ABSTRACT
Resumo Enquadramento: A identificação do delirium pelos enfermeiros é de extrema relevância. Assim, parece relevante a possibilidade de recurso à versão portuguesa da Nursing Delirium Screening Scale (Nu-DESC). Objetivo: Avaliar as propriedades psicométricas da versão portuguesa da Nu-DESC em contexto cirúrgico. Metodologia: Estudo metodológico, incluindo utentes com 65 ou mais anos de idade, com o diagnóstico de fratura proximal do fémur. Recorreu-se a três medidas de avaliação para analisar a concordância entre os resultados obtidos através das mesmas. Resultados: Numa amostra de 81 utentes, a sensibilidade da Nu-DESC foi de 92% relativamente ao Confusion Assessment Method (CAM) e de 91% face à aplicação dos critérios do DSM-5. Já a especificidade do instrumento foi de 98% relativamente ao CAM e de 94% face à aplicação dos critérios do DSM-5. O alfa de Cronbach da Nu-DESC variou entre 0,86 e 0,89. Conclusão: A avaliação das propriedades psicométricas da Nu-DESC num contexto cirúrgico confirmou que a escala apresenta uma elevada sensibilidade e especificidade para a avaliação de delirium nesse mesmo contexto.
Abstract Background: The identification of delirium by nurses extremely relevant. The Portuguese version of the Nursing Delirium Screening Scale (Nu-DESC) is a tool that can be used in this setting. Objective: To evaluate the psychometric properties of the Portuguese version of the Nu-DESC in a surgical context. Methodology: Methodological study with patients aged 65 years or older with a diagnosis of proximal femur fracture. Three assessment tools were used to analyze the agreement between the results. Results: In a sample of 81 patients, the sensitivity of the Nu-DESC was 92% compared to the Confusion Assessment Method (CAM) and 91% compared to the application of the DSM-5 criteria. The specificity of the instrument was 98% compared to CAM and 94% compared to the DSM-5. Cronbach's alpha ranged between 0.86 and 0.89 Conclusion: The evaluation of the psychometric properties of the Nu-DESC in a surgical context confirmed the validity and reliability of the instrument. The results show that the scale has a high sensitivity and specificity for assessing delirium.
Resumen Marco contextual: La identificación del delirio por parte del personal de enfermería es extremadamente importante. De ahí la posibilidad de utilizar la versión portuguesa del Nursing Delirium Screening Scale (Nu-DESC). Objetivo: Evaluar las propiedades psicométricas de la versión portuguesa del Nu-DESC en entornos quirúrgicos. Metodología: Estudio metodológico que incluyó a usuarios de 65 años o más, con diagnóstico de fractura proximal de fémur. Se utilizaron tres medidas de evaluación para analizar la concordancia entre los resultados obtenidos a través de ellas. Resultados: En una muestra de 81 usuarios, la sensibilidad del Nu-DESC fue del 92% en relación con el Confusion Assessment Method (CAM) y del 91% cuando se aplican los criterios del DSM-5. La especificidad del instrumento fue del 98% en relación con el CAM y del 94% frente a la aplicación del DSM-5. El alfa de Cronbach de la Nu-DESC varió entre 0,86 y 0,89. Conclusión: La evaluación de las propiedades psicométricas de la Nu-DESC en un contexto quirúrgico confirmó que la escala presenta una alta sensibilidad y especificidad para la evaluación del delirio en este mismo contexto.
ABSTRACT
Changes in fauna and abiotic factors in estuaries are a consequence of their exploitation; thus, bivalve mollusks, as they filter, are widely used as environmental bioindicators. The aim of this study was to analyze the existence of seasonal variation in the concentration of total coliforms (TC) and thermotolerant coliforms (Ct), in addition to correlating the data obtained with the salinity and temperature in collection areas of Mytella falcata and the soft tissue cultivated in the Estuarine Complex of Cananéia. Two biweekly samples of water and tissue were taken, for 12 consecutive months, in nine cultivation areas of M. falcata. The analysis of the water samples showed that the Fisheries Institute, Mosquiteiro, and Itapitangui have high TC densities, with respective annual averages of 772.22, 592.67, and 563.75 most probable number (MPN).100 ml-1 . The highest concentrations of TC and Ct occurred in the summer, in most areas. There was a decrease in both TC and Ct with increasing salinity. However, there was an increase in Ct with increasing temperature. The soft tissue showed TC densities from 9 to 26 MPN.100 ml-1 and Ct densities from 6 to 14 MPN.100 ml-1 , displaying the highest counts in the summer. Places where coliforms were found in high concentrations could indicate contamination, because Ct do not support higher salinities for a long time. PRACTITIONER POINTS: The general mean was 77.64 (total coliforms) and 39.35 (thermotolerant) MPN.100 ml-1 . Annual average (thermotolerant) exceeded the permitted Brazilian limit in five points. Higher concentrations of total and thermotolerant coliforms occurred in the summer. In mollusk's tissue, concentrations of thermotolerant were 6.30 to 26.16 MPN.100 g-1 . Coliforms' MPN varied with increasing salinity and temperature.
