The Brazilian Portuguese version of the ICIQ-OABqol: cross-cultural adaptation and reliability.

INTRODUCTION AND HYPOTHESIS: The International Consultation on Incontinence Questionnaire Overactive Bladder Symptoms Quality of Life (ICIQ-OABqol) Module evaluates the quality of life of individuals with overactive bladder (OAB) symptoms, and its use in scientific studies and clinical practice is recommended by the International Continence Society. The aim was to conduct the cross-cultural adaptation and validation of the Brazilian Portuguese version of the ICIQ-OABqol (ICIQ-OABqol_portuguese) in individuals with OAB symptoms. METHODS: An observational cross-sectional study was performed at the Clinical Physiotherapy of PUC MINAS in Belo Horizonte, MG, Brazil, between March 2017 and October 2018. The translation was previously carried out by the Mapi Research Institute. After receiving the translated questionnaire, the cross-cultural adaptation process was conducted as follows: (1) review by an expert committee (13 experts); (2) pre-test (n = 30); (3) cross-cultural adaptation; (4) validation of the ICIQ-OABqol_portuguese. We analyzed the intraexaminer reliability validation (n = 118) and internal consistency measurement (Cronbach's α coefficient), test-retest reliability (ICC) and correlation between the ICIQ-OAB and ICIQ-OABqol_portuguese questionnaires through Pearson's correlation coefficient and Bland-Altman scatter plot and concordance. Confirmatory factor analysis was used to confirm the domains of the instrument. RESULTS: The ICIQ-OABqol was cross-culturally adapted to Brazilian Portuguese and presented satisfactory internal consistency (α-Cronbach coefficient 0.88), adequate construct validity, strong reliability considering the test-retest with an interval of 19.68 (±6.98) days and moderate correlation with the ICIQ-OAB. CONCLUSIONS: The Brazilian Portuguese version of the ICIQ-OABqol shows satisfactory psychometric properties and can be used to evaluate the quality of life of individuals of both sexes with OAB symptoms.

Comparison of macroscopic resorption time for a self-locking device and suture material in ovarian pedicle ligation in dogs.

A resorbable self-locking device (LigaTie) was developed to enable safe and easy surgical ligation of blood vessels. The aim of this study was to compare the long-term in vivo resorption of the device to a commercially available suture of equivalent material (Maxon) following ovarian pedicle ligation. After ovariohysterectomy follow-up ultrasound examinations were performed monthly on 21 dogs ligated with the device and 22 dogs ligated with the suture material until no hyperechoic remnants, acoustic shadowing or local tissue reactions were detected. In both groups, the ovarian pedicles gradually decreased in size. Ligation material was considered macroscopically resorbed when ultrasound showed no signs of the device or suture, ovarian pedicle or tissue reaction. Macroscopic resorption had occurred without signs of complications and was complete by four months for sutures and 5.5 months for the device. The results show that resorption time in vivo for the resorbable self-locking device is mildly longer than suture of the same material and that no complications of device resorption were detected, supporting that the resorbable self-locking device is safe for in vivo use.

Contaminación fúngica ambiental en tres centros de enseñanza primaria del cantón central de la provincia de Heredia, Costa Rica / Aerial fungal contamination in three primary schools of the province of Heredia, Costa Rica

