Influence of Congenital Heart Defect Types over Cardiopulmonary Bypass, Aortic Cross-Clamping, and Intensive Care Unit Length of Stay and Their Association with Genetic Factors

Aim: Surgical correction of congenital heart defects (CHD) often requires interruption of blood flow through cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC), for which duration(s) are considered to be prognostic factors, along with intensive care unit (ICU) length of stay (ICULOS). The aim of this study was to evaluate these surgical prognostic factors in pediatric patients with different types of CHD regarding their type of lesion and associated genetic factors. Study Design: Cross-sectional cohort study with 307 pediatric patients. Place and Duration of Study: Pediatric Intensive Care Unit (ICU) of Hospital da Criança Santo Antônio, in Porto Alegre/RS, Brazil, from 2006-2009 (3 years) Methodology: After inclusion criteria, we studied 266 pediatric patients admitted for the first time in a reference cardiac pediatric ICU from Southern Brazil following cardiac surgery. Intraoperative prognostic factors such as duration of CPB, ACC and ICULOS, in addition to dysmorphological and cytogenetic examinations were compiled and analyzed. P-values of <0.05 were considered significant. Results: CPB time was associated to four outflow tract defects (Tetralogy of Fallot [ToF], transposition of the great arteries [TGA], double outlet right ventricle, and truncus arteriosus [TA]), atrioventricular septal defect, and hypoplastic left heart syndrome (HLHS) (P < 0.001). ACC duration was associated with three outflow tract defects (ToF, TGA, and TA) and HLHS (P < 0.001). Moreover, CPB and ACC times showed an association with cyanotic and complex heart defects, as well as prolonged ICULOS (P < 0.001). There was no relationship between these prognostic factors and syndromic aspects or cytogenetic findings. Conclusions: CHD type has an impact over CPB and ACC duration and ICULOS, whereas genetic factors are not associated with those prognostic factors.

Attitude of the Staff Nurses toward COVID Care and Work Challenges Faced by Them

Background: At the beginning of pandemic, many of the nurses were scared of contracting COVID infection by themselves. The work of nurses during the pandemic was highly appreciated by the society though they worked with severe challenges. Hence, it was utmost necessary to explore the attitude of the nurses toward COVID care and what challenges they faced during caring for the COVID patients. Objectives: The main objectives of the study were to assess the attitude of the nurses toward working in COVID units, to identify the challenges faced by the nurses, and to find out the relationship between the nurses attitude and challenges. Methods: The study was carried out adopting descriptive survey design with 190 conveniently selected staff nurses working in the selected COVID care units of Kolkata and Bankura. Two self‑developed rating scales were administered using self‑reporting method to measure the attitude and challenges of the nurses. Results: All the staff nurses expressed their favorable (positive) attitude. Maximum (64.21%) of the staff nurses had a high level of challenges. A very weak positive correlation found between attitude of the staff nurses toward COVID care and challenges they faced (ρ = 0.197, P = 0.006). Computation of Chi‑square test revealed that neither attitude nor challenges was influenced by any of the personal characteristics of the nurses. Conclusion: In spite of working with a high level of challenges, the majority of the nurses demonstrated favorable attitude toward taking care of COVID patients.

Negative affect symptoms, anxiety sensitivity, and vasomotor symptoms during perimenopause

Objective: Vasomotor symptoms affect 60-80% of women during the menopausal transition. Anxiety, depression, and anxiety sensitivity can have an important role in the distressful experience of vasomotor symptoms. Our aim was to evaluate the prevalence and association of vasomotor and negative affect symptoms. Methods: A cross-sectional study was conducted with 89 perimenopausal women aged 45-55 years. Broad psychiatric and clinical evaluations were carried out. The primary outcome was the vasomotor symptom problem rating and the main study factor was anxiety sensitivity. Linear regression analyses were conducted to examine the associations between the study factors and the primary outcome, and a multiple regression model was created to assess which variables were independently associated with vasomotor symptom problem rating. Results: The prevalence of anxiety, depression, and vasomotor symptoms were 58, 62, and 73%, respectively. Negative affect symptoms were positively associated with vasomotor symptom problem rating. The association of anxiety sensitivity and vasomotor symptom problem rating remained significant after controlling for perimenopausal stage, thyrotropin, follicle-stimulating hormone levels, and psychotropic medication use (β = 0.314, p = 0.002). Conclusion: A better understanding of the experience of vasomotor symptoms is needed, especially the role of negative affect symptoms and anxiety sensitivity. New strategies focusing on related thoughts and behaviors could improve the quality of life of perimenopausal women.

Long-term obesity is associated with depression and neuroinflammation

ABSTRACT Objective: Obesity is characterized by a state of chronic, low-intensity systemic inflammation frequently associated with insulin resistance and dyslipidemia. Materials and methods: Given that chronic inflammation has been implicated in the pathogenesis of mood disorders, we investigated if chronic obesity that was initiated early in life - lasting through adulthood - could be more harmful to memory impairment and mood fluctuations such as depression. Results: Here we show that pre-pubertal male rats (30 days old) treated with a high-fat diet (40%) for 8-months gained ~50% more weight when compared to controls, exhibited depression and anxiety-like behaviors but no memory impairment. The prefrontal cortex of the obese rats exhibited an increase in the expression of genes related to inflammatory response, such as NFKb, MMP9, CCl2, PPARb, and PPARg. There were no alterations in genes known to be related to depression. Conclusion: Long-lasting obesity with onset in prepuberal age led to depression and neuroinflammation but not to memory impairment.

