Percepção e satisfação corporal de estudantes universitários vegetarianos / Perception and body satisfaction of vegetarian students / Percepción y satisfacción corporal de los estudiantes vegetarianos

INTRODUÇÃO: A percepção e satisfação corporal têm sido amplamente estudadas em diversos públicos, principalmente em estudantes universitários; porém, existem poucas investigações com vegetarianos, sendo assim, torna-se necessário avaliar se o padrão alimentar vegetariano está relacionado com os fenômenos inerentes à imagem corporal. OBJETIVO: Avaliar a percepção e a satisfação corporal entre estudantes universitários vegetarianos. MÉTODO: Trata-se de um estudo transversal com 123 participantes, no qual foram aplicados o Questionário de Imagem Corporal - BSQ (Body Shape Questionnaire) e a Escala de Silhuetas de Stunkard. RESULTADOS: Os dados mostraram que 86,2% dos participantes eram eutróficos (IMC=22,4±3,3), sendo o score obtido no BSQ foi de 84,6 pontos (±36,0) correspondente à leve insatisfação com a imagem corporal. Cerca de 82,1% dos estudantes se mostravam insatisfeitos com a silhueta, dentre estes, 61,4% desejavam diminuí-la. CONCLUSÃO: O padrão alimentar (ovolactovegetariano, lactovegetariano, vegetariano estrito e vegano) não se relacionou com a insatisfação corporal, mas sim o desejo de ter silhuetas magras que são valorizadas pelo padrão de beleza vigente.

INTRODUCTION: For Body perception and satisfaction have been widely studied among different publics, especially among college students; however, there are few investigations with vegetarians. Therefore, it is necessary to evaluate whether the vegetarian eating pattern is related to the phenomena inherent to body image. OBJECTIVE: To evaluate body perception and body satisfaction among vegetarian college students. METHOD: This is a cross-sectional study with 123 participants, in which the Body Image Questionnaire (BSQ) and the Stunkard Silhouette Scale were applied. RESULTS: The data showed that 86.2% of the participants were eutrophic (BMI=22.4±3.3), and the score obtained in the BSQ was 84.6 points (±36.0) corresponding to a mild dissatisfaction with body image. About 82.1% of the students were dissatisfied with their silhouette, and 61.4% of them wanted to reduce it. CONCLUSION: Dietary patterns (ovolactovegetarian, lactovegetarian, strict vegetarian, and vegan) were not related to body dissatisfaction, but rather the desire to have thin silhouettes that are valued by the prevailing beauty standard.

INTRODUCCIÓN: La percepción y satisfacción corporal han sido ampliamente estudiadas entre diferentes públicos, especialmente entre estudiantes universitarios; sin embargo, existen pocos estudios sobre vegetarianos, por lo que es necesario evaluar si el patrón alimentario vegetariano está relacionado con los fenómenos inherentes a la imagen corporal. OBJETIVO: Evaluar la percepción corporal y la satisfacción corporal entre estudiantes universitarios vegetarianos. MÉTODO: Se trata de un estudio transversal con 123 participantes, en el que se aplicaron el Cuestionario de Imagen Corporal - BSQ (Body Shape Questionnaire) y la Escala de Siluetas de Stunkard. RESULTADOS: Los datos mostraron que el 86,2% de los participantes eran eutróficos (IMC=22,4±3,3), y la puntuación obtenida en el BSQ fue de 84,6 puntos (±36,0) correspondiente a una insatisfacción leve con la imagen corporal. Alrededor del 82,1% de los estudiantes estaban insatisfechos con su silueta, entre ellos, el 61,4% deseaba reducirla. CONCLUSIÓN: El patrón alimentario (ovolactovegetariano, lactovegetariano, vegetariano estricto y vegano) no estaba relacionado con la insatisfacción corporal, sino con el deseo de tener siluetas delgadas que son valoradas por el estándar de belleza vigente.

Comparative analysis of SARS-CoV-2 variants Alpha (B.1.1.7), Gamma (P.1), Zeta (P.2) and Delta (B.1.617.2) in Vero-E6 cells: ultrastructural characterization of cytopathology and replication kinetics

Abstract This study compares the effects of virus-cell interactions among SARS-CoV-2 variants of concern (VOCs) isolated in Brazil in 2021, hypothesizing a correlation between cellular alterations and mortality and between viral load and transmissibility. For this purpose, reference isolates of Alpha, Gamma, Zeta, and Delta variants were inoculated into monolayers of Vero-E6 cells. Viral RNA was quantified in cell supernatants by RT‒PCR, and infected cells were analyzed by Transmission Electron Microscopy (TEM) for qualitative and quantitative evaluation of cellular changes 24, 48, and 72 hours postinfection (hpi). Ultrastructural analyses showed that all variants of SARS-CoV-2 altered the structure and function of mitochondria, nucleus, and rough endoplasmic reticulum of cells. Monolayers infected with the Delta variant showed the highest number of modified cells and the greatest statistically significant differences compared to those of other variants. Viral particles were observed in the cytosol and the cell membrane in 100 % of the cells at 48 hpi. Alpha showed the highest mean particle diameter (79 nm), and Gamma and Delta were the smallest (75 nm). Alpha and Gamma had the highest particle frequency per field at 48 hpi, while the same was observed for Zeta and Delta at 72 hpi and 24 hpi, respectively. The cycle threshold of viral RNA varied among the target protein, VOC, and time of infection. The findings presented here demonstrate that all four VOCs evaluated caused ultrastructural changes in Vero-E6 cells, which were more prominent when infection occured with the Delta variant.

