Aprender e ensinar de modo circular e não totalitário: ensaios em etnoeducação com quilombolas na região amazônica / Learning and teaching in a circular and non-totalitarian way: essays in ethnoeducation with quilombolas in the Amazon region / Aprender y enseñar de forma circular y no totalitaria: ensayos en etnoeducación con quilombolas en la región amazónica

Pretendemos discutir a experiência em etnoeducação que construímos junto à escola Nossa Senhora da Aparecida, situada na comunidade quilombola Boa Vista do Cuminã, na região de Oriximiná (PA). Partimos do histórico de um grupo de extensão, pesquisa e intervenção em etnoeducação da Universidade Federal Fluminense, que ao longo de oito anos desenvolveu experiências de formação coletiva de múltiplos educadores. A etnoeducação se inspira na etnografia como metodologia de ativação de dispositivos comunitários e coletivos de ensinar e aprender com. Nesse processo, a transdisciplinaridade rompe posições hierárquicas e disciplinares dos espaços de ensinar e aprender na "escola", na vida comunitária, e impulsiona o protagonismo das "agências", individuais e coletivas, em jogo nessas ações de etnoeducação. Buscaremos, no final deste artigo, relatar uma experiência coletiva de ensino e aprendizagem na comunidade quilombola de Boa Vista Cuminã

We intend to discuss the experience in ethnoeducation, which we built with the Nossa Senhora da Apare-cida school, located in the quilombola community Boa Vista Cuminã, in the region of Oriximiná (PA). We started from the background of a group of extension, research and intervention in ethnoeducation at the Universidade Federal Fluminense, which, for eight years, developed experiences of collective formation of multiple educators. Ethnoeducation is inspired by ethnography as a methodology for activating community and collective devices for teaching and learning with. In this process, transdisciplinarity breaks hierarchi-cal and disciplinary positions of the spaces for teaching and learning in the "school", in community life, and boosts the protagonism of the "agencies", individual and collective, at play in these ethnoeducation actions. We will seek, at the end of this article, to report a collective teaching and learning experience in the quilombola community of Boa Vista Cuminã

Pretendemos discutir la experiencia en etnoeducación que construimos con la escuela Nossa Senhora da Aparecida, localizada en la comunidad quilombola Boa Vista Cuminã, en la región de Oriximiná (PA). Partimos de la historia de un grupo de extensión, investigación e intervención en etnoeducación de la Universidad Federal Fluminense, que a lo largo de ocho años desarrolló experiencias de formación colectiva de educadores múltiples. La etnoeducación se inspira en la etnografía como metodología para la activación de dispositivos comunitarios y colectivos de enseñanza y aprendizaje con. En ese proceso, la transdisciplinariedad rompe posiciones jerárquicas y disciplinares de los espacios de enseñanza y aprendizaje en la "escuela", en la vida comunitaria, y empuja el protagonismo de las "agencias", individuales y colectivas, en juego en esas acciones de etnoeducación. Intentaremos, al final de este artículo, relatar una experiencia colectiva de enseñanza y aprendizaje en la comunidad quilombola de Boa Vista Cuminã

Real-world outcomes and complications of different surgical approaches for significant submacular haemorrhages

Purpose: To evaluate the outcomes and complications after different surgical management of cases with significant sumacular hemorrhage (SMH) of size more than 4 disc diameter (DD). Methods: It was a retrospective interventional study. All consecutive 103 cases of significant SMHs were treated by vitrectomy and divided into three groups. In Group A (<4 weeks, confined to the macula or extending inferiorly, n = 62), vitrectomy, subretinal cocktail of tissue plasminogen activator (tPA), antivascular endothelial growth factor, and air with SF6 gas; in Group B (4–8 weeks, extending beyond macula, n = 31), subretinal tPA followed by SMH drainage either by retinotomy (Group B?1, n = 17) or by temporal 180?degree retinectomy (Group B?2, n = 14) with silicone oil (SO) tamponade; and in Group C (>8 weeks, extending beyond macula, n = 10), SMH removal with autologous retinal pigment epithelium (RPE)?Choroid patch graft transplantations with SO tamponade were performed. Parameters evaluated were best corrected visual acuity (BCVA), Optos, optical computerized tomography, and ultrasonography as required. Results: Significant visual improvement was seen from mean preoperative to mean postoperative BCVA in Group A (P < 0.001), Group B (P < 0.001), and Group C (P < 0.001). Postoperative complications were recurrent SMH (4.84% vs 12.90% vs 10%), vitreous hemorrhage (6.45%, GroupA), hyphema (4.84% vs 12.90% vs 10%), hypotony (nil vs 3.23% vs 20%), macular hole formation (6.45%, Group A), epiretinal membrane (16.13%, Group B), and retinal detachment (3.23%, Group A and 10%, Group C). Conclusion: Surgical approaches for significant submacular hemorrhage are visually awarding, though certain specific complications may arise

Preparation of colloidal gold immunochromatographic test strip for rapid detection of Pseudomonas aeruginosa / 中国生物制品学杂志

@#Objective To develop a colloidal gold immunochromatographic test strip for rapid and accurate detection of Pseudomonas aeruginosa(P.aeruginosa,Pa).Methods After bioinformatics analysis of Pa outer membrane protein OprF,the gene sequence with abundant antigenic determinants and high intraspecific homology was chemically synthesized,and then connected to pET-28a(+)vector to construct the expression vector pET-28a-OprF,which was transformed into E.coli BL21(DE3)and induced by IPTG. The recombinant OprF protein was purified by Ni Sepharose~(TM)6 Fast Flow and used to immunize two female BALB/c mice for 3～4 times by multi-point subcutaneous injection in the back at the first immunization and intraperitoneal injection at subsequent immunizations. The monoclonal antibodies were screened by animal cell fusion technique,and the colloidal gold immunochromatographic test strip for rapid detection of Pa was prepared by using monoclonal antibody and double antibody sandwich immunochromatography technique. The specificity,sensitivity and stability of the test strip were evaluated.Results Two monoclonal antibodies,Pa-1# and Pa-2#,were obtained with the titer of 1∶409 600,and both of them recognized OprF specifically. The prepared colloidal gold immunochromatographic test strip showed a sensitivity of 1. 0×10~6CFU/mL and had no cross reaction with 9 common respiratory pathogens with a good stability.Conclusion The prepared colloidal gold immunochromatographic test strip can detect Pa rapidly within 15 min,with high specificity and good stability.

