In vivo evaluation of the antiretroviral activity of Melia azedarach against small ruminant lentiviruses in goat colostrum and milk.

This study aimed to evaluate in vivo the use of the extract from the leaves of Melia azedarach in the ethyl acetate fraction at a concentration of 150 µg/mL as an antiretroviral treatment against small ruminant lentiviruses (SRLV) in goat colostrum, and milk with a 90-min action. Two groups of six kids were treated with the extract. One group received three supplies of colostrum from does naturally positive for SRLV, treated with the ethyl acetate fraction of M. azedarach (EAF-MA) for three days, while the other group consumed milk from does also carrying the virus with the respective extract twice a day for five days. After undergoing treatment, all animals began to receive thermized milk until weaning (60 days) and were monitored for six months using nested polymerase chain reaction (nPCR) and western blot (WB) tests. The study revealed cumulative percentages of positive animals in WB or nPCR in the milk group of 66.66% on the seventh day, 83.33% in the following week, and 100% at 120 days, while the colostrum group showed values of 66.66% at 14 days, 83.33% at 90 days, and 100% at 120 days. Variation and intermittency were observed in viral detection, but all animals tested positive in WB or nPCR at some point. A potential delay in infection was observed, which was more significant in the colostrum group. The need for the combination of serological and molecular tests for a more efficient detection of the disease is also emphasized.

Systematic Debriefing for Critical Events Facilitates Team Dynamics, Education, and Process Improvement.

BACKGROUND: Debriefing is used in clinical settings to support interprofessional staff, improve processes, and identify educational needs. Nurses who lead debriefing sessions are empowered to improve processes. PROBLEM: Nurse leaders identified the need for debriefing outside the critical care areas due to the rising acuity levels. APPROACH: Two nurse leaders developed a debriefing initiative in one urban teaching hospital following rapid responses, codes, and stressful situations. Nurses developed a Debriefing Facilitation Guide to collect qualitative aspects of clinical emergencies to improve processes, education, and team dynamics. OUTCOMES: Following each debriefing session, we deductively purposively coded the qualitative data into 3 a priori themes: the American Heart Association's team dynamics, process improvement, and educational opportunities. We identified opportunities for improvement for these themes during our first 54 debriefing sessions. CONCLUSIONS: Following each debriefing session, the debriefing nurse leader intervened on all educational and process improvement opportunities identified and facilitated positive team dynamics.

Detection and isolation of small ruminant lentivirus in the amniotic fluid of goats.

The objective of this study was to verify the presence of small ruminant lentivirus in the amniotic fluid of goats using molecular tests and viral isolation by cocultivation in the amniotic fluid of naturally infected goats. The study analyzed eight goats: seven were small ruminant lentivirus-positive and one was negative. The amniotic fluid was collected from each of the eight animals during cesarean section at 147 days of pregnancy. Cocultivation was undertaken using secondary goat nictitating membrane cell cultures obtained by explant from a small ruminant lentivirus-negative calf followed by trypsinization and sub-cultivation of the cells for 63 days. During this period, five supernatant collections were performed for DNA extraction and subsequent nested polymerase chain reaction. DNA was extracted from the amniotic fluid after 3 h of cellular sedimentation, from which a sample of 600 µL was taken from the sediment and another 600 µL sample from the supernatant. After DNA extraction, nested polymerase chain reaction was performed. Of the eight goats, 62.5 % (05/08) were small ruminant lentivirus-positive, with 43.75 % (07/16) of the total samples positive when considering the two repetitions (supernatant and cell sediment). Moreover, positivity was confirmed by small ruminant lentivirus pro-viral DNA amplification in the cell supernatant throughout the cocultivation period. Small ruminant lentivirus were present in the amniotic fluid samples from the naturally infected goats indicating an intrauterine transmission route. Moreover, this biological fluid can be adopted for the diagnosis of these lentiviruse because it is an important risk factor related to intrauterine transmission.

Teaching Evidence-Based Sepsis Care: A Sepsis Escape Room.

BACKGROUND: Using evidence-based sepsis guidelines, nurse educators identified the nursing skills required to recognize and treat sepsis. METHOD: Nurse educators created an innovative, interactive sepsis escape room to provide sepsis education. The escape room included a manikin, puzzles, distractors, riddles, and props. Participants were given 20 minutes to solve four puzzles/riddles to treat the sepsis patient and escape the room. RESULTS: All but two (N = 16) groups solved the clues and riddles to prioritize treatment in the allotted time. Evaluations were excellent. Mean score (1 = poor to 5 = outstanding) for overall escape room experience was 4.92. Adherence data improved on the Surviving Sepsis Campaign sepsis performance measure intervention bundles (SEP 1-3 care bundles) 2 months following the escape room. Bundles are a group of interventions that improve care. CONCLUSION: The escape room engaged nurses in educational gaming, stimulating critical thinking and problem solving contributing to improved clinical outcomes. [J Contin Educ Nurs. 2021;52(5):217-225.].