Primary infection of BALB/c mice with a dengue virus type 4 strain leads to kidney injury

BACKGROUND Dengue is a disease caused by dengue virus (DENV-1 through -4). Among the four serotypes, DENV-4 remains the least studied. Acute kidney injury is a potential complication of dengue generally associated with severe dengue infection. OBJECTIVES The goal of this study was to investigate the alterations caused by experimental dengue infection in the kidney of adult BALB/c mice. METHODS In this study, BALB/c mice were infected through the intravenous route with a DENV-4 strain, isolated from a human patient. The kidneys of the mice were procured and subject to histopathological and ultrastructural analysis. FINDINGS The presence of the viral antigen was confirmed through immunohistochemistry. Analysis of tissue sections revealed the presence of inflammatory cell infiltrate throughout the parenchyma. Glomerular enlargement was a common find. Necrosis of tubular cells and haemorrhage were also observed. Analysis of the kidney on a transmission electron microscope allowed a closer look into the necrotic tubular cells, which presented nuclei with condensed chromatin, and loss of cytoplasm. MAIN CONCLUSIONS Even though the kidney is probably not a primary target of dengue infection in mice, the inoculation of the virus in the blood appears to damage the renal tissue through local inflammation.

Monkeypox (Mpox) virus isolation and ultrastructural characterisation from a Brazilian human sample case

BACKGROUND According to the last 2023 Monkeypox (Mpox) Outbreak Global Map from the Centres for Disease Control and Prevention (CDC), more than 100 countries with no Mpox infection report cases. Brazil stands out in this group and is the second country with the highest number of cases in the last outbreak. OBJECTIVE To contribute to knowledge of the virus infection effects in a cellular model, which is important for diagnosis infections not yet included in a provider´s differential diagnosis and for developing viral inhibition strategies. METHODS We describe a virus isolation protocol for a human clinical sample from a patient from Brazil, the viral growth in a cell model through plaque forming units (PFU) assay, reverse transcriptase polymerase chain reaction (RT-PCR) and transmission electron microscopy (TEM). FINDINGS We follow the viral isolation in Vero cell culture from a Mpox positive clinically diagnosed sample and show the infection effects on cellular structures using a TEM. MAIN CONCLUSIONS Understanding the impact of viral growth on cellular structures and its replication kinetics may offer better strategies for the development of new drugs with antiviral properties.

Vitamin A deficiency and association between serum retinol and IGF-1 concentrations in Brazilian children with Down syndrome

Abstract Objective: To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. Methods: Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirão Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 μmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. Results: VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). Conclusion: a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.

Adverse events in critically ill patients: a cross-sectional study / Eventos adversos en pacientes de cuidado intensivo: estudio transversal / Eventos adversos em pacientes de terapia intensiva: estudo transversal

Abstract Objective: To identify the prevalence of adverse events and the critically ill patient's need for care in an intensive care unit. Method: This is a cross-sectional study, carried out from January to March 2020. The adverse events investigated were pressure injury, accidental orotracheal extubation, fall, loss of central venous access, and healthcare-associated infection. The number of hours required for patient care was measured by the Nursing Activities Score. The categorical independent variables were described by absolute and relative frequencies, and the continuous ones, by central tendency. The magnitude measure was the odds ratio and a confidence interval of 95% was considered. Results: of the 88 patients evaluated, 52.3% had adverse events, which were associated with a greater need for care, severity, and longer hospital stay. The mean Nursing Activities Score was 51.01% (12 h 24 min), with a deficit of 20% to 30% of nursing staff in the unit being identified. Conclusion: The prevalence of adverse events in the unit is high and the shortage of nursing staff in the unit revealed the need for adequate staffing to reduce the damage caused by the care provided to critically ill patients.

RESUMEN Objetivo: identificar la prevalencia de eventos adversos y la necesidad de cuidado del paciente crítico en una unidad de cuidado intensivo (UCI). Método: estudio transversal, realizado entre enero y marzo de 2020. Los eventos adversos investigados fueron: lesión por presión, extubación oro traqueal accidental, caída, pérdida de acceso venoso central e infección relacionada a la asistencia a la salud. El número de horas necesarias para el cuidado del paciente se midió por la Nursing Activities Score. Las variables independientes categóricas fueron descriptas por frecuencia absoluta y relativa, y las continuas, por tendencia central. La medida de magnitud fue la razón de oportunidad (odds ratio) y se consideró un intervalo de confianza del 95%. Resultados: de los 88 pacientes evaluados, un 52,3% presentaron eventos adversos, los cuales fueron asociados a necesidad de cuidados más intensa, gravedad y tiempo de ingreso más extenso. El Nursing Activities Score medio fue un 51,01% (12 h 24 min), siendo identificado un déficit entre 20% y 30% de personal de enfermería en la unidad. Conclusión: la prevalencia de los eventos adversos en la unidad es alta y el déficit de personal de enfermería en la unidad reveló la necesidad de dimensionamiento adecuado de personal para reducir los daños causados por los cuidados prestados a los pacientes críticos.