Coparenting Intervention Programs: A Systematic Literature Review / Programas de intervención en coparentalidad: una revisión sistemática de la literatura / Programas de intervenção em coparentalidade: uma revisão sistemática da literatura / Coparenting Intervention Programs: A Systematic Literature Review

The coparenting relationship affects parents' and chil-dren's socioemotional well-being. Thus, we reviewed evidence in the scientific literature to describe the ob-jectives and organization of coparenting intervention programs, to examine the design of these studies and summarize evidence concerning the effectiveness of these programs. The following electronic databases were used: Bireme, Psycnet, Periódicoscapes, and IndexPsi Periódicos. The review was carried out in April 2020 with no restrictions involving the date of publication. The keywords used were "coparenting", combined with any of the following terms "training", "intervention", or "program", in Portuguese, English, and Spanish. Based on the study criteria 34 texts about 17 intervention programs were examined to gain in-formation about research design, program objectives and format, topics covered, intervention strategies, and evidence of program effectiveness. We observed that an experimental design was used in two-thirds of the studies with pretest, posttest, and follow-up evaluations. In many programs, parenting was also addressed. An array of psychoeducational intervention strategies was used to improve abilities such as emotional regula-tion, bidirectional communication, and joint decision-making. The programs were effective in helping parents to develop a more positive coparenting relationship (for example, by increasing support and reducing conflicts) and to improve their parenting (by reducing harsh pa-renting behaviors), with longitudinal studies indicating the stability of these effects. These findings indicate that coparenting can be improved and that working on the coparenting relationship is an important way of strengthening the socioemotional well-being of parents and their children.

La relación de coparentalidad afecta el bienestar socioemocional de padres e hijos. Dada su importancia, revisamos la evidencia en la literatura científica para describir los objetivos y la organización de los programas de intervención en coparentalidad que han sido evaluados, examinar el diseño de los estudios de evaluación y resumir la evidencia relativa a la eficacia de estos. Se utilizaron las bases de datos electrónicas Bireme, Psycnet, Periódicos capesy IndexPsi Periódicos. La revisión se realizó en abril del 2020, sin restricciones en la fecha de publicación. La palabra clave utilizada fue coparenting, combinada con cualquiera de los siguientes términos: training, intervention, o program. En portugués, inglés y español. Se identificaron 34 textos de 17 programas de intervención. Estos artículos fueron examinados para obtener información sobre el diseño de la investigación, los objetivos y el formato del programa, los temas tratados, las estrategias de in-tervención y la evidencia de la eficacia del programa. Observamos que en dos tercios de los estudios se utilizó un diseño experimental con evaluaciones previas, posteriores y de seguimiento. En muchos programas también se abordó la crianza de los hijos. Se utilizó una serie de estrategias de intervención psicoeducativas para mejorar habilidades como la regulación emocional, la comunicación bidireccional y la toma de decisiones conjunta. Los programas fueron eficaces para ayudar a los padres a desarrollar una relación de coparentalidad más positiva (por ejemplo, aumentando el apoyo y reduciendo los conflictos) y mejorar su crianza (por ejemplo, reduciendo las conductas de crianza duras), con estudios longitudinales que indican la estabilidad de dichos efectos. Estos resultados muestran que la coparentalidad puede mejorarse y que trabajar en esa relación es una forma de fortalecer el bienestar socioemocional de padres e hijos.

A relação coparental afeta o bem-estar socioemocional de pais e filhos. Dada a sua importância, revisamos as evidências na literatura científica para descrever os ob-jetivos e a organização dos programas de intervenção coparental que foram avaliados, examinamos o desenho dos estudos de avaliação e resumimos as evidências sobre sua eficácia. Foram utilizadas as bases de dados eletrônicas Bireme, Psycnet, Periódicos capes e Pe-riódicos IndexPsi. A revisão foi realizada em abril de 2020, sem restrições quanto à data de publicação. As palavras-chave utilizadas foram "coparenting", combi-nada com qualquer um dos seguintes termos: "training", "intervention" ou "program" em português, inglês e espanhol. Foram identificados 34 textos sobre 17 pro-gramas de intervenção. Esses artigos foram revisados para obter informações sobre o desenho da pesquisa, objetivos e formato do programa, tópicos abordados, estratégias de intervenção e evidências da eficácia do programa. Descobrimos que dois terços dos estudos usaram um desenho experimental com avaliações prévias, posteriores e de acompanhamento. A paren-talidade também foi abordada em muitos programas. Uma série de estratégias de intervenção psicoeducati-vas foram utilizadas para melhorar habilidades como a regulação emocional, comunicação bidirecional e tomada de decisão conjunta. Os programas foram efi-cazes em ajudar os pais a desenvolver uma relação de coparentalidade mais positiva (por exemplo, aumen-tando o apoio e reduzindo conflitos) e melhorar sua parentalidade (por exemplo, reduzindo comportamentos parentais severos), com estudos longitudinais indicando a estabilidade desses efeitos. Esses resultados indicam que a coparentalidade pode ser aprimorada e que tra-balhar a relação coparental é uma forma de fortalecer o bem-estar socioemocional de pais e filhos.

La opinión pública colombiana sobre el acuerdo de paz 2016-2020: punitivismo, desconfianza y ostracismo / Colombian public opinion on the 2016-2020 peace agreement: punitivism, distrust and ostracism / Opinião pública colombiana sobre o acordo de paz de 2016-2020: punitivismo, desconfiança e ostracismo

Después de varias décadas de conflicto armado en Colombia, el Gobierno colombiano y las Farc-EP firmaron, en 2016, el Acuerdo Final para la terminación del conflicto y la construcción de una paz estable y duradera. No obstante, este acuerdo no fue refrendado por la ciudadanía, en un plebiscito celebrado ese mismo año. En 2018, ganó las elecciones presidenciales un candidato que prometió cambiar las condiciones del Acuerdos Final y modificar uno de sus principales instrumentos: la Jurisdicción Especial para la Paz (JEP). En ese contexto esta investigación se pregunta: ¿cuál es la opinión de los colombianos sobre el Acuerdo Final y la JEP? La investigación indaga en las opiniones de los colombianos a través de un análisis estadístico comparativo de tres encuestas de opinión de 2016, 2018 y 2020. Los resultados detallan los cambios actitudinales ocurridos en esos años, como la disminución del rechazo frontal a los Acuerdos de Paz y el leve incremento de las posibilidades de reintegración de los excombatientes a la vida civil. También, expone algunas reticencias al cambio, como la desconfianza persistente, la reafirmación del rechazo al indulto de los excombatientes (punitivismo) y a su participación política (ostracismo).