La aplicación de la calibración FRIDEX de la herramienta FRAX(R) para determinar el riesgo absoluto de fractura osteoporótica en mujeres españolas / The application of the FRIDEX calibration of the FRAX tool to determine the absolute risk of osteoporotic fracture among Spanish women

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Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS / Association of general and abdominal obesity with hypertension, dyslipidemia and prediabetes in the PREDAPS study

Introducción y objetivos: Algunas medidas antropométricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociación de diversos indicadores antropométricos de obesidad con hipertensión, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas). Métodos: Análisis transversal de la información recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definió obesidad general como índice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perímetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) índice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociación se estimó mediante regresión logística. Resultados: La hipertensión arterial mostró la asociación más alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal según el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteínas de alta densidad mostraron la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostró la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal según el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08). Conclusiones: Los indicadores de obesidad abdominal mostraron la mayor asociación con la presencia de prediabetes. La relación de los indicadores antropométricos con hipertensión y con dislipemia mostró resultados heterogéneos (AU)

Introduction and objectives: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Methods: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30 kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102 cm in men/WC ≥ 88 cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Results: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Conclusions: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results (AU)

Effects of different sucrose concentrations on vitrified porcine preantral follicles: Qualitative and quantitative analysis.

The aim of the present study was to perform a qualitative and quantitative analysis of the effect of different sucrose concentrations combined with ethylene glycol in the preservation of vitrified porcine preantral follicles. Fragments of ovarian cortex were vitrified in cryotubes containing 200 µl of the vitrification solution (30% Ethylene Glycol; 20% Fetal Bovine Serum; 0 M-0.25 M - 0.75 M or 1 M sucrose) and stored in liquid nitrogen for a week. Histological analysis showed that after vitrification the number of normal follicles decreased compared to the fresh tissue (control). The percentage of normal primordial follicles was sucrose dose dependent. The percentage of normal primary follicles was similar in 0 M or 0.25 M sucrose, while higher concentrations (0.75 M and 1 M) increased significantly the percentage of abnormal follicles (p < 0.05). Morphometric analysis showed a statistically significant reduction in the total area of primordial follicles with 0.75 M sucrose and a significant increase in the cytoplasmic area of primordial follicles with 0 M sucrose (p < 0.05). The qualitative and the quantitative analysis appear to be a complementary tool when choosing a vitrification protocol. For our cryopreservation system - vitrification of ovarian cortex slices in cryotubes-the best vitrification medium was TCM 199-Hepes with 30% de ethylene glycol, 20% of Fetal Bovine Serum and 0 or 0.25 M sucrose. The present study shows that the use of high sucrose concentrations in the vitrification solution has a deleterious effect on the preservation of porcine preantral follicles contained in ovarian tissue. Consequently, its use at 0.75 M or 1 M wouldn't be recommended.

Analysis of FHS community health agents knowledge about oral health / Análise do conhecimento sobre saúde bucal de agentes comunitários de saúde da ESF

The community health agents (CHA) are considered health promoters in Brazilian communities teaching them about health promotion and disease prevention, including oral health. According to the Ministry of Health, CHAs must know about seven major oral health issues in Brazil. Thus, the objective of this study was to evaluate the oral health knowledge level of CHAs in the city of Belem, Pará State, Brazil. The study was based on a self-guided script, through a pre-prepared questionnaire containing 16 multiple- choice questions related to oral health knowledge. The survey was conducted with 94 agents from seven Family Health stations featuring oral health teams in Belem. It was concluded that community agents should be better prepared about oral care, as not all oral health issues were known by the CHAs oral health teams in Belem.

Os agentes comunitários de saúde (ACS) são considerados promotores de saúde nas comunidades brasileiras instruindo-as sobre promoção de saúde e prevenção de doenças, inclusive em saúde bucal. De acordo com o Ministério da Saúde, os ACS's devem conhecer sete principais agravos bucais no Brasil. Dessa forma, o objetivo deste trabalho foi avaliar o nível de conhecimento dos ACS's em Belém, Estado do Pará, Brasil sobre saúde oral. O estudo foi baseado em um roteiro auto gerenciado, por meio de um questionário pré-elaborado, contendo 16 questões objetivas referentes ao conhecimento sobre saúde bucal. A pesquisa foi realizada com 94 agentes em sete Unidades de Saúde da Família com equipes de saúde bucal do município de Belém. E concluiu-se, portanto, que os agentes comunitários devem ser melhor preparados acerca dos cuidados bucais, pois não são todos os agravos em saúde bucal que são conhecidos pelos ACS's das equipes de saúde bucal em Belém.