RESUMO Objetivo: identificar a prevalência de eventos adversos e a necessidade de cuidado do paciente crítico em uma unidade de terapia intensiva. Método: estudo transversal, realizado de janeiro a março de 2020. Os eventos adversos investigados foram: lesão por pressão, extubação orotraqueal acidental, queda, perda de acesso venoso central e infecção relacionada à assistência à saúde. O número de horas necessárias para o cuidado do paciente foi mensurado pela Nursing Activities Score. As variáveis independentes categóricas foram descritas por frequências absoluta e relativa, e as contínuas, por tendência central. A medida de magnitude foi a razão de chance e considerou-se intervalo de confiança de 95%. Resultados: dos 88 pacientes avaliados, 52,3% apresentaram eventos adversos, os quais foram associados à maior necessidade de cuidados, gravidade e ao maior tempo de internação. O Nursing Activities Score médio foi 51,01% (12 h 24 min), sendo identificado um déficit de 20% a 30% de pessoal de enfermagem na unidade. Conclusão: a prevalência dos eventos adversos na unidade é alta e o déficit de pessoal de enfermagem na unidade revelou a necessidade de dimensionamento adequado de pessoal para reduzir os danos ocasionados pelos cuidados prestados aos pacientes críticos.

Morphology and morphogenesis of SARS-CoV-2 in Vero-E6 cells

BACKGROUND The coronaviruses (CoVs) called the attention of the world for causing outbreaks of severe acute respiratory syndrome (SARS-CoV), in Asia in 2002-03, and respiratory disease in the Middle East (MERS-CoV), in 2012. In December 2019, yet again a new coronavirus (SARS-CoV-2) first identified in Wuhan, China, was associated with a severe respiratory infection, known today as COVID-19. This new virus quickly spread throughout China and 30 additional countries. As result, the World Health Organization (WHO) elevated the status of the COVID-19 outbreak from emergency of international concern to pandemic on March 11, 2020. The impact of COVID-19 on public health and economy fueled a worldwide race to approve therapeutic and prophylactic agents, but so far, there are no specific antiviral drugs or vaccines available. In current scenario, the development of in vitro systems for viral mass production and for testing antiviral and vaccine candidates proves to be an urgent matter. OBJECTIVE The objective of this paper is study the biology of SARS-CoV-2 in Vero-E6 cells at the ultrastructural level. METHODS In this study, we documented, by transmission electron microscopy and real-time reverse transcription polymerase chain reaction (RT-PCR), the infection of Vero-E6 cells with SARS-CoV-2 samples isolated from Brazilian patients. FINDINGS The infected cells presented cytopathic effects and SARS-CoV-2 particles were observed attached to the cell surface and inside cytoplasmic vesicles. The entry of the virus into cells occurred through the endocytic pathway or by fusion of the viral envelope with the cell membrane. Assembled nucleocapsids were verified inside rough endoplasmic reticulum cisterns (RER). Viral maturation seemed to occur by budding of viral particles from the RER into smooth membrane vesicles. MAIN CONCLUSIONS Therefore, the susceptibility of Vero-E6 cells to SARS-CoV-2 infection and the viral pathway inside the cells were demonstrated by ultrastructural analysis.

Dengue, Yellow Fever, Zika and Chikungunya epidemic arboviruses in Brazil: ultrastructural aspects

BACKGROUND The impact of arbovirus cocirculation in Brazil is unknown. Dengue virus (DENV) reinfection may result in more intense viraemia or immunopathology, leading to more severe disease. The Zika virus (ZIKV) epidemic in the Americas provided pathogenicity evidence that had not been previously observed in flavivirus infections. In contrast to other flaviviruses, electron microscopy studies have shown that ZIKV may replicate in viroplasm-like structures. Flaviviruses produce an ensemble of structurally different virions, collectively contributing to tissue tropism and virus dissemination. OBJECTIVES AND METHODS In this work, the Aedes albopictus mosquito cell lineage (C6/36 cells) and kidney epithelial cells from African green monkeys (Vero cells) were infected with samples of the main circulating arboviruses in Brazil [DENV-1, DENV-2, DENV-3, DENV-4, ZIKV, Yellow Fever virus (YFV) and Chikungunya virus (CHIKV)], and ultrastructural studies by transmission electron microscopy were performed. FINDINGS We observed that ZIKV, the DENV serotypes, YFV and CHIKV particles are spherical. ZIKV, DENV-1, -2, -3 and -4 presented diameters of 40-50 nm, and CHIKV presented approximate diameters of 50-60 nm. Viroplasm-like structures was observed in ZIKV replication cycle. MAIN CONCLUSIONS The morphogenesis of these arboviruses is similar to what has been presented in previous studies. However, we understand that further studies are needed to investigate the relationship between viroplasm-like structures and ZIKV replication dynamics.

Nursing Activities Score: qual periodicidade ideal para avaliação da carga de trabalho? / Nursing Activities Score: ¿cuál es la periodicidad ideal para analizar la carga de trabajo? / Nursing Activities Score: what is the ideal periodicity for assessing workload?

