Maintenance of sterility in SMS packaging in dental environments: concern with biosafety

Healthcare services must be guided by biosafety practices and microbial control. This control is highly influenced by humidity, which directly impacts the maintenance of sterility of the materials used in the appointments. High concentration of moisture, in the form of aerosol, splashes and spills, is caused during dental care. During the COVID-19 times the contamination by aerosol and droplets worries greatly. Considering that it could cause harm to the sterility of an autoclaved material, especially in dental environments, the objective was to evaluate the behavior of SMS sterilization packages (Spunbonded / Meltblown / Spunbonded) against microbial penetration in an aqueous vehicle. SMS of three brands were challenged, equally divided into two groups: virgin and processed (subjected to a single autoclaving cycle). Each specimen was aseptically deposited on Macconkey agar. Subsequently, 5 µL of Escherichia coliATCC 25922 saline solution [108CFU mL-1] was deposited in center of the SMS specimen and the dish incubated at36°C/ 48h. Reading was performed by the presence or absence of bacterial growth typical of the species under the SMS, observed on the back of Petri dish. The lowest penetration rate observed was 60% for one of the brands in the virgin condition, and 75% for two brands in the processed condition. Statistical analysis showed an association between bacterial penetration and the evaluated group, this association being valid only in the virgin condition. The different SMS behave similarly in terms of resistance to bacterial penetration after being processed. The data show that moisture can assist in bacterial transport through sterilized SMS. Therefore, SMS packages are not able to prevent bacterial penetration, and possibly other microorganisms, when in aqueous vehicles, offering a potential risk of breaking the aseptic chain. Thus, care must be taken in routines for handling and storage sterile packaging.

Rol de tutor par: experiencia de estudiantes de medicina / The experience of medical students as peer tutors

Background: Peer tutoring is a process of accompaniment carried out by a student with certain features and skills, whose objective is to support and guide, academically and emotionally, other students who may require it. Aim: To assess the experience of medical students who played the role of peer tutor. Material and Methods: We carried out semi-structured in-depth interviews, with prior informed consent, to a non-probabilistic and intentional sample of six students who performed the role of peer tutor, during 2017 and 2018. The data analysis followed the scheme of constant comparison and progressive reduction in a manual way, according to the comparative method, guaranteeing scientific rigor, maintaining criteria of credibility, dependence, confirmability, and transferability. Results: The first level identified 234 units of meaning that originated in the third level, two qualitative domains, oriented to the contribution of peer tutors derived from their experience to strengthen both the process of peer tutor training and the management of peer tutoring. Conclusions: Peer tutoring as a teaching-learning strategy contributes to the development of generic competences and metacognitive skills, generating high levels of personal satisfaction and identification their teaching role.

Tratamento da mordida aberta anterior: revisão de literatura / Treatment of previous open bite: literary review

Objetivo: realizar uma revisão de literatura sobre os tipos de tratamento empregados na correção da mordida aberta anterior. Materiais e métodos: foi realizada uma busca nas bases de dados PubMed, SciELO e Google Acadêmico. Os termos inseridos na pesquisa foram: Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Revisão da Literatura: a mordida aberta anterior (MAA) é uma má oclusão dentária que pode promover alteração do perfil e da fisionomia do indivíduo, dificultando também a apreensão e o corte dos alimentos. A MAA é uma das más oclusões de maior comprometimento estético-funcional, podendo ser dentária ou esquelética. A etiologia da mordida aberta anterior é multifatorial, sendo que as principais causas são hereditariedade e causas ambientais. Esses fatores interferem no crescimento e desenvolvimento normais das estruturas faciais, modificando não somente a morfologia, mas, também, a função do sistema estomatognático. Considerações finais: conclui-se que o diagnóstico precoce e a remoção do fator etiológico são fundamentais para a evolução adequada do tratamento ortodôntico.(AU)

Objective: to perform a literature review on the types of treatment used in anterior open bite correction. Materials and methods: a search was performed in the PubMed, SciELO, and Google Scholar databases. The terms entered in the search were Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Literature Review: anterior open bite (AOB) is a dental malocclusion that may change the profile and physiognomy of individuals, making it difficult to grasp and cut food. The AOB is one of the malocclusions with the most aesthetic and functional impairments, and it may be dental or skeletal. The etiology of anterior open bite is multifactorial and the main causes are heredity and environmental causes. These factors interfere with the normal growth and development of facial structures, modifying not only the morphology but also the function of the stomatognathic system. Final considerations: it is concluded that the early diagnosis and removal of the etiological factor are essential for the proper evolution of the orthodontic treatment.(AU)

Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon / The Mexican consensus on the diagnosis and treatment of diverticular disease of the colon

Desde la publicación en 2008 de las guías de diagnóstico y tratamiento de la enfermedad diverticular del colon de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed de enero de 2008 a julio de 2018 con el fin de revisar y actualizar las guías 2008 y proporcionar nuevas recomendaciones basadas en la evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron los enunciados, que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Cuarenta y tres enunciados fueron finalmente votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología, fisiopatología y factores de riesgo. Se revisó con especial énfasis la utilidad de la tomografía computarizada y de la colonoscopia, así como los métodos endoscópicos para el control de la hemorragia. Se discutió sobre el tratamiento ambulatorio de la diverticulitis no complicada, el papel de la rifaximina y la mesalazina, en el manejo de la diverticulitis aguda complicada tanto en sus alternativas mínimamente invasivas hasta las opciones quirúrgicas con énfasis en sus indicaciones, limitaciones y contraindicaciones. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presentan la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.