Justificación y objetivo: las esporas fúngicas aéreas son consideradas agentes etiológicos de la rinitis alérgica y el asma. El objetivo del presente estudio fue analizar la contaminación fúngica ambiental en tres centros de enseñanza primaria del cantón Central de la provincia de Heredia, midiendo la concentración de esporas fúngicas aéreas por metro cúbico. Métodos: se utilizó el equipo para muestreo volumétrico aéreo Burkard Personal Volumetric Air Sampler durante las épocas seca y lluviosa. Los conteos de esporas se relacionaron con los factores meteorológicos y las características estructurales de los centros educativos analizados. Resultados: se encontró un total de 1391,89 ± 119,70 esporas/m3 en marzo, 3194,45 ± 577,03 esporas/m3 en mayo, 3747,12 ± 568,05 esporas/m3 en octubre y 1009,99 ± 81,24 esporas/m3 en diciembre. En marzo, octubre y diciembre, aproximadamente el 91,0% de estas esporas pertenecían a cuatro grupos: Aspergillus/Penicillium, ascosporas, basidiosporas y Cladosporium. Sin embargo, en mayo el 78,46% de las esporas identificadas pertenecían al género Cladosporium. Al correlacionar la concentración de esporas fúngicas se encontró correlación negativa con la velocidad del viento (-0.418, p<0.05), correlación positiva con la precipitación pluvial (0,568, p<0,05), correlación positiva con el porcentaje de humedad relativa (0,504, p<0,05), y no se encontró correlación con los cambios de temperatura. Conclusión: la concentración de esporas fúngicas encontrada en las tres escuelas muestreadas es mayor al límite de 1000 esporas por metro cúbico, considerado saludable.

Background and aim: Fungal spores are considered etiological agents of allergic rhinitis and asthma; therefore, it is advised to monitor fungal levels within the classrooms. The aim of this paper was to study fungal aerial contamination in three public schools of Heredia by measuring the concentration of aerial fungal spores per cubic meter. Methods: We used the Burkard Personal Volumetric Air Sampler to collect and identify fungal spores during the dry and rainy season. The relationship between the fungal spore concentration, the meteorological factors and structural characteristics of the schools was determined. Results: A total of 1391.89 ± 119.70 spores/m3 was found in March, 3194.45 ± 577.03 spores/ m3 in May, 3747.12 ± 568.05 spores/m3 in October and 1009.99 ± 81.24 spores/m3 in December. Except for May, approximately 91.0 % of the spores identified belonged to four groups: Aspergillus/ Penicillium, ascospores, basidiospores and Cladosporium. In May, 78.46 % of the spores identified were Cladosporium. A negative correlation was found between spore concentration and wind velocity (-0.418; p<0.05), and a positive one with rain (0.568; p<0.05) and with humidity (0.504; p<0.05). No correlation was found with temperature changes. Conclusion: The three schools analysed presented fungal spore concentrations which exceeded the limit of 1000 spores per cubic meter which is considered as healthy.

Propionibacterium acnes-killed attenuates the inflammatory response and protects mice from sepsis by modulating inflammatory factors

BACKGROUND: Sepsis is a systemic inflammation associated with infection caused by pathogenic micro-organisms with high mortality rates. OBJECTIVE: In this study, we investigated the protective effect of Propionibacterium acnes-killed against polymicrobial sepsis induced by cecal ligation and puncture. METHODS: The mice were treated by intramuscular route in 1, 3, 5, and 7 days before the cecal ligation and puncture induction. The control group animals received vehicle (saline solution 0.9%) and the animals of the treated group received the P. acnes-killed (0.4 mg/animal). After anesthesia, midline laparotomy was performed with exposure of cecum followed by ligature and one transverse perforation of the same, with a 18 G needle, for induction of lethal sepsis. After surgery, the cecum of the animals was replaced into the peritoneal cavity, and it was closed with a 4.0 nylon suture. The survival of animals subjected to lethal sepsis was evaluated after cecal ligation and puncture induction. Six hours after the induction of sepsis, neutrophil migration, the number of bacteria, TNF-α, MCP-1, IL-6, and IL-10 were performed in the peritoneal lavage. RESULTS: Prophylactic treatment with P. acnes-killed increased the survival of the animals, followed by a significant decrease in the TNF-α, IL-10, and MCP-1 levels, 6 h after cecal ligation and puncture. Furthermore, P. acnes-killed administration reduced the number of bacteria in the peritoneal cavity with increased migration of leukocytes, especially neutrophils. CONCLUSION: P. acnes-killed promoted increased survival rate of animals with sepsis, in part attributed to its immunomodulatory properties against pathogenic microorganisms, as well as better control of infection by reducing bacterial counts.

Propionibacterium acnes-killed attenuates the inflammatory response and protects mice from sepsis by modulating inflammatory factors.