After several decades of armed conflict in Colombia, the Colombian Government and the Farc-EP signed, in 2016, the Final Agreement for the termination of the conflict and the construction of a stable and lasting peace. However, this agreement was not endorsed by the citizenry, in a plebiscite held that same year. In 2018, the presidential elections were won by a candidate who promised to change the conditions of the Final Agreement and to modify one of its main instruments: the Special Jurisdiction for Peace (JEP). In this context, this research asks: what is the opinion of Colombians on the Final Agreement and the SJP? The research inquiries into the opinions of Colombians through a comparative statistical analysis of three opinion polls from 2016, 2018 and 2020. The results detail the attitudinal changes that occurred in those years, such as the decrease in the frontal rejection of the Peace Accords and the slight increase in the possibilities of reintegration of ex-combatants to civilian life. It also exposes some reluctance to change, such as persistent distrust, the reaffirmation of the rejection of pardoning ex-combatants (punitivism) and their political participation (ostracism).

Após várias décadas de conflito armado na Colômbia, o governo colombiano e as FARC-EP assinaram, em 2016, o Acordo Final para o fim do conflito e a construção de uma paz estável e duradoura. Entretanto, este acordo não foi endossado pelos cidadãos em um plebiscito realizado no mesmo ano. Em 2018, as eleições presidenciais foram ganhas por um candidato que prometeu mudar as condições do Acordo Final e modificar um de seus principais instrumentos: a Jurisdição Especial para a Paz (JEP). Neste contexto, esta pesquisa pergunta: qual é a opinião dos colombianos sobre o Acordo Final e o SJP? A pesquisa investiga as opiniões dos colombianos através de uma análise estatística comparativa de três pesquisas de opinião de 2016, 2018 e 2020. Os resultados detalham as mudanças de atitude que ocorreram nesses anos, tais como a diminuição da rejeição direta dos Acordos de Paz e o leve aumento das possibilidades de reintegração de ex-combatentes na vida civil. Também expõe alguma relutância em mudar, como a desconfiança persistente, a reafirmação da rejeição do perdão de ex-combatentes (punitivismo) e de sua participação política (ostracismo).

Optimization of expression yield in a stable cell line expressing a novel mutated chimeric tissue plasminogen activator (mt-PA)

Abstract The development of stable cell lines producing recombinant proteins is very time-consuming and laborious. One of the practical approaches successfully performed is Fluorescence-Activated Cell Sorting (FACS). A mutated chimeric tissue plasminogen activator (mt-PA) was developed by removing the first three domains of t-PA, insertion of GHRP sequence and mutation toward resistance to plasminogen activator inhibitor-1 (PAI-1). In the current study, a new stable CHO-DG44 cell line producing mt-PA was developed by two sequential clonal selections: FACS and clonal-selection by limiting dilution. Furthermore, the expression was more evaluated using two different expression media. Finally, the high-producing clones were selected based on the dot blot and amidolytic activity test. The transfection efficiency of CHO-DG44 cells was 38% as measured by flow cytometry on green fluorescent protein (GFP). After performing FACS on stable cell pools, the expression yield was increased to fifty-fold. In terms of growth profile, CD-DG44 showed higher viability and cell density results than ProCHO5 medium. The expression of mt-PA was significantly higher in CD-DG44 than in ProCHO5, 765 and 280 IU/mL, respectively. Our data indicated that selection of an appropriate expression medium played a critical role in the development of potent producing stable cells by FACS.

Corneal structure and endothelial morphological changes after uneventful phacoemulsification in type 2 diabetic and nondiabetic patients / Alterações da estrutura e endotélio da cornea após facoemulsificação sem complicações em pacientes diabéticos tipo 2 e não diabéticos

ABSTRACT Purpose: The aim of this study was to compare corneal structure and endothelial morphological changes after uneventful phacoemulsification cataract surgery between type 2 diabetic and nondiabetic patients and to determine the preoperative and intraoperative factors that may predict greater endothelial cell density loss. Methods: Forty-five diabetic pa­tients (45 eyes) and 43 controls (43 eyes) with age-related cataract were enrolled in this prospective observational study. Corneal (thickness and volume) and anterior segment parameters were measured by Scheimpflug tomography; endothelial cell density and morphology (coefficient of variation of cell size, hexagonal cells) were recorded using noncontact specular microscopy. Patients were evaluated preoperatively and at one and six months after surgery. Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographic, clinical, ocular, and intraoperative parameters and postoperative endothelial cell density changes at six months. Results: Significant postoperative endothelial cell loss occurred one month after surgery in both groups (p<0.001), which remained stable until month 6; there were no differences between patients with and without diabetes mellitus at any time point. The mean postoperative central corneal thickness at one and six months did not change significantly from the mean preoperative value in either group (p>0.05). Multivariate linear regression analysis showed that older age (p=0.042) and higher cataract grades (p=0.001) were significantly associated with greater endothelial cell density reduction at six-month follow-up. Conclusion: This study showed that older age and denser cataracts might be associated with greater endothelial cell density reduction after cataract surgery. Other factors, such as diabetes mellitus and preoperative anterior segment parameters, did not influence postoperative changes in endothelial cell density.

