crenças; o que nesta pesquisa foi estudado por meio das representações sociais. Este artigo objetivou compreender as representações sociais (RS) acerca dos cuidados de idosos para pessoas idosas e membros de sua rede social. Derivou do segundo estudo da tese intitulada “O cuidado do idoso: representações e práticas sociais”, da primeira autora, de natureza empírica, por meio de pesquisa de campo, com delineamento descritivo, comparativo de corte transversal. Participaram do estudo 40 pessoas idosas e 40 membros da rede social dos respectivos idosos. A coleta de dados ocorreu por meio de entrevista semiestruturada, associada a técnica de entrevista episódica. As entrevistas passaram por classificação hierárquica de texto (IRAMUTEQ), e os dados sócio demográficos por descrição estatística (SPSS). Referente ao objeto social “cuidar da pessoa idosa”, foram identificadas dimensões representacionais, quais sejam: “satisfação das necessidades básicas, sobrecarga, gastos financeiros versus obrigação e retribuição”. Houve primazia de aspectos pragmáticos em detrimento aos afetivos, isto é, majoritariamente a significação de cuidar da pessoa idosa estava permeada pela prática, o que sugere a necessidade do reforçamento de práticas de cuidado de cunho afetivo e não somente de cunho técnico.

Dermatobia hominis (D. hominis) is a botfly that causes furuncular myiasis in several species of domestic and wild animals. However, reports of feline infestation by larvae of this dipteran are rare.To report the natural occurrence of furuncular myiasis caused by D. hominis in five cats and the efficacy of topical fluralaner for its treatment.Five adult mixed-breed cats (four males, one female) were diagnosed and treated, all living in the state of Rio de Janeiro, Brazil.The cats were treated with topical fluralaner. After this treatment, the larvae were dead after 24 h in three cats and after 48 h in two. There was spontaneous expulsion of larvae in two cats, and it was necessary to perform manual expression for removal of dead larvae in the other three cats.Dermatobia hominis can cause furuncular myiasis in cats, although this appears to be less common than in other animal species. Topical fluralaner proved to be effective in the treatment of this parasitic disease.Dermatobia hominis (D. hominis) est un oestre qui cause une myiase furonculeuse chez plusieurs espèces d’animaux sauvages. Cependant des données sur l’infestation féline par les larves de ce diptère sont rares.Décrire le développement naturel de myiase furonculeuse causée par D. hominis chez cinq chats et l’efficacité de fluralaner topique comme traitement.Cinq chats adultes croisés (quatre males et une femelle) ont été diagnostiqués et traités, tous vivant dans l’état de Rio de Janeiro, Brésil. RÉSULTATS: Les chats ont été traités avec du fluralaner topique. Après ce traitement, les larves ont été tuées après 24h pour trois chats et après 48h pour ceux chats. Il y a eu une expulsion spontanée des larves de deux chats, et il a été nécessaire de réaliser un retrait manuel des larves mortes pour les trois autres chats.Dermatobia hominis peut causer une myiase furonculeuse chez le chat, bien qu’elle semble moins fréquente que dans d’autres espèces. Le fluralaner topique a prouvé son efficacité dans le traitement de cette maladie parasitaire.INTRODUCCIÓN: Dermatobia hominis (D. hominis) es una mosca común que causa miasis foruncular en varias especies de animales domésticos y salvajes. Sin embargo, los informes de infestación felina por larvas de este dípteros son raros. OBJETIVO: describir una miasis foruncular natural causada por D. hominis en cinco gatos y la eficacia del fluralaner tópico para su tratamiento. ANIMALES: se diagnosticaron y trataron cinco gatos adultos de raza mestiza (cuatro machos, una hembra), todos viviendo en el estado de Río de Janeiro, Brasil. RESULTADOS: los gatos fueron tratados con fluralaner tópico. Después de este tratamiento, las larvas murieron a las 24 h en tres gatos y a las 48 h en dos. Hubo expulsión espontánea de larvas en dos gatos, y fue necesario realizar una extracción manual para remover las larvas muertas en los otros tres gatos. CONCLUSIONES E IMPORTANCIA CLÍNICA: Dermatobia hominis puede causar miasis foruncular en gatos, aunque esto parece ser menos común que en otras especies animales. El fluralaner tópico demostró ser eficaz en el tratamiento de esta enfermedad parasitaria.Dermatobia hominis (D. hominis) ist eine Dasselfliege, die eine furunkulöse Myiasis bei verschiedenen domestizierten und wilden Tierspezies verursacht. Berichte über einen Befall dieser Zweiflügler Larven bei Katzen sind jedoch selten. ZIEL: Ein Bericht über das natürliche Auftreten einer furunkulösen Myiasis, verursacht durch D. hominis, bei fünf Katzen und die Wirksamkeit von topisch eingesetztem Fluralaner für ihre Behandlung.Fünf erwachsene Mischlingskatzen (vier männliche, eine weibliche), die alle im Staat Rio de Janeiro in Brasilien lebten, wurden diagnostiziert und behandelt.Die Katzen wurden topisch mit Fluralaner behandelt. Nach dieser Behandlung waren die Larven innerhalb von 24h bei drei und nach 48h bei zwei Katzen tot. Es bestand eine spontane Austreibung von Larven bei zwei Katzen und bei weiteren drei Katzen war es nötig, tote Larven manuell auszudrücken, um sie zu entfernen.Dermatobia hominis kann eine furunkulöse Myiasis bei Katzen verursachen, obwohl dies seltener vorzukommen scheint als bei anderen Tierspezies. Eine topische Verabreichung von Fluralaner zeigte sich als wirksame Behandlung dieser parasitären Erkrankung.背景: Dermatobia hominis(D. hominis) は、数種の家畜や野生動物に癤性蝿蛆症を引き起こすヒツジバエ科の蝿である。しかし、この双翅類の幼虫がネコに感染したという報告は稀である。 目的: 本研究の目的は、5頭の猫におけるD. hominisによる癤性蝿蛆症の自然発生およびその治療に対する外用フルララネルの有効性を報告することであった。 被験動物: ブラジルのリオデジャネイロ州に住む5頭のMIX成猫 (雄4頭、雌1頭) が診断され、治療を受けた。 結果: 猫たちはフルララネルの外用薬で治療した。この治療後、3頭の猫では24時間後に、2頭では48時間後に幼虫は死んでいた。2頭の猫では幼虫の自然排出があり、他の3頭の猫では死んだ幼虫の除去に用手介助を行う必要があった。 結論と臨床上の重要性: Dermatobia hominisは猫において癤性蝿蛆症を引き起こす可能性があるが, 他の動物種に比べてその頻度は低いようである。この寄生虫症の治療に外用フルララネルが有効であることがわかった。.背景: 人肤蝇(Dermatobia hominis,D.hominis)是一种引起几种家养和野生动物疖性蝇蛆病的肤蝇。然而, 猫被这种双翅目幼虫侵扰的报道很少。 目的: 报告5只猫自然发生人皮蝇引起的疖性蝇蛆病, 以及外用氟雷拉纳对其治疗的疗效。 动物: 诊断并治疗了5只成年杂种猫 (4只雄性, 1只雌性) , 均生活在巴西里约热内卢州。 结果: 猫接受氟雷拉纳外部治疗。治疗后24 h,3只猫身上的幼虫死亡, 48 h后2只猫身上的幼虫死亡。2只猫自发排出幼虫, 另3只猫需要进行人工挤压才能清除死亡幼虫。 结论和临床重要性: 人肤蝇可引起猫疖性蝇蛆病, 尽管这似乎不如其他动物种属常见。外用氟雷拉纳被证明对治疗这种寄生虫病有效。.Dermatobia hominis (D. hominis) é uma mosca que causa miíase furunculosa em diversas espécies de animais domésticos e selvagens. Entretanto, relatos de infestação em felinos por larvas deste díptero são raras.Relatar a ocorrência natural de miíase furunculosa causada por D. hominis em cinco gatos e a eficácia do fluralaner tópico no seu tratamento.Cinco gatos adultos sem raça definida (quatro machos, uma fêmea) foram diagnosticados e tratados, todos habitantes do estado do Rio de Janeiro.Os gatos foram tratados com fluralaner tópico. Após este tratamento, observou-se que as larvas estavam mortas após 24 horas em três gatos e após 48h em dois. Houve expulsão espontânea das larvas em dois gatos, e foi necessário realizar a expressão manual para a remoção das larvas mortas nos outros três gatos. CONCLUSÕES E IMPORTÂNCIA CLÍNICA: Dermatobia hominis pode causar miíase furunculosa em gatos, apesar disto ser aparentemente menos frequente que em outras espécies de animais. O fluralaner tópico demonstrou ter boa eficácia no tratamento desta doença parasitária.

