Vínculos entre psicooncología y enfermería en el cuidado continuo de personas con cáncer de próstata / Links between Psycho-Oncology and Nursing in the Ongoing Care of Individuals with Prostate Cancer

Introducción: La enfermería en oncología ocupa un lugar preponderante dentro del equipo multidisciplinar, y el concepto de cuidado va más allá de actividades técnicas, donde toda relación terapéutica implica, de modo necesario, un proceso de relación interpersonal, para lo cual se deben desarrollar habilidades y destrezas comunicativas. Objetivo: Analizar los vínculos entre la psicooncología y la enfermería en el cuidado continuo de personas con cáncer de próstata. Métodos: Revisión bibliográfica sistemática de artículos publicados desde 2011 hasta 2020 en las bases de datos SciELO, Google académico y Dialnet. Se elaboró la pregunta guía a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante los descriptores en Ciencias de la Salud (DeCS) "Psicooncología", "Enfermería", "Cuidados continuos", "Neoplasia de la próstata" y "Enfermedades crónicas" con los operadores booleanos AND y OR. Se utilizó el diagrama de flujo (PRISMA). Se accedió a interpretar los referentes teóricos y organización del conocimiento en las 16 bibliografías seleccionadas. Conclusiones: La revisión realizada permitió enfatizar la importancia de integrar técnicas y habilidades de la psicooncología, sus beneficios y aplicación desde las perspectivas de enfermería, con el propósito de favorecer el bienestar biopsicosocial de la persona con cáncer de próstata(AU)

Introduction: Nursing in oncology occupies a preponderant place within the multidisciplinary team, and the concept of care goes beyond technical activities, any therapeutic relationship necessarily implies an interpersonal relationship process, for which skills and communication skills must be developed. Objective: To analyze the links between psycho-oncology and nursing in the continuous care of individuals with prostate cancer. Methods: We develop a systematic bibliographic review of articles published from 2011 to 2020 in the SciELO, Google academic and Dialnet databases. The guiding question was developed through the acronym PICo. The search strategy was carried out using the Health Sciences (DeCS) descriptors "Psychooncology", "Nursing", "Continuous care", "Prostate neoplasia" and "Chronic diseases" with the Boolean operators AND and OR. PRISMA flow chart was used. It was agreed to interpret the theoretical references and organization of knowledge in the 16 selected bibliographies. Conclusions: The review carried out made it possible to emphasize the importance of integrating techniques and skills of psycho-oncology, their benefits and application from the nursing perspectives, with the purpose of favoring the bio psychosocial well-being of the person with prostate cancer(AU)

Puntos de encuentro entre Teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer prostático / Meeting Points between Swanson's and Roy´s Theories in Continuous Care for the Elderly with Prostate Cancer

Introducción: La gestión del cuidado de enfermería, en las personas mayores es un desafío actual para la profesión. Lo que implica planificar y coordinar cuidados seguros y de calidad. Donde se atribuye la necesidad de integrar el enfoque de las teorías y su práctica en el cuidado sistémico y dinámico a la persona en su realidad total. Objetivo: Analizar los puntos de encuentro entre las teorías de Swanson y Roy en el cuidado continuo del adulto mayor con cáncer de próstata. Métodos: Revisión bibliográfica sistemática, durante 2019, de artículos publicados desde 2009 hasta 2019 en las bases de datos SciELO y Google académico. La pregunta guía se elaboró a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante aceptación de los descriptores en Ciencias de la Salud (DeCS) "Teorías de enfermería", "Modelo de adaptación de Callista Roy", "Teoría de Kristen Swanson", "Cuidados continuos", "Adulto mayor", "Neoplasia de la próstata" y "Enfermedades crónicas" con el operador booleano AND, se utilizó el diagrama de flujo (PRISMA). El análisis de contenido permitió interpretar los referentes teóricos y la organización del conocimiento de las 13 bibliografías seleccionadas. Conclusiones: Resulta limitada la producción científica encontrada en relación al alcance de las teorías de Swanson y Roy en la atención al paciente con cáncer. Ambas teorías tienen implícitas, en la fundamentación de sus componentes, un acercamiento biopsicosocial al modo de cuidar en la práctica clínica y la cultura del cuidado continuo en el adulto mayor con cáncer de próstata, desde la perspectiva de enfermería(AU)