Subject(s)
Mytilidae , Water , Animals , Brazil , Water Microbiology , Water Pollution/analysisABSTRACT
Esta pesquisa teve por objetivo avaliar a qualidade microbiológica de amostras da água e do tecido de Mytella guyanensis (Mollusca: Bivalva) espécie de relevante interesse comercial e que faz parte direta da renda e alimentação das comunidades tradicionais em regiões litorâneas. Este estudo foi realizado em duas comunidades do Estuário de Cananeia conhecidos como Retiro e Itanhoapina. Durante o período de 2017, onde a espécie é coletada para consumo humano, as amostras de água e do bivalve foram coletadas nas localidades a fim de determinar as concentrações de coliformes totais e termotolerantes. As Amostras de água e de M. guyanensis foram analisadas para determinar o Número Mais Provável de Coliformes (NMP), baseado na Técnica de Tubo Múltiplo. Os resultados das analises, demonstraram baixas concentrações de coliformes nas amostras de água, tendo ocorrido resultado semelhante para as amostras de tecidos dos indivíduos coletados. A análise da água apresentou média geométrica de 34,81 coliformes totais e 20,70 MPN 100 mL-1 de coliformes termotolerantes. As médias de coliformes nos tecidos moles de M. guyanensis foram de 190 MPN g-1 para coliformes totais e 174 MPN g-1 para coliformes termotolerantes. As concentrações de coliformes no tecido dos espécimes coletados, apresentaram correlação positiva com a temperatura e negativa com a salinidade. Houve diferenças significativas entre a sazonalidade em relação à concentração de coliformes totais e termotolerantes no tecido. O verão período de chuvas, apresentou a maior média sazonal de coliformes em M. guyanensis. Todas os valores obtidos para NMP de coliformes estiveram abaixo do limite estabelecido pela legislação.
This study aimed to evaluate the microbiological quality of water and tissue samples of Mytella guyanensis (Mollusk: Bivalve), a species of relevant commercial interest and is a direct part of the income and food of traditional communities in coastal regions. This study was carried out in two communities in the Cananeia Estuary known as Retiro and Itanhoapina. During the period of 2017, where the species is collected for human consumption, water and bivalve samples were collected in the localities in order to determine the concentrations of total and thermotolerant coliforms. The samples of water and M. guyanensis were analyzed to determine the Most Probable Number (MPN) of Coliforms, based on the Multiple Tube Technique. The results of the analyses showed low concentrations of coliforms in the water samples, with a similar result for the tissue samples of the individuals collected. The water analysis showed a geometric mean of 34.81 total coliforms and 20.70 MPN 100 mL-1 of thermotolerant coliforms. The averages of coliforms in the soft tissues of M. guyanensis were 190 MPN g -1 for total coliforms and 174 MPN g -1 for thermotolerant coliforms. The concentrations of coliforms in the tissue of the collected specimens showed a positive correlation with temperature and a negative correlation with salinity. There were significant differences between seasonality in relation to the concentration of total and thermotolerant coliforms in the tissue. The summer rainy season showed the highest seasonal average of coliforms in M. guyanensis. All values obtained for MPN of coliforms were below the limit established by the legislation.
Subject(s)
Muscle Weakness/etiology , Myasthenia Gravis/complications , Ophthalmoplegia/etiology , Vision, Binocular/physiology , Visual Acuity , Fingers , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Muscle Weakness/diagnosis , Muscle, Skeletal/physiopathology , Myasthenia Gravis/diagnosis , Ophthalmoplegia/diagnosis , Ophthalmoplegia/physiopathology , Retinal Pigment Epithelium/pathology , Tomography, Optical CoherenceABSTRACT
OBJECTIVE: Demographic and clinical characteristics associated with nonarteritic anterior ischemic optic neuropathy (NAION) are well described. Patients with hematologic neoplasms may share some of these characteristics, and it may be useful clinically to better understand this set of patients. Our objective is to review systematically the characteristics of patients with both hematologic malignancies and NAION. DESIGN: Systematic review. PARTICIPANTS: Patients with NAION diagnosis related in time to a hematologic neoplasm. METHODS: Data sources for the study included MEDLINE, Web of Science, LILACS, SciELO, and OpenGrey. The study eligibility criteria included case reports and case series. RESULTS: We found 261 records, with 15 studies included plus our case report. A total of 19 patients (8 female) with mean age of 54.6 years (range, 12-87) were analyzed: 37% (7) non-Hodgkin lymphoma; 26% (5) myeloproliferative neoplasms; 21% (4) myelodysplasia; 16% (3) leukemias. The limitations included verification bias, inability to test statistical association between NAION and hematologic neoplasms, the small number of cases, and confounding factors related to medical history and specific interventions in each case limited the robustness of our conclusions. CONCLUSIONS: Our results identified the characteristics of patients with NAION and hematologic neoplasms related in time. Additional observational studies may enlighten the importance of looking for evidence of an occult neoplastic disorder in patients presenting with NAION. A prompt diagnosis would be of invaluable significance for the best management, in terms of follow-up and therapeutics.