Resumo Objetivo: Comparar a carga de trabalho obtida a partir do Nursing Activities Score (NAS) pontuado três vezes ao dia, no final de cada turno de trabalho, e pontuado uma vez ao dia considerando as 24 horas. Métodos: Estudo longitudinal prospectivo, realizado com adultos internados em um Centro de Terapia Intensiva de um hospital público de alta complexidade do sul do Brasil. A coleta de dados foi realizada através do sistema Epimed Monitor®. No primeiro período do estudo (Período 1) a pontuação média do NAS foi obtida a partir de três avaliações diárias e no segundo período (Período 2) o NAS foi pontuado uma vez ao dia. A comparação das variáveis foi verificada por meio dos testes t-Studente Mann Whitney U. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da instituição de origem. Resultados: Durante o estudo foram realizadas 1738 avaliações de NAS em 338 pacientes. A média de pontuação do NAS foi de 74±20,9% para o total de pacientes. Não houve diferença entre a média do Período 1 (74,1±20,8%) e a média do Período 2 (73,9±21%) (p= 0,806). O Período 2 teve mais avaliações na categoria de NAS <50% e menos avaliações na categoria de NAS 50,1-100% em relação ao Período 1 (p<0,001 e p= 0,029, respectivamente). Conclusão: A pontuação média do NAS é semelhante quando comparada a aferição realizada três vezes ao dia com a realizada uma vez ao dia considerando as 24 horas anteriores para avaliação de carga de trabalho de enfermagem.

Resumen Objetivo: Comparar la carga de trabajo obtenida a partir del Nursing Activities Score (NAS) con valoración tres veces por día, al final de cada turno de trabajo, y con valoración una vez por día considerando las 24 horas. Métodos: Estudio longitudinal prospectivo, realizado con adultos internados en un Centro de Terapia Intensiva de un hospital público de alta complejidad en el sur de Brasil. La recolección de datos fue realizada a través del sistema Epimed Monitor®. En el primer período del estudio (Período 1), la valoración promedio del NAS fue obtenida a partir de tres evaluaciones diarias y en el segundo período (Período 2), el NAS fue valorado una vez por día. La comparación de las variables fue verificada a través de las pruebas t-Student y Mann Whitney U. El estudio fue aprobado por el Comité de Ética de Investigación de la institución de origen. Resultados: Durante el estudio se realizaron 1738 evaluaciones de NAS en 338 pacientes. El promedio de valoración del NAS fue 74±20,9% para el total de pacientes. No hubo diferencia entre el promedio del Período 1 (74,1±20,8%) y el promedio del Período 2 (73,9±21%) (p= 0,806). El Período 2 tuvo más evaluaciones en la categoría de NAS <50% y menos en la categoría de NAS 50,1-100% con relación al Período 1 (p<0,001 y p= 0,029, respectivamente). Conclusión: La valoración promedio del NAS es semejante cuando se compara la evaluación realizada tres veces por día con la realizada una vez al día considerando las 24 horas anteriores para analizar la carga de trabajo de enfermería.

Abstract Objective: To compare the workload obtained from the Nursing Activities Score (NAS), rated three times a day, at the end of each work shift, and scored once per day for a 24-hour period. Methods: A prospective longitudinal study with adults hospitalized at an intensive care center, from a highly complex public hospital in southern Brazil. The data collection was conducted using the Epimed Monitor®. In the first period of the study (Period 1), the mean NAS score was obtained using three daily evaluations, and in the second period (Period 2) the NAS was scored once per day. The comparison of the variables was verified using the Mann Whitney and student t-test. The study was approved by the Research Ethics Committee of the institution. Results: During the study, 1738 NAS evaluations were performed on 338 patients. The mean NAS score was 74±20.9% for the total number of patients. There was no difference between the mean of Period 1 (74.1±20.8%) and the mean of Period 2 (73.9 ± 21%) (p=0.806). Period 2 had more evaluations in the NAS category ≤50% and fewer evaluations in the NAS category 50.1-100%, as compared to Period 1 (p<0.001 and p=0.029, respectively). Conclusion: The mean NAS score was similar when comparing assessments conducted three-times-per-day with the one performed once a day, assessing the nursing workload based on the previous 24 hours.

Motivos da internação por ordem judicial na terapia intensiva: perspectiva do enfermeiro / Reasons for hospitalization by judicial order in intensive therapy: nurse perspective

Objetivo: analisar os motivos da internação por ordem judicial na UTI, na perspectiva dos enfermeiros intensivistas. Metodologia: pesquisa qualitativa, exploratória e analítica cujos participantes foram 108 enfermeiros intensivistas, atuantes em UTI nas regiões sudeste e sul do Brasil e que afirmaram já ter vivenciado situações de internação por ordem judicial. Os dados foram coletados por um questionário, no período entre abril de 2015 à agosto de 2016 e analisados de acordo com a Análise de Conteúdo. Resultados: foram analisadas as categorias aumento pela demanda pelo serviço de UTI e falta de estrutura institucional e na região da residência do paciente. Conclusões: a internação por ordem judicial, em muitos casos, é o único meio do paciente ter seus direitos garantidos.

Objective: to analyze the reasons for hospitalization by judicial order in the ICU, from the perspective of intensive care nurses. Methodology: qualitative, exploratory and analytical research whose participants were 108 intensive nurses, working in ICUs in the southeastern and southern regions of Brazil and who have already experienced situations of hospitalization by judicial order. The data were collected by a questionnaire, in the period between April 2015 to August 2016 and analyzed according to the Content Analysis. Results: the categories were analyzed by the increase in demand for the ICU service and lack of institutional structure and in the region of the patient’s residence. Conclusions: hospitalization by court order, in many cases, is the only way for patients to have their rights guaranteed.