Dimensional stability of alginate molds scanned at different storage times / Estabilidade dimensional de moldes de alginato digitalizados em diferentes tempos de armazenamento

ABSTRACT The aim of this study was to evaluate the precision and accuracy of molds made with four commercial brands of alginate scanned at different times using digital model analysis. Eighty molds of a standard Typodont were made using 4 types of alginate (CCC: Cavex Color Change; IA: Identic Alginate; HY5: Hydrogum 5 and JP: Jeltrate Plus). The molds were scanned at four times: immediately (T1), 24h (T2), 72h (T3) and 120h (T4) after molding. Measurements were taken in three dimensions: anteroposterior, transverse and vertical. Significant differences in dimensional changes were noted between the materials over time (p <0.05). Anteroposterior dimensional variation was noted between times, especially for IA and JP. For transverse and vertical variables, a difference was found between the groups, especially at 24 h, 72 h and 120 h. CCC presented significant dimensional shrinkage only at T120 (transverse). IA and JP presented larger dimensional distortions in the vertical measurements. The molding materials used were not dimensionally stable when evaluated after 120 hours of molding. However, such evidence suggests that alginates with longer storage time, such as Cavex Color Change, are more accurate than conventional alginates.

RESUMO O objetivo do presente estudo foi avaliar a precisao e acurácia por meio de análise de modelos digitais de moldes digitalizados obtidos com quatro marcas comerciais de alginato em diferentes tempos. Oitenta moldes de um Typodont padrao foram obtidos utilizando 4 tipos de alginato (CCC: Cavex Color Change; IA: Identic Alginate; HY5: Hydrogum 5 e JP: Jeltrate Plus). Os moldes foram escaneados em quatro tempos: mediatamente (T1), 24h (T2), 72h (T3) e 120h (T4) após a moldagem. As medidas foram feitas em très dimensoes: ântero-posterior, transversal e vertical. Diferenças significativas nas mudanças dimensionais foram observadas entre os materiais ao longo do tempo (p <0,05). Variação dimensional ântero-posterior foi observada entre os tempos, principalmente para IA e JP. Para as variáveis transversal e vertical houve diferenga entre os grupos, principalmente em 24h, 72h e 120h. CCC apresentou contração dimensional significativa apenas em T120 (transversal). IA e JP apresentaram maiores distorções dimensionais na vertical. Os materiais de moldagem utilizados nao foram dimensionalmente estáveis quando avaliados após 120 horas de moldagem. No entanto, tais evidencias sugerem que os alginatos com maior tempo de armazenamento, como Cavex Color Change, sao mais precisos do que os alginatos convencionais.

Beyond ventilatory support: challenges in general practice and in the treatment of critically Ill children and adolescents with SARS-CoV-2 infection

SUMMARY Severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2 infection) is a new challenge for all countries, and children are predisposed to acquire this disease. Some studies have demonstrated more severe diseases in adults, but critically ill pediatric patients have been described in all ages. Pulmonary involvement is the major feature, and ventilatory support is common in critical cases. Nevertheless, other very important therapeutic approaches must be considered. In this article, we reviewed extensively all recent medical literature to point out the main clinical attitudes to support these pediatric patients during their period in respiratory support. Radiologic findings, fluid therapy, hemodynamic support, use of inotropic/vasopressors, nutritional therapy, antiviral therapy, corticosteroids, antithrombotic therapy, and immunoglobulins are analyzed to guide all professionals during hospitalization. We emphasize the importance of a multi-professional approach for adequate recovery.

RESUMO A síndrome respiratória aguda grave (SRAG) pelo novo coronavirus (SARS-CoV-2) é um novo desafio para todos os países e crianças estão predispostas a adquirir a doença. Alguns estudos demonstraram quadros mais graves em adultos, mas crianças criticamente doentes foram descritas em todas as idades. O envolvimento pulmonar é a principal característica e a necessidade de suporte ventilatório é comum nos casos mais graves. Entretanto, outras abordagens terapêuticas importantes devem ser consideradas. Nesse artigo revisamos extensamente a literature médica até o momento a fim de citar os principais recursos terapêuticos para o manejo dos pacientes pediátricos durante o período de suporte ventilatório. Achados radiológicos, terapia fluídica, terapia antiviral, o uso de corticosteroides, terapia antitrombótica e o uso de imunoglobulinas foram analisados a fim de guiar os profissionais durante o período de hospitalização desses pacientes. Nós reforçamos a importância de uma abordagem multiprofissional para recuperação adequada.