Efeito metafilático do zinco injetável sobre parâmetros metabólicos e oxidativos de ovelhas no pós-parto imediato / Metaphylactic effect of injectable zinc on metabolic and oxidative parameters of sheep in the immediate postpartum

The aim of this study was to evaluate a new source of injectable organic zinc (zinc edetate) on the energy and oxidative profile in sheep during the immediate postpartum period. Twenty-six Texel breed animals were previously identified and divided into two experimental groups: the treated group (TG; n= 13) that comprised the animals that received a subcutaneous (SC) injection of 100 mg of zinc edetate (2 mL) fifteen days before the parturition expected date and the control group (CG; n=13) that comprised the animals that received 2mL of physiological solution at the same date of TG. Blood samples were collected on the parturition day for the assessment of serum fructosamine, cholesterol and triglycerides, insulin-like growth factor type 1 (IGF-1), the oxidative stress index (OSi) and blood zinc concentration. In addition to these parameters, the measurement of zinc was made in food given to the animals. There was no difference in metabolic parameters and OSi between the experimental groups (P>0.05), as well as in blood zinc concentrations (P>0.05). The parenteral zinc edentate does not change the energy and oxidative profile of sheep in immediate postpartum.(AU)

Saúde e qualidade de vida: discursos de docentes no cotidiano de uma escola pública de Santa Catarina / Health and quality of life: teachers' speeches in daily life of a public school in Santa Catarina / Salud y calidad de vida: discursos de docentes en el cotidiano de una escuela pública de Santa Catarina

Resumo A pesquisa teve por objetivo conhecer as concepções sobre saúde, doença, qualidade de vida e temas afins de docentes de uma escola pública de Florianópolis, Santa Catarina, Brasil, 2013. Estudo qualitativo, descritivo, com dados coletados por meio de grupo focal e entrevistas semiestruturadas. A estratégia de grupo focal adotada foi orientada segundo a abordagem do ‘círculo de cultura’, no qual os participantes expressaram suas concepções sobre os temas estudados e refletiram sobre como contribuir com estratégias de promoção da saúde no contexto escolar por meio da educação em saúde. O universo da pesquisa foi formado por 16 docentes da rede estadual de ensino; oito docentes confirmaram a participação no grupo focal e, desses, apenas seis compareceram do primeiro ao último encontro. Ao final os dados revelaram que os docentes percebem uma estreita relação entre saúde e qualidade de vida e que uma vida saudável é possível na presença de enfermidade. Enfatizaram a necessidade de maior participação dos pais e profissionais da saúde no processo de educação em saúde e, também, de um preparo sistemático e permanente sobre as questões que envolvam saúde no contexto escolar. As concepções dos docentes reafirmam que a dimensão social sobressai à biológica e que o conhecimento e a valorização desses aspectos, na prática docente, podem ampliar as ações em saúde.

Abstract The research aimed to know the conceptions of health, disease, quality of life and other topics in teachers of a public school in Florianópolis, Santa Catarina, Brazil, 2013. A qualitative and descriptive study was carried out with data collected in focus group and semi-structured interviews. The focal group strategy was oriented on the approach of the ‘circle of culture’, in which the participants expressed their concepts on the studied themes and reflected on how to contribute to health promotion strategies in the school context through education on health. The research universe included 16 teachers from state schools; eight teachers confirmed their participation in the focus group and, of these, only six attended the first to the last meeting. At the end, the data revealed that teachers perceive a close relationship between health and quality of life and that a healthy life is possible in the presence of disease. They emphasized the need for greater participation of parents and health professionals in the health education process and also a systematic and continuing preparation on issues involving health in the school context. Conceptions of teachers reaffirm that the social dimension exceeds the biological one and that knowledge and appreciation of these aspects, in teaching practice, can broaden health actions.

Resumen La investigación tuvo por objetivo conocer las concepciones sobre salud, enfermedad, calidad de vida y temas afines de docentes de una escuela pública de Florianópolis, Santa Catarina, Brasil, 2013. Estudio cualitativo, de naturaleza descriptiva, con datos colectados por medio de grupo focal y entrevistas semiestructuradas. La estrategia de grupo focal adoptada fue orientada según el abordaje del ‘círculo de cultura’, en el cual los participantes expresaron sus concepciones sobre los temas estudiados y reflejan sobre como contribuir con estrategias de promoción de la salud en el contexto escolar por medio de educación en salud. El universo de la investigación fue formado por 16 docentes de la red estadual de enseño; ocho docentes confirmaron la participación en el grupo focal y, de esos, apenas seis comparecieron del primero al último encuentro. Al final los datos revelaron que los docentes perciben una estrecha relación entre salud y calidad de vida y que una vida saludable es posible en la presencia de enfermedad. Enfatizaron la necesidad de mayor participación de los padres y profesionales de la salud en el proceso de educación en salud y, también, de un preparo sistemático y permanente sobre las cuestiones que envuelven salud en el contexto escolar. Las concepciones de los docentes reafirman que la dimensión social sobresale a la biológica y que el conocimiento y la valorización de esos aspectos, en la práctica docente, pueden ampliar las acciones en salud.