Objetivo: analizar los motivos de la internación por orden judicial en la UTI, en la perspectiva de los enfermeros intensivos. Metodología: investigación cualitativa, exploratoria y analítica cuyos participantes fueron 108 enfermeros intensivistas, actuantes en UTI en las regiones sudeste y sur de Brasil y que afirmaron haber vivido situaciones de internación por orden judicial. Los datos fueron recolectados por un cuestionario, en el período entre abril de 2015 a agosto de 2016 y analizados de acuerdo con el Análisis de Contenido. Resultados: se analizaron las categorías aumento por la demanda por el servicio de UTI y falta de estructura institucional y en la región de la residencia del paciente. Conclusiones: la internación por orden judicial, en muchos casos, es el único medio del paciente tener sus derechos garantizados.

First detection of dengue virus in the saliva of immunocompetent murine model

The lack of an experimental animal model for the study of dengue pathogenesis is a limiting factor for the development of vaccines and drugs. In previous studies, our group demonstrated the susceptibility of BALB/c mice to infection by dengue virus (DENV) 1 and 2, and the virus was successfully isolated in several organs. In this study, BALB/c mice were experimentally infected intravenously with DENV-4, and samples of their saliva were collected. Viral RNA extracted from the saliva samples was subjected to qRT-PCR, with a detection limit of 0.002 PFU/mL. The presence of DENV-4 viral RNA was detected in the saliva of two mice, presenting viral titers of 109 RNA/mL. The detection of DENV RNA via saliva sampling is not a common practice in dengue diagnosis, due to the lower detection rates in human patients. However, the results observed in this study seem to indicate that, as in humans, detection rates of DENV RNA in mouse saliva are also low, correlating the infection in both cases. This study reports the first DENV detection in the saliva of BALB/c immunocompetent mice experimentally infected with non-neuroadapted DENV-4.

Risk factors for fall occurrence in hospitalized adult patients: a case-control study / Fatores de risco para quedas em pacientes adultos hospitalizados: um estudo caso-controle / Factores de riesgo para caídas en pacientes adultos hospitalizados: un estudio caso-control

ABSTRACT Objective: to identify risk factors for falls in hospitalized adult patients. Methods: a matched case-control study (one control for each case). A quantitative study conducted in clinical and surgical units of a teaching hospital in Southern Brazil. The sample comprised 358 patients. Data were collected over 18 months between 2013-2014. Data analysis was performed with descriptive statistics and conditional logistic regression using Microsoft Excel and SPSS version 18.0. Results: risk factors identified were: disorientation/confusion [OR 4.25 (1.99 to 9.08), p<0.001]; frequent urination [OR 4.50 (1.86 to 10.87), p=0.001]; walking limitation [OR 4.34 (2.05 to 9.14), p<0.001]; absence of caregiver [OR 0.37 (0.22 to 0.63), p<0.001]; postoperative period [OR 0.50 (0.26 to 0.94), p=0.03]; and number of medications administered within 72 hours prior the fall [OR 1.20 (1.04 to 1.39) p=0.01]. Conclusion: risk for falls is multifactorial. However, understanding these factors provides support to clinical decision-making and positively influences patient safety.

RESUMO Objetivo: identificar os fatores de risco para a ocorrência de quedas em pacientes adultos hospitalizados. Métodos: estudo do tipo caso-controle pareado (um controle para cada caso). Pesquisa quantitativa realizada em unidades clínicas e cirúrgicas de um hospital universitário da região Sul do Brasil. A amostra incluiu 358 pacientes. Os dados foram coletados durante 18 meses, entre 2013-2014. A análise dos dados foi realizada por meio de estatística descritiva e regressão logística condicional, utilizando o Microsoft Excel e o SPSS versão 18.0. Resultados: os fatores de risco identificados foram: desorientação/confusão [OR 4,25 (1,99 a 9,08), p<0,001]; micção frequente [OR 4,50 (1,86 a 10,87), p=0,001]; limitação para caminhar [OR 4,34 (2,05 a 9,14), p<0,001]; ausência de cuidador [OR 0,37 (0,22 a 0,63), p<0,001]; período pós-operatório [OR 0,50 (0,26 a 0,94), p=0,03]; e o número de medicamentos administrados nas 72 horas anteriores à queda [OR 1,20 (1,04 a 1,39) p=0,01]. Conclusão: os riscos para quedas são multifatoriais. Todavia, conhecê-los dá suporte à decisão clínica do enfermeiro, o que contribui para a busca das melhores intervenções preventivas e impacta positivamente na segurança dos pacientes.

RESUMEN Objetivo: identificar los factores de riesgo para la ocurrencia de caídas en pacientes adultos hospitalizados. Métodos: un estudio caso-control emparejado (un control para cada caso). Investigación cuantitativa llevada a cabo en unidades clínicas y quirúrgicas de un hospital universitario en el Sur de Brasil. La muestra constó de 358 pacientes. Se recopilaron datos durante 18 meses, entre 2013-2014. El análisis de los datos se realizó mediante estadística descriptiva y regresión logística condicional, utilizando el Microsoft Excel y el SPSS versión 18.0. Resultados: los factores de riesgo identificados fueron: desorientación/confusión [OR 4,25 (1,99 a 9,08), p<0,001]; micción frecuente [OR 4,50 (1,86 a 10,87), p=0,001]; limitación para caminar [OR 4,34 (2,05 a 9,14), p<0,001]; ausencia de cuidadores [OR 0,37 (0,22 a 0,63), p<0,001]; período postoperatorio [OR 0,50 (0,26 a 0,94), p=0,03]; y número de medicamentos administrados dentro de las 72 horas previas a la caída [OR 1,20 (1,04 a 1,39) p=0,01]. Conclusión: los riesgos de caídas son multifactoriales. Sin embargo, la comprensión de estos factores respalda la toma de decisiones clínicas y tiene un impacto positivo en la seguridad del paciente.