RESUMO Objetivo: Comparar a estrutura da córnea e as alterações mor­fológicas endoteliais após cirurgia de catarata por facoemulsificação sem intercorrências entre pacientes com diabetes mellitus tipo 2 e não diabéticos; e determinar quais fatores pré e intra-operatórios relacionados com a maior redução da densidade celular endotelial. Métodos: Quarenta e cinco diabéticos (45 olhos) e 43 (43 olhos) controlos com catarata relacionada à idade foram incluídos neste estudo observacional prospectivo. Os parâmetros da córnea (espessura e volume) e do segmento anterior foram medidos pela tomografia Scheimpflug; a densidade e morfologia celular endotelial (coeficiente de variação do tamanho das células, células hexagonais) foram registrados usando microscopia especular não contato. Os pacientes foram avaliados no pré-operatório, 1 e 6 meses após a cirurgia. Foi realizada uma análise de regressão linear uni e multivariada para avaliar a relação entre os parâmetros demográficos, clínicos, oculares e intra-operatórios com a redução da densidade celular endotelial aos 6 meses. Resultados: Nos dois grupos houve uma perda significativa de células endoteliais ao 1º mês pós-ope­ratório (p<0,001), que permaneceu estável até ao 6º mês; sem diferenças estatisticas entre os grupos diabetes mellitus e não diabetes mellitus em qualquer avaliação. A espessura média da córnea no pós-operatório central aos 1 e 6 meses não mudou significativamente em relação ao valor médio pré-operatório nos dois grupos (p>0.05). A análise de regressão multivariada linear mostrou que a idade avançada (p=0.042) e os graus mais elevados de catarata (p=0.001) foram significativamente associados à maior redução densidade celular endotelial aos 6 meses de seguimento. Conclusão: Este estudo mostrou que a idade avançada e as cataratas mais densas podem predispor a uma maior redução densidade celular endotelial após a cirurgia de catarata. Outros fatores, como diabetes mellitus e parâmetros pré-operatórios do segmento anterior, não influenciaram significativamente as alterações pós-operatórias da densidade celular endotelial.

Subfoveal choroidal thickness and retinal nerve fiber layer alterations in chronic heart failure patients / Espessura coroidal subfoveal e alterações da camada de fibras nervosas da retina em pacientes com insuficiência cardíaca crônica

ABSTRACT Purpose: To comparatively evaluate the subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness in patients with chronic heart failure relative to control subjects. Methods: A total of 72 chronic heart failure patients and 40 healthy control subjects were enrolled in this study. The patients were categorized into 2 groups: group 1: patients with 30-50% left ventricle ejection fraction and group 2: patients with the corresponding fraction value of <30%. The subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness were measured by spectral domain-optical coherence tomography. Results: The mean subfoveal choroidal thickness was 250.24 ± 68.34 µm in group 1 and 216.72 ± 71.24 µm in group 2, while it was 273.64 ± 77.68 µm in the control group. The differences among the 3 groups were statistically significant. The average peripapillary retinal nerve fiber layer thicknesses were 100.34 ± 8.24, 95.44 ± 6.67, and 102.34 ± 8.24 µm, respectively. No significant differences were noted in the peripapillary retinal nerve fiber layer thicknesses between group 1 and control group, but it was significantly lower in group 2. Conclusion: Our study thus revealed that the subfoveal choroidal thickness was lower in patients belonging to both the chronic heart failure groups in comparison to those in the control group. However, the alteration in the peripapillary retinal nerve fiber layer thickness was noted in only patients with <30% left ventricle ejection fraction. In the clinical practice, reductions in these values are correlated with decreased left ventricle ejection fraction, which may be important for the follow-up of chorioretinal diseases and the evaluation of glaucoma risks in patients with chronic heart failures.

RESUMO Objetivo: O objetivo do nosso estudo foi avaliar a espessura coroidal subfoveal e a camada peripapilar de fibras nervosas da retina em pacientes com insuficiência cardíaca crônica, em comparação com um grupo de controle. Métodos: Setenta e dois pacientes com insuficiência cardíaca crônica e 40 controles saudáveis foram inscritos. Os pacientes com insuficiência cardíaca crônica foram divididos em dois grupos, de acordo com a fração de ejeção do ventrículo esquerdo. Pacientes com fração de ejeção do ventrículo esquerdo de 30-50% foram incluídos no grupo 1, enquanto valores de fração de ejeção do ventrículo esquerdo inferiores a 30% foram incluídos no grupo 2. A espessura coroidal subfoveal e a espessura da camada peripapilar de fibras nervosas da retina foram medidas por tomografia de coerência óptica de domínio espectral. Resultados: A espessura média da coroide subfoveal foi de 250,24 ± 68,34 µm no grupo 1, 216,72 ± 71,24 µm no grupo 2 e 273,64 ± 77,68 µm no grupo controle. As diferenças entre os três grupos foram estatisticamente significativas. A espessura média da camada peripapilar de fibras nervosas da retina foi de 100,34 ± 8,24 µm, 95,44 ± 6,67 µm e 102,34 ± 8,24 µm, respectivamente. Não houve diferença significativa na espessura da camada peripapilar de fibras nervosas da retina entre o grupo 1 e o grupo controle, mas os valores foram significativamente menores no grupo 2. Conclusão: Nosso estudo mostrou que a espessura coroidal subfoveal foi menor em ambos os grupos de insuficiência cardíaca crônica, em comparação com controles saudáveis. Porém, a camada peripapilar de fibras nervosas da retina mostrou-se alterada apenas em pacientes com menos de 30% da fração de ejeção do ventrículo esquerdo. Na prática clínica, reduções nesses valores, correlacionadas com a diminuição da fração de ejeção do ventrículo esquerdo, podem ser importantes para o acompanhamento de doenças coriorretinianas e a avaliação dos riscos de glaucoma em pacientes com insuficiência cardíaca crônica.