Subject(s)
Hematologic Neoplasms/physiopathology , Leukemia, Myeloid, Acute/physiopathology , Optic Neuropathy, Ischemic/physiopathology , Aged , Hematologic Neoplasms/diagnosis , Humans , Leukemia, Myeloid, Acute/diagnosis , Male , Optic Neuropathy, Ischemic/diagnosis , Risk Factors , Visual AcuityABSTRACT
Giant cell arteritis with ocular involvement is an ocular emergency. Arteritic anterior ischaemic optic neuropathy (AAION) is the most common ophthalmological manifestation associated with this disease. Visual loss is usually permanent with rare cases showing visual recovery. Visual improvement, if it occurs, is generally limited, and the visual field defects are persistent and severe. The main goal of AAION treatment is the preservation of vision in the fellow eye. In patients with neurophthalmological manifestations, high-dose corticosteroids should be initiated immediately and aggressively, and maintained thereafter. We present a case of AAION and severe vision loss where significant visual recovery was seen after treatment.
Subject(s)
Giant Cell Arteritis/physiopathology , Aged, 80 and over , Biopsy , Blindness/diagnosis , Blindness/pathology , Blindness/physiopathology , Diagnosis, Differential , Female , Giant Cell Arteritis/diagnosis , Giant Cell Arteritis/pathology , Humans , Optic Neuropathy, Ischemic/diagnosis , Optic Neuropathy, Ischemic/pathology , Optic Neuropathy, Ischemic/physiopathology , Tomography, X-Ray Computed , Ultrasonography, Doppler, ColorSubject(s)
Psychomotor Disorders/diagnosis , Retinal Diseases/diagnosis , Sandhoff Disease/diagnosis , Demyelinating Diseases/diagnosis , Humans , Infant , Magnetic Resonance Imaging , Male , Optic Nerve Diseases/diagnosis , Pupil Disorders/diagnosis , Retinal Diseases/blood , Sandhoff Disease/blood , beta-Hexosaminidase alpha Chain/blood , beta-Hexosaminidase beta Chain/bloodABSTRACT
O presente trabalho tem como finalidade divulgar o estado da arte das Orquidacea e discorrer sobre a sua sistemática evolutiva, antropismo e valor econômico. O trabalho teve como base uma cuidadosa revisão bibliográfica, bem como a análise da coleção do Orquidário do Estado de São Paulo e exsicatas do herbário Maria Eneyda P. K. Fidalgo, do Instituto de Botânica do Estado de São Paulo, provenientes de todo o Brasil.
The present work aims to present the state-of-the-art of Orchidaceae and discuss its evolutive systematic, anthropism and economical value. The work took as its bases a careful bibliographical survey as well as the analysis of the collection of the Orchidarium of Sao Paulo State and exsiccates of the herbarium Maria Eneyda P. K. Nobleman, of the Institute of Botany of Sao Paulo State, comingfrom all parts of Brazil.
Este trabajo pretende presentar el actual nivel de conocimiento de las Orchidaceae y hablar de su sistemática evolutiva, antropismo y valor económico. El trabajo tomó como sus bases una revisión bibliográfica cuidadosa así como el análisis de la colección del Orchidarium del estado de São Paulo y exsicatos del herbario Maria Eneyda P. K. Nobleman, del Instituto de Botánica del Estado de São Paulo, que viene de todas las partes de Brasil.