Background This cross-sectional study investigated the association between chronotype, food craving and weight gain in pregnant women. Methods In total, 245 pregnant women attending the public health service in Brazil were included. Chronotype was derived from the time of mid-sleep time on free days, with a further correction for calculated sleep debt, and higher scores on this variable indicate a tendency to eveningness. A Food Craving Questionnaire Trait and State assessment was performed, and weight gain was calculated. Generalised linear models were used to determine the association between the variables under analysis. Results Evening types presented higher anticipation of relief from negative states and feelings as a result of eating as a usual behaviour compared to morning (P = 0.013) and non-evening types (P = 0.028); less intense desire to eat as a sporadic behaviour compared to morning (P = 0.012) and non-evening types (P = 0.009); and less anticipation of positive reinforcement that may result from eating as a sporadic behaviour than non-evening types (P = 0.022). We also found a significant association between chronotype score and anticipation of relief from negative states and feelings as a result of eating (P = 0.004); anticipation of positive reinforcement that may result from eating (P = 0.013) as a usual behaviour; weight gain during the early gestational period (P = 0.024); and intense desire to eat (P = 0.045) as a sporadic behaviour. Conclusions We conclude that evening chronotype was associated with the food craving trait. Pregnant women who tend to eveningness are more likely to gain weight in the early gestational period.

Objective The aim of this study was to analyze the effect of nighttime energy intake on daily energy and macronutrient distribution and weight gain during pregnancy. Methods This was a prospective cohort study carried out with 100 pregnant women and the data collection occurred once per trimester. A dietary intake was assessed by three 24-h dietary recalls in each trimester, totaling nine dietary recalls. The distribution of energy and macronutrient intake was evaluated at meals throughout the day in each trimester and overall pregnancy. Women were classified as having “lower” or “higher” nighttime intake (1900 to 0559) if consumption in this period were below or above the median of the population, respectively, for at least two trimesters. Recommendations from the Institute of Medicine were used to assess the adequacy of weight gain. Generalized estimating equation models were used to determine the effects of nighttime intake and gestational trimesters on daily energy distribution and weight gain. Results In overall pregnancy, the higher group consumed a higher percentage of energy and macronutrients in the evening meals, and less energy, proteins, and lipids in morning meals when compared with the lower group. Also, women in the higher group had greater excessive weight gain in the third trimester compared with the lower group. Conclusion Pregnant women with a higher energy intake at night had a lower percentage of energy, protein, and lipid intake in morning meals and a higher percentage of energy and macronutrient intake in the evening meals during pregnancy. A worse standard of gestational weight gain in the third trimester was also observed in pregnant women with a higher energy intake at night.

Studies have suggested that eating at later times may be a risk factor for being overweight. The aim of this study was to investigate the association of caloric midpoint on the anthropometric profile and calorie and macronutrient intake during the day. The study included 718 Brazilian undergraduate students (20.5 ± 2.9 years old; 67% women). Dietary intake was assessed by 24-h recall and the diurnal variation of calorie consumption was evaluated by caloric midpoint average time at which 50% of daily energy were consumed. Participants were classified into two groups according to caloric midpoint median; early eaters (caloric midpoint ≤ 3:00 pm) or late eaters (caloric midpoint > 3:00 pm). Body weight and waist circumference were measured and body mass index (BMI) was determined. Generalized linear models adjusted for confounding variables were used to determine the association between variables. The late eaters presented higher BMI when compared to early eaters (23.0 kg/m2 ± 0.3 vs. 22.1 kg/m2 ± 0.2, respectively; p = .02). Late eaters reported a higher total daily consumption of energy (p < .001) and proportion consumed after 9:00 pm (p < .001), as well as total daily carbohydrate (p < .001), protein (p < .001), fat (p < .001), saturated fat (p < .001), and cholesterol (p = .04) intake when compared with early eaters. We conclude that concentrating food intake later in the day is associated with higher total energy and macronutrient intake as well as a higher average BMI.