Comparative cytogenetic survey of the giant bonytongue Arapaima fish (Osteoglossiformes: Arapaimidae), across different Amazonian and Tocantins/Araguaia River basins

The South American giant fishes of the genus Arapaima, commonly known as pirarucu, are one of the most iconic among Osteoglossiformes. Previously cytogenetic studies have identified their karyotype characteristics; however, characterization of cytotaxonomic differentiation across their distribution range remains unknown. In this study, we compared chromosomal characteristics using conventional and molecular cytogenetic protocols in pirarucu populations from the Amazon and Tocantins-Araguaia river basins to verify if there is differentiation among representatives of this genus. Our data revealed that individuals from all populations present the same diploid chromosome number 2n=56 and karyotype composed of 14 pairs of meta- to submetacentric and 14 pairs of subtelo- to acrocentric chromosomes. The minor and major rDNA sites are in separate chromosomal pairs, in which major rDNA sites corresponds to large heterochromatic blocks. Comparative genomic hybridizations (CGH) showed that the genome of these populations shared a great portion of repetitive elements, due to a lack of substantial specific signals. Our comparative cytogenetic data analysis of pirarucu suggested that, although significant genetic differences occur among populations, their general karyotype patterns remain conserved.(AU)

Os peixes gigantes da América do Sul do gêneroArapaima, comumente conhecidos como pirarucus, são um dos mais icônicos de Osteoglossiformes. Estudos citogenéticos prévios identificaram suas características cariotípicas, entretanto a caracterização da diferenciação citotaxonômica através de suas distribuições geográficas ainda são desconhecidas. Nesse estudo, nós comparamos características cromossômicas utilizando técnicas de citogenética clássica e molecular em populações das bacias dos rios Amazonas e Tocantins-Araguaia, a fim de verificar se há alguma diferenciação entre representantes desse gênero. Nossos dados revelaram que indivíduos de todas as populações apresentam número diploide de 2n=56 cromossomos e que seus cariótipos são compostos de 14 pares de cromossomos meta- e submetacêntricos e 14 pares de subtelo- e acrocêntricos. Os sítios maiores e menores de rDNA estão localizados em pares cromossômicos separados, onde os sítios maiores de rDNA correspondem a grandes blocos heterocromáticos. Hibridizações genômicas comparativas (CGH) mostraram que o genoma dos espécimes dessas populações é amplamente compartilhado, devido à falta de sinais substanciais específicos. Nossos dados de citogenética comparativa do pirarucu sugerem que embora diferenças genéticas significativas ocorram entre populações, os padrões cariotípicos gerais se mantêm conservados.(AU)

Relação tempo de tela e aptidão cardiorrespiratória: associação com pressão arterial alterada em escolares / Relation between screen time and cardiorespiratory fitness: association with altered blood pressure in schoolchildren

Objetiva-se verificar se a relação tempo de tela (TT) e aptidão cardiorrespiratória (APCR) está associada com as alterações na pressão arterial (PA) em crianças e adolescentes. Trata-se de um estudo transversal com 2166 escolares, de ambos os sexos, com idades entre 6 e 17 anos. Foi aplicado um questionário com questões referentes ao estilo de vida, para verificação do TT (computador, vídeo game e TV), que foi computado em horas e classificado como elevado TT (≥ 2 horas diárias) e baixo TT (< 2 horas diárias). Para avaliação da PA, foi considerada alterada nos casos limítrofes e hipertensão, para pressão arterial sistólica (PAS) e diastólica (PAD). A APCR foi avaliada por meio do teste de corrida/caminhada de 6 minutos. Para a análise dos dados foi utilizada a estatística descritiva, por meio da frequência e percentual, para caracterizar os sujeitos, sendo aplicada a regressão de Poisson para obtenção dos valores de razão de prevalência (RP) e intervalos de confiança (IC), na relação da variável preditora (relação TT/APCR) com o desfecho (PA alterada). Como resultados encontrados, observou-se que 24,8% dos escolares apresentam elevado TT e baixos níveis de APCR. Em relação à PA, 18,7% dos indivíduos estiveram com a PAS alterada e 15,4% com PAD alterada. A associação entre PA alterada e a relação TT/APCR somente foi evidenciada para PAS entre as meninas. Nesse sentido, observou-se que a alteração na PAS é mais prevalente entre os escolares com baixo TT/inapto (RP: 1,07; p=0,008) e com elevado TT/inapto (RP: 1,06; p=0,029). Conclui-se que as meninas com baixos níveis de APCR, independente do TT, apresentam maior prevalência de PAS alterada....(AU)

This study aims to verify if the relation of screen time (ST) and cardiorespiratory fitness (CRF) is associated with the presence of alteration in blood pressure (BP) in children and adolescents. This is a cross-sectional study with 2166 students, aged 6 to 17 years. A questionnaire with questions related to lifestyle was used to verify the ST (computer, video game and TV), which was computed in hours and classified as high ST (≥ 2 hours daily) and low ST (<2 hours daily). For BP evaluation, borderline cases and hypertension were considered as altered BP, for systolic (SBP) and diastolic (DBP) pressure. CRF was assessed by the 6-minute walk/run test. For data analysis, descriptive statistics were used, by means of frequency and percentage, to characterize the subjects, and Poisson regression was used to obtain the prevalence ratio (PR) and confidence intervals (CI) values, in relation to the predictor variable ST/CRF) with the outcome (PA altered). As results, we observed that 24.8% of the students present high ST and low levels of CRF. In relation to BP, 18.7% and 15.4% of subjects had altered SBP and DBP, respectively. The association between altered BP and the ST/CRF ratio was only evidenced for SBP among girls. In this sense, it was observed that the change in SBP is more prevalent among schoolchildren with low ST/inapt (PR: 1.07, p = 0.008) and with high ST/inapt (PR: 1.06, p = 0.029). It is concluded that girls with low CRF levels, regardless of ST, present a higher prevalence of altered SBP....(AU)

Associação da fadiga com capacidade do exercício em pacientes hepatopatas crônicos candidatos a transplante hepático / Association between fatigue and exercise capacity in patients with chronic liver disease awaiting liver transplantation