Análise do processo formativo de uma residência de enfermagem em terapia intensiva / Análisis del proceso formativo de una residencia de enfermería en terapia intensiva / Analysis of the training process of a nursing internship in intensive care

Objetivo: analisar o processo formativo de uma Residência de Enfermagem em Terapia Intensiva sob a ótica dos egressos. Método: estudo descritivo, exploratório e quantitativo. Participaram todos os egressos da residência entre os anos de 2004 a 2012. Deles, 91 retornaram o instrumento de pesquisa enviado por e-mail e preenchido entre julho e setembro de 2013. Os dados foram analisados através da estatística descritiva. Resultados: o currículo teve maior frequência de avaliação satisfatória (87,9%); a relação entre aulas teóricas e práticas (44%) e o relacionamento com a preceptoria (34,1%) destacaram-se como avaliação intermediária. Todos relataram desenvolver competências para o mercado laboral e apenas 3,3% informaram alguma insatisfação com a residência. Conclusão: a pesquisa identificou que programas de residência devem ter propostas avaliativas que analisem diversos aspectos relacionados ao curso, além da avaliação cognitiva dos residentes. Recomenda-se implementar projetos de educação permanente que abordem atualização científica e formação pedagógica de preceptores e coordenadores.

Objetivo: analizar el proceso formativo de una Residencia de Enfermería en Terapia Intensiva bajo la óptica de los egresados. Método: estudio descriptivo, exploratorio y cuantitativo. Participaron todos los egresados de la residencia entre los años 2004 y 2012. De ellos, 91 devolvieron el instrumento de investigación enviado por e-mail diligenciado entre julio y septiembre de 2013. Los datos fueron analizados a través de la estadística descriptiva. Resultados: el currículo tuvo mayor frecuencia de evaluación satisfactoria (87,9%); la relación entre clases teóricas y prácticas (44%) y la relación con la tutoría de residentes (34,1%) se destacaron con evaluación intermedia. Todos relataron desarrollar competencias para el mercado laboral y apenas 3,3% informaron alguna insatisfacción con la residencia. Conclusión: la investigación identificó que los programas de residencia deben tener propuestas de evaluación que analicen diversos aspectos relacionados con el curso, además de la evaluación cognitiva de los residentes. Se recomienda implementar proyectos de educación permanente que aborden la actualización científica y la formación pedagógica de tutores y coordinadores.

Objective: to analyze the training process of a Nursing Internship in Intensive Care from the point of view of the former interns. Method: descriptive, exploratory, and quantitative study. All the former interns of the internship program between 2004 and 2012 participated in the study, 91 of which returned the research form sent via email and filled out between July and September, 2013. The data was analyzed through descriptive statistics. Results: the curriculum was more often rated in a satisfactory fashion (87.9%); the relationship between theoretical and practical classes (44.0%) and their relationship with the mentored studies (34.1%) stood out as average assessments. All respondents reported having developed skills for the labor market and only 3.3% reported some dissatisfaction with the internship. Conclusion: the study identified that internship programs should have feedback mechanisms for several aspects of the course, in addition to the interns' cognitive evaluation. We recommended implementing ongoing education projects with scientific updating and educational training for mentors and coordinators.

Prevalência de síndrome de burnout em médicos intensivistas de cinco capitais brasileiras / Prevalence of burnout syndrome in intensivist doctors in five Brazilian capitals

RESUMO Objetivo: Estimar a prevalência de burnout em médicos intensivistas que trabalham em unidades de terapia intensiva adulto, pediátrica e neonatal, de cinco capitais brasileiras. Métodos: Estudo epidemiológico descritivo, com amostra aleatória e estratificada por conglomerado, de 180 médicos intensivistas de cinco capitais, representando as regiões geográficas brasileiras: Porto Alegre (RS), São Paulo (SP), Salvador (BA), Goiânia (GO) e Belém (PA). Um questionário autoaplicável avaliou dados sociodemográficos e o nível de burnout foi avaliado por meio do Maslach Burnout Inventory. Resultados: Foram avaliados 180 médicos, sendo 54,4% do sexo feminino. A média de idade foi 39 ± 8,1 anos, 63,4% com a especialização como a maior titulação, 55,7% com até 10 anos de trabalho em unidade de terapia intensiva e 46,1% possuíam título de especialista em terapia intensiva. A maioria (50,3%) tinha carga horária semanal de trabalho entre 49 e 72 horas, e o tipo de vínculo mais frequente foi empregado assalariado. Níveis elevados de exaustão emocional, despersonalização e ineficácia foram encontrados em 50,6%, 26,1% e 15,0%, respectivamente. A prevalência de burnout foi de 61,7%, quando considerado nível alto em pelo menos uma dimensão e de 5% com nível alto nas três dimensões simultaneamente. Conclusão: Observou-se elevada prevalência da síndrome de burnout entre os médicos intensivistas. Estratégias para promoção e proteção à saúde desses trabalhadores devem ser discutidas e implementadas nos hospitais.