Introduction: Nursing care management in the elderly is a current challenge for the profession. This implies planning and coordinating safe and quality care, processes requiring to integrate theoretical approach and their praxis into systemic and dynamic care to the person in a total reality. Objective: To analyze the meeting points between the theories of Swanson and Roy in the continuous care of the elderly with prostate cancer. Methods: Systematic bibliographic review, carried out during 2019, of articles published from 2009 to 2019 in the SciELO and Google Scholar databases. The guiding question was developed through the acronym PICO. The search strategy was carried out by accepting the following descriptors in Health Sciences (DeCS): teorías de enfermería [nursing theories], modelo de adaptación de Callista Roy [Callista Roy's adaptation model], teoría de Kristen Swanson [Kristen Swanson's theory], cuidados continuos [continuous cares], adulto mayor [elderly], neoplasia de la próstata [prostate neoplasm] and enfermedades crónicas [chronic diseases] with the Boolean operator AND. The flow diagram (PRISMA) was used. Content analysis allowed to interpret the theoretical references and to organize knowledge of the thirteen selected bibliographies. Conclusions: There is limited scientific production found about the scope of Swanson's and Roy´s theories regarding the care of patients with cancer. Both theories include implicitly, in the foundation of their components, a biopsychosocial approach to the way of caring, in clinical praxis, as well as the culture of continuous care for the elderly with prostate cancer, from the nursing perspective(AU)

DIA DOS MORTOS E A VIVÊNCIA DO LUTO: RELATO DE EXPERIÊNCIA / DAY OF THE DEAD AND THE EXPERIENCE OF BEREAVEMENT: EXPERIENCE SAMPLING / DÍA DE LOS MUERTOS Y EL LUTO: NARRACIÓN DE LA EXPERIENCIA

O luto envolve dimensões individuais, familiares, socioculturais e espirituais, demandando do psicólogo abertura para dialogar com outras áreas de conhecimento, visando ampliar a compreensão da experiência de quem sofre a perda de alguém significativo. Este trabalho objetiva relatar a participação de três psicólogas brasileiras na festa do Dia dos Mortos, em Ocotepec, México. O método utilizado foi a etnografia, com registro das observações em diário de campo individuais. Observou-se a importância dos rituais para o enfrentamento do luto e suas diferentes expressões. A presença de diversos símbolos que resgatam a lembrança da pessoa falecida, preservando sua memória, possibilitou considerar o modelo de vínculos contínuos no enfrentamento de uma perda significativa. A morte é celebrada e versada coletivamente no México, enquanto é tema tabu no Brasil. A vivência desses ritos possibilitou compreender os atravessamentos sociais e culturais da morte e do luto, experiência salutar para a construção de uma clínica ampliada.

Bereavement involves individual, familial, social, cultural and spiritual dimensions, demanding that psychologists open to dialogue with other areas of knowledge, aiming to broaden the understanding of the experience of those who suffer the loss of someone significant. This work aims to report the participation of three psychologists in the Day of the Dead party, in Ocotepec, Mexico. The method used was ethnography, with observations recorded in individuals field diaries. The presence of several symbols that recover the memory of the deceased person, preserving their memory, made it possible to consider the model of continuous bonds in coping with a significant loss. Death is celebrated and versed collectively in Mexico, while it is a taboo subject in Brazil. The experience of these rites made it possible to understand the social and cultural crossings of death and grief, a healthy experience to build an expanded clinic.

El duelo involucra dimensiones individuales, familiares, socioculturales y espirituales que exigen del psicólogo apertura para dialogar con otras áreas del conocimiento, ampliando la comprensión de la experiencia de aquel que sufre la pérdida de alguien significativo. Este trabajo relata la participación de psicólogas brasileñas en la fiesta del Día de Muertos en Ocotepec, México. El método utilizado fue la etnografía, con registro de observaciones en diarios de campo. Se observó la importancia de los rituales en el afrontamiento del duelo. La presencia de símbolos que rescatan el recuerdo de la persona fallecida permitió considerar el modelo de enlaces continuos en el afrontamiento de una pérdida significativa. La muerte es celebrada y reconocida colectivamente en México, mientras que en Brasil es un tema tabú. La vivencia de estos rituales permitió comprender las intersecciones sociales y culturales de la muerte y el duelo, experiencia benéfica para la construcción de una clínica ampliada.