BACKGROUND: Sepsis is a systemic inflammation associated with infection caused by pathogenic micro-organisms with high mortality rates. OBJECTIVE: In this study, we investigated the protective effect of Propionibacterium acnes-killed against polymicrobial sepsis induced by cecal ligation and puncture. METHODS: The mice were treated by intramuscular route in 1, 3, 5, and 7 days before the cecal ligation and puncture induction. The control group animals received vehicle (saline solution 0.9%) and the animals of the treated group received the P. acnes-killed (0.4mg/animal). After anesthesia, midline laparotomy was performed with exposure of cecum followed by ligature and one transverse perforation of the same, with a 18G needle, for induction of lethal sepsis. After surgery, the cecum of the animals was replaced into the peritoneal cavity, and it was closed with a 4.0 nylon suture. The survival of animals subjected to lethal sepsis was evaluated after cecal ligation and puncture induction. Six hours after the induction of sepsis, neutrophil migration, the number of bacteria, TNF-α, MCP-1, IL-6, and IL-10 were performed in the peritoneal lavage. RESULTS: Prophylactic treatment with P. acnes-killed increased the survival of the animals, followed by a significant decrease in the TNF-α, IL-10, and MCP-1 levels, 6h after cecal ligation and puncture. Furthermore, P. acnes-killed administration reduced the number of bacteria in the peritoneal cavity with increased migration of leukocytes, especially neutrophils. CONCLUSION: P. acnes-killed promoted increased survival rate of animals with sepsis, in part attributed to its immunomodulatory properties against pathogenic microorganisms, as well as better control of infection by reducing bacterial counts.

Zymomonas mobilis culture protects against sepsis by modulating the inflammatory response, alleviating bacterial burden and suppressing splenocyte apoptosis.

Microorganisms with immunomodulating effects beneficially affect the host organism by improving the microbial equilibrium and balancing the immune system. Zymomonas mobilis is reported to have antagonistic properties against yeast and other pathogenic microorganisms in humans and animals. This study assessed the effects of Z. mobilis UFPEDA 202 (10(9)CFU/mL) cultures on polymicrobial sepsis induced by cecal ligation and puncture (CLP). The survival of animals subjected to lethal sepsis was evaluated after pre-treatment, post-treatment or a combination of both. 6h after the induction of sepsis, neutrophil migration, the number of bacteria, myeloperoxidase, TNF-α, MCP-1, and IL-10 were performed in the peritoneal lavage of animals. Histopathological changes in the spleen of animals were evaluated by light microscopy, and apoptosis of splenocytes was analyzed by transmission electron microscopy. The results showed that the combination of prophylactic and therapeutic treatment with Z. mobilis increased the survival of animals by 50% at 96 h after the induction of sepsis. There was a reduction in the levels of TNF-α and myeloperoxidase (MPO) in lung tissue. There was also a reduction in the number of viable bacteria in peritoneal fluid. However, increases in neutrophil migration and IL-10 levels were observed. The observed levels of MCP-1 remained similar to the control. Histopathology analysis showed a decrease in acute lung injury. The group pre-treated with the Z. mobilis culture demonstrated a marked decrease in the number of apoptotic cells in the spleen (24%). This study demonstrates that Z. mobilis cultures increased the survival of animals with severe sepsis. This survival was mediated by improvement of neutrophil migration, enhanced activity against pathogenic enteric bacteria and reduced lung injury.

Anti-inflammatory and anti-arthritic activities of 3,4-dihydro-2,2-dimethyl-2H-naphthol[1,2-b]pyran-5,6-dione (ß-lapachone).

