Potential of coffee straw biochal as a substrate conditioner in seed lettuce and sorghum germination and vigority.

The use of residues from coffee production to obtain biochar is a sustainable approach, which aims to minimize the environmental impact of these materials. In this study, the effect of adding coffee straw biochar on the physiological quality of lettuce and sorghum seeds was investigated. Thus, the objective of this work was to study the effect of adding different concentrations of coffee biochar in the substrate composition on the physiological quality of lettuce (Lactuca sativa) and sorghum (Sorghum bicolor) seeds. The experimental design used was completely randomized, with five concentrations of biochar (0; 7.5; 15; 30 and 60%), conducted with four replications of 25 seeds. The use of biochar in the concentrations studied does not provide an increase in the average germination percentage and vigor of lettuce and sorghum seeds. The increase in the concentration of biochar caused less seed vigor, suggesting a toxic effect. For seed germination, there was no significant difference between lettuce and sorghum species, regardless of treatment. For the germination speed index, sorghum seeds have higher means, except for the treatment with the addition of 15% coffee straw biochar. Lettuce seeds have higher shoot length averages, except for treatment with 100% commercial substrate. The sorghum seeds have higher mean root length and dry mass than lettuce, regardless of the treatment.

Maturation and harvest time of Ateleia glazioveana Baill. seeds.

Ateleia glazioveana Baill. is a pioneer, rustic and can be used for forest recovery. This work aimed to study the process of physiological maturation of this species. The research was carried out in the city of Alegre - ES, the trees were identified in the floral anthesis and accompanied during the filling of the fruits and development of the seeds until the complete maturation. The fruits were harvested at the following stages 7, 14, 21, 28, 35 and 42 days after anthesis, and characterized according to: morphometry, moisture, fresh and dry mass of fruits and seeds, germination, germination speed index, shoot and root length and dry mass of seedlings. The regression equations were adjusted for the main characteristics analyzed as a function of the harvest period. The point of physiological maturity of timbó occurred at 42 days after anthesis.

Surface charge and dynamic mechanoelectrical stimuli improves adhesion, proliferation and differentiation of neuron-like cells.

Neuronal diseases and trauma are among the current major health-care problems. Patients frequently develop an irreversible state of neuronal disfunction that lacks treatment, strongly reducing life quality and expectancy. Novel strategies are thus necessary and tissue engineering research is struggling to provide alternatives to current treatments, making use of biomaterials capable to provide cell supports and active stimuli to develop permissive environments for neural regeneration. As neuronal cells are naturally found in electrical microenvironments, the electrically active materials can pave the way for new and effective neuroregenerative therapies. In this work the influence of piezoelectric poly(vinylidene fluoride) with different surface charges and dynamic mechanoelectrical stimuli on neuron-like cells adhesion, proliferation and differentiation was addressed. It is successfully demonstrated that both surface charge and electrically active dynamic microenvironments can be suitable to improve neuron-like cells adhesion, proliferation, and differentiation. These findings provide new knowledge to develop effective approaches for preclinical applications.

A atuação da equipe multiprofissional em um paciente idoso cardiopata em cuidados paliativos no hospital / The performance of the multiprofessional team in an elderly patient with heart disease in palliative care at the hospital