Calidad de atención y mejora continua en el abordaje integral del cáncer de mama: Evaluación de indicadores en una Unidad de Mastología / Quality of care and continous improvement in a comprehensive approach of breast cancer management: evaluation of indicators in a breast center

Introducción: las Unidades de Mastología son organizaciones que tienen por objetivo abordar la patología mamaria de manera multidisciplinaria e integral. A nivel mundial se han implementado programas para evaluar la calidad de atención a través del cumplimiento de indicadores propuestos por Sociedades Científicas u organismos gubernamentales. Algunos de estos han sido propuestos y revisados por la Sociedad Europea de Mastología (EUSOMA). Objetivo: evaluar la calidad de atención de la Unidad de Mastología del Hospital Juan A. Fernández a través del análisis de una serie de indicadores propuestos por EUSOMA como estándares de calidad de atención en centros de patología mamaria. Material y método: estudio descriptivo retrospectivo analizando la base de datos de las pacientes con cáncer de mama estadios 0 a III operadas entre 2015 y 2019. Se analizaron 25 indicadores de procesos propuestos por EUSOMA en 2017. Se registraron las características de la población, y el porcentaje de pacientes en las cuales se cumple la condición de cada uno de los indicadores. Se registró si el indicador alcanza o supera el mínimo estándar, o si alcanza o supera el valor ideal. Resultados: se evaluaron 284 pacientes. Se observó el cumplimiento de la mayoría de los estándares propuestos (18 de 25), alcanzando o superando en el 25% de los indicadores evaluados el valor ideal. Se lograron alcanzar los estándares de calidad de atención relacionados con el diagnóstico clínico y preoperatorio, caracterización anatomopatológica completa en carcinoma invasor, evaluación multidisciplinaria, tratamiento quirúrgico primario en carcinoma invasor e in situ. Se alcanzaron los objetivos tendientes a evitar el sobretratamiento quirúrgico en carcinoma invasor y en cirugía conservadora en carcinoma in situ. En relación a los tratamientos adyuvantes, se alcanzaron los estándares relacionados con radioterapia post cirugía conservadora y post mastectomía, así como también el tratamiento con hormonoterapia y quimioterapia. El seguimiento de los pacientes se realizó en tiempo en tiempo y forma de acuerdo al indicador establecido. Existen 3 indicadores de calidad obligatorios en los que no se alcanzó el estándar mínimo: se observó la necesidad de mejorar la accesibilidad a los tratamientos antiHer2neu en neoadyuvancia, y de reducir los tiempos de espera al inicio del tratamiento. Conclusiones: se observó el cumplimiento de la mayoría de los estándares propuestos. Dado que existen indicadores obligatorios en los que no se alcanzó el estándar mínimo, los esfuerzos primarios deberán centrarse prioritaria e inicialmente en diseñar una planificación que permita alcanzar estos objetivos, así como también mantener en el tiempo los valores positivos ya alcanzados. Se pone de manifiesto la necesidad de implementar políticas a nivel sanitario nacional que permitan mejorar la accesibilidad a medicación oncológica. A su vez, destacamos la importancia de definir indicadores propios con valores ajustados a las características de nuestro país y mantener una evaluación periódica de la calidad de atención a través de los mismos.

Introduction: Breast Units are organizations that manage Breast Cancer in a comprehensive and multidisciplinary approach. Worlwide, programs have been developed in order to evaluate quality of care through the achievement of certain standards of care that have been proposed by scientific organizations, medical associations or government health departments. Some of these indicators have beeb proposed by the European Society of Breast Cancer Specialist (EUSOMA). Objective: to evaluate quality of care in the Breast Unit at Hospital Juan A Fernández (Buenos Aires, Argentina) through the analysis of a series of indicators described by EUSOMA as standard of care in breast centers. Material and method: we performed a descriptive, retrospective analysis of our database including patients with breast cancer stage 0 to III that wer treated between 2015 and 2019. We studied 25 quality of care process indicators proposed by EUSOMA in 2017. We registered population characteristics and the percentage of patients in which each indicator mínimum requirements were achieved. We also studied whether our results achieved or were beyond the ideal targets for each indicator. Results: a total of 284 patients were evaluated. The mínimum standard of care was achieved in most of the evaluated indicators (18 of 25) and in 25% of these, our results achieved or exce3ded the ideal requirements. The indicators in which the mínimum or ideal standard of care was accomplished were regarding clinical and preoperative diagnosis anatomopathological characterisation in invasive breast cancer, multidisciplinary approach, primary surgical management in invasive and in situ breast cancer, avoidanc of overtreatement in invasive breast cancer and breast conserving therapy in carcinoma in situ. Regarding adjuvant treatment, the standard of care was achieved in radiotherapy after breast conserving surgery and after mastectomy, endocrine therapy and chemotherapy. The follow up timing was according to the indicator. There were 3 mandatory indicators in which the mínimum standards were not achieved and were regarding accesibility to anti Her2neu agents in neoadjuvant setting, and timing form diagnosis to firts treatment. Conclusions: we observed that out Breast Unit achieved most of the quality of care indicators described by EUSOMA. However, there 3 mandatory indicators where the results were below the mínimum. This is why future efforts should be focused on designing and planning new measures that will allow these objectives to be accomplished, as well as maintaining what has already been achived. Our results also show the imperious need to implement national public health pólices that would grant a better accesiblility to oncologic medications. We also analysed the importance of defining our own local quality of care indicators in relation to our health policies and current situation, as well as the importance of a continuous evaluation of quality of care through these indicators.