Tiroidectomía y paratiroidectomía endoscópica transoral con abordaje vestibular(TOETVA TOEPVA): Experiencia inicial en el Hospital Universitario Austral / Transoral endoscopic thyroidectomy and parathyroidectomy vestibular approach (TOETVA TOEPVA): intial experience in Hospital Universitario Austral

RESUMEN Antecedentes: la cervicotomía de Kocher ha sido el abordaje clásico para la cirugía tiroidea y paratiroidea. El aumento en la preocupación por la cicatriz cervical ha generado un interés creciente por disminuir su tamaño o trasladarla a lugares menos visibles. Anuwong publica 60 casos de TOETVA/TOEPVA en 2016, con resultados óptimos. Objetivos: comunicar la experiencia con la tiroidectomía y paratiroidectomía transoral endoscópica con abordaje vestibular en el Hospital Universitario Austral. Material y métodos: análisis retrospetivo, sobre base prospectiva, de 18 procedimientos, entre mayo de 2019 y marzo de 2020. Se realizaron 2 paratiroidectomías, 13 lobectomías, 4 tiroidectomías totales, una con linfadenectomía central; una paciente presentó 2 patologías (adenoma paratiroideo y nódulo tiroideo). Citología según Bethesda: categoría II: 7; indeterminada: 1 y categoría VI: 9. Resultados: 18 pacientes femeninas. Mediana de edad: 41 años. Media del tamaño nodular: 30 mm. Volumen glandular medio: 24 mL. Conversión: 1 caso. Promedio de tiempo quirúrgico: lobectomía, 260 minutos; tiroidectomía total, 262 minutos. Histología definitiva: carcinoma papilar, 11; bocio nodular, 6; adenoma paratiroideo, 2. Complicaciones: equimosis leve, 12 pacientes; hipoparatiroidismo transitorio, 1 caso; paresia recurrencial transitoria, 1 caso; hiposensibilidad mentoniana transitoria, 1 caso. Dos casos de tiroidectomía total por cáncer: tiroglobulina a las 6 semanas < 0,1 μUI/mL. Conclusiones: 1) Es un abordaje seguro y ofrece resultados cosméticos excelentes. 2) Puede implementarse con equipamiento endoscópico convencional, con curva de aprendizaje corta y escasa morbilidad. 3) Alternativa para el tratamiento del carcinoma papilar de bajo riesgo. 4) Es prioritario garantizar la seguridad del paciente.

ABSTRACT Background: Kocher's cervicotomy has been the classic approach for thyroid and parathyroid surgery. The greater concern about neck scarring has generated an increasing interest in reducing scar size or leaving the scar in less visible places. In 2016 Anuwong published 60 cases of TOETVA/TOEPVA with optimal outcomes. Objectives: The aim of this study is to report the initial experience with transoral endoscopic thyroidectomy and parathyroidectomy vestibular approach in Hospital Universitario Austral. Material and methods: We conducted a retrospective analysis of 18 prospective procedures performed between May 2019 and March 2020. The procedures performed were 2 parathyroidectomies, 13 lobectomies, 4 total thyroidectomies, 1 with central lymph node dissection; one patient presented a parathyroid adenoma and a benign thyroid nodule. Cytology report according to the Bethesda system: category II in 7 cases, VI in 9 and indeterminate in 1. Results: 18 female patients. Median age: 41 years. Mean nodule size: 30 mm. Mean gland volume: 24 mL. Conversion. 1 case. Mean operative time: lobectomy, 260 minutes; total thyroidectomy, 262 minutes. Definite histology: papillary thyroid carcinoma,11; benign nodular goiter, 6; parathyroid adenoma, 2. Complications: mild ecchymosis, 12 patients; temporary hyperparathyroidism, 1 case; temporary recurrent laryngeal palsy, 1 case; temporary numbness of the mental region in 1 case. In the two cases undergoing total thyroidectomy due to cancer, thyroglobulin level 6 weeks after surgery was < 0.1 μIU/mL. Conclusions: 1) The transoral approach is a safe and feasible procedure that offers excellent cosmetic results. 2) It can be implemented using conventional endoscopic equipment, has a short learning curve and low morbidity rate. 3)It constitutes an alternative for the treatment of low-risk papillary thyroid carcinoma. 4) Patient's safety should be guaranteed.

Tratamiento y manejo fibrinolítico en síndrome de Nicolau: Caso clínico / Fibrinolytic treatment and management in Nicolau syndrome: Clinical case

RESUMEN Introducción: El síndrome de Nicolau (SN), conocido como embolia cutis medicamentosa o dermatitis livedoide es un acontecimiento adverso debido a la administración de inyecciones intramusculares, intraarteriales, subcutánea e incluso intraarticulares asociado a diversos fármacos1. Se desconoce toda la patogenia de este síndrome, pero se ha asociado a lesión vascular, trombosis arterial, espasmo reflejo de las arterias, oclusión vascular por microembolia e inflamación. Caso clínico: Paciente masculino de 32 años de edad, luego de inyección intramuscular de penicilina benzatínica presenta dolor intenso en área de inyección que se acompaña de lesiones eritematosas a nivel de abdomen, escroto y miembro inferior derecho además de presentar dolor, pareste-sia, palidez moteado eritematoso (livedo) y disminución de pulsos en dicha extremidad por lo que se diagnostica isquemia aguda (IA) que requirió tratamien-to fibrinolitico, entre otros fármacos. Conclusión: El síndrome de Nicolau es una condición iatrogénica que puede ser producida por inyección de múltiples medicamentos, puede presentar diferentes síntomas y signos como lesión neurológica, necrosis en área de irrigación de vasos afectados e incluso isquemia aguda. En este caso el manejo con rt-PA fue efectivo en tratar la isquemia. El conocimiento de este síndrome y sus complicaciones facilitaría su manejo2.Palabras claves: Síndrome Nicolau, bencilpenicilina, anticoagulante, rt-PA

ABSTRACT Introduction: Nicolau syndrome (NS), known as cutaneous embolism or livedoid dermatitis, is an adverse event due to the administration of intramuscular, intraarterial, subcutaneous and intraarticular injections associated with various drugs1. The entire pathogenesis of this syndrome is unknown, but it has been associated with vascular injury, arterial thrombosis, reflex spasm of the arteries, vascular occlusion due to microemboli, and inflammation. Clinical case: 32-year-old male. After an intramuscular injection of benzathine penicillin, the patient presented severe pain in the injection area accompanied by erythem-atous lesions at the level of the abdomen, scrotum, and right lower limb. In addition to that, the patient presented pain, paresthesia, and mottled paleness erythema (livedo). Moreover, the patient had a decreased pulse in the right limb, acute ischemia was diagnosed and required fibrinolitic treatment, among other drugs. Conclusion: Nicolau Syndrome, is an iatrogenic condition that is produced by injection of multiple drugs. It can produce different symptoms and signs from neurological injury, necrosis in the irrigation area of affected vessels and acute ischemia. rt-PA management in this case was effective in treating ischemia. It is essential to know about this syndrome and its complications. This would facilitate its management2.Keywords: Nicolau syndrome, benzylpenicillin, anticoagulant, rt-PA.