Sequence analysis of the 5′ third of glycoprotein C gene of South American bovine herpesviruses 1 and 5

Bovine herpesviruses 1 (BoHV-1) and 5 (BoHV-5) share high genetic and antigenic similarities, but exhibit marked differences in tissue tropism and neurovirulence. The amino-terminal region of glycoprotein C (gC), which is markedly different in each of the viruses, is involved in virus binding to cellular receptors and in interactions with the immune system. This study investigated the genetic and antigenic differences of the 5′ region of the gC (5′ gC) gene (amino-terminal) of South American BoHV-1 (n=19) and BoHV-5 (n=25) isolates. Sequence alignments of 374 nucleotides (104 amino acids) revealed mean similarity levels of 97.3 and 94.2% among BoHV-1 gC (gC1), respectively, 96.8 and 95.6% among BoHV-5 gC (gC5), and 62 and 53.3% between gC1 and gC5. Differences included the absence of 40 amino acid residues (27 encompassing predicted linear epitopes) scattered throughout 5′ gC1 compared to 5′ gC5. Virus neutralizing assays testing BoHV-1 and BoHV-5 antisera against each isolate revealed a high degree of cross-neutralization between the viruses, yet some isolates were neutralized at very low titers by heterologous sera, and a few BoHV-5 isolates reacted weakly with either sera. The virus neutralization differences observed within the same viral species, and more pronounced between BoHV-1 and BoHV-5, likely reflect sequence differences in neutralizing epitopes. These results demonstrate that the 5′ gC region is well conserved within each viral species but is divergent between BoHV-1 and BoHV-5, likely contributing to their biological and antigenic differences.

Validación del instrumento: Calidad de vida en el trabajo CVT-GOHISALO en enfermería del primer nivel de atención / Validation tool: quality of life at work in the first level nursing care

El estudio se orientó a validar en el contexto peruano, el instrumento Calidad de Vida en el Trabajo CVT-GOHISALO en enfermeras que laboran en el primer nivel de atención del Ministerio de salud. Estudio transversal descriptivo, se realizó en 81 enfermeros(as), que laboran en el servicio de salud del primer nivel de atención. Los resultados muestran una confiabilidad de alpha de Cronbach de 0.9 para los resultados totales y para cada dimensión, así como una correlación intraclase de 0,9. Los resultados del instrumento CVT, muestran que la calidad de vida del profesional de enfermería en el primer nivel de atención está por debajo de los parámetros de satisfacción (Tmayor o igual a 40), indicando una vulnerabilidad al riesgo de desequilibrio en la calidad de vida en el trabajo. Se sugiere continuar con el proceso de validación en poblaciones similares, así como utilizar la información generada por el presente instrumento a fines de mejorar la calidad de vida del trabajo del profesional de enfermería.

The study was oriented to validate in the Peruvian context, the Quality of Life instrument in the CVT- GOHISALO Work in nurses working in the first level of attention in the Ministry of Health. Descriptive cross-sectional study was performed in 81 nurses (as), who work in the service of primary health care. The results show a Cronbach alpha reliability of 0.9 for the overall results and for each dimension, as well as an intraclass correlation of 0.9. The results of the CVT instrument shows that the quality of life of the nurse in the first level of attention is below of the satisfaction parameters ( T mayor o igual a 40 ), indicating a vulnerability to the risk of imbalance in the quality of working life. It is suggested to continue the validation process in similar populations and use the information generated by this instrument in order to improve the quality of working life of the professional nursing.

O uso da aromaterapia no combate ao estresse / Use of aromatherapy in the fight against stress

O modelo biomédico tradicional, muitas vezes, realiza o atendimento fragmentado, não dá ênfase ao ser humano em sua totalidade. A correria do dia a dia faz com que o homem fique mais vulnerável aos agentes estressores, desestabilizando seu organismo. Por isso, há necessidade do atendimento acolhedor e humanitário por meio do cuidado integral, promovendo o bem-estar e qualidade de vida. As terapias complementares como a aromaterapia vem ganhando grande destaque nas áreas da estética e saúde. Essas terapias, segundo referenciais como os de Helman (2004), conseguem muitas vezes proporcionar para as pessoas que utilizam a sensação de equilíbrio corpóreo e bem-estar entre outros aspectos pessoais / individuais. Vários óleos essenciais são utilizados para o tratamento do estresse e devem ser manipulados por um profissional com conhecimento científico sobre os efeitos que proporciona. O objetivo do presente trabalho, consiste em uma levantamento bibliográfico da utilização dos óleos essenciais no tratamento do estresse, bem como em suas consequências a para a saúde. Conclui-se que a aromaterapia possui um papel significativo nos efeitos do estresse, pois proporciona momentos de satisfação e bem estar ao paciente.