INTRODUÇÃO: A população idosa está aumentando e em decorrência os casos de Acidente Vascular Cerebral Hemorrágico (AVCH) o que traz um sofrimento a todos. Frente a esse panorama, os Cuidados Paliativos vêm como uma abordagem para auxiliar no cuidado que tem como objetivo reduzir a dor nas dimensões; psicológicas, sociais, físicas e espirituais. OBJETIVO: O manejo do sofrimento do paciente e de seus familiares no processo de adoecimento. RELATO DE CASO: Lucas fez cirurgia cardíaca de Revascularização do Miocárdio e evoluiu com Acidente Vascular Cerebral Isquêmico em Lobo Occipital Esquerdo em peri-operatório, ficou em intubação orotraqueal prolongada, em consequência fez uso de sonda de alimentação enteral, traqueostomia (TQT) sendo indicado Cuidados Paliativos proporcionais. Após um período, o nível de consciência oscilava o que não contribuiu para a retirada dos dispositivos, sendo indicada a gastrostomia (GTT), qual teve complicações clinicas como inflamação. Na enfermaria, a equipe identificou maior nível de alerta e consciência com a equipe e sua família, sendo assim realizado o trabalho conjunto da psicologia com a fonoaudiologia e com a fisioterapia que tinha como objetivo a melhora da comunicação (desmame da TQT) e deglutição (retirada da via alternativa de alimentação - GTT), havendo sucesso total na retirada dos dispositivos. Nos atendimentos psicológicos Lucas sofreu por estar limitado e dependente e demonstrava quando se contorcia, ao escutar os médicos falando com a família, ao ser cuidado no banho e ao pedir comida porque estava com fome e não podia comer. No processo fomos trabalhando que a inflamação possivelmente era também psicossomático, ou seja, devido as invasões pelos procedimentos no corpo a mente não conseguia pensar e elaborar mas o corpo reagia. Um momento delicado no processo ocorreu quando o filho foi hospitalizado e Lucas sofreu com sua ausência nas visitas e nas videochamadas. RESULTADO: O cuidado integral ao paciente e a família possibilitou a equipe aliviar o sofrimento emocional, respeitar o desejo e propiciar sustentação e condições da ida para casa. A esposa contou que ele sentava a mesa e fazia todas as refeições com os netos. A família unida pode viver, brindar a vida e guardar as memórias das fotos tiradas e dos vídeos, e assim, trabalharam a despedida. CONCLUSÃO: No caso de Lucas mostramos a importância do trabalho eficaz da equipe multiprofissional na reabilitação do paciente conseguindo retirar os dispositivos e a tão sonhada alta hospitalar.

Os desafios da comunicação no paciente em cuidados paliativos com afasia de expressão / The challenges of communication in palliative care patients with expression aphasia

INTRODUÇÃO: O Cuidado Paliativo visa o cuidado integral do paciente desde o diagnóstico de uma doença ameaçadora à vida. A equipe multiprofissional que atua nos Cuidados Paliativos busca o alívio do sofrimento biopsicossocial e espiritual sendo a comunicação um pilar imprescindível no processo do cuidado. OBJETIVO: Relatar a atuação multidisciplinar nas questões relacionadas à comunicação não verbal no caso de M. em Cuidado Paliativo. RELATO DE CASO: M. tem histórico de três Infartos Agudo do Miocárdio prévios e Acidente Vascular Cerebral isquêmico 2021. Indicado Cuidados Paliativos devido Síndrome Coronariana Aguda anterior extenso com angioplastia sem sucesso evoluindo com disfunção ventricular grave. M. foi avaliado quanto à comunicação e apresentava um quadro de Afasia com compreensão preservada e dificuldade importante na expressão verbal e escrita o que o limitava na comunicação com a equipe e familiares. No trabalho fonoaudiológico, durante o período de internação, foram construídas pranchas de comunicação com as demandas do paciente contendo sentimentos, imagens dos verbos principais de ação, alimentos de sua rotina, elementos de vestuário e membros da família. E, desse modo, visou favorecer a comunicação do paciente com os familiares para expressar os seus desejos. Na conferência familiar um dado que a esposa contou foi que ao adoecer M. percebeu a proximidade da morte e gravou uma despedida com mensagens de agradecimentos e perdão. E, nesse momento, ele estava muito angustiado por não conseguir se comunicar pelo verbal. Os atendimentos psicológicos propiciaram uma abertura de escuta da comunicação não verbal que era expressada pelos gestos, o corpo que se agitava, o olhar que comunicava as emoções e com a postura. Os conteúdos trazidos eram a dor, o medo de ser abandonado, de não se recuperar e de ter que retornar à Unidade Terapia Intensiva caso piorasse. Foi realizada a diretiva antecipada respeitando o seu desejo e autonomia de caso piorar que fosse cuidado junto aos familiares sem ter o corpo invadido. A rede de apoio conteve e atendeu suas necessidades diminuindo a angústia. A questão relevante foi trabalhar a melhora do seu quadro e o preparo de M. para casa o que causou grande alívio pois estava menos ansioso e mais próximo à vida do que a morte. Também, a questão da autoimagem e do luto por suas perdas foram abordadas. CONCLUSÃO: Através desse caso mostramos a importância de buscar alternativas de comunicação não verbal na tentativa de melhorar a comunicação e minimizar o sofrimento do paciente, família e equipe.