ABSTRACT BACKGROUND: Fatigue is highly prevalent in end stage liver disease, the studies about its association with exercise capacity in cirrhotic patients before liver are scarse. OBJECTIVE: In this study, we evaluated fatigue in 95 in end stage liver disease patients awaiting transplantation, compared to healthy volunteers, and tested the association between exercise capacity and fatigue. METHODS: Cross-sectional study of patients with chronic liver disease treated at a referral center in Fortaleza, Brazil. Fatigue was quantified with the Fatigue Severity Scale. The patients were submitted to the 6-min walk test, the 6-min step test, the Hospital Anxiety and Depression Scale, C-reative protein measurement and hematocrit count, measurement of dyspnea among other tests. Fatigue data were obtained from healthy individuals for comparison with patients. RESULTS: The mean age of patients was 45.9±12.3 years, and 53.7% were male. Fatigue, anxiety and depression levels were higher among end stage liver disease patients than among controls. A negative correlation was observed between 6 min step test and Fatigue Severity Scale score (r= -0.2; P=0.02) and between hematocrit count and Fatigue Severity Scale score (r= -0.24; P=0.002). Dyspnea on the Borg scale and fatigue were positively correlated (r=31; P=0.002). In the multivariate analysis, low 6-min step test values and high levels of dyspnea were associated with fatigue. CONCLUSION: Fatigue was more prevalent and severe in end stage liver disease patients than in healthy controls. Low 6MST values and high levels of dyspnea were associated with fatigue in this scenario.

RESUMO CONTEXTO: A fadiga é uma queixa comum em indivíduos com doença hepática crônica candidatos a transplante hepático. Estudos sobre sua associação com capacidade do exercício são escassos. OBJETIVO: Avaliar a fadiga de pacientes com hepatopia crônica candidatos a transplante hepático comparando com um grupo de indivíduos saudáveis. Avaliar a associação da fadiga com capacidade de exercício. MÉTODOS: Este é um estudo transversal com pacientes hepatopatas crônicos num centro de referência em Fortaleza, Brasil. Foi utilizado o questionário de gravidade da fadiga. Os pacientes realizaram o teste da caminhada dos 6 min, teste do degrau 6 min, foi aplicada a escala de ansiedade e depressão, foram dosados proteína C reativa e hematócrito. RESULTADO: A idade média dos pacientes foi de 45,9±12,3 anos, sendo que 53,7% eram homens. Os níveis de fadiga e ansiedade e depressão eram maiores entre os pacientes hepatopatas crônicos quando comparados ao grupo controle. Uma correlação inversa foi observada entre fadiga e o teste do degrau (r= -0,2; P=0,02) também entre hematócrito e fadiga (r= -0,24; P=0,002). Houve uma correlação positiva entre dispneia, através da escala de Borg, e fadiga (r=31; P=0,002). Na análise multivariada um baixo desempenho no teste do degrau e um nível maior de dispneia mostraram uma associação com fadiga. CONCLUSÃO: A fadiga é mais frequente entre os pacientes hepatopatas crônicos quando comparados ao grupo controle. O baixo desempenho na capacidade de exercício e uma queixa maior de dispneia apresentaram uma associação com fadiga nestes pacientes.

Efeitos de um programa de intervenção interdisciplinar sobre a função pulmonar, força de membros superiores e aptidão cardiorrespiratória de adolescentes com excesso de peso / Effects of an interdisciplinary intervention program on pulmonary function, strength of superior members and cardiorespiratory fitness of teens with overweight

O objetivo deste estudo foi avaliar os efeitos de um programa de intervenção sobre a função pulmonar, aptidão cardiorrespiratória (APCR) e força explosiva de membros superiores (FMS) de adolescentes com excesso de peso. De caráter quase-experimental, o estudo avaliou 46 adolescentes com excesso de peso, alocados no Grupo Experimental (GE) (n=23) e Grupo Controle (GC) (n=23). O GE participou do programa de intervenção interdisciplinar, três vezes por semana, com orientação nutricional, psicológica e exercícios físicos ao longo de seis meses. Foram realizadas avaliações, da função pulmonar, APCR e FMS de ambos os grupos, antes e após o programa. A análise estatística realizada no programa SPSS, comparou os resultados pré e pós-teste, entre os grupos, utilizando o teste t Student para amostras independentes e o teste de Mann-Whitney. A comparação intragrupos foi realizada através do teste Student ou Wilcoxon (p<0,05). Não houve diferença significativa entre o GE e GC na comparação das variáveis espirométricas referentes à função pulmonar, APCR e FMS, tanto no pré-teste, quanto no pósteste. Na comparação intragrupo, o programa de intervenção foi eficaz no aumento da APCR (p=0,035) e da FMS (p=0,009) nos adolescentes do sexo masculino do grupo experimental. No GC houve redução do fluxo expiratório forçado entre 25 e 75% da curva de capacidade vital forçada (FEF25/75 (% predito)) no sexo masculino (p=0,039). Conclui-se que, embora o programa de intervenção não tenha demonstrado modificações significativas nos parâmetros avaliados na comparação intergrupos, observou-se melhora da APCR e FMS do sexo masculino do GE, ressaltando a importância da prática de atividade física orientada....(AU)