The traditional biomedical model often provides a fragmented care, not emphasizing the human being in its entirety. The everyday rush makes humans become more vulnerable to stressors, destabilizing their body. Thus, there is the need for warm and humanitarian assistance through comprehensive care, promoting well-being and quality of life. Complementary therapies such as aromatherapy have gained great prominence in the s of aesthetics and health. These therapies, according to references such as Helman (2004), can often provide the sensation of balance and well-being, among other personal/individual aspects. Various essential oils are used for treating stress and should be handled by a professional with scientific knowledge on the effects they provide. The aim of this work consists in a literature review on the use of essential oils in the treatment of stress and its consequences in terms of health. It can be concluded that aromatherapy has a significant role in the effects of stress as it provides moments of satisfaction and well-being to the patient.

Inactivated Parapoxvirus ovis induces a transient increase in the expression of proinflammatory, Th1-related, and autoregulatory cytokines in mice

The immunostimulatory properties of inactivated Parapoxvirus ovis (iPPVO) have long been investigated in different animal species and experimental settings. In this study, we investigated the effects of iPPVO on cytokine expression in mice after intraperitoneal inoculation. Spleen and sera collected from iPPVO-treated mice at intervals after inoculation were submitted to cytokine mRNA determination by real-time PCR (qPCR), serum protein concentration by ELISA, and interferon (IFN)-α/β activity by bioassay. The spleen of iPPVO-treated animals showed a significant increase in mRNA expression of all cytokines assayed, with different kinetics and magnitude. Proinflammatory cytokines interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α), and IL-8 mRNA peaked at 24 hours postinoculation (hpi; 5.4-fold increase) and 48 hpi (3- and 10-fold increases), respectively. A 15-fold increase in IFN-γ and 6-fold IL-12 mRNA increase were detected at 48 and 24 hpi, respectively. Increased expression of autoregulatory cytokines (Th2), mainly IL-10 and IL-4, could be detected at later times (72 and 96 hpi) with peaks of 4.7- and 4.9-fold increases, respectively. IFN-I antiviral activity against encephalomyocarditis virus was demonstrated in sera of treated animals between 6 and 12 hpi, with a >90% reduction in the number of plaques. Measurement of serum proteins by ELISA revealed increased levels of IL-1, TNF-α, IL-12, IFN-γ, and IL-10, with kinetics similar to those observed by qPCR, especially for IL-12 and IFN-γ. These data demonstrate that iPPVO induced a transient and complex cytokine response, initially represented by Th1-related cytokines followed by autoregulatory and Th2 cytokines.

Productos de apoyo para paciente con amputación transmetacarpiana / Support products for patient with transmetacarpal amputation

Propósito: Analizar propiedades funcionales y antropométricas de los PA, criterios de selección de diseño, procesos de confección y materiales de fabricación, para analizar las ventajas y/o desventajas que proporcionan y el impacto de esto sobre la CV, ya que los PA disponibles en el mercado no siempre se adaptan a requerimientos del individuo. Se demostrará a través de la presentación de un caso clínico con amputación transmetacarpiana izquierda, de 60 años sufrida el 24/11/2012. Metodología y Materiales: Mediciones antropométricas elementos termoplásticos y de descarte. Resultados: A partir del análisis de propiedades y características de los PA se podría establecer la forma en la cual éstos inciden en la CV de las personas en cuanto a confort, seguridad e independencia funcional, y a partir de ello conocer el grado de satisfacción del usuario respecto a su participación ocupacional en las AVD. Conclusiones: Respecto al desarrollo de PA, se están abriendo nuevas posibilidades para la mejora de la CV de la población en general. Si bien el avance tecnológico está orientado a potenciar la autonomía de los usuarios mediante nuevas y variadas estrategias se ha ido intensificando en campos como la rehabilitación y la antropometría, es necesario en más de una ocasión incorporar acciones que permitan al paciente mejorar su economía, funcionalidad, durabilidad y adecuación estética.

Purpose: Analyze SP functional and anthropometric properties, design selection criteria, preparation processes and manufacturing materials, to analyze the advantages and/or disadvantages that they have and their impact on the LQ, since the SP available in the market do not always adapt to the individual’s requirements. It will be demonstrated through the presentation of a clinical case with left transmetacarpal amputation, 60 years old, suffered on 11/24/2012. Methodology and Materials: anthropometric measures, thermoplastic and disposable items. Results: From the analysis of properties and characteristics of the SP it could be established the way in which they affect people’s LQ in terms of comfort, safety and functional independence, and considering this we can determine the degree of the user’s satisfaction regarding occupational participation in DLA. Conclusions: Regarding the SP development, new possibilities are appearing for the improvement of general population LQ. Even though the technological advance oriented to highlight the user’s autonomy through new and various strategies has been intensifying in some other fields like rehabilitation and anthropometry, it is necessary in more than one occasion to incorporate actions that allow the patient to enhance his functionality with economy criteria, functionality, durability and aesthetics as quality standards in design and construction.