Cancer incidence and mortality trends in France over 1990-2018 for solid tumors: the sex gap is narrowing.

OBJECTIVE: To analyze trends in cancer incidence and mortality (France, 1990-2018), with a focus on men-women disparities. METHODS: Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. RESULTS: For all-cancers, the sex gap narrowed over 1990-2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). CONCLUSION: In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends.

Patterned separator membranes with pillar surface microstructures for improved battery performance.

In order to improve battery performance by tuning battery separator membranes, this work reports on porous poly(vinylidene fluoride-co-trifluoroethylene) - P(VDF-TrFE)- membranes with surface pillar microstructures. Separators with tailored pillar diameter, height and bulk thickness were fabricated by template patterning and computer simulations, allowing to evaluate the effect of the pillar microstructure characteristics on battery performance. It is shown that the different pillar microstructures of the separators affect the uptake value (150-325%), ionic conductivity value (0.8-1.6 mS·cm-1) and discharge capacity of the lithium ion batteries (LIB) when compared with the separator without pillars. The experimental charge-discharge behavior demonstrates that the pillar parameters affect battery performance and the best microstructure leading to 80 mAh·g-1 at 2C. Battery performance can be thus optimized by adjusting pillar diameter, height and bulk thickness of the separators keeping its volume constant, as demonstrated also by the simulation results. The parameter with most influence in battery performance is the bulk thickness of the separator, allowing to obtain a maximum discharge capacity value of 117.8 mAh·g-1 at 90C for a thickness of 0.01 mm. Thus, this work shows that the optimization of the pillar microstructure of the separator membranes allows increasing the capacity towards a new generation of high-performance LIBs.

A atuação da equipe multiprofissional em uma criança após COVID ­ 19 / The role of the multidisciplinary team in a child after COVID - 19

INTRODUÇÃO: As crianças com cardiopatias congênitas são consideradas grupo de risco para COVID - 19. A equipe multiprofissional enfrenta um desafio adicional no cuidado pós COVID - 19, tendo que trabalhar de forma mais articulada e com melhor comunicação em um plano terapêutico na recuperação da criança e da família. OBJETIVO: Relatar o trabalho da psicologia junto a equipe multiprofissional no processo terapêutico pós COVID-19. MÉTODO: Realizada entrevistas, atendimentos individuais e em conjunto (psicologia e fonoaudiologia) e reuniões com a equipe multiprofissional na UTI e na enfermaria. Relato de caso: RMDS de sete anos compreende que nasceu com problema cardíaco tendo que realizar vários procedimentos cirúrgicos, acompanhamento contínuo e ter uma vida mais restrita do que outras crianças. Após diagnóstico de COVID-19 ficou em intubação orotraqueal prolongada em consequência realizada traqueostomia e fez uso de sonda de alimentação. Foi realizada na UTI uma reunião da equipe com a família com o objetivo de esclarecer a piora do quadro respiratório e o plano de cuidado. Ele se sentia angustiado e falou do medo de morrer, de não querer a intubação e pediu para conversar com cada médico que cuidava dele. Referia saudades da irmã, dos amigos e vontade de revê-los. Após a volta para o quarto, foi realizado o trabalho conjunto com a fonoaudiologia, que tinha como objetivo a adaptação de válvula de fala para melhor comunicação. RMDS permitiu a adaptação da válvula de fala em poucas sessões referindo incômodo. Durante o processo terapêutico foi diagnosticado com traqueomalacia, sendo assim finalizada a proposta de adaptação de válvula de fala. O trabalho da fonoaudiologia junto a psicologia nesse momento teve foco na comunicação não verbal. Superou essa fase, retornou para casa. RESULTADO: Com os atendimentos conjuntos notou-se a criação de um espaço do paciente em manifestar desejos, sonhos, expressar emoções e trabalhar o luto por suas perdas. Também foi possível uma melhor interação e confiança com a equipe. CONCLUSÃO: O trabalho do psicólogo é fundamental na equipe multidisciplinar atuando na comunicação e nos atendimentos conjuntos do paciente de modo integral dentro de um plano de cuidado. Desse modo, propicia uma melhor reabilitação e qualidade de vida no pós COVID-19.