IntroductionEighty per cent of the sexually active population will get human papillomavirus (HPV) infection, which is the most prevalent sexually transmitted disease worldwide. Persistence of high-grade HPV infection may evolve to a cervical intraepithelial neoplasia (CIN), and these lesions may be precursors of cervical cancer. However, this progression can be prevented by the administration of therapeutic vaccines which use the main oncoproteins responsible for cancer development in an attempt to trigger a more specific and effective immunological response against this disorder. We aim to evaluate the safety, efficacy and immunogenicity of therapeutic vaccines in the treatment of patients with high-grade CIN 2/3 associated with HPV.Methods and analysisA systematic review of clinical trials will be undertaken. Medline, Excerpta Medica Database, Cochrane Central Register of Controlled Trials, Web of Science, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online and Scopus will be searched, with no restriction regarding publication date. Primary outcomes will include measures related to safety, efficacy and the immunogenicity of the therapeutic vaccines used in these patients. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methodological appraisal of the studies will be assessed by the Cochrane Risk-of-Bias Tool for randomised controlled trials, and the quality evidence of the risk of bias in single studies will be evaluated by Grading of Recommendations Assessment, Development and Evaluation. A narrative synthesis will be done for all included studies. Outcomes will be analysed according to the subgroups of HPV type, CIN grade, route of vaccine administration and vaccine type. Also, if sufficient data are available, a meta-analysis will be conducted. The effect sizes will be generated using Hedges’ g score for both fixed and random effect models. I2statistics will be used to assess heterogeneity and identify their potential sources.Ethics and disseminationEthical approval is not required as primary data will not be collected. Findings will be disseminated widely via peer-reviewed publication and in different media, for example, conferences, congresses or symposia.PROSPERO registration numberCRD42017077428.

Despite the increased understanding of the oncological mechanisms underlying Glioblastoma multiforme (GBM) pathophysiology, and recent advances in therapeutic strategies such as maximal surgical resection and post-operative radiotherapy with concomitant and adjuvant temozolomide chemotherapy, the prognosis for patients with brain tumors remains limited. Evidences indicate that the assessment of DNA methylation status in cancer stem cells would allow identifying molecules expressed in these cells, to lead to targeted elimination of this critical population from brain tumors, making the glioblastoma treatment more effective. This study aimed to analyze the role of microRNA-181d associated with the methylation status of the O6-methylguanine methyl transferase (MGMT) gene in Glioblastoma multiforme cancer stem cells subjected to treatment with temozolomide and ionizing radiation. Such responses were analyzed in terms of cell survival, evaluation of the MGMT gene methylation status by MS-HRM (Methylation-Sensitive High Resolution Melting), and analysis of miRNA-181d and MGMT gene expression by relative quantification of mRNA levels in cancer stem cells subjected to treatment with temozolomide and ionizing radiation, isolated or combined. We showed that ionizing radiation and temozolomide reduced the viability of cancer stem cells from GBM patients, as well as modified MGMT gene and miRNA-181d expression in cancer stem cells, suggesting that miRNA-181d interferes in the glioblastoma cancer stem cell response to treatment with temozolomide and ionizing radiation.

Purpose This study aimed to compare two methods for final impression during the fabrication of complete dentures: a traditional method using custom trays (T-group) and a simplified method using the trial denture baseplate (S-group). Methods A pragmatic clinical trial was conducted among edentulous individuals referred for conventional denture treatment. A consecutive sample of edentulous patients was assigned to two groups by cluster randomisation according to the final impression strategy, 30 in the T-group and 38 in the S-group. In the T-group, an auto-polymerising acrylic resin custom tray was used for impression; in the S-group, the final impression was performed using the try-in dentures. For both groups, zinc oxide eugenol paste was used as the impression material. The quality of the dentures was assessed using two rating scales (Functional Assessment of the Dentures and Kapur method). Moreover, clinical time for denture fabrication, number of post-insertion appointments for adjustments, patient satisfaction and post-treatment oral health-related quality of life impacts were also assessed. Results There were no significant differences between groups regarding prosthodontic and patient-reported outcomes. The S-group demanded less clinical time (P = 0.002), with a 23.3% mean reduction in clinical time (P = 0.002) and lower number of appointments until the delivery of the dentures (S-group = 4.18 vs T-group = 5.0; P = 0.001). Conclusions This study showed that the alternative method for final impression is less time-consuming and has similar clinical outcomes when compared to the traditional final impression method. Findings suggest that this alternative may be considered when efficiency is a critical issue in healthcare services.