The objective of the study was to evaluate the effects of an interdisciplinary intervention program on lung function, cardiorespiratory fitness and upper limb strength in overweight schoolchildren. The study is characterized as quasi-experimental, performed with adolescents diagnosed with overweight /obesity, constituted by experimental group and control group. The experimental group participated in an interdisciplinary program with a duration of six months, and an evaluation was carried out prior to and at the end of the program. The intervention sessions were performed on three days of the week and constituted by physical exercises, nutritional and psychological orientation. Anthropometric assessments, cardiorespiratory fitness, upper limb explosive force and pulmonary function were performed. For the comparison of the variables in the pre- and post-test moments, between the control and experimental groups, the t test was used for independent samples and the Mann-Whitney test was used for the nonparametric variables. In the intragroup comparison, the t-test for paired samples was used for the variables of normal distribution and, for non-parametric variables, the Wilcoxon test was applied. The tests performed adopted the level of significance of p <0.05. In the intragroup comparison, the male gender of the experimental group showed a significant increase in cardiorespiratory fitness (p = 0.035) and upper limb explosive force (p = 0.009). There was a reduction in forced expiratory flow between 25 and 75% of the forced vital capacity curve (FEF25/75% predicted) in the male sex of the CG (p <0.039). The female sex of both groups did not show significant alterations in the evaluated parameters. In conclusion, the intervention program was effective in increasing the levels of cardiorespiratory fitness and explosive strength of upper limbs of the male adolescents of the experimental group. Spirometric parameters did not show significant changes in both sexes....(AU)

Assessment of metatextual awareness and its prediction of reading comprehension / Avaliação da consciência metatextual e sua predição da compreensão de leitura / Evaluación de la conciencia metatextual y su predicción de comprensión de lectura

This study aimed to reveal evidence of the validity of the Assessment Questionnaire of Metatextual Awareness (QACM). The main objective was to verify whether metatextual awareness could predict reading comprehension, and the secondary objectives were: to verify metatextual awareness and reading comprehension through two Cloze tests and the QACM; to search criterion validity evidence based on the variable "school year"; and to identify the internal consistency index of the items. The participants were 277 elementary school students from a public school in the state of São Paulo. The results showed that the students' average scores increased from the 3rd to the 5th years of school, demonstrating a criterion validity of the school year. The QACM got a good internal consistency index of 0.80. The performance on the QACM explains 46% of the performance variance on the Cloze, showing that they are shared skills.

Este trabalho buscou apresentar evidências de validade para o Questionário de Avaliação da Consciência Metatextual (QACM). O objetivo principal foi verificar se a consciência metatextual poderia ser preditiva da compreensão de leitura; os objetivos secundários, averiguar a consciência metatextual e a compreensão de leitura por meio de dois testes de Cloze e do QACM; buscar evidências de validade de critério com base na variável "ano escolar"; identificar o índice de consistência interna dos itens. Participaram 277 alunos, do 3º ao 5º ano do ensino fundamental de uma escola pública do interior do estado de São Paulo. Os resultados mostraram que as médias dos alunos aumentaram do 3º ao 5º ano, evidenciando a validade de critério pelo ano escolar. O QACM obteve um bom índice de consistência interna, de 0,80. Constatou-se que 46% da variância no desempenho no Cloze foram explicadas pelo desempenho no QACM, demonstrando que são habilidades compartilhadas.

Este estudio buscó evidencias de validez para el Cuestionario de Evaluación de la Conciencia Meta textual (QACM). El objetivo principal fue verificar si la consciencia meta textual podría ser predictiva de la comprensión de lectura, y los secundarios fueron: averiguar la consciencia meta textual y la comprensión de lectura con dos testes de Cloze y el QACM; buscar evidencias de validez de criterio con base en el año escolar; e identificar el índice de consistencia interna de los ítems. Participaron 277 estudiantes de educación primaria de una escuela pública de São Paulo-Brasil. Los resultados mostraron que los puntajes medios de los estudiantes aumentaron del 3º al 5º año, lo que demuestra la validez de criterio para el año escolar. El QACM tuvo un buen índice de consistencia interna. Se encontró que el 46% de la varianza en el rendimiento del Cloze se explica por el desempeño en el QACM, mostrando que son habilidades compartidas.

The diversity of Odonata adults's at Pampa Biome from Brazil / Diversidad de adultos de Odonata en el Bioma Pampa brasileño

Abstract The growth of humankind has brought with it several environmental problems that have worsened over time, including the loss of insect biodiversity. The Odonata order have been indicated by several authors as relevant bioindicators for assessing and monitoring environmental conditions of specific locations. The main objective of this study was to conduct an inventory of the Odonata diversity in the Pampa Biome, of the Southern region of the state of Rio Grande do Sul, Brazil. The species survey was conducted between November 2014 and October 2015. Adult insects were collected in Capão do Leão, Pelotas and Rio Grande cities. Each location was visited nine times, totalizing 54 samplings. Entomological nets were used for capturing adult insects, which were then kept in entomological envelopes. The identification of the specimens was carried out with taxonomic keys of Lencioni and Heckman. In addition, Chao-1, the Shannon-Wiener and Jackknife indexes were associated with the sampling areas. During the species survey a total of 2 680 Odonata specimens were collected, representing 45 species encompassed in 22 genera and six families. The Libellulidae and Coenagrionidae families were registered in 60 and 30 % of the specimens sampled, followed of the Aeshnidae, Calopterygidae, Gomphidae and Lestidae, of reduced occurrence. The genera Erythrodiplax, Micrathyria and Ischnura were found at least once in all the visited sites. The study resulted in the registration for the first time of the following species: Progomphus complicatus Selys, Lestes minutus Selys, Homeoura ambigua Ris, and Tauriphila xiphea Ris. These species were not previously reported in any Odonata study of the Brazilian state of Rio Grande do Sul. In regard to Odonata diversity in the Southern region of Rio Grande do Sul, Libellulidae and Coenagrionidae are the families more abundants. Erythrodiplax and Micrathyria are the most common genera. Miathyria marcella represented 9.6 % of all collected libellulidae and was the most abundant specie. Capão do Leão has the largest species diversity (wealth), the largest number of collected specimens and more diversity than Pelotas and Rio Grande. However, the results showed that the Odonatofauna in the State are still little known, and new studies are needed to better describe this group in other regions.(AU)