Improving sample preheating capabilities for dynamic loading on high-pulsed power drivers.

The CEA operates several High-Pulsed Power (HPP) drivers for dynamic loading experiments. The aim of these experiments is to provide quantitative information about the response of various materials of interest, mainly under quasi-isentropic compression. In order to improve our ability to explore these materials' behavior over a wide range of thermodynamic paths and starting from various non-ambient conditions, we developed a device capable of pre-heating both metallic and nonmetallic samples up to several hundred degrees prior to loading. This device is based on conductive heating and on a configuration that allows homogeneous heating with unprecedented temperature stability on our HPP platforms. Moreover, it is designed to allow efficient sample heating, within extremely severe electromagnetic environments associated with such platforms. The main features of this preheating device, whose design was guided by extensive thermal simulations, are presented, along with various technical solutions that enabled its insertion in a reliable experimental configuration on our HPP drivers. The results obtained from preliminary experiments on a composite material (carbon fibers embedded in epoxy resin) and on a high purity copper sample preheated to 323 K and 573 K, respectively, are presented. The performance and robustness of this heating device are potentially valuable for extending the range of studies in dynamic loading experiments for various materials under ramp compression using HPP drivers.

Spiramyin-loaded PLGA implants for the treatment of ocular toxoplasmosis: development, characterization, biocompatibility, and anti-toxoplasma activity.

Ocular toxoplasmosis is the major cause of infectious posterior uveitis worldwide, inducing visual field defect and/or blindness. Despite the severity of this disease, an effective treatment is still lacking. In this study, spiramycin-loaded PLGA implants were developed aiming at the treatment of ocular toxoplasmosis. Implants were manufactured by a hot-molding technique, characterized by Fourier Transform Infrared Spectroscopy, X-Ray Diffraction, Differential Scanning Calorimetry, Scanning Electron Microscopy; evaluated in terms of ocular biocompatibility by immunofluorescence, flow cytometry, cell migration, Hen's egg test-chorioallantoic membrane (HET-CAM) irritation test; and investigated in terms of in vitro efficacy against Toxoplasma gondii . Characterization techniques indicated that spiramycin was dispersed into the polymeric chains and both substances preserved their physical structures in implants. The HET-CAM test indicated that implants did not induce hemorrhage or coagulation, being non-irritant to the CAM. ARPE-19 cells showed viability by MTT assay, and normality in cell cycle kinetics and morphology, without stimulating cell death by apoptosis. Finally, they were highly effective against intracellular parasites without inducing human retinal pigment epithelial cell death. In conclusion, spiramycin-loaded PLGA implants represent a promising therapeutic alternative for the local treatment of ocular toxoplasmosis.

Above- and below-ground effects of an ecosystem engineer ant in Mediterranean dry grasslands.