OBJECTIVE AND DESIGN: The purpose of this study was to evaluate the anti-inflammatory and anti-arthritic activities of 3,4-dihydro-2,2-dimethyl-2H-naphthol[1,2-b]pyran-5,6-dione (ß-lapachone; ß-lap) and to elucidate its probable mode of action. METHODS: Carrageenan-induced paw edema, cell migration evaluation and production of pro-inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-6 and nitric oxide were used for this study. Freund's complete adjuvant (FCA)-induced arthritis was used as a model of chronic inflammation. ß-Lap was tested in doses of 40 and 60 mg/kg, orally. RESULTS: In the paw edema test, the dose of 60 mg/kg gave a higher percentage inhibition of edema (49.3 %) than control. ß-Lap inhibited neutrophil migration and reduced concentrations of TNF-α, IL-6 and NO in peritoneal exudates of animals with peritonitis. In the arthritis test, ß-lap inhibited edema and NO production in the serum of treated animals. CONCLUSION: Significant anti-inflammatory and anti-arthritic activities were observed in animals treated with ß-lap. The effects of ß-lap can be attributed in part to immunomodulation with reduction of pro-inflammatory cytokines and NO.

Conhecimento e ações preventivas em dengue em Pedro Juan Caballero, Paraguai / Knowledge and preventive actions in dengue in Pedro Juan Caballero, Paraguay

O presente trabalho teve como objetivo identificar o conhecimento e as atitudes em relação à dengue de moradores de dois bairros com maior índice larvário e dois com menor índice larvário da cidade de Pedro Juan Caballero – Paraguai. Foram realizadas entrevistas estruturadas com moradores maiores de 18 anos residentes nos quatro bairros. Os resultados mostram que em média há 2 a 3 pessoas por domicilio, a renda familiar situa-se entre 1 e 2 salários mínimos e a maioria possui ensino fundamental completo. Metade dos entrevistados referiu já ter sido acometido por dengue e a maioria procurou serviços de saúde. Há bom nível de conhecimento sobre o que é dengue e como se transmite, sendo que as informações foram majoritariamente obtidas por meio da mídia. Há bom conhecimento sobre os locais viáveis para o desenvolvimento do Aedes aegypiti e embora haja adequada higiene no intra e peridomicílio, há acúmulo de resíduos e pneus em ruas e terrenos baldios, o que é mencionado como fator principal para o desenvolvimento de mosquitos e, conseqüentemente, surgimento de casos de dengue. Medidas profiláticas públicas são fundamentais para que haja controle do vetor e da doença em Pedro Juan Caballero.

Onicomicosis por hongos fuliginosos / Onychomycosis caused by demateaceous fungi

Las infecciones de las uñas producidas por hongos son un problema de frecuente consulta dermatológica. Los dermatofitos son la mayor causa de estas infecciones, siendo trichophyton rubrum el agente etiológico más importante. Sin embargo, los hongos no dermatofitos, tanto hialinos como fuliginosos, pueden ser también responsables de estos cuadros clínicos. Debido a que estos hongos tienden a ser resistentes a los antimicóticos comúnmente usados para tratar las onicomicosis, es que se hace indispensable que el clínico se asegure por medio de un examen de laboratorio de la etiología de la infección. Métodos: Se estudiaron tres casos de pacientes con lesiones en uñas, que acudieron al laboratorio de Micología Médica, Facultad de Microbiología, Universidad de Costa Rica. Se realizaron los análisis de rutina para aislamiento e identificación de hongos patógenos. Resultados: En los tres casos estudiados se observó al examen directo micelio fuliginoso. En uno de los casos se aisló e identificó Scytalidium dimidiatum, hongo que presenta resistencia a los antigúngicos utilizados para tratar onicomicosis. Conclusión. El reporte de hongos diferentes a los dermatofitos como agentes atiológicos de onicomicosis es importante para que el médico pueda elegir el tratamiento más recomendado para este tipo de infección.

Onychomycosis is one of thecommonest dermatological conditions. Dermatophytes, especially Trichophyton rubrum, are responsible for the majority of infections. However, hyaline non-dermathophyte and demataceous fungi may also cause nail infections. The antifungal agents commonly use to treat non-dermatophyte nail infections are of low efficacy. Thus, the medical doctormust be provided with a laboratory diagnosis of the etiological agent before treating the patient. Methods: Three clinical cases of nail infections werestudied in the laboratory of Medical Mycology, School of Microbiology, University of Costa Rica. Routine analysis for the isolation and identification of fungal pathogens wereperformed. Results: In the three clinical cases studied demataceous mycelia was observed in the direct mount. In one of the cases Scytalidium dimidiatum, a fungus resistant to antifungal therapy, was isolated. Conclusion: It is important to report non-dermathophyte fungi that are known to cause onychomycosis to guide the medical doctor in the treatment of this infection.