Breast cancer survivors display altered inflammatory responses to immune challenges relative to cancer-naive controls likely due to previous cancer treatments, stress associated with cancer, and/or tumor physiology. Proper inflammatory responses are necessary for adaptive sickness behaviors (e.g., fatigue, anorexia, and fever) and neuroinflammatory pathways are also implicated in mental health disturbances (e.g., cognitive impairment, depression) suffered by cancer patients and survivors. Rodent cancer models indicate that tumors are sufficient to exacerbate neuroinflammatory responses after an immune challenge, however primary tumors are not usually present in cancer survivors, and the behavioral consequences of these brain changes remain understudied. Therefore, we tested the extent to which mammary tumor resection attenuates tumor-induced neuroinflammation and sickness behavior following an immune challenge (i.p. lipopolysaccharide [LPS] injection) in mice. Tnf-α, Il-1β, and Il-6 mRNA decreased in multiple brain regions of LPS-treated tumor-bearing mice relative to LPS-treated controls; tumor resection attenuated these effects in some cases (but not Tnf-α). Tumors also attenuated sickness behaviors (hypothermia and lethargy) compared to LPS-treated controls. Tumor resection reversed these behavioral consequences, although basal body temperature remained elevated, comparable to tumor-bearing mice. Thus, tumors significantly modulate neuroinflammatory pathways with functional consequences and tumor resection mitigates most, but not all, of these changes.

The stress associated with cancer development leads to disturbances in the hypothalamic-pituitary-adrenal axis and suppresses important facets of the immune response. The use of complementary therapies in the treatment of women with breast cancer has demonstrated therapeutic benefits that entail improvements in the patients’ quality of life. The objective of this article is to present evidence on the use of complementary therapies as a stress reduction strategy and on its stimulating effects on the immune system of women with breast cancer. This is a reflexive updating article that will support the health professionals’ understanding on the use of complementary therapies in breast cancer care. The use of complementary therapies in the treatment of women with breast cancer has significantly improved these subjects’ stress, depression, fatigue, anxiety, and, consequently, their quality of life, as well as their immune response, which is mainly illustrated by the increased number and cytotoxic activity of natural killer cells. Clinicians, health professionals, and patients need to be cautious about using complementary therapies and fully understand the real benefits and risks associated with each therapy. Little or no supporting evidence is available to clarify the effects on the immune system of women with breast cancer, and the consequent therapeutic benefits obtained through the use of these practices.

A paisagem é uma construção coletiva e se constitui como resultado de disputas entre grupos que procuram marcar o mundo de acordo com suas concepções. No universo urbano, inscrições no território podem assumir variada compleição e apresentar distintos níveis de significação, como marcos urbanos e/ou monumentos. Em razão da marcante presença de portais instalados nas rodovias paranaenses, este texto tem o objetivo de instigar juízos acerca da sua contribuição para a conformação da paisagem. Para tanto, a partir de sucintos apontamentos sobre a categoria de paisagem e o conceito de monumento, apresenta-se uma classificação e uma sucinta descrição desses portais com vistas a identificá-los como elementos representantes de nosso estágio comunal. Trata-se de resultado de inquietação que se consolidou por varredura digital exploratória das entradas rodoviárias dos municípios do Paraná no Google Street View, alimentado por notícias disponíveis na internet.

In recent years, translational research (TR) has become a new approach for bridging basic research and clinical practice. This article examines studies in which the authors used TR to learn more about the underlying causes of selected symptoms, and to discuss these results in the context of cancer nursing and symptom management. A literature review was undertaken, plus critical analysis of the authors. TR conducted by cancer nursing scholars has been relatively limited in the past, but is becoming more common as nurses complete additional academic work in the basic sciences and develop research teams with colleagues of those areas of knowledge. The goal in these studies is to show how a set of variables explains differential interventional effects. The availability of TR provides new evidence for the management of symptoms experienced by individuals with cancer, which could lead to improvements in the care of cancer patients across the world.