Síndrome de Budd-Chiari: una rara presentación de un cáncer renal / Budd-Chiari syndrome: a rare presentation of renal cancer

El Cáncer Renal se presenta habitualmente como un hallazgo de las imágenes abdominales y cuando se manifiesta clínicamente lo hace a través de los efectos que produce una gran masa abdominal o las metástasis a distancia. En este trabajo se presenta un caso de cáncer renal cuyas manifestaciones clínicas fueron secundarias a la obstrucción de las venas supra hepáticas, es decir un síndrome de Budd-Chiari florido por la presencia de un trombo tumoral en la cava retro hepática. El diagnóstico oportuno y una evaluación adecuada con imágenes permitieron la ejecución de un plan de tratamiento que incluyó un abordaje combinado abdominal y torácico que permitió un tratamiento no solo sintomático sino que potencialmente curativo de un cáncer renal con esta rara presentación.

Renal Cancer usually occurs as a finding of abdominal imaging and when it clinically manifests itself it does so through a large abdominal mass or distant metastases. In this paper we present a case of renal cancer whose clinical manifestations were secondary to obstruction of hepatic veins, a Budd-Chiari syndrome because of the presence of a tumor thrombus in the retro hepatic vena cava. Early diagnosis and appropriate imaging evaluation allowed the implementation of a treatment plan that included a combined abdominal and thoracic approach allowing not only a symptomatic treatment but potentially curative treatment of renal cancer with this rare presentation.

Descripción de la función sexual en mujeres con alteraciones de piso pélvico en un hospital público de Santiago / Sexual function of a group of women with any pelvic floor disorder in a public hospital of Santiago, Chile

Antecedentes: Se estima que entre 25-50 por ciento de las mujeres sufrirá de alguna alteración del piso pélvico durante su vida. La función sexual es un concepto complejo y multidimensional. Se ha planteado que a mayor sintomatología de alteraciones de piso pélvico, las mujeres presentan mayores inconvenientes en su respuesta sexual. Objetivo: Describir la función sexual de un grupo de mujeres que presentan algún tipo de trastorno de piso pélvico. Método: Estudio descriptivo a 195 mujeres con diagnóstico de alteraciones de piso pélvico utilizando un cuestionario que incluía evaluación de aspectos sociodemográficos y de la función sexual con instrumento PISQ-12. Para el análisis se utilizaron medidas de tendencia central y dispersión. Resultados: 73,7 por ciento de las mujeres refieren tener algún grado de insatisfacción con su vida sexual actual afectando principalmente el área del deseo sexual. Dentro de las limitaciones en la relación sexual reportadas se encuentran: orgasmos menos frecuentes (70,5 por ciento), dispareunia (89,5 por ciento), problemas de erección (40 por ciento) y eyaculación precoz (47,4 por ciento) en sus parejas. Conclusión: Las mujeres reportan niveles de insatisfacción con su vida sexual, disminución de su deseo sexual, dolor durante la relación sexual y disminución de la intensidad del orgasmo. Es importante incorporar en la atención de este grupo de mujeres una evaluación sistemática de la función sexual, centrándose no solo en la respuesta sexual femenina, sino que también identificando aquellas limitaciones de la mujer y de la pareja que pueden estar influyendo en su satisfacción sexual.

Background: It is estimated that between 25- 50 percent of women will suffer from a pelvic floor disorder during their lifetime. Sexual function is a complex and multidimensional concept. It has been suggested that to greater symptoms of pelvic floor disorders, women have major problems in sexual response. Objective: To describe the sexual function of a group of women with any pelvic floor disorder in a public hospital of Santiago, Chile. Method: A descriptive study of 195 women diagnosed with pelvic floor disorders using a questionnaire that included assessment of sociodemographic and sexual function instrument PISQ-12. For the analysis used measures of central tendency and dispersion. Results: 73.7 percent of referred women have some degree of dissatisfaction with their current sex life mainly affecting the area of sexual desire. Within the limitations in sexual intercourse reported are: less intense orgasms (70.5 percent), dyspareunia (89.5 percent), erectile dysfunction (40 percent) and premature ejaculation (47.4 percent) in their partners. Conclusion: Women report levels of dissatisfaction with their sex life, decreased sexual desire, pain during intercourse and decreased intensity of orgasm. It is important to incorporate in the care of these women a systematic assessment of sexual function focusing not only on the female sexual response, but also identifying those limitations of women and couples that may be influencing women's sexual satisfaction.

Calidad de vida en mujeres con alteraciones del piso pélvico: revisión de la literatura / Quality of life in women with pelvic floor disorders: literature review

Antecedentes: El riesgo de desarrollar prolapso genital aumenta con la edad, con un efecto negativo en la calidad de vida. Objetivo: Describir el efecto de los trastornos del piso pélvico en la calidad de vida en las distintas dimensiones, sin mediar intervenciones. Método: Se realizó una búsqueda en las bases de datos Pubmed, Cinhal, Proquest y Scielo durante mayo de 2011. Resultados: Los síntomas generan un gran impacto en la calidad de vida afectando la función sexual, actividades cotidianas y generando efectos negativos en aspectos psicosociales, como la imagen corporal y el desempeño de las mujeres. Conclusión: Es necesario generar una atención integral centrada en síntomas, función sexual, educación y apoyo emocional.