ABSTRACT Objective: To estimate the prevalence of burnout in intensivist doctors working in adult, pediatric and neonatal intensive care units in five Brazilian capitals. Methods: Descriptive epidemiological study with a random sample stratified by conglomerate with 180 intensivist doctors from five capitals representing the Brazilian geographic regions: Porto Alegre (RS), Sao Paulo (SP), Salvador (BA), Goiania (GO) and Belem (PA). A self-administered questionnaire examining sociodemographic data and the level of burnout was evaluated through the Maslach Burnout Inventory. Results: A total of 180 doctors were evaluated, of which 54.4% were female. The average age was 39 ± 8.1 years, 63.4% had specialization as the highest degree, 55.7% had up to 10 years of work experience in an intensive care unit, and 46.1% had the title intensive care specialist. Most (50.3%) had weekly workloads between 49 and 72 hours, and the most frequent employee type was salaried. High levels of emotional exhaustion, depersonalization and inefficacy were found (50.6%, 26.1% and 15.0%, respectively). The prevalence of burnout was 61.7% when considering a high level in at least one dimension and 5% with a high level in three dimensions simultaneously. Conclusion: A high prevalence of burnout syndrome among intensivist doctors was observed. Strategies for the promotion and protection of health in these workers must be discussed and implemented in hospitals.

Ultrastructure of Zika virus particles in cell cultures

Zika virus (ZIKV) has infected thousands of Brazilian people and spread to other American countries since 2015. The introduction of ZIKV brought a strong impact to public health in Brazil. It is of utmost importance to identify a susceptible cell line that will enable the isolation and identification of the virus from patient samples, viral mass production, and testing of drug and vaccine candidates. Besides real-time reverse transcriptase polymerase chain reaction diagnosis for detecting the viral genome, virus isolation in cell lines was useful in order to study the structure of the viral particle and its behaviour inside cells. Analysis of ZIKV infected cell lines was achieved using transmission electron microscopy (TEM). Blood was obtained from a Brazilian patient during the first days after presenting with signs of the disease, and ZIKV from the patient’s blood was isolated in the C6/36 mosquito cell line. Afterwards, Vero cells were inoculated with the viral suspension, fixed six days after inoculation, embedded in polymers, and ultra-thin cut. Like dengue viruses, this flavivirus showed numerous virus particles present inside cellular vesicles thereby confirming the susceptibility of the Vero cell line to ZIKV replication. TEM is a unique technique available to make the virus visible.

Low impact to fixed cell processing aiming transmission electron microscopy

In cell culture, cell structures suffer strong impact due to centrifugation during processing for electron microscope observation. In order to minimise this effect, a new protocol was successfully developed. Using conventional reagents and equipments, it took over one week, but cell compression was reduced to none or the lowest deformation possible.

Advances in the use of nanocarriers for cancer diagnosis and treatment / Avanços na utilização de nanocarreadores no tratamento e no diagnóstico de câncer

ABSTRACT The use of nanocarriers as drug delivery systems for therapeutic or imaging agents can improve the pharmacological properties of commonly used compounds in cancer diagnosis and treatment. Advances in the surface engineering of nanoparticles to accommodate targeting ligands turned nanocarriers attractive candidates for future work involving targeted drug delivery. Although not targeted, several nanocarriers have been approved for clinical use and they are currently used to treat and/or diagnosis various types of cancers. Furthermore, there are several formulations, which are now in various stages of clinical trials. This review examined some approved formulations and discussed the advantages of using nanocarriers in cancer therapy.

RESUMO A utilização de nanocarreadores como sistemas de entrega de drogas para agentes terapêuticos ou de imagem pode aumentar as propriedades farmacológicas dos compostos normalmente utilizados no tratamento e diagnóstico de câncer. Avanços em engenharia de superfície de nanopartículas para a acomodação de ligantes alvo têm feito dos nanocarreadores candidatos atrativos para um futuro trabalho envolvendo entrega de droga direcionada. Embora não direcionados, muitos nanocarreadores terapêuticos foram aprovados para uso clínico no tratamento e/ou diagnóstico de vários tipos de câncer. Além disso, há várias outras formulações que se encontram agora em estágio de testes clínicos. Este artigo de revisão examinou algumas formulações aprovadas e discutiu as vantagens da utilização de nanocarreadores na terapia de câncer.