CHEMical KINetics SimuLATOR (Chemkinlator): A friendly user interface for chemical kinetics simulations / CHEMical KINetics SimuLATOR (Chemkinlator): Una herramienta amigable para realizar simulaciones de cinética química / CHEMical KINetics SimuLATOR (Chemkinlator): Uma ferramenta amigável para realizar simulações de cinética química

Abstract CHEMicalKINetics SimuLATOR (Chemkinlator) is a Graphical User Interface for the simulation of reaction mechanisms. The interface allows the user to see and change the parameters of a reaction network within a single window. Chemkinlator comes with built-in support for three types of kinetic simulations: Time Series, which computes the concentration of all species in an interval of time for the defined model; Bifurcation diagrams, which are the result of running several Time Series simulations over gradually different kinetic rate constants; and Flow/Temperature time series, which takes into account the effect of flow in the Continuous-flow well-Stirred Tank Reactor, and the effect of temperature on the rates constants according to the Arrhenius equation. In our research group, Chemkinlator has been the primary tool used to test the predictions made by algorithms that analyze homochirality phenomena. Chemkinlator is written in C++14 and Qt, and it uses the Fortran subroutine DLSODE to solve the differential equations associated with the reaction networks. Chemkinlator is open source software under the Apache 2.0 license and can be downloaded freely from https://gitlab.com/homochirality/chemkinlator.

Resumen CHEMical KINetics SimuLATOR (Chemkinlator) es una interfaz gráfica para realizar simulaciones de mecanismos de reacción. La interfaz le permite al usuario ver y cambiar los parámetros de una red de reacciones en una única ventana. Chemkinlator puede realizar tres tipos de simulaciones cinéticas: Time Series, calcula la concentración de cada especie en un intervalo de tiempo del modelo estudiado; Bifurcation, es el resultado de ejecutar varias veces las simulaciones del modo Time Series, cambiando gradualmente diferentes constantes de velocidad; y Flow/ Temperature es una serie de tiempo en la que se tiene en cuenta el efecto del flujo considerando un Reactor de Flujo Continuo bien Agitado y el efecto de la temperatura sobre las constantes de velocidad según la ecuación de Arrhenius. En nuestro grupo de investigación, Chemkinlator ha sido la herramienta principal para verificar las predicciones hechas por los algoritmos que analizan el fenómeno de homochiralidad. Chemkinlator está escrito en C++14 y Qt, y usa la subrutina de Fortran DLSODE para resolver las ecuaciones diferenciales relacionadas con los mecanismos de reacción. Chemkinlator es software de código abierto bajo la licencia Apache 2.0 y se puede descargar libremente de https://gitlab.com/homochirality/chemkinlator.

Resumo O CHEMical KINetics SimuLATOR (Chemkinlator) é uma interface gráfica para realizar simulações de mecanismos de reação. A interface permite ao usuário visualizar e alterar os parâmetros de uma rede de reação em uma única janela. O Chemkinlator pode realizar três tipos de simulações cinéticas: Time Series, calcula a concentração de cada espécie em um intervalo de tempo do modelo estudado; Bifurcation, é o resultado de executar várias vezes as simulações do modo Time Series, modificando gradualmente diferentes constantes de velocidade; e Flow/Temperature é uma serie de tempo que se considera o efeito do fluxo considerando um Reator de Fluxo Continuo bem Agitado e o efeito da temperatura sobre as constantes de velocidade pela equação de Arrhenius. No nosso grupo de investigação, o Chemkinlator tem sido a principal ferramenta para verificar as predições realizadas pelos algoritmos que analisam o fenómeno de homoquiralidade. O Chemkinlator está escrito em C++14 e Qt, e usa a sub-rotina de Fortran DLSODE para resolver as equações diferenciais relacionadas com os mecanismos de reação. O Chemkinlator é um software de código aberto baixo a licença Apache 2.0 e pode ser descarregado livremente em https://gitlab.com/homochirality/chemkinlator.