Subject(s)
Biodiversity , Orchidaceae/growth & developmentABSTRACT
The synthesis, in vitro antifungal evaluation and structure-activity relationship studies of 14 compounds of the N-phenyl-, N-aryl-, N-phenylalkyl- maleimide and 3,4-dichloromaleimide series are reported. The compounds were evaluated against a panel of standardized yeasts and filamentous fungi as well as clinical isolates of Candida albicans. The activities of N-phenylalkyl-3,4-dichloromaleimide derivatives but not those of N-phenylalkyl-maleimide derivatives showed to be dependent on the length of the alkyl chain. N-Phenylpropyl-3,4-dichloromaleimide showed the broadest spectrum of action and lower minimal inhibitory concentrations (MIC) in all of the fungi tested. The nitrogen-carbon distance between the two rings seems to play an important role in the antifungal behavior of these compounds. The most active structure showed inhibited (1,3)beta-D-glucan and chitin synthases, enzymes that catalyze the synthesis of the major fungal cell-wall polymers.
Subject(s)
Antifungal Agents/chemical synthesis , Antifungal Agents/pharmacology , Maleimides/chemical synthesis , Maleimides/pharmacology , Cell Survival/drug effects , Chitin Synthase/antagonists & inhibitors , Fungi/drug effects , Glucosyltransferases/antagonists & inhibitors , Microbial Sensitivity Tests , Models, Molecular , Molecular Conformation , Structure-Activity RelationshipABSTRACT
The synthesis and antifungal properties of a series of new N-aryl alpha,beta-substituted succinimides against a panel of dermatophytes of clinical relevance are reported. Among those compounds possessing a N-phenyl substituent, 7-thia-2-azabicyclo[2,2,1]hept-2-en-3-amine[5,6-c]succinimide was the better inhibitor of Trichophyton rubrum, the major ethiological agent of all infections produced by dermatophytes. In contrast, succinimides containing a N-(p-sulfonylphenyl) substituent, only inhibited Epidermophyton floccosum, all active compounds possessing an oxabicyclo group in positions alpha,beta of the imide. Substituents on the oxabicyclo group were important for the activity. Regarding the mechanism of action, N-(p-N'-4-methoxyphenylsulfamoylphenyl)-8-oxabicyclo[2,2,1]hept-4-en-3- methyl[5,6-c]succinimide produced a mottled inhibition halo in the Neurospora crassa assay, showing that it would act by inhibiting the synthesis or assembly of the fungal cell wall.
Subject(s)
Antifungal Agents/chemical synthesis , Antifungal Agents/pharmacology , Arthrodermataceae/drug effects , Succinimides/chemical synthesis , Succinimides/pharmacology , Arthrodermataceae/ultrastructure , Microbial Sensitivity Tests , Neurospora crassa/drug effects , Neurospora crassa/ultrastructureABSTRACT
This work describes the phytochemical analysis and analgesic activity of a non polar fraction obtained from Adiantum cuneatum grown in Brazil. The results showed that the hexane fraction as well as two pure compounds, identified as filicene (1) and filicenal (2), given intraperitoneally, exhibited potent analgesic activity when evaluated in two models of pain in mice, writhing test and formalin-induced pain. Compound 1 presented a calculated ID50 value of 19.5 micromol/kg body weight, when evaluated in writhing test, being about 7-fold more active than some reference drugs, like as acetyl salicylic acid and acetaminophen. It also inhibited both phases (neurogenic and inflammatory) of the formalin test at 10 mg/kg (24 micromol/kg). The chemical composition of the plant grown in Brazil is similar to that grown in other countries. The results confirm and justify the popular use of this plant for the treatment of dolorous processes.
Subject(s)
Adiantum/chemistry , Analgesics/chemistry , Analgesics/pharmacology , Plants, Medicinal/chemistry , Adiantum/growth & development , Analgesics/isolation & purification , Animals , Brazil , Female , Formaldehyde , Male , Medicine, Traditional , Mice , Pain/chemically induced , Pain/drug therapy , Plant Extracts/chemistry , Plant Extracts/isolation & purification , Plant Extracts/pharmacology , Plant Leaves/chemistry , Plants, Medicinal/growth & developmentABSTRACT
This paper describes the synthesis of new cyclic imides obtained by reaction with aminophenazone (CAS 58-15-1, 4-aminoantipyrine) and different anhydrides with further cyclization with acetic acid under reflux. Their structures were confirmed by spectral data (IR and NMR) and elemental analysis. The analgesic activity of the synthesized compounds was investigated initially with the writhing test in mice and the most promising compound, a 3,4-dichloromaleimide derivative (3), was analyzed using other models of nociception. The results indicated that compound 3 exerts potent analgesic activity in mice, being more active than some reference drugs. The analgesia caused by this compound was not reversed by naloxone in the writhing test. In the hotplate test, compound 3 did not increase the latency period of pain induced by thermal stimuli, confirming that it does not interact with opioid systems.