Prevalência das diferentes patologias no ambulatório de clínica cirúrgica do Centro de Especialidades Médicas (CEMED) de Barbacena / Prevalence of different diseases treated in the outpatient surgical clinic of CEMED, Barbacena

A cirurgia ambulatorial surgiu com o propósito de reduzir os custos de internação dos pacientes, diminuir o tempo de hospitalização e otimizar os leitos hospitalares, e como tal vem sendo utilizada a vários anos na prática médica.A presente pesquisa teve como objetivo determinar a prevalência das patologias atendidas no ambulatório de clínica cirúrgica do Centro de Especialidades Médicas de Barbacena (CEMED), Minas Gerais. Esse estudo foi realizado como corte transversal através de coleta de dados em prontuários de atendimento do CEMED no período de 2009 a 2010. Obtidos os dados e após análise a patologia mais presente foi lesão benigna com 16,8% seguida de cisto com 11,5% e lesão maligna com 8,4% dos casos. O sexo feminino foi o mais prevalente com 57,26%. A faixa etária mais atendida foi de 41 a 60 anos (32,26%). A cor predominante foi leucodérmico com 74,2%. O procedimento mais realizado foi a consulta 59,4% em comparação com 32,6% de procedimentos cirúrgicos. A região mais afetada foi a cabeça e o pescoço (41,3%). Portanto o estudo conclui que a variedade no perfil de atendimentos do ambulatório cirúrgico do CEMED demonstra a necessidade de se realizarem cada vez mais estudos com a finalidade de otimizar os serviços providos pelo mesmo.

Nursing workload in a coronary unit according to the Nursing Activities Score / Carga de trabajo en unidad coronaria según la Nursing Activities Score / Carga de trabalho em unidade coronariana segundo o Nursing Activities Score

Objective: this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument.Method: this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012.Results: A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts.Conclusion: according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

Objetivo: verificar la carga de trabajo de enfermería medida por la Nursing Activities Score en una unidad coronaria, su relación con los turnos de trabajo y comparar el cuadro de enfermería existente en la unidad con lo proyectado según los dados del instrumento.Método: estudio longitudinal realizado en un hospital universitario de la región sur de Brasil en el periodo de abril a junio de 2012. Resultados: se realizaron 604 medidas por turnos, en una muestra de 61 pacientes. La carga de trabajo fue del 47% (±12) en el análisis por turnos, con promedios más elevados en el turno de la tarde.Conclusión: se observó la necesidad de en promedio dos y hasta 2,4 profesionales de enfermería, estando consistente con el cuantitativo real de la unidad. El instrumento posibilito medir la carga de trabajo de enfermería e delinear la variabilidad de las demandas en los diferentes turnos de trabajo.

Objetivo: verificar a carga de trabalho de enfermagem aferida pelo Nursing Activities Score em uma unidade coronariana, analisar sua relação com os turnos de trabalho e comparar o quadro de enfermagem existente na unidade com o projetado segundo os dados do instrumento.Método: estudo longitudinal conduzido em um hospital universitário da região sul do Brasil no período de abril a junho de 2012. Foram realizadas 604 medidas por turnos, em uma amostra de 61 pacientes. A carga de trabalho foi de 47% (±12) na análise por turnos, com média mais elevada no turno da tarde.Resultados: observou-se a necessidade de em média dois e até 2,4 profissionais de enfermagem, estando condizente com o quantitativo real da unidade.Conclusão: o instrumento possibilitou mensurar a carga de trabalho de enfermagem e delinear a variabilidade das demandas nos diferentes turnos de trabalho.

Tumoração retro-orbitária sugestiva de meningocele da bainha do nervo óptico / Retro-orbital tumor suggestive of optic nerve sheath meningocele

Meningocele da bainha do nervo óptico é uma condição extremamente rara, com poucos casos relatados na literatura. Exames de imagem revelam alargamento tubular-cístico do nervo óptico, com espessamento do mesmo. Os sintomas são muitas vezes relacionados com o comprometimento do nervo, ocasionando diminuição de lenta a acelerada da acuidade visual. O tratamento cirúrgico precoce por meio da descompressão da bainha do nervo óptico pode proporcionar melhora da função visual. Apresenta-se um caso de paciente com as características clínicas e radiológicas desta condição patológica rara. Paciente masculino, atendido no serviço com queixa de proptose do olho direito (OD) desde nascimento, com progressão nos últimos meses associada à dor. Melhor acuidade visual corrigida de conta dedos a 50 cm do OD. Olho esquerdo sem anormalidades. Ressonância Magnética de OD demonstrou formação expansiva cística de limites definidos em situação intraconal em órbita direita, em íntima relação com nervo óptico, determinando compressão, deformidade e deslocamento anterior do bulbo ocular, além de apresentar sinal semelhante ao líquor em todas as sequências obtidas. Suscitou-se hipótese diagnóstica de meningocele da bainha do nervo óptico direito e o paciente foi encaminhado para cirurgia descompressiva.

Meningocele of the optic nerve sheath is an extremely rare condition with a few cases reported in literature. Image studies reveal tubularcystic enlargement of the optic nerve although with the same thickness. Symptoms are often related to the involvement of the optic nerve, leading from slow to accelerated decreasing of the visual acuity. The early surgical treatment is the decompression of the optic nerve sheath, which it could provide improvement of visual function. We are presenting a case report of a patient who showed clinical and radiological signs of this rare pathological condition. Male patient attended at service complaining of proptosis of right eye (OD) since birth, in progress during the last months associated to stabbing pain. Best corrected visual acuity (BCVA) of OD was movements at 50 cm far; OS showed no abnormalities. Nuclear Magnetic Resonance of the OD showed expansive formation with cystic aspect, defined boundaries, located in an intraconal situation on the right orbit cavity and in a closing anatomical relationship to the optic nerve, inducing compression, deformity and anterior displacement of this eye besides presenting signal similar to spine liquor in all sequences obtained. The first hypothesis was meningocele of right optic nerve sheath. Then, patient was referred for surgical decompression.