Violence against women: historical trajectory of a care program (Curitiba - 1997-2014) / Violencia contra las mujeres: la trayectoria histórica de un programa de atención (Curitiba - 1997-2014) / Violência contra mulheres: trajetória histórica de um programa de atenção (Curitiba - 1997-2014)

ABSTRACT Objective: To analyze the historical trajectory and the contributions of the Programa de Atenção às Mulheres em Situação de Violência (Program of Care to Women Victims of Violence) of Curitiba. Method: Research with documentary and local approach, inspired by the Dimension of Political History, to unveil power relations, political representations, symbols and discourses. Eighty-eight sources were used for the period 1997-2014. The data collection was performed in May 2016 and presented in the timeline modality. Results: The historical trajectory of the program indicates intersectoral and interinstitutional experience that has been increasing and originating important innovations in care to women based on humanization and from the perspective of comprehensiveness. Final considerations: Historicizing the Program contributed to the reflection on the construction of practices aimed at confronting violence, the need for intersectoral actions and looks that involve its complexity.

RESUMEN Objetivo: Analizar la trayectoria histórica y las contribuciones del Programa de Atención a las Mujeres en Situación de Violencia de Curitiba. Método: Investigación con enfoque documental y local, inspirada en la Dimensión de la Historia Política, para revelar relaciones de poder, representaciones políticas, símbolos y discursos. Se utilizaron 88 fuentes para el período 1997-2014. La recolección de datos fue realizada en mayo de 2016 y presentada en la modalidad línea del tiempo. Resultados: La trayectoria histórica del programa indica una experiencia intersectorial e interinstitucional, que se ha ido ampliando y originando importantes innovaciones en la atención a mujeres pautadas en la humanización y en la perspectiva de la integralidad. Consideraciones finales: Historizar el programa contribuyó a la reflexión acerca de la construcción de prácticas dirigidas al enfrentamiento de la violencia, la necesidad de acciones intersectoriales y miradas que involucren su complejidad.

RESUMO Objetivo: Analisar a trajetória histórica e as contribuições do Programa de Atenção às Mulheres em Situação de Violência de Curitiba. Método: Pesquisa com abordagem documental e local, inspirada na Dimensão da História Política, para descortinar relações de poder, representações políticas, símbolos e discursos. Foram utilizadas 88 fontes referentes ao período de 1997-2014. A coleta de dados foi realizada em maio de 2016 e apresentada na modalidade linha do tempo. Resultados: A trajetória histórica do programa indica experiência intersetorial e interinstitucional que foi se ampliando e originando importantes inovações na atenção às mulheres pautadas na humanização e na perspectiva da integralidade. Considerações finais: Historicizar o Programa contribuiu na reflexão acerca da construção de práticas voltadas ao enfrentamento da violência, a necessidade de ações intersetoriais e olhares que envolvam sua complexidade.

Protaper Next: la evolución / Protaper Next: the evolution

El objetivo del presente artículo es describir y analizar las características técnicas y de diseño del sistema Protaper Next. Este sistema aparece en el mercado odontológico en el año 2012, transformándose en el sucesor del Protaper Universal. Una de sus principales modificaciones consiste en la disminución del número de instrumentos requeridos para realizar el tratamiento endodóntico.

The objective of this article is to describe and analyze the technical and design characteristics of the Protaper Next System.This system appeared at the dental market in 2012 becoming the successor of Protaper Universal.One of its main modifications is the minor numbers of instruments required for doing an endodontic treatment.

Effect of continuous positive airway pressure (CPAP) therapy on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) / 中华全科医师杂志

Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P ＜ 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P ＜ 0.01,P ＜ 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P ＜ 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P ＜ 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P ＜ 0.05 or P ＜ 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P ＜ 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.

Effects of nasal continuous positive airway pressure or intubation in very low birth weight preterm infants / 中华围产医学杂志