Aislamiento de candida spp y otras levaduras en el personal que labora en áreas críticas del Hospital San Juan de Dios / Isolation of candida spp and other yeasts from health care workers in critical care units of the San Juan de Dios Hospital

Los pacientes internados en hospitales, principalmente aquellos que se encuentran severamente enfermos, son más susceptibles a las infecciones por hongos oportunistas, en comparación con la población general. El personal hospitalario puede ser fuente potencial de infección para estos pacientes, ya que normalmente actúa como portador de gérmenes, que eventualmente podrían ser transmitidos a los pacientes. Se describe, en esta investigación, el aislamiento de hongos levaduriformes a partir de las manos y la cavidad oral, en un grupo de 77 trabajadores del Hospital San Juan de Dios, en servicios donde se han reportado más casos de infecciones por este tipo de hongos. Métodos: Se realizó un hisopado de cavidad oral y manos de cada participante y se cultivaron placas con agar glucosado de Sabouraud (AGS) y Mycosel. A los aislamientos de levaduras se les determinó la capacidad de crecimiento a 37 grados centígrados, resistencia a la cicloheximida, producción de tubo germinativo, fosfolipasas y proteinasas y se determinó la sensibilidad in vitro al fluconazol por medio de método de microdilución en placa. Resultados: El 72,7 por ciento de los participantes resultaron positivos para el aislamiento de levaduras, la especie aislada con mayor frecuencia fue candida parapsilosis, seguida de C. albicans y C. famata. La mayor positividad se obtuvo en el servicio de cirugía 3, 83.3 por ciento, seguido de la UCI, 71.4 por ciento y neonatología, 58 por ciento. Conclusión: Estos resultados instan a mejorar las acciones preventivas en el manejo de los pacientes, a ser más estrictos en las normas de higiene de manos y promover, en otros centros hospitalarios, la realización de este tipo de estudios, para disminuir los brotes nosocomiales por transmisión horizontal.

Critically ill patients are more susceptible than the general populationto opportunistic fungal infections. Health workers could be a potential infectious focus to these patients. Thus in this investigation we report the isolation of yeast from the hands and oral cavity in a group of 77 employees of the San Juan de Dios Hospital from Services where infecctionsdue to these fungi had previously been reported. Methods: Samples from oral cavity and both hands were taken from 77 individuals. Each sample was platted into Sabouraud´s dextrose agar and Mycosel agar. Each yeast isolate wasanalyzed for growth capacity at 37°C, cycloheximide resistance, germ tube formation, phospholipase and proteinase production. Further, in vitro susceptibility testing of each isolate tofluconazol was performed using a microdilution method. Results: A 72.7% yeast positivity was found in all samples taken. Candida parapsilosis was themost frequent isolate, followed by C. albicans and C. famata. The ward with the greatest positivity was Surgery 3 (83.3%), followed by Intensive Care Unit (71.4%) and Neonatology (58%).Conclusion: These findings suggest that strict aseptic handling of patients should be observed to avoid horizontal transmission of yeasts in these wards. Similar studies should be conduced inothers hospitals.