Background: The risk of develop genital prolapse increases with age, with a negative effect in quality of life. Objective: The aim of this review is to describe the effect of pelvic floor disorders on quality of life in the different dimensions in women, without any interventions. Method: It developed a review in Pubmed, Cinhal, Proquest and Scielo database during may of 2011. Results: The symptoms produce a great impact on quality of life affecting sexual function, daily activities and it produce negative psychosocial effects like body image and women's performance. Conclusion: Must be necessary generate a integral attention to women, focused on symptoms, sexual function, education and emotional support.

Experimental infection of calves with recombinants of bovine herpesvirus 5 defective in glycoprotein E (gE), thymidine kinase (TK) and both, gE/TK / Infecção experimental de bezerros com recombinantes do herpesvírus bovino tipo 5 defectivos na glicoproteína E (gE), timidina quinase (TK) e ambos, gE/TK

This article describes an investigation on the virulence/attenuation of bovine herpesvirus type 5 (BoHV-5) recombinants deleted in the genes encoding glycoprotein E (BoHV-5gEΔ), thymidine kinase (BoHV-5TKΔ), and both gE and TK (BoHV-5gEΔTKΔ). Seronegative calves (80 to 90 days-old) inoculated with the parental strain (SV-507/99, n=5) shed virus in nasal secretions for up to 15 days (average 10.8 days). Duration of virus shedding was 11 days for BoHV-5gΔ, 9.6 days for BoHV-5TKΔ and 6.2 days for BoHV-5gEΔTKΔ groups. The highest titers were observed between days 1 and 6 post-infection (pi) for SV-507/99 (10(6.8)TCID50/mL), 10(5.1)TCID50/mL (BoHV-5gEΔ), 10(5.9)TCID50/mL (BoHV-5TKΔ) and 10(4.7)TCID50/mL (BoHV-5gEΔTKΔ). Calves inoculated with the parental virus presented anorexia, profound apathy and loss of body condition. Two calves were euthanized in extremis on days 10 and 11 pi; infectious virus was recovered from several areas of the brain. In contrast, calves inoculated with the recombinants remained healthy and a few presented a mild and transient nasal secretion. Dexamethasone (Dx) administration at day 42 pi resulted in virus shedding by all controls calves (mean duration 3.7 days), by 2/5 of BoHV-5TKΔ calves (two days) and 2/5 of BoHV-5gEΔ (one day). No virus shedding was detected in BoHV-5gEΔTKΔ calves upon Dx treatment. PCR examination of brain sections of calves euthanized at day 30 post Dx treatment revealed the presence of latent viral DNA widely distributed in the brain of SV-507/99 calves. Latent viral DNA was detected in a few sections (3/30) of the brains of BoHV-5gEΔ calves and was not detected in the brains of calves inoculated with BoHV-5TKΔ and BoHV-5gEΔTKΔ. These results show that the single BoHV-5 mutants (gE and tk-deleted) are attenuated for calves and establish and/or reactivate latent infection inefficiently. The double mutant BoHV-5gEΔTKΔ is fully attenuated and appears not to establish or not reactivate efficiently from latent infection. Thus, these recombinants, especially the double mutant BoHV-5gEΔTKΔ, display an adequate phenotype for use in modified-live vaccine formulations.