Early neurobehavioral development of preterm infants / Desenvolvimento neurocomportamental inicial de bebês prematuros

The aim of the present study was to assess the very early neurobehavioral development of preterm infants and to examine differences regarding sex. Two-hundred and two preterm infants were assessed by the Neurobehavioral Assessment of the Preterm Infant (NAPI), which was carried out at 32-37 weeks post-conceptional age in the hospital setting. The infants' performance was compared to a norm-referenced sample and a comparison between groups regarding sex was also done. In comparison to the NAPI norm-reference, the preterm infants showed less muscular tonicity on the scarf sign, less vigor and spontaneous movement, higher alertness and orientation, weaker cry, and more sleep state. There was no statistical difference between males and females preterm infants at NAPI performances.(AU)

O objetivo do estudo foi avaliar o desenvolvimento neurocomportamental inicial de bebês prematuros e examinar as diferenças quanto ao sexo. Foram avaliados 202 bebês nascidos pré-termo pela Avaliação Neurocomportamental para Prematuros (NAPI), que foi realizada na fase de 32-37 semanas de idade pós-concepcional no contexto hospitalar. O desempenho dos bebês no NAPI foi comparado com a amostra de padronização do instrumento e também foi feita a comparação entre grupos diferenciados pelo sexo. Em relação à amostra de padronização, os bebês deste estudo apresentaram menor tonicidade muscular no sinal de cachecol, menor vigor e movimento espontâneo, mais alerta e orientação, choro mais fraco e mais estado de sono. Houve um padrão semelhante de desempenho neurocomportamental dos meninos e meninas nascidos prematuros.(AU)

Early neurobehavioral development of preterm infants / Desenvolvimento neurocomportamental inicial de bebês prematuros

The aim of the present study was to assess the very early neurobehavioral development of preterm infants and to examine differences regarding sex. Two-hundred and two preterm infants were assessed by the Neurobehavioral Assessment of the Preterm Infant (NAPI), which was carried out at 32-37 weeks post-conceptional age in the hospital setting. The infants' performance was compared to a norm-referenced sample and a comparison between groups regarding sex was also done. In comparison to the NAPI norm-reference, the preterm infants showed less muscular tonicity on the scarf sign, less vigor and spontaneous movement, higher alertness and orientation, weaker cry, and more sleep state. There was no statistical difference between males and females preterm infants at NAPI performances.

O objetivo do estudo foi avaliar o desenvolvimento neurocomportamental inicial de bebês prematuros e examinar as diferenças quanto ao sexo. Foram avaliados 202 bebês nascidos pré-termo pela Avaliação Neurocomportamental para Prematuros (NAPI), que foi realizada na fase de 32-37 semanas de idade pós-concepcional no contexto hospitalar. O desempenho dos bebês no NAPI foi comparado com a amostra de padronização do instrumento e também foi feita a comparação entre grupos diferenciados pelo sexo. Em relação à amostra de padronização, os bebês deste estudo apresentaram menor tonicidade muscular no sinal de cachecol, menor vigor e movimento espontâneo, mais alerta e orientação, choro mais fraco e mais estado de sono. Houve um padrão semelhante de desempenho neurocomportamental dos meninos e meninas nascidos prematuros.

Postprandial effect of orlistat on the peaking of lipid level after sequential high fat meals.

BACKGROUND: Postprandial lipemia has been found to be strongly associated with atherosclerosis due to its atherogenic and thrombogenic lipoprotein changes. This phenomenon occurs even in normal subjects especially after high fat meals. Orlistat, an anti- obesity drug, has been shown to address postprandial lipemia after a single high fat meal. OBJECTIVES: To compare the effects of orlistat and placebo on the postprandial lipid levels after sequential high-fat meals in healthy individuals with normal fasting lipid levels. PATIENTS AND METHODS: Thirty-one healthy adult volunteers with normal fasting lipid levels were fed 50% fat meals (3 meals and 2 snacks of pre-weighted butter and bread). The subjects were blindly randomized to receive either placebo or orlistat 120 mg before each main meal. The outcome parameters were total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and very-low-density lipoprotein (VLDL) cholesterol levels measured at fasting (0 h) and every 2 h thereafter, until the sixteenth hour. Additionally, we estimated the lipid levels at the fifth and ninth hour. RESULTS: The non-orlistat group showed a significant postprandial rise in the levels of TG and VLDL, which began 4 h after breakfast (P < 0.05); this rise in levels was sustained until 9 h after breakfast for TG and up to 10 h after breakfast for VLDL. In contrast, only one significant rise in both TG and VLDL levels (at 4 h after breakfast) was noted in the orlistat group. The maximum mean difference from the baseline TG level for the orlistat group was lower than that for the non-orlistat group (0.22 mmol/L vs. 0.756 mmol/L, respectively). Similarly, the maximum mean difference from the baseline VLDL level from baseline in the orlistat group was only 0.099 mmol/L, which was lower than that in the non-orlistat group (0.588 mmol/L). LDL levels rose to a lesser extent in the orlistat group than in the non-orlistat group (0.268 vs. 0.362 mmol/L). The TC levels did not show a postprandial rise; instead, the levels reduced in both groups, with the orlistat group showing a higher reduction than the non-orlistat group (-0.288 vs. -0.188 mmol/L). The orlistat group did not show any significant differences in the HDL measurements. CONCLUSIONS: Administration of orlistat abolished the significantly sustained postprandial rise of TG and VLDL levels in healthy individuals who were fed sequential 50% fat meals.