ObjectiveTo investigate the effects of nasal continuous positive airway pressure (nCPAP) and intubation in very low birth weight preterm infants. Methods One hundred and twenty-three very low birth weight preterm infants with respiratory distress within 60 minutes after birth were randomly assigned to nCPAP (n=63) or intubation group (n=60).Outcomes at 7,28 days and 36 corrected gestational weeks were assessed with x2 or t-test. ResultsThere were no significant difference in fatality rate and incidence of bronchopulmonary dysplasia between nCPAP group and intubation group [7.9％ (5/63) vs 6.6％(4/60),4.8％(3/63) vs 3.3％(2/60),x2 =0.07and 0.16,P＞0.05].In nCPAP group,the use of pulmonary sulfactant was 27.0％ (17/63),lower than that (83.3 ％,50/60) in intubation group (x2 =39.34,OR=0.3,90 ％ CI:0.2-0.6,P＜0.05) ;The nCPAP group had fewer ventilation support in 28 days [17.5％ (11/63) vs 25.0％ (15/60),OR=0.7,90％ CI:0.4-1.4] and 36 weeks [6.3％ (4/63) vs 8.3％ (5/60),OR=0.8,90％ CI:0.2-2.4] than those in intubation group but without statistical difference (x2=1.05 and 0.01,P＞0.05,respectively).The incidence of air leak in nCPAP group were lower than intubation group [11.1％ (7/63) vs 33.3％ (20/60),x2 =8.86,OR=0.3,90％00 CI:0.2-0.7,P＜0.05].There was no significant difference for other complications between two groups. ConclusionsIn very low birth weight preterm infants,early nCPAP dose not significantly reduce the fatality rate and the incidence of bronchopulmonary dysplasia as compared with intubation ventilation,but shorten the time of ventilation and lower the incidence of air leak.

Influência da luz na germinação in vitro de sementes de tamareira (Phoenix dactylifera L.) / Influence of light on date palm (Phoenix dactylifera L.) in vitro seed germination

A tamareira (Phoenix dactylifera L.) é uma espécie da família arecaceae que produz frutos comestíveis altamente nutritivos e é de notável importância para muitos países do Norte da África, do Oriente Médio e da Ásia Oriental. Devido aos seus caracteres botânicos e à sua capacidade de desenvolvimento em regiões quentes e áridas e em diversos tipos de solos, a tâmara torna-se uma ótima opção para o Nordeste Brasileiro. Com o presente trabalho, objetivou-se estudar a germinação de sementes de tamareira, cv. Khadrawy, focalizando o comportamento fotoblástico das sementes. As sementes foram submetidas ao escuro contínuo e a fotoperíodo de 12 horas. O delineamento experimental utilizado foi completamente casualizado com quatro repetições de 25 sementes. Os parâmetros avaliados foram porcentagem e velocidade de germinação. A germinação das sementes não se restringiu a um dos tratamentos, respondendo positivamente tanto na presença quanto na ausência de luz. A velocidade de germinação, porém, foi sensivelmente mais alta nas sementes expostas ao escuro contínuo. Os resultados obtidos permitiram classificar as sementes de tamareira cv. Khadrawy como indiferentes à luz.

Date tree (Phoenix dactylifera L.) is a palm (Arecaceae) that produces nutritious fruits and has notable importance for many countries of the North of Africa, the Middle East and Eastern Asia. Due to the botanical characters and for the development in hot and barren regions and diverse types of soil, the date becomes an excellent option for the Brazilian Northeast. This study had as objective to study the seed germination of date palm cv. Khadrawy, being focused the photoblastic behavior of the seeds. The seeds were submitted to continuous dark and photoperiod of 12 hours. The experimental design used was completely randomized with four replicates of 25 seeds. Percentage and speed of germination were evaluated. Seed germination occurred in the presence of light and the dark, however the speed of germination was significantly higher in seeds submitted to continuous dark. The results allowed to classify the date palm seeds cv. Khadrawy as indifferent to light for germination.

The use of Fluorescence Resonance Energy Transfer (FRET) peptidesfor measurement of clinically important proteolytic enzymes

Proteolytic enzymes have a fundamental role in many biological processes and are associated with multiple pathological conditions. Therefore, targeting these enzymes may be important for a better understanding of their function and development of therapeutic inhibitors. Fluorescence Resonance Energy Transfer (FRET) peptides are convenient tools for the study of peptidases specificity as they allow monitoring of the reaction on a continuous basis, providing a rapid method for the determination of enzymatic activity. Hydrolysis of a peptide bond between the donor/acceptor pair generates fluorescence that permits the measurement of the activity of nanomolar concentrations of the enzyme. The assays can be performed directly in a cuvette of the fluorimeter or adapted for determinations in a 96-well fluorescence plate reader. The synthesis of FRET peptides containing ortho-aminobenzoic acid (Abz) as fluorescent group and 2, 4-dinitrophenyl (Dnp) or N-(2, 4-dinitrophenyl)ethylenediamine (EDDnp) as quencher was optimized by our group and became an important line of research at the Department of Biophysics of the Federal University of São Paulo. Recently, Abz/Dnp FRET peptide libraries were developed allowing high-throughput screening of peptidases substrate specificity. This review presents the consolidation of our research activities undertaken between 1993 and 2008 on the synthesis of peptides and study of peptidases specificities.

As enzimas proteolíticas têm um papel fundamental em muitos processos biológicos e estão associadas a vários estados patológicos. Por isso, o estudo da especificidade das peptidases pode ser importante para uma melhor compreensão da função destas enzimas e para o desenvolvimento de inibidores. Os substratos com supressão intramolecular de fluorescência constituem uma excelente ferramenta, pois permitem o monitoramento da reação de forma contínua, proporcionando um método prático e rápido para a determinação da atividade enzimática. A hidrólise de qualquer ligação da cadeia peptídica entre o grupo doador e o grupo supressor gera fluorescência que permite detectar concentração nanomolar de enzima. Os ensaios podem ser acompanhados diretamente na cubeta ou adaptados para determinações de fluorescência em leitoras de placa. A síntese dos peptídeos com supressão intramolecular de fluorescência contendo o grupo fluorescente Abz (orto-aminobenzóico) e o grupo supressor EDDnp (N-[2, 4-dinitrofenil]-etilenodiamino ou Dnp (2, 4-dinitrophenyl) foi otimizada pelo nosso grupo e tornou-se uma importante linha de pesquisa no Departamento de Biofísica da Universidade Federal de São Paulo. Recentemente, foram desenvolvidas bibliotecas de peptídeos fluorogênico contendo Abz/Dnp como grupo doador/supressor trazendo um grande avanço no estudo de especificidade das peptidases. Esta revisão apresenta o trabalho desenvolvido pelo nosso grupo entre 1993 e 2008 sobre a síntese de peptídeos e o estudo da especificidade de peptidases.

Meios contínuos em neurocirurgia vascular e neurorradiologia intervencionista. Parte I / Mechanics of continuous media in vascular neurosurgery and endovascular neuroradiological procedures

Os aneurismas e as placas de ateroma compartem não somente um elevado índice de morbimortalidade, como também sua localização. Isso sugere que fatores hemodinâmicos contribuam no seu desenvolvimento. A quantificação de forças hemodinâmicas é complicada, especialmente em vasos intracranianos; porém, avanços recentes em mecânica computacional têm permitido calcular sua magnitude e distribuição em modelos arteriais com ajuda de técnicas de dinâmica de fluidos computacionais. No entanto, a compreensão desses modelos e a verificação de sua validade e limitações dependem do conhecimento de seu desenho e dos parâmetros hemodinâmicos utilizados. Por outro lado, a determinação das propriedades mecânicas das paredes arteriais é crucial, não somente para a compreensão das alterações do sistema cardiovascular no tempo e das causas responsáveis que dão origem às lesões vasculares, bem como para a realização da angioplastia, o planejamento de pontes arteriais e a seleção de próteses endovasculares. Dessa forma, a mais importante contribuição que podemos obter do conhecimento da biomecânica, em geral, e da mecânica dos meios contínuos, em particular, se encontra no melhor entendimento da fisiologia. Nesta revisão, passamos pelos conceitos fundamentais utilizados na formulação dos problemas da mecânica dos meios contínuos, com ênfase na pesquisa biomecânica das lesões vasculares, no intuito de oferecer algumas definições que promovam a análise crítica dos resultados nesse campo.

Cerebral aneurysms and atherosclerosis share not only a high rate of morbidity and mortality, but also its location. It suggests that hemodynamic factors contribute to their development. Quantification of hemodynamic forces is complicated, especially in intracranial arteries. However, recent advances in computational mechanics have allowed calculating the magnitude and distribution of these forces in arterial models with the help of techniques of computational fluid dynamics. However, the understanding of these models and verification of their validity and limitations depend on the knowledge of its design and hemodynamic parameters. Furthermore, the determination of mechanical properties of the arterial walls is crucial, not only for the understanding of the changes of the cardiovascular system in time and the causes of the injuries that they develop, as well as to the realization of angioplasty, planning of arterial bypass or the selection of endovascular prosthesis, for example. Thus, concepts on mechanics of continuous media are needed in the body of knowledge of all interested in cerebrovascular disease. In this review, we look the fundamental concepts used in the formulation of the problems of the mechanics of continuous media, focusing on biomechanics research of vascular lesions, in order to provide some definitions that promote the critical analysis of the results in this . The most important contribution that we can get from the knowledge of biomechanics, in general, and from the mechanics of continuous media, in particular, is a better understanding of physiology.