Clinical Observation of Bupi Qingfei Decoction in Treatment of Bronchiectasis Colonized by Pseudomonas aeruginosa / 中国实验方剂学杂志

Objective:To evaluate the clinical efficacy of Bupi Qingfei decoction in the treatment of bronchiectasis colonized by<italic> Pseudomonas aeruginosa</italic> （PA） （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）. Method:A total of 72 bronchiectasis patients colonized with PA （ lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome ） were randomly divided into the observation group （36 cases， two cases were lost to follow-up and three dropped out） and control group （36 cases， three cases were lost to follow-up and four dropped out）. There were 31 cases in the observation group and 29 cases in the control group completing the trial. Patients in the observation group were treated with Bupi Qingfei decoction orally，once in the morning and again in the evening， one bag every other day， and simulated azithromycin tablet at the dose of 0.5 g，once every other day， while those in the control group with azithromycin tablet at 0.5 g，once every other day， and simulated Bupi Qingfei decoction， once in the morning and again in the evening， one bag every other day. Patients in both groups received health education and postural expectoration. The treatment lasted for 24 weeks，followed by a 24-week follow-up. The frequency of acute exacerbation，quality of life （St. George's Respiratory Questionnaire） score，traditional Chinese medicine （TCM） syndrome score，lung function ［forced expiratory volume in one second percentage of predicted（FEV₁%pred） and FEV₁/forced vital capacity（FVC）］， and serum immunoglobulin （Ig）A，IgE，IgG，and IgM levels of the two groups were evaluated after treatment. Result:The frequencies of acute exacerbation after 24 weeks of treatment and during the 24-week follow-up in the observation group were lower than those in the control group （<italic>P</italic><0.05）. The total quality of life （St. George's Respiratory Questionnaire） score and symptom scores in the observation group after 24 weeks of treatment were significantly decreased as compared with those before treatment （<italic>P</italic><0.05）. There was no significant improvement in the quality of life in the control group either after 24 weeks of treatment or during the 24-week follow-up. The effective rate against TCM syndrome in the observation group was 64.52%（20/31） after 12 weeks of treatment，which was obviously higher than 31.03%（9/29） in the control group （<italic>χ</italic>²=6.726，<italic>P</italic><0.05）. After 24 weeks of treatment，the effective rate in the observation group was 83.87%， slightly higher than 68.97% in the control group. After 12 and 24 weeks of treatment，the scores of cough，expectoration，fatigue，anorexia，spontaneous sweating，abdominal distension， and loose stool in the observation group were better than those in the control group （<italic>P</italic><0.05）. There were no significant changes in lung function and serum immunoglobulin classes in the two groups. Conclusion:Bupi Qingfei decoction is effective in reducing the frequency of acute exacerbation， alleviating the symptoms， and improving the quality of life of bronchiectasis patients colonized by PA （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）.

Biosynthesis and metabolism regulation of terpenoids in Pogostemon cablin: a review / 中国中药杂志

The terpenoids in Pogostemon cablin have complex structures and abundant pharmacological effects. Patchouli alcohol(PA) and pogostone(PO) have a high medicinal value by virtue of anti-tumor, anti-inflammatory, antibacterial, antioxidant, and other biological activities. Due to the low content of terpenoid metabolites in P. cablin, the study of biosynthesis and metabolism regulation can provide a biosynthetic basis for obtaining high-content terpenoids. In this study, key enzyme genes in biosynthesis, transcription factors in metabolism regulation, spatio-temporal expression of terpene synthase were reviewed, aiming to provide a reference for the development, protection, and utilization of P. cablin resources.

A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support / Journal of Rural Medicine

Objective: Herein, we report a patient with acute cerebral infarction with a favorable prognosis after being managed by a general physician with support from the telestroke program.Patient and Methods: An 85-year-old man was transferred to a regional hospital due to sudden onset of dysarthria and left hemiparesis. As no neurosurgeons or neurologists were available in that hospital or area, the patient was examined by a general physician who diagnosed him with cardioembolic stroke on the left middle cerebral artery territory. The physician consulted a stroke specialist using the telestroke system; with the support from the telestroke program, the physician administered thrombolytic therapy 4 hours and 10 minutes after the onset of symptoms.Results: The patient’s National Institutes of Health Stroke Scale score improved from 9 to 3 and he was subsequently transferred to the stroke center. However, the occluded left middle cerebral artery had already re-canalized. His hemiparesis completely improved one week after the onset.Conclusion: A telemedicine system for general physicians is indispensable in areas without accessible stroke specialists as it provides access to a standard of care for hyper-acute stroke patient assessment and management, and helps improve neuroprognosis.

Emotion regulation and healthy behaviors of the body energy balance in adults: A review of evidence / Emotion regulation and healthy behaviors of the body energy balance in adults: A review of evidence

Abstract There is no document that analyzes the state of the art of scientific research published between 2013 and 2018 in relation to possible interdependence links between emotional regulation [ER] and healthy behaviors associated with Body Energy Balance [BEB] (physical activity, balanced diet and sleep hygiene). To achieve this purpose, an exploratory systematic review was conducted, whose search criteria were "emotion regulation", "emotion dysregulation" connected with the Boolean operator "AND" to the keywords "sleep hygiene", "eating behavior" and "physical activity". Terms like "alexithymia", "depression", "stress", "negative emotions", and "rumination" were omitted. The methodological quality of the evidence was assessed with a patented rubric. After applying the analysis criteria, 35 articles were obtained, reporting the existence of reciprocal associations and interactions between ER and at least one of the three behaviors associated with BEB were analyzed. It is concluded that, despite the importance of these behaviors in the vital maintenance of people and the clear impact that emotional regulation has on them, their research has not been sufficient, and more empirical studies in this regard in Latin America are needed.