Desenvolvimento neurocomportamental de bebês prematuros avaliados na fase de 32 a 37 semanas de idade pós-concepcional / Neurobehavioral development on premature babies between 32nd to 3Th weeks post-conception

O avanço na qualidade de atendimento intensivo na fase neonatallevou ao aumento dos índices de sobrevivência de bebês prematuros. A grande preocupação, não diz respeito tão somente à sobrevida, mas principalmente à qualidade de vida. O presente estudo teve por objetivo principal caracterizar o desenvolvimento neurocomportamental de bebês nascidos pré-termo antes de atingir o termo de 40 semanas de idade pós-concepcional. Os objetivos específicos foram: a) comparar o desempenho neurocomportamental da amostra de estudo com a amostra original da padronização do teste NAPI; b) comparar os indicadores de desenvolvimento neurocomportamental em grupos diferenciados pelos problemas perinatais; c) comparar os indicadores de desenvolvimento neurocomportamental em grupos diferenciados quanto ao sexo. A amostra foi composta por 202 bebês pré-termo (' < OU=' 37 semanas de idade gestacional), de ambos os sexos, com baixo peso ( < 2500g), estáveis clinicamente e internados na Unidade de Terapia Intensiva Neonatal ou Berçário de Cuidados Intermediários do Hospital Materno-Infantil da cidade de Goiânia (GO), no período de setembro de 2004 a janeiro de 2006. Foram utilizados os seguintes instrumentos: Avaliação Neurocomportamental do Pré- Termo (NAPI), roteiro de anamnese, prontuário médico e Questionário de Classificação Sócio - Econômico. O procedimento de avaliação dos bebês foi filmado. O índice de acordo entre observadores foi de 88

. A análise dos vídeos foi processada para obter a pontuação do desempenho dos bebês, de acordo com o NAPI. Primeiramente, os dados foram submetidos à análise estatística descritiva. As variáveis discretas foram quantificadas em termos de frequência, prevalência ou porcentagem e as variáveis contínuas em termos de média e desvio padrão, mediana, valores mínimo e máximo. Procedeu-se à comparação entre os desempenhos no NAPI obtidos na amostra do estudo e os resultados da amostra do teste...(AU)

The quality improvement on newborn's intensive care leaded to higher levels for premature babies survival rates. The bigger preoccupation doesn't regard simply their survival, but further on, regards quality of life. This study has the main objective to typify the neurobehavioral development on preterm born babies, before the 40th week of post-conceptional age. As specific objectives: a) to compare neurobehavioral performance of this study's sample to the original standard sample of NAPI test; b) to parallel indicators of neurobehavioral development in groups classified according to perinatal problems; c) to compare neurobehavioral development indicators from groups created according the gender. The sample has been composed of 202 preterm infants (gestational age ' < OU=' 37 weeks), both genders, underweight ( < 2500 g), clinically stable and on therapy at the Neonatallntensive Care Unit or Intermediary Care Nursery of the Goiânia's 'Hospital Materno-Infantil', for the period of September 2004 to January 2006. The following instruments were applied: Neurobehavioral Assessment for the Preterm Infant (NAPI), guide for anamnesis, medical history and a Questionnaire for Socioeconomical Individuation'. The procedure for babies evaluation was filmed. The accordance rate among the beholders has been about 880;0. The videos analysis had the purpose of rating babies' performances according to NAPI. Firstly, data were submitted to descriptive statistic analysis. The discret variances were quantified depending on frequency, prevalence or percentage and continuous variances in terms of medium value and standard deviation, median, minimum and maximum values. Then the comparison of NAPI performances on study's sample and test's standard results, between both genders and two groups (one with perinatal problems -PIG, such as anoxia, hemorrhaging and hydrocephalus and another group without any perinatal problem)...(AU)