Within a local assemblage, ecosystem engineers can have major impacts on population dynamics, community composition and ecosystem functions by transforming or creating new habitats. They act as an ecological filter altering community composition through a set of environmental variables. The impact of ants on their environment has been widely studied, but their multi-component effects (both trophic and non-trophic) have been rarely addressed. We investigated the roles of Messor barbarus, one of the commonest harvester ant species in south-western European Mediterranean grasslands. We analysed soil physico-chemical parameters, above-ground vegetation (e.g. species richness, plant community, micro-local heterogeneity, plant biomass) and above- and below-ground fauna (macrofauna, Collembola, Acari and nematodes). A clear and strong local impact of M. barbarus on soil, vegetation and fauna compartments emerges. The environmental filter is altered by modifications to soil physico-chemical properties, and the biotic filter by changes to plant communities and altered above- and below-ground fauna abundance, occurrence and community structure. The engineering activity of M. barbarus affects not only these separate ecosystem components but also the trophic and non-trophic relationships between them. By altering ecological filters at a local scale, M. barbarus creates habitat heterogeneity that may in turn increase ecological niches in these highly diverse ecosystems.

Comparison of tissue artifacts in punch and scalpel biopsies of oral and maxillofacial lesions: A systematic review and meta-analysis.

AIM: The aim of this systematic review and meta-analysis was to compare the occurrence of tissue artifacts in punch and scalpel biopsies of oral and maxillofacial lesions. METHODS: Electronic searches were conducted in four databases (PubMed, Scopus, Web of Science and Ovid). Study selection, data extraction, and quality assessment of the included articles were performed independently by two authors. An evaluation of the strength of the evidence (GRADE) and meta-analysis were conducted. Odds ratio and confidence intervals (CI) were provided. RESULTS: After the removal of duplicates, 466 references were identified. Four studies evaluating artifacts, such as crush, fragmentation, splits, hemorrhage, curling, and orientation artifacts and also those induced by improper surgical removal, were included. Specimens obtained using scalpel biopsy were 2.98 times more likely (CI=1.53-5.80) to present crushes and 12.36 times more likely (CI=2.64-57.83) to present splits than specimens procured using punch biopsy. Scalpel biopsies were also 2.40 times more likely to present fragmentation than punch biopsies (CI=1.01-5.72). No significant differences between scalpel and punch biopsies were found concerning the presence of hemorrhage, curling, or orientation artifacts and those induced by improper surgical removal. After sensitivity analysis, samples obtained from scalpel biopsy were 6.18 times more likely to present hemorrhage than those from a punch biopsy (CI=2.21-17.28). Based on the GRADE evaluation, the confidence in the effect estimate of the sub-group analysis of crush and fragmentation was moderate. For the other subgroup analysis, the confidence was low or very low. CONCLUSION: Punch biopsies were less likely to produce artifacts, such as crush, fragmentation, splits, and hemorrhage, than biopsies obtained with a scalpel.

Effect of annealing on the magnetic states of FEBID-grown cobalt nanopatterns examined by off-axis electron holography.

The growth of cobalt nanopatterns (NPs) using focused electron-beam induced deposition (FEBID) for localised magnetic studies is presented. The initial FEBID products are shown to be polycrystalline and form hetero-structured core-shell NPs through surface oxidation. Off-axis electron holography is performed to reconstruct their morphology, thickness profile and image their individual magnetic vortex domain states. In situ annealing to 400°C promoted migration of the Co-overspray to grow the Co NPs and improved their crystallinity through coarsening, as well as induced diffusion of embedded carbon out of their surface. It is found that the change in their morphology and chemical instability under heating restricts their suitability for examining thermally induced magnetic variations. LAY DESCRIPTION: In this paper, electron microscopy is used to deposit magnetic cobalt nanopatterns and characterise the effect of in-situ heating on their chemistry, structure and magnetic properties. The electron beam of the secondary electron microscope is used to dissociate an injected precursor gas near the SiN membrane substrate of in-situ transmission electron microscopy (TEM) chips and locally deposit the elemental Co in circular patterns ∼ 90 nm in diameter. TEM reveals formation of a Co-oxide shell and embedding of carbon from the precursor gas during growth. The technique of electron holography is used to image the magnetism of the core-shell Co / Co-oxide nanopatterns, which are shown to exhibit magnetic vortex states. In-situ annealing results in migration of the Co overspray to increase their height and carbon diffusion from their surface, as well as change in their original magnetic state through change of orientation. It is found that the change in the morphology and chemistry of Co nanopatterns under heating limits their use for studying the effect of temperature on their magnetism in isolation.