Resumen No existe en la actualidad un documento que analice el estado del conocimiento de las investigaciones científicas publicadas en los últimos años con respecto a los posibles vínculos de interdependencia entre la regulación emocional (RE) y las conductas asociadas al balance energético corporal (BEC) -actividad física, alimentación balanceada e higiene del sueño-. Por tanto, para lograr dicho propósito, en el presente estudio se realizó una revisión sistemática exploratoria, cuyos criterios de búsqueda fueron los términos "emotion regulation" y "emotion dysregulation", conectados con el operador booleano "AND" a las palabras clave "sleep hygiene", "eating behavior" y "physical activity" -términos como "alexithymia", "depression", "stress", "negative emotions", y "rumination" fueron omitidos-; donde se valoró la calidad metodológica de la evidencia de los artículos a partir una rúbrica patentada. Tras aplicar los criterios de inclusión establecidos, se obtuvo un total de 35 artículos que reportaban la existencia de asociaciones e interacciones recíprocas entre la RE y al menos una de las tres conductas asociadas al BEC. Como resultado, se puede afirmar que, a pesar de la importancia de dichas conductas en el mantenimiento vital de las personas y el claro impacto que tiene la regulación emocional sobre ellas, su estudio no ha sido suficiente, y por tanto se necesitan más investigaciones empíricas en el contexto latinoamericano.

Combination Of Momordica Charantia And Phyllanthus Amarus For Hepatoprotective Activity In Ethanol And Anti-Tubercular Drugs Induced Hepatotoxicity In Rats

Objective: To evaluate the synergistic protective effect of Momordica charantia and Phyllanthus amarus combination (MC+PA) of doses 200 and 400 mg/kg on the liver in different experimental models of hepatotoxicity. Methods: The hepatoprotective activity was evaluated in ethanol and anti-tubercular drugs (isoniazid-INH, rifampicin-RIF) induced hepatotoxicity models. Hepatotoxicity in both models was induced to all groups except the normal control. Intoxicated rats were treated with silymarin and various doses of MC+PA for 8 d in ethanol-induced and 21 d in INH+RIF induced hepatotoxicity models. At the completion of study, the biochemical markers and the anti-oxidant status (SOD and MDA) were measured and also the histopathological evaluation of the liver tissue was carried out. Results: Combination therapy remarkably reduced the elevated profile of the biochemical markers and thereby improved the anti-oxidant status, thus exhibiting the synergistic hepatoprotective effect when compared with the positive control group (p<0.001). Histopathological evaluation demonstrated that MC+PA decreased the liver damage significantly in comparison with the positive group. Conclusion: The current work suggests that the combined extract showed synergistic effects on ethanol and anti-tubercular drugs induced hepatotoxicity models by significantly decreasing the liver damage.

Effectiveness of Manual Physical Therapy and NSAIDs as a Combination Therapy in Arthritis Patient-A Case Series

Among various types of arthritis Osteoarthritis (OA), Psoriatic arthritis (PA) and Gouty arthritis (GA) are the major ones which have been studied and cause hindrance in movements in many patients. Here we have discussed the treatment modality, a combination of manual therapy and NSAIDs (Ibuprofen) for relieving the symptoms of arthritis. A total of six patients were included consisting of osteoarthritis, psoriatic arthritis and gouty arthritis who presented at the medical office of Dr. Barengolts (MD in USA) and Aybek Izzatov (MD in Uzbekistan) Tyan Anmo Massage School. The study was conducted from October 2019 to March 2020. The treatment consisted of 30 sessions performed for half a year, one week per month (5 days in a month). Significant improvement in symptoms was seen as after 6 months we saw there was reduction in morning stiffness and improved range of motion. The pain score shifted from 5-6 to 2-3 on VAS pain scale. The results signify that the combination therapy wherein manual therapy and NSAIDs worked in an effective way to reduce the level of severity of pain and other associated symptoms.

Conocimientos, Actitudes y prácticas de prevención de riesgo del cáncer bucal en población mayor de 15 años. Panamá. / [Knowledge, attitudes and practices of prevention of oral cancer risk in popul oral cancer risk in population over 15 years old. Panama.

Introducción: El Cáncer Bucal es una enfermedad de importancia en Salud Pública. En Panamá, se desconoce la incidencia y prevalencia de la enfermedad y no se dispone de información por tipo de patología, lesión, localización, ni estudios de conocimientos, ac­ titudes y prácticas, relacionados a los factores de riesgo. Objetivo General: analizar los conocimientos, actitudes y prácticas de prevención de Cáncer Bucal en la población mayor de 15 años. Materiales y Método: estudio descriptivo transversal, realizado en las Regiones Sanitarias de San Miguelito, Metropolitana y Panamá Oeste. Se realizó un muestreo por conveniencia en 42 instalaciones de salud del primer nivel de atención, a la población que acudió al servicio odontológico durante cuatro meses. Se aplicó una encuesta de Conocimiento, Actitudes y Prácticas de prevención de factores de riesgo al cáncer bucal, considerando variables de estilo de vida. Para el análisis estadístico, se utilizaron los programas Epi Info versión 7.2 y XLSTAT 2019 y presentados los datos en medidas paramétricas y no paramétricas. Resultados: se encuestó un total de 3,832 personas mayores de 15 años. La mayor proporción fueron mujeres en edades de 25 y 34 años. En relación al conocimiento, el 81% desconoce los factores de riesgo de cáncer bucal y según la actitud, el 63% no asiste al control odontológico periódicamente. Las prácticas reflejaron hábitos relaciona­ dos al consumo de tabaco y alcohol. Conclusión: La población mayor de 15 años del estudio, desconoce los factores de riesgo del cáncer bucal y manifiesta limitada actitud de práctica preventiva.