Micosis superficiales diagnosticadas en el Laboratorio de micología médica de la Universidad de Costa Rica / Superficial mycosis diagnosed in the laboratory of medical mycology of Costa Rica University

Las micosis superficiales son causa frecuente de consulta, tanto en los servicios de dermatología como en medicina general. En estas afecciones resulta de gran interés el realizar los estudios microbiológicos para hacer el diagnóstico diferencial y para conocer el agente etiológico causante de la patología, no sólo por los aspectos epidemiológicos que esto implica, sino también por el tratamiento. En este estudio se recolectaron 265 muestras de piel y uñas de personas que acudieron al servicio de diagnóstico de la Sección de Micología Médica de la Facultad de Microbiología, Universidad de Costa Rica. Las afecciones en uñas representaron el 67,5 por ciento de los casos atendidos. Trichophyton rubrum es el hongo más aislado; otros dermatofitos y Candida sp también se aislaron de uñas y de piel. Fusarium sp, que es un hongo filamentoso no dermatofito, se aisló de uñas de manos y pies. Este hallazgo es relevante, dado que Fusarium sp., como agente emergente de onicomicosis, no responde bien al tratamiento con fluconazol.

Superficial mycosis is a frequent cause of consultation in Dermatology and Gene- ral Medicine. The microbiological stu- dies of this fungal condition are important not only to do the differential diagnosis, but also to establish the causing agent of the disease as well as its epidemiological aspects and the treatment. In this study 265 skin and nail samples have been collected from individuals at the Laboratory of Medical Mycology of School of Microbiology, Costa Rica University. Nail diseases represent 67,5% of the total cases studied. Trichophyton rubrum was the most frequent isolated fungus; also, other dermatophytes and Candida sp. were isolated from nail and skin. Fusarium sp., a filamentous non-dermatophyte fungus, was isolated from both finger and toe nails. This fin- ding is of relevant, since Fusarium sp., an emergent etiological agent of onychomycosis, does not respond well to treatment based on fluconazol.

Fusarium sp como agente etiológico de onicomicosis: informe de tres casos y revisión de la literatura / Fusarium sp like etiologico agent of onicomicosis: report of three cases and revision of literature

Usualmente las onicomicosis se asocian con dermatofitos o Candida; no obstante, otros hongos diferentes a estos se han asociado a esta condición clínica, entre ellos Fusarium, un hongo que muchas veces se considera contaminante de laboratorio; por lo que es importante correlacionar el examen directo con el cultivo. Se describen tres casos de onicomicosis asociados a Fusarium sp., en uno de ellos el hallazgo más relevante y raro fue la intensa coloración verdosa de la uña. En los tres casos se aisló repetidamente el agente en cuestión. Se discute la importancia de identificar otros agentes diferentes de los usuales en onicomicosis, pues esos no responden a los tratamientos convencionales.

Dermatophytes and Candida spp. are the most common agents associated with onychomycosis. However, other fungi that are considered laboratory contaminants, such as Fusarium spp. have been isolated from this clinical condition as etiological agents. In the present communication, three cases of onychomycosis caused by Fusarium are described. The nail of one of the patients exhibited an intense dark green color, which is a rare finding in this pathology. In all cases the fungus was repeatedly isolated. The importance of identifying the etiological agent is emphasized since conventional treatment for onychomycosis is ineffective against Fusarium.

Local anesthesia in cervico-facial ritidoplasty

the authors present their experience of 200 pacient's submitted to cervico-facial ritidoplasty under local anesthesia at Clincia de Cirurgia Plastica Ruy Vieira between 1985 and 1989. the anesthetist, surgical atmosphere and proper equipament are indispensable, so that the patient is monitorized to allows the imediate finding of any systemic disturbance due to the rapid absortion of the local anesthetic and its correction. The duration of the aneshesia is the restrictive factor, and the surgeon must have security and dominate the operatory tecnique. This anesthetic technique gives a better level for undermining, minor bleeding, smaller postoperatory morbidity and the collaboration of the patient in some phases of the surgery

Drenagem trans-hepática nas estenoses benignas altas da via biliar principal / Transanastomosic drainage in the benign stenosis of the upper biliary tree

As estenoses benignas altas da via biliar continuam desafiando o cirurgiäo. No reparo destas estenoses, dentre as alternativas técnicas utilizadas, o uso de tubos transanastomóticos é discutido. Neste trabalho, analisamos a nossa experiência com a utilizaçäo de tubos trans-hepáticos em 18 pacientes portadores de estenoses benignas altas da via biliar principal