Determination of serum aflatoxin B1-lysine and biochemical parameters in broiler chicks fed an aflatoxin B1-contaminated diet.

In the present trial, the levels of serum aflatoxin B1 (AFB1)-lysine and their relationship with biochemical parameters in broiler chicks fed an AFB1-contaminated diet were determined. The experimental design was completely randomized with two treatments (control and 222.17 µg/kg AFB1) and 20 bird per treatment. Feeds were offered to broiler chicks for 14 days, from 28 to 42 days of age. Animals were vaccinated against Newcastle's and Marek's diseases on the 14th day of life, and were killed at 42 days of age. Broilers receiving AFB1 did not demonstrate any sign of toxicity. Compared with controls, aspartate aminotransferase and globulin levels were not affected in the AFB1-treated group. However, higher levels of gamma-glutamyl transferase and lower concentrations of total protein and albumin were observed in the group receiving AFB1 on days 35 and 42. AFB1-lysine were detected in the serum of all broilers fed the AFB1-contaminated diet, at mean levels of 56.52-77.83 ng/mg albumin on days 35 and 42 of age, respectively. These values indicated the internal dose of AFB1 in birds, which negatively correlated with total protein, albumin, and globulin levels. Data indicated that AFB1-lysine shows the potential to be a sensitive and specific biomarker for the evaluation of broiler exposure to dietary aflatoxin, as well as for diagnostic purposes. Further studies are necessary to determine physiologically-based toxicokinetics of serum AFB1-lysine in broilers.

Microbial safety status of Serro artisanal cheese produced in Brazil.

Considering the growing consumption of artisanal foods worldwide, we aimed to evaluate the microbial safety of Serro artisanal cheese (SAC), produced in Minas Gerais State, Brazil. This cheese is produced with raw milk using 1 of 2 natural starter cultures: "pingo" and "rala." A total of 53 SAC samples (pingo = 8; rala = 45) were obtained from different farmers and subjected to conventional and molecular assays to detect and enumerate Listeria monocytogenes, Salmonella spp., coagulase-positive staphylococci (CPS), diarrheagenic Escherichia coli, Mycobacterium tuberculosis, and Brucella abortus. The SAC samples were also subjected to an ELISA to detect classical staphylococcal enterotoxins (CSE: SEA, SEB, SEC, SED, SEE) and to PCR assays to detect staphylococcal enterotoxin-related genes (sea, seb, sec, sed, see). Coagulase-positive staphylococci isolates were obtained and tested by the same assays to detect their potential in CSE production and presence of CSE-related genes. None of the SAC samples showed any of the screened food-borne pathogens and zoonotic agents, and none showed the presence of CSE by phenotypic and genotypic approaches. Despite the absence of microbial hazards, mean counts of CPS in SAC samples were 5.2 log cfu/g (pingo starter) and 4.6 log cfu/g (rala starter), indicating poor hygiene practices during production. None of the tested CPS isolates (n = 116) produced CSE or presented CSE-related genes. Despite the relative microbial safety, hygienic conditions during SAC production must be improved to meet official guidelines established in Brazil.