Resumen El crecimiento de la humanidad ha traído consigo varios problemas ambientales que han empeorado con el tiempo, incluida la pérdida de biodiversidad de insectos. Varios autores han mencionado especies del orden Odonata como bioindicadores relevantes para evaluar y controlar las condiciones ambientales de lugares específicos. El objetivo principal de este estudio fue realizar un inventario de la diversidad de Odonata en el Bioma Pampa, en la región sur del estado de Rio Grande do Sul, Brasil. El censo de especies se realizó entre noviembre 2014 y octubre 2015. Se recolectaron insectos adultos en las ciudades de Capão do Leão, Pelotas y Rio Grande. Cada área fue visitada nueve veces, totalizando 54 muestreos. Se usaron redes entomológicas para capturar insectos adultos, que luego se mantuvieron en sobres entomológicos. La identificación de los ejemplares se realizó con claves taxonómicas de Lencioni y Heckman. Además, Chao-1, los índices de Shannon-Wiener y Jackknife se asociaron con las áreas de muestreo. Durante el censo de especies se recolectó un total de 2 680 especímenes de Odonata, que representan 45 especies comprendidas en 22 géneros y seis familias. Las familias Libellulidae y Coenagrionidae se registraron en 60 y 30 % de los especímenes muestreados, seguidos de los Aeshnidae, Calopterygidae, Gomphidae y Lestidae, de presencia reducida. Los géneros Erythrodiplax, Micrathyria e Ischnura se encontraron al menos una vez en todos los sitios visitados. El estudio resultó en el registro por primera vez de las siguientes especies: Progomphus complicatus Selys, Lestes minutus Selys, Homeoura ambigua Ris y Tauriphila xiphea Ris. Estas especies no se informaron previamente en ningún estudio de Odonata en el estado brasileño de Rio Grande do Sul. Con respecto a la diversidad de Odonata en la región sur de Rio Grande do Sul, Libellulidae y Coenagrionidae son las familias más abundantes. Erythrodiplax y Micrathyria son los géneros más comunes. Miathyria marcella representó el 9.6 % de todos los libellulidae recolectados y fue la especie más abundante. La ciudad de Capão do Leão tiene la mayor diversidad de especies (riqueza), la mayor cantidad de especímenes recolectados y la mayor diversidad que Pelotas y Río Grande. Sin embargo, los resultados mostraron que la Odonatofauna en el estado aún es poco conocida, y se necesitan nuevos estudios para describir mejor este grupo en otras regiones.(AU)

Estudo dos efeitos de placebo X medicamento homeopático na totalidade sintomática característica em hipertensos / Pilot comparative study of the placebo effects and homoeopathic drugs, on the pressure levels of high blood pressure patients

Os autores realizaram um estudo piloto de investigação clínica, no ambulatório da Associação Paulista de Homeopatia, para verificar os efeitos de placebo e de medicamentos homeopáticos, escolhidos por totalidade sintomática característica individual, com um grupo de pacientes portadores de hipertensão arterial. Foi enfocada a capacidade de atuação do placebo e de dinamizações sucessivas de medicamento único, 6C, 12C, 30C e 200C, em doses repetidas, 2 vezes ao dia, na referida totalidade sintomatológica, considerando-se seu desaparecimento ou melhoria. Placebo e homeopatia foram fornecidos em frascos idênticos, a cada 4 semanas, começando pelo placebo, até atingir a 200C. Consultas de controle a cada 2 semanas. Concluise pela significância do medicamento homeopático, que não produziu praticamente agravações ou patogenesias, em doses repetidas. A partir da experiência, os autores sugeres condições melhores para feitura de trabalhos semelhantes, para uma melhor avaliação estatística. (AU)

Nineteen patients with idiopathic high blood pressure were subjected to treatment with placebo and homeopathic medicines. Their effects on the characteristic symptoms used to select the individual medication of each patients were analyzed. Statistically significant effect was found for the homeopathic drugs. No aggravation of pathogenetic symptoms practically occurred with doses taken twice daily. Based on their experience, the authors suggest how to improve studies in this field. (AU)

Estudo piloto comparativo dos efeitos de placebo e medicação homeopática sobre os níveis pressóricos de pacientes hipertensos / Pilot comparative study of the placebo effects and homoeopathic drugs, on the pressure levels of high blood pressure patients