Introduction: Oral Cancer is an importance disease in Public Health. In Panama, the in­ cidence and prevalence of the disease is unknown and there is no information available by type of pathology, injury, location, or studies of knowledge, attitudes and practices re­ lated to risk factors. General Objective: to analyze the knowledge, attitudes and practi­ ces of prevention of Oral Cancer in the population over 15 years old. Materials and Methods: cross­sectional descriptive study, carried out in San Miguelito, Metropolitan and Panamá Oeste Health Regions. Sampling was carried out for convenience in 42 health facilities of the first level of health care, to the population that attended the dental service during four months. A survey of Knowledge, Attitudes and Practices of preven­ tion of risk factors to oral cancer was applied, considering Lifestyle variables. For the statistical analysis, the Epi Info version 7.2 and XLSTAT 2019 programs were used and the data presented in parametric and non­parametric measurements. Results: a total of 3,832 people over 15 years of age were surveyed. The highest propor­ tions were women between the ages of 25 and 34. In relation to knowledge, 81% do not know the risk factors for oral cancer and according to the attitude, 63%, do not attend pe­ riodically to a dental control. The practices reflected habits related to consumption of to­ bacco and alcohol. Conclusion: The population over 15 years old of the study ignores the risk factors of oral cancer and manifests a limited attitude of preventive practice.

Condições de saúde e características do trabalho de enfermeiros de um hospital universitário / Health conditions and Nurses' work characteristics at a university hospital

Objetivo: analisar o perfil sociodemográfico, as condições de saúde e as características do trabalho de enfermeiros. Métodos: estudo transversal, realizado com 152 enfermeiros de um hospital universitário. Utilizou-se de instrumento estruturado, o qual foi analisado por estatística descritiva. Resultados: os enfermeiros consideraram a saúde como boa (50,7%), realizavam atividade física (53,3%), não fumavam (92,8%), não consumiam álcool (56,6%), apresentavam algum problema de saúde (63,2%) e utilizam medicamentos diariamente (54,6%). Observou-se maior quantitativo de profissionais do ambulatório (17,8%) e clínica médica (15,8%), que atuavam no hospital estudado por até cinco anos (61,2%), celetistas (74,3%), sem outro vínculo empregatício (54,6%), do turno diurno (56,6%), com escala de seis horas (36,2%), que referiram ausência do trabalho por até cinco dias (38,2%), devido a problemas de saúde (41,4%). Conclusão: percebeu-se presença de processos de adoecimento entre os profissionais, os quais podem interferir na qualidade e segurança do cuidado prestado

Objective: to analyze the sociodemographic profile, health conditions, and nurses' work characteristics. Methods: a cross-sectional study conducted with 152 nurses from a uni-versity hospital. We used a structured instrument analyzed using descriptive statistics. Results: nurses considered their health good (50.7%), performed physical activity (53.3%), did not smoke (92.8%), did not consume alcohol (56.6%), had some health problems (63.2%) and used medication daily (54.6%). There was a higher number of professionals working in the outpatient clinic (17.8%) and emergency medicine (15.8%), who worked in the studied hospital for up to five years (61.2%), were employees subject to the Con-solidation of Labor Laws (74.3%), without another employ-ment relationship (54.6%), day shift (56.6%), had a six-hour schedule (36.2%), reported absence from work for up to five days (38.2%), due to health problems (41.4%). Conclusion: we noticed the presence of illness processes among profes-sionals, which can interfere in the quality and safety of care

Construction of an oral squamous cell carcinoma cell line for stable PA28γ overexpression / 华西口腔医学杂志

OBJECTIVE@#To construct a PA28γ overexpression cell line and determine its effects after infecting an oral squa-mous cell carcinoma (OSCC) cell line.@*METHODS@#The PA28γ gene was cloned into the pLOV.CMV.cherry.2A.EF1a.PuroR lentiviral vector by polymerase chain reaction (PCR), and PCR and DNA sequencing alignment analysis were used for identification. Then, 293T cells were used to package viral diseases. Infected OSCC cells were used to construct a cell line with stable PA28γ overexpression. Finally, the level of PA28γ expression in the OSCC cell line was detected through Western blot.@*RESULTS@#The successful construction of PA28γ recombinant lentiviral vectors was confirmed by DNA sequencing. The results of immunofluorescence showed that the PA28γ overexpression lentivirus successfully infected the OSCC cells and showed cherry red fluorescence. The results of Western blot demonstrated that the constructed cells with stable PA28γ overexpression significantly increased the expression of PA28γ.@*CONCLUSIONS@#The PA28γ overexpression lentiviral vector can significantly increase its protein expression in OSCC cells. We provide a stable OSCC cell line for further study on the effect of PA28γ in OSCC.

Ultrastructural changes detected using swept-source optical coherence tomography in severe vitreopapillary traction: a case report / Alterações ultraestruturais detectadas pela tomografia de coerência óptica de fonte de varredura em tração vitreopapilar grave: relato de caso

ABSTRACT Vitreopapillary traction is an uncommon condition characterized by strong adhesion and the traction of the posterior hyaloid onto the optic disc and peripapillary retina, leading to optic disc elevation and visual loss. An 85-year-old man presented with a 6-month history of slow, progressive visual loss in the left eye along with optic disc edema. Swept-source optical coherence tomography B-scans revealed circumpapillary anterior-posterior persistent traction of dense vitreous strands onto the optic disc. Visual field examination demonstrated mild, generalized, diffuse sensitivity loss and blind-spot enlargement. A 25-gauge posterior vitrectomy was performed with posterior hyaloid separation from the optic disc, resulting in significant anatomical and visual improvement. In conclusion, swept-source optical coherence tomography aids in understanding the mechanism underlying visual loss in vitreopapillary traction. Moreover, posterior vitrectomy can effectively promote anatomical and visual improvements in these cases.

RESUMO A tração vitreopapilar é uma condição incomum caracterizada por forte adesão e tração da hialoide posterior no disco óptico e retina peripapilar, levando à elevação do disco óptico e à perda visual. Um homem de 85 anos apresentou uma história de 6 meses de perda visual lenta e progressiva no olho esquerdo, juntamente com edema do disco óptico. A tomografia de coerência óptica por fonte de varredura revelou tração persistente ântero-posterior peripapilar com traves vítreas densas sobre o disco óptico. Exame de campo visual demonstrou perda de sensibilidade difusa, generalizada, leve e aumento do ponto cego. Uma vitrectomia posterior de calibre 25 foi realizada com separação hialóide posterior do disco óptico, resultando em melhora anatômica e visual significativa. Em conclusão, a tomografia de coerência óptica por fonte de varredura auxilia na compreensão do mecanismo subjacente à perda visual na síndrome de tração vitreopapilar. Além disso, a vitrectomia posterior pode efetivamente promover melhorias visuais e anatômicas nesses casos.