A atuação do psicólogo na equipe multiprofissional em cuidados paliativos: relato de caso / Psychologist's role in the multiprofessional team in palliative care: case report

INTRODUÇÃO: A atuação da psicologia junto à equipe multiprofissional na construção de um plano terapêutico é de extrema importância visando atender as necessidades do paciente em todas as esferas: bio-psico-social-familiar-espiritual. Esse relato tem o objetivo de descrever um atendimento multiprofissional em Cuidados Paliativos. RELATO DE CASO: C.L de 68 anos, com diagnóstico de IC, foi internada no Instituto de Cardiologia em fevereiro de 2018. Apresentou piora clínica e evoluiu com necessidade de cânula de traqueostomia e dieta por via alternativa de alimentação, sendo indicado tratamento paliativo em maio de 2018. Durante a internação, C.L estava impossibilitada de comunicar-se verbalmente devido ao uso de ventilação mecânica, porém apresentava comunicação não verbal intensa. Observou-se um quadro de depressão. Nesse momento a intervenção fonoaudiológica permitiu a comunicação verbal por meio da válvula de fonação e posterior decanulação, além da reintrodução da alimentação por via oral. Em alguns períodos o atendimento fonoaudiológico foi realizado em conjunto com a psicóloga o que permitiu a paciente expressar o luto pela morte de vários membros da família. A primeira necessidade verbal trazida pela paciente foi o falecimento do filho com câncer enquanto estava internada. Demonstrou sofrimento por não ter participado dos cuidados, não ter se despedido e não ter dito que o amava; assim não realizou os rituais de passagem. O trabalho psicológico foi focado no luto, desejo de retorno para casa e no cuidado com os familiares. O trabalho da equipe multiprofissional propiciou sua alta em julho de 2018 com reinternação em um mês. RESULTADOS: Nos atendimentos psicológicos ela realizou uma narrativa de sua história. O retorno para a casa a permitiu cuidados familiares, realizar as atividades que desejava, como ir à igreja, rever os amigos, conseguiu se despedir, falar sobre o falecimento do filho e também compartilhar seu sofrimento. Faleceu em setembro de 2018. CONCLUSÃO: A intervenção do psicólogo na equipe multiprofissional no plano de cuidado permitiu focar as necessidades da C.L e de sua família nas esferas: bio-psico-social-familiar-espiritual melhorando assim sua qualidade de vida durante o processo de finitude. (AU)

Linfoma leucemizado em felino coinfectado com os vírus da imunodeficiência felina e da leucemia felina: relato de caso / Lymphoma in leukemic phase in feline coinfected with feline immunodeficiency virus and feline leukemia virus: case report

O presente trabalho teve por objetivo relatar um caso de linfoma leucemizado em um felino coinfectado com os vírus da imunodeficiência felina (FIV) e o da leucemia felina (FeLV). Foram realizados exames de hemograma, contagem de reticulócitos, mielograma, bioquímica, teste de imunocromatografia para FIV e FeLV, imunofluorescência indireta (IFA) para FeLV, radiografia torácica e citologia renal. Esse último exame revelou um linfoma extranodal. Foi determinante para a conclusão diagnóstica a associação dos sinais clínicos corroborados com a infiltração de elevada quantidade de células linfoblásticas na medula óssea, exibindo critérios citomorfológicos de malignidade, como mitoses atípicas, relacionadas à presença de corpúsculos linfoglandulares e material hematopoiético inter-relacionado. O linfoma é uma neoplasia relativamente comum em felinos, entretanto, a apresentação leucemizada é rara, podendo representar um desafio diagnóstico clínico, o que torna fundamental a inclusão da citologia medular na prática clínica dessa espécie.(AU)

The present study aimed to report a case of lymphoma in leukemic phase in feline coinfected with feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Blood counts, reticulocyte counts, bone marrow avaluation, biochemistry, immunochromatography assay for FIV and FeLV, indirect immunofluorescence (IFA) for FeLV, thoracic radiography and renal citology were performed. This last examination revealed extranodal lymphoma. The association of the clinical signs with the infiltration of a high number of lymphoblastic cells in the bone marrow with cytomorphological criteria of malignancy, atypical mitoses, lymphoglandular corpuscles and hematopoietic material were determinant for the diagnostic conclusion. Lymphoma is a relatively common neoplasm in felines, however the leukemic phase is rare and may represent a clinical diagnostic challenge, making it essential to include bone marrow cytology in the clinical practice of this species.(AU)