Os autores realizaram um estudo piloto, na Associação Paulista de Homeopatia, para averiguar os efeitos de placebo e medicação homeopática sobe os níveis pressóricos de pacientes portadores de hipertensão arterial sistêmica idiopática. Foram estudados 19 pacientes em uso concomitante ou não de drogas hipotensoras, sendo 14 do sexo feminino, com idade média de 53 anos, e 5 do sexo masculino, com idade média de 44 anos. Fez-se uso do medicamento homeopático único, escolhido por totalidade sintomática característica, nas dinamizações 6C, 12C, 30C, 200C, em doses repetidas, 2 vezes ao dia, por 4 semanas cada. Todos os pacientes receberam previamente placebo por um período de 4 semanas (fase "washout"). Constatou-se efeito significativo da terapêutica homeopática, porém, dentro de uma dinamização individualizada para cada paciente, além da individualização do medicamento. Os autores finalmente fazem considerações para estudos futuros. (AU)

The authors performed a pilot study at the São Paulo Medical Homeopathic Association to investigate the effects of placebo and homeopathic treatment on the blood pressure of patients with idiopathic hypertension. We analyzed 19 patients concomitantly using or not antihypertensive agents, 14 females, with average age 53 years old, and 5 males, with average age 44 years old. One single homeopathic drug was selected as per the total set of characteristic symptoms, and prescribed in dilutions 6C, 12C, 30C and 200C, in repeated doses, twice per day, over 4 weeks each. All the patients previously received placebo over 4 weeks (washout). We found significant effect of homeopathic treatment, however, only for the best individual dilution, in addition to the individualization of the prescribed drugs. The authors finally make some considerations relative to future studies. (au)

A Simple and High-yield Synthesis of Hexadecyl Ferulate and Its In Vitro Antioxidant Potential

ABSTRACT Ferulic acid (FA) is a phenolic compound with well-known antioxidant potential that can be used as a promising anti-inflammatory and anti-cancer molecule. Furthermore, it has been reported to have neuroprotective activity. One of the main problems, which limit its clinical use, is its low bioavailability when administered orally. This limitation can be circumvented by changes in their structure and/or for preparing lipid-based formulations. The aim of this study was to synthesize a derivative of FA, the hexadecyl ferulate (HF). This compound would be more susceptible to pass through blood-brain barrier (BBB) due to its lipophilic character. The HF was obtained by Steglich esterification and yielded 76.77 ± 1.35%. Its structural characterization was performed by spectroscopic methods of Fourier-transformed infrared spectroscopy (FTIR) and nuclear magnetic resonance (NMR). FTIR spectrum of HF presented two typical bands of ester group, a C=O ester stretching band at 1725 cm-1 and a C-O stretching band at 1159 cm-1. The 1H and 13C spectral data confirmed the chemical structure of HF. Regarding the 13C NMR spectrum, HF showed a chemical shift at δ 167.39 ppm which corresponded to the carbonyl carbon of the ester group. Concerning the in vitro antioxidant potential, HF had equivalent or improved scavenger activity than FA leading to IC50 values of 0.083 ± 0.009 nmol.mL-1 and 0.027 ± 0.002 nmol.mL-1 in DPPH radical scavenging and ABTS radical cation decolorization assays, respectively. Further studies are required in order to investigate the antioxidant effect of HF in biological media.

Alterações fisiológicas e motivação da prática física do boxe: o virtual é viável? / Acute physiological changes and motivation to exercise boxing: Is the "virtual" boxing feasible?

Este estudo analisou alterações metabólicas, cardiovasculares e motivacionais de adultos jovens submetidos a uma sessão de boxe real e virtual, utilizando o console Xbox360 com Kinect. Em um estudo experimental cruzado, 10 adultos jovens saudáveis, de ambos os sexos, eutróficos (idade: 21±1 anos; índice de massa corporal: 23±1kg/m2 ; consumo de oxigênio pico: 25,5±5,9mL/kg/min) foram submetidos aleatoriamente a sessões de boxe real (saco de areia) e virtual (Kinect Sports Boxing) com duração de 15 minutos cada, com intervalo de 24h entre as sessões. A frequência cardíaca foi registrada durante todas as sessões e pressão arterial sistólica e diastólica antes e após as sessões. O gasto energético e o consumo de oxigênio foram estimados a partir da intensidade e duração das sessões. Ao final de cada sessão, registraram-se a percepção subjetiva de esforço e o grau de satisfação/motivação. A sessão de boxe real apresentou maior gasto energético, consumo de oxigênio, frequência cardíaca média e percepção subjetiva de esforço comparada à sessão virtual (P<0,05). Contudo, frequência cardíaca máxima, pressão arterial sistólica e diastólica e motivação/satisfação foram similares entre as sessões (P>0,05). Conclui-se que apesar de as alterações fisiológicas terem sido maiores na sessão real, caso o praticante não tenha a opção de sair de casa para treinar o boxe real ou apresente condições clínicas específicas, o virtual apresenta-se viável. Além disso, em virtude de a pressão arterial, frequência cardíaca máxima e motivação à prática apresentarem-se semelhantes à sessão real, indica-se o boxe virtual como uma prática de variabilidade ao treino dos praticantes de boxe....(AU)

This study analyzed metabolic, cardiovascular and motivational changes of young adults who underwent real and virtual boxing sessions, using the active video games in Xbox360 with Kinect. In a crossover study, 10 young adults, both sexes, eutrophics (age: 21±1 years; body mass index: 23±1kg/m2; oxygen consumption-peak: 25.5±5.9mL/kg/min) underwent real (sandbag) and virtual (Kinect Sports Boxing) randomized boxing sessions, lasting 15 minutes each, separated by 24 hours. Average and maximum heart rate were recorded during the sessions and systolic and diastolic blood pressure before and after sessions. Caloric expenditure and oxygen consumption were estimated from the session's intensity and duration. At the end of each session, perceived exertion and satisfaction/motivation scores were recorded. Real boxing session showed caloric expenditure, oxygen consumption, average heart rate and perceived exertion higher compared to the virtual session (P<0.05). However, maximum heart rate, systolic and diastolic blood pressure and motivation/satisfaction were similar between sessions (P>0.05). In conclusion, although metabolic changes had been higher in the real session, the virtual shows feasible, considering the subject not have the option of leaving home to train boxing or presents specific clinical conditions. Moreover, due to blood pressure, maximum heart rate and motivation to practice showed similar to the real session, virtual boxing is indicated as an alternative training to boxing practitioners....(AU)

Dano hepático induzido por medicamentos em pacientes ambulatoriais: análise retrospectiva da utilização de medicamentos / Drug-induced liver injury in outpatients: retrospective analysis of medication use

Introdução: pouco se sabe sobre a hepatotoxicidade no Brasil, principalmente na assistência básica do Sistema Único de Saúde, devido à subnotificação. Objetivo: determinar a prevalência de Dano Hepático Induzido por Medicamentos (DHIM), em pacientes ambulatoriais. Método: estudo retrospectivo. Foram coletados os dados dos pacientes atendidos em clínica especializada por gastroenterologistas no período de 01 a 31 de agosto de 2010. Resultados: dos 139 pacientes atendidos, foram encontrados quatro casos com suspeita de DHIM (2,87%). A idade média foi de 47,3 anos, 66,2% eram mulheres e média de medicamentos utilizados de 3,36/paciente. Os casos foram validados com a utilização da escala de RUCAM, por especialistas, confirmando um caso por uso de rifampicina e dapsona de sódico e três casos classificados como possível DHIM. Paciente 1- antissecretores; Paciente 2- glicocorticoides; Paciente 3- antimicrobianos. Conclusão: apesar da baixa incidência de DHIM, o quadro resultante pode ser grave, acarretando em grandes perdas econômicas para o paciente e para o sistema de saúde.

Introduction: little is known about hepatotoxicity in Brazil, especially in the basic care of the Unified Health System, due to underreporting of cases. Aims: to determine the prevalence of Drug-Induced Liver Injury (DHIM) in outpatients. Methods: retrospective study. We collected data from medical records, of patients seen in a specialized clinic by gastroenterologists from August 01 to August 31, 2010. Results: of 139 patients enrolled, four cases were found with suspected DHIM (2.87%): The mean age was 47.3 years, 66.2% were women and average medication used 3.36 per patient. The cases were validated with the use of RUCAM scale, by specialists, confirming a case caused by rifampicin and dapsone and three cases classified as possible DHIM: Patient 1- antisecretory; Patient 2- glucocorticoids; Patient 3- antimicrobials. Conclusion: despite the low incidence of DHIM, the resulting picture can be severe, causing huge economic losses for both the patient and the healthcare system.

Dificuldades na implantação da política nacional de atenção integral à saúde do homem / Difficulties in the implantation of the national policy of integrated health care of man

O Ministério da Saúde lançou aPolítica Nacional de Atenção Integral à Saúde do Homem em 2009 e entre as metas do seu plano de ação estava implantar essa política em todos os municípios brasileiros até 2011. Este trabalho objetivou conhecer, segundo a percepção dos profissionais do serviço e da gestão, as dificuldades no processo de implantação da Política Nacional de Atenção Integral à Saúde do Homem no município de Cuité ­PB. Trata-se de uma pesquisa de abordagem qualitativa. Na coleta de dados, foi utilizada a entrevista semiestruturada.A amostra constituiu-se por onze profissionais de saúde, sendo nove profissionais do serviço e dois da gestão. A análise do material empírico obtido foi realizada de acordo com a técnica de Análise de Conteúdo, modalidade Temática. Os resultados mostraram que as dificuldades encontradas foram: baixa procura masculina pelos serviços de saúde por questões culturais; ausência de capacitação dos profissionais do serviço para atuar conforme a política; e pouco envolvimento das esferas governamentais a fim de garantir a sustentabilidade das ações. Com isso, percebe-se a necessidade de colocar a saúde do homem como ação prioritária no município para a efetiva implantação da política com o compromisso e apoio dos gestores locais.

The Brazilian Ministry of Health launched the National Policy on Integrated Health Care of Man in 2009 and among the goals of their action plan was to deploy this policy in all municipalities by 2011. The objective of this work was to know, according to the perception of service and management professionals, difficulties in the process of implementing this policy for Integrated Healthcare Man in Cuité (PB). This research is a qualitative approach and in the data collection semi-structured interview was used. The sample consisted of eleven health professionals, nine of service and two of management. The analysis of empirical data obtained was performed using the technique of content analysis, thematic modality. The results showed low male demand for health services for cultural reasons, lack of training for the service professionals to act in accordance with the policy and little involvement of the governmental spheres to ensure the sustainability of actions. So, it is necessary to put the man ́s health as a priority for an effective policy implementation with the commitment and support of local managers.