Este artigo descreve uma investigação da virulência/atenuação de recombinantes do herpesvírus bovino tipo 5 (BoHV-5) com deleções nos genes da glicoproteína E (BoHV-5gEΔ), timidina quinase (BoHV-5TKΔ), e ambos gE e TK (BoHV-5gEΔTKΔ). Bezerros soronegativos (80-90 dias de idade) inoculados com o vírus parental SV-507/99 (n=5) excretaram o vírus em secreções nasais por até 15 dias (média de 10,8 dias). Nos animais inoculados com os recombinantes, a duração da excreção viral foi de 11 dias (BoHV-5gEΔ), 9,6 dias (BoHV-5TKΔ) e 6,2 dias (BoHV-5gEΔTKΔ). Os maiores títulos foram observados entre os dias 1 e 6 pós-inoculação (pi), sendo de 10(6,8)TCID50/mL para o SV-507/99, 10(5,1)TCID50/mL (BoHV-5gEΔ), 10(5,9)TCID50/mL (BoHV-5TKΔ) e 10(4,7)TCIΔ50/mL (BoHV-5gEΔTKΔ). Os bezerros inoculados com o vírus parental apresentaram anorexia e apatia; três deles mostraram apatia profunda e perda da condição corporal. Dois bezerros foram eutanasiados in extremis nos dias 10 e 11 pi, respectivamente e o vírus foi isolado de várias regiões do encéfalo. Já os bezerros inoculados com os recombinantes permaneceram saudáveis; alguns apresentaram uma secreção nasal serosa transitória. Administração de dexametasona (Dx) no dia 42 pi resultou em excreção viral por todos os bezerros inoculados com o vírus parental (duração média de 3,7 dias), por 2 de 5 bezerros dos grupos BoHV-5TKΔ (dois dias) e BoHV-5gEΔ (um dia). Os bezerros inoculados com o duplo mutante BoHV-5gEΔTKΔ não excretaram o vírus após o tratamento com Dx. Pesquisa de DNA viral por PCR no dia 30 pós-Dx revelou uma ampla distribuição do DNA do vírus parental no encéfalo; poucas seções (3/30) foram positivas no encéfalo dos animais do grupo BoHV-5gEΔ, e não detectou-se DNA latente no encéfalo dos animais dos grupos BoHV-5TKΔ e BoHV-5gEΔTKΔ. Esses resultados demonstram que os mutantes simples (gE and tk-deletados) são atenuados para bezerros e estabelecem e/ou reativam infecção latente ineficientemente. Já o duplo mutante BoHV-5gEΔTKΔ é atenuado e parece não estabelecer e/ou não reativar eficientemente a infecção latente. Portanto, os vírus recombinantes, e em especial o duplo mutante BoHV-5gEΔTKΔ apresentam um fenótipo compatível com a sua inclusão em vacinas vivas modificadas.

Construction and growth properties of bovine herpesvirus type 5 recombinants defective in the glycoprotein E or thymidine kinase gene or both

Bovine herpesvirus type 5 (BoHV-5) is an important pathogen of cattle in South America. We describe here the construction and characterization of deletion mutants defective in the glycoprotein E (gE) or thymidine kinase (TK) gene or both (gE/TK) from a highly neurovirulent and well-characterized Brazilian BoHV-5 strain (SV507/99). A gE-deleted recombinant virus (BoHV-5 gE∆) was first generated in which the entire gE open reading frame was replaced with a chimeric green fluorescent protein gene. A TK-deleted recombinant virus (BoHV-5 TK∆) was then generated in which most of the TK open reading frame sequences were deleted and replaced with a chimeric â-galactosidase gene. Subsequently, using the BoHV-5 gE∆ virus as backbone, a double gene-deleted (TK plus gE) BoHV-5 recombinant (BoHV-5 gE/TK∆) was generated. The deletion of the gE and TK genes was confirmed by immunoblotting and PCR, respectively. In Madin Darby bovine kidney (MDBK) cells, the mutants lacking gE (BoHV-5 gE∆) and TK + gE (BoHV-5 gE/TK∆) produced small plaques while the TK-deleted BoHV-5 produced wild-type-sized plaques. The growth kinetics and virus yields in MDBK cells for all three recombinants (BoHV-5 gE∆, BoHV-5 TK∆ and BoHV-5 gE/TK∆) were similar to those of the parental virus. It is our belief that the dual gene-deleted recombinant (BoHV-5 gE/TK∆) produced on the background of a highly neurovirulent Brazilian BoHV-5 strain may have potential application in a vaccine against BoHV-5.

A bovine herpesvirus 5 recombinant defective in the thymidine kinase (TK) gene and a double mutant lacking TK and the glycoprotein E gene are fully attenuated for rabbits

Bovine herpesvirus 5 (BoHV-5), the agent of herpetic meningoencephalitis in cattle, is an important pathogen of cattle in South America and several efforts have been made to produce safer and more effective vaccines. In the present study, we investigated in rabbits the virulence of three recombinant viruses constructed from a neurovirulent Brazilian BoHV-5 strain (SV507/99). The recombinants are defective in glycoprotein E (BoHV-5gEÄ), thymidine kinase (BoHV-5TKÄ) and both proteins (BoHV-5gEÄTKÄ). Rabbits inoculated with the parental virus (N = 8) developed neurological disease and died or were euthanized in extremis between days 7 and 13 post-infection (pi). Infectivity was detected in several areas of their brains. Three of 8 rabbits inoculated with the recombinant BoHV-5gEÄ developed neurological signs between days 10 and 15 pi and were also euthanized. A more restricted virus distribution was detected in the brain of these animals. Rabbits inoculated with the recombinants BoHV-5TKÄ (N = 8) or BoHV-5gEÄTKÄ (N = 8) remained healthy throughout the experiment in spite of variable levels of virus replication in the nose. Dexamethasone (Dx) administration to rabbits inoculated with the three recombinants at day 42 pi did not result in viral reactivation, as demonstrated by absence of virus shedding and/or increase in virus neutralizing titers. Nevertheless, viral DNA was detected in the trigeminal ganglia or olfactory bulbs of all animals at day 28 post-Dx, demonstrating they were latently infected. These results show that recombinants BoHV-5TKÄ and BoHV-5gEÄTKÄ are attenuated for rabbits and constitute potential vaccine candidates upon the confirmation of this phenotype in cattle.