Visualización de clases construidas para el análisis de registros continuos de parámetros clínicos / Visualization of classes constructed for the analysis of continuous recordings of clinical parameters / VisualizaÇÃO de classes construidas para a análise de registros continuos de ParÂmetros Clínicos

Se procesaron registros de la presión arterial sistólica (PAS), diastólica (PAD) y de la frecuencia cardíaca (FC) efectuados durante todo el día en situación basal y a las 6, 26 y 52 semanas de tratamiento. Para ello se aplicaron técnicas multidimensionales de datos con el enfoque de la escuela francesa (análisis de correspondencias múltiples seguido de la construcción de clusters sobre coordenadas factoriales), logrando una partición en tres clases. Se consideró luego cada clase como un objeto simbólico y se realizaron gráficos de estrellas multivariantes que pusieron en evidencia los diferentes perfiles de las clases, posibilitando una satisfactoria visualización gráfica.

Systolic and diastolic arterial blood pressure and heart frequency performed all along the day under basal conditions and at 6, 26 and 52 weeks of treatment were processed. Multidimensional data techniques were applied with the French school approach (multiple correspondence analysis followed by construction of clusters on factorial coordinates), achieving partition in three classes. Thereafter, each class was considered as a symbolic object and multivariant star graphs were drawn to show the different class profiles, making possible a satisfactory graphic visualization.

Processaram-se registros da pressão arterial sistólica (PAS), diastólica (PAD) e da freqüência cardíaca (FC) efetuados durante todo o dia em situação basal e as 6, 26 e 52 semanas de tratamento. Para isto se aplicaram técnicas multidimensionais de dados com o enfoque da escola francesa (análise de correspondências múltiples seguido da construção de clusters sobre coordenadas fatoriais), logrando uma partição em três classes. Consideraram-se em seguida cada classe como um objeto simbólico e se realizaram gráficos de estrelas multivariantes que puseram em evidência os diferentes perfis das classes, possibilitando uma satisfatória visualização gráfica.

Bloqueos regionales continuos en anestesiología pediátrica / Continuous regional blocks in pediatric anesthesia

La demanda por aumentar la eficiencia y disminuir la estadía hospitalaria ha llevado a los anestesiólogos a buscar técnicas que mejoren el bienestar del paciente tratando el dolor intra y post-operatorio, como también que permitan un alta precoz. Se describen en este artículo dos trabajos realizados en pacientes pediátricos de la Clínica Alemana basados en bloqueo continuo de nervios periféricos. El primero se relaciona con el bloqueo continuo de los nervios ilioinguinal e iliohipogástrico bajo anestesia general en los casos de pacientes fisurados que presentan una fístula vestíbulo-oral cuya cirugía consiste en colocar injerto de cresta ilíaca en la fístula. El segundo es un bloqueo de fascia ilíaca en pacientes con ruptura de ligamento cruzado anterior de rodilla en los que se realiza una plastía de ligamento cruzado anterior de rodilla con injerto semitendinoso o hueso-tendón-hueso. Este tipo de bloqueos continuos periféricos son fáciles de realizar y seguros para manejar el dolor intra y post-operatorio; no se han reportado complicaciones ni efectos colaterales ya que las dosis utilizadas están muy por debajo de los máximos niveles de anestésicos locales permitidos. Se sugiere considerar los bloqueos regionales periféricos como primera opción en el tratamiento del dolor post-operatorio.

The demand for increased efficiency and decreased hospital stay force the anesthesiologist to find new techniques for acute postoperative pain management which are increasingly recognized for their positive effect on the length of hospital stay, functional recovery and patient and parent satisfaction. In this article we described two studies related with continuous peripheral blocks at Clínica Alemana of Santiago Chile performed in pediatric patients. The first is an ilioinguinal and iliohypogastric continuous block that we performed in children under general anesthesia who has oral vestibular fistulae and it is repair with iliaca bone graft. The second one is a fascia iliac compartment continuous block in patients with ruptured of anterior cruciated ligament of the knee repaired with semitendinous ligament or bone tendinose bone. These techniques have been shown to be effective and safe in controlling postoperative pain, both at rest and during physical therapy. There are no reports about complications or side effects. The local anesthetic doses are under the maximum level permitted. We suggest to consider as an option the peripheral nerve blocks in the post operative pain management and treatment.

To evaluate the clearance of cytokines by the technique of continuos filtration of blood in patients suffering from severe intoxicated infected burn

71 patients with severe burns, who had had various organ dysfunction were divided randomly into 2 groups: one underwent continuous veno-venous hemofiltration (CVVH), and the other was control group. Results showed a significant decrease of plasma level of cytokine, including IL2, IL6, IL8 and TNF after CVVH (p<0.01). In addition, mortality rate of CVVH group accounted for 38.71%, considerably lower than those of the control group