Trabalho em saúde e a implantação do acolhimento na atenção primária à saúde: afeto, empatia ou alteridade? / Trabajo en salud y la implantación de la acogida en la atención primaria a la salud: ¿afecto, empatía o alteridad? / Health work and the implementation of user embracement in primary healthcare: affection, empathy or alterity?

Desenvolvemos uma reflexão teórica sobre o trabalho na Atenção Primária à Saúde (APS) na diretriz do acolhimento, buscando possibilidades de superar a alienação em seu processo produtivo, a partir de relatos de experiência da implantação do acolhimento em serviços de APS. Identificamos as seguintes perspectivas teóricas nas relações interpessoais nos serviços, com indicadores de avanços na humanização do trabalho em saúde e de uma aproximação com a subjetividade: afeto, empatia e alteridade. Ainda que todas sejam adequadas e mesmo complementares entre si, fazemos nossa opção pela alteridade como perspectiva teórica capaz de instrumentalizar o trabalhador da saúde para desenvolver o acolhimento, sem deixar de garantir sua própria humanização. Esta abre possibilidades de enfrentamento das situações do cotidiano dos serviços de saúde, oferecendo aos profissionais condições de construírem seu trabalho sem limitá-lo à perspectiva biomédica e preservando sua própria saúde.

We conducted a theoretical reflection on the work of primary healthcare professionals in the scope of user embracement, searching for possibilities to overcome alienation in their production process, based on experience reports regarding user embracement implementation in primary healthcare services. We identified the following theoretical perspectives which we consider useful in order to enhance humanization in the work in the health area and also to foster subjectivity in interpersonal relationships: affection, empathy and alterity. Although they are closely related to each other, we believe alterity is the theoretical perspective that is able to give the health worker conditions to develop user embracement while ensuring his/her own humanization. Alterity opens possibilities to cope with everyday situations in the healthcare services, providing health professionals with the conditions to work without restricting themselves to a biomedical point of view and, at the same time, preserving their own health.

Desarrollamos una reflexión teórica sabre el trabajo en la Atención Primaria a la Salud (APS) en la directriz de la acogida, buscando posibilidades de superar la alienación en su proceso productivo a partir de relatos de experiencia de la implantación de la acogida en servicios de APS. Identificamos las siguientes perspectivas teóricas en las relaciones interpersonales en los servicios, con indicadores de avances en la humanización del trabajo en salud y de una aproximación con la subjetividad: afecto, empatía y alteridad. Aunque todas sean adecuadas y basta complementarias entre sí, hacemos nuestra opción par la alteridad como perspectiva teórica capaz de instrumentalizar al trabajador de la salud para desarrollar la acogida sin dejar de garantizar su propia humanización. De este modo se abren posibilidades de afrontar las situaciones cotidianas de los servicios de salud, ofreciendo a los profesionales condiciones de construir su trabajo sin limitarlo a la perspectiva biomédica y de preservar su propia salud.

Avaliação funcional e histológica da tireoide de ovinos suplementados com fluoreto de sódio por um período de 150 dias / Functional and histological evaluations of thyroid of sheep submitted to sodium fluoride administration

Avaliou-se o efeito da administração de fluoreto de sódio sobre a tireoide de 12 ovinos, distribuídos em dois grupos: o grupo controle (n=6) recebeu somente sal iodado (5g de NaCl/animal + 0,2ppm I/kg MS) e o grupo tratado (n=6), sal iodado (5g de NaCl/animal + 0,2ppm I/kg MS) adicionado de fluoreto de sódio (4,7mg F/kg de peso corporal), durante 150 dias. Amostras de sangue foram coletadas para análise sérica de I e F, triiodotironina (T3) e tetraiodotironina (T4) nos dias zero, 60, 90 e 150 de tratamento. Também se coletou urina, correspondente às 24 horas, para análise da excreção urinária de I e F. Após a eutanásia dos animais, a tireoide foi removida para posterior exame. Quanto ao I urinário, não foi observada diferença estatística entre os grupos controle e tratado e dentro de cada grupo, entre os tempos. As concentrações de T3 e T4 não diferiram entre os grupos e dentro de cada grupo nos diferentes tempos. Quanto à avaliação histopatológica da tireoide, não foram observadas alterações na integridade estrutural. Conclui-se que a administração crônica de fluoreto de sódio não interfere na função e na integridade histológica da glândula tireoide de ovinos com dieta não restritiva de iodo.

The effect of sodium fluoride administration on thyroid function and morphology in sheep was evaluated using 12 lambs. Animals were allotted in two groups: control that received 5g NaCl + 0.2ppm I/kg DM and treated which received the same treatment plus sodium fluoride (4.7mg F/kg BW), daily, for 150 days. Blood samples were collected for determination of F, I, T3, and T4. Urine production was collected for measurement of F and I. After euthanasia at 150 days of treatment, thyroid glands were removed for analysis. No differences were found between or within groups for urinary I. Also, no differences were found for T3 and T4 on serum I between groups or among time points. No histological alterations were found in the thyroids. In conclusion, chronic sodium fluoride treatment did not affect thyroid function